In the first part of the review, we discussed questions of bone tissue structural organization, Wnt-proteins function, bone morphogenic proteins, preosteoblast to osteoblast differentiation processes, synthetic function of osteoblasts and osteoblast importance in the regulation of osteoclast function.

Nowadays hematopoietic stem cell transplantation (HSCT) has become a common treatment for various hematological diseases (malignant and nonmalignant) and solid tumors. However, survival in patients can be seriously limited by the development of HSCT-related complications. Acute kidney injury (AKI) is a common complication in patients following HSCT, which seriously affects both short and long-term outcomes. In this article epidemiology, etiology, pathogenesis and diagnostics data of AKI following HSCT are described.

The modern practice the effectiveness of applying oral sorbents as a treatment of CKD is discussed. Carbo «AST-120» (Japan) is compared with carbo activatus «SCN» and «Carbon» (Russia). The summary of the effectiveness data on taking oral sorbents to extend a before dialysis period and reducing uremic intoxication is provided.

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. Second part of work discusses diagnostic value of such biomarkers as low molecular weight proteins (alfa1-microglobuline, beta2-microglobuline etc.), intracellular enzymes, micro-RNA as well as the ability of using several markers in one panel.

AIM OF RESEARH. Determine the level of expression of miR-21 in the urine of patients with nephropathy and to compare it with other signs of kidney damage, including morphological. PATIENTS AND METHODS. Seventeen patients with different nephropathy confirmed by kidney biopsy were examined. Glomerular filtration rate was assessed by creatinine clearance, CKD-EPI formula. Daily urinary protein has been established. The degree of glomerulosclerosis was evaluated quantitatively; tubular atrophy, tubulointerstitial fibrosis were evaluated semi-quantitatively on a scale from one to three (0 - no changes; 1 - minor changes, 1-25%; 2 - moderate changes, 25-50%; 3 - severe changes, >50%). miR-21 expression in the urine was determined by a RT-PCR assay and calculated using the 2-deilaCt protocol. miR-21 expression in the urine of healthy donors (n=10) was taken as control. RESULTS. The level of miR-21 expression in the urine in patients with nephropathy were significantly higher than in control (0,3070 [the lower and the upper quartiles: 0,1540; 0,4060] vs 0,001 [0,0002; 0,0254] respectively; P=0,00024). There was strong positive correlation between urinary miR-21 and daily urinary protein (Rs=0,570; P<0,05). There were no correlations between urinary miR-21 and morphological changes (glomerular, tubulointerstitial sclerosis, tubular atrophy). However, the level of expression of miRNA-21 in the urine of patients with moderate atrophy of tubules (0,354 [0,308; 0,933]; n=7) was significantly higher than with minor one (0,211 [0,033; 0,038]; n=10; P=0,04). CONCLUSION. These data suggest that the level of miR-21 expression in the urine to a certain degree can be associated with the severity of renal damage in patients with nephropathies, including the severity of morphological changes, but further research is needed in this area.

AIM OF RESEARH: The objective of this study was to determine the cost effectiveness of intravenous paricalcitol versus combination cinacalcet+alfacalcidol in patients with chronic kidney dis-ease (CKD) in the health care setting in Russia in 2013. PATIENTS AND METHODS: This analysis is performed for patients on hemodialysis with diagnosed increased parathyroid hormone levels of above 300 pg/ml despite standard treatment consisting of die-tary restriction in phosphorus and calcium containing binders. A Markov process model was developed employing data sources from the published litera-ture, paricalcitol clinical trials, official Russian price/tariff lists and national population statis-tics. The primary perspective of the study was that of the national health care payer. The base case analysis is based on a 5-years time horizon. Clinical and economic outcomes were dis-counted at 5%. RESULTS: The use of paricalcitol leads to a cost saving of RUR 47,36 and an increase in life years gained (0.099 years) and a gain in QALYs (0.067). Consequently the use of paricalcitol is dominant over the use of combination cinacalcet+alfacalcidol. CONCLUSION: The results showed that the favourable clinical benefit of a intravenous parical-citol results in positive short and long-term health economic benefits in patients on hemodi-alysis. This study suggests that the use of paricalcitol in patients with severe chronic kidney disease may be cost-effective from the perspective of the national health insurance fund in Russia.

AIM OF RESEARCH: to identify the opportunities of Doppler sonography and kinetic characteristics of PSA in differential diagnostics of chronic prostatitis and prostate cancer to specify indications for prostate biopsy performing. PATIENTS AND METHODS: in urological Department of Road clinical hospital JSCo “RZD” from 2010 till 2011 were examined 67 patients (23 patients with chronic prostatitis and 44 patients with prostate cancer) for differential diagnosis of these pathological conditions. To determine supplemental indications for prostate biopsy all patients were performed Doppler research. RESULTS: the use of Doppler research with transrectal ultrasound (Transrectal US) provided to reveal significant differences of blood flow factors in basal and medial areas of prostate gland at prostate cancer and chronic prostatitis and also PSA level and its kinetic characteristics. CONCLUSION: full assessment of PSA kinetic characteristics and transrectal US data with Doppler research provide to optimize differential diagnosis carried out between prostatitis and prostate cancer and also technique of multifocal prostate biopsy performing with regard to its blood flow factors evaluation.

INTRODUCTION. Nephrectomy can be performed by open (ON), laparoscopic (LN) or robot-assisted (RN) method. All methods provide identically certain cancer treatment, however, in recent years the tendency for wider application of minimally invasive methods was noticed. AIM OF RESEARH: to compare three methods of nephrectomy in patients with localized kidney cancer. PATIENTS AND METHODS. We performed 73 open, 10 laparoscopic and 23 robot-assisted nephrectomies to patients with kidney cancer stage T1-2N0M0. We evaluated main factors such as serum creatinine concentration and glomerular filtration rate, surgery duration, extent of blood loss, post operation bed day period. RESULTS. Average duration of ON was lower than LN and RN (139,5; 184,5 and 152,5 min respectively). Average extent of blood loss at ON (447 ml) was significantly higher than at LN and RN (302 and 213 ml respectively). Increase of serum creatinine was 44,7%, 52,2% and 52,9% for ON, LN and RN respectively. Post operation bed day was longer after ON (12 days) than after LN and RN (8 and 7 days respectively). CONCLUSION. After ON, LN and RN appears early acute kidney injury. In blood loss questions and patients post operation recovery ON conceded LN and RN in spite of less operation duration. Preference should be given minimally invasive methods which provide high and comparable to each other results.