Shcherban T. Optimization of treatment of diabetic nephropathy combined with hypertension based on their clinical and pathogenetic features.

The thesis is devoted to the optimization of treatment of diabetic nephropathy associated with hypertension based on the study neutrophilic link pathogenic cellular mechanisms of these diseases and the characteristics of their course. Patients with comorbidity were characterized by increased expression of adhesion molecules CD54 and CD11b-integrin, enlarged aggregation and superoxide production and imbalance of NO-synthase in neutrophils. The closed correlation between the functional characteristics of neutrophils and glomerular filtration rate and micro albuminuria indicate on the important role of these cells in the pathogenesis and progression of comorbid disorders. It revealed a significant increase of aldosterone levels in comorbid patients, which is associated with the violation of kidney function. Expediency of the using of L-arginine and selective aldosterone receptor antagonist eplerenone in the complex treatment of patients with diabetic nephropathy combined with hypertension on the basis of their positive effects on neutrophil link of cellular mechanisms of inflammation and the renal function.