Interactomics emerges today to become a novel tool for molecular and cellular investigations. Interactomics is an area of bioinformatics and systems biology that relies on the fundamental idea of the necessity to bring the cellular levels (from metabolome and up to epigenome) into single analytical dimension. Such an analytical system may become a powerful tool for the precise investigations of the subtle molecular mechanisms underlying the function of various tissues in both normal and pathologic states. In the aspect of nephrology, interactomics is a highly promising approach to treat a wide range of nephropathies and kidney-related erythropoietin secretion disorders.

Stable existence of complex self-organizing systems is supported by a network of feedback that submit information from the “output” of the system to its control elements. From the cybernetic point of view the excretory system is a “way out” of human metabolic network. Therefore, nephrological aspects of systemic medicine require a special attention. According to the concept of phenoptosis, effective existence of biological communities is often supported by mechanisms of weakening or destroy of individuals. Systemic manifestation of phenoptosis mechanisms is an age related increase of frequency and severity of abnormalities, including kidney diseases. A key element of most phenoptosis processes is increased generation of reactive oxygen species by mitochondria. Using of mitochondria-targeted antioxidants (Skulachev ions with antioxidant load - SkQ) allows to “turn off” such mechanisms, reducing mitochondrial oxidative stress. At the same time the course of acute renal injury induced by acute ischemia improves. Mortality of laboratory animals significantly decreases. For future clinical trials of SkQ oral dosage forms a systemic therapeutic effect in the treatment of renal disease could be expected.

In this review morbidity of chronic tubulo-interstitial nephritis (CTIN) induced by administration of nonsteroid anti-inflammatory drugs (NSAIDs) is discussed. The reasons of difference between epidemioligical data of different researchers are considered. Nephrotoxicity at long administration of selective and non selective inhibitors of cyclooxigenase and possible mechanisms of nephron hemodynamics violations development is discussed. Possibilities of early diagnostics of CTIN using enzymuriya evaluation methods are discussed. This review provides data based on literature analysis according to various enzymes definition in urine to reveal nephrotoxicity on subclinical stage of CTIN.

Contemporary submission about biocompatibility of modern polymer materials are considered in this article. Special attention paid to the biocompatibility of polymer dialysis membranes, their impact on hemostasis and patient’s survival on hemodialysis. There are descried perspective areas of creation and using composite and polymer materials for hemodialysis.

AIM. To ascertain role and analysis of modern concepts of biochemical markers of morphofunctional myocardium and large arteries alterations in patients with end-stage renal failure (ESRF). PATIENTS AND METHODS. A total of 105 patients (57 females and 48 males aged 23-62 years) on hemodialysis participated in the study. The patients were examined clinically with estimation of the levels of parathormone, calcium, phosphorus, adiponectin, homocysteine, leptin, malondialdehyde (MDA) and the activities of catalase and superoxide dismutase (SOD), erythrocytic indexes, serum ferritin and blood transferrin. Echocardiography with Doppler sonography were made on Aloka-4000 unit for an assessment of left ventricular geometry, diastolic and systolic function including intima-media complex thickness (IMC) of carotid and femoral arteries. Therapeutic policy included correction of anemia, arterial hypertension, phosphorus-calcium metabolism. RESULTS. The higher concentrations of parathormone, calcium, phosphorus, homocysteine and leptin correlated with anemia intensity, severity of diastolic and systolic dysfunction and LVH. The higher concentration of MDA and decreased activities of catalase and SOD correlated with the severity of functional changes in the cardiovascular system in examined patients. CONCLUSION. The increase of level of biochemical markers of calcium-phosphorus metabolism, oxidative stress and dyslipidemia in patients with end-stage renal failure, which correlate with cardiovascular system damage level, confirm its important role in the development of cardiovascular complications in ESRF.

AIM OF THE STUDY – to assess the availability and effectiveness of treatment of patients with diseases of the kidneys and urinary tract in out-patient conditions. PATIENTS AND METHODS. The article presents the results of a comprehensive analysis of the efficiency and economy of the activities of the day hospital versus clinic 24-hour hospital in the treatment of patients with kidney disease. Shows the need to activate and improve preventive work in outpatient link to reduce pathology level in organs of the urinary system. THE RESULTS. Study of the cost-effectiveness of using day hospital in treatment of patients with CKD versus one in the 24-hour hospital showed that cash savings in 2012 year was about 750 thousand rub. The effectiveness of treatment with both forms of medical assistance was identical and made 76,11 ± 2.32% and 78,19 ± 2.21%, respectively (p >0.05). Found no reliable differences between patient’s assessment of quality of medical care in the day (8.1 ± 0.92 points) and 24-hour hospital (8.02 ± 0.68 points). Shows the necessity and reasonability of day hospital network extension with continuity of medical care delivery at outpatient hospital, day hospital and 24-hour hospital.

THE AIM: consideration of predictive model of hypertensive nephropathy (HN) development by a complex assessment of cardiovascular risk factors at hypertensive patients. MATERIALS AND METHODS: 330 hypertensive patients without chronic kidney disease were included in research (male – 303 (91,8%) female – 27 (8,2%). At all patients was interview and physical examination, determine standard serum measurement, calculate glomerular filtration rate (GFR) and microalbuminuria (MAU), was defined office blood pressure (BP) and 24-hour blood pressure monitoring, echocardiography . MAU more 15 mg/days and/or GFR lower than 60 ml/min was markers of HN. RESULTS: At patients with HN was significantly increased level of serum glucose, cholesterol, triglycerides and heart rate. Normal BP and BMI reduce risk of development of HN by 12%. (р=0,03), and 31% (р=0,03), respectively. According to 24 hour blood pressure monitoring data one of the most powerful factors which influence at risk of HN development is hypertension episodes percentage factor. The Metabolic Syndrome (MetS) is independent risk factor of development of HN. At patients with MetS the frequency of occurrence of HN was authentically higher in comparison with patients with hypertension without MetS – 35,2% and 16,7% (р=0,02). CONCLUSION: use of a complex assessment of risk factors and definition of risk of development of HN is a priority at patients with hypertension. All this allows defining necessary tactics of the further medical actions directed on prevention of emergence of a HN at the early stages.

OBJECTIVE: to evaluate gender characteristics of lipid correcting and nephroprotecting effects of different variants of hypolipidemic therapy application to patients with metabolic syndrome (MetS). PATIENTS AND METHODS. The research involves 172 patients with MetS (81 males and 91 females) who were administered original simvastatin (MSD) 20 mg/per day, achieving the target level low density lipoprotein cholesterol (LDL-C) in 29 patients. The remaining patients were randomized into 2 groups: in the first the dose of simvastatin was increased to 40 mg/per day, the second group patients were administered the fixed combination: simvastatin 20 mg + ezetimibe 10mg (MSD). Initially, after 1, 2 and 6 months data of lipid profile were evaluated, C-reactive protein (CRP), microalbuminuria, blood creatinin and glomerular filtration rate (GFR) (MDRD). Results. Simvastatin 40mg/per day ensured the attaining of a target level of LDL-C with 81.2 % of males and 55.9 % of females (t<0.05), and the combination «simvastatin + ezetimibe» – 86,8 % of females and 64.1% of males (t<0.05). The application of simvastatin, as well as the fixed combination «simvastatin 20mg + ezetimibe 10 mg» ensured the significant reduction of microalbuminuria and the increasing of GFR regardless of sex, nevertheless the application of statin made more significant effect on the renal function with males whereas the therapy with combination «simvastatin 20mg + ezetimibe 10mg» of females in the degree of change of microalbuminuria and GFR gave better results than the same treatment of males. CONCLUSION. The combined therapy with MetS provides more considerable lipid correcting and nephroprotecting effects on females compared with males.

AIM OF THE STUDY is to examine body adaptive response to the dynamics of the complex treatment of pyelonephritis in children for predicting the risk of a possible relapse. PATIENTS AND METHODS. The results of a study of adaptive reactions in 210 children with pyelonephritis are presented in the article. Chemiluminescence serum, whole blood and urine tests, evaluation of adaptive reactions leukocyte count, crystallography of urine are used in this study. RESULTS. The results obtained demonstrate various versions of violations of the child’s adaptation to the active phase of microbial inflammation in the urinary system depending on the degree of disease activity. Restructuring adaptive response depending on disease activity decrease was observed. It was found long-term preservation of violations of adaptation in chronic pyelonephritis. The results led us to conclusion that physico-chemical properties of urine characterizes the state of the local adaptive-compensatory mechanisms of the urinary system. The prognostic significance of determining the adaptive capacity of the organism, as well as the physico-chemical properties of the urine are shown. CONCLUSION. It was found that a comprehensive evaluation of adaptive responses to general and local levels can predict the nature of the flow of pyelonephritis and conduct timely correction of these states for the prevention of a possible relapse.

THE AIM. Identify the types of relations between patients on chronic hemodialysis (HD), directly to the most hemodialysis (as a separate constituent of the disease), to reveal their relationship to the factors and types of attitudes toward the disease as a whole. PATIENTS AND METHODS. Examined 45 patients aged 21 to 75 years old who are being treated on HD during 6 to 102 months. The types of patients respond to illness by questionnaire A.E. Lichko. Testing of patients to determine the type of relationship to the HD conducted by questionnaire, based on the typology of “psycho-social reactions to the disease,” Z. Lipowski and data of psychotherapeutic interviews with patients. We also tested by questionnaire “HAM” – health, activity, mood. According to test results identified 3 types of relationship to the HD – positive, negative and indifferent. In order to identify the factors that influence the type of relationship to the HD, conducted statistical evaluation of the clinical and laboratory data, age, duration of HD, working patients, HD severe complications and comorbidities; correlation analysis. RESULTS. In the studied group of patients, 28 (62.2%) patients were diagnosed with a certain type of relationship to the HD, in 17 (37.8%) patients had symptoms of several types of collection. The predominant frequency of occurrence is defined III (positive) the type of relationship to the HD. A negative correlation was established between age and state of health, age and the type of negative attitude to the HD. CONCLUSION. Relationship to the HD reflects the totality of the individual understanding patients ‘meaning’ HD, his emotional reactions and accumulated coping strategies. 3 types of relationship allocated to HD: negative, positive, indifferent. Of objective factors that influence the type of attitude to the HD, according to the study, is the age indicator.

AIM. Search of noninvasive methods of diagnostics of chronic glomerulonephritis (CGN) emergence and progression based on outcome analyses of standard methods and proteomic urine examination. PATIENTS AND METHODS. The study included 60 patients which were divided into two groups. First group included 30 patients with renal cancer (RC). Average age 52,8±2,6 years. Morphologic variants of renal cancer were presented by three forms: clear-cell carcinoma (n=15), papillary carcinoma (n=9) and chromophobe carcinoma (n=6). Second group included 30 patients with CGN (18 male and 12 female), average age 37,2±1,3 years. According to results of nephrobiopsy in group of patients with CGN were revealed following morphologic variants: IgA-nephropathy (n=12); membranous proliferative glomerulonephritis (MPGN, n=7), focal segmental glomerulosclerosis (FSGS, n=5), minimal change disease (lipoid nephrosis) (LN, n=4), membranous glomerulonephritis (MGN, n=2). Control group was formed from practically healthy people, average age 52,1±1,8 years. To all patients were carried out general research methods (kidneys ultrasound, general blood analysis, general urine analysis, creatinine and blood urea concentration) and mass spectrometry of urine. RESULTS. Were revealed clinical and laboratory signs of CGN: arterial hypertension, anemy, azotemia, hypoproteinemia, hypoalbuminemia, hypercholesterinemia, hypercoagulation, hyperhidratation, proteinuria, micro- and macrohematuria, lymphocyteuria, cylindruria, decrease of glomerular filtration rate. Were revealed functional groups of new proteins which composed molecular profiles of patients with CGN explaining mechanisms of anemia progression, immune-inflammatory process, hypoxia and angiogenesis in renal parenchyma. CONCLUSION. Analysis of proteomic urine spectrum of patients with CGN and RC provides to divide protein spectrum into conditional groups. It provides to identify received proteins as potential sensitive and specific markers of disease emergence and progression.

Preservation of the renal function is the principal task in treatment of tumors of the kidneys. The studies performed over recent decades show that chronic kidney diseases (CKD) are much more widespread than it was presumed earlier, while the traditional methods used for assessment of the renal function often underrate the occurrence of the CKD, which carries more serious consequences than previously thought. The CKD lead to disorder of the renal functions with subsequent transition to renal insufficiency, which heightens the risk of development and progression of cardiovascular diseases. In patients with renal cell cancer (RCC) the differences between the oncospecific and the overall survival rates become significant as early as three years after the surgical treatment. One of the significant reasons for the absence of positive changes in the overall survival of the RCC patients is deterioration of the renal function after surgical removal of the renal tissue against the background of CKD. Different studies show that the combination of RCC and CKD leading to deterioration of the renal function is found in a substantial number of patients. Thus, the modern therapy for RCC patients must focus on optimization of the renal functions, prevention of CKD, and minimization of the CKD degree, whenever possible. Research aimed at improvement of the renal function in CKD patients after surgery should be one of the priorities of oncourology.

This article provides an overview of the literature on systemic lipomatosis (Madelung's disease), as well as two clinical descriptions of the system lipomatosis in combination with kidney disease. Both male patient. In the first case, a combination with a microscopic poliangiit lipomatosis and renal injury on the type of glomerulonephritis. In the second case lipomatosis combined with chronic glomerulonephritis that developed against the background of renal cancer and disease von Hippel–Lindau.

The article presents the main milestones in the development of nephrology in Rostov region. Author provides information about the conduct of the first studies in the field of renal pathology scientists Rostov Medical Institute at the beginning of the last century. The stages of formation and development of the nephrology service nephrology in the region are present. Article contains information about activity of the Rostov Regional Society of Nephrology, and its contribution to the development of science and education of nephrologists Don.