Clinical and Pathogenetic Features of Respiratory Disorders in Patients with Diabetic Nephropathy and Obesity
About the author:
Оspanova т. S., Zaozerskaya N. V.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
The article presents data on the clinical and pathogenetic features of respiratory disorders occurring in patients with diabetes mellitus complicated with diabetic nephropathy and obesity. In developed countries, the number of patients with diabetes mellitus is an average of 3-6 % of the general population. The incidence of type 1 diabetes for the past 30-40 years has been a steady upward trend. Abdominal obesity, hypertension and type 2 diabetes are the main factors increasing the number of patients with chronic kidney disease. Renal disease in patients with diabetes is the leading cause of mortality. Global renal registers indicate that 21. 7 – 32. 4 % of all patients suffering from the terminal chronic kidney disease have diabetic nephropathy. Some authors have noted that diabetes and impaired glucose tolerance are independently associated with obstructive and restrictive changes in lung function. In patients with obesity the presence of obstructive sleep apnea in 50 % of individuals was often observed. In patients with diabetic nephropathy and obesity respiratory function was examined. It was found significant obstructive ventilation disorders, which is progressing as the worsening of renal function. Obstructive changes were found in 50 % of patients with diabetes with diabetic nephropathy without obesity (p < 0,001). The same changes were found only in 35,7 % of patients with diabetes mellitus and obesity. That fact means that respiratory disorders may occur as independent changes in the lungs, which develop on the background of diabetic microangiopathy. Considering diabetic microangiopathy as a system process, it should be noted that it may damage lings as well as other organs. Lung alveolar-capillary network is the largest in the human body. In patients with diabetic nephropathy the kidney failure progression leads to worsening of ventilation disorders. Also it is revealed the kidney failure progression proportion of patients with mixed ventilation disorders increases. The uniformity of changes of respiratory functions in patients with diabetes mellitus with different degree of chronic renal failure indicates stereotype violations of respiratory disorders, which do not depend on the severity of chronic kidney disease. Early identification of the nature and extent of lung damage, as well as their functional activity in the progression of complications of diabetes in conjunction with obesity will more closely predict the development of cardiopulmonary complications and prevent the growth of mortality in these patients. This should be paying attention to practitioner in the early diagnosis of diabetic angiopathy.
Tags:
diabetes, obesity, diabetic nephropathy, respiratory disorders
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 (106), 2014 year, 157-161 pages, index UDK 616. 379 – 008. 64 – 02: 616. 61:616. 21. 23 – 036 – 092