THE FUNCTIONAL CONDITION OF THE DETOXICATION FUNCTION OF LUNGS IN PATIENTS WITH TERMINAL STAGE OF THE CHRONIC KIDNEY DISEASE, COMPLICATED BY CONGESTIVE HEART FAILURE

Abstract

Aim. To study the functional condition of the detoxication function of lungs in patients with terminal stages of chronic kidney disease, complicated by congestive heart failure. Materials and methods. The work conducts a prospect analysis of 100 patients treated during the years 2012 -2018, with the terminal stage of chronic kidney disease, complicated by congestive heart failure. Chronic kidney disease was classified according to NKF-K/DOQI (2003) and congestive heart failure according to the criteria of the European Cardiologists Society (ECS). Three main groups were formed out of 100 patients with terminal stage of chronic kidney disease, complicated by congestive heart failure: 1 group - 19 patients; 2 group - 54 patients; 3 group - 27 patients. They were compared with the control group of 30 healthy volunteers. Results and discussion. The syndrome of endogenic intoxication of various severity stages that brings to polysystem failure was the reason for the worsening of the condition of patients with terminal stages of chronic kidney disease and the development of organ complications and an increase in the mortality rate. The basis of the syndrome of endogenic intoxication in patients with terminal stage of the chronic kidney disease complicated by congestive heart failure is a composition of toxic substances of various molecular mass and chemical structure in the circulatory systems: oligopeptides of low, average and high mass. Conclusion. 19,0% of patients with terminal stage of chronic kidney disease complicated by congestive heart failure with an ejection fraction of more than 50% had a syndrome of endogenic intoxication in 1, 2 stages and detoxication function of lungs in a stage of compensation. 54,0% of patients with an ejection fraction of the left ventricle of 40% -50% had a 2nd stage of the syndrome of endogenic intoxication and sub-compensation stage of the detoxication function of lungs. 27,0% of patients with an ejection fraction of left ventricle less than 40% had a functionally compensated stage of the syndrome of endogenic intoxication.