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BBC: 53.4
Borsukov A.V., Gorbatenko O.A.
Possibilities of Differential Diagnosis of Diabetic and Atherosclerotic Angionephrosclerosis Based on Echocontrasty of the Kidneys and Ultrasound Examination of the Main Vessels of the Neck
Keywords: atherosclerotic angionephrosclerosis, diabetic angionephrosclerosis, contrast-enhanced ultrasound
Relevance. Currently, atherosclerosis is one of the leading causes of mortality and disability of the population. Since diabetic angionephrosclerosis in patients with DM develops for a long time and mainly in patients of the age group of the population, a differential diagnosis between diabetic and atherosclerotic angionephrosclerosis is necessary, which is reflected in the patent for the invention (patent RU No. 2785489). Aim of the research. To evaluate the effectiveness of a new method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis based on echocontrasty of the kidneys and ultrasound examination of the vessels of the neck. Materials and methods. In the period from 2019 to 2022, 86 people were examined, who underwent a comprehensive clinical laboratory and multiparametric ultrasound examination with subsequent assessment of the diagnosis of angioedema according to the original technique (Patent No. 2785489). All patients underwent a comprehensive diagnosis, including: collection of complaints and anamnesis, lipidogram, laboratory biochemical examination (capillary blood glucose mmol / L, glycated hemoglobin (HbA1c, %), multiparametric ultrasound examination of the kidneys in B-mode with further Doppler assessment of the state of hemodynamics in the renal vessels, ultrasound of the intima-media complex carotid artery. Results and discussions. As a result of the study, the patients were divided into 2 groups: group 1 (n = 44) – patients with glucose levels ≥ 6.1 mmol/l; group 2 (n = 42) – patients with glucose levels ≤6.1 mmol/l. As a result of complex clinical and laboratory and multiparametric ultrasound examination, combined with contrast-enhanced ultrasound examination of the kidneys, the differential diagnosis of atherosclerotic and diabetic angionephrosclerosis was evaluated according to the proposed method. Diabetic angionephrosclerosis was detected in 31.81% of group 1 patients, and atherosclerotic angionephrosclerosis was detected in 11.3% of patients. In group 2, 69.04% had atherosclerotic angionephrosclerosis, diabetic angionephrosclerosis was not detected in any of their studied group 2 patients. Conclusions. 1. Thus, using the method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis (patent RU No. 2785489), it allows to separate diabetic and atherosclerotic angionephrosclerosis, as well as to correct diagnostic and therapeutic tactics of patient management with the possibility of preventing early vascular complications. 2. The proposed method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis allows monitoring the effectiveness of treatment of most diabetic and atherosclerotic angionephropathy.
References
- Dedov I.I., Shestakova M.V., Vikulova O.K. Epidemiologiya sakharnogo diabeta v Ros-siiskoi Federatsii: kliniko-statisticheskii analiz po dannym federal’nogo registra sakhar-nogo diabeta [Epidemiology of diabetes mellitus in Russian Federation: clinical and statistical report according to the federal diabetes registry] Sakharnyi diabet [Diabetes mellitus]. 2017. T. 20 №. 1. pp. 13–41.
- Dzgoeva F.U., Remizov O.V. Postkontrastnoe ostroe povrezhdenie pochek. Obnovlennye rekomendatsii Komiteta po bezopasnosti kontrastnykh sredstv Evropeiskogo obshchestva urogeni-tal’noi radiologii 2018. Chast’ 1 [Post-contrast acute kidney injury. Updated recommendations of the Committee on the Safety of Contrast Media of the European Society of Urogenital Radiology 2018. Part 1] Nefrologiya [Nephrology]. 2019. T. 23 № 3. pp. 10–20.
- Bel’skaya G.N., Chuprina S.E., Vorob’eva A.A. et al. Kognitivnye narusheniya pri insul’te: vozmozhnosti medikamentoznoi korrektsii [Cognitive disorders in stroke: the possibilities of drug correction]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova, 2016, vol. 116, no. 5, pp. 33–37.
- Osetrova N.B. Rasprostranennost’ i struktura khronicheskoi bolezni pochek u lits star-she 50 let [Prevalence and structure of chronic kidney disease in persons older than 50 years]. In: Dostizheniya personalizirovannoi meditsiny segodnya – rezul’tat prakticheskogo zdravookhraneniya zavtra: sb. tez. VII Vseros. kongressa endokrinologov [Proc. of 7th Congress of Endocrinologists «The achievements of personalized medicine today are the result of practical healthcare tomorrow»]. Moscow, UPPrint Publ., 2016, p. 194. DOI: 10.14341/VIIREC.
- Borsukov A.V., Gorbatenko O.A. Sposob differentsial’noi diagnostiki ateroskleroticheskogo i diabeticheskogo angionefroskleroza [Method of differential diagnosis of atherosclerotic and diabetic angionephrosclerosis]. Patent RF, no. 2785489, 2022.
- Didigova R.T., Inarokova A.M., Imagozheva M.Ya. et al. Sovremennye vzglyady na etiologiyu i diagnostiku ishemicheskoi bolezni serdtsa [Modern views on the etiology and diagnosis of coronary heart disease]. Lechebnoe delo, 2011, no. 4, pp. 11–17.
- Smirnov A.V., Esayan A.M., Kayukov G.I. et al. Sovremennye podkhody k zamedleniyu progressirovaniya bolezni pochek [Modern approaches to slowing the progression of kidney disease]. Nefrologiya, 2003, vol. 3, pp. 89–99.
- Basta G.A., Schmidt M., Caterina De R. et al. Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiovascular research., 2004, vol. 63, no. 4, pp. 582–592. DOI: 10.1016/j.cardiores.2004.05.001.
- Benjamin E.J., Muntner P., Bittencourt M.S. et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. , 2019, vol. 139, no. 10, pp. e56–e528. DOI: 10.1161/CIR.0000000000000659.
- Claudon M., Dietrich C.F., Choi B.I. et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver – update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med., 2013, vol. 34(1), pp. 11–29. DOI: 10.1055/s-0032-1325499.
- Colwell J.A., Lopes-Virella M., Halushka V. Pathogenesis of atherosclerosis in diabetes mellitus. Diabetes care, 1981, vol. 4, no. 1, pp. 121–133. DOI: 10.2337/diacare.4.1.121.
- Galesic K., Brkljacic B., Sabljar-Matovinovic et al. Renal vascular resistance in essential hypertension: duplex-Doppler ultrasonographic evaluation. Angiology., 2000, vol. 51, no 8, pp. 667–675.
- Libby P. The Heart in COVID-19: Primary Target or Secondary Bystander? JACC Basic Transl Sci., 2020, vol. 5, no. 5, pp. 537–542. DOI: 10.1016/j.jacbts.2020.04.001.
- Li J.C., Xu Z.H., Zhang Y.X. et al. Impact of atherosclerosis and age on Doppler sonographic parameters in the diagnosis of renal artery stenosis. J Ultrasound Med., 2012, vol. 31, no. 5, pp. 747–755. DOI: 10.7863/jum.2012.31.5.747.
- Mancia G., De Backer G., Dominiczak A. et al. The Task Force for the management of arterial hypertension of the European Society of Hypertension and of the European Society of Cardiolody. 2007 Guidelines for the management of arterial hypertension. Hypertens, 2007, vol. 25, pp. 1105–1187.
- Mogensen C.E. Microalbuminuria as a predictor of clinical diabetic nephropathy. Kidney Int., 1987, vol. 31, pp. 673–689.
- Moorhead J.F., Chan M.K., El-Nahas M. et al. Lipid nephrotoxicity in chronic progressive glomerular and tubulointerstitial disease. Lancet, 1982, vol. 2(8311), pp. 1309–1311.
- Saam T., Yuan C., Chu B. et al. Predictors of carotid atherosclerotic plaque progression as measured by noninvasive magnetic resonance imaging. , 2007, vol. 194(2), pp. e34–e42. DOI: 10.1016/j.atherosclerosis.2006.08.016.
- Weskott H.-P. Contrast sonography. 1st ed. Bremen, UNI-MED, 2014, 284 p.
- World Health Statistics 2020: monitoring health for the SGs, sustainable Development Goals. World Health Organization, 2020, p. 92.
About authors
- Borsukov Aleksey V.
- Doctor of Medical Sciences, Professor, Head of the Problem Research Laboratory «Diagnostic Research and Minimally Invasive Technologies», Smolensk State Medical University, Russia, Smolensk (bor55@yandex.ru; ORCID: https://orcid.org/0000-0003-4047-7252)
- Gorbatenko Olga O.
- Junior Scientist, Fundamental Research Laboratory «Diagnostic Researches and Minimally Invasive Technologies», Smolensk State Medical University, Russia, Smolensk (olya.gorbatenko.94@mail.ru; ORCID: https://orcid.org/0000-0002-8820-7713)
Article link
Borsukov A.V., Gorbatenko O.A. Possibilities of Differential Diagnosis of Diabetic and Atherosclerotic Angionephrosclerosis Based on Echocontrasty of the Kidneys and Ultrasound Examination of the Main Vessels of the Neck [Electronic resource] // Acta medica Eurasica. – 2023. – №1. P. 19-30. – URL: https://acta-medica-eurasica.ru/en/single/2023/1/3/. DOI: 10.47026/2413-4864-2023-1-19-30.