Currently, extensive amount of material was accumulated based, includingly, on the placebo-controlled, multicenter studies, which allows us to recommend the use of angiotensin II receptor blockers for the treatment of dialysis patients in order to normalize blood pressure, myocardial and vascular remodeling and, ultimately, reduce mortality in this group of patients.

Review of the literature concerns the organization of circadian rhythms and the place of kidney in their regulation. The description of the central pacemaker (the suprachiasmatic nucleus of the hypothalamus) and its interaction with the peripheral oscillators, including – the kidney is discussed. The daily fluctuations of excretory kidney function, the velocity of glomerular filtrationand tubular reabsorption are viewed. The modern views on the provision of circadian rhythms of renal function in the context of recent achievements in molecular biology and genetics are discussed.

For more than 20 years to correct anemia in patients with chronic kidney disease (CKD) are used medications which stimulate erythropoesis (MSE). Currently in Russia there are multiple preparations of the MSE group: epoetin-α (epokrin, eralfon, Eprex), epoetin-β (Recormon), epoetin-ω (epomaks), darbepoetin-α (Aranesp), pegylated epoetin-β (Mircera ). Despite the fact that the study of the effectiveness of therapy MSE and its impact on the progression of CKD and cardiovascular disease was the subject of many studies, there is still no consensus regarding indications for treatment of MSE, the optimal therapeutic regimen and target hemoglobin levels.

THE AIM. To determine the frequency of abdominal aorta calcification (AAC) and the associated factors in patients on chronic hemodialysis (HD). Patients and Methods. In 65 patients (male / female -34/31), 52,3 ± 11,8 years, treated with HD in average 77,1 ± 76,8 months, in addition to conventional clinical and laboratory parameters there were determined C-reactive protein (CRP), intact parathyroid hormone (PTH), lipid profile, the thickness of the intima-media of carotid arteries (IMT). Monitoring of ECGand blood pressure, standard echocardiography, forearm bone mineral density (BMD), X-ray evaluation of AAC severity were made. Duration of therapy with active form of vitamin D (alfacalcidol) was evaluated. RESULTS. AAC was found in 58.5% of the patients. Correlation analysis showed that AAC was more significant in patients with: greater duration of HD, higher levels of blood calcium, PTH, CRP, lower body mass index (BMI), low BMD, thicker IMT, myocardial ischemia, frequent ventricular premature beats at ECG monitoring, large diameter and wall thickness of the right ventricle, thick wall of the left ventricle, high pulmonary artery pressure. According to multivariate methods AAC was more common in people with long duration of HD and a shorter duration of alfacalcidol therapy. CONCLUSION. AAC was detected in 58,5% of patients on HD and was associated with disorders of phosphorus-calcium metabolism, hyperparathyroidism, adverse changes of intracardiac hemodynamics. For the first time there was found an inverse relationship of severity of AAC with forearm BMD of the duration of alfacalcidol therapy.

THE AIM. Research objective is to investigate the audiotherapy influence on general and psychic status of patients with chronic renal disease and patients on long-term hemodialysis. PATIENTS AND METHODS. 14 patients (5 male, 9 female, 20-60 years) with chronic renal disease on long-term hemodialysis were studied. Structured interview and visual analogue scale were used to evaluate the intensity of chronic pain, chronic pruritus, anxiety and depression. RESULTS. The research showed that patient’s music preferences didn’t influence the audioobjects listening. The audiotherapy sessions lowered anxiety and depression intensity, chronic pruritus and chronic pain. Persistent diminution of indices was shown only in depression sphere. CONCLUSION. The findings show apparent symptomatic effect of audiotherapy sessions.

THE AIM. To study of the effectiveness of endovidesurgical urethrolithotomy. PATIENTS AND METHODS. The results endovideosurgical urethrolithotomy were studied in 63 patients suffering from urethrolithiasis. RESULTS. Of the 63 patients with uretherolithiasis in 61 (96.8%) the method was effective. Lumbotomy was performed in 1 (1,6%) patient due to intense arterial bleeding from Trocar canal. In 1 (1,6%) patient due to the large defect of peritoneum, which was formed in the allocation of the urethra, after removing the stone was used open access for more reliable sealing of the peritoneum, to avoid falling back urine in the postoperative period. Thus, endovideosurgical urethrolitotomy was effective in 61 (96.9%) patients. CONCLUSION. Endovideosurgical urethrolithotomy is an effective treatment for patients with urethral stones, and should find wide application.

THE GOAL of the study was evaluation of detrusor contractility disorders in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS. 146 patients were undergone urodynamic investigations including urofluometry and miction cystometry (pressure-flow testing). Miction cystometry data obtained was further interpreted by W.Shafer nomogram. Bladder emptying index as ratio of urine voiding volume to maximal bladder volume by cystometry was determined as well. RESULTS. Decrease of detrusor contractility has been found in 56,2% of patients with BPH. Bladder contractility data, as determined by W.Shafer nomogram, depends on degree of infravesical obstruction (IVO). Bladder emptying index characterizing both degree of bladder emptying and duration of contraction does not depend on the presence and degree of IVO. Presence of lumbar osteoarthrosis and diabetes mellitus aggravate bladder emptying. CONCLUSION. In a significant proportion of patients with BPH disorders of lower urinary tract function are stipulated by the decrease of bladder contractility, but not by IVO, that should be considered in a treatment decision.

This review is a conclusion of up-to-date conceptions about genetics, mechanisms of development, clinical features and diagnostics of autosomal dominant polycystic kidney disease (ADPKD). The quantitative and qualitative description of mutations in causative genes, novel criteria for ultrasound diagnostics of ADPKD and agents for pathogenetic therapy of ADPKD, which are under phase III controlled clinical trials are presented.

THE AIM. The comparative analysis of informativenes of calculated methods of evaluation of glomerular filtration rate in the people of elderly and senile age, survivors of the Siege of Leningrad with discirculatory encephalopathy (DE). PATIENTS AND METHODS: the investigation was performed on 138 patients (age 65-92) with DE of stage 2. 2 groups have undergone to the analysis: 100 patients – survivors of the Siege of Leningrad and 38 patients who were not exposed at child’s age to multifactorial stress («not residents of the Siege»). Middle age was 74,63 + 5,25 and 74,71+6,9 years accordingly. Glomerular filtration rate (GFR) was defined by two settlement methods: – Coсkcroft and Gault equation and MDRD. At 17 patients (residents of the Siege) – middle age – 75,08 +2,3, and at 24 patients («not resident of the Siege») – middle age 74,5 + 6,25 concentration of melatonin in a saliva was investigated. RESULTS. GFR at technique use on Coсkcroft and Gault and MDRD at «residents of the Siege» was authentically more low, than at comparison group, lower levels at use of Coсkcroft and Gault equation. Stages of chronic kidney disease (CKD) were defined in research. At residents of the Siege close direct correlation dependences between concentration of salva melatonin, age and a technique of definition of GFR by Kokroft-Galt equation have been revealed. While at «not residents of the Siege» close correlation dependence was registered only between age of patients and of Kokroft-Galt equation. Authentic correlation dependence on age and a technique of calculation GFR under formula MDRD has been received only in «residents of the Siege» group. CONCLUSION. Results of the research testify on more informative settlement of GFR screening definition with use of the Kokraft-Galt equation at patients of elderly and senile age with DE, and also at a special contingent – patients endured the Siege of Leningrad. The hypofiltration registered at «residents of the Siege» is a specific phenomenon, instead of an equivalent of higher degree CKD. The given phenomenon, most likely, is caused by morphofunctional features of kidneys after the transferred multifactorial stress in the childhood – the Siege of Leningrad.

In the hardware-software Exalis one of the options is an indicator, which significantly correlates with a known quantity Kt/V, characterizing an adequate dose of dialysis, which a patient receives during the procedure. The article is devoted to an attempt to properly assess the relationship and differences between these two indicators.