ULTRASOUND DIAGNOSIS OF KIDNEY DAMAGE IN PATIENTS WITH CHRONIC HEART FAILURE

Objective. Develop a method for ultrasound diagnosis of kidney damage with the development of chronic kidney disease (CKD) in chronic heart failure (CHF).

Materials and methods. In 2017—2018 a clinical and instrumental study of 203 patients was performed on the basis of Minsk First City Clinical Hospital including 111 (54.7%) women and 92 (45.3%) men aged 40—86 years. Inclusion criteria: sinus rhythm, essential arterial hypertension, chronic ischemic heart disease, CHF. Exclusion criteria: glomerular, tubular interstitial kidney disease, obstructive uropathy, renal artery stenosis, congenital kidney disease. Ultrasound kidneys examinations were performed at Siemens Acuson S1000 or Siemens Acuson X300 (Germany) machines.

Results. The complex of ultrasound signs includes pulse index (PI) in the kidneys segmental arteries >1.26 (sensitivity 81.8%, specificity 66.7%), resistance index (RI) >0.68 (sensitivity 84.1%, specificity 70.8%), index of the kidneys total volume £126.38 cm3/m2 (sensitivity 50.5%, specificity 86.7%), parenchyma width £1.68 cm (sensitivity 79.8%, specificity 63.3%) as the structural and hemodynamic markers of the renal damage and CKD in CHF patients. The complex of ultrasound features — PI in kidneys segmental arteries of the is >1.55 (sensitivity 67.9%, specificity 82.5%), RI>0,75 (sensitivity 67.9%, specificity 87.5%), index of total kidney volume is £126.38 cm3/m2 (sensitivity 69.6%, specificity 79.5%), the parenchyma width is £1.68 cm (sensitivity 89.3%, specificity 45.2%), is a structural and hemodynamic marker of kidney damage in CKD with reduced glomerular filtration rate in patients with CHF.

 

Conclusion. The method of ultrasound diagnosis of kidney damage with development of CKD in CHF patients demonstrate a high sensitivity and specificity allowing it recommend for using in ultrasound diagnosis.

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Автор(ы): O. M. Zherko