Российский кардиологический журнал (Mar 2018)

TRIMETAZIDINE INFLUENCE ON FILTRATION AND TUBULOINTERSTITIAL FUNCTION OF KIDNEYS IN ISCHEMIC HEART DISEASE PATIENTS WITH CHRONIC HEART FAILURE AND RENAL DYSFUNCTION

  • N. A. Koziolova,
  • I. I. Kolegova,
  • M. V. Surovtseva

DOI
https://doi.org/10.15829/1560-4071-2018-1-57-62
Journal volume & issue
Vol. 0, no. 1
pp. 57 – 62

Abstract

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Aim. Evaluation of trimetazidine influence on the parameters of filtration and tubulo-interstinal function of kidneys in angina patients of II-III functional class (FC) and stable chronic heart failure (CHF) of II-III FC with chronic kidney disease (CKD) stage 3.Material and methods. Totally, 288 stable angina (II-III FC) patients included, among them a cohort selected of 162 (56,3%) CHF II-III FC. In 62 (38,3%) CKD of stage 3 was diagnosed. All CHF and stage 3 CKD patients were randomized to equal 2 groups depending on the kind of treatment. First group patients, together with standard CHF and coronary heart disease (CHD) management, were taking trimetazidine (Preductal МR®, Servier, France) 35 mg in the morning, and the second group patients did not receive trimetazidine. Treatment duration lasted 6 months. For renal function assessment, glomerular filtration rate (GFR) was implemented (CKD-EPIcre), calculated via serum creatinine and cystatin C in the blood (CKD-EPIcys), albumincreatinine ratio in single urine portion (UACR), molecules of tubules damage (KIM-1) in urea, tissue inhibitor of matrix proteases type 1 in the blood (ТIMP-1).Results. Introduction of trimetazidine to the standard therapy of CHD with CHF and CKD stage 3 makes it to not only improve clinical course of the disease, but increases exercise tolerance and demonstrates regression of disorder of kidney function by the dynamics of cystatin C (p=0,005), GFR increase, calculated by cystatin С (p=0,012), decrease of UACR (p=0,002), KIM-1 (p<0,001), restores positive collagenolysis in renal interstitium by dynamics of TIMP-1 decline (p<0,001).Conclusion. Trimetazidine shows nephroprotective effect if added to the treatment of CHD and CHF patients comorbid with CKD stage 3. The effect is characterized by improved filtration function, decrease of albumin secretion with urine, decrease of tubular disorder by suppression of collagen formation in renal interstitium.

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