CLINICAL EFFICACY OF S-ADENOSYLMETHIONINE IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS AND CHRONIC KIDNEY DISEASE I-II STAGE.

The article presents a theoretical generalization of the results of the clinical efficacy of S-adenosylmethionine in patients with non-alcoholic steatohepatitis (NASH) in comorbidity with obesity and chronic kidney disease (CKD) of the 1st-2nd stages. The objective of the article was to determine the likely effect of S-adenosylmethionine and Meldonium on the clinical course of non-alcoholic steatohepatitis (NASH) and chronic kidney disease (CKD) of the I-II stages. We examined 75 patients with NASH with comorbid obesity I degree and CKD I and II dgrees. To determine the efficacy of the treatment, 3 groups of patients were randomized according to age, sex, degree of obesity, activity of the cytolytic syndrome of NASH and the stage of the CKD. SAM possesses powerful membrane-stabilizing properties, stably eliminates the manifestations of cytolysis, cholestasis, mesenchymal-inflammatory syndrome, increases the albumin-synthesizing function of the liver in patients with NASH and prevents the loss of albumins in the conditions of CKD І-ІІ st. At the same time, complex therapy of SAM and vazonate is superior to the effectiveness of correction of these syndromes due to the implementation of powerful metabolic, antioxidant, antihypoxant, energy-specific properties of Meldonium and may be recommended for the introduction into the practice of internal medicine and gastroenterology for treatment NASH on the background of obesity and CKD I and II stages. The established nephroprotective properties of SAM that are potentiated by Meldonium are probably due to the ability of these drugs to eliminate endothelial dysfunction, improve microcirculation, and prevent the progression of kidney fibrosis. S-adenosylmethionine (ahepta) in a dose of 600 mg sublingually in patients with non-alcoholic steatohepatitis on the background of obesity and chronic kidney disease of the 1st and 2nd st. produces powerful membrane-stabilizing effects on the affected hepatocytes, stably eliminates the clinical manifestations of the disease, the intensity of cytolysis, cholestasis, mesenchymal-inflammatory syndrome, inhibits the progression of hepatic and renal dysfunction (increases the albumin-synthesizing function of the liver, the velocity of glomerular filtration) by optimizing the control of fibrosis of the liver and kidneys. Complex therapy with S-adenosylmethionine (ahape) and Meldonium (500 mg /day)(vasonate) is superior to the correction of these syndromes NASH and CKD, since the vasonate potentially potentiates the action of S-adenosylmethionine in acute and distant observation periods.