Chemerin is a protein consisting of 131-137 amino acids and is expressed predominantly in adipose tissue. Effects of chemerin implemented through action on chemokine-like receptor 1 -CMKLR1. CMKLR1 expressed on myeloid dendritic cells as well as a number of plasmoid, thereby participating in the reactions, both innate and acquired immunity. In addition to the metabolic effects, it was described a series of reactions that are directly or indirectly related to the inflammatory response in which hemerin and its receptors demonstrated their participation. Chemerin stimulates the adhesion of macrophages to fibronectin, adhesion molecules ICAM-1 (intercellular adhesion molecula 1) and VCAM-1 (vascular cell adhesion molecule-1). Adhesive effects of chemerin realized through its impact on CMKLR1, located on the membrane of macrophages. Analysis of the role of chemerin in the inflammatory process, suggesting its importance in developing inflammation in renal tissue in glomerulonephritis and tubulointerstitial nephritis. Research on this issue is currently not enough. Since proteases are directly involved in the activation of prochemerin, association their high concentrations with kidney damage, including macrophage infiltration and an increase in interstitial space of the kidney. Since protease directly involved in the activation of prochemerin, a link their high concentrations with renal damage, including macrophage infiltration and increased interstitial space renal tissue may be mediated by elevated levels of activated chemerin.

According to modern molecular biology concepts, uric acid and homocysteine are activators and participants prooxidant positive feedback loop that also includes xanthine oxidoreductase and NADP∙H-oxidase complexes as direct prooxidant agents. Due to the physiological and biochemical features, the kidney may be the organ that is the most exposed to this contour effects. The present review focuses on nephrological implications of biochemical, physiological and interactomic properties of the circuit and its components.

AIM: to study of influence of ammonium molybdate on urine formation function of kidneys in modeling of the experimental hypercalcaemia on white rats. MATERIAL AND METHODS. Ammonium molybdate (50 mg/kg) was introduced through a probe into a stomach of the intact rats daily within a month. Hypercalcaemia was created by intragastric introduction of 10% calcium chloride solution (0,15 ml on 100 g of body weight) within a month. Studying of the main processes of a urine formation, indicators of a cortex-papillary gradient of urea and sodium concentration in layers of renal tissues, the analysis of the blood content of electrolytes (sodium, potassium, calcium) and their kidney processing was carried out in the conditions of 6 hour spontaneous diuresis and 3-hour water diuresis. RESULTS. Introduction of ammonium molybdate leads to the violation of ion-water excretory renal function, causing poliuria, proteinuria, decrease in a tubular reabsorption of sodium and calcium, increasing their excretion and promoting hyponatremiya development; has kaliuretic and hyperkaliemic effect. Reduction of urine osmolarity in conditions of the renal cortex-papillary osmotic gradient reduction and decrease in tubular transport of osmotically free water Т^CН₂O in the conditions of a poliuria testifies to the violation of renal concentrating function. Molybdenum introduction in the conditions of hyperhydratation reduced the percent of the removal of water loading, owing to increase in a tubular reabsorption of water with less effective decrease in a cortex-papillary osmotic gradient. Functional ability of kidneys to the removal of excess liquid from the organism and to osmotic dilution decreased in molybdenic intoxication. Use of calcium chloride promoted reduction of the expressiveness of ion-osmoregulatory renal function indicators changes, restoring level of the excretion of electrolytes, osmotic purification of plasma and an excretion of osmotically free water. CONCLUSION. The experimental model of a hypercalcaemia softens the expressiveness of nephrotoxic effects of molybdenum, has beneficial impact on the safety of the renal functional state and concentrating ability indicators that can testify to the mutually competitive relations between calcium and molybdenum.

Case of fast development of chronic renal failure in patients with asymptomatic hypertensive nephropathy is presented. The patient was performed a renal puncture biopsy - hypertensive nephrosclerosis (arterio-arteriosclerosis) was revealed. In confirmation of family history it was dentified a heterozygous type of polymorphisms in genes that regulate blood pressure. Patient started antihypertensive therapy with receptor blocker angiotensin and diuretics.

Granulomatous interstitial nephritis (GIN) is a rare variant of renal injury with morphological manifestation by presence of sarcoid type granulomas. Pathogenesis of this condition is poorly understood. We present the case of a patient with renal failure caused by GIN with unknown longtime subfebrility without extrarenal sarcoidosis and hypercalcaemia. Renal biopsy revealed sarcoid granupomas. Long-term small doses corticosteroid therapy is the most effective method of treatment GIN.

Atypical hemolytic uremic syndrome (aHUS) is a rare disorder, characterized by the development of hemolytic anemia, thrombocytopenia, and acute renal injury due to a thrombotic microangiopathy. Under our supervision is six patients with aHUS., three of which have passed in-patient treatment, medical examination, three others - were consulted in absentia. Three patients -are male, three - female; age of the patients varied from 10 to 73 years (two children and four adults). All patients, regardless of age first sign of aHUS disease arose sharply with rapid deterioration caused by oliguria, azotemia, edema, anemic and hypertension syndromes. All patients on the background of the therapy aggravation was cut short, however, three patients (disease duration of which more than 1 year), in subsequent disease had anticipated 5 (patient 1), 3 (patient 3), 6 times (patient 4), 3 times (patient 6). Patients with aHUS are suggested the therapy with infusions of fresh frozen plasma, plasmaexchange. In our observation after ineffective plasma exchange and starting renal replacement therapy (peritoneal dialysis) eculizumab appointed to one patient (ID 10). With renal replacement therapy during the year, managed to reduce the azotemia phenomenon, however, remained hypertensive syndrome, anemia. Eculizumab therapy caused regression of symptoms and necessity of renal replacement therapy.

THE AIM: to determine nephrin urine excretion in patients with nephrotic syndrome (NS) associated with rheumatoid arthritis (RA). PATIENTS AND METHODS. We enrolled in the study 50 patients with seropositive RA and NS., the control group was formed from 25 healthy persons. Kidney biopsy was performed in 36 patients (glomerulonephritis was diagnosed in 16 patients, АА-amyloidosis - in 20 patients). RESULTS. Urine nephrin concentration in patients with RA and NS was higher than in the control group: 6.9 (3.4; 8.1) ng/ml 3.9 (2.8; 5.7) ng/ml, p <0,01, respectively. Also, only in the group of patients with RA and NS we find positive correlation between the levels of urinary excretion of nephrin and daily proteinuria (r = 0,42; p = 0,03). Urine nephrin levels in patients of the glomerulonephritis - 8,8 (6,1; 9,7) and amyloidosis groups - 5,9 (3,2; 7,3) ng/ml were higher than in the control group (p=0,03 and p=0,04 respectively). Also urine nephrin level in patients with AA-amyloidosis was low than in glomerulonephritis patients (p=0,04). CONCLUSION. We first determined the increased nefrinuria in different variants of nephrotic syndrome in patients with RA. Obtained preliminary evidence of increased nefrinuria development as in glomerulonephritis and amyloidosis in patients with RA can be used in the clinic to clarify the severity of morphological damage in podocytes damage in patients with different nephropathies.

THE AIM: to search noninvasive diagnostic IgA-nephropathy and focal segmental glomerulosclerosis (FSGS) based at proteomic studies of urine. PATIENTS AND METHODS. The study included 61 patients, who were divided into two groups. The first group included 31 patients with FSGS and 30 patients with IgA-nephropathy. All patients underwent general clinical research methods (complete blood count, urinalysis, blood creatinine concentration with the definition of the glomerular filtration rate) and mass spectrometry of urine. RESULTS. It was identified clinical and laboratory signs of glomerulonephritis: hypertension, azotemia, proteinuria, hematuria, decreased glomerular filtration rate. It was identified pathogenetic features of IgA-nephropathy and FSGS, with highlighting the functional groups of protein markers that reflect the way the progression of glomerulonephritis. CONCLUSION. Proteomic analysis of the spectrum of urine of patients with IgA-nephropathy and FSGS allows to use the proteins as potential markers of the progression of glomerulonephritis.

THE AIM: to estimate influence of risk factors and parameters of local coronary factors on probability of development of microalbuminuria (MAU) at patients with ischemic heart disease (IHD) and indications to myocardial revascularization. PATIENTS AND METHODS. Research included 90 patients with IHD and indications to recovery of an intracoronary blood circulation. At entry into the study we evaluated the severity of the clinical status of each respondent and analysis of the prevalence of risk factors. RESULTS. As a result of the conducted research a number of risk factors was established, which significantly increase the probability of development of MAU., such as presence of postinfarction cardiosclerosis, atrial fibrillation, acceleration of cardiac rhythm, some parameters of local coronary factors, showing the severity of atherosclerotic damage of the coronary vessels. We establish additional risk factors, the existence of which exacerbates the impact of the major risk factors for the development of MAU. CONCLUSION. The presence of MAU reflects the overall severity of the pathological process in the cardiovascular and renal systems, as an integral marker of poor prognosis. Identified predictors of cardiovascular events associated with the formation of albuminuria.

THE AIM: to study the characteristics of cardiorenal relationships in hypertensive patients with diabetes mellitus (DM) type 2. PATIENTS AND METHODS. The study included 120 patients with arterial hypertension stage I-III in age from 40 to 65 years: 60 diabetic hypertensivepatients (studygroup) and 60 non-diabetichypertensive patients (control group). We performed ambulatory blood pressure monitoring, echocardiography, studied endothelial function, evaluated the artery stiffness, estimated renal function and metabolic parameters. RESULTS. A prognostic unfavorable changes of ambulatory blood pressure profile, a significantly higher incidence of left ventricular hypertrophy (LVH) were found in diabetic hypertensive patients in comparison with non-diabetic hypertensive patients. There were no patients with normal diastolic left ventricular function in the study group. Increased pulse wave velocity (PWV e.) was noted in 83.3 % diabetic hypertensive patients. More severe endothelial dysfunction, tubular and glomerular dysfunction were identified in diabetic hypertensive patients in comparison with non-diabetic hypertensive patients. Severe insulin resistance (IR) leaded to metabolic changes - glucosetoxicity, lipidotoxicity in diabetic hypertensive patients. CONCLUSION. The study shows the presence of cardiorenal interactions and interrelations between IR and target organ damage in hypertensive patients with type 2 diabetes. IR can be considered as an independent predictor cardiovascular and renal disease. Accordingly, IR correction will help us to optimize the results of treatment cardiovascular diseases and kidneys diseases in hypertensive patients with type 2 diabetes.

AIM: to study factors of epithelial and mesenchymal transformation in glomerulonephritis. PATIENTS AND METHODS. The study included 8 patients with various forms of chronic glomerulonephritis. Mean age of patients was 36.8 (22 to 60) years. To estimate epithelial cell phenotype we used monoclonal antibodies (company DAKO, ready-to-use (RTU) to pancytokeratin (clone AE1/AE3), E-cadherin (clone NCH-38), CD-10 (clone 56C6), as markers of mesenchymal differentiation we used monoclonal antibodies to vimentin (clone V9) and alpha-smooth muscle actin (clone 1A4). Evaluation of proliferative activity of tubular epithelium was performed with antibodies to Ki67 (clone MIB-1). RESULTS. EMT markers analysis showed the following. In areas where there were no signs of interstitial fibrosis pancytokeratin AE1/AE3 expression was determined along the membrane and cytoplasm of epithelial collecting ducts of cortex and medulla. In the epithelium of convoluted tubules reaction was less pronounced. Positive reaction with antibodies to CD-10 was observed in the epithelium and glomerular mesangial cells, mainly on the apical surface of convoluted and direct tubules epithelium, but was absent in the epithelium of collecting ducts. Expression of E-cadherin was revealed only in the epithelium of cortical and medullary collecting ducts. Differentiation mesenchymal marker vimentin was positive in the cytoplasm of single cells in convoluted tubules. CONCLUSION. The study confirmed possibility of changing of the epithelial phenotype to mesenchymal cells of the nephron tubules and ducts in various forms of glomerulonephritis. These changes are associated with the development of interstitial fibrosis. Increasing of number of proliferating cells in the areas of EMT possibly due to activation of reparative processes.

AIM: to evaluate the hormonal status and the formation of the reproductive system to optimize the clinical supervision of adolescents girls with chronic pyelonephritis (CP). PATIENTS AND METHODS. Anatomical and functional features of the reproductive system were studied at 60 patients aged 16 to 18 years. Control group consisted of 60 girls of similar age (2 groups of health), with the absence of microbial and inflammatory diseases of the urinary system. The research included definition of hormones of sexagenarian (follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (Te), estradiol (Е2), progesterone (Pr)), adaptive metabolic orientation (cortisol) and catecholamines (noradrenaline, adrenaline). It is revealed, that in CP there is a tendency to decrease FSH and prolactine, with the significant increase in the level of LH and cortizol. Ultrasound picture of the ovaries in CP was characterized by an increase in the ovaries, the presence of small cystic formations that lie on the basis of early formation of reproductive disorders and inflammatory urogenital diseases. CONCLUSION. The adolescents girls with CP, revealed significant violations of puberty and the menstrual cycle.