Keywords
Abstract
Objective. To evaluate the clinical and laboratory consequences of damage to the renal parenchyma and microcirculatory bed in patients with arterial hypertension associated with diabetes mellitus, and to determine the relationship between albuminuria, eGFR, renal Doppler parameters, and microcirculation markers.A conditional clinical observational study included 90 patients. The patients were divided into three groups: Group 1 — patients with type 2 diabetes mellitus and arterial hypertension, n=45; Group 2 — patients with type 2 diabetes mellitus without arterial hypertension, n=25; Group 3 — patients with arterial hypertension without diabetes mellitus, n=20.In all patients, blood pressure, HbA1c, creatinine, eGFR, urinary albumin-to-creatinine ratio, renal ultrasound, renal parenchymal thickness, renal Doppler resistive index, and peripheral microcirculation parameters were assessed. Statistical analysis included ANOVA, the Kruskal–Wallis test, the χ² test, Spearman correlation analysis, multivariate regression analysis, and ROC analysis.In the group with combined diabetes mellitus and hypertension, albuminuria, renal resistive index, and decreased eGFR were more pronounced than in the other groups. In Group 1, the mean eGFR was 62.8±18.5 ml/min/1.73 m², the median UACR was 118 mg/g, and the renal RI was 0.72±0.06. UACR showed a positive correlation with systolic blood pressure, HbA1c, and renal RI. In multivariate regression analysis, renal RI and systolic blood pressure were identified as independent predictors of albuminuria.Arterial hypertension associated with diabetes mellitus aggravates damage to the renal parenchyma and microcirculatory bed. This condition is manifested by albuminuria, decreased eGFR, increased renal Doppler resistive index, and impaired microcirculation. The combined assessment of UACR, eGFR, and renal Doppler parameters during early screening is important for detecting the early stages of diabetic nephropathy.
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