Fylenko Y. Clinical and pathogenetic significance of adipokines in patients with hypertension in combination with chronic kidney disease

Українська версія

Thesis for the degree of Doctor of Philosophy (PhD)

State registration number


Applicant for


  • 222 - Медицина


Specialized Academic Board

ДФ 64.609.037

The Kharkiv Medical Academy of Postgraduate Education


Hypertension is the most common human disease. According to the WHO, at the end of 2020, 1.13 billion people suffer from hypertension, of which only 60% know about their diagnosis and only one in ten receives treatment. Hypertension is an important socio-economic and medical problem not only because of its widespread prevalence, but also because of the leading place it occupies in the structure of overall mortality. This disease remains the main risk factor for coronary heart disease, vascular accidents (heart attack, stroke, thrombosis), kidney damage. In Ukraine, cardiovascular disease is the leading cause of death. According to this indicator, our country remains one of the world leaders. According to statistics, in Kharkiv as of 01.04.2021 108 777 patients with hypertension were registered (for the same period in 2020 – 116 593), for the 1st quarter of 2021 for the first time 6 169 patients were detected. 6 537), the incidence of hypertension was 511.7 per 100 thousand population (in 2020 – 534.7). Arterial hypertension of any severity worsens the prognosis and accelerates the development of kidney disease. Scientists have been able to establish a direct link between blood pressure and the formation of chronic kidney disease. Severe forms of arterial hypertension lead to renal failure for several years, and in moderate arterial hypertension atherosclerotic changes in the kidneys develop more slowly. Therefore, with any increase in blood pressure, it is necessary to monitor renal function. In addition, scientists have found that the level of systolic blood pressure – is the most significant predictor of chronic kidney disease, in contrast to diastolic. The kidneys are the filters of our body. Their main task is to remove toxins and excess fluid from the blood. The kidneys also help maintain acid-base balance, control blood pressure, produce red blood cells and maintain bone strength. Kidney disease is a "silent killer" that can significantly affect your quality of life. Chronic kidney disease causes the kidneys to gradually and irreversibly stop cleansing the blood of toxins, removing excess fluid from the body and maintaining hormonal balance. 10% of the world's population lives with chronic kidney disease, and more than 2 million people worldwide receive dialysis or transplant treatment. The disease usually progresses unnoticed, often disrupting most of the kidney function before symptoms appear. Early detection of renal impairment is crucial because it allows appropriate treatment to be initiated until irreversible deterioration or complications. Problems can be detected by laboratory tests of blood (to measure creatinine levels and assess glomerular filtration rate) and urine (to measure creatinine and albumin excretion). In this regard, the following goal of our study was identified: to increase the effectiveness of diagnosis and treatment of patients with hypertension in combination with CKD, based on the assessment of adipokines: leptin, omentin, resistin and visfatin, as well as their relationship. A comprehensive examination of 100 patients with GC and GC in combination with CKD, who applied to the outpatient department on the basis of the Medical and Sanitary Unit of HTZ Kharkiv in the period from 2019 to 2021. According to the study design, 49 patients with GC of the II-ІІІ degrees were included, as well as 51 patients with HD of the II degree in combination with CKD, who were examined on the basis of the Medical and Sanitary Unit of the HTZ of Kharkiv, and 20 practically healthy individuals. Indicators of adipokine levels increase with decreasing GFR (at GFR = 90-60 ml / min) in patients of both groups, but if GFR decreases by more than 60 ml / min, the levels of adipokines in the blood stop rising, or even begin to decline. associated with depletion of the adipokine system, peptide levels in the blood are reduced, which exacerbates further metabolic disorders in this category of patients. In our opinion, it was interesting to investigate the nature of the relationship between leptin, omentin, resistin and visfatin. Thus, in patients with GC and patients with HD in combination with CKD, adipokines had a significant correlation between them. Thus, we can say that in conditions of metabolic disorders, perivascular adipocytes become dysfunctional, which leads to increased production of adipokines. In our work, we quite clearly trace the dynamics of adipokine growth in patients with HD in combination with CKD. These data indicate an important diagnostic value of adipokines in patients with HD in combination with CKD. The main provisions and conclusions of the dissertation are implemented in the practice of the following treatment and prevention measures of Ukraine: Medical and sanitary part of PJSC "Kharkiv Tractor Plant" Kharkiv, which is confirmed by the acts of implementation.


Similar theses