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No 3 (2010)
- Year: 2010
- Articles: 15
- URL: https://journals.eco-vector.com/2075-3594/issue/view/6294
Articles
4-6
Low birth weight as a risk factor for chronic kidney disease
Abstract
Role of intrauterine growth retardation and low birth weight as risk factors of arterial hypertension and chronic kidney disease are discussed. It is shown, that low birth weight and reduced nephron number may contribute to end-stage renal failure prevalence and enhance progression of several chronic kidney diseases
Clinical nephrology. 2010;(3):7-12
7-12
13-18
19-23
24-28
29-38
39-44
Prevalence of diabetic nephropathy and chronic kidney disease in diabetes mellitus in Russian Federation
Abstract
Purpose: Investigation of prevalence of diabetic nephropathy and CKD in adult patients with type 1 and type 2 diabetes mellitus in the Russian Federation.
Materials and Methods: In 20 regions of Russia, 7174 patients with type 1 and type 2 diabetes mellitus were examined. Laboratory examination included measurement of HbA1c level, blood creatinine, urea, and CL levels, albumin excretion in a spot urine sample, BP measurement, and examination of the ocular fundus. The concentration of albumin in spot urine sample of 20 mg/l to 200 mg/l was considered as a MAU, above 200 mg/l - as PU. GFR was calculated by Cockcroft-Gault formula. Statistical analysis of results of the study was performed using STATISTICA 6 software. The data are presented as median and 25th and 75th percentiles (Me [25%, 75%]). Values of P<0.05 were considered statistically significant for all measurements.
Results: The actual prevalence of DN was 40.1% (type 1 DM) and 39.3% (type 2 DM), reportable prevalence - 28.8% and 8.7%, respectively. Pathological urinary albumin excretion was observed in 42% of patients with type 1 DM and in 46,2% of patients with type 2 DM. The prevalence of this indicator was increased with patient age and duration of DM, as well as poor control of carbohydrate metabolism and blood pressure. The prevalence of CKD stages 2-3 was significantly higher in patients with type 2 DM than in patients with type 1 diabetes. Further examination for identification of causes of non-diabetic CKD is required in 15% (type 1 DM) and 41.2% (type 2 DM) patients with MAU and GFR <60 ml/min/1.73 m².
Conclusion: The annual screening can detect complications of diabetes mellitus at earlier stages. Compensation of carbohydrate metabolism and blood pressure in patients with diabetes mellitus inhibits the progression of DN.
Clinical nephrology. 2010;(3):45-50
45-50
Monocyte chemoattractant protein-1 and transforming growth factor-beta1 urinary excretion as a marker of renal fibrosis in chronic glomerulonephritis
Abstract
Purpose: Estimation the content of fibrogenic mediators - monocytic chemotactic protein-1 (MCP-1) and transforming growth factor-β1 (TGF-β1) in the urine and kidney tissue in patients with CGN, and specification their significance for the evaluation of inflammation and fibrosis in the kidney and as prediction criteria.
Materials and Methods: The study enrolled 83 patients with active CGN (Group I - with moderate urinary syndrome, Group II - with nephrotic syndrome (NS), Group III - with severe proteinuria, arterial hypertension and progressive renal failure). Urinary MCP-1 and TGF-β excretion was analyzed by ELISA method. The control group included 12 healthy individuals. Morphometry of 25 biopsy materials of kidney with measurement of interstitial area, the degree of cellular inflammatory infiltration of the interstitium, as well as the degree of interstitial expression of α-SMA, main myofibroblastic marker, were performed.
Results: The level of urinary MCP-1 excretion was higher in all groups of patients with active CGN as compared with healthy controls, and in patients with NS (Group II) was significantly higher than in patients with moderate urinary syndrome (Group I). In particular, high level of urinary MCP-1 excretion was in Group III. The level of TGF β was also higher in CGN patients as compared with healthy controls. The TGF-β excretion was depend mainly on the level of creatininemia, and high level of TGF-β excretion was observed in patients with severe progressive course of nephritis with persistent renal dysfunction (Group III). There was a direct correlation between levels of urinary MCP-1 excretion and the severity of inflammatory cell infiltration of interstitium (RS = 0.8, P<0.001). Levels of urinary MCP-1 and TGF-β excretion were correlated with the value of TIF, estimated by interstitium area (RS = 0.78, P<0.001 and RS = 0.5, P<0.05, respectively), and with the number of major producers of TIF - interstitial myofibroblasts expressing α-SMA (RS = 0.64, P<0.05 and RS = 0.65, P<0.05, respectively).
Conclusion: The results demonstrate the important role of MCP-1 and TGF-β1 in the remodeling of tubulointerstitium. The studied parameters are markers of TIF, and the definition of urinary MCP-1 and TGF-β1 excretion is a helpful noninvasive method that allows monitoring disease activity and fibrosis stages, and assesses the prognosis of CGN
Clinical nephrology. 2010;(3):51-55
51-55
56-61
62-67
68-71
72-75
THERAPEUTICAL TRIALS IN NEPHROLOGY
Clinical nephrology. 2010;(3):76-77
76-77
78-79