nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1023Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESХроническая болезнь почек и ассоциированные с ней нарушения нутриционного статуса у больных бронхиальной астмойChronic kidney disease and nutrition disturbance in patients with asthmaШутовА. М.ShutovA. M.amshu@mail.ruИсаеваМ. В.IsaevaM. V.noemail@neicon.ruСеровВ. А.SerovV. A.noemail@neicon.ruПацуковаН. Н.PatcukovaN. N.noemail@neicon.ruКафедра терапии и профессиональных болезней медицинского факультета Ульяновского государственного университета и Центральная городская клиническая больница, г. УльяновскRussian Federation2009190620251113943Copyright © Шутов А.М., Исаева М.В., Серов В.А., Пацукова Н.Н., 20252025Шутов А.М., Исаева М.В., Серов В.А., Пацукова Н.Н.Shutov A.M., Isaeva M.V., Serov V.A., Patcukova N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1023

Цель. Изучить связь между нурушениями нутриционного статуса, функциональным состоянием почек и течением бронхиальной астмы (БА). Методы. Обследовано 109 больных бронхиальной астмой (67 женщин, 42 мужчины, средний возраст 50 ± 16 лет). При диагностике и лечении БА придерживались рекомендаций GINA, 2005. Исключены больные сахарным диабетом, пациенты с интермиттирующей БА. 27 больных имели БА легкой или средней тяжести, 82 - тяжелую персистирующую астму. Определяли индекс массы тела, объем талии, с помощью калипера (Accu-Measure, USA) определяли толщину кожно-жировых складок и рассчитывали тощую и жировую массу тела (Durnin-Womersley). Анализировали содержание гемоглобина и альбумина. Скорость клубочковой фильтрации (СКФ) рассчитывали по формуле MDRD (Modification of Diet in Renal Disease study equation). Результаты. ИМТ был выше у больных тяжелой БА, чем у больных БА легкой и средней тяжести (28,3 ± 5,6 и 25,9 ± 4,7 кг/м2, p = 0,02). У больных тяжелой БА была больше ЖМТ (26,2 ± 9,6 и 19,7 ± 8,5 кг, p = 0,007), но ТМТ (49,6 ± 10,1 и 52,7 ± 10,7 кг, p = 0,3) и окружность талии (101,5 ± 13,4 и 96,0 ± 13,8 см, соотв., p = 0,2) достоверно не различались. СКФ была значительно выше у больных БА легкой/средней тяжести, чем у больных тяжелой персистирующей БА (88,0 ± 22,6 и 71,5 ± 19,2; p = 0,006). Обнаружена прямая связь между СКФ и уровнем гемоглобина (r = 0,30; p = 0,002), и обратная связь между индексом ЖМТ и уровнем гемоглобина (r = -0,41; p = 0,00002). Не установлено зависимости между уровнем гемоглобина и ИМТ (r = -0,19, p = 0,05), индексом ТМТ (r = 0,18; p = 0,06). Заключение. Наличие ХБП ассоциировано с тяжелым течением бронхиальной астмы. Увеличение жировой массы у больных БА ассоциировано с наличием ХБП. Наличие ХБП отягощает течение бронхиальной астмы.

The aim of this study was to evaluate the relationship between nutritional disorders, kidney dysfunction and severity of asthma. Methods. 109 patients (67 females, 42 males, mean age 50 ± 16 years) with asthma were studied. Asthma severity was classified according to the GINA (2005) guidelines. Nutritive status was estimated by skinfold method. The body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) for each individual were calculated. Hemoglobin concentration, serum creatinine and albumin were measured. Glomerular filtration rate (GFR) was calculated with the Modification of Diet in Renal Disease (MDRD) study equation. Results. BMI was higher in patients with severe asthma, than in those with mild or moderate asthma (28,3 ± 5,6 vs 25,9 ± 4,7 kg/m2, respectively, p = 0,02). Patients with severe asthma have higher fat mass (26,2 ± 9,6 vs 19,7 ± 8,5 kg, respectively, p = 0,007), but lean mass (49,6 ± 10,1 vs 52,7 ± 10,7 kg, respectively, p = 0,3) and waist circumference did not differ (101,5 ± 13,4 vs 96,0 ± 13,8 cm, respectively, p = 0,2). GFR was lower in patients with severe asthma, than in those with mild or moderate asthma (88,0 ± 22,6 vs 71,5 ± 19,2 ml/min/1,73 m2, respectively, p = 0,006). Hemoglobin concentration correlated significantly with GFR (r = 0,30, p = 0,002), FMI (r = -0,41, p = 0,00002), but not with BMI or FFMI. We conclude that increased total fat mass correlates with chronic kidney disease in patients with asthma. The severity of asthma also correlates with the presence of chronic kidney disease.

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