THE AIM of the investigation was to assess the reaction of erythrocytes to uremia and hemodialysis treatment based on many years of studying different types of hemolysis. PATIENTS AND METHODS. The examination included 108 patients with chronic renal failure (66 men and 42 women; mean age 43.29±1.22 years). The patients received 200 sessions of standard bicarbonate dislysis. The control group consisted of 27 healthy subjects (17 men and 12 women; mean age 46.2±3.1 years). The time of acidic, osmotic and ultrasonic hemolysis was studied as well as the osmotic resistance of erythrocytes. RESULTS. The time of acidic hemolysis in patients before the beginning of the hemodialysis session was 33.8% longer as compared with the same index for the control group (t=12.4; p<0.001). Although the time of acidic hemolysis was 11.8% shorter due to the hemodialysis session, it was still 18% higher (t=7.3; p<0.001). The osmotic resistance in patients before dialysis was 6.5% higher than normal (t=2.35; p<0.05), and after dialysis it was 9.23% reliably higher (t=5.04; p<0.001). The duration of osmotic and ultrasonic hemolysis before and after dialysis did not reliably differ from the similar indices of the control group. Weak negative correlation was revealed between the time of acidic hemolysis and content of calcium and albumin in the patients’ blood plasma after hemodialysis session. The correlation coefficients were 0.206± 0.070 (t=2.96; p<0.01) and 0.216±0.069 (t=3.11; p<0/001) respectively. The first factor with the greatest weight included the indices of arterial pressure before and after the hemodialysis session showing the state of the patients’ cardiovascular system. The second component with the relative weight a little more than 8% characterized the effectiveness of the hemodialysis session. The third factor included the concentration of albumine and cholesterol in blood

plasma. The fourth factor consisted of the indices associated exclusively with the acidic and ultrasonic resistance of erythrocytes.The indices of osmotic resistance were included but in the ninth factor. CONCLUSION. An analysis of the data on the erythrocyte resistance to acidic and osmotic hemolysis showing the functional state of red blood cells as a whole and, in particular, their plasmatic membranes, has revealed a reliably positive influence of the hemodialysis procedure on the cellular sector of organism of the dialysis treated patients. It was shown that in the course of the hemodialysis session the acidic hemolysis time shortened and the osmotic resistance of erythrocytes considerably increased. The correlation and factor analysis of the data obtained has confirmed high degree of autonomy of erythrocytes. For all this, the indices of different types of hemolysis, being somewhat inferior by their informative value to clinical and biochemical indices, nevertheless have sufficiently high factor significance.

THE AIM of the investigation was to study the influence of age on indices of quality of life (QL) of patients with chronic renal failure treated by hemodialysis (HD). PATIENTS AND METHODS. Among 142 examined patients treated by chronic HD there were 83 patients aged from 16 to 44, 47 patients aged from 45 to 59 and 12 from 60 to 74 years. The parameters of quality of life were determined in all the patient by the SF36 method. Clinicolaboratory indices were determined for the estimation of effects of age and of objective indices of the patients’ somatic state on their QL. RESULTS. It was shown that most indices of physical functioning of HD patients such as resistance to physical loads (PF), intensity of pain (BP), general health (GH), total index of the physical state became worse with age. As for the assessment of mental health, the ANOVA data showed that agerelated worsening was noted but in one of five indices of mental functioning general activity (V). The range correlation analysis after Spirmen has detected a correlation of several indices of mental health with age, but the tightness of these bonds was substantially less than between age and indices of physical functioning. Multivariate regression analysis has shown that age has an independent effect on the integral indices of physical and mental health. The other predictors of the value of the total index of physical health are the level of blood serum albumin and CaP product, while the level of hemoglobin and duration of HD treatment allow prediction of the value of total index of mental health. CONCLUSION. Agerelated changes of QL of HD patients are characterized by marked deterioration of the indices of physical functioning caused by age. The agedependent lowering of subjective estimation of the mental state is less pronounced. The patients’ age is a substantial factor influencing the total components of QL.

THE AIM of the work was to study magnesium homeostasis and diurnal monitoring of arterial pressure in girls of juvenile age with different forms of chronic pyelonephritis. PATINTS AND METHODS. 126 girls of juvenile age were examined. Control group consisted of 55 girls, besides there were 49 girls with chronic secondary pyelonephritis in the stage of clinicolaboratory remission, and 22 girls with chronic secondary pyelonephritis at the stage of exacerbation. RESULTS. Patients with chronic pyelonephritis (CP) at the stage of clinicolaboratory remission at the stage of exacerbation had different deviations in magnesium metabolism as compared with the girls from the control group. Curves of magnesium diurnal excretion with urine in sick girls differed from those of the control group. The arterial pressure (AP) levels and pulse by the results of diurnal monitoring of AP (DMAP) in patients with different forms of pyelonephritis were within normal for this gender and age, but in certain periods of time reliably higher than in the control group. There appeared a reliable correlation between mean values of erythrocyte magnesium and AD in the group of patients with CP at the stage of clinicolaboratory remission as compared with healthy girls. CONCLUSION. It was found that reliably decreased erythrocyte magnesium in CP patients in the stage of clinicolaboratory remission may be considered as a criterion of chronization of the inflammatory process. The change of the shape of diurnal magnesium excretion with urine in patients with CP at the stage of clinico laboratory remission as compared with CP at the stage of exacerbation may be considered as a criterion of exacerbation of the inflammatory process. The changes revealed in studying magnesium homeostasis and DMAP in the group at the stage of clinico laboratory remission show that these patients should be included in the group of risk of the development of arterial hypertension.

THE AIM of the investigation was to assess the role of modifiable factors in the development of stability of arterial hypertension (AH) in relation to hypotensive therapy as a whole and to therapy with loop diuretics in patients with chronic renal failure (CRF). PATIENTS AND METHODS. Under examination there were 103 patients with CRF and secondary AH. In 42 patients AH could be easily corrected by standard hypotensive therapy. In 61 patients AH failed to be corrected, so in order to normalize arterial pressure these patients received injections of furosemid in dose of 80 mg (120 mg at GFR<30 ml/min) in addition to their treatment. In these patients an assessment was made of the influence on the development of AH of such factors as age, gender, character of therapy received by the patients from the moment of diagnosis of the disease, keeping the regimen of treatment by the patient. RESULTS. Patients limiting consumption of salt could more easily reach normal arterial pressure both against the background of usual hypotensive therapy (χ2= 10.38; p<0.001) and under effects of furosemid (χ2=9.35; p<0.004), than patients taking salt ad libitum. Excessive consumption of water also facilitated the development of stable AH (χ2 =5.86; p<0.02). Indirect findings were obtained concerning the ability of the angiotensinconverting enzyme inhibitors to prevent the development of stable AH. Inconstant taking of hypotensive drugs facilitated the formation of stable hypertension (χ2 =5.19; p<0.02). CONCLUSION. The development of difficult to correct AH in pathology of the kidneys depends on many external modifiable factors that proves the significant role of the patients and doctors in prevention of progression of AH.

THE AIM of the work was to study the interrelationship between the blood lipid level and endothelium function in patients with chronic renal failure (CRF). PATIENTS AND METHODS. The group under study included patients with chronic pyelonephritis and hypertension variant of glomerulonephritis: 25 of them had normal function of the kidneys, 58 had predialysis stage of CRF and 27 had the endstage CRF receiving substitution therapy with hemodialysis (HD). All the patients had arterial hypertension. They received adequate hypotensive therapy. The patients under study had no clinical symptoms of ischemic heart disease (IHD) or atherosclerosis of the cerebral arteries, signs of exacerbation of the main kidney disease or coexistent pathology. HD was adequate (sKt/V>1.2). Cholesterol, low density lipoprotein cholesterol (LDLPC), high density lipoprotein cholesterol (HDLPC), triglycerides, endotheliumdependent vasodilatation (EDV) and endotheliumindependent vasodilatation (EIV) were determined. RESULTS. General cholesterol was somewhat higher in patients without CRF and with the predialysis stage of CRF, while in the group of HD patients it was within the normal. Mean values of LDLPC and HDLPC, triglycerides were within the normal. Reliable negative correlative interrelation was noted between EDV and blood triglyceride level. No reliable correlative interrelation was noted with general cholesterol, LDLPC and HDLPC. Reliable positive interrelation was detected between EIV and LDLPC having antiatherogenic properties. No relationships were detected between EIV and cholesterol level and LDLPC. CONCLUSION. It can be suggested that triglycerides represent the factor influencing the development of endothelial dysfunction in patients with different stages of CRF, while LDLPC have protective effects on the endothelium.

THE AIM of the investigation was to specify the quality of life (QL) indices and patters of attitude to disease of patients with severe chronic heart failure (CHF) and microalbuminuria (MA). PATIENTS AND METHODS. The efficiency of treatment of CHF with ACE inhibitors was investigated in 30 patients by clinical signs and quality of life criteria. RESULTS. Patients with severe heart failure had low indices of quality of life and nonadaptive patterns of attitude to disease. ACE inhibitor of prolonged effects lisinopril was found to be effective in treatment of heart failure both by somatic indices and by life quality characteristics. Patients constantly treated with lisinopril had more rational attitude to their disease. CONCLUSION. Treatment with lisinipril results in better somatic state of the patients, lower excretion of albumin with urine and improves indices of life quality.

THE AIM of the investigation was to compare vasomotor activity of blood vessels in patients with atherosclerosis and chronic kidney disease (CKD) with hyperlipidemia using electrophoretic tests with 0.2% solution of acetylcholine chloride (endotheliumdependent vasodilatation) and 1% solution of nitroglycerin (endotheliumindependent vasodilatation). PATIENTS AND METHODS. Tests with vasoactive substances were made in 20 patients with II stage obliterating atherosclerosis of lower extremities (OASLE) by Fontaine (mean age 56±6 years), 22 patients with CKD (mean age 45±3 years) and 20 healthy subjects (mean age 44±3 years). Microcirculation in the skin was assessed by the method of high frequency ultrasound dopplerography («MinimaxdopplerK», transducer with radiation frequency 25 MHz monitoring the tissue 5 mm deep). RESULTS. Patients with OASLE had impaired endothelium dependent vasodilatation, and patients with CKD had impaired both endotheliumdependent and endotheliumindependent vasodilatation. Changed reactivity was characteristic of microcirculation bed vessels not involved into the atherosclerotic process. CONCLUSION. OASLE and CKD are accompanied by systemic endothelial dysfunction. Changed reactivity of the vessels, at the level of the microcirculatory bed included, is considered to be manifestation of endothelial dysfunction.

THE AIM of the investigation was to assess the role of impairments of circadian rhythms of arterial pressure (AP) in progression of renal failure in patients with chronic glomerulonephritis (CGN) and diabetic nephropathy (DN), their interrelation with activity of reninangiotensin aldosteron system. PATIENTS AND METHODS. Examination of 63 patients with different degrees of renal failure included 34 women and 29 men. There were 33 patients (52%) with CGN and 30 (48%) with DN. All the patients received antihypertensive therapy in order to reduce average AP .to the level of 92 mm Hg (125/75 mm Hg). Circadian monitoring of AD (CMAD) was performed in all the patients. On the day of CMAD plasma renin activity was specified. The rate of progressing chronic renal failure (CRF) was specified by the time of doubling the blood creatinin level. RESULTS. Patients with DN and CRF did not differ by the main laboratory parameters with the exception of more pronounced proteinuria in diabetics. In dipers with DN the rate of progression of CRF was 27.8+3.7 months, with the impaired circadian rhythm of AP 21.2+4.4 months. In the group of patients with CGN the rate of progression of CRF was substantially slower in dipers than in patients with impaired circadian profile of AP (44.0±5.5 and 24.3±7.6 months respectively). Patients with CGN and DN with the impaired circadian rhythm had approximately similar rate of progression of CRF (24.3±7.6 and 21.2±4.4 months respectively; MannWhitney U test; Z = 1.0; p= 0.9). The rate of progression of CRF in dipers with DN was 27.8±3.7 months, with CGN 44.0±5.5 months (MannWhitney U test; Z = 2.0; p=0.04). The same regularity was also observed in cases of the achieved and not achieved required level of AP (25.4±6.4 and 20.4±3.5 months respectively; MannWhitney U test; Z = 0.34; p=0.74). CONCLUSION. The rate of progression of CRF in patients with DN was higher than with CGN with the normal circadian rhythm or the achieved required level of AP. Patients with CGN and DN with the impaired circadian rhythm or not achieved required level of AP had approximately similar rate of progression of CRF.

THE AIM of the investigation was to detect specific clinicomorphological features appearing in acute poisonings with pallid toadstools. MATERIAL AND METHODS. An analysis was made of 2 case histories of hospital patients and 4 acts (conclusions) of medicolegal experts on examination of corpses of subjects dead from poisonings with toadstools. Under investigation there were 30 micropreparations of kidneys and liver stained with hematoxylin and eosin. RESUILTS. Characteristic clinical symptoms of poisoning were found as well as the following morphological alterations: in the liver widely spread necroses of hepatocytes; in the kidneys steatosis and dysproteinosis with the formation in basal parts of the cells of convoluted tubules of small vacuoles containing lipids with swelling and pronounced granular structure of cytoplasm, in the collecting tubules granular cylinders. CONCLUSION. Specific features found in histological investigation point to the development of severe dystrophic changes.

THE AIM of the investigation was to study catalase metabolism in experimental animals with chronic glomerulonephritis. MATERIAL AND METHODS. The work was carried out in not thoroughbred male white rats with body mass 140160 g. Experimental model of glomerulonephritis (Heimann nephritis) was induced in experimental animals by intramuscular injecting homogenate of healthy rat kidneys in Freund’s adjuvant. The biochemical indices in rats were specified in three weeks after autoimmunization of the animals. RESULTS. It was found that chronic glomerulonephritis resulting from oxidative stress was followed by a sharp drop of catalase activity. It was shown to be due to a sharp inhibition of the rate of accumulation (Ks) of enzyme protein (from 5 to 8 times) in blood, kidneys and liver of the rats with glomerulonephritis as compared with control animals and to lead to a reliable decrease of catalase concentration in those tissues. At the same time the obviously compensatory decrease of decomposition (Kd) of the fermentative protein was observed and, as a result, a longer period of its «halflife» (t1/2) which in certain degree compensated the deficit of newly synthesized molecules of catalase. CONCLUSION. It was established that the earlier found reliable drop of catalase activity in blood, kidneys and liver of rats during the development of glomerulonephritis was due to sharply decreased rate of its biosynthesis / accumulation in these tissues.

THE AIM of the investigation was to study functions of the kidneys after retropubic radical prostatectomy. PATIENTS AND METHODS. 150 patients with localized forms of prostate carcinoma were examined after retropubic radical prostatectomy. RESULTS. The most informative factors of risk concerning the development of impairment of kidney functions were elderly age, signs of involvement of seminal vesicles and prostate capsule in the tumor, high degree of traumaticity of the operation. CONCLUSION. Impairments of the nitrogen and water excreting function of the kidneys, electrolytic balance were mots important as well as activation of processes of acido and ammoniogenesis which developed in the early postoperative period.

THE AIM of the investigation was to study activity of nucleolar organizers and clinical course of transitional cell carcinoma of the bladder and to compare clinical and morphological signs with indices of the distribution of nucleoli and argentophilic granules in tumor cells. PATIENTS AND METHODS. Data of the primary examination and of five years of dispensary observation after radical operative treatment of 61 patients with transitional cell carcinoma of the bladder were studied retrospectively. In addition to standard examination the ablated tissues of the tumors were stained with silver nitrate and under 1000 magnification the indices of the distribution of nucleoli and argentophilic granules were counted and analyzed and compared with clinical data taken before operations and during the postoperative dispensary followup. RESULTS. A correlation was revealed between indices of the distribution of nucleoli and nucleolar organizers and gender (p<0.001), age (p=0.077), blood group (p=0.038), rhesus factor (p=0.091), complains to dysuria (p=0.040), macrohematuria (p=0.063), content of erythrocytes (p=0.009) and leukocytes (p=0.015) in peripheral blood, presence of uremia (p<0.001), bacteriuria (p<0.001), leukocyturia (p=0.005), deep invasion (p=0.034) and degree of differentiation (p=0.0009) of carcinoma, as well as of recurrences (p<0.001) of tumors and survival of patients (p=0.021). The investigation of the parameters of distribution of nucleoli and bladder carcinomas granules allowed to specify risk of recurrences and death of patients from progression of the tumors after operative treatment. CONCLUSION. Investigation of activity of nucleolar organizers give additional information on properties of bladder carcinomas and prognosis of the disease.

THE AIM of the work was to determine the place of the systemic enzymotherapy drug Vobenzyme in complex treatment of patients with chronic prostatitis. PATIENTS AND METHODS. Under examination there were 110 patients with chronic prostatitis in phase of active inflammation; 70 of them were given Vobenzyme in addition to traditional antibacterial and antiinflammatory therapy and 40 patients were treated by traditional antibacterial therapy and made up the group of comparison. The dose of Vobenzyme was 500 mg three times a day during a month, followed by two repeated courses with a one month interval. Immune status, blood flow in the prostate by rheography, clinical manifestations of the disease were studied in all the patients. Laboratory investigation of the prostate secretion (or ejaculate) were made. RESULTS. In patients given Vobenzyme in complex treatment immunological indices were normalized, organic blood flow was considerably improved, analyses of the prostate secretion or ejaculate were also normalized. CONCLUSION. The data obtained allow to recommend inclusion of Vobenzyme as a means of systemic enzymotherapy in the complex treatment of patients with chronic prostatitis.