No 2 (2014)

Разработаны Комитетом экспертов Российского кардиологического общества (РКО), Научного общества нефрологов России (НОНР), Российской ассоциации эндокринологов (РАЭ), Российского медицинского общества по артериальной гипертонии (РМОАГ), Национального общества по изучению атеросклероза (НОА), Российского научного медицинского общества терапевтов (РНМОТ)

Aim. Analysis of the structure of nephrotuberculosis and definition of clinical symptoms of the disease at current stage. Methods. a retrospective analysis of a computer database of 112 newly diagnosed patients with nephrotuberculosis who were registered from 2006 to 2013 was performed. Clinical and sex-age structure of the disease, the methods of detection and the main symptoms of 112 patients with nephrotuberculosis and 74 patients with ureteral stricture of nonspecific etiology were evaluated. The presence of specific disease of urinary tract organs and/ or ureteral strictures were criteria for the inclusion in the study (n = 186). Depending on the etiology of the disease and the presence of ureteral stricture, all patients were divided into 3 groups. The first group included 48 (25.8 %) patients with nephrotuberculosis without extension to the ureter. The second group consisted of 64 (34.4 %) patients with renal tuberculosis involving the ureter. Third group consisted of 74 (39.8 %) patients (37 women and 37 men) with ureteral stricture of nonspecific genesis aged 18 to 80 (48.5 ± 1.7) years. Results. Tuberculosis of the kidney with extension to the ureter is characterized by high proportion of the later stages of degradation of the kidney, cri, involvement of the bladder and the perirenal tissue in inflammation compared with isolated nephrotuberculosis. cri against the background of a specific ureteritis is significantly pronounced than in uretral stricture of nonspecific genesis. Conclusion. In the structure of nephrotuberculosis, more than half of cases accounted for advanced destructive forms of the disease with the most severe clinical course, with typical predominance of persons older than 50 years among patients with advanced destructive forms of nephrotuberculosis, reflecting the pathogenesis of renal tuberculosis - a slow progressive course of the disease.

Aim. Diagnosis of chronic kidney disease at early stages. Methods. The 50 patients aged 18 to 76 years (51.7 ± 1З.4) with risk factors for renal disease (arterial hypertension, hypercholesterolemia, intrarenal vessels) were examined. The comparison group consisted of 30 volunteers without CKD risk factors and signs of kidney damage. We examined the NGAL levels and calculated NGAL / albumin ratio in all patients. Results. According to the proposed method, the coefficient of NGAL/albumin above 0.27 indicates presence of CKD.

Aim. Determination of the features of changes of matrix metalloproteinases and their inhibitors as criteria of disease progression in children with autosomal dominant kidney disease. Methods. The study included 26 children (15 boys and 11 girls ) aged 4 to 16 years (mean age - 11.7 ± 4.81) with autosomal dominant polycystic kidney disease. Main components of proteolysis - matrix metalloproteinases (MMP -1, MMP -2, MMP -3, MMP -9), tissue inhibitors of matrix metalloproteinases (TIMP-1 and TIMP-2) and plasminogen activator inhibitor type 1 (РАI-1) were evaluated in blood and urine by Elisa. Results. Arterial hypertension was revealed in 35 % of cases. Significant correlations between indices of time of arterial hypertension, glomerular filtration rate and ММР, TIMP and РАI -1 were identified. The relationship between the MMP-3, MMP-9, РАI-1 blood levels, TIMP-1 urine levels, and total kidney volume on CT was found. Excretion of MMP-9 and TIMP-1 in the urine increase with increasing volume of nephrosclerosis on SPECT - CT. Increasing the volume of cysts on SPECT - CT accompanies with increase of blood and urine MMP-2 levels, and urine TIMP-1 levels. Reduction of integral reuptake index leads to the increase levels of matrix metalloproteinase inhibitors: TIMP -1 in urine and the activity of РАI -1 in the blood. Conclusion. The relationships between matrix metalloproteinases and their inhibitors and clinical signs of autosomal dominant polycystic kidney disease in children suggest an important role of matrix metalloproteinases and their inhibitors in the mechanisms of disease progression through their participation in the development of fibrotic changes, and justifies the search for new approaches to inhibit fibrosis in renal tissue aimed tothe correction of imbalances in the system of ММР/ММР inhibitors.

Intraperitoneal bleeding at late postoperative period in CAPD patiens it is enough rare complication. The Late diagnostics hemoperitoneum can bring about unsatisfactory work of peritoneal catheter transfer on gemodialysis, mortal upshot. Presented clinical observation demonstrates the consequences of the late diagnostics extensive intraperitoneal bleedings.