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No 4 (2010)
- Year: 2010
- Articles: 12
- URL: https://journals.eco-vector.com/2075-3594/issue/view/6295
Articles
4-11
12-18
19-25
Vyzhivaemost' bol'nykh terminal'noy khronicheskoy pochechnoy nedostatochnost'yu, poluchayushchikh postoyannyy ambulatornyy peritoneal'nyy dializ
Abstract
Aim. Estimation of cumulative survival and factors of unfavorable prognosis in patients with terminal renal failure, receiving continuous peritoneal dialysis (CAPD).
Methods. In 20 male and 30 female on CAPD were performed echocardiocardiography (in dry and full with dialysis solution abdominal cavity), 24-hour ECG-monitoring and blood pressure monitoring, ultrasound scanning of kidneys and vena cava inferior.
Results. Cardiovascular complications were major (33,4% among all causes) cause of death in patients on CAPD. The leadings factors of cardiovascular remodeling in CAPD patients were serum albumin level <38 g/l, latent or evident hyperhydratation, low residual kidney function and levels of fractional urea clearance and creatinine clearance below the goal values.
Conclusion. Cardiovascular causes are the leading cause of death in CAPD patients.
Clinical nephrology. 2010;(4):26-33
26-33
ROL' AL'DOSTERONA V PORAZhENII POChEK PRI METABOLIChESKOM SINDROME, ASSOTsIIROVANNOM S OZhIRENIEM
Abstract
Aim of the study. To determine role of aldosterone in chronic kidney disease development in metabolic syndrome, associated with obesity.
Materials and methods. 79 patients with metabolic syndrome (64,6% male, 35,4% female, age 36 - 58 years) were included into the study. All patients were divided into 3 groups: 1st with body mass index (BMI) 25,0-29,9 kg/m², 2nd - with BMI 30,0-39,9 kg/m², 3rd - третья - с with BMI >40,0 kg/m². In al patients microalbuminuria, plasma renin activity and aldosterone concentration, insulin and HOMA-insulinoresistance (HОМА-IR) were determined.
Результаты. As BMI increased, plasma aldosterone concentration rose independently of plasma renin activity. Plasma aldosterone concentration was directly associated with lipid and glucose metabolism parameters and iverslu associated with glomerular filtration rate. Plasma aldosterone concentration was an independent determinant of microalbuminuria.
Conclusion. Rise of plasma aldosterone concentration is one of the independent risk factor of development of nephropathy, associated with metabolic syndrome and obesity.
Clinical nephrology. 2010;(4):34-44
34-44
PORAZhENIE POChEK I NARUShENIYa V SISTEME GEMOSTAZA PRI PODOSTROM INFEKTsIONNOM ENDOKARDITE
Abstract
Aim of the study. Determination of kidney affection peculiarities and role of haemostasis disoders in it's development in infective endocarditis.
Material and methods. 120 patients with infective endocarditis were included into the study. In all of them routine blood and urine parameters, as well as bacteriological and haemostasis tests were performed. 2-dimension transthoracic and transesopahgeal echocardiography, ultrasound scanning of kidneys were also done.
Results. Sighs of kidney involvement were detected in 77% of patients. In 90,3% changes of the urinalysis were seen, in 87% - haematuria, in 50% - proteinuria, in 55% - leucocyturia. Chronic kidney failure developed in 33,3% patients. In 10% ultrasound sighs of renal infarction were detected. In 10 autopsies were shown, that all of this patients with infective endocarditis had glomerulophritis, most of them - membranoproliferative, 6 of them had kidney infarctions. In 43 (46,2%) of patients severe disorders of haemostasis system were detected. Changes of urinalysis correlated with severity of haemostasis system disorders.
Conclusion. Renal involvement in infective endocarditis is associated with various changes of the urine, renal failure and kidney infarctions are frequent. Membramoproliferative glomerulonephritis is the most frequent type of glomerulonephritis in infective endocarditis patients. Haemostasis disorders are often seen in infective endocarditis, associated with kidney involvement and determine the severity of the urine changes.
Clinical nephrology. 2010;(4):39-44
39-44
NEFRINURIYa KAK POKAZATEL' STRUKTURNO-FUNKTsIONAL'NYKh NARUShENIY GLOMERULYaRNOGO FIL'TRA U BOL'NYKh PROTEINURIChESKIMI FORMAMI NEFRITA
Abstract
Aim of the study. Determination of urinary excretion of nephrin as a marker of kidney damage and glomerular barrier deterioration in patients with chronic glomerulonephritis.
Materials and methods. 74 patients with chronic glomerulonephritis were included into the study - 18 with non-active nephritis (1st group), 18 - with prominent changes in urinalysis (2nd group), 38 - with nephrotic syndrome (3rd group). 10 healthy subjects were included into the control group. Urinary excretion of nephrin was determined by ELISA method. In 23 patients with nephrotic syndrome urinary excretion of nephrin was assessed according to the immunosupressive therapy efficacy.
Results. Urinary excretion of nephrin was higher in active forms of glomerulonephritis, in patients with nephrotic syndrome (3rd group) - significantly higher, than in patients with prominent changes in urinalysis (2nd group). Value of urinary excretion of nephrin was connected with presence of arterial hypertension and duration of nephrotic syndrome: <17 ng/ml in less than 6 months, >17 ng/ml in >17 ng/ml. Patients with urinary excretion of nephrin <17 ng/ml had 23-fold higher probability of nephrotic syndrome remission.
Conclusion. Urinary excretion of nephrin can be used as a marker of glomerular barrier damage, glomerulonephritis activity and immunosupressive therapy efficacy.
Clinical nephrology. 2010;(4):45-51
45-51
OSOBENNOSTI TEChENIYa INFEKTsIONNOGO ENDOKARDITA U PATsIENTOV, NAKhODYaShchIKhSYa NA PROGRAMMNOM GEMODIALIZE
Abstract
Aim of the study. To study clinical evolution of infective endocarditis in patients with terminal renal failure, receiving chronic hemodyalisis.
Materials and methods. 5 patients on chronic hemodyalisis with infective endocarditis were analyzed.
Results. Patients on chronic hemodyalisis demonstrated vascular accesses as a gate of infection, rapid development of heart valvular defect (predominantly valvular insufficiency), frequency of aortic valve involvement and unfavorable prognosis.
Conclusion. Infective endocarditis, developed in chronic hemodyalisis patients, is characterized with malignant course, that require development of strategy of its prophylaxis
Clinical nephrology. 2010;(4):52-54
52-54
Vozrastno-polovye osobennosti pokazateley lipidnogo obmena u bol'nykh, poluchayushchie lechenie programmnym gemodializom
Abstract
Aim of the study. To study dynamic of blood lipoprotein parameters in patients with chronic renal failure and determine influence of gender, age and heamodyalisis.
Materials and methods. 283 patients were included into the study, 175 of them received heamodyalisis, 98 - with predyalisis renal failure, 80 had chronic renal failure without renal failure. Among standard clinical, laboratory and instrumental methods of investigation, parameters of lipoprotein metabolism were determined.
Results. Both in men and women lowering of total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol levels in chronic renal failure, especially in patients on haemodyalisis, was detected. In women this type of changes of blood lipoprotein parameters was more prominent.
Conclusion. In patients with chronic, especially terminal, renal failure, influence of gender and age on blood lipoprotein parameters levels should be taken into account.
Clinical nephrology. 2010;(4):55-58
55-58
59-68
69-75
76-80