PREVENTION OF THE PROGRESSION OF CHRONIC KIDNEY DISEASE BY DECOMPENSATION OF CHRONIC HEART FAILURE

The progression of chronic kidney disease in patients with acutedecompensation of chronic heart failure is associated with a complex ofcauses. In acute decompensation of chronic heart failure with adecrease in the left ventricular ejection fraction, there is a decrease inrenal perfusion, which leads to a subsequent decrease in theglomerular filtration rate (GFR) [1]. Another possible cause may beadverse reactions of the body to aggressive therapy with loop diuretics,which is part of the complex therapy for acute decompensation ofchronic heart failure [2]. Such adverse reactions include: activation ofneurohormonal systems, leading to increased resistance of the renalvessels, as well as hypovolemia and electrolyte disturbances, leading toischemia and hyperosmolar damage to the renal tubules [3, 4]. Theprogression of chronic kidney disease is an independent risk factor forthe development of cardiovascular complications and the cause ofdeath in patients is 10-20 times more common than in the generalpopulation [5]. Prevention of the progression of chronic kidney diseasein patients with acute decompensation of chronic heart failure can beeffective in improving kidney perfusion by reducing the resistance ofthe organ's vessels and reducing the adverse reactions of loop diuretictherapy. Improvement of renal perfusion is possible with the additionof standard therapy for acute decompensation of chronic heart failurewith dihydropyridine-type calcium antagonists. These drugs canachieve a pronounced renoprotective effect in patients with diseases ofthe cardiovascular system and diabetic nephropathy by restoring thevasomotor tone of the afferent arterioles of the renal glomeruli [6, 7].Reducing the adverse reactions of loop diuretic therapy is possiblewhen changing the drug administration regimen from single bolusinjections to extended intravenous infusio