No 2 (2015)

This literature review analyzes the evolution of views on the initial events that cause the development of mineral and bone disorders in patients with kidney disease. Specific attention is given to disturbances of the Wnt-signal transmission. According to modern concepts it is the most important cause of the formation of bone tissue pathology even in the absence of other manifestations of mineral and bone disorders.

The aim of the study was to investigate the incidence and severity of acute kidney injury (AKI) defined according to the KDIGO Recommendations in patients with community-acquired pneumonia (Cap). 162 patients with cap were included in the study. It was found that cap was complicated by AKI in 16.7% of cases. Most Aki cases were observed in elderly patients with respiratory failure, a history of urinary tract diseases, systolic hypotension of <90 mm Hg and diastolic hypotension of <60 mm Hg. aki was associated with an increased risk of poor prognosis in patients with community-acquired pneumonia.

Objective. To study features of renal dysfunction and risk factors for CKD in COPD patients. Materials and methods. 300 inpatient medical records (form 003/y) of the Pulmonary Department of Krasnodar Тен №2 with the verified diagnosis of COPD stages і-iv (76.3% male, mean age 68.51±9.85 years, the average length of the disease 20.9±3.2 years; 23.6% women, mean age 65.95±10,1 years, average length disease 17.2±2.2 years). Estimated glomerular filtration rate (eGFR) was calculated in all patients with the use of the CKD-Ері equation. results. Moderate reduction of eGFRCKD-EPI 89-60 ml/min/i,73m 2 (37.з%), hyperfiltration was found in 22% of patients, eGFRCKD-EPI reduction ranged from 59 to 45 ml/min/1,73m 2 was detected in 26.7% of patients and eGFRCKD-EPI of 44-30 ml/min/1,73m 2 - in 3.3% of patients. There was a high prevalence of potentially modifiable CKD risk factors: ELEVATED CRP LEVELS - in 100% of patients, smoking - in 92%, age 65 years - in 78.6%, hypertension - in 65.6%, genitourinary diseases - in 53 3%, excess BMI and obesity -in 36%, long-term use of NSAIDS - in 36%, impaired carbohydrate metabolism - in 17.6%. Conclusions. The high prevalence of risk factors for CKD and reduced eGFRCKD-EPI in COPD patients shows that special attention to renal function should be paid in these patients.

The purpose of the study: To develop a complex program for the treatment of multi-symptom enuresis in children based on analysis of etiopathogenic factors leading to the formation of the disease. Material and methods: 107 patients aged 5 to 12 years with complaints of bedwetting with features of primary enuresis, occurring at least 3 times a month and lasting at least 3 consecutive months were enrolled in the study. Exclusion criteria were the presence of malformations of the urinary system, requiring surgical correction; acute infection of the urinary system; chronic kidney disease; acute stage of chronic somatic comorbidities; endocrine diseases; organic pathology of the central and peripheral nervous system; mental disorders. The study used the following methods: clinical signs and history, laboratory tests, urodynamic examination, instrumental radiological and neurophysiological methods, examination of the autonomic nervous system, assessment of quality of life (questionnaire Pediatric Quality of Life Inventory - PedsQL TM4.0). Results: The most important etiopathogenetical factors of primary multi-symptom enuresis (PME) in children were identified and their role in the development of the disease was established. The role of the autonomic nervous system dysfunction in the development of PES in children depending on the functioning of the bladder was proven. Affected aspects of quality of life were determined and the necessity of early treatment of children with PES was substantiated. Given the findings of the study, combination therapy was proposed and substantiated. Its efficacy was evaluated and compared with monotherapy. The study results showed a significant positive cumulative effect (82.5%) of the combination therapy of multi-symptom enuresis (p<0.05).

The number of patients in need of renal transplantation is steadily increasing. The demand for donor organs remains high. This paper analyzes the theoretical aspects as well as the clinical efficacy of extracorporeal membrane oxygenation in the renal transplant program for preconditioning of asystolic donors.

The article discusses the growing number of elderly patients with chronic kidney disease. Renal transplantation is considered to be an effective treatment modality for end-stage kidney disease. The authors provide the analysis of renal transplantation results (2009-2013) in two groups: patients aged 18 to 55 years and those older than 55 years. In conclusions, renal transplantation offers a substantial advantage in elderly patients.