G.E. Dudnik, А.S. Solonovich, A.V. Liashenko Correction of renal dysfunction in patients with chronic heart failure and reduced left ventricular ejection fraction

The aim – to study the possibilities of correction of renal function parameters in patients with CHF and reduced LV EF on the background of treatment with a fixed combination of meldonium with gamma buterobetaine.

Material and methods. A total of 24 patients with stable CHF and reduced left ventricular ejection fraction (EF < 40 %), II–IV NYHA classes were examined. Among them, 17 people had CHD, 5 people – dilated cardiomyopathy. All patients underwent general clinical examination, determination of levels of creatinine, blood urea nitrogen, uric acid, microalbuminuria, GFR using the formula CKD-EPI. Ultrasound diagnosis of the vasodilating function of the brachial artery endothelium was performed using a test with reactive hyperemia. Against the background of standard treatment, patients received a fixed combination of meldonium with gamma-butyrobetaine (GBB) at a dose of 2 tablets 3 times a day (every 8 h) for 4 weeks. Results. Against the background of a 4-week intake of a combination of 360 mg of meldonium and 120 mg of GBB three times a day, patients had a statistically significant improvement in creatinine and GFR. Uric acid levels in the blood plasma of patients did not significantly change. There was no significant effect on the level of heart rate and systolic blood pressure. The levels of daily MAU significantly decreased, as well as blood urea nitrogen. There was a statistically significant improvement in vasodilator function of the endothelium. Conclusions. In stable patients with CHF and reduced LV EF, addition of meldonium 360 mg with GBB 120 mg to the standard pharmacotherapy is accompanied by improvement of renal function shown by significant reduction of blood creatinine, increase of GFR, decrease of blood urea nitrogen and daily MAU. This treatment improves vasodilator endothelial function.

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