Патогенетические механизмы контрастной нефропатии у пациентов с ишемической болезнью сердца и сахарным диабетом 2 типа: инновационные методы и перспективы

Abstract. Contrast-induced nephropathy (CIN) represents a significant clinical challenge, particularly among patients diagnosed with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM). The increased susceptibility of this group highlights the urgent need for more effective preventive measures to mitigate risks and preserve kidney function. Background. This study aims to investigate the fundamental pathogenetic mechanisms contributing to the development of CIN and assess the effectiveness of various preventive interventions in patients with CAD and T2DM. Materials and Methods. The study was conducted in two distinct phases. The first phase involved a retrospective analysis of medical records from 56 patients who had undergone endovascular procedures involving contrast agents. The second phase included a prospective follow-up of 65 high-risk patients to evaluate preventive strategies.Clinical and laboratory indicators were meticulously analyzed, with a particular emphasis on tracking oxidative stress dynamics and endothelial function, which are considered pivotal in the pathogenesis of CIN. Results. The research led to the development of a novel risk assessment scale for predicting CIN occurrence. Preventive treatment with the antioxidant N-acetylcysteine (NAC) demonstrated a marked reduction in kidney damage rates, whereas the use of theophylline was found to be less effective. This highlights the superiority of antioxidant-based approaches in mitigating CIN risks. Conclusion. The findings underscore the efficacy of incorporating antioxidant therapies, particularly N-acetylcysteine, as a preventive measure for CIN in patients with coexisting cardiovascular and metabolic conditions. Implementing these strategies not only reduces the likelihood of renal complications but also improves the overall prognosis for this vulnerable population.

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