No 5 (2013)

Aim. Estimation of influence of peack natriuresis on sodium reabsorbtion enchancement and it's association with urinary excretion of Tamm-Horsfal protein (ТНР). Methods. 28 patients (mean age 47 ± 7,5 years) were included into the study. All patients were randomized to torasemide SR (n = і4) and torasemide IR (n = і4). Sodium excretion was determined in 8 urinary portions, collected every 3 hours during 24 hours; urinary excretion of THP was also analyzed. Questionnarie «Charlton: Salt Screener» was used for determination of salt intake. Results. Area under curve (AUC) of torasemide SR and torasemide IR did not differ significantly, but torasemide SR induced more prolonged diuresis. During 06.00-09.00 no differences in torasemide SR and torasemide IR-induced sodium reabsorbtion were observed, in 09.00—і2.00 interval sodium reabsorbtion demostrated peack of diuretic efficacy, in і2.00—і5.00 sodium reabsorbtion was enchanced in patients on torasemide IR. Sodium reabsorbtion restoration was seen in 24.00-03.00. Peack of urinary ТНР concentration was seen in period of maximum sodium retention. Conclusion. Torasemide SR is characterized by more prolonged elimination period, prolonged natriuresis and absence of sodium retenstion and elevation of Tamm-Horsfal protein.

Aim. Estimation of prevalence, severity, clinical variants and outcomes of acute kidney injury (Akin) in patients, hospitalized with acute decompensation of chronic heart failure. Methods. і83 patients with acute decompensation of chronic heart failure (age 68,9 ± 9,4 years, arterial hypertension in 87%, coronary heart disease in 56%, myocardial infarction in 53%, chronic heart failure in 56%, diabetes mellitus type 2 in 36%, anemia in 20%) were included into the study. akin prevalence was assessed according to KDIGO recommendations (2012). Results. akin was found 4і% of patients; in 55% of them akin was transient. 63% of patients with akin had previous chronic kidney disease. In 56% of patients akin was diagnosed retrospectively accornidng to decrease of creatininemia during hospitalization. akin in acute decompensation of chronic heart failure is associated with unfavorable outcomes: INCREASE in mortality during first 30 days (17% vs 0% in patients without akin) and in frequency of hospitalizations due to chronic heart failure decompensation (48% vs 37% in patients without akin). Conclusion. Acute kidney injury in acute decompesation of chronic heart failure is associated with significant decrease in prognosis.

Aim. Estimation of efficacy of Blemaren therapy in patients with urate nephrolithiasis and uretherolithiasis. Methods. 24 patients (із male, 11 female, age 23 - 65 years) with uretherolithiasis received Blemaren for 1 month. Size of uretheral concrements varied from 0,2 to і,2 sm. Changes of uretheral concrements size was detected by ultrasound scanning, X-Ray and multispiral computed tomography. Results. after Blemaren therapy in і4 (58,3%) patients complete dissolution of uretheral concrements was detected without upper urinary tract drainage. In 10 (4і,7%) patients diminishing of concrement's size was noticed. Conclusion. Blemaren therapy is associated with dissolution of uretheral concrements in more than 50% of patients with urate nephrolithiasis.

Aim. Estimation of efficacy of prophylaxis of cytomegalovirus infection with valganciclovir in renal transplant recipients. Methods. Retrospective study included 349 renal transplant recipients: 17i of them received valganciclovir during 3 - 6 months. Patients, who received tacrolimus, more frequently used tacrolimus, those, who did not -cyclosporine. Median follow-up period duration was > 2 years (25,8 [і2,5; 40,6] months in valganciclovir group, 65.4 [50,6; 97,4] months in control group). Results. Valganciclovir use lead to decrease of frequency of active cytomegalovirus infection during 12 months of follow-up (7,0 % vs 22,6 %, p < 0,001), frequency of replication of all herpes-group viruses (9,2 % vs 32,4 %, p < 0,001); trend to decrease of all pneumonias was also observed (9,7 % vs 16 %, p = 0,ii). 1- and 2-year event-free survival was also higher in valganciclovir group (1-year: 78.4 % vs 65,2 %, P = 0,006; 2-year: 76,6 % VS 63,5 %, P = 0,009). Conclusion. Use of valganciclovir in renal transplant recipients leads to decrease of frequency of active cytomegalovirus infection and increase in event-free survival.

Aim. Estimation of role of localization, gender and age of clinical signs manifestation in clinical course of renal hypoplasia. Methods. 424 chidren were included into the study: 236 — with renal hypoplasia, 131 — with inborn renal agenesia, 57 — with renal dysplasia. Localisation of anomaly, age and gender of patients were analyzed. Results. Renal hypoplasia and dysplasia are more frequently found in girls, renal agenesia — in boys. Trend for lesion asymmetry was found in children age > 1 year; right-sided localization was seen more often. Renal hypoplasia is diagnosed predominantly in children < 1 year and > 7 years, in whom signs of chronic renal failure are obvious. Mortality is highest in children < 1 year and if localization of renal anomaly is bilateral. Conclusion. Renal hypoplasia in children is associated with unfavorable prognosis, especially in children age < 1 year and in bilateral localization of anomaly.

Risk factors and mechanisms of development and progression of chronic kidney disease are reviewed.