Current concepts of secondary hyperparathyroidism development and progression based on new data about pathophysiology and molecular mechanisms of phosphate-regulating systems interactions in terms of fibroblast growth factor 23 and Klotho role

The article contains analysis of contemporary data on the role of systemic and local inflammation in diabetic nephropathy. Renal effects of proinflammatory cytokines (tumor necrosis factor-α, interleukin-1, interleukin-6, interleukin-18) are described. The main directions of pathogenetic therapy are discussed. Further investigations are needed to elucidate inflammatory mechanisms of renal irritation at diabetes mellitus and prognostic relevance of inflammatory markers in patients with diabetic nephropathy

Arrhythmias are common in renal transplant recipients and predict the cardiovascular mortality. In the review currently available data of particular arrythmias in this group of patients is discussed; main arrythmias risk factors and the mechanisms of its development are presented

THE AIM of this study was to examine relative effect of SLEDD (sustained low-efficiency daily dialysis) with standard bicarbonate and with acetate-free dialysate on acetatemia dynamics and haemodynamic stability in patients with acute kidney injury (AKI) after cardiac surgery. PATIENTS AND METHODS. Thirty-five patients with AKI., who requires renal replacement therapy (RRT), were divided into two 2 groups. 46 SLEDD with bicarbonate dialysate (contains 3 mmol/l of acetate) were performed in group A (n=18). 52 SLEDD with acetate-free dialysate «Krebsol» were performed in group B. Serum acetate level, acid-base balance factors and electrolytes, episodes of intradialisis hypotension and arrhythmias were evaluated. RESULTS. After SLEDD with bicarbonate dialysate initial acetate concentration increased averagely 4 times. On the contrary, after SLEDD with acetate-free dialisate acetate range didn't alter. In both groups was achieved decrease of azotaemia and permanent correrction of electrolytic homeostasis and acid-base balance. At the same time usage of acetate-free dialysate significantly modulated hemodynamic complications. CONCLUSION. The study has shown that even «small» acetate concentrate in standard bicarbonate dialysate may become a cause of significant acetatemia and, as a consequence, can induce hemodynamic complications at SLEDD in patients with AKI. Usage of SLEDD with acetate-free dialysate reduced risk of intradialisis complications development

THE AIM: investigation of arterial blood pressure (ABP) daily profile specifications at patients with chronic heart failure (CHF) depending on functional kidneys state. PATIENTS AND METHODS. 184 patients with CHF were searched (101 men and 83 women), average age - 56.7 years. 20 patients were diagnosed I functional class (FC), 105 - II., 58 - III CHF FC and 1 - IV CHF FC. Glomerular filtration rate (GFR) was counted by MDRD formula, average GFR was 58.6±18.9 ml/min/1.73m². CHF ordered sample was divided into quartiles. RESULTS. Patients from quartile 4 had higher value of ABP. There was shown positive correlation of diurnial and average daily systolic and diastolic ABP., diastolic ABP hypertension time index with CHF value. Meaningful differences were detected in night decreasing level (NDL) of systolic and diastolic ABP at patients of CHF with different GFR: ABP NDL was statically rather lower at patients with CHF from 1 quartile. CONCLUSION. Results of the research testify about appreciable ABP diurnial rhythm disturbances at patients with CHF associated with chronic kidney disease which can potentially affect on disease prognosis. It is necessary to provide further investigations of diurnial ABPM factors alteration prognostic value determination at patients with CHF and usage of received information for treatment optimization

THE AIM. Research of low-protein diet (LPD) with Ketosteril long-term administration effect on cardio-vascular system and rats values with experimentally decreasing of functional nephron quantity. MATERIAL AND METHODS. Work is completed on Wistar male rats with 5/6 nephrectomy (NE). During 4 months after NE one group of rats received standard diet (20.16% animal protein), another group - LPD with 10% Ketosteril. Control rats received either standard or low-protein diet. RESULTS. Administration of LPD with Ketosteril retarded experimental uremia progression, reduced phosphatemia, proteinuria, prevented triglyceride concentration increasing in serum. Experimental LPD cardioprotective effect included improving mean arterial pressure and prevention myocardium weight rising in rats with NE. RESULTS. Long-term usage of qualitatively and quantitatively balanced low- protein makes reno- and cardioprotective effects on animals with experimental kidney failure

THE AIM. To detect possible relationship of furosemide pharmacological effect on kidneys function at rats from different diuretic doses with "dose-effect" response graphing. MATERIAL AND METHODS. The research was done at male Wistar rats. Daily factors of urinary passage and electrolyte excretion were determined after single subcutaneous injection of furosemide with doses 0,5, 1, 2, 5, 10, 20 mg/kg. RESULTS. It provides suggestions that furosemide complexing with NKCC happens in the range of 1-2 mg/kg doses. Saturation of potassium excretion transfers was registered in the range from 2 to 5 mg/kg on retention of sodium excretion increment linearity. In a range from 5 to 20 mg/kg sequential sodium and chlorine excretion increase was observed at invariable potassium excretion level. CONCLUSION. "Dose-effect" dependence received data analysis allowed to reveal a number of furosemide diuretic and saluretic activity laws. Sodium ions excretion reaches first saturation threshold at furosemide doses from 0,5 to 2 mg/kg, then at high doses further slow allocation increase of these ions is observed. Potassium ions excretion dependence of furosemide dose differs from sodium excretion. The curve has one saturation threshold, which is reached at doses from 1,5 to 5,0 mg/kg, and at higher doses potassium ions excretion is invariable. Chloride ions excretion is proportional to total potassium and sodium ions excretion tellingly to all cation-chlorine transporters series which are carrying out electroneutral transport

THE AIM. Investigate diagnostic significance of prostate specific antigen (PSA) level detection in blood plasma and its kinetic characteristics (PSA development speed and doubling time) at patients selection for control "C-cholin positron-emission/ computerized tomography (PET/CT) to show local recurrences at patients with prostate cancer (PC) and to ascertain factors dependence on primary treatment methof - radiotherapy (RT) or radical prostate ectomy (RP). PATIENTS AND METHODS. Investigation is based on 125 patients examination and treatment after RT (64 patients) or RP (61 patients) in regard to histologically approved PC. Investigation was carried on for every patient after any variant of treatment with ¹¹C-cholin PET/CT to show local recurrences. Clinicopathologic characteristics at patients after RP and RT were compared. PSA development speed and PSA doubling time were calculated. ROC-analysis of data was done with SPSS-16 statistic program. RESULTS. Average PSA value much differ after RP and RT (4,8 ng/ml and 12,9 ng/ml). There is relation between values of rate of PSA development, doubling time and recurrence presence or absence diagnosed by results of PET/CT. ROC analysis didn't show important differs between patients after RP and RT by PSA level (AUC=0,646 and 0,721) and rate of PSA development (AUC=0,691 and 0,663) that confirms proposition about independence of these data from primary treatment method. CONCLUSION. PSA values and its kinetic characteristics don't depend on primary treatment mode. PSA doubling time is most important value at patients selection for control C-choline PET/CT for PC local recurrence detection after RT and RP

This review is a conclusion of up-to-date conceptions about genetics, development mechanisms, clinical picture, diagnostics and treatment of hypophosphathemic rickets determined by renal tubular phosphate reabsorption impairment

ABSTRACT THE AIM: to assess the role of arterial hypertension in prognosis of course of glomerulonephritis in children. PATIENTS AND METHODS. 300 children from 3 to 18 years old with different forms of glomerulonephritis were observed. Observation included pedigree and catamnesis of the disease during 2-12 years. One hundred parameters were analysed, including anamnesis and clinical symptoms, renal function indexes, plasma phospholipid spectrum and immune indexes. RESULTS. Arterial hypertension is the most significant clinical symptom in glomerulonephritis. If blood pressure is increased more than 2 weeks from the disease onset, risk of lingering and chronic course is higher. In acute and chronic glomerulonephritis arterial hypertension is supported by different methods.