The last twenty years the question of close biological association between a periodontal disease and vascular pathologies, such as cardiovascular diseases (CVD), cerebrovascular diseases (CVD) is widely discussed. In recent years the question of such association -with the chronic kidney disease (CKD) is discussed too. The presented literature review allows to note that periodontal-renal relationship exists. It predetermines need of use of a syndemic paradigm of interdisciplinary approach for consideration of patients from a position of periodontal-renal relationship especially in geriatric practice where polymorbid pathology is presented.

The review presents data on the use of succinate-containing drugs in various fields of modern medicine

In the past few years increasing attention attended to the possibility of using biomarkers in the diagnosis of acute kidney injury because of disadvantages of the traditional parameters such as serum creatinine and urea, diuresis measurement, which on the one hand depends on a number of extrarenal factors, on the other - they change occurs in the later, irreversible stages of renal tissue damage. This article analyzes the possibility of using a number of markers in the early diagnosis of different types of AKI. First part of work discusses the concept of biomarker, approaches to classification, as well as proven according to experimental and clinical studies diagnostic value of the most studied biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule (KIM-1), interleukin- 18, the liver fatty acid binding protein (L-FABP), cystatin C, etc.

DEFINITION OF THE DISEASE: AL amyloidosis results from extra-cellular deposition of fibril-forming monoclonal immunoglobulin (Ig) light chains (LC) (most commonly of lambda isotype) usually secreted by a small plasma cell clone. Most patients have evidence of isolated monoclonal gammopathy or smoldering myeloma, and the occurrence of AL amyloidosis in patients with symptomatic multiple myeloma or other B-cell lymphoproliferative disorders is unusual. The key event in the development of AL amyloidosis is the change in the secondary or tertiary structure of an abnormal monoclonal LC, which results in instable conformation. This conformational change is responsible for abnormal folding of the LC, rich in β leaves, which assemble into monomers that stack together to form amyloid fibrils. EPIDEMIOLOGY: AL amyloidosis is the most common type of systemic amyloidois in developed countries with an estimated incidence of 9 cases/million inhabitant/year. The average age of diagnosed patients is 65 years and less than 10% of patients are under 50. CLINICAL DESCRIPTION: The clinical presentation is protean, because of the wide number of tissues or organs that may be affected. The most common presenting symptoms are asthenia and dyspnoea, which are poorly specific and may account for delayed diagnosis. Renal manifestations are the most frequent, affecting two thirds of patients at presentation. They are characterized by heavy proteinuria, with nephrotic syndrome and impaired renal function in half of the patients. Heart involvement, which is present at diagnosis in more than 50% of patients, leading to restrictive cardiopathy, is the most serious complication and engages prognosis. DIAGNOSTIC METHODS: The diagnosis relies on pathological examination of an involved site showing Congo red-positive amyloid deposits, with typical apple-green birefringence under polarized light, that stain positive with an anti-LC antibody by immunohistochemistry and/or immunofluorescence. Due to the systemic nature of the disease, non-invasive biopsies such as abdominal fat aspiration should be considered before taking biopsies from involved organs, in order to reduce the risk of bleeding complications. DIFFERENTIAL DIAGNOSIS: Systemic AL amyloidosis should be distinguished from other diseases related to deposition of monoclonal LC, and from other forms of systemic amyloidosis. When pathological studies have failed to identify the nature of amyloid deposits, genetic studies should be performed to diagnose hereditary amyloidosis. MANAGMENT: Treatment of AL amyloidosis is based on chemotherapy, aimed at controlling the underlying plasma clone that produces amyloidogenic LC. The hematological response should be carefully checked by serial measurements of serum free LC. The association of an alkylating agent with high-dose dexamethasone has proven to be effective in two thirds of patients and is considered as the current reference treatment. New agents used in the treatment of multiple myeloma are under investigation and appear to increase hematological response rates. Symptomatic measures and supportive care is necessary in patients with organ failure. Noticeably, usual treatments for cardiac failure (i.e. calcium inhibitors, β-blockers, angiotensin converting enzyme inhibitors) are inefficient or even dangerous in patients with amyloid heart disease, that should be managed using diuretics. Amiodarone and pace maker implantation should be considered in patients with rhythm or conduction abnormalities. In selected cases, heart and kidney transplantation may be associated with prolonged patient and graft survival. PROGNOSIS: Survival in AL amyloidosis depends on the spectrum of organ involvement (amyloid heart disease being the main prognosis factor), the severity of individual organs involved and haematological response to treatment.

THE AIM OF RESEARCH was to study the mechanisms of ion regulation in the kidneys under the conditions of histohemic hypoxia (HHH), as well as the nephroprotective properties of diltiazem and flocalin. MATERIALS AND METHODS. The experiments were made on non-linear laboratory whitw rats with 0.15-0.17 kg weight after 5% water load. HHH was modeled by administration of sodium nitrite at a dose of 50 mg/kg and 2,4-dinitrophenol at a dose of 3 mg/kg. After 30 days we administered diltiazem and flocalin intragastrically at a dose of 5 mg/kg each on 1% starch solution during 7 days. Concentration of sodium and potassium ions in urine and blood plasma was measured with flame photometry, and creatinine concentration was measured with colorimetry technique. RESULTS. Progression of histohemic nephropathy in rats was characterized by the decrease of glomerular filtration rate (GFR), decrease of filtrational sodium load, inhibition of tubular sodium reabsorption, increase of natriuresis and kaliuresis. After administration of diltiazem the studied indexes of renal function in rats with HHH did not change. Conversely under the influence of flocalin GFR and filtrational sodium load increased, water reabsorption restored, proximal transport of sodium ions increased, kaliuresis decreased. CONCLUSION. Assessment of the renal effects of the representatives of calcium and potassium channels has shown that unlike diltiazem, flocalin can be regarded as a nephroprotective agent under the conditions of histohemic hypoxic lesion of kidneys.

AIM. The aim of the investigation was to study the character and frequency of lower and upper urinary tract symptoms in patients with pelvic organs prolapse of the 4th stage, as well as to estimate the effectiveness of reconstructive surgery of the pelvis and correction of detected impairments. PATIENTS AND METHODS. 89 women with pelvic organs prolapse of the 4th stage participated in the investigation. RESULTS. All 89 (100%) patients had difficult frequent urination and incomplete emptying of the bladder before the operation. Bilateral ureterohydronephrosis was revealed in 20 (22,5%) of 89 patients. Performed operations provided effective reconstruction of normal anatomy of the pelvic floor and eradicated obstructive symptoms in 86 (96,6%) of 89 patients. In 47 (52,8%) of 89 women urine stress-incontinence developed during the postoperative period. CONCLUSION. Transvaginal operation with the use of mesh endoprostheses results in effective normal anatomy restoration of obstructive symptoms of urination. However the development of urine stress-incontinence in more than half of patients requires methods of prognosing of this complication and reasoning of indications for performing single-stage combined operation.

AIM OF THE STUDY was to determine the detection rates for BK and JC polyomaviruses in urine sediment and blood leucocytes of patients after kidney transplantation (Tx), dependent on patients’ age and duration of post-transplant follow-up. PATIENTS AND METHODS. The study involved 52 patients (pts) after Tx, including those with chronic glomerulonephritis/nephropathies (n=38), diabetic nephropathy (n=14). All patients received immunosuppression based on calcineurin inhibitors, MMF and prednosone. DNA was isolated from urinary sediments and peripheral blood leukocytes. BK and JC DNA were determined by means of gene-specific polymerase chain reaction (PCR). RESULTS. Incidence of polyomaviruses in urine was 25% and 14% for ВК and JC, respectively. Blood samples were PCR-positive for ВК (33% of samples), and JC (28%). Viruria and viremia were not significantly associated, while a distinct correlation was found between BK- and JC-positivity either in urine sediment or in blood leucocytes. BK/JC co-infection was found in 8% of urinary specimens, and 13% of blood specimens. Urine JC positivity in patients with diabetic nephropathy increased, as compared to other groups (33% vs 23%, р=0,04), being especially high during 2nd year post-Tx. CONCLUSION. Our data are indicative for rather high BK and JC positivity, including co-infection (BK+JC), both in urinary and blood cells. Age, post-Tx period and diabetes are suggested to be a potential confounders. Clinical and biological value of the data obtained requires further studies.