Clinical nephrology

Background. The concept of health-related quality of life (QOL) as a key factor in patient-physician interaction is relevant for making management decisions to optimize medical care for nephrology patients from a patient-centered healthcare perspective.

Objective. Assessment and comparison of the QOL of patients with chronic kidney disease (CKD) on hemodialysis (HD) and peritoneal dialysis (PD) using a patient-centered approach to selecting and evaluating the effectiveness of medical care for this category of patients at the regional level of the Russian Federation.

Material and methods. Data were collected at the Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology of the Moscow Healthcare Department. The medical and social characteristics and health-related QOL of patients with CKD on HD and PD were examined. QOL was assessed using the KDQOL-SF™ v.1.3 questionnaire for dialysis patients. An analysis of the QOL dynamics of HD patients before and after their inclusion in the Telenephrocenter remote monitoring program was conducted, as well as a comparative analysis of the QOL of HD patients and PD patients included in the Telenephrocenter program. The study included 163 HD patients and 50 PD patients. The study was conducted from December 2023 to June 2024. Statistical analysis was performed using IBM SPSS.25 software.

Results. Patients with CKD on dialysis have low QOL. Differences in medical and social characteristics were identified between patients on HD and PD. Implementation of the Telenephrocenter program resulted in improved QOL among HD patients 3 and 6 months after program implementation. Patients on PD had better QOL indicators related to self-assessment of the physical component of health, while patients on HD had better indicators related to the psychological and social components of health.

Conclusion. Assessing the QOL of patients with CKD on dialysis is an important component of modern clinical trials conducted to optimize medical care for nephrology patients from a patient-centered perspective.

Аim of the study was to develop a molecular genetic biomarkers panel to identify correlations between gene polymorphisms and urolithiasis.

Material and methods. Modern molecular biological methods were used: polymerase chain reaction (PCR) using various DNA polymerases, CRISPR-Cas technology (using various Cas nucleases (SpCas9, CcCas9, CoCas9, PpCas9) to detect genetic polymorphisms), RNA synthesis methods, restriction analysis, electrophoretic methods, and spectrophotometric analysis.

Results. Study confirmed potential of using CRISPR-Cas technology for detecting genetic polymorphisms associated with risk of urolithiasis. Most significant results obtained when working with VDR and TRPV5 gene polymorphisms, demonstrating the specific detection feasibility of mutant variants using CcCas9, CoCas9, and PpCas9-based systems. Study identified certain limitations of the method when working with CALCR and RGS14 polymorphisms, indicating the need for further optimization of experimental conditions and the selection of more effective systems for specific targets. Hractical significance of the study lies in the potential application of the developed approaches to creating a diagnostic panel of genetic markers for urolithiasis.

Conclusions. This study laid the foundation for the creation an effective diagnostic platform capable of making a significant contribution to the development of personalized medicine in the field of urolithiasis.

Objective. Evaluation of the relationship between phase angle (PA) and sarcopenia indicators in patients with chronic heart failure (CHF) and chronic kidney disease (CKD).

Materials and methods. The study included 144 patients with CHF and CKD, of whom 46 (32%) had no signs of sarcopenia (Group 1), 62 (43%) were diagnosed with presarcopenia (Group 2), and 36 (25%) with established sarcopenia (Group 3). In the overall sample, the mean age was 68.04±9.72 years.

Results. The PA significantly differed between the groups: the median PA increased from the non-sarcopenic to the sarcopenic group (p=0.0017), with pairwise differences between groups 1–3 (p=0.0007) and 2–3 (p=0.024), and a trend between 1–2 (p=0.059). Correlation analysis revealed associations between muscle status and nutritional and renal parameters: skeletal muscle mass correlated with albumin (p=0.61; p=0.015) and creatinine (p=0.29; p=0.004), PA - with glomerular filtration rate (GFR) (p=0.38; p=0.00016), and shoulder muscle area with GFR (p=0.43; p=0.0006) and C-reactive protein (p=-0.62; p=0.002), indicating a link between deteriorating kidney function and inflammation with muscle degradation and the severity of sarcopenia.

Conclusion. PA significantly differs in patients with CHF and CKD depending on sarcopenic status (p< 0.001). PA can be considered as a promising indicator for early screening and risk stratification of sarcopenia.

Background. Currently, more than 537 million people worldwide suffer from type 2 diabetes mellitus (DM2), and this number is projected to increase to 783 million by 2045. Among the chronic DM2complications, diabetic microangiopathy and nephropathy occupy a special place. Albuminuria, podocinuria, and nephrinuria are considered early preclinical markers of kidney damage in DM2. Clinical forms of kidney damage in DM2 include acute kidney injury (AKI), acute kidney disease, chronic kidney disease (CKD), and others. Risk factors for the development of AKI in DM2 patients include advanced age, male gender, long-term disease, uncontrolled glycemic profile, arterial hypertension, short-term exposure to extreme heat, infectious and inflammatory processes, the presence of CKD, and others. The development of acute kidney injury (AKI) in DM2 worsens the long-term prognosis and increases the risk of in-hospital mortality.

Description of the clinical case. This article presents the results of a clinical folloew-up of patient R., 66, with AKI that developed against the background of type 2 diabetes mellitus. It is demonstrated that timely diagnosis and treatment of AKI can lead to a favorable outcome. During the patient’s follow-up, serum biomarkers—creatinine and cystatin C—were used to assess renal function.

Introduction. Kidney transplant recipients are at increased risk of malignant neoplasms compared to patients who have not undergone kidney transplantation, which is associated with the influence of specific factors inherent to this group.

Objective. To determine the role of malignant neoplasms in the structure of mortality in kidney transplant recipients.

Material and methods. The literature review was conducted using PubMed, Scopus, eLibrary, Web of Science, and Google Scholar databases. The search covered articles in Russian and English. From the initial selection of 69 publications, 28 of the most relevant studies from 2020 to 2025 were selected, corresponding to the objective of the review.

Conclusion. Kidney transplant recipients have increased incidence and mortality from malignant neoplasms compared to the general population. The high heterogeneity in cancer mortality rates among recipients across countries is likely due not only to regional differences in cancer incidence but also to the implementation of malignant neoplasm screening, which enables early detection of tumors.

This article examines the evolution of the concept of metabolic syndrome (MS) and its close association with the development of chronic kidney disease (CKD). MS is a cluster of disorders including abdominal obesity, insulin resistance, dyslipidemia, and arterial hypertension, which significantly increases the risk of developing cardiovascular complications, type 2 diabetes mellitus, and CKD. The incidence of MS and CKD continues to rise worldwide, resulting in high mortality, primarily from cardiovascular complications. The authors note the growing need for early detection and correction of metabolic risk factors, the need to develop methods for preclinical diagnosis of CKD in patients with MS, and a multidisciplinary approach to patient management. Key objectives include identifying early biomarkers of kidney damage and the widespread implementation of preventive strategies to reduce the risk of cardiovascular and renal complications in patients with MS.