PHARMACOLOGICAL CORRECTION OF METABOLIC SYNDROME AND CHRONIC KIDNEY DISEASE

Abstract

Aim. Optimization of pharmacotherapy of patients with metabolic syndrome and chronic kidney disease according to the nephroprotective properties of antihypertensive drugs.Methods. 81 patients (38 male, 43 female, age 29-79 years, mean age 53,4± 11,6 years) with metabolic syndrome and normal kidney function were included into the study. In all patients estimated glomerular filtration rate (eGFR) according to the Cockroft-Gault formula and microalbuminuria were determined. Antihypertensive and nephroprotective efficacy of zofenopril, losartan, nebivolol and fixed combination of lisinopril and hydrochlorothiazide were assessed.Results. 57 (70,4%) patients with metabolic syndrome had renal function deterioration: 19 (23,5%) - hyperfiltration (eGFR >110 ml/min/1,73 m2), 38 (46,9%) - hypofiltration (eGFR <90 ml/min/1,73 m2). Progression of chronic kidney disease was connected with increasing age. Endothelin-1 concentration increased according to blood pressure rise. Zofenopril, losartan, nebivolol and fixed combination of lisinopril and hydrochlorothiazide demonstrated antihypertensive and nephroprotective effect in methabolic syndrome.Conclusion. Changes in eGFR can be found up to 2/ 3 patients with metabolic syndrome and can be corrected by antihypertensive drugs.

Keywords

• metabolic syndrome
• chronic kidney disease
• antihypertensive drugs
• nephroprotection
• glomerular filtration rate
• microalbuminuria