Dzhuryak V. Mechanisms of chronic kidney disease development in arterial hypertensive patients, depending on their adverse course's predictors

The thesis is devoted to the establishment of molecular immunological mechanisms of chronic kidney disease (CKD) in patients with essential arterial hypertension (EAH) depending on the polymorphism of the cytochrome 11b2 aldosterone synthetase gene (CYP11B2, -344C / T, rs1799998), gender, taking into account metabolic disorders, disintegration of adaptive mechanisms of nonspecific anti-infective protection, immunological reactivity and concomitant risk factors. The development of CKD in patients with EAH depending on CYP11B2 gene (rs1799998) genotypes was approximated by regression multifactor correlation analysis with mathematical models of logit regression. It was found that in EAH patients' residents of Northern Bukovina mutation of the CYP11B2 gene (rs1799998) in the homozygous state occurs with a frequency of 30.56%, which does not differ from that in control group 29.17%. It was found that the polymorphic site of the CYP11B2 gene (rs1799998) is associated, according to ANOVA analysis, with a decrease in GFR for creatinine and Cystatin-C, an increase in aldosterone, stronger in women than in men, especially in the presence of DM type 2; increase in SBP and DBP in women, and lower levels of ALT and AST especially in TT-genotype carriers, and in men only with an increase in the ratio of waist circumference to hip circumference (W/H). It was established that the EAH course, especially in T-allele carriers of the CYP11B2 gene (344C> T), is accompanied by changes in the immune-inflammatory response. It was found that in patients with EAH the CKD appearance with a GFR decrease calculated on creatinine and cystatin-C, regardless of the genotypes of the gene CYP11B2 (rs1799998) inversely depends on the concentration of creatinine and cystatin-C blood levels, on blood glucose levels in CC-genotype carriers, as well as age and sex.