Выявление и оценка предикторов развития подагрической нефропатии

Аннотация

According to the literature, the frequency of kidney damage in patients with gout varies in rather large limits from 30 % to 70 %. Today scientists distinguish the concept known as "gouty nephropathy", which characterizes all renal pathology that occurs due to gout. Pathogenesis of gouty nephropathy is associ-ated with hyperproduction of uric acid and imbalance between tubular secretion and urat reabsorption pro-cesses. But there is no clear opinion that hyperuricemia is a marker of renal dysfunction or risk factor. This contradictory opinion is due to the fact that it is difficult to estimate the early stages of gouty nephropathy. This process undergoes a long time subclinically and is diagnosed only at later stages of the disease. The first har-binger of kidney damage is increasing of microproteins in urine - microproteinuria. Materials and methods. 103 patients with chronic gouty arthritis were examined. All patients were male, without history of kidney dys-function. Determination of microproteins in urine with help of an ELISA method allowed to suspect subclinical course of gouty nephropathy. Therefore, patients were divided into 2 groups: I (n = 58) - patients with subclin-ical gouty nephropathy (56.3 %), II (n = 45) - control group, patients without kidney damage (43.7 %). All cal-culations were carried out on a personal computer using “statistica”. Also, Spearman's correlation coefficients are established. Results and discussion. It was found that the presence of obesity, hypertension, diabetes melli-tus with a high level of reliability is associated with an increased level of urine microalbumins and microglobu-lins. Also, close relationships between urine microalbumins, microglobulins and triglycerides, uric acid levels in blood and urine have been determined. Conclusion. Thus, during the research it was established that the factors that are likely to contribute to the onset of gouty nephropathy include: the presence of obesity, hyper-tension, diabetes mellitus, hyperuricemia, hypertriglyceridemia. It should be noted that all the most likely pre-dictors are modifying and close attention to them and control will be allowed to reduce the incidence of gouty nephropathy