The current kidney care model focused on late-stage disease and in-center hemodialysis is unsustainable, due to costs, environmental burden, poor outcomes, and reduced quality of life. The 78[th] World Health Assembly’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, Kidney Health for All: Caring for People, Protecting the Planet , calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy (KRT). Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality of life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of public, policymakers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.

Research into the role of ectopic Tas2R bitter taste receptors in bronchial asthma encompasses a wide range of pathogenesis factors, including, primarily, their involvement in the development of broncho-obstructive syndrome. The role of the Tas2R signaling pathway in the immune response is less studied. This review analyzes currently available studies on the expression of Tas2R receptors on cells of both the innate immune response, including components such as physical barriers (skin and mucous membranes), and the adaptive immune response (dendritic cells, Tand B-lymphocytes). Data on the expression and primary functions mediated by Tas2R receptors in various cells of the immune system are presented. Tas2R signaling is generally involved in the regulation of immunological processes such as inflammation, including the release of cytokines from immune cells and the stimulation of phagocytosis. Tas2R receptors also participate in the recognition of various pathogens, allergens, and molecules such as quorum-sensing molecules secreted by Gram-negative bacteria. Tas2R receptors are considered promising pharmacological targets, particularly for difficult-to-control forms of bronchial asthma resistant to glucocorticoid therapy. 

BACKGROUND. Chronic kidney disease (CKD) is a persistent disorder of kidney structure or function lasting more than three months, with diabetes mellitus being one of its leading causes worldwide. Since 2023, finerenone a nonsteroidal mineralocorticoid receptor antagonist (MRA) has been approved in the Russian Federation. Preclinical and clinical studies have demonstrated its anti-inflammatory and antifibrotic effects, positioning finerenone as a promising treatment for patients with type 2 diabetes mellitus (T2DM) and CKD. While initial data from scientific literature show encouraging results, further research is needed to better understand its mechanism of action and evaluate long-term outcomes. 

THE AIM: to evaluation of the efficacy and safety of finerenone in patients with type 2 diabetes mellitus and chronic kidney disease. 

PATIENTS AND METHODS . As part of a clinical observation study, 25 patients with comorbid type 2 diabetes mellitus and chronic kidney disease were evaluated. All participants underwent comprehensive testing, including the assessments of biochemical parameters of kidney function, carbohydrate metabolism and lipid profile. Finerenone was used as an adjunctive therapy. A follow-up evaluation was performed after 6 months of therapy. Statistical analysis was performed using specialized software employing parametric or nonparametric methods, depending on the nature of the data distribution. The critical significance level of p < 0.05. 

RESULTS. The study included 25 patients with type 2 diabetes mellitus and chronic kidney disease (mean age 60.28 ± 6.90 years, comprising 15 were men (60 %) and 10 were women (40 %). After six months of finerenone therapy, significant reductions in albuminuria (219→158 mg/g, p<0.001) and improvements in GFR (56.2→59.8 ml/min, p<0.001) were observed. Normalization of albuminuria was registered in 12 % of patients. Regarding the safety of use, a decrease in cardiovascular risk was noted 32 % to 16 %. 

CONCLUSIONS. In patients with diabetic nephropathy, finerenone demonstrates significant nephroprotective effects, as evidenced by redused in albuminuria (p<0.0001) and improved glomerular filtration rates. The drug also exhibits a favorable safety profile with no clinically significant impact on electrolyte balance (p<0.05). Of particular interest is the demonstrated decrease in the proportion of patients at high cardiovascular risk (from 32 % to 16 %). These findings support the inclusion of finerenone in combination therapy regimens for diabetic kidney disease.

BACKGROUND. Diagnosis of kidney diseases remains a serious challenge, as in many cases it is based on the examination of a kidney biopsy specimen, since the morphological form of the disease determines the treatment strategy, including the use of aggressive pharmacological agents. Non-invasive determination of the pathogenetic group of nephropathy reduces the risk of drug exposure in cases of treatment without morphological diagnosis. 

THE AIM. Development of a mathematical apparatus for constructing virtual morphological characteristics of the kidneys based on aggregate data on their functional status. 

PATIENTS AND METHODS. Artificial intelligence technologies with machine learning based on data from 571 patients with morphological diagnoses. 

RESULTS. The proposed set of medical informatics methods demonstrates potential for virtual pathomorphological modeling and improving healthcare safety by providing clinical decision support. 

CONCLUSION. The proposed system can be used as a clinical decision support tool, enabling patient stratification into three pathogenetic groups (glomerular, tubulointerstitial, and vascular) that differ in principles of clinical management and drug therapy. This highlights the potential of medical informatics and machine learning methods for improving the clinical interpretability of nephrobiopsy data.

We analyzed the electronic medical records of 769 patients hospitalized at the Vladimirsky Regional Scientific Research Institute (MONIKI) with a positive nasopharyngeal polymerase chain reaction (PCR) test for SARS-CoV2. Acute kidney failure complicated the course of COVID-19 in 350 patients (46 %). Of the 350 patients with acute kidney failure, 132 died (37.7 %), and 218 patients (62.3 %) survived. The analyzed cohort of patients with acute kidney failure included patients with severe and critical COVID-19. The severity of the patients' condition was determined by near-total lung damage (CT scan 3-4 in 308 patients, 40.1 %), the need for mechanical ventilation (320 patients, 42 %), and comorbidities (diabetes mellitus in 28.6 % of patients, hypertension in 81.1 %, obesity in 21.1 %). In the post-COVID period, of 218 surviving patients with AKI, chronic kidney disease was observed in 169 patients (77.5 %). CKD C3a was the most common type (42 % of patients), while stage 2 CKD was less common (36.1 %). CKD C3b was observed in 15.9 % of patients. Thus, patients who have experienced acute kidney injury (AKI) during COVID-19 are susceptible to developing chronic kidney disease (CKD) in the post-COVID period, which necessitates their follow-up observation for the early detection of renal dysfunction and the prescription of nephroprotective therapy.

BACKGROUND. Optimal mineral and bone disorder (CKD-MBD) targets after parathyroidectomy (PTX) in dialysis patients remain undefined, and current guidelines do not address this population specifically. 

PATIENTS AND METHODS . This retrospective single-centre cohort study included adult patients on dialysis who underwent subtotal or total PTX with autotransplantation between 2011 and 2019. A total of 485 patients with available preoperative and postoperative laboratory data were analyzed. Serum parathyroid hormone (PTH), phosphate, total and ionized calcium, and alkaline phosphatase were measured before PTX and within predefined postoperative time windows (3–6, 9–12, 24–36 and 48–60 months) to account for intraindividual variability and missing values. The primary endpoint was all-cause mortality; successful kidney transplantation and the end of follow-up were treated as censoring events. Associations between CKD-MBD parameters and survival were examined using Cox proportional hazards models adjusted for demographics, dialysis vintage, primary kidney disease, prior transplantation and type of PTX. 

RESULTS. Preoperative PTH, phosphate and calcium showed no significant linear or non-linear association with survival, either as continuous variables or across quartiles. In contrast, postoperative CKD-MBD status at 3–6 months provided stronger prognostic discrimination. In comparison with the “intermediate” pattern (PTH 150–300 pg/mL, phosphate 0.81–1.45 mmol/L, calcium 2.15–2.50 mmol/L) combinations of low PTH with high or very high phosphate levels were linked to increased risk. Calcium levels were not consistently associated with survival across time windows or categorizations. 

CONCLUSIONS. Long-term survival after PTX in dialysis patients is driven mainly by postoperative phosphate control and maintenance of PTH within an intermediate range, while preoperative CKD-MBD parameters have limited independent prognostic impact.

THE AIM: To study heart and aortic involvement in patients with nephrotic syndrome (NS) depending on sex. 

PATIENTS AND METHODS. A retrospective analysis included 170 patients (mean age 32.1±12.0 years) with verified NS based on clinical and laboratory findings. All participants were divided into two subgroups: men (n=105) and women (n=65). Laboratory parameters, general clinical data, electrocardiographic (ECG), and echocardiographic parameters were assessed. 

RESULTS . In men with NS, the mean levels of diastolic and mean arterial pressure, platelet count, total cholesterol (TC), and creatinine were significantly higher, while total protein concentration was significantly lower compared to women. Women with NS had a statistically significantly higher heart rate, while hemoglobin (Hb), hematocrit, erythrocyte count, and mean corpuscular hemoglobin levels were significantly lower. Among all patients with NS, ECG signs of myocardial excitability and conduction disturbances were detected in 17.6 % and 4.1 % of cases, respectively. Left ventricular (LV) repolarization abnormalities were observed in 20 patients (11.7 %). Pathological ECG changes were found in 29 (27.6 %) men and 28 (43.0 %) women. Men had significantly larger linear dimensions of the LV, right ventricle, and aortic outflow tract compared to women. LV myocardial hypertrophy was detected in 17 (10 %) patients, while concentric LV remodeling was observed in 5 (2.9 %) cases. LV myocardial hypertrophy was more common in women. In men with NS, the LV myocardial mass index was significantly correlated with daily proteinuria (r=0.378; p=0.036), TC level (r=0.222; p=0.041), and fibrinogen concentration (r=0.306; p=0.021), while it was inversely correlated with albumin concentration (r=0.371; p=0.039). In women, the LV myocardial mass index showed a positive correlation with daily proteinuria (r=0.265; p=0.016) and fibrinogen concentration (r=0.230; p=0.019). 

CONCLUSION. Patients with NS frequently exhibit ECG signs of myocardial excitability and LV repolarization disturbances. Cardiac involvement in NS is primarily represented by concentric LV remodeling in men and eccentric LV myocardial hypertrophy in women. Regardless of sex, LV myocardial mass is strongly associated with daily proteinuria and fibrinogen concentration, while the diameter of the aortic outflow tract is linked to diastolic blood pressure levels.

BACKGROUND. Lipoprotein(a) [Lp(a)] is a subclass of lipoproteins representing LDL with a single molecule of apolipoprotein B100 covalently bound to the protein apoliprotein (a). The concentration of lp(a) is determined by genetic and significant individual fluctuations (from <1 to >200 mg/dl) in the population. While the adverse effects of LP(a) on cardiovascular diseases have been proven by numerous studies, the results of studies aimed at assessing the relationship between lp(a) and CKD are contradictory. Lp(a) has not yet been included in current guidelines or public health policies for the prevention, detection, management or surveillance of CKD. 

THE AIM. To study the role of Lp(a) as a potential biomarker of CKD. 

PATIENTS AND METHODS . A retrospective single-center study was conducted with the participation of 170 patients from the Hadassah Medical Moscow clinic, divided into groups according to Lp(a) levels (<30 mg/dl, 30-50 mg/dl, >50 mg/dl). Renal function parameters (GFR, creatinine, albumin, uric acid), lipid profile, anamnestic data, and the presence of atherosclerosis were analyzed. Statistical analysis performed using Excel and Python. 

RESULTS . There were no significant differences in renal function between the groups with different Lp(a) levels. A weak negative correlation was found between Lp(a) and GFR (r = –0.11, p = 0.147), which did not reach significance. The level of Lp(a) had no effect on the lipid profile (LDL, HDL, cholesterol, triacylglycerol). 

CONCLUSIONS. Lp(a) has no significant effect on kidney function in the studied population. Further multicenter studies with a larger sample are needed to confirm the results.

In recent decades, urinary tract infections (UTIs) have become a leading cause of bacterial infections, posing a threat to human life and health. Chronic pyelonephritis, in particular, is the leading cause of chronic kidney disease.Given the multifactorial pathogenesis of chronic pyelonephritis (CPN), a multidisciplinary approach is crucial in the treatment of this disease. This justifies the need to determine the antimicrobial efficacy of new generations of antibacterial and immunomodulatory drugs, including lyophilized E. coli bacterial lysate, aimed at preventing the progression of CPN and achieving long-term disease remission.

BACKGROUND. The aim of the study was to examine the relationship between sleep quality, physical and mental health, quality of life, and fatigue levels in healthcare personnel. 

PATIENTS AND METHODS. The study included 103 resident physicians (52 men, 49 women) with an average age of 32.4 ± 5.1 years. Validated questionnaires were used for a comprehensive assessment: the Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), Perceived Stress Scale (PSS), Satisfaction with Life Scale (SWLS), EQ-5D-5L with EQ-VAS, and the SF-12 Health Survey. Participants were divided into three groups based on their medical specialty: Group 1 internal medicine (62 people), Group 2 surgery (30 people), and Group 3 functional diagnostics (11 people). No statistically significant differences in sleep duration were found between the groups. Among functional diagnostics residents, poor sleep quality, increased sleep latency, lower life satisfaction, and insomnia were more prevalent. 

RESULTS. Sleep duration was negatively correlated with obesity, years of education, anxiety, stress tolerance, sleepiness, and sleep quality (higher PSQI scores), and positively correlated with life satisfaction. Life satisfaction was significantly lower among respondents who lived away from their families, were physically inactive, and had insufficient sleep duration and poor sleep quality. The visual analog scale (EQ-VAS) included a summary assessment of mobility, self-care, usual activities, pain, and anxiety; however, no statistically significant relationships were found for any of these individual indicators. No statistically significant associations were found regarding the SF-12 Health-Related Quality of Life scale scores. 

CONCLUSION. Our study involved young doctors, many of whom presented with sleep disturbances (often unrecognized), despite the absence of obesity, anxiety, depression, and relatively high social well-being. Undoubtedly, their risk of developing chronic non-communicable diseases and professional burnout will increase over time. Therefore, prevention programs for at least cardiovascular diseases in medical personnel should incorporate routine monitoring of sleep parameters and non-pharmacological interventions.

INTRODUCTION . Urolithiasis is a common urological pathology with a high recurrence rate. Experimental models on rodents are the main tool for studying the pathogenesis of stone formation and the search for therapeutic targets.

THE AIM: To develop models of acute oxalate urolithiasis in ICR mice and evaluate the role of uromodulin (UMO) in protecting the kidneys from crystal-induced damage.

MATERIALS AND METHODS. The study was performed on 18 male ICR mice (CD 1). Mice were intraperitoneally injected with sodium oxalate in two doses: 2.5 mg/100 g body weight (NaOx L) and 5 mg/100 g body weight (NaOx H). The biochemical parameters of blood, glomerular filtration rate by FITC inulin clearance, colloidal composition of urine, urinary excretion of UMO and ions, morphology of sediment and internal organs were evaluated in the experiment.

RESULTS . A high dose of the pathology inducer caused severe acute nephropathy with pronounced azotemia, decreased GFR, accumulation of large CaOx containing nanoparticles, and deep tubulointerstitial damage. A dose of 2.5 mg/100 g of body weight formed a milder, generally compensated lesion with a transient peak of crystalluria. In this group, the dynamics of urinary UMO excretion and colloidal profile most convincingly demonstrated its nephroprotective and anti-crystallogenic role.

CONCLUSIONS. The developed two-dose model of acute Ox urolithiasis in mice allows differentiated study of severe crystal-induced kidney damage (5 mg/100 g) and mechanisms of effective crystal clearance with the participation of UMO (2.5 mg/100 g), which creates the basis for molecular genetic studies on transgenic and knockout lines of mice.

INTRODUCTION. Chronic kidney disease (CKD), particularly infectious tubulointerstitial nephritis, is a significant medical and social problem, characterized by morphological changes in the nephron that are difficult to study in detail using traditional methods. Modern technologies, such as 18F-FDG PET/CT and transmission electron microscopy (TEM) with subsequent 3D reconstruction, offer new opportunities for assessing the structural and functional state of the nephron and renal parenchyma. 

THE AIM. To evaluate ultrastructural 3D visualization of the nephron during the progression of chronic kidney disease using infectious tubulointerstitial nephritis as an example.

 MATERIALS AND METHODS. A pilot study was conducted involving three patients who underwent PET/CT with calculation of the standardized uptake level (SUVmax) of 18F-FDG by the kidneys and TEM of renal parenchymal biopsies at 10,000x magnification to study the ultrastructure of nephrons. Based on electron microscopy data, 3D block reconstruction of the nephron was performed, as well as 3D sectional reconstruction of the kidney after nephrectomy using a macrospecimen. 

RESULTS. In patients with infectious tubulointerstitial nephritis, 3D ultrastructural findings revealed thickening and disorganization of the basement membranes, focal necrosis, glomerular sclerosis, and epithelial desquamation. SUVmax values on PET/CT decreased proportionally to the severity of ultrastructural changes. 

CONCLUSION. An original method for ultrastructural 3D visualization of the nephron at 10,000x magnification using transmission electron microscopy data during chronic kidney disease (CKD) is evaluated using infectious tubulointerstitial nephritis as an example. This method is complemented by PET/CT imaging of renal parenchyma metabolism to 18F-FDG and 3D anatomical visual reconstruction of the renal parenchyma using a post-nephrectomy specimen.