RENAL HEMODYNAMICS IN PATIENTS WITH HYPERTENSION AND STAGE II–III CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The purpose of the study is to assess the changes in renal blood flow during the combined course of essential hypertension and stage II-III chronic obstructive pulmonary disease. Participants and methods. The study included 60 patients, divided into three clinical groups: Group 1 involved 15 patients with stage II essential hypertension (mean age 52.87 ± 1.36 years; male-to-female ratio 73.33%/26.67%); Group 2 included 15 patients with stage II–III chronic obstructive pulmonary disease (COPD) (mean age 48.01 ± 2.75 years; male-to-female ratio 86.67%/13.33%); Group 3 included 30 patients with stage II–III COPD combined with stage II essential hypertension and stage I–III arterial hypertension (23 men and 7 women; mean age 57.49 ± 2.39 years). These patients had no other clinically significant concomitant pathologies and had not received systematic antihypertensive therapy. A control group of 20 healthy donors was also examined. Results. The study of renal blood flow dynamics at the levels of the common trunk, segmental, and interlobar branches of the renal artery revealed statistically significant changes, particularly in the presence of comorbidity. A notable increase in the parameters Vmax, Vmin, and Vaverage, as well as the resistive index (RI) and pulsatility index (PI), was observed in patients with chronic obstructive pulmonary disease (COPD) combined with essential hypertension. These changes indicate impaired renal hemodynamics, characterized by increased microvascular resistance in the interlobar branches. The severity of disturbances in key Doppler parameters of renal blood flow at the levels of the common trunk, segmental, and interlobar branches was associated with elevated RI and PI values in patients with the comorbidity of essential hypertension and COPD (p<0.05), as well as in those with essential hypertension alone (p<0.05). In contrast, patients with COPD alone exhibited higher values of Vmax, Vmin, and Vaverage at these levels of the renal artery. Conclusions. The evolution of linear velocity and vascular resistance indices in the renal vessels across the studied patient groups showed a consistent, proportional pattern, with more pronounced renal blood flow impairment observed in patients with the comorbidity of essential hypertension and chronic obstructive pulmonary disease, based on key Doppler criteria.