title: [The role of renal anemia and cardiovascular disease in the progression of chronic glomerulonephritis].
abstract: OBJECTIVE
  To study the rate of chronic glomerulonephritis progression when added by anemia and cardiovascular disease (CVD).
  
  
  METHODS
  231 patients (133 men and 98 women) with predialysis chronic glomerulonephritis (CGN) were examined. The patients' mean age of was 35.8±11.8 years; the disease duration was 1 to 17 years. The disease onset was the date when urinalysis showed evidence of persistent proteinuria and (or) hematuria. Besides, the time when anemia developed and the clinical and instrumental signs of CVD appeared was taken as the initial reference point; the time when end-stage renal failure was diagnosed was taken to be the endpoint. Red blood cell counts with the inclusion of its indices, hemoglobin concentration, hematocrit values, daily proteinuria values, and glomerular filtration rate were analyzed. The biochemical parameters included the concentrations of electrolytes, creatinine, fibrinogen, iron, cholesterol, total protein and C-reactive protein (CRP). Electrocardiography and echocardiography, bicycle ergometry and 24-hour ECG monitoring were used to detect CVD.
  
  
  RESULTS
  The presence of anemia and CVD in patients with predialysis CGN versus those without anemia and CVD was associated with an increase in the concentrations of CRP [36.2 and 12.6%; respectively; (p<0.05)], creatinine [123.0 (83.2-217.0) and 86.5 (72.0-128.5) µmol/L; (p<0.05)] and a decrease in GFR [65.4 (30.8-95.5) and 92.7 (64.5-122.3) ml/min; (p<0.05)]. The 8-year survival of patients with CGN concurrent with CVD was noted to be 58% whereas the renal survival in patients with CGN + CVD + anemia was shorter and the 6-year survival in this case was as high as 52%.
  
  
  CONCLUSIONS
  Anemia and CVD in patients with CGN serve as additional independent factors for the progression of the underlying disease. The concurrence of CGN, anemia, and CVD substantially reduces the predialysis period.
authors.affiliation: Department of General Therapy with Course of Family Medicine, I.K. Akhunbaev Kirghiz State Medical Academy, Bishkek, Kirghizia.
authors.forename: I T
authors.initials: IT
authors.lastname: Murkamilov
authors.affiliation: N.I. Pirogov Russian National Research Medical University, Moscow, Russia.
authors.forename: I G
authors.initials: IG
authors.lastname: Gordeev
authors.affiliation: Department of General Therapy with Course of Family Medicine, I.K. Akhunbaev Kirghiz State Medical Academy, Bishkek, Kirghizia.
authors.forename: R R
authors.initials: RR
authors.lastname: Kaliev
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D006417:Hematuria / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology; D006435:Renal Dialysis / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia; D061665:Time-to-Treatment