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No 5 (2011)
- Year: 2011
- Articles: 13
- URL: https://journals.eco-vector.com/2075-3594/issue/view/6302
Articles
4-16
17-24
24-27
28-35
Cardio-renal interrelations in patients with diabetes mellitus type 2 and obesity
Abstract
Aim. Assessment of interrelations of myocardial remodeling with obesity and development of diabetic nephropathy in patients with dibetes mellitus type 2. (DM 2)
Methods. 84 patients with DM 2 (38 male, 46 female, mean age 58,1±6,3 лет) were included into the study. Body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio were measured. Serum creatinine, uric acid, lipid metabolism parameters, adipokines (leptin, adiponectin) levels were determined. Kidney disease severity was assessed according to glomerular filtration rate (GFR) and albuminuria. Left ventricular myocardial mass (LVM) was measured according to echocardiography. Patients were divided into groups according to h DM duration <5 years and >5 years as well as witth BMI <30 kg/m2 and >30 kg/m2.
Results. In patients with DM duration > 5 years, but not in with DM duration < 5 years, t frequency of left ventricular hypertrophy and kidney disease severity increased according to the obesity enhancemen. Antropometric parameters, uricemia and glycated hemoglobin level were determinants of left ventricular hypertrophy and diabetic nephropathy development.
Conclusion. In diabetes mellitus type 2 obesity favores development of left ventricular hypertrophy and diabetic nephropathy development as clue components of cardiorenal syndrome.
Clinical nephrology. 2011;(5):36-40
36-40
New opportunities in treatment of secondary hyperparathyreoidism in patients on program haemodialysis with combination of cinacalcet and low doses of low doses of vitamin D sterols
Abstract
Aim: The aim of the study was to evaluate the treatment of secondary hyperparathyroidism by combined therapy with cinacalcet and low doses of vitamin D sterols (alfacalcidol).
Methods. 50 hemodialysis patients were analysed. The enrolled subjects were with iPTH >300 pg/ml and serum calcium >1.9 mmol/l. Cinacalcet was titrated sequentially during 12 weeks, starting from 30mg/day to achieve iPTH ‹300 pg/ml . If intact PTH fell below 150 pg/ml, the dose of cinacalcet was reduced to 30mg every other day. Patients received alfacalcidol with mean doses 0.3±0.2 mcg/day. The dose of alfacalcidol could be increased if serum Ca was ‹2.1 mmol/l or in presence of clinical symptoms of hypocalcaemia. Alfacalcidol was discontinued if intact PTH fell below 150 pg/ml. The study continued for 12 months.
Results. After the treatment, mean decreases for serum iPTH were 51.8%, from 748.8±317.6 to 387.9±247.4 pg/ml (р<0.001). Mean concentration of P decreased by 16%, from 2.24±0.68 to 1.87±0.6 mmol/l (р<0.01), Ca decreased by 5.7% (from 2.25±0.25 to 2.12±0.23 mmol/l ,р<0.01) after 3 months therapy, and by 6.2% after 6 months. Serum calcium mostly decreased by 18.5% in patients with hypercalcaemia (Ca>2.5 mmol/l). During the study serum calcium concentration was corrected by application of alfacalcidol or calcim-based binders. Mean values of Са×Р decreased by 17.4% ( from 5.0±1.48 до 4.13±1.36 mmol/l, р<0.01).
Conclusion. Combined therapy with cinacalcet and low doses of vitamin D sterols (alfacalcidol) improved control of secondary hyperparathyroidism in patients on hemodialysis and made it possible to treat subjects with hyper-, hypocalcaemia and hyperphosphataemia.
Clinical nephrology. 2011;(5):41-46
41-46
LONG-TERM SUSTAINED LOW EFFICIENCY DIALYSIS IN TREATMENT OF PATIENTS WITH CARDIORENAL SYNDROME
Abstract
Aim. Assessment of clinical efficacy of long-term sustained low efficiency dialysis in treatment of patients with cardiorenal syndrome (CRS), refractory to standard therapy.
Methods. 31 patients (19 male и 12 female) с CRS were included into the study (age 59 - 82, mean 72,2±1,3 years). Despite use of standard treatment protocols, all patients shown signs of hyperhydration.
Results. Improvement in blood biochemistry and central hemodynamic parameters was registered. Enhancement of diuresis and decrease of furosemide dose was seen.
Conclusion. Long-term sustained low efficiency dialysis is effective in CRS, resistant to standard treatment protocols.
Clinical nephrology. 2011;(5):47-50
47-50
OUTCOMES OF DYSMETABOLIC NEPHROPATHIES: RESULTS OF THE RETROSPECTIVE STUDY
Abstract
Aim. Assessment of long-term outcomes of dysmetabolic nephropathy.
Methods. 40 patients (14 male, 26 female, age 16 - 28 years) with dysmetabolic nephropathy in childhood were included into the study. 30 healthy volunteers served as controls. In all patients parameters, characterizing renal function, were determined.
Results. 2 patients demonstrated isolated crystaluria, 21 - signs of dysmetabolic nephropathy, 10 had tubulo-interstitial nephritis, 7 - isolated changes in urinalysis. In comparison with healthy controls, group of patients, who had dysmetabolic nephropathy in childhood, shown decreased tubular water reabsorbtion, elevated uric acid clearance, fractional excretion of uric acid and calcium, and raised urinary concentration of oxalic acid.
Conclusion. Long-term outcomes of dysmetabolic nephropathy are variable and may be considered for long monitoring of signs of chronic kidney disease in this patients.
Clinical nephrology. 2011;(5):51-53
51-53
URINARY CONCENTRATION OF MATRIX METALLOPROTEINASES -2 AND -9 AND THEIR TISSUE INHIBITORS IN CHILDREN WITH PYELONEPHRITIS
Abstract
Aim. Determination of role of matrix metalloproteinases (MMP) -2 and -9 and their tissue inhibitor (TIMP) in development and progression of pyelonephritis in children.
Methods. 80 children (mean age 8,79 ± 0,26 лет) with pyelonephritis were included into the study. Patients were divided into 4 groups: 1st (n=15) - patients with acute pyelonephritis, 2nd (n= 31) - patients with attack of chronic pyelonephritis, 3rd (n=26) - children with remission of chronic pyelonephritis without urodynamics disorders, 4th group (n=8) - children with chronic pyelonephritis, associated with urinary tract anomalies (vesico-uretral reflux, hydronephrosis, megaureter). 18 healthy children served as a contol group In all patients urinary activity of MMP-2, MMP-9 and TIMP were determined; in active pyelonephritis - at baseline and after 10 - 14 days of antibacterial therapy.
Results. All patients with pyelonephritis demonstrated elevation of excretion of MMP-2, MMP-9 and TIMP. Urinary excretion of MMP-9 was highest in patients with acute pyelonephritis in comparison with control group and patients with chronic pyelonephritis. Antibacterial therapy lead to decrease of urinary activity of MMP-2, MMP-9 and TIMP.
Conclusion. Urinary excretion of MMP and TIMP in pyelonephritis can detect activity of kidney damage and prognosis of renal disease.
Clinical nephrology. 2011;(5):54-57
54-57
Nephroprotective effect of angiotensin-converting enzyme inhibitors in children with Alport syndrome
Abstract
Цель. Оценить эффективность ингибиторов ангиотензин-превращающего фермента (АПФ) у детей с синдромом Альпорта (СА).
Материал и методы. Обследовано 22 ребенка с СА, средний возраст 12,75 ± 0,81 лет. I группа (n = 14) получала ингибиторов АПФ; II группа (n = 8) не получала ингибиторов АПФ. Средняя длительность терапии/наблюдения 2,03 ± 0,28 лет. В динамике оценивали протеинурию, сывороточный уровень креатинина и холестерина крови, расчетную скорость клубочковой фильтрации (СКФ), ультразвуковую картину почек.
Результаты. При применении ингибиторов АПФ снижение протеинурии было отмечено у 75 % детей и только у 12,5 % детей, не принимавших ингибиторов АПФ (р < 0,01). При непрогрессирующем течении СА отмечены достоверные различия в динамике протеинурии (дети, получавшие ингибиторы АПФ, -31,3 % в год; дети, не получавшие ингибиторов АПФ, +127,9 % в год; p < 0,01). При прогрессирующем течении СА ингибиторы АПФ уменьшали протеинурию у 66,7 % больных; у детей, не получавших ингибиторов АПФ, с прогрессирующим течением СА протеинурия не уменьшалась. При хронической болезни почек (ХБП) II cтадии ингибиторы АПФ обусловливали уменьшение протеинурии у 100 % больных, при ХБП I cтадии - у 40 % больных. Предикторами отсутствия эффективности ингибиторов при СА были стабильная протеинурия, холестеринемия > 6 ммоль/л, позднее начало лечения и нарастание эхогенности почечной паренхимы в 1-й год лечения.
Заключение. Целесообразно раннее начало лечения ингибиторами АПФ детей с СА и протеинурией.
Clinical nephrology. 2011;(5):58-63
58-63
The pathomorphological changes in the kidneys of rats in the experimental simulations of infection and non-infected vesicoureteric reflux (experimental study)
Abstract
Path morphological changes in the kidneys of rats were studied in the experimental simulations of urethral stenosis, urinary tract infection, as well as their combination. It is ascertained that every time the simulated pathological processes are be observed, the considerable morphological changes mainly occurred in the tubules and interstitial of the kidneys. The changes presented with signs of infiltrative-productive inflammation as well as fibrosis of differing levels of intensity. A definite correlation between the type of simulated pathological process and the intensity of morphological changes in the kidneys was revealed.
Clinical nephrology. 2011;(5):64-71
64-71
72-77
78-80