International Medical Journal, Vol. 23., Iss. 1, 2017, P. 45−49.
RENAL INVOLVEMENT IN POLYARTERITIS NODOSA
Research and Practice Center of Preventive and Clinical Medicine, Kyiv, Ukraine
Polyarteritis nodosa (PAN) refers to a systemic vasculitis of medium−sized vessels, and the renal changes are determined by stenosing processes and development of microaneurysms of the renal vessels, that drastically reduces survival rate of the patients. To determine the frequency of kidney damage in PAN, to estimate relationships with extrarenal manifestations of the disease and the pathogenesis of nephropathy, the patients with polyarteritis nodosa accompanied by nephropathy were investigated. Total protein, fibronectin, ?2−microglobulin, creatinine, urea, uric acid and nitrite in the urine were studied, physical and chemical superficially active, viscoelastic and relaxation properties of the urine were determined; renal ultrasound, ultrasound of the vessels and renal angiography were performed. Kidney damage occurred in 62 % of patients with polyarteritis nodosa, that in 42 % of cases was followed by renal failure, that depended on the age and sex of the patients, pathology of the skeletal muscles, endocardium, cardiac valvular apparatus and peripheral nervous system (polyneuropathy), the nature of the course and the degree of activity of the disease, the presence of viral hepatitis B antigen and some cardiovascular indicators (peripheral and pulmonary vascular resistance, the size of the left atrium, the diameter of the brachial artery during vasodilation), and rates of progression of nephropathy were closely related to blood levels of C−reactive protein and rheumatoid factor, that have some predictive value. Nephropathy is a frequent manifestation of PAN requiring development of criteria for early diagnosis and prognosis of renal pathology in such patients.
Key words: polyarteritis nodosa, renal failure, vascular vasodilation, immunological indices.