Endothelial dysfunction in severe forms of acute renal failure. New approaches to pathogenetic therapy

Aim. To study endothelial function in different variants of acute renal failure (AAF) at various stages of the disease. Material and methods. The study of 36 patients with severe ARF at the stages of oliguria and recovery of diuresis included a clinico-laboratory analysis of characteristics of ARF of various etiology and follow-up of plasmic concentrations of endothelin-1, thromboxan A(2) and prostacyclin in different ARF variants at different ARF stages. Results. The oliguric phase of severe ARF ran with significant elevation of the level of vasoconstrictive endothelial hormones (endothelin-1 and thromboxan A(2) and a fall of a vasodilator prostacyclin. Recovery of diuresis normalized the above parameters. Conclusion. Mechanisms of ARF development involve endothelial dysfunction manifesting with alteration of vasoactive hormones synthesis with a dominant rise of a vasoconstrictive hormones concentration.