Optimization of treatment and prevention of metabolic and functional disorders in diabetic nephropathy

Dzugkoev S.G.

Institute for Biomedical Research — branch of the Federal State Budgetary Institution of Science «Vladikavkaz Scientific Center of the Russian Academy of Sciences» of the Ministry of Education and Science of Russia

Dzugkoeva F.S.

Authors:

Dzugkoev S.G., Dzugkoeva F.S.

More about the authors

Journal: Russian Journal of Preventive Medicine. 2022;25(3): 18‑24

DOI: 10.17116/profmed20222503118

Downloaded: 38

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Dzugkoev SG, Dzugkoeva FS. Optimization of treatment and prevention of metabolic and functional disorders in diabetic nephropathy. Russian Journal of Preventive Medicine. 2022;25(3):18‑24. (In Russ.)
https://doi.org/10.17116/profmed20222503118

Подписка 2025-2 (Russian Journal of Preventive Medicine)

Close metadata

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.

Keywords:

diabetic nephropathy

glycated hemoglobin

indicators of the functional state of the kidneys

metabolic indicators

Authors:

Dzugkoev S.G.

Dzugkoeva F.S.

Received:

02.07.2021

Accepted:

26.01.2022

List of references:

Dedov II, Shestakova MV, Majorov AYu. Algoritmy specializirovannoj medicinskoj pomoshchi bol’nym saharnym diabetom. Pod red. Dedova I.I., Shestakovoj M.V., Majorova A.Yu. 9-j vypusk (dopolnennyj). M.: UP PRINT; 2019. (In Russ.).
Dedov II, Shestakova MV. Saharnyj diabet tipa 1: realii i perspektivy. Pod redakciej Dedova I.I., Shestakovoj M.V. M.: Medicinskoe informacionnoe agentstvo; 2016. (In Russ.).
Sokolova LK, Pushkarev VM, Pushkarev VV, Kovzun EI, Tron’ko ND. Diabetes mellitus and atherosclerosis. The role of inflammation processes in pathogenesis (literature review). Mezhdunarodnyj endokrinologicheskij zhurnal. 2017;13(7):486-498. (In Russ.). https://doi.org/10.22141/2224-0721.13.7.2017.115747
Fateeva VV, Vorob’eva OV. Nitricoxide: from mechanism of action to pharmacologica leffects in cerebrovascular diseases. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2017;117(10):131-135. (In Russ.). https://doi.org/10.17116/jnevro2017117101131-135
Lam PH, Packer M, Fonarow GC, Faselis C, Allman RM, Morgan CJ, Singh SN, Pitt B, Ahmed A. Early Effects of Starting Doses of Enalapril in Patients with Chronic Heart Failure in the SOLVD Treatment Trial. The American Journal of Medicine. 2020;133(2):25-31. https://doi.org/10.1016/j.amjmed.2019.06.053
Van Hecken A, Burckhardt BB, Khalil F, de Hoon J, Klingmann I, Herbots M, Laeer S, Lagler FB, Breitkreutz J. Relative Bioavailability of Enalapril Administered as Orodispersible Minitablets in Healthy Adults. Clinical Pharmacology in Drug Development. 2020;9(2):203-213. https://doi.org/10.1002/cpdd.728
Martelli A, Testai L, Colletti A, Cicero AFG. Coenzyme Q10: Clinical Applications in Cardiovascular Diseases. Antioxidants. 2020;9(4):341. https://doi.org/10.3390/antiox9040341
Qu H, Meng YY, Chai H, Liang F, Zhang JY, Gao ZY, Shi DZ. The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. European Journal of Medical Research. 2018;23(1):57. https://doi.org/10.1186/s40001-018-0353-6
Zhang X, Shi Z, Liu Q, Quan H, Cheng X. Effects of coenzyme Q10 intervention on diabetic kidney disease: A systematic review and meta-analysis. Medicine. 2019;98(24):e15850. https://doi.org/10.1097/MD.0000000000015850
Xiao L, Xu X, Zhang F, Wang M, Xu Y, Tang D, Wang J, Qin Y, Liu Y, Tang C, He L, Greka A, Zhou Z, Liu F, Dong Z, Sun L. The mitochondria-targeted antioxidant MitoQ ameliorated tubular injury mediated by mitophagy in diabetic kidney disease via Nrf2/PINK1. Redox Biology. 2017;11: 297-311. https://doi.org/10.1016/j.redox.2016.12.022
Asakawa T, Matsushita S. Coloring conditions of thiobarbituricacid test, for detecting lipid hydroperoxides. Lipids. 1980;15:137-140. https://doi.org/10.1007/BF02540959
Korolyuk MA, Ivanova LI, Majorova IG. Method for determination of catalase activity. Laboratornoe delo. 1988;1:16-19. (In Russ.).
Sirota TV. A new approach in the study of adrenaline autooxidation and its use to measure the activity of superoxide dismutase. Voprosy medicinskoj himii. 1999;3:263-272. (In Russ.).
Metel’skaya VA, Gumanova NG. Screening method for determining the level of nitric oxide metabolites in human serum. Klinicheskaya laboratornaya diagnostika. 2005;6:15-18. (In Russ.).
Natochin YuV. Fiziologiya vodno-solevogo obmena i pochki. Pod. red. Natochina Yu.V. SPb.: Nauka; 1993. (In Russ.).
Natochin YuV. Diabetes: the functional state of the kidney. Saharnyj diabet. 2002;1:22-24. (In Russ.).
Dzugkoev SG, Mozhaeva IV, Margieva OI, Dzugkoeva FS. Mechanisms of development of endothelial dysfunction and methods of pathogenetic correction in diabetes mellitus. Medicinskij vestnik Severnogo Kavkaza. 2015;4: 451-459. (In Russ.).
Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. The Canadian Journal of Cardiology. 2018;34(5):575-584. https://doi.org/10.1016/j.cjca.2017.12.005
Shamansurova ZM, Muhamedova FA, Coj AG. Disruption of the activity of sodium-potassium ATPase of erythrocytes in patients with diabetes mellitus. Saharnyj diabet. 2009;2:55-57. (In Russ.).

Close metadata