No 3 (2014)

Aim. Study of association of асе, CYP11B2 and NOS3 gene polymorphisms with echocardiographic signs of left ventricular (LV) remodeling in patients with chronic glomerulonephritis. Methods. Echocardiography was performed in 80 patients with chronic glomerulonephritis (38 male, 42 female). Left ventricular hypertrophy/left ventricular diastolic dysfunction were detected. Polymorphysms of the following genes were INDENTIFIED: I/d of асе gene, С(-344)Т OF СУР11В2 GENE AND 4A/4B OF NOS3 GENE. Results. Left ventricular hypertrophy was detected in 2і,7 %, left ventricular diasctolic dysfunction in 26,3 % of patients with chronic glomerulonephritis. Signs of cardiac remodeling were associated with age, body mass index (BMI), blood pressure (ВР), smoking, dyslipoproteidemia, hyperphibrinogenemia, glomerular fitration rate and serum phosphate concentration. Polymorphisms of асе, CYP11B2 and NOS3 genes were not associated with left ventricular hypertrophy prevalence. Carriers of T allele of CYP11B2 gene demonstrated higher values of integral of velocity of left ventricular left filling and lower levels of Е/а index in comparison with СС homozygotes. Carriers of T allele of CYP11B2 gene also had a trend to increase of end diastolic size of left ventricle. Diastolic dysfunction was more often found in 4b allele homozygous carriers of NOS3 gene. Conclusion. Polymorphisms of renin-angiotensin-aldosterone system genes and NOS3 gene are not associated with left ventricular hypertrophy in chronic glomerulonephritis. Carriers of 4b/4b allele of NOS3 gene have a trend to left ventricular dysfunction development.

Aim. Study of prevalence of various types of cardiac remodeling in patients with predialysis stages of chronic kidney disease (CKD). Methods. 123 patients with chronic kidney disease stage II - IV were included into the study. Prevalence of pathological types of cardiac remodeling was assessed and echocardiographical description of structural modification of left ventricle was performed. Resulys. Structural remodeling of left ventricle was found in 31% of patients with predialysis chronic kidney disease. Most frequently (in і7,8% of patients) eccentric remodeling of left ventricle was found. Left ventricular end diastolic size (5,56±0,09 SM) and end diastolic volume (152,4±5,7 ml) were highest in patients with eccentric remodeling of left ventricle. Conclusion. Almost one third of patients with predialysis chronic renal failure demonstrate echocardiographic signs of left ventricular remodeling.

Aim. Determination of diagnostic ability of anthropometry and bioelectric impedance analysis in early diagnosis of nutritive disorders in chronic kidney disease (CKD) patients. Methods. 180 patients with CKD (80 - CKD ііі - IV stages, 1ОО - CKD V stage, 61 male and 119 female; age 21 - 80 (mean 46,7 ± io,8) years) were included into the study. Standard anthropometry and bioelectric impedance analysis were performed in all patients. Results. Lean body mass and body fat mass can be detected more precisely by bioelectric impedance analysis. Nutritive disorders in CKD are associated with estimated glomerular filtration rate < ЗО ml/min/1,73 m 2, anemia, hypalbuminemia, depression and some nutritional habits. Nutritive status in CKD can be corrected with low-protein diet supplied with keto-aminoacids. Conclusion. Bioelectric impedance analysis is useful in diagnosing pf nutritive disorders in chronic kidney disease patients.

Aim. To improve the outcomes of pregnancy and childbirth, based on early diagnosis of endothelial dysfunction in women with hypertension without significant proteinuria and conducting medical and preventive actions aimed at its correction. Methods. Study design: a comparative longitudinal prospective cohort. We examined 80 women, ЗО of them - with gestational hypertension, received comprehensive treatment using sulodexide, 30 - the same without sulodexide and 20 - with normal blood pressure (control). Research methods included: clinical, laboratory (study of the hemostatic system, spontaneous and stimulated platelet aggregation, von Willebrand factor), functionality (ultrasonic and fetometry placentometry, Doppler, electrocardiography, kardiomonitoring of the fetus), and morphological methods (macroscopic and organometric of placenta). Results. The analysis of the effect of therapeutic factor (sulodexide) largest odds ratio in patients with gestational hypertension (GAG ) compared with conventional therapy showed that CRF OR=0,18 (95 % CI 0,18-0,54), VZRP OR=0,16 (95 % Cl 0,04-0,48 ), hypoxia OR=0,15 (95 % Cl 0,04-0,59). That is a retrospective comparison of the influence of this factor on the two groups showed a significant decrease these complications when using it. Conclusions. The effectiveness of complex treatment in the early stages of placental insufficiency in women with gag using LMWH is determined at a frequency of chronic placental failure (23,3 % vs. 63,3 %) and the risk of chronic fetal hypoxia and intrauterine growth retardation reduced by З times and depends on the severity of compensatory reactions of the placenta.

Aim. Assessment of prostatic expression of protein KI-67 and collagen IV in benign prostatic hyperplasia and prostatic cancer. Methods. Specimes of prostatic tissue of 53 patients (age 52-83 years) with prostatic adenocarcinoma and 10 -with benign prostatic hyperplasia were analysed. All patients were BIOPSIED in 2010-2014 years. Results. High expression of collagen IV was found in benign prostatic hyperplasia, in prostatic adenocarcinoma expression of collagen IV was low. Glisson scale stage corellated with cell proliferation index according to KI-67 expression (rs =0,674). Conclusion. Measurement of KI-67 expression can be used in differential diagnosis between benign prostatic hyperplasia and prostatic adenocarcinoma.

18 апреля 2014 г. в Москве состоялось заседание Российского экспертного совета по проблеме тромботических микроангио-патий, в состав которого вошли представители ведущих российских нефрологических школ, в т.ч. педиатрических. Заседание было посвящено проблемам современной диагностики и лечения атипичного гемолитико-уремического синдрома, одного из немногих в настоящий момент орфанных заболеваний в нефрологии. Внимание к проблеме ТМА в России было привлечено относительно недавно, в связи с чем главным фактором, ограничивающим успешную диагностику и лечение, является низкая информированность врачей об этой группе болезней. Руководствуясь международным опытом и принятыми в разных странах мира национальными рекомендациями, участники Экспертного совета обсудили задачи, стоящие перед Российским нефрологическим сообществом в области диагностики и лечения атипичного гемолитико-уремического синдрома. Результатом работы Экспертного совета стала Резолюция, представленная вашему вниманию.