Secondary hyperparathyreosis (SHPT) is a common sign of chronic kidney disease (CKD) and leads not only to osteodystrophy, which increases the risk of fractures, but also to outerosteal signs, which include vessel calcification, hypertension, anemia,skin erythema, and sexual dysfunction. Epidemiologic data show the connection between high blood levels of parathormone (PTH), calcium (Ca) and phosphate (P) with higher mortality of the patients. Traditional therapy SHPT in patients on renal replacement therapy vitamin D (VD) and phosphate-binders suppresses secretion of parathormone, but also leads to hypercalciemia and hyperphosphatemia, which therefore leads to ectopic calcification and higher mortality. Therefore in 2004 a new class of medication – calcimimetics (CM), the only representative of which nowadays is cinacalcet (CC) (Mimpara, Sensipar) – was introduced. CC increases the threshold of the reaction of calcium-sensitive receptors of parathyroid gland on blood calcium – the most strong inhibitor of PTH secretion, which leads to decrease of this hormone in blood, decreased resorbtion of Ca and P out of bones and leads to their decrease in blood concentrations. In various investigations was shown that CM can provoke regression of hyperplasia PTG, decreasing the risk of parathyroidectomy. The evidence that CC decreases the severity of uremic osteodystrophy and the frequency of fractures was obtained. Because of the decrease in levels of PTH, blood Ca and P, and also direct action on blood vessels, CC slows down vessel calcinosis. In experimental investigations was shown that CC decreases the severity of arterial hyper pressure, probably because of the direct vasodilatation effect, and also suppression of the rennin secretion. At the endpointthe use of CC decreases the frequency of hospitalizations for the cause of cardiovascular pathology. Nowadays the investigation on the influence of CC on patient survival takes place. The medicine has a good control of SHPT in patients after renal transplantation and allows to avoid parathyroidectomy. In animal experiments with the use of calcimimetics the date on effective decrease of proteinuria and slow progression of the decrease of the glomerular filtration speed were received, which supports the use of CC on the early stages of CKD, but this data needs more clinical evidence. The increasing amount of proven data base of the effective combination CC and low doses of VD in patients on the renal replacement therapy (keeping in mind positive cardiac and nephroprotective effects of the later ones).

The review consists of data on the specialties of the renal damage in patients with connective tissue diseases. The attention is given to such nosologic forms as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, systemic vasculitis. The questions of diagnostics, treatment and prognosis were discussed.

THE AIM of the investigation was to evaluate the dynamics of blood pressure (BP) during the haemodyalisis (HD) session and during the interdyalisis period, and also daily profile of BP in prevalent group of patients, who receive treatment by chronic HD. PATIENTS AND METHODS. A prevalent group of stable patients on programmed haemodyalisis was investigated (n = 70). To all patients was performed 48 hours BP ambulatory monitoring (BMAP). The dynamics of BP changes during the course of HD procedure was analyzed; the mean values and calculated indexes of systolic (SBP), diastolic (DBP), pulse (PBD) and mean BP (BPm) during HD procedure, in day and night interdyalisis period were evaluated. RESULTS. During the HD procedure a reliable decrease of SBP, DBP and BPm (all p < 0,0001) took place. The reliable dynamics of PBP during the HD procedure does not take place (p = 0,34). The stability of the dynamics for SBP, DBP, BPm and PBP in interdyalisis period are common: during the first day after the HD procedure a tendency to the decrease of the BP is noted, with the minimal values during the first night; the BP values during the 1st and 2nd days after dialysis are practically the same; the night values of BP in the 2nd day significantly increase; by the end of the 2nd day of the evaluation BP returns to its base level. Between the 1st and 2nd day of the evaluation the reliable differences in the BP dynamics at night were noted, which had to do with SBP (p = 0,0004) and BPm (p = 0,021). The differences in the dynamics of DBP in 1st and 2nd night did not reach the chosen level of reliability (p = 0,08). Most of the patients (61,4%) had disturbed daily profile in the 1st night after the HD procedure, with the increase of this values in the 2nd night (79 %). The decrease of the ability to the night BP decrease in the 2nd night of the investigation is supported by calculated parameters, as the part of BP evaluation, with the increase of the hypertension threshold and time hypertension index for SBP, the differences on the same indexes for DBP was not noted. CONCLUSION. The method of 48 hour BP monitoring allows close evaluation of the conformity dynamics and daily profile of BP, which can be significant for diagnostics of hypertension/hypotension in dialysis patients and therapy correction.

BACKGROUND. In patients on on-line convective treatments, given the considerable quantity of dialysis fluid re-infused, the small amount of acetate present in bicarbonate dialysis fluid as a pH stabilizing factor may allow a significant transfer of that anion to the patient, possibly inducing cytokine activation. METHODS. To verify this hypothesis, we performed on-line haemodiafiltration (OL-HDF) with (3 mmol/l) and without acetate in dialysis fluid in a cross-over randomized order on 12 prevalent patients. RESULTS. In comparison with the pre-treatment values, plasma acetate levels were unchanged during and after acetate-free OL-HDF, while they were 5–6 times higher in the course of OL-HDF containing acetate in dialysis fluid; plasma acetate levels returned to basal values 2 h after the end of the procedure. The total increase of bases in the patient attributable to acetate was 36%. Plasma bicarbonate values at the end of treatment were significantly lower in treatments without acetate, as compared to those with acetate. Interleukin-6 plasma levels were super-imposable at the beginning and in the course of the two methods compared, but there was a tendency towards a greater increase at an interval of 2 h following OL-HDF with acetate. CONCLUSIONS. Our preliminary results confirm the assumption that body gain of acetate is particularly high in convective treatments, while acetate-free OL-HDF slows down acetate burden. Clinical advantages due to these effects should be evaluated in properly designed prospective studies.

THE AIM of the work was to study the dynamics of thrombocytes, indices of the erythropoiesis and metabolism of the ferrum in patients with chronic kidney disease (CKD) at the stage of program haemodialysis, including the same indices after course of extracorporeal autohemomagnetic therapy (EAHMT). PATIENTS AND METHODS. The work included 104 patients (control-51, experiment-53) with ESRD. All doses of the ferrum-containing drugs and erythropoietin were not variable 2 month before and during of the research. Course of EAHMT (6 procedures) was used during of a permanent haemodialysis. RESULTS. Significant elevation of erythrocytes, hemoglobin, albumin and thrombocytes levels (in the presence of the thrombocytopenia), and also ferritin plasma level was decreased after the course of EAHMT. CONCLUSION. Risk of the complications from hematological disorders stresses the necessity of timely detection and adequate correction of them. EAHMT can be included in traditional treatment of anemia, thrombocytopenia in patients on permanent haemodialysis.

THE AIM to determine the deficit frequency of 25 (OH) vitamin D (calcidiol – CD) and 1,25 (OH)₂ vitamin D (calcitriol – CT) in patients with chronic kidney disease (CKD) and its connection with the cardiac and vessel system state. PATENTS AND METHODS. 94 patents of 60,1±12,6 years of age with CKD stages 1-4, in most cases (91,5 %) suffering from diabetic nephropathy had a one time evaluation of the levels of CD and CT, lipidogram, the thickness of the intimae and media of the carotid arteries (CIM), echocardiography, ECG and BP monitoring. RESULTS. In the whole group the deficit of CD (< 3,75 pmol/l) was noted in 25,7 % of the patients, the CT deficit (< 53 pmol/l) – in 62,8 % and insufficiency of CD (<75 pmol/l) in 78,8 % of the patients. The level of CD, in patients evaluated in April – June was much lower than in those evaluated in September – December. The level of CT was reversely connected with the thickness of the back left ventricular wall (LV), BP level and directly connected with the glomerular filtration rate and the lipid of high density level. Besides that, CT was reversely correlated with the triglyceride level and with of the calcinosis of aorta extend (CAA). The CD level was directly connected with the diastolic function of the LV and reversely with the presence of IHD, thickness of the intima-media complex of the carotid arteries, and the presence of heart failure (HF). CONCLUSION. The deficiency of CD can be seen in patients with CKD more often than in the total population and the level of CD is dependant on the season. The low values of CT are combined with more eminent CAA and cardiac valve, hypertension, hypertrophy of the left ventricle, dislipidemia. The low values of CD are associated with more frequent risks of ICD, HF, diastolic myocardial dysfunction, calcinosis of cardiac valves.

THE AIM is the study of the data dynamics of osmolality of saliva of women with pathologic pregnancy and with paradontitis during pregnancy. PATIENTS AND METHODS. 4 groups of women were investigated: the control group of non pregnant women of the reproductive age, pregnant women with physiologic pregnancy (24-28 weeks) without the signs of paradontitis (10 people, pregnant women with generalized paradontitis I-II stages in the time of remission (10 people), women with pathologic pregnancy without the signs of inflammatory paradont (10 patients). From each group 2 saliva tests were collected, the first test was taken in the morning on the empty stomach. Then mouth wash was prescribed with the 0,9 % saline solution and after 30 minutes the second test was taken. In the saliva tests the value of osmolality, nitrite concentration, total calcium and nonorganic phosphates, and also the concentration of medium mass molecules were determined (λ = 254 nm and 280 nm). By means of immunoferment analysis the amount of estradiol, testosteron, and dehydroepiandrosteron-sulfate in saliva tests of the control group of nonpregnant and pregnant women, and also in women with the sings of pathologic pregnancy were evaluated. RESULTS. Was determined that saliva is hyperosmic fluid, and mouth wash with 0,9% saline solution in the group of health nonpregnant women leads to the decrease in osmolality of saliva. Also was noted that physiologic flow of pregnancy leads to the decrease in saliva of somatically active substances, nitrates and total calcium, and the mouth rinse with the 0,9% saline solution does not lead to the decrease in the concentration of osmotically active substances in saliva. In pathologic pregnancy flow the characteristic for the physiological pregnancy decrease of the value of the concentration of osmotically active substances and nitrates does not take place. In the saliva of pregnant women with paradontitis the concentration of nitrates and medium weight molecules are at their highest, and also a stable increase of osmolality of saliva in comparison with health women take place. It was noted that the paradontitis flow during the pregnancy is characterized by a higher level in saliva of DHEA-sulfate and the decrease of estradiol, in comparison with control group of pregnant women. CONCLUSION. The investigation of osmotic consistence of saliva can give a valuable information about the state of the mouth cavity state during physiologic and pathologic pregnancy flow.

THE AIM of the study was a try to evaluate the influence of the regional lymphatic antibacterial therapy (RLAT) and immunocorrecting therapy by polyoxydoniem on various immunologic characteristics in chronic secondary nonobstructive pyelonephritis (CSNPN). PATENTS AND METHODS. 60 children, suffering with CSNPN, at the age from 4 to 14 years old were evaluated. The patients were divided into three groups depending on the treatment method. The first group included 17 patients with standard therapy. The second group included 21 patients who had lymphotropic antibacterial therapy, and the third group included 22 patients with RLAT in complex with polyoxydoneum. The material for the investigation of the immune status was peripheral blood, from elbow vein with heparin (25 un/ml) in patients with acute recurrent chronical processes and in the period of remission. All patients had immunologic investigation. RESULTS. Comparative evaluation of immunologic investigation, conducted after treatment of CSNPN depending on the treatment showed a lower effectiveness of the standart therapy in comparison to RLAT, where the positive movements in immune status of the patients were noted. With that a not sufficient efficiency of RLAt in non specific and also not full repair of the specific chains of the immune system needed and additional immunocorrecting medicine. We noticed a positive dynamics of all studied immune figures in complex use of RLAT and polyoxidonium. CONCLUSION. The use of immunomodulator polyoxidonium in combination with RLAT in CSNPN is the most sufficient method of therapy. This methods leads to restoration of CD 16, CD 3, CD4, has positive effect on phagocytosis state and circulating immune complexes.

THE AIM of the investigation was to study the influence of the long term introduction of fitocomplexes of th cell culture of Rubia cordifolia on the renal function of rats in the conditions of experimental oxalate nephrolithiasis. MATERIALS AND METHODS. For the modeling of the kidney stone disease the male rats Wistar during the three weeks received as drink water 1% solution of ethilenglicol. The prophylactic effect of fitocomplexes of Rubia Cordifoliawere evaluated in conditions of simultaneous injection of the cell culture in the dose of 75 mg/kg in suspension based on starch mucus. In the urine test, collected during 24 hours, the concentration of oxalate-, phosphate-ions and calcium ions, and also the activity of lactetdehydrogenase enzime, gamma-glutaminiltransferase and N-acetyl-β-D-glucoseaminidase were evaluated. RESULTS. Under the influence of ethyleneglycol the oxalate nephrolithiasis developed in rats, with was accompanied by the increase of the oxalate excretion and the development of the fermenturia. In the conditions of prophylactic use of the fitocomplexes of the cell cultures of the Rubia Cardifoliawas noted the decrease in oxalate excretion in 2,6 times in comparison with the rats with experimental nephrolithiasis. During the use of this fito-medicine the stabilization of the activity of marker enzimes, especially lactatdehydrogenase and gamma glutamiltransferase was registered. CONCLUSION. The good influence of the prophylactic use of fitocomplexes of th cell culture of Rubia Cordifoliaon the flow of the experimental kidney stone disease was realized in lower development of oxaluria and stabilization of the activity of the urine marker ferments.

The review demonstrates a comparative evaluation of the current methods of chronic prostatitis treatment. The common views on existing methods of therapy of such patients are discussed. Was shown that the treatment of patients with chronic prostatitis should be complex and needs to keep in mind the action on all parts of the etiology and pathogenesis chains. The individual approach to each patient allows to construct a more deep and careful specific treatment scheme, improving, therefore, the effectiveness and quality of the results.

THE AIM of the investigation was to evaluate the effectiveness of the treatment of the patients with acute cystitis by rectal suppositories Prostatilen (Cytomed). MATERIALS AND METHODS. For the reproduction of acute cystitis in the urinary bladder cavity of the 60 white female rats of uncertain breed through the urethra was injected 0,5 ml of the suspension of dimexid and orthoksilol in ration 3:1 and exposition of 3 minutes. The treatment began on the next day and were divided into 4 groups. The rats of the 1^st group (n=20) daily received prostatilen in intramuscular injections in the dose of 0,1 mg/100 g during 10 days, in the 2^nd group during the same dates and intramuscular – fortum in the dose of 1,0 mg/ 100g, the third group (n=10) there was no treatment and the fourth group consisted of intact rats (n=10). On the next day after the last injection the rats were decapitated and had a macroscopic investigation of the urinary bladder and general urinary test, and weight coefficient was calculated. In clinical conditions the effectiveness of prostatilen was tested in treatment of 18 women from the age of 17 to 42, who were injected prostatilen in suppositories daily during 5 days at night. RESULTS. The treatment of prostatilen in experimental conditions gave a result comparable also in the weight coefficient data with those in treatment of fortum. The macroscopic evaluation of the urinary bladder showed a non significant increase in the wall thickness of the urinary bladder, the mucus lining did not change. The mucus of the non treated patents had edema and hyperemia with local bleedings. In clinical conditions the leucocyteuria and erythrocyteuria, as well as clinical signs of the disease, seized by 7-8^th day from the beginning of the treatment. CONCLUSION. Experimental and clinical investigations showed the effectiveness of prostatilen in treatment of acute cystitis. Its use showedin monotherapy as well as in complex treatment of such patients, that in some cases its is possible to refuse from antibacterial therapy.

THE AIM of the investigation is the evaluation of the effectiveness of the lavomax use in patients with chronicle bacterial prostatitis. PATIENTS AND METHODS. The objects of the investigation were 59 patients who were divided in the control and basic group. The control group included 24 patients, who had traditional therapy of the chronicle bacterial prostatitis, and the basic group – of 35 patients, who besides traditional therapy in addition received immunomodulator Lavomax. RESULTS. After the three weeks of treatment the patients of the basic group had an increase in T-lymphocytes amount from 43,2±3,4 to 62,10±3,17%, with full normalization in 32 patients (91,4%), while in the control group this figure came to normal amount only in 16 patients (67%). Lavomax increased the functional activity of T-lymphocytes. More obvious was the increase of blood T-helpers – from 30,2±3,4% to 36,7± 3,8 5 in the basic group, and also with the increase of the T-suppressor/T-helper ratio from  0,93±0,21 to 1,73±0,19. Lavomax had a positive influence on humoral immune system, with the increase of IgA level from 0,78±0,17 g/l to 4,12±1,18 g/l, in control group this figure did not show relative change. CONCLUSION. The received data demonstrates the effectiveness of immunotherapy with the use of Lavomax in patients with chronicle bacterial prostatitis.

In Vein in 1761 a work on Latin named «Inventum novum ex percussione thoracis humani ut signoabstrusos interni pectoris morbos detergendi» (A new invention, which allows on the basis of percussion data of human thorax, as a sign, to discover diseases hidden in the depth) by Leopold Auenbrugger, consisted of 14 signs, each one of them was followed by thorough explanation was published. There Auenbrugger gives an explanation to pathologic processes from the position of medical knowledge of his time. Despite short description, Auenbrugger discusses almost all basic questions of the percussion use as a diagnostic method, especially: its technique, method of conduction, analyzed percutory tone as a norm or pathology. The author is an inventor of aso called «passing through» percussion: «one should tap slowly and gently on the chest, to be precise, to tap by the tips of the straight and held together fingers». Although not his university colleagues in Vein, nor English, German, French or Russian doctors of that time did not consider «Inventum novum» as a great discovery, which needs a more broad attention. Therefore, even though the physicians sometimes used this percussion, they never mentioned this method in their scientific work. This matter began to change in 1808, when Paris saw the work of the famous French doctor, leib – physician of Napoleon I, Corvisart Jan Nicolas de Mare; (1755–1821) «Nouvelle method pour reconnaitre les maladies internes de la poitrine par la percussion de cette cavite par Auenbrugger, ouvrage traduit du latin et commente», («A new method method for the determination of the internal thoracic diseases by means percussion of this cavity by Auenbrugger method, this work was translated from latin with commentaries»). However only the year 1819 can be considered as a year of the physical diagnostics in medicine was born. Many modifications of percutory method, its use in modern physical examination of the patient one more time emphasizes the significance of the discovery of the Vein doctor Leopold Auenbrugger, whom we remember 200 years after his death (May 17, 1809).