No 2 (2013)

Aim. Study of clinical significance of serum concentrations of fibroblast growth factor-23 (FGF-23)/Klotho in patients with chronic kidney disease (CKD) stages I — V were . Methods. 70 patients (30 male, 40 female) with CKD stages I — V (mean age 41±6,7 years) were included into the study. Signs of target organ damage, serum concentrations of FGF23/Klotho were determined. Results. Serum concentration of FGF23/Klotho was associated with serum C-reactive protein level (r = (+)0,370, p<0,01 and r = (-) 0,453, p<001), nutritive status ( r = (+)0,559, p<0,01 and r = (-)0,581, p<0,01) and proteinuria (r = (+)0,305, p<0,05 and r = (-)0,502,p<0,01). Coefficient FGF-23/Klotho correlates with anemia severity. Conclusion. Determination of FGF23/Klotho can be used for determination of prognosis of CKD.

Aim. Optimization of early diagnosis of chronic kidney disease (CKD) in men with solitary functioning kidney by means of comorbidity analysis. Methods. Comorbidities and androgen status in 90 men (mean age 54,5±5,2 years) with solitary functioning kidney were analysed. Results. 65,6% men with solitary functioning kidney have comobities, 35,5% - androgen deficiency, which is most frequently found in patients with obesity and diabetes mellitus. Obesity, insulin-resistance and diabetes mellitus are predominantley seen in patients with androgen deficiency. Estimated glomerular filtration rate (eGFR) was the most valuable parameter in characterization of kidney function and correlated with endogenous testosterone level (r=0,245, p<0,05). Conclusion. In men with solitary functioning kidney decrease of estimated glomerular filtration rate is associated with androgen deficiency and connected comorbidities.

Aim. Estimation of influence of immunological selection of donor-recipient pair on renal allograft survival. Methods. Renal allograft survival was analyzed in 347 patients, undergone renal allotransplantation (mean age 36,98±0,60 years (12 - 58 years), 229 male, 118 female). HLA antigenes (a, b and DR-loci) were typed by serological method and genetic analysis. Results. Renal allograft survival improved in patients, in whom genetic analysis was used for selection of donor-recipient pair. Number of non-coincident antigen pairs influenced renal allograft survival, which was longest in patients with no dr loci non-coincidence. Conclusion. Immunological selection of donor-recipient pair is useful for prologation renal allograft survival.

Modern classification of systemic vasculitides, approved by international experts committee, is discussed.

Aim. Characteristics of clinical and morphological signs of focal segmental glomerulosclerosis in Kazakh children. Methods. Focal segmental glomerulosclerosis (FSGS) was diagnosed in renal biopsy in 19 children with steroid-resistant nephrotic syndrome. Clinical, laboratory signs and renal prognosis were analyzed. Results. In 47,4% of children tip-lesion or typical variants of FSGS were found. Cellular and perihilar variants of FSGS were not found. There were significant correlations between glomerular and tubular damage. Arterial hypertension and hematuria, but not proteinuria, determinate poor prognosis in FSGS. Conclusion. One of the main causes of steroid-resistant nephrotic syndrome in Kazakh children is typical or tiplesion variants of focal segmental glomerulosclerosis.

Modern statement on congenital anomalies of kidney and urinary tract (CAKUT) syndrome in children is shown with description of case reports.

Role of salt-sensitivity and salt consumption in development of arterial hypertensiona and target organ damage is reviewed.