Kidney pathology in type 1 diabetes mellitus (DM) occupies a leading position among the vascular complications of DM due to the prevalence, disability and mortality of people of working age. More than 30% of patients on hemodialysis have diabetes. In this regard, timely diagnosis of kidney pathology and optimization of treatment and prevention of the pathological process are relevant.
PURPOSE OF THE STUDY
To study the features of metabolic and functional disorders in diabetic nephropathy in patients with type 1 diabetes and to develop a method for optimizing treatment and preventing further progression of the disease.
MATERIAL AND METHODS
The study is clinical and experimental, conducted with the inclusion of patients with type 1 diabetes and in an experiment on animals. The study included 49 patients with type 1 DM (21 men, 29 women), disease duration 6—8 years, age 18—43 years, and 20 healthy individuals without DM — the control group. All patients had severe hyperglycemia, elevated HbA1c levels, and impaired renal function. Experimental DM was modeled on Wistar rats. The studies were carried out by biochemical and functional methods.
RESULTS
The pathogenetic role of metabolic disorders — the process of lipid peroxidation, reduced production of nitrogen oxides, vascular endothelial dysfunction in the development of nephropathy — has been established. Complex therapy, including the angiotensin-converting enzyme inhibitor enalapril and the antioxidant coenzyme Q10 against the background of basic drugs, caused a positive trend in metabolic parameters and the functional state of the kidneys. Data from experimental studies were used to establish causal relationships of kidney disorders in patients with type 1 diabetes.
CONCLUSION
A comparative analysis of data on metabolic and functional changes in the kidneys in type 1 diabetes mellitus made it possible to optimize basic therapy by including the angiotensin-converting enzyme inhibitor enalapril and the antioxidant coenzyme Q10. Evidence has been obtained indicating a positive effect of complex therapy on the metabolic and functional parameters of the kidneys in patients with type 1 diabetes mellitus.