CLINICAL EXPERIMENTAL DYNAMICS OF RENAL PARENCHYMAL AND MICROCIRCULATORY VEIN DAMAGE IN TRANSIENT ARTERIAL HYPERTENSION AS A RESULT OF DIABETES
Keywords:
diabetes mellitus, arterial hypertension, diabetic nephropathy, glomerular hyperfiltration, albuminuria, endothelial dysfunction, SGLT2 inhibitors, finerenone.Abstract
Arterial hypertension in the setting of diabetes mellitus creates a complex of mutually reinforcing (synergistic) pathogenic factors that accelerate damage to the renal parenchyma and microcirculatory system. Hyperglycemia “fragile” the capillary network through endothelial dysfunction, glomerular hyperfiltration, oxidative stress and inflammation, while arterial hypertension increases intraarterial hypertenial pressure, deepens arteriolar remodeling, hyalinosis and ischemia. As a result, in the early stages, functional reversible disorders (albuminuria, hyperfiltration, impaired microcirculatory autoregulation) predominate, and then irreversible structural changes such as nodular glomerulosclerosis, tubulointerstitial fibrosis, loss of peritubular capillaries and renal failure are formed. This article discusses the time dynamics of these processes in clinical observations and experimental models, modern biomarkers, treatment strategies, and the relevance of the problem based on Uzbek and world statistics.
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