Early identification of kidney disease can protect kidney health, prevent kidney disease progression and related complications, reduce cardiovascular disease risk, and decrease mortality. We must ask “Are your kidneys ok?” using serum creatinine to estimate kidney function and urine albumin to assess for kidney and endothelial damage. Evaluation for causes and risk factors for chronic kidney disease (CKD) includes testing for diabetes and measurement of blood pressure and body mass index. This World Kidney Day we assert that case-finding in high-risk populations, or even population level screening, can decrease the burden of kidney disease globally. Early-stage CKD is asymptomatic and simple to test for, and recent paradigm shifting CKD treatments such as sodium glucose co-transporter-2 inhibitors dramatically improve outcomes and favor the cost-benefit analysis for screening or case-finding programs. Despite this, numerous barriers exist, including resource allocation, health care funding, health care infrastructure, and health care professional and population awareness of kidney disease. Coordinated efforts by major kidney nongovernmental organizations to prioritize the kidney health agenda for governments and aligning early detection efforts with other current programs will maximize efficiencies.

The coronavirus has emerged as a global health threat due to its rapid geographical spread over the past two decades. This article explores the current understanding of the origin, transmission, diagnosis, and coronavirus disease 2019 (COVID-19). Although COVID-19 is primarily a respiratory disease, the kidneys may be among the target organs for infection with the coronavirus of the 2nd severe acute respiratory syndrome (SARS-COV-2). Regardless of the initial kidney function, acute kidney injury is a common complication of COVID-19 associated with increased morbidity and mortality. COVID-19 most often causes acute tubular necrosis; however, collapsing focal segmental glomerulosclerosis and direct viral tropism of the kidneys have also been documented in some cases. AKI, secondary to COVID-19, has a multifactorial origin. The data presented in the review will help to understand the features of the development and course of acute kidney injury in patients with COVID-19, especially with prolonged viral infection.

The prevalence of urolithiasis, despite the success in its treatment, has been increasing in recent decades. Chronic kidney disease (CKD) is a natural complication of urolithiasis and is therefore also characterized by a tendency to increase in prevalence. This led to our interest in CKD in patients with urolithiasis and approaches to optimizing optimal patient management tactics. The analysis of modern literature sources is carried out, the epidemiological, pathogenetic and clinical aspects of the features of the course of CKD on the background of urolithiasis are considered. Practical recommendations are formulated. 

BACKGROUND. Cancer is the second most common cause of mortality and morbidity in kidney transplant recipients (KTRs) after cardiovascular diseases (CVDs). KTRs have at least twice the risk of developing cancer or dying from it compared to the general population. THE AIM: to calculate the standardized incidence ratio (SIR) and mortality ratio (SMR) of malignancies in KTRs registered at Municipal Clinical Hospital № 52 of the Moscow Healthcare Department and to determine independent risk factors for MN. PATIENTS AND METHODS. From January 1, 1989 to December 31, 2023, we followed 2146 KTRs registered at Municipal Clinical Hospital №52 of the Moscow Healthcare Department, in whom 14.4 % (n=310) MN were detected. In the malignancies group, the most common were non-melanoma skin cancer (NMSC) 30.3 % (n=91) and kidney cancer 11.3 % (n=41), 37.7 % (n=117) of patients died, of which 46.2 % (n=54) died directly from this cause. RESULTS. In kidney transplant recipients, the overall risk of malignancies was approximately three times higher than in the Russian population (SIR 2.85, 95 % CI: 2.4–3.2, P<0.05). The highest incidence was observed for kidney cancer SIR 5.8 (95 % CI: 4.0–7.5, P<0.05), non-melanoma skin cancer (NMSC) SIR 5.8 (95 % CI: 4.6–6.9, P<0.05), melanoma SIR 3.99 (95 % CI: 3.5–4.3, P<0.05), cervical cancer SIR 3.0 (95 % CI: 1.5–4.4, P<0.05), thyroid cancer SIR 2.1 (95 % CI: 1.4–2.9, P<0.05) and chronic lymphocytic leukemia (CLL, ICD codes: C91.1–9) SIR 10.3 (95 % CI: 4.5–16.0, P<0.05). Mortality from all types of malignancies after kidney transplantation slightly exceeded the general population mortality in the Russian Federation (SMR 1.3, 95 % CI: 1.1–1.4, P<0.05). The highest mortality after transplantation was from NMSC SMR 51.4 (95 % CI: 25.3–77.4, P<0.05) and melanoma SMR 8.6 (95 % CI: 2.5–14.6, P<0.05). CONCLUSIONS. The overall incidence of malignancies after kidney transplantation in patients registered at Municipal Clinical Hospital №52 of the Moscow Healthcare Department in 1989–2023 is almost 3 times higher than the general population incidence in the Russian Federation (overall SIR = 2.85 (95 % CI: 2.4–3.2, P<0.05). Mortality from malignancies (overall SMR = 1.3 (95 % CI: 1.1–1.4, P<0.05)) is slightly higher than the general population incidence. A possible reason for the almost twofold difference between the incidence and mortality from malignancies in the Russian Federation may be the high risk of competing causes of mortality in KTRs, especially CVDs.

THE AIM: to estimate the characteristics of the phenotype of congenital anomalies of the kidneys and urinary tract (CAKUT), renal function and survival using the method of E. Kaplan-P. Meier (1958) in children to predict the progression of chronic kidney disease (CKD). PATIENTS AND METHODS: The study included 127 patients aged from 1 month to 17 years 11 months: Group I – 113 (89 %) patients with CAKUT, without association with syndromes (isolated); Group II – 14 (11 %) patients with CAKUT associated with orphan syndromes and numerical chromosomal diseases (syndromic). As defined by K/DOQI (2002) and R. Hogg et al. (2003), in pediatric patients CKD stages were stratified according to glomerular filtration rate (GFR) criteria, calculated by creatinine clearance (mmol/l) in the formula G.J. Schwartz, and albuminuria/proteinuria categories. The study of renal survival in patients with CAKUT involved the construction of life tables and the moment non-interval E.L. Kaplan - P. Meier method (1958). The term “survivors” is used for children with CAKUT who have preserved GFR or compensated CKD. CONCLUSION: In the structure of CAKUT in children with isolated phenotypes, a predominance of renal/renal anomalies (76.9 %), vesicoureteral reflux (53.1 %), ureterohydronephrosis/ hydronephrosis (41.6 %) was revealed. In the structure of CAKUT in hereditary syndromes and numerical chromosomal diseases, out of 14 patients, 13 (92.8 %) had kidney anomalies, 9 (62.3 %) hydronephrosis, 3 (21.4 %) VUR. Features of CAKUT in orphan syndromes due to gene mutations have been established in pediatric patients: Fraser type 1 (FRAS1), Pierson (LAMB2), Lowe (OCLR), Lowe (OCRL, ROBO2), FOXP1 (FOXP1), Schuurs–Hoeijmakers (PACS1), Dent 2 (OCLR), Renal–Coloboma (PAX2),  chromosomal Shereshevsky–Turner disease (monosomy 45X); Down  (trisomy 21 chromosome)  associated with Sensenbrenner (WDR35) syndrome; autosomal dominant renal hypoplasia/aplasia syndrome type 3 (GREB1L). The progression of CKD was established in 92 children aged over 2 years with isolated CAKUT from C1 with preserved GFR (27.2 %) to С2 (8,7 %), С3 (50 %), С4 (9,8 %), С5 (4,3 %). In 11 children aged over 2 years with CAKUT in orphan syndromes, CKD stage was stratified C1 with preserved GFR (5); C2 (5); C5

(1). The probability of 5-year, 10-year and 15-year renal survival in children and adolescents with isolated CAKUT is 94.4 %, 89.5 % and 66.5 %, respectively. The probability of 5-year and 10-year preservation of renal function (CKD C1 with a normal level of GFR) in children and adolescents over 2 years of age with CAKUT associated with hereditary syndromes is reduced (58.5 % and 32.0 %, respectively).

BACKGROUND. The kidneys play a key role in maintaining water-electrolyte homeostasis. However, for the diagnosis of chronic kidney disease (CKD), only indicators reflecting the degree of damage to the glomeruli are used. Electrolyte transport disorders that are directly related to maintaining circulating blood volume, blood pressure, osmotic pressure, and acid-base status are not taken into account. The aim of the study was to clarify the role of water-electrolyte disorders in "non-glomerular" kidney diseases. PATIENTS AND METHODS. 145 patients with CKD of "nonglomerular" etiology aged 50.2±13.9 years were examined, among them 76 men and 69 women. The causes of CKD were chronic tubulointerstitial nephritis (CTIN, 31 patients), type 2 diabetes mellitus (DM, 33 patients), hypertension (AH, 45 patients), AL-amyloidosis (AL, 36 patients). A traditional nephrological clinical and laboratory examination was performed, including determination of concentrations of creatinine, urea and electrolytes in blood serum and urine. Based on the data obtained, urinary clearance and excreted fractions of each of these substances were calculated according to standard algorithms, as well as proximal and distal sodium reabsorption. Statistical analysis of the obtained data was carried out using generally accepted parametric and nonparametric methods. RESULTS. The main indicators in the examination of patients corresponded to the clinical picture of the nature of kidney damage in the underlying disease. Patients of all groups consumed 30-60 % of dietary protein, and table salt was 1.9-2.2 times higher than recommended standards. The proximal sodium reabsorption was 15-25  % higher than normal values. Salt intake positively correlated with urinary clearance of creatinine, urea; potassium; sodium; calcium; chlorine; inorganic phosphate; and distal sodium reabsorption. At the same time, there was no relationship between the severity of proteinuria and the consumption of dietary protein, table salt, total and proximal sodium reabsorption, as well as urinary creatinine, urea, and electrolyte clearances. The results of the factor analysis revealed differences in the structure of the structure of mutual relationships between proteinuria, systolic blood pressure, creatinine, urea, and electrolyte clearance variables depending on the underlying disease. The magnitude of the partial correlation coefficients indicated that salt intake is accompanied by an increase in the excretion of all electrolytes, regardless of eGFR. CONCLUSION. Increased salt intake is formally accompanied by an increase in urinary excretion of all electrolytes. At the same time, sodium reabsorption increases, primarily proximal (hormone-independent). Hypernatremia does not develop, therefore sodium is deposited. One of the locations is the endothelium, which should cause a local inflammatory reaction that can support microcirculation disorders in the glomeruli with a gradual decrease in the excretory function of the kidneys. Probably, in addition to the classical indicators of CKD, it is worth adding a periodic calculation of dietary protein intake based on daily excretion of urea and table salt based on daily excretion of sodium and chloride.

BACKGROUND. Achieving the best outcomes of dialysis treatment is hindered by limited monitoring of important parameters and lack of consensus on minimum and optimal standards of safety, quality of dialysis, and its organization, which prevents comparative analysis. After running out the possibilities to improve dialysis outcomes by increasing diffusion and convection transfer, the researchers turned to evaluating patient-reported outcomes and ways to improve them. THE AIM. To present the results of a pilot study of symptoms severity and prevalence, as well as their relationship to the treatment characteristics. PATIENTS AND METHODS. In a one-center cohort study, we included 137 patients aged 55±15 years, 41 % women. Symptoms were assessed by the Dialysis Symptom Index, 30 symptoms with a score of 1-5 ("not bothering at all" - "very bothering"). The dialysis monitoring program included monthly/quarterly routine indicators of uremic syndromes correction, assessment of bioimpedance, degree of protein-energy wasting, and sarcopenia. RESULTS. The average symptom score was 50±15 (Me; Q1-Q3: 50, 37-60, from 30 (no symptoms) to 109), a direct relationship was found between the severity and prevalence of symptoms. The overall score in the multiple regression analysis was directly related to the severity of protein-energy wasting (+3.8 points/degree, (95 %CI 0.5-7; p=0.022), phosphate levels (+0.17 points/0.1 mmol/l; (0.03–0.30; p=0.017), and inversely – with hemoglobin level (-0.26 points / 1 g/l; -0.49-(-0.03); p= 0.024), albumin (-0.18 points/1 g/ l; -0.36-(-0.001); p = 0.047), grip power (-0.17 points/1 kg; -0.49-(-0.03); p= 0.024). CONCLUSION. Dialysis patients have a severe symptomatic burden. The symptom clusters demonstrate numerous links with the treatment parameters, which opens up the possibility for targeted interventions in order to achieve better outcomes.

BACKGROUND. Excessive transfusions of red blood cells (RBC) for anemia without bleeding can lead to simultaneous changes of blood rheological properties in the form of its viscosity increase and, accordingly, to a change in the functional ability of the child's kidneys, taking into account functional and morphological immaturity by age, especially during oncological and hematological diseases treatment. THE AIM: to study the effect of increased hemoglobin (Hb) and hematocrit levels on excretory kidney function from a single RBC transfusion in children weighing up to 30 kg with oncological and hematological diseases. PATIENTS AND METHODS. The study included 753 RBC transfusions in 175 patients from 3 months to 11 years old, with a body weight of up to 30 kg, with anemia without bleeding. The spread of Hb growth was from 3 to 69 g/l, in 12.9 % of cases (n=97) increase in Hb was ≥31 g/l. The RBC dose range was from 3.76 to 21.59 ml/kg. RESULTS. With an increase of Hb ≥31 g/l in infants in 62.5 % of cases (n=10) decrease in glomerular filtration rate (GFR) to a maximum of 20 ml/min (22 % of the initial level) was identified, in children in 49.4 % of cases (n=40) to a maximum of 56 ml/min (30.6 % of the initial level). In the validation group (15 RBC transfusions in 15 patients), a comparison analysis of the Schwartz, Hoek, and combined Schwartz equations for GFR calculation was carried out. CONCLUSIONS. According to the validation data of GFR calculation methods, the Schwartz formula had sufficient accuracy for kidney function monitoring in dynamics in pediatric oncology. The level of Hb increase ≥31 g/l from a single dose RBC transfusion was classified as potentially unsafe for the correction of anemia without bleeding in children with oncological and hematological diseases.

BACKGROUND. Reduction of the reproductive ability of the body and the cessation of menstrual function entails a change in the nervous, cardiovascular, bone, and neuroendocrine systems, which cannot but affect the quality of life of this category of patients. The literature data point to the relationship of emotional status with menopause and the developing visceral pathology, and also in some studies compared the severity of the menopausal syndrome in women with different psychological personality types. THE AIM was to assess the psycho-emotional state of women with arterial hypertension and menopausal syndrome. PATIENTS AND METHODS. The study involved 30 women with climacteric syndrome and arterial hypertension (AH), 30 women with arterial hypertension and without climacteric syndrome, and 20 women with climacteric syndrome without AH – control group. The mean age was 56.01±0.59 years. There were used clinical examination included a standardized questionnaire, history taking, and physical examination. RESULTS. In 1st group AH I was in 10%, AH II – 90 %, in group 2 AH I – 23.33 %, AH II – 76.67 %, respectively. The average blood pressure: in the 1st group 151.7±2.31/93.1±1.79 mmHg., in the 2nd group – 141.3±2.72/90.04±1.74 mmHg. CONCLUSIONS. Menopausal women are a special category of patients due to the frequent formation of hypertension in them. Against the background of a progressive decrease in estrogen synthesis, the clinical manifestations of arterial hypertension are aggravated, especially when combined with signs of menopausal syndrome.

BACKGROUND: Fabry disease is a rare hereditary X-linked lysosomal accumulation disease, caused by a decrease in the activity of alpha-galactosidase A. This leads to the accumulation of glycosfingolipids in different tissues of the body. Due to its rarity and variety of symptoms, it is difficult to diagnose Fabry disease correctly. Early diagnosis is crucial for timely therapeutic intervention and slowing down the development of organ damage. The aim of this study was to screen patients with Fabry's disease in the V.A Baranov Republican Hospital. 27 patients (16 women and 11 men), who were undergoing hemodialysis treatment for terminal renal failure in the hemodialysis department at the Karelia Republican Hospital named after V.A.Baranov, participated in the screening. Also, one patient (a man) from the cardiology department of V.A's Republican Hospital was included in the study. Baranov, observed for hypertrophic cardiomyopathy. Screening was carried out by determining the concentration of globotrialsingosine (LySo-GB3) in dry blood stains by tandem mass spectrometry (TMS) at the National Medical Research Center for Children's Health in Moscow. RESULTS: At the time of publication, among 27 hemodialysis patients, no decrease in α-galactosidase-A activity was revealed. The screening is still ongoing. Also, during the study, the first Fabry disease patient who began enzyme replacement therapy was discovered in the cardiology department. CONCLUSION: The study results confirm the rarity of the disease and the wide range of its manifestations. A clinical case illustrates the development of cardiovascular and cerebrovascular complications and renal failure progression in Fabry disease.