Renal function in patients with chronic kidney disease and hypertension degree 1–2 against the background of SARS-CoV-2

Background. SARS-CoV-2 infection in patients with chronic kidney disease (CKD) and hypertension degree 1–2 worsens the state of cardiovascular system may contribute to events adverse renal risks. The presence CKD combination its medical correction renin-angiotensin-aldosterone (RAAS) inhibitors causes a significant impact on health infected SARS-CoV-2. uses RAAS, namely receptor for angiotensin-converting enzyme (ACE) 2, as tool enter cell. To choose further approaches treatment, this three pathological conditions requires careful analysis research. Objective: study functional kidneys Materials methods. article is fragment BIRCOV (ARB, ACE inhibitors, DRi COVID-19) trial, which was designed according POEM (Patient-Oriented Evidence that Matters). (two-center, open-label, initiative-randomized, parallel arms) prospective enrolled 120 1–2, it lasted 1 year registered at ClinicalTrials.gov (NCT03336203). One hundred twelve outpatients hypertension, 83 CKD, were selected. At end study, 108 remained, their results are presented subsequent statistical processing. Division into groups occurred depending drugs received (ACE angiotensin blockers (ARBs) or direct renin inhibitor (DRIs)). Endpoints were: estimated glomerular filtration rate (eGFR), average blood pressure, albuminuria level. In 24 patients, urine albumin creatinine ratio analyzed beginning SARS-CoV-2, then 4, 12, weeks after onset disease. Mathematical processing evaluation research done statistics package. Results. All divided 3 drug: 35 (32 %) them ARBs, 42 (39 31 (29 DRIs. manifestation decrease pressure recorded during first two weeks, return baseline week 12 group people who lowest indicator DRI group. use (risk (RR) 1.648, 95% confidence interval (CI) 0.772–3.519, number needed treat (NNT) 7.0) ARBs (RR 13.023, CI 1.815–93.426, NNT 19) treatment significantly increased risk withdrawal compared Patients had similar dynamics observation. higher mean values obtained other participants trial. A simultaneous eGFR systolic documented, most pronounced CKD. took 0–24 weeks: correlation coefficient 0.815. correlated There less than 60 ml/min 4 from 28 versus 22 used DRIs: absolute 0.667 2.00, 1.337–2.92, 3.0). relative reduction 16.6 (95% 5.263–52.360, 1.774) receiving all 2.049 0.361–11.22, 1.064 DRIs entire sample 0.116–9.797, 431.6). After follow-up, almost returned stage 2–3a. An increase (which did not reach within disease) stable function (the statistically different 2–24 weeks). Males progression end-stage second disease, observed reciprocal level uric acid, differed values. dexamethasone accompanied by (Р ≤ 0.05) preservation these disorders 3b-4 up observation 0.686, 0.264–1.780, 7.636). Conclusions. course characterized development hypotension among those taking — GFR, hypotension, an ratio, transient cases. Albuminuria practically unchanged when using 2 greatest risks unfavorable prognosis. authors hypothesized about mechanism effect (ARB effect), i.e., reducing comparable dual RAAS blockade ARBs.