Nephrology (Saint-Petersburg)最新文献

{"title":"Unobvious long-term effects of COVID-19 for kidneys. The literature review","authors":"V. A. Fedulkina, A. A. Artamonova","doi":"10.36485/1561-6274-2024-28-2-23-30","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-23-30","url":null,"abstract":"The impact of COVID-19 on the course of chronic kidney disease (CKD) has already been confirmed by researchers around the world. Basically, studying kidney damage in COVID-19, the authors pay attention to the new coronavirus infection in terms of the development of acute kidney injury (AKI) or mortality from it in patients with existing CKD, especially patients receiving hemodialysis or having a transplanted kidney, providing an analysis of mortality, risks and forecasts. However, there is still no published description of how this infection can affect the function of kidneys that did not have signs of CKD before COVID-19. Currently, studies devoted to the analysis of long-term results of observation and treatment of such patients are especially scarce. The review examines foreign and domestic studies concerning both the influence of chronic kidney disease on the severity of coronavirus infection and the risks of developing kidney disease after COVID-19, including the development of acute kidney injury and in the long term. This approach can highlight the relevance of timely identification of patients with developing CKD in the early stages among patients with COVID-19 for the purpose of their further follow-up and timely prescription of nephroprotective therapy. The search for literature sources was carried out using PubMed, Science Direct, eLibrary using the keywords “coronavirus”, “COVID-19”, “SARS-CoV-2”, “acute kidney injury”, “chronic kidney disease” and their combinations covering publications from 2019 to 2023 in Russian and English.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141654271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of excessive salt consumption on the functional state of microvascular vessels of the skin of rats with renal dysfunction","authors":"G. Ivanova, M. Khasun, M. Parastaeva, A. S. Rumyantsev, O. Beresneva","doi":"10.36485/1561-6274-2024-28-1-105-115","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-105-115","url":null,"abstract":"Background. Cardiovascular complications are common in chronic kidney disease (CKD). The relationship between the cardiovascular system and the kidneys is complex and diverse, but the question of the mechanisms of the influence of excess NaCl consumption on the functional state of blood vessels during renal dysfunction remains relevant.The aim: to evaluate the effect of a high-salt diet on the functional state of microcirculatory vessels (MCR) of the skin in rats at an early stage of renal dysfunction.Material and Methods. The study was conducted on Wistar rats. The first SO group included animals subjected to sham surgery (SO) and receiving a standard diet (0.34% NaCl); in the second, HS group – animals that also underwent a sham operation, but received a high-salt diet (4% NaCl); in the third, NE group – rats subjected to ¾ nephrectomy (NE) and receiving a standard diet; the fourth, HS+ NE group included rats subjected to ¾ NE and fed a high-salt diet (4% NaCl). Blood pressure (BP) was measured in the tail using the cuff method (Sistola, Russia), MCR was assessed using laser Doppler flowmetry (LDF). The reactivity of skin microvessels was assessed by changes in the MCR index before and after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (NP). Based on the assessment of the spectral characteristics of fluctuations in the MCR index obtained using Wavelet analysis, the value of endothelial, neurogenic and myogenic microvascular tone was calculated.Results. 4 months after ¾ NE, rats showed a decrease in the excretory function of the kidneys. In rats on a highsalt diet, an increase in blood urea levels was noted. The blood pressure in rats of the SO+HS group did not significantly differ from the control animals of the SO group (131 ± 8 and 125 ± 4 mmHg, respectively, NS), NE led to a significant increase in blood pressure (135 ± 5 mmHg in rats of the NE group, and 145 ± 7 mmHg – in the NE+HS group). The average MCR was higher in rats receiving a high-salt diet (SO+HS and NE+HS groups), compared with animals of the corresponding group receiving a standard diet. The combination of NE and high-salt load has an inhibitory effect on the amplitude of fluctuations in the intensity of perfusion in all studied ranges: endothelial, neurogenic and myogenic, while the calculated value of skin microvascular tone in three ranges was the highest in NE+HS group rats. In all experimental groups, the reactivity to AH was reduced compared with the SO group, and after NP iontophoresis, the average perfusion rate significantly decreased only in groups of animals receiving a high-salt diet: SO+HS and NE+HS.Conclusion. A high-salt diet in rats with an initial stage of renal dysfunction contributes to an increase in blood pressure and a decrease in natriuresis compared with animals with NE who received a standard diet. With excessive consumption of table salt in rats after NE, the intensity of cutaneous MCR increases, while reducing the variability of the M","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Condition of the cardiovascular system in Wistar rats with experimental renal dysfunction","authors":"O. Beresneva, M. Parastaeva, G. Ivanova, A. Ivanova, O. G. Ognev, A. Kucher","doi":"10.36485/1561-6274-2024-28-1-96-104","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-96-104","url":null,"abstract":"The aim: to evaluate functional and structural changes in blood vessels and myocardium in Wistar rats at different stages of the formation of experimental kidney dysfunction.Materials and Methods. Four groups of animals were studied. The first two groups consisted of rats subjected to 5/6 nephrectomy (NE). The period after NE is 2 or 4 months. The third and fourth groups included sham-operated (SO) animals of a similar observation period. After the end of the experiment, blood pressure was measured in rats, the left ventricular mass index (LVMI) was calculated, a biochemical blood test, histological, immunohistochemical and electron microscopic examination of the myocardium were performed, and the contractile activity of the portal vein was recorded for a period of 2 months (in vitro).Results. 2 months after NE, an increase in blood pressure, LVMI, and a decrease in the autorhythmic contractile activity of the portal vein were detected in rats. At the histological level, thickening of cardiomyocytes and arterial vessel walls and the presence of perivascular fibrosis were noted. After 4 months, in rats with NE, the increase in blood pressure, cardiomyocyte hypertrophy and perivascular fibrosis progressed. The thickness of cardiomyocytes was 14.1±3.11 μm, which was significantly greater than in the group with NE for 2 months (12.5±1.5 μm; p=0.008). At this period of observation, electron microscopic examination revealed deintegration of myofibrils, disruption of myofibril stacking and z-disk structure, and changes in the shape of mitochondria. 2 months after NE, an increase in the area of open capillaries was detected in rats (1902.8±202.9 μm²) compared to the corresponding LO animals (730.4±58.2 μm²; p=0.000). As renal dysfunction develops, the capillary area tends to increase (2139.1±396.5 μm²; p =0.120).Conclusion. In Wistar rats with renal dysfunction, changes were detected not only in the level of blood pressure, but also in the functional activity of the intravenous fluid, as well as in the structural components of the myocardium – cardiomyocytes, stroma and blood vessels. The increase in myocardial mass at the histological level was manifested by a significant increase in the thickness of cardiomyocytes, the volume of connective tissue, and the thickness of the wall of arterial vessels, reaching a maximum value at a longer period after NE.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"18 89","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of renal replacement therapy on glycaemic variability and indices of carbohydrate metabolism in patients with diabetes mellitus","authors":"T. N. Markova, V. O. Yavorskaya, A. I. Ushakova, V. A. Berdinsky, T. V. Ibragimova, L. A. Kumakhova, A. D. Orlova, A. D. Markov, S. S. Usatiuk","doi":"10.36485/1561-6274-2024-28-1-80-89","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-80-89","url":null,"abstract":"Background. Patients with diabetes mellitus (DM) on renal replacement therapy (RRT) have high glycaemia variability (GV), the severity of which may depend on the dialysis method.The aim: To study GV in patients with type 1 diabetes and type 2 diabetes (on baseline-bolus insulin therapy) receiving RRT with programmed hemodialysis (PHD) and continuous ambulatory peritoneal dialysis (CAPD).Patients and Methods: Twenty-seven patients with terminal chronic renal failure and DM receiving RRT from July 2022 to March 2023 were studied. Patients underwent flash glucose monitoring (FGM) using FreeStyle Librе portable system with further evaluation of GV parameters and indices, median days of measurement – 14.Results. In the total group, 7 patients (23,3 %) had TIR > 70 %, mean TIR value was 56,3 %±22,0 %, 66,7 % of patients had CV > 36 %, mean CV value was 38,5 %±9,6 %. All indices of GV (MAGE, LBGI, HBGI, M-value, J-index, Conga, LI) exceeded the reference values. When comparing GV indices in patients on PHD and CAPD, it was revealed that LBGI in PHD group was 10,1±5,71 vs CAPD – 5,58±4,22, p=0,025. The critical point of glucose reduction on PHD was the fourth hour from the beginning of the procedure (57.1 % of patients had glycemia < 3.9 mmol/l). Higher median glucose values were found in the first three days of FGM compared to the last three days in both PHD group (p=0.002) and CAPD group (p=0.022).Conclusions. Patients with diabetes on RRT have high GV, low percentage of achieving TIR due to high risk of hypoglycemic conditions in patients on PHD. The critical point of glycaemia reduction is fourth hour after the start of the PHD session. Patients on CAPD have a lower risk of hypoglycemia. FGM improves glycaemic control.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"35 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the role of albuminuria and uromodulin in the early diagnosis of renal function disorders in some types of obesity phenotypes","authors":"A. G. Gadaev, R. K. Dadabayeva","doi":"10.36485/1561-6274-2024-28-1-72-79","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-72-79","url":null,"abstract":"The aim: to study of the relationship of biological markers reflecting damage of the kidneys with its functional state, as well as with clinical, metabolic, hormonal parameters and immunoinflammatory processes in obesity phenotypes.Patients and Methods: The study involved 224 obese Uzbek women who were divided into 2 groups according to the recommended criteria for metabolic syndrome: group 1 consisted of 133 women diagnosed with metabolic complicated obesity, average age 42.0±0.5; Group 2 consisted of 91 women diagnosed with metabolic healthy obesity, average age 41.7±0.7. The control group consisted of 45 healthy volunteers (women, mean age 43.2±0.8, body mass index ˂ 30 kg/m2, waist circumference less than 80 cm). In the observation groups, anthropometric indicators, blood pressure, biochemical tests and blood lipid spectrum, levels of leptin, insulin, cystatin C and uromodulin in the blood serum, gradations of microalbuminuria in urine were determined, the glomerular filtration rate was calculated for cystatin C and creatinine and the obtained indicators were compared.Results. In both obesity phenotypes, the amount of microalbuminuria and cystatin C significantly increased in group 1 compared to these indicators in group 2 and the control group, and the amount of uromodulin in the blood serum, on the contrary, decreased compared to the indicators in group 2 and control group (r ˂ 0.001) . An increase in the gradation of microalbuminuria and cystatin C and a decrease in the amount of uromodulin in the blood serum in both groups was expressed by a decrease in the estimated glomerular filtration rate, which was clearly expressed in group 1 (χ2 = 4.5, r = 0.034). Also, an increase in body mass index was characterized by an increase in cardiometabolic disorders, an increase in the gradation of microalbuminuria, a decrease in the level of uromodulin in the blood serum and cytokinemia (p ˂ 0.001).Conclusion. In both obesity phenotypes, an increase in the degree of obesity was manifested by an increase in the level of cardiometabolic risk, as well as an increase in subclinical kidney damage. It is considered appropriate to determine the amount of uromodulin and cystatin C in blood serum and assess the gradation of microalbuminuria in the early diagnosis of renal dysfunction in obesity.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140263247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of glomerulopathies in kidney neoplasms","authors":"T. A. Garkusha, E. S. Stolyarevich, V. Khorzhevskii, S. V. Ivliev, M. Firsov","doi":"10.36485/1561-6274-2024-28-1-90-95","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-90-95","url":null,"abstract":"Background. Malignant neoplasms, including those of the kidneys, are widespread in the world. The main treatment for kidney tumors is surgery, one of its options is nephrectomy. Malignant tumors of various localizations can lead to a variety of kidney damage. Glomerulopathies of various origins are often asymptomatic, and therefore, patients do not seek medical help. For the diagnosis of glomerulopathies, it is necessary to assess morphological changes with the formulation of an immunofluorescence reaction and electron microscopy.The aim: to analyze the clinical manifestations, frequency and structure of glomerulopathies in kidney neoplasms.Patients and Methods. The study included 141 patients. The patients underwent nephrectomy, the daily protein loss, the number of altered erythrocytes in the urine, the level of creatinine in the blood serum were determined, and the glomerular filtration rate (CKD-EPI) was calculated. Morphological evaluation of samples included immunofluorescence reaction and electron microscopy. To assess the statistical significance of the relationship between variables, Spearman's nonparametric rank correlation coefficient (Rs) was calculated. The results obtained were considered significant at p<0.05. RESULTS. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies. CONCLUSION. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist Keywords: tumor, glomerulonephritis, diabetic nephropathy, glomerular filtration rate> ˂ 0.05.Results. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies.Conclusion. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage th","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"44 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital complications in patients with acute kidney injury after coronary artery bypass grafting","authors":"L. A. Arutyunyan, L. V. Kremneva, L. I. Gapon, S. Shalaev","doi":"10.36485/1561-6274-2024-28-1-63-71","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-63-71","url":null,"abstract":"The aim was to assess the incidence of hospital complications in patients with acute kidney injury (AKI) after coronary artery bypass grafting (CABG).Patients and Methods. The study included 77 patients with stable angina who underwent CABG, aged 65 (61-69) years, 77,9 % men. The number of patients with arterial hypertension was 96,1 %, with carbohydrate metabolism disorders 45,5 %, with chronic kidney disease (CKD) 22,1 %, and with myocardial infarction (MI) 57,1 %. CABG on the working heart was performed in 28,6 %, bimammary CABG in 49,4 %. The duration of artificial circulation was 64 (55-82) minutes; the number of shunts implanted was 2,7+0,7 units. CKD was diagnosed when the glomerular filtration rate was less than 60 ml/min. The development of AKI was assessed according to the KDIGO criteria (2012).Results. CABG related AKI was detected in 10 (13 %) patients, of which grade 1 in 9 (11,7 %), grade 2 in 1 (1,3 %). The indicators associated with AKI after CABG were more severe initial CKD (stages 3b and 4 CKD – 20 % vs 1,5 %, p=0,043), a higher incidence of acute heart failure (in terms of adrenaline requirement – 30 % vs 5,9 %, p=0,043), more occluded coronary arteries (in the groups with and without CABG: one occlusion 70 % and 52,2 %, two occlusions 0 % and 13,4 %, three occlusions 10 % and 0 %, respectively, p=0,028). More severe CKD (stages 3b and 4) statistically significantly increased the relative risk of AKI after CABG by an average of 2,9 times. Among patients with AKI compared to patients without AKI after CABG, there was a higher incidence of cardiac death (20 % vs 0 %, p=0,015), intraoperative MI (60 % vs 8,9 %, p=0,001), acute heart failure (30 % vs 5,9 %, p=0,043).Conclusion. The incidence of AKI following CABG was 13 %. The development of AKI was associated with more severe initial CKD. Patients with postoperative AKI had a poor hospital prognosis.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension as a risk factor for the development of CKD in children with CAKUT syndrome and its correction","authors":"I. Karimdzhanov, G. A. Yusupova, G. Iskanova, N. A. Isrаilova","doi":"10.36485/1561-6274-2024-28-1-43-49","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-43-49","url":null,"abstract":"The review is devoted to the development of end-stage renal failure (ESRD) in children with congenital anomalies of the kidneys and urinary tract (CAKUT syndrome. In this regard, measures to slow the progression of chronic kidney disease (CKD) are important. One of the independent risk factors for a decrease in excretory renal function is arterial hypertension (AH), the correction of which is a mandatory component of nephroprotection. CAKUT syndrome is associated with a congenital decrease of the mass of active nephrons, which inevitably leads to hyperfiltration, the main cause of the development of ESRD has a high prevalence in CACUT syndrome and plays a special role in maintaining hyperfiltration. The presence of cysts, nephrosclerosis sites, and endothelial dysfunction contribute to the activation of renin secretion with a further increase in the role of the renin-angiotensin-aldosterone system (RAAS). Angiotensin II is not only a powerful vasoconstrictor. Its effects on sympathetic stimulation of dense spot, hyperplasia of smooth muscle cells, increased expression of several growth factors, cytokines and chemokines is known. The result of the interaction of this complex is the development of glomerular hypertrophy, tubulointerstitial inflammation and fibrosis. Blood pressure correction should begin with lifestyle modification. It is recommended to start taking antihypertensive drugs in children with blood pressure > 90 percentile. Among the first-line pharmacological drugs for the treatment of hypertension, angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin II type I receptor blockers (ARBs) play a major role. Unlike adults, a combination of them is possible.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal function and cardiovascular risk in overweight patients","authors":"I. Murkamilov, K. Aitbaev, V. V. Fomin, J. A. Murkamilova, P. Astanin, T. Yusupova, Z. Yusupova, F. Yusupov, N. N. Mamatov, D. Ymankulov, I. Kudaibergenova","doi":"10.36485/1561-6274-2024-28-1-50-62","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-50-62","url":null,"abstract":"Background. Currently, in most countries of the world, there is a tendency for an annual increase in the proportion of overweight people (OW). Studies performed in various age groups and devoted to the relationship of OW with the functional state of the kidneys show contradictory results.The aim: to study the functional state of the kidneys and the prevalence of risk factors for cardiovascular complications in OW, taking into account gender differences.Patients and Methods. A cross–sectional single-center study was conducted with the participation of 154 patients (73 men and 81 women) with body mass index (BMI) 25.0–29.9 kg/m2), whose average age was 53.9±12.6 years. Anthropometric and biochemical parameters were evaluated in all patients, the functional state of the kidneys (according to serum creatinine and cystatin C) was studied, and an analysis of cardiovascular risk factors was carried out.Results. Analysis of excretory renal function by cystatin C showed that in most of the examined individuals, regardless of gender, there was a decrease in eGFR to CKD stages 2 and 3a. OW among men was statistically significantly more often associated with hypertriglyceridemia (32.8 %), tachycardia (38.3 %) and atherosclerotic lesion of the carotid arteries (24.6 %). In the subgroup of women with ischemic heart disease, the average age, the content of low-density lipoproteins, the double product index, the frequency of hypercholesterolemia, dyslipidemia and hypertrophy of the left ventricle (LVH), mainly of the eccentric type, were significantly higher, and the hemoglobin content and the number of red blood cells were significantly lower. Significant correlations of eGFR with concentrations of hemoglobin and C-reactive protein, as well as with the value of the left ventricular myocardial mass index (LVMI) were found in men with ischemic heart disease. Correlations of eGFR with the levels of systolic, mean, pulse and central blood pressure, index of functional changes, LDL-C, triglycerides, hemoglobin, fibrinogen, metabolic index, as well as LVMI were found in women with ischemic heart disease. The value of LVH in women was significantly associated with the level of central blood pressure, cystatin C, LDL, hemolobin, fibrinogen, metabolic index, and eGFR. In the general sample of patients with ischemic heart disease, the content of serum cystatin C was positively correlated with LVH and inversely with eGFR calculated by cystatin C. There was a weak negative relationship between the level of central arterial pressure and eGFR by cystatin C.Conclusion. Evaluation of excretory renal function, according to cystatin C and serum creatinine, in individuals with ISM has a higher diagnostic value than evaluation using methods based on the use of serum creatinine alone. In males, the presence of OW is associated with tachycardia, hypertriglyceridemia, a significant decrease in GFR and an increase in the frequency of atherosclerotic changes in the carotid arteries. Th","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"96 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140079753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of clinical guidelines for the diagnosis, treatment and prevention of urinary tract infection in children","authors":"V. V. Snopkov, S. Baiko","doi":"10.36485/1561-6274-2024-28-1-30-42","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-1-30-42","url":null,"abstract":"Urinary tract infection (UTI) is one of the most common bacterial diseases in childhood. The difficulty of diagnosis and timely administration of adequate therapy is associated with differences in the clinical course of the disease in different age groups, localization of the infectious process (upper and lower urinary tract), methods of urine collection and interpretation of the obtained results. The possibility and amount of instrumental diagnostics also varies depending on the region and the specifics of the organization of the healthcare system. The problem of increasing resistance of microorganisms is aggravated by the often-excessive prescription of antimicrobial chemotherapy drugs, which leads to a narrowing of the range of available drugs and the possibility of their use in appropriate age groups. All of the above explains the lack of uniform approaches and the existence of many international and local clinical recommendations on the problem of UTI. This review highlights the features of urine collection in non- and toilet-trained children and also discusses the assumptions and limitations of using screening methods for urinalysis. Indications for urine culture and differences in the interpretation of results depending on the method of obtaining a urine sample are presented, as well as data on modern instrumental diagnostic methods and strategies for their use in practice. A comparative description of current international clinical recommendations for the diagnosis, treatment and prevention of UTIs in children is provided.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"8 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}