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No 2 (2011)
- Year: 2011
- Articles: 16
- URL: https://journals.eco-vector.com/2075-3594/issue/view/6299
Articles
Variants of the lupous nephritis course
Clinical nephrology. 2011;(2):5-8
5-8
9-13
Treatment of anemia with methoxypolyethyleneglycol - epoetin beta in patients on haemodyalisis
Abstract
Aim. Determination of efficacy and safety of methoxypolyethyleneglycol-epoetin beta (MEB) in patients with terminal renal failure on hemodyalysis, who previously received recombinant human erythropoietin (rhEPO) preparations.
Methods. 30 patients (14 male, 16 female, mean age 58,5±14,6 years) with terminal renal failure on hemodyalysis were included into prospective study. Baseline hemoglobin (Hb) level was 100 - 130 g/l. All patients were switched from rhEPO to MEB. Duration of study was 12 months.
Results. Mean Hb level at the end of the study was 115,5±13,2 g/l; mean haematocrit level - (Hct) - 33,4±3,2%; no significant difference from baseline levels was detected. Target Hb level was maintained with MEB in 12 months in 85%. Blood pressure levels were stable. MEB was well tolerated.
Conclusion. MEB is effective in maintenance of Hb level in patient on hemodialysis, previously treated with rhEPO
Clinical nephrology. 2011;(2):14-19
14-19
The efficacy and safety evaluation of the domestic erythropoietin-β. The review and open multicenter study report
Abstract
Цель. Оценить эффективность и безопасность отечественного препарата эритропоэтина бета Эпостима при внутривенном введении пациентам на гемодиализе.
Материал и методы. 30 стабильных пациентов на гемодиализе были переведены с оригинальных препаратов эритропоэтина на равные дозы Эпостима на три месяца. В ходе исследования оценивались возможность достичь целевых уровней гемоглобина (Hb) 110-130 г/л, необходимая для этого доза и колебания уровней гемоглобина, а также клинические и биохимические критерии безопасности.
Результаты. У 29 пациентов удалось достичь целевого уровня Hb, у одного с исходным Hb 102 г/л он оставался стабильным. При исходном Hb 112 ± 8 г/л средний за время лечения составил 115 ± 9 г/л. При исходной средней дозе эритропоэтина 104 ± 52 МЕ/кг/нед изменение дозы при переводе на Эпостим составило в группе со стабильно целевым уровнем Hb (n = 12) +7 ± 21 МЕ/кг/нед (р = 0,329), с флуктуациями Hb вниз
(< 110 г/л) +13 ± 17 МЕ/кг/нед (р = 0,036), с флуктуациями Hb вверх (> 130 г/л) +10 ± 30 МЕ/кг/нед (р = 0,319), в целом по группе не достигнув значимого отличия от исходного (+8 ± 23 МЕ/кг/нед, р = 0,093). Нежелательных явлений, связанных с применением Эпостима, зафиксировано не было.
Заключение. В коротком трехмесячном исследовании продемонстрирована возможность внутривенным введением Эпостима в дозах, не отличающихся от доз оригинальных эритропоэтинов, достигать целевых значений гемоглобина у гемодиализных пациентов
Clinical nephrology. 2011;(2):20-26
20-26
Klirens kreatinina v dolgosrochnom prognozirovanii riska serdechno-sosudistoy smerti u bol'nykh ostrym koronarnym sindromom bez pod\"emov segmenta ST
Abstract
Aim. Assessment role of renal dysfunction as a risk factor of cardiovascular death in patients with acute coronary syndrome (ACS) without ST elevation in prospective clinical study.
Methods. 149 patients with ACS without ST elevation were prospectively observed during 1 year. Renal function was estimated according to the creatinine clearance; microalbuminuria was also determined. Role of renal damage sighs as risk factors of cardiovascular death was evaluated.
Results. During 6 and 12 months lowering of creatinine clearance was associated with higher mortality (р<0,001). Creatinine clearance correlated with 12 month mortality (p=0,004).
Conclusion. Lowering of creatinine clearance is on of the markers of unfavorable prognosis in ACS without ST elevation
Clinical nephrology. 2011;(2):27-30
27-30
Use of trihydric iron preparations in treatment of anemia in patients with pre-dialysis renal failure
Abstract
Aim. Study of prevalence of anemia and iron deficiency in patients with chronic kidney disease (CKD) stage III - IV and assessment of trihydric iron preparations. Methods. 234 patients with chronic glomerulonephritis (primary and in systemic diseases) were included into the study; all of them had CKD III - IV stage. In 141 patients oral (Maltofer) and intravenous (Venofer) trihydric iron preparations were used.
Results. Anemia was revealed in 185 (84,2%) patients with CKD III - IV stages; prevalence of anemia increased according to glomerular filtration rate (GFR) decrease. In patients with systemic diseases anemia and iron deficiency were found more often even in mild decrease of GFR. Maltofer and Venofer were effective in anemia correction in CKD stage III - IV patients.
Conclusion. Anemia is frequent in CKD stage III - IV patients, especially in systemic diseases; in its correction trihydric iron preparations are effective
Clinical nephrology. 2011;(2):31-34
31-34
Structural remodeling of myocardium in patients with arterial hypertension, receiving chronic haemodyalisis
Abstract
Aim. Study of role of terminal renal failure, haemodialysis, arterial hypertension on myocardial remodeling.
Methods. 371 patients (172 - on program haemodialysis, 116 - with predialysis renal failure, 83 - with preserved renal function) were included into the study. Standard methods of investigations were used.
Results. In patients with terminal renal failure types of myocardial remodeling depended on duration of chronic kidney disease and arterial hypertension, blood pressure (BP) level and serum lipoproteins level. Left ventricular mass index (LVMI) depended on gender, age, BP and serum lipoproteins concentrations. Conclusion. Arterial hypertension and chronic kidney disease predisposes to myocardial remodeling in patients with terminal renal failure, receiving program haemodialysis.
Clinical nephrology. 2011;(2):35-39
35-39
PATIENT TRAINING AS AN APPROACH TO ENHANSING OF TREATMENT COMPLIANCE IN RENAL ARTERIAL HYPERTENSION
Abstract
Aim. Study of patient training role in enhancing of treatment compliance in renal arterial hypertension.
Methods. In nephrological department patients training about risks, associated with arterial hypertension, and aims of antihypertensive therapy was performed.
Results. Baseline treatment compliance was low; patients also were poorly adherent to doctor prescriptions and did not control their blood pressure (BP) levels; none of them had target BP levels. After 6 month of training treatment compliance significantly improved, 25% reached target BP levels.
Conclusion. Patients training helps to improve compliance to antihypertensive therapy in renal arterial hypertension.
Clinical nephrology. 2011;(2):40-44
40-44
EPIDEMIOLOGY AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC RENAL FAILIRE AND ANEMIA, RECEIVING PROGRAMM HEMODYALISISPart 2. Quality of life and costs of erythropoietin treatment
Abstract
Aim. Assessment of life quality of patients with terminal renal failure an its dynamics during erythropoietin treatment.
Methods. Results of survey of 1395 patients with terminal renal failure and anemia, receiving program hemodyalisis, were analyzed.
Results. Most of the patients with terminal renal failure shows deterioration of life quality. Most of the erythropoietin medications can be used to achieve hemoglobin level >100 mmol/l; Eralfon is more effective, than Epocrin and helps to reduce treatment costs.
Conclusion. Erythropoietin medications can improve life quality and reduce treatment costs in patients with terminal renal failure
Clinical nephrology. 2011;(2):45-48
45-48
DYNAMICS OF BASELINE LEVELS OF HEMOSTASIS SYSTEM IN KIDNEY DISEASES
Abstract
Aim. Study of dynamics of baseline hemostasis system activity in chronic kidney diseases.
Methods. Markers of procoagulation, anticoagulation and fibrinolytic system were studied in 131 patient with kidney disease.
Results. Enhancement of prothrombinase and kallikrein blood level in kidney disease is associated with decrease of activity of antithrombin III and C3 complement. Elevation of plasma heparin level, fibrinogen/fibrin degradation products and complexes of heparin with thrombogenic plasma proteins was also observed. Acceleration of I and II phases of hemostasis is combined with inhibition of III phase.
Conclusion. Dynamics of activity of coagulation and anticoagulation systems is observed in kidney diseases
Clinical nephrology. 2011;(2):49-51
49-51
Structure of morphological changes in kidneys and role of kidney biopsy in correction of treatment strategy of nephropathies in Moscow region residents
Abstract
Aim. Analysis of frequency of morphological forms of chronic kidney disease in Moscow region residents, hospitalized into department of internal diseases.
Methods. 49 patients (32 male, 17 female, age 19 - 73 years) were included into the study. Clue signs of kidney diseases were haematuria in 40%, leucocyturia in 15,8%, hyaline and granular casts in the urine in 29,6%, nephrotic syndrome in 48,9%, anemia in 35,8%, arterial hypertension in 50%, chronic renal failure in 55%. In 26 patients renal biopsy was performed. Staining of renal tissue with haematoxylin-eosin, trichrom, PAS-reaction, Kongo-roth and immunofluorescence were performed.
Results. Kidney biopsy revealed 10 variants of morphological changes of renal tissue. The most frequent was focal and segmental glomerulosclerosis (10 (38,5%) patients), IgA-nephropathy (3 (12,5%) patients), and amyloidosis (3 (11,5%) patients. Results of kidney biopsy lead to patients referral to specialized nephrological clinical centers and/or start of active immunosuppressive therapy.
Conclusion. Kidnet biopsy, performed in patients with chronic kidney diseases, hospitalized to internal diseases departments, help to confirm diagnosis and promotes adequate choice of treatment strategy.
Clinical nephrology. 2011;(2):52-55
52-55
mycophenolate mofetil IN TREATMENT OF STEROID-RESISTANT NEPHROTIC SYNDROME IN CHILDREN
Abstract
Aim. Assessment of efficacy and safety of micofenolat mofetil in treatment of primary steroid-resistant nephrotic syndrome in children.
Methods. 18 children with primary non-familial steroid-resistant nephrotic syndrome (7 patients with focal-segmental glomerulosclerosis, 7 - with mesangioproliferative glomerulonephritis, (GN), 3 - with minimal change nephrotic syndrome, 1 - with membranoproliferative GN) were included into the study. Mycophenolate mofetil was 31,8 mg/kg/24h was dispensed with methylprednisolone (0,5-1,0 mg/kg/48h).
Results. Complete clinical and laboratory remission was achieved in 22% of patients, partial - in 28%, 50% demonstrated no effect. Efficacy of micofenolat mofetil did not depend of morphological type of nephrotic syndrome. Adverse events were registered in 28% patients: immunodepression in 17%, anemia - in 11%.
Conclusion. Micofenolat mofetil сan induce complete or partial remission in 50% of children with steroid-resistant nephrotic syndrome
Clinical nephrology. 2011;(2):56-60
56-60
61-69
70-74
75-78
79-79