ИСТИНА

Objective: to assess the role of obesity in the development of chronic kidney disease in patients with chronic sarcoidosis; to identify groups of patients who need more active treatment. Methods: 78 patients with chronic sarcoidosis (CS) were observed at the Sechenov University in 2017. Patients were divided into 4 groups: gr. 1 - patients with high activity of CS and obesity (BMI≥ 30 kg/m2) (n = 17), gr. 2 - patients with high activity of CS without obesity (n = 23), gr. 3 - patients with CS in remission and obesity (n = 18) and gr. 4 - patients with CS in remission without obesity (n = 20). Activity of CS was assessed on the basis of clinical, radiological, laboratory (including serum ACE activity) signs. The patients in all groups were comparable in age and gender. None of the patients had diabetes mellitus and severe arterial hypertension. The glomerular filtration rate (GFR) was estimated by the CKD-EPI formula. Results: when comparing the patients in each of the four groups, it was found that the lowest values of GFR were observed in patients of group 1, with active CS and obesity (GFR 71±10 ml/min/1.73m2), significantly lower than in patients with active CS and normal body weight (group 2, GFR 83±8 ml/min/1.73m2) (p=0,04465). The same pattern was observed in patients with CS in remission: the patients with obesity (group 3) showed lower GFR rates than the patients with normal body weight (group 4): 82±7 ml/min/1.73m2 vs. 110±12 ml/min/1.73m2 (p=0,00061). Attention is drawn to the fact that obesity and sarcoidosis activity made a comparable contribution to the GFR value: GFR in group 2 (high CS activity without obesity) was almost identical to group 3 (obese patients with remission of sarcoidosis) (83±8 ml/min/1.73 m2 vs. 82±7 ml/min/1.73 m2, p=0,96476). Conclusion: The results indicate a negative effect of obesity on the reduction in the glomerular filtration rate in patients with CS, which must be taken into account in the management of this category of patients.