Although anti-C1q autoantibodies have been described more than four decades ago a constant stream of papers describing clinical associations or functional consequences highlights that anti-C1q antibodies are still hot and happening. By far the largest set of studies focus on anti-C1q antibodies is systemic lupus erythematosus (SLE). In SLE anti-C1q antibodies associate with involvement of lupus nephritis in such a way that in the absence of anti-C1q antibodies it is unlikely that a flare in nephritis will occur. Anti-C1q antibodies occur in several autoimmune conditions but also in healthy individuals. Although considerable progress has been made in the understanding of how anti-C1q antibodies may contribute to tissue injury there is still a lot to learn about the processes involved in the breaking of tolerance to this protein. There has been considerable improvement in the assays employed to test for the presence of anti-C1q antibodies. Hopefully with these new and standardized assays at hand larger clinical association studies will be conducted with independent replication. Such large-scale studies will reveal the true value of clinical testing for anti-C1q autoantibodies in several clinical conditions.

The association between sarcoidosis and glomerular diseases has not been extensively investigated in a large series and the potential features of this uncommon association remain to be determined. METHODS: We retrospectively identified 26 patients with biopsy-proven glomerular lesions that occurred in a sarcoidosis context. Potential remission of glomerular disease and sarcoidosis under specific treatment (steroid and/or immunosuppressive agents) was recorded for all patients. Demographic, clinical and biological characteristics were assessed at the time of kidney biopsy for each patient. Therapeutic data were analyzed for all patients. RESULTS: Glomerular disease occurred after the diagnosis of sarcoidosis in 11 of 26 cases (42%) (mean delay of 9.7 years). In six patients (23%), the glomerulopathy preceded the sarcoidosis diagnosis (mean delay 8 years). In the last nine patients (35%), both conditions occurred simultaneously. The most frequent glomerular disease occurring in sarcoidosis patients was membranous nephropathy in eleven cases. Other glomerular lesions included IgA nephropathy in six cases, focal segmental glomerulosclerosis in four patients, minimal change nephrotic syndrome for three patients and proliferative lupus nephritis in two patients. Granulomatous interstitial nephritis was associated with glomerular disease in six patients and was exclusively found in patients in whom the both disease occurred simultaneously. In nine patients with simultaneous glomerular and sarcoidosis diseases, we observed a strong dissociation between glomerular disease and sarcoidosis in terms of steroid responsiveness. At the end of the follow-up (mean of 8.4 years), six patients had reached end-stage renal disease and three patients had died. CONCLUSIONS: A wide spectrum of glomerular lesions is associated with sarcoidosis. The close temporal relationship observed in some patients suggests common causative molecular mechanisms of glomerular injury but complete remission of both diseases in response to exclusive steroid therapy is infrequent.

Literary data about the mechanisms of toxic effect of indoxyl sulfate at kidney disfunction are provided in the review.

The review discusses the features of the manifestations of idiopathic hypercalciuria in children. The various methods of treatment of idiopathic hypercalciuria in children are discussed.

AIM OF RESEARCH: to evaluate the effectiveness of the bilateral epicutaneous electromyostimulation (BEEM) of lower extremities in the rehabilitation of hemodialysis patients. PATIENTS AND METHODS. The study included 24 patients with CKD Vd. Patients were divided on 2 groups: the BEEM group (N=12) and control group (N=12), comparable by sex, age, duration of renal replacement therapy and Charlson comorbidity index. The BEEM group underwent the procedures of muscle stimulation of the lower extremities during hemodialysis sessions for 4 weeks, 3 times per week and 3 BEEM treatments each session for 30 minutes each procedure, while the CG remained on previous dialysis regimen. In both groups before and after the investigations were carried out blood tests, a 6-minute walk test (6MWT) with oxygen saturation sensor and data collection by Total Symptom Score (TSS) polyneuropathy questionnaire. During the study the adverse events was monitored in both groups. RESULTS. Significant decreasing in serum levels of creatinine (from 0,85±0,21 to 0,80±0,17 mmol/l, p < 0.05) and urea (from 23,5±5,1 to 20,4±3,9, p < 0.05) was observed in the BEEM group compared with the control group. Other laboratory parameters were not significantly changed. There was noted a certain decreasing in the TSS pain scale from 1,8±1,0 to 1,11±0,7 points (p < 0.05) and in the resulting TSS from 3,66±2,3 to 2,22±1,2 points (p < 0.05) in BEEM group compared with the control. Unlike the control group, the distance walked in the 6MWT in the BEEM group increased from 431±113 to 455±99 m (p < 0.05) and there was significant reduction of the dyspnea (from 3,7±1,1 to 2,9±1,4 points, p < 0.05) and fatigue (from 4,3±2,0 to 2,5±1.6 points, p < 0.05) after the 6-minute walk test. Significant adverse events during the study were not observed. CONCLUSION: The BEEM procedure during hemodialysis is a safe intervention, what can enhance the efficiency of the procedures in form of lowering baseline creatinine and urea, reduce symptoms of polyneuropathy, and increase the physical adaptation of the hemodialysis patients.

THE AIM. To study structural and functional features of cardio-vascular system depending on the level of daily albuminuria in women with metabolic syndrome (MS) at perimenopause. PATIENTS AND METHODS. A total of 67 women in perimenopause with MS were selected and divided into two groups: general - patients with MS and MA (n=34) and control group - with MS and normoalbuminuria (NA) (n=33). All patients were performed evaluation of daily albumin excretion by urinary way and calculation of body mass index (BMI). Also they were performed following examinations: arterial pressure daily monitoring, common carotid artery intima-media thickness test (CCAIMT), test with reactive hyperemia, echocardiography. RESULTS. Cardiac remodeling was observed in menopausal women with MS and MA in 88,2% cases, mainly by concentric hypertrophy type (50% cases). Mean left ventricular mass and left ventricular mass index were significantly higher in general group as compared to MS and NA group (242,10±18,70g and 162,80±7,50g; (р<0,01). 121,58±7,70g/m²vs 95,16±3,40g/m²; P=0,002 respectively). Endothelial dependent vasodilation disorder inwomen with MS and MA was revealed in 76,5% cases. In patients of general group CCAIMT was accurately higher than in women with MS and MA: 0,89±0,05mm and 0,72±0,05mm (р<0,05) respectively. The effect of systolic and diastolic arterial pressure on MA is verified by linear regression analyses data. CONCLUSION. MA at MS in perimenopause is associated with concentric LVH., endothelial dysfunction and increased values of CCAIMT.

THE AIM. To examine content of essential microelements (zinc (Zn), ferrum) and macroelements magnium (Mg), calcium in biological media in patients with program hemodialysis. PATIENTS AND METHODS: 20 healthy persons and 66 patients (group 1 - 31 patients with diuresis and group 2 - 35 patient without urination) treated by chronic bicarbonate standard hemodialysis. Mg, Zn, Fe, Ca level in blood and urine were measured before and after hemodialysis by atomic absorption spectrophotometry method. RESULT. Patients had significantly lower level not only Ca and Fe, but Zn (22,8±0,84 vs 17,6±0,34 мкг/мл) and Mg (22,8±0,84 vs 18,8±0,344 мкг/мл), the level of elements significantly decreased after dialysis procedure. In group 1 Mg and Zn level in blood were significantly lower (17,1±0,31 и 19,2±0,34 and 1,31±0,091 vs 1,49±0,11 ml/min). In comparison to healthy people 1 group had increased level of Mg and Zn excretion, clearance (2,95±0,39 vs 6,03±0,56 ml/min, p<0,01; (0,29±0,03 vs 0,57±0,029 ml/min, p<0,001) and excretion fraction (0,927±0,031 vs 0,718±0,019, p<0,001; 2,62±0,37 vs 4,95±0,33 mcg/ ml, p<0,01). Statistical analysis showed Mg inverse correlation with age, albumin and Ca level, direct correlation with PTH (p<0,05). CONCLUSION. Hemodialysis patients has not only Ca and Fe, but Mg and Zn deficit. Patients with urination has deeper level of Mg and Zn deficit; Mg correlates with age, Ca, P, PTH level.

THE AIM. To study the metabolic abnormalities in children of Barnaul with the infection of the urinary system and to identify the relationship between the infection of the urinary system and idiopathic hypercalciuria. PATIENTS AND METHODS. The study included 49 children with the infection of the urinary system in age from 1 year to 14 years (42 girls and 7 boys, mean age 6,6 ± 3,7 years) hospitalized in nephrologic department of the «Town Children Hospital № 1» of Barnaul. All patients performed clinical examination and biochemical examination of blood and urine samples with a certain level of calcium, phosphor, creatinine, urea and uric acid levels, urine enzymes alkaline phosphatase, and gamma-glutamyl transferase, the urine calcium/creatinine ratio. RESULTS. In 49% of children revealed a combination the infection of the urinary system with metabolic disorders, with statistically significantly more frequently detected the calcium oxalate cristaluriya. Over 70% of children had the urine calcium/creatinine ratio greater than 0.2 indicating the idiopathic hypekalciuria. CONCLUSION. Urinary tract infection in children is often combined with idiopathic hypercalciuria indicating a need to define the daily excretion of calcium or calcium/creatinine in the urine of children with microbial and inflammatory diseases of the urinary system, and a decision on the correction of metabolic disorders.

AIM OF STUDY. To improve the main perioperative results of robotic (RPN), laparoscopic (LPN) and open (OPN) partial nephrectomy by employment of new parenchyma suture using contemporary suture material. PATIENTS AND METHODS. In this study 168 patients with T1N0M0 stage renal cell carcinoma were treated via OPN, LPN and RPN (97, 41 and 30 patients, respectively). Every group was divided in two: in the first one (basic subgroup) kidney’s parenchyma was sutured with Vicryl and Lapra-Ty clips (only Vicryl for the OPN group) and in the second one parenchyma was sutured with modified technique (modified subgroup) using V-loc, Hem-o-Lok and modified Z-shaped stitches in LPN and RPN groups (no V-loc for OPN group). We compared mean operation time, WIT, blood loss and alteration of serum creatinine and glomerular filtrarion rate (GFR) between subgroups in every group. RESULTS. In the modified subgroup of OPN group WIT was shorter compared to the basic subgroup (11,1 vs 14,6 min; p=0,044). In LPN group mean operation time was shorter in modified subgroup (135,4 vs 185,0 min; p=0,011) as well as WIT (14,1 vs 19,3 min; p=0,0003). Blood loss was also less in modified subgroup (286,1 vs 347,0 ml; p=0,033). In the modified subgroup of RPN group WIT was less than in basic subgroup (12,0 vs 15,7 min; p=0,001); the elevation of serum creatinine level was less (6,0% vs 24,8 %; p=0,019) and depression of GFR was lower (4,0% vs 22,2%; p=0,041). CONCLUSION. The application of V-loс and Hem-o-Lok and Z-shaped suturing technique during suturing in partial nephrectomy reduces WIT and mean operation time and decreases blood loss.