No 2 (2009)

Nowadays sporadic cases and outbursts of acute post streptococcus glomerulonephritis are still registered. Albuminuria and decrease of glomerular filtration rate can persist for a long time after clinical remission of acute glomerulonephritis is achieved. Further studies of streptococcus features, including their genetic and phenotypic variability, as well as mediators, regulating processes of inflammation response in kidney tissue, let develop more effective pathogenetic approaches for acute glomerulonephritis prevention and treatment. Today acute glomerulonephritis can be considered as one of the determinants of chronic kidney disease

Principles of kidney ultrasound examination and it's diagnostic value is characterized. Approaches to the interpretation of the results of kidney ultrasound examination are described

ACE inhibitors slow irreversible worsening of renal function in chronic kidney disease with proteinuria, that is due not only to their blood pressure lowering effect, but also to their ability to reduce proteinuria. The reference prove of ACE inhibitors nephroprotective action was shown in trials REIN and AASK, in which ramipril was used

Beta-blockers can be discussed as one of the approaches to limit chronic kidney disease progression, as well as to prevent cardiovascular complications in this patients. Therapeutic opportunities of beta-blockers should be explained by their effects on pathological sympathetic overactivation

Serum amyloid A (SAA) plasma level was measured at 43 patients with chronic inflammatory diseases, including 31 patients with reactive AA-amyloidosis and 12 patients not having amyloidosis (control group). SAA-protein concentration was measured with immune-enzyme analysis (ELISA) in laboratory, corresponding to European standards. The level of immunoglobulin light chains was measured at 31 patients with AL-amyloidosis. Low plasma concentration of immunoglobulin light chains, detected with Freelite method, or its decrease after treatment, indicates relatively favorable prognosis. In contrast, high plasma level of immunoglobulin light chains show very unfavorable outcome. Increase of SAA plasma level indicates risk of nephrotic syndrome development. Conclusion. Circulating amyloid precursor concentrations can be used in monitoring of disease progression. Conclusion: plasma level measurement of amyloide's proteins-predecessors can be used for amyloidosis diagnostic and prognosis of outcomes

Correlation of hypoxia-inducible factor-1α (HIF-1α) expression in kidney tissue in chronic glomeruloneohritis (GN) with nephrosclerosis severity, deterioration of renal function and anemia was studied. Chronic GN progression was correlated with morphological signs of tubulo-interstitial ischemia. Increased HIF-1α tubular production was associated with lower risk of anemia development at patients with chronic GN and nephrosclerosis. Conclusion. Production of HIF-1α by renal tubular epithelium can be considered as one of the protective mechanisms against anemia development

Membranous nephropathy with nephrotic syndrome can be paraneoplastic, especially in elderly. Approaches to differentiation of primary and paraneoplastic membranous nephropathy are discussed