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No 6 (2011)
- Year: 2011
- Articles: 13
- URL: https://journals.eco-vector.com/2075-3594/issue/view/6303
Articles
The Global Role of Kidney Transplantation
Abstract
World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.
Clinical nephrology. 2011;(6):4-8
4-8
9-15
16-24
Role of ADAMTS13 deficiency in development of renal microcirculatory tromboses, not associated with thrombotic, thrombocytopenic purpura
Abstract
Aim. Assessment of activity of ADAMTS13, von Willebrand factor and thrombocytes in patients with thrombophilic states and kidney diseases.
Methods. 20 patients with thrombophilia (genetically based and antiphospholipid syndrome) and kidney diseases (lupus nephritis, chronic glomerulonephritis) with morphological signs of renal thrombotic microngiopathy were included into the study. In all patients serum activity of ADAMTS13 and von Willebrand factor was determined.
Results. Serum activity of ADAMTS13 below the reference (<93%) values (56-92%) was found in 8 (40%) of patients. Serum activity of ADAMTS13 inversly correlated with level of von Willebrand factor (r= -0,3, р<0,05) and directly correlated with thrombocytes blood count (r= 0,57, р<0,01). The most low levels of serum activity of ADAMTS13 were seen in 2 patients with morphological signs of renal acute thrombotic microangiopathy.
Conclusion. Deterioration of ADAMTS13 - von Willebrand factor - thrombocytes cascade can be interpreted as universal mechanism of thombus formation in renal microcirculation.
Clinical nephrology. 2011;(6):25-31
25-31
Prevalence of chronic kidney disease and it's etiological structure in patients with rheumatoid arthritis
Abstract
Aim. Assessment of prevalence and ethiological structure of chronic kidney disease (CKD) in rheumatoid arthritis (RA) patients.
Methods. 301 patients, hospitalized with RA in 2010, were screened for signs of CKD: estimated glomerular filtration rate (eGFR) according to MDRD formula, creatininemia were determined, urinalysis, if indications persisted - proteinuria, ultrasound scanning of kidneys, Duplex scanning of renal arteries were performed.
Results. 84,7% of patients with RA demonstrated signs of CKD, in group of patients older than 60 years CKD was found in 96%.In 44,5% of patients with CKD only changes in urinalysis were found, but eGFR values were within normal ranges. In 59,2% of patients with RA CKD II stage was found. eGFR was associated with age, clinical stage and activity of RA, concomitant renal and cardiovascular diseases.
Conclusion. CKD signs can be found frequently in patients with RA.
Clinical nephrology. 2011;(6):32-35
32-35
CLINICAL SIGHNIFICANCE OF ADIPONECTINEMIA IN DEVELOPMENT OF TARGET ORGAN-DAMAGE IN METABOLIC SYNDROME, ASSOCIATED WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Abstract
Aim. Assessment of clinical significance of plasma adiponectin level in development of target organ damage (TOD) in metabolic syndrome, associated with non-alcoholic fatty liver disease.
Methods. 86 patients (64 male, 22 female; mean age 44+11 years) with metabolic syndrome, associated with non-alcoholic fatty liver disease (ultrasound features of hepatic stetatosis and/or non-alcoholic steatohepatitis) were included into the study. Risk factors and plasma levels of leptin and adiponectin were determined.
Results. Frequency of left ventricular hypertrophy, carotid atherosclerosis and chronic kidney disease increaser significantly according to the elevation of number of signs of target organ damage. Patients with >3 signs of target organ damage had the highest rate of non-alcoholic steatohepatitis (78% vs 39% in patients with 1 sign of TOD, р<0,05). Increase in number of signs of TOD was associated with elevation of leptin/adiponectin ratio. Plasma level of adiponectin significantly decreased in patients with carotid atherosclerosis (14,9±10,8 vs 32,5±22,5 mcg/ml, р=0,005) and inversely correlated with intima-media thickness of common carotid artery. Plasma adiponectin level directle correlated with HDL plasma level, leptinemia and DeRitis ratio.
Conslusion. In metabolic syndrome, associated with non-alcoholic fatty liver disease, organoprotective effects of adiponectin gradually diminish, that leads to increase of intensity of TOD.
Clinical nephrology. 2011;(6):36-41
36-41
СLINICAL INTERRELATIONS OF ARTERIAL HYPERTENSION AND GOUT
Abstract
Aim. Characteristics of interrelations of arterial hypertension, uric acid metabolism parameters and severity of gout.
Methods. 65 patients with gout without chronic kidney disease were included into the study; 50 of them had arterial hypertension. Standard biochemical parameters of blood and urine, characterizing uric acid metabolism, were analyzed.
Results. Hypertensive patients had more severe gout (severity index 3,6 [2,7; 5] vs 2,2 [2; 3]) and higher levels of uricemia (555[472,5; 625,5] vs 454 [355;504] mcmol/l). Patients with arterial hypertension III stage had highest levels of uricemia and the most severe gout.
Conclusion. Uricemia and severity of gout increased according to the enhancement of arterial hypertension.
Clinical nephrology. 2011;(6):42-44
42-44
Inborn arterio-venous renal fistules: mini-invasive diagnosis and treament
Abstract
Renal arteriovenous malformations (AVMs) are abnormal communications between the intrarenal arterial and venous systems. These malformations are either congenital, acquired (often by iatrogenic means) or idiopathic, and are usually diagnosed while revealing the source of macrohematuria (Multislice spiral CT or angiography). Endovascular method - super selective embolization (SSE) was widely implemented (as monotherapy) in diagnostics and treatment of congenital renal arteriovenous malformations that are clinically apparent during the last decade. This method is considered to be an alternative to an open surgery (kidney resection or nephroectomy).
We posses an experience of successful use of SSE to treat hematuria caused by congenital AVMs in three patients. In all observations we managed to gain a good clinical effect without performing an open surgery. The complications during the embolization and post-embolization period were not observed.
Thus, the SSE is an effective and less invasive method of endovascular diagnostics and liquidation of hemorrhage, caused by congenital renal AVM.
Clinical nephrology. 2011;(6):45-47
45-47
48-51
52-54
55-58
59-66
67-72