arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2019-25-1-6-13arthyper-1794Research ArticleЛЕКЦИЯLECTUREПоражение почек при эссенциальной артериальной гипертензии: патогенетические основы ранней диагностикиKidney damage in essential arterial hypertension: pathogenetic issues for early diagnosticsМельниковаЛ. В.MelnikovaL. V.

Мельникова Людмила Владимировна — доктор медицинских наук, профессор кафедры общей врачебной практики и поликлинической терапии

ул. Баррикадная, д. 2/1, Москва, 125993

Lyudmila V. Melnikova, MD, PhD, DSc, Professor, Department of the General Medical Practice and Outpatient Therapy

2/1 Barrikadnaya street, Moscow, 125993

melnikovalv@rmapo.ruОсиповаЕ. В.OsipovaE. V.

Осипова Елена Валентиновна — ассистент кафедры ультразвуковой диагностики

Пенза

Elena V. Osipova, MD, Assistant, Department of Ultrasonic Diagnostics

Penza

Федеральное государственное бюджетное  образовательное учреждение дополнительного  профессионального образования «Российская медицинская  академия непрерывного профессионального образования»  Министерства здравоохранения Российской ФедерацииРоссияAcademy of Advanced Medical Training   of the Russian FederationRussian FederationПензенский институт усовершенствования врачей —  филиал федерального государственного бюджетного  образовательного учреждения дополнительного  профессионального образования «Российская медицинская  академия непрерывного профессионального образования»  Министерства здравоохранения Российской ФедерацииРоссияPenza Institute of Advanced Medical Training,   the Branch of the Academy of Advanced Medical Training   of the Russian FederationRussian Federation201928032019251613Copyright © Мельникова Л.В., Осипова Е.В., 20192019Мельникова Л.В., Осипова Е.В.Melnikova L.V., Osipova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1794

В статье рассматриваются вопросы ранней диагностики поражения почек у больных эссенциальной артериальной гипертензией. Излагаются патогенетические механизмы гипертонического ремоделирования сосудов почек. На основании данных доказательной медицины обозначены акценты использования в диагностике лабораторных методов (расчет скорости клубочковой фильтрации и определение микроальбуминурии). Подтверждается значимость допплерографических методов изучения внутрипочечной гемодинамики (оценка индекса резистентности и времени ускорения кровотока) для своевременного обнаружения изменений почечных сосудов и коррекции терапевтической тактики.

We review main issues of early diagnostics of kidney damage in patients with essential hypertension. The remodeling of renal vessels and the underlying mechanisms are discussed. The evidence-based data are reviewed to substantiate the use of laboratory methods for the kidney damage diagnostics (calculation of glomerular fltration rate and microalbuminuria). We discuss the role of Doppler methods in the assessment of intrarenal hemodynamics (the resistance index and blood flow acceleration time) for timely detection of changes in renal vessels and the choice of management strategy.

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The authors declare that there are no conflicts of interest present.