№ 3 (2010)

E.M. Tareev contribution to problem of glomerulonepritis is discussed

Reasons for start of antihypertensive therapy from angiotensin II receptor blockers are discussed.

Risk factors and treatment strategy of chronic kidney disease are discussed

Frequency and prognostic significance of renal function deterioration in acute myocardial infarction are discussed. Approaches for diagnosis of renal failure in acute myocardial infarction and for treatment of such patients are shown

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

Role of obesity in vascular remodeling, both in general population and is special groups of patients. Risk factors and consequences of vascular remodeling in obesity are shown

Observations of patients with systemic amyloidosis with renal and cardiac involvement are discussed

The meaning of term Bright disease and it's history are described.