[Effect of eprosartan on the hemostatic system in patients with chronic kidney disease associated with hereditary thrombophilia].

AIM: To study the effect of eprosartan, an angiotensin II type 1 (AT1) receptor blocker, with sympatholytic activity on the hemostatic system in patients with chronic kidney disease (CKD) associated with hereditary thrombophilia. SUBJECTS AND METHODS: The 12-week open-label uncontrolled trial included 31 patients with Stages I-II CKD: 15 patients with chronic glomerulonephritis and 16 with diabetic nephropathy burdening types 1 and 2 diabetes mellitus (DM) in 10 and 6 cases, respectively. In all the patients, CKD was associated with one of the heterozygous forms of thrombophilia: the polymorphic methylenetetrahydrofolate reductase gene variant C677T was found in 18 patients; the polymorphic coagulation factor V gene variant G1691A was in 9; and the polymorphic coagulation factor II gene variant G20210A in 4. Along with the thorough examination accepted in nephrology and endocrinology clinics, investigations of vascular-thrombocytic and secondary hemostasis and the anticoagulant and fibrinolytic systems were made before and after treatment. RESULTS: Eprosartan therapy caused positive changes in the indicators of vascular-thrombocytic (diminished platelet aggregation, reduced surplus of von Willebrand factor and endothelin-1) and secondary (decreased coagulation factor VII activity, longer activated partial thromboplastin time) hemostasis and the anticoagulant (reduced antithrombin III deficiency) and fibrinolytic (elevated blood plasminogen concentrations) systems. CONCLUSION: The pleiotropic effects of eprosartan may be used to correct hypercoagulability syndrome in patients with CKD associated with hereditary thrombophilia.

[The effectiveness of eprosartan in patients with chronic glomerulonephritis].

The subjects of this 12-week open non-controlled study of the organoprotective efficiency of eprosartan were 15 patients with chronic glomerulonephritis. The results of the investigation demonstrated high organoprotective activity of eprosartan in a dose of 600 mg a day, which manifested by anti-proteinuric and anti-hematuric effects, as well as positive changes in the parameters of intragromerular filtration, reduction of left ventricular hypertrophy and rigidity, and normalization of the vascularmotor function of the brachial arterial endothelium. To a large extent, the organoprotective activity of eprosartan depends on the unique pharmacodynamic profile of this drug, which is able to decrease excessive functional activity of the sympathetico-adrenal system, which is reflected in the dynamics of the cardiac rhythm dispersion parameters.

[The course of chronic glomerulonephritis in chronic opisthorchiasis].

AIM: To characterize clinical, functional and morphological features of chronic glomerulonephritis (CGN) running with chronic opisthorchiasis (CO) and to justify dehelminthization. MATERIAL AND METHODS: Clinical, functional and morphological examinations of the kidneys, immunological characteristics were studied in 100 patients with primary CGN and CO (group 1), 30 patients with CGN free of CO (group 2) and 40 patients with long-term CO. RESULTS: CGN in CO runs with frequent rise of creatinine, glomerular filtration and canal reabsorption fall. Pathogenetic therapy with addition of pulse cyclophosphamide in a dose 10 mg/kg and conduction of dehelminthization a year later lead to long-term remission and inhibition of nephrosclerosis development. CONCLUSION: Clinicofunctional and morphological characteristics of the kidneys in mixed pathology necessitate addition of immunosuppressor cyclophosphamide in a dose 10 mg/kg and dehelminthization in combined treatment of patients with glomerulonephritis and opisthorchiasis.