Kolomiiets M. Optimization of diagnostic and treatment of chronic heart failure patients with concomitant chronic kidney disease based on the xanthine metabolism violations study.

The dissertation deals with the actual and promising area - examination of xanthine metabolism violations in patients with chronic heart failure and concomitant chronic kidney disease, that can improve the diagnostic and treatment in this cohort of patients. The particular pathogenetic importance of up-regulations of xanthine pathway in the progression of heart failure, when it is combined with chronic kidney disease was established. The prevalence of asymptomatic hyperuricemia among patients with chronic heart failure and concomitant chronic kidney disease in Ukrainian population and factors that contribute to the xanthine metabolism violations are shown. Based on the findings was demonstrated the necessity of additional assessment of xanthine oxidase activity and uric acid levels in patients with chronic heart failure and concomitant chronic kidney disease, because of the changes in metabolism and increase in xanthine oxidase activity in this group of patients. The analysis of the effect of diuretics, ACE inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, ?-blockers, digitalis glycosides on uric acid levels and xanthine oxidase activity gives the reason for optimizing therapeutic approaches to the treatment of patients with chronic heart failure and concomitant chronic kidney disease in the presence of xanthine metabolism violations.