[Microcirculatory disorders in the genesis of sclerodermic nephropathy]

Biomicroscopy of the vessels of the conjunctiva (BMV), the determination of erythrocyte and platelet aggregation capacity and investigations of the effective cutaneous and muscular blood flow and blood plasma renin activity were employed to study microcirculation in 110 patients with systemic sclerodermia (SSD) (74 with and 36 without renal lesion). The detected disturbances were correlated with the nature and gravity of sclerodermic nephropathy (SN). In BMV the frequency of intravascular platelet aggregation increased with a rise of the gravity of renal pathology. The quantitative determination of erythrocyte and platelet aggregation capacity revealed a significant acceleration of the aggregation of the blood cell elements in the SSD patients which correlated with SN presence and gravity as well as with renal function indices. Renin plasma activity was significantly raised in patients with severe renal pathology. There was correlation between the indices of function of the kidneys and ultrastructural signs of lesion of their microcirculatory bed. The results of the study served as a basis for the differential use of vascular drugs and the development of new pharmacotherapeutic methods for SSD patients with renal lesion.