Кардиопротективные эффекты сукцинатсодержащего диализирующего раствора

AIM OF RESEARCH. Estimation of cardioprotective effect of dialysis fluid with succinate at patients with end-stage kidney failure receiving chronic hemodialysis treatment. PATIENTS AND METHODS. 90 patients of two dialysis departments randomized to 2 groups took part in crossover study. Active group of research received chronic hemodialysis with dialysis fluid with succinate during 6 months and control group received chronic hemodialysis with standard bicarbonate dialysis fluid with subsequent “decussation” after 3-month’s washout period. Dynamics of blood biochemical measurements, data of ECG 24-hour monitoring during which was carried out the 6-minute walk distance (6MWD), echocardiography data (ECHO) were estimated. RESULTS. After 6 months of treatment with acidosuccinate in comparison with control decrease in level of inorganic phosphates, calcium, sodium, creatinine, urea, uric acid and increase of total protein and albumin in blood was noted. Decrease of aldosterone content in blood was noted at female patients. According to 24-hour cardiomonitoring with control of arterial blood pressure (ABP) was noted decrease of systolic ABP, decrease of heart rate in daytime, decrease of heart rhythm disorder and time duration of ST-segment depression episodes. 6MWD demonstrated increase of exercise tolerance. The tendency to decrease of miocardial hypertrophy was noted at ECHO. CONCLUSION. This research showed positive effect of hemodialysis with dialysis fluid wih succinate on cardio-vascular system of petients received chronic hemodialysis treatment, it also allowed to reveal a number of cardioprotective mechanisms of succinate which were not described before (hypophosphatemic, hyponatremic and hypotensive effect, decrease of protein catabolism, decrease of GGT and aldosterone level in patients’ blood). Administration of acidosuccinate is especially recommended to patients with high risk of cardio-vascular complications.