THE AIM of the investigation was to determine the incidence of calcinosis of the mitral (MV) and aortal (AV) heart valves in patients in the predialysis period of chronic kidney disease (CKD) and the associated factors. PATIENTS AND METHODS. The investigation included 317 patients (46.1% of men and 53.9% of women) with 1-5 stages of CKD in the predialysis period. The age of the patients was 50.7±15.2 years (14-84). There were 30.7% of patients with chronic glomerulonephritis, 29.4% with diabetic nephropathy, 17.7% with essential hypertension, 22.0% with other diseases. Doppleroechocardiography (Doppler-EchoCG), daily monitoring of AP, ECG were performed. The state of MV and AV was assessed: norm, hardening, calcinosis (of fibrous ring or cusps). The thickness of the carotid artery intima-media complex (IMC) was measured on two sides at 3 levels. In part of the patients the intact parathormone was determined, densitometry of the forearm bones was made, the thickness of cortical layers of the 2nd metacarpal bone was determined by X-ray examination, total extension of the abdominal aorta calcinosis was measured by the A.E.Hak el al. method. RESULTS. Valve calcinosis was detected in 22.1% of the first group patients: AV – in 6.3%, MV – in 4.1% and of the both valves in 11.7%. A comparison of the groups different in the presence of valve calcinosis (AV, MV or both) has shown that patients with calcinosis had greater thickness of IMC (p< 0.001), older age (p<0.001), more often incidence of diabetes mellitus (p<0.001), IHD (p<0.001), heart failure (p<0.001), higher AP (p<0.001), lower GFR by MDRD formula (p=0.033), less sizes of the kidneys (p=0.039) and their parenchyma thickness (p=0.015), tendency towards higher values of parathormone (p= 0.089). Using multifactor methods (discriminative analysis) revealed that valve calcinosis was independently influenced by IMC thichness (p=0.001) and diabetes mellitus (p=0.024). CONCLUSION. Heart valve calcinosis was revealed in 22.1% of the patients in the predialysis period of CKD. It was closely associated with atherosclerosis (in its turn associated with the patient’s age, hypertension, lower GFR, inflammatory alterations) and diabetes mellitus.

THE AIM of the investigation was to compare the methods of kaliperometry and bioimpedancemetry for diagnosis of insufficient nutrition in chronic hemodialysis patients. PATIENTS AND METHODS. Under examination there were 86 patients (40 women and 46 men aged 52.2±1.3 years) with the V stage chronic kidney disease treated by hemodialysis. Kaliperometry and integral two-hour impedancemetry were used for the assessment of the trophological status. The nutritional status of the patient was assessed by a complex method of nutritional assessment. RESULTS. Insufficient nutrition of the Ist degree was found in 87% of the patients, of the II degree – in 13%. The use of kaliperometry results in growing (15%) fat mass both in men and in women. CONCLUSION. We recommend bioimpedancemetry for the assessment of the degree of insufficiency of nutrition in patients on hemodialysis.

THE AIM of the study was to examine how renal dysfunction affected the prevalence of Helicobacter pylori. PATIENTS AND METHODS. We studied 31 patients undergoing long-term dialysis and 28 controls without renal disease. Upper gastrointestinal endoscopy was done in all the patients involved in the study. On endoscopy, biopsy specimens were taken for analysis of H.pylori infection by urease test and culture. RESULTS. The prevalence of antral urease activity was significantly less in patients with renal disease than in the control group (51.6% and 85.7%, p<0.01), although the prevalence of positive culture test in dialysis patients didn’t differ from that of the control group (41,7% and 57.1%). The sensitivity of the urease test to diagnose H.pylori infection was 80.0% in the group of patients with end-stage renal disease and 93.8% in the controls. All isolates from the dialysis patients were susceptible to amoxicillin, furasolidone and tetracycline whereas 3 were resistant to azithromycin, 1 was resistant to clarithromycin and all patients were resistant to metranidazole. All isolates from the control group were susceptible to clarithromycin. CONCLUSION. The prevalence of H.pylori infection was the same in dialysis patients when compared with controls. The sensitivity of the urease test was reduced in patients with end-stage renal disease. The number of clarithromycin-resistant isolates was founf to rise in the group of dialysis patients.

THE AIM of the investigation was to study the interrelations of duration of chronic kidney disease (CKD), time of substitution therapy, immunological indices (interleukins 1, 2, 6, 10) and morphological and endoscopic changes against the background of gastroenterological pathology. PATIENTS AND METHODS. The investigation included 43 patients, 32 of them had clinical manifestations of chronic renal failure (CRF). The following methods were used: analysis of complaints, case history, objective examinations, general clinical and biochemical analyses of blood, fibrogastroduodenoscopy with biopsy, immunological investigations for determination of the presence of Helicobacter pylori (HP) and interleukins in bioptates. RESULTS. The investigation has revealed reliable interrelations between abdominal pains, discomfort and the presence of cytokines (p<0.001) in the main group of patients. The same reliability was observed between the presence of HP in the bioptate and such symptoms as changed appetite in patients with chronic kidney disease (CKD) in the dialysis stage and gastro-intestinal pathology (p<0.05) and the length of substitution therapy (p<0.05). Reliable interrelations were also found between the indices of duration of CRF and IL1 (p<0.05), IL6 (p <0.001), IL10 (p<0.001). CONCLUSION. The data obtained show sufficiently high incidence of HP infection with the prevailing weak and medium degree of microbial contamination; there were reliable corelations between the sense of discomfort and pain in the abdomen and the presence of cytokines in CRF patients; period of time of CRF and duration of substitution therapy had sufficiently strong correlation with the presence of cytokines 1, 2, 6 and 10 in mucosa bioptates.

THE AIM of the investigation was to determine the level of total IgE and to determine the level of IL-4 and IFN-γ in patients with minimally changed nephrotic syndrome and atopic dermatitis. PATIENTS AND METHODS. The investigation included 56 patients with initial and relapsed steroid-sensitive MCNS (13 females and 43 males, aged 1-20 years) and also 50 patients with atopic dermatitis (19 females and 31 males, aged 1-16 years). The levels of specific IgE in blood serum were determined by means of the enzyme test-systems to alimentary, household allergens and allergens of grass and trees in children with MCNS. The level of specific IgE was evaluated as negative-, low+, moderate ++, high +++, highest ++++. The moderate, high and highest levels of IgE in blood of the examined patients were considered for diagnosis. L-4 and IFN-y were measured by an immunoassay technique using monoclonal antibodies. RESULTS. Our investigation showed that there were no statistically significant differences between allergic diseases, level of specific IgE and L-4 in 56 patients with MCNS and 50 patients with atopic dermatis. CONCLUSION. The fact that there were no significant differences in specific IgE, L-4 and IFN-γ in children with MCNS and atopic dermatitis allows a supposition that these diseases have identical mechanisms of pathogenesis with 1-type IgE reaction.

THE AIM of the investigation was to study homeostatic reactions of the kidneys on administration of solutions of potassium chloride prepared with tap water and distilled water. MATERIAL AND METHODS. Intragastric infusions of 0.45% solutions of potassium chloride in 3% volume of body mass were made through a probe to white outbred rats. Total diuresis was registered for 2 hours and the concentration of sodium, potassium, magnesium, titrated acids and ammonia were determined. Excretion of the substances under study was calculated totally for 2 hours in recalculation on 100 g of body mass of the animal. RESULTS. It was found that excretion of potassium by the kidneys was reliably higher in the animals which were given solutions of potassium chloride prepared with distilled water, with the absence of reliable changes of diuresis, excretion of sodium, potassium, magnesium, titrated acids and ammonia. CONCLUSION. It is supposed that the differences in reactions of the white rat kidneys are associated with specific physical structure of tap water and distilled water.

THE AIM of the investigation was to compare effects of low-intensity laser radiation (LILR) with wave length 632.8 nm and L-arginine simultaneously on mechanical activity of cardiomyocytes and contractility of smooth muscle cells (SMC) of the portal vein in Wistar rats with experimental chronic renal failure (CRF with the level of blood urea 13.8±3.1 mmol/l). MATERIAL AND METHODS. Effects of LILR and L-arginine on SMC of the portal vein and cardiomyocytes of Wistar rats with CRF (resection of 5/6 of kidney mass) were investigated. Mechanical activity of the heart papillary muscle and contractile activity of the portal vein were registered in isometric regimen. RESULTS. It was shown that laser irradiation and L-arginine (1.15 mmol/l) (in any succession of exposures) caused additional relaxation of the portal vein of control rats, but failed to influence the vein tone of rats with CRF that is evidence of lower activity of NO-synthase in the portal vein endothelium of rats with CRF. Effects of LILR and L-arginine were followed by practically complete recovery of mechanical activity of the myocardium in CRF rats up to the level of intact animals that suggests a possibility of additional synthesis of NO in the myocardium with increased content of the substrate in the incubation medium. CONCLUSION. The results of the comparative investigation of effects of LILR and L-arinine on the myocardium and SMC of the portal vein of the same rats with CRF-1 have shown that, as distinct from myocardium, the effect of LILR and L-arginine on SMC of the portal vein depends on the state of the vascular epithelium: the degree of disturbance of L-arginine metabolism and activity of NOS.