Nephrology (Saint-Petersburg)最新文献

{"title":"Approaches to predicting the risk of acute cerebrovascular accident in patients with stage 5 chronic kidney disease and bone mineral disorders","authors":"A. Mambetova, Sh. N. Gutarаeva, I. L. Semyonova","doi":"10.36485/1561-6274-2022-26-3-66-71","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-66-71","url":null,"abstract":"   BACKGROUND. Among the causes of death in patients with chronic kidney disease (CKD) on dialysis, cardiovascular complications play a leading role. One of them is acute incidences of cerebral circulation (AICC). The assessment of the impact of mineral and bone disorders on the risk of developing AICC is interesting and on par with the assessment of the impact of traditional risk factors.   THE AIM: to evaluate the effects of bone mineral disorders on the risk of acute cerebrovascular accident in patients with stage 5 D CKD.   PATIENTS AND METHODS. A single-center cohort prospective (three-year) study of 85 patients with stage 5D CKD on program hemodialysis was conducted. In the first stage, we evaluated traditional risk factors (blood pressure, echocardiography parameters) and parameters that reflect bone mineral disorders (parathyroid hormone, blood phosphate, calcium levels, 1.25 (OH) D, fibroblast growth factor-FGF-23, a-klotho of blood). Signs of calcification of the heart valves (CHV) and the aortic wall (CAW) were also recorded. In the second stage, three years later, patients were re-examined with the registration of the endpoint, which was identified as cases of fatal and non-fatal AICC.   RESULTS. Within three years, 10 cases of AICC were registered. Mineral and bone disorders in patients on hemodialysis, such as hyperphosphatemia, CKD and its severity are risk factors for the development of AICC. It is shown that the severity of CCS and pulse pressure levels determined before the dialysis procedure and intradialytic have a positive effect on the risk of AICC. Factors such as FGF-23 and α-Klotho of blood have not demonstrated their effect on the risk of AICC.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76280524","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":"Еvaluation the functional reserve of the kidneys in patients with chronic heart failure who have had the COVID-19 infection","authors":"A. Gadaev, R. Turakulov, N. V. Pirmatova, F. I. Hudjakulova","doi":"10.36485/1561-6274-2022-26-3-59-65","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-59-65","url":null,"abstract":"   THE AIM: to evaluate the functional reserve of the kidneys (FRK), and the effectiveness of empagliflozin (EMPA), a selective reversible inhibitor of sodium-glucose cotransporter type 2 (SGLT 2), in patients with chronic heart failure who have had COVID-19 infection.   PATIENTS AND METHODS: To assess the state of renal function in patients with coronary heart disease (CHF), the most accessible and convenient method for determining FRK using 0.45 % saline was chosen. The study involved 110 patients with CHF developed as a result of coronary artery disease and hypertension. The first group consisted of 40 patientswith CHF who have had COVID-19 infection (16 (40 %) men and 24 (60 %) women, mean age 63.2 ± 1.2 years). They received EMPA in addition to standard therapy. The second group consisted of 40 patients with CHF who have also had COVID-19 (24 (60 %) men and 16 (40 %) women, mean age 64.1 ± 1.2 years). They received only standard therapy (ACE inhibitors or ARB,beta-blockers, AMCR). The control group consisted of 30 CHF patients who haven’t had COVID-19 infection (16 (53.33 %) men and 14 (46.67 %) women, mean age 61.8 ± 1.2 years). They received only standard therapy.   RESULTS. In patients of the first group (standard treatment+ EMPA) the FRK was 2.9 ± 0.2 % before and 8.1 ± 0.2 % after the treatment, which indicates a significant increase (p<0.001). The creatinine level before the treatment and exercise was 147.7±2.7 μmol/l, and after the exercise, it decreased to 144.7±2.5 μmol/l. After the standard therapy, a decrease in its index by 102.5±1.4 μmol/l and 99.7 ± 1.3 μmol/l, respectively, was established. The glomerular filtration rate before treatment and exercise was 56.8 ± 1.5 ml/min, and after exercise, it increased to 54.3 ± 1.6 ml/min. After the treatment, these values were 60.3 ± 2.01 ml/min and 62.7±2.08 ml/min, respectively. In patients of the second group (standard treatment), FRK was 4.4 ± 0.1 % before and 3.0 ± 0.2 % after treatment.   CONCLUSION: Thus, in patients of the first group, who received EMPA along with standard CHF treatment, an increase in FRK by 2.8 times was found (p < 0.01). In the group of patients with CHF who did not receive an inhibitor of sodium-glucose transporter type 2 EMPA in combination with standard therapy, a decrease in FRK by 1.3 times was found (p > 0.05). While in the control group, FRK increased by 1.1 times (p > 0.05). Thus, the results show that in the first group, the FRK index was 2.9 %, which indicates the absence of a reserve, while after complex therapy in combination with EMPA, this increased to 8.1 %, which indicates the presence of a reserve. However, in the second group, the decrease in these indicators from 4.4 % to 3.3 %, respectively, suggests the absence of FRK. In the control group, this figure increased from 6.7 % before treatment to 7.1 % after.This indicates a decrease in FRK in this group of patients. Thus, the decrease in the FRK in patients of the first group compared with the","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78265160","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":"Polymorphism of genes of immune-inflammatory response, thrombophilia, and arterial hypertension in kidney diseases in children (literature review)","authors":"A. Vyalkova, I. V. Zorin, G. K. Karymova, S. A. Chesnokova","doi":"10.36485/1561-6274-2022-26-3-40-51","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-40-51","url":null,"abstract":"   Modern scientific data and the emergence of new opportunities for the development of pediatrics and nephrology are inextricably linked with medical genetics, the role of which is especially important for understanding the etiology and pathogenesis of many diseases of the urinary system. In 35–80 % of children with diffuse connective tissue diseases, kidney damage is formed, which is one of the leading causes of comorbidity of pathology and mortality of patients. Modern genetic research will allow not only to decipher the nature of diseases but also to scientifically substantiate adequate therapy. The active development of methods for the molecular diagnosis of kidney diseases opens up a large section of medicine, which can be called \"molecular nephropathology\". Further study of kidney diseases from the standpoint of molecular biology will allow us to take a fresh look at the pathogenesis of many diseases and solve a number of problems from the standpoint of personalized therapy, which takes into account the genetic characteristics of the patient. The active development of genetic research in nephrology has led to an understanding of the role of genetic mutations and polymorphisms leading to the occurrence of nephropathies in children. Correct clarification of the causes of the development of the disease can radically change the tactics of managing a patient by a nephrologist and rheumatologist. Determination of the genetic cause of the development of nephropathy is important in children since it justifies the need to examine other family members, it will allow predicting the risk of developing kidney pathology in diffuse connective tissue diseases, which is very important, predicting the response to immunosuppressive therapy. The development of molecular diagnostic methods is increasingly opening up prospects for a personalized approach to the study of pathology at various levels of interaction; these achievements provide a qualitative assessment of DNA, RNA, proteins, and their metabolites, which makes it possible to determine new biomarkers. The article deals with gene polymorphisms in secondary nephropathies in children with diffuse connective tissue diseases (systemic lupus erythematosus, systemic microthrombovasculitis, rheumatoid arthritis).","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77487318","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":"Atypical hemolytic-uremic syndrome: evolution of treatment and impact of clinical and genetic characteristics on possibility of eculizumab withdrawal","authors":"E. Prokopenko","doi":"10.36485/1561-6274-2022-26-3-19-29","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-19-29","url":null,"abstract":"   Atypical hemolytic uremic syndrome (aHUS) is a rare variant of thrombotic microangiopathy (TMA) associated with uncontrolled activation of alternative complement pathway due to mutations in complement regulatory protein genes or antibodies formation to regulators. Clinical manifestations of aHUS can be triggered by infections, sepsis, pregnancy, autoimmune diseases, organ transplantation, and other complement-activating conditions. Previously, the only treatment option for aHUS was plasma therapy – fresh frozen plasma infusions or plasma exchange, but its effectiveness was insufficient. Currently, targeted treatment available – recombinant monoclonal antibodies against complement C5 protein – eculizumab with high efficiency in achieving aHUS remission, renal function recovery, and preventing TMA at kidney transplantation. For a long time, the question of the optimal duration of treatment and the possibility of eculizumab discontinuing remained unresolved. It was shown that aHUS relapses developed in 20-35 % of patients after discontinuation of complement-blocking therapy. The article presents an overview of a large number of studies of eculizumab treatment outcomes and the possibility of its withdrawal, including a French prospective multicenter study that identified risk factors for aHUS relapse after eculizumab discontinuation: the presence of rare variants of complement genes, female gender, increased soluble C5b-9 plasma level. In patients who did not have rare genetic variants, the risk of relapse was less than 5 %. In general, eculizumab discontinuation after achieving complete remission of aHUS and renal function recovery in patients with low risk of recurrence can provide better tolerability of maintenance treatment, and decrease the incidence of infectious complications and the financial burden on the healthcare system.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84850138","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":"Cryoglobulinemic vasculitis associated with HCV infection: still a problem?","authors":"S. Milovanova, L. Lysenko (Kozlovskaya), L. Milovanova, D. T. Abdurahmanov, M. Taranova, A. V. Volkov","doi":"10.36485/1561-6274-2022-26-3-30-39","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-30-39","url":null,"abstract":"   The review presents the main data on the problem of cryoglobulinemic vasculitis associated with HCV infection. The options for the course are considered, and modern diagnostic criteria, the choice of tactics, and the effectiveness of various treatment regimens are presented. The use of modern antiviral drugs makes it possible to achieve the eradication of the virus in 95 % of patients. However, in some patients, clinical and immunologic markers of vasculitis persist despite viral clearance. The article discusses the concept that the persistence of B-cell clones after achieving a sustained virological response may underlie the pathogenesis of HCV-independent CV reactivation.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"60 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86778764","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":"Anti–glomerular basement membrane disease with rapidly progressive glomerulonephritis and hemorrhagic alveolitis in pediatric patients (reviev of literature)","authors":"N. Savenkova, K. A. Papayan","doi":"10.36485/1561-6274-2022-26-3-9-18","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-9-18","url":null,"abstract":"   The article is devoted to controversial issues of autoimmune small vessel vasculitis with kidney and lung damage. Modern data on the features of pathogenesis, clinical manifestation, treatment, outcome, and prognosis of the disease with AT to GBM have presented: an idiopathic disease with AT of class IgG (IgG1 and IgG3) against non-collagen domain-1 (NC1) α3-chain ofcollagen type IV GBM (Goodpasture autoantigen); with the simultaneous increase in AT to GBM and ANCA; \"de novo\" diseases with AT to the α5(IV) and α3(IV) chains of GBM type IV collagen in renal graft with Alport syndrome in pediatric patients.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88960411","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":"PROFESSOR ANDREY VLADIMIROVICH VATAZIN (to the 65-th birthday)","authors":"A. Editorial","doi":"10.36485/1561-6274-2021-26-2-114-115","DOIUrl":"https://doi.org/10.36485/1561-6274-2021-26-2-114-115","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"2012 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87967773","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":"TO THE FORENSIC MEDICAL SUPPORT OF KIDNEY TRANSPLANTATION IN ST. PETERSBURG","authors":"O. D. Yagmurov, V. D. Isakov, V. V. Vasilenko","doi":"10.36485/1561-6274-2022-26-2-93-98","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-2-93-98","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81893041","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":"НEMODIALIASIS AND COVID-19 (ANALYSIS OF THE FIRST YEAR OF THE PANDEMIC IN MAKHACHKALA)","authors":"P. G. Gadzhieva, Z. A. Agalavova, M. J. Gadzhiyavdibirova, L. B. Gasanova","doi":"10.36485/1561-6274-2022-26-2-85-92","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-2-85-92","url":null,"abstract":"BACKGROUND. Patients receiving treatment with programmed hemodialysis are at high risk for the incidence of COVID-19. THE AIM: to analyze the clinical picture, features of the course, risk factors and treatment options in COVID-19 patients treated with programmed hemodialysis in Makhachkala. PATIENTS AND METHODS. 162 patients (87 men and 75 women) were treated with HD for terminal renal failure were under observation in the GBU RD \"RKB\" of Makhachkala, repurposed to provide medical care to patients infected with SARS-CoV-2 from April 2019 to April 2020. The study was single-center, retrospective and uncontrolled. The end point of observation was considered to be the patient's discharge from the hospital or death. Patients who continued treatment at the end of the study were excluded from it. RESULTS. Infection with SARS-CoV-2 in 101 (62.3%) patients was confirmed by PCR results, and in the rest – by a characteristic pattern determined by CT of the chest organs. The fatal outcome of COVID-19 in patients with HD was associated with a more severe and widespread lung lesion (CT-3 and CT-4), which was diagnosed significantly more often compared to the surviving patients. In a significant number of patients with end-stage CKD treated with HD, it is characterized by a severe course and an unfavorable prognosis. In this regard, there is a need to search for effective and safe methods of prevention and treatment in groups at increased risk of infection and severe COVID-19. CONCLUSION. Patients with CKD have an increased risk of developing severe COVID-19. Concomitant cardiovascular diseases and diabetes mellitus may predispose to this. Given the availability of a vaccine or approved therapy, nephrologists should advise patients with CKD to follow the recommendations of social isolation. © 2022 Educational Autonomous Non-Profit Organization Nephrology. All rights reserved.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78539464","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":"COMPREHENSIVE ASSESSMENT OF THE FUNCTIONAL STATE OF THE KIDNEYS AND HEMODYNAMICS IN THE PROGNOSIS OF CARDIOVASCULAR RISK IN PATIENTS WITH CHRONIC PYELONEPHRITIS AND ARTERIAL HYPERTENSION","authors":"S. A. Oskolkov, S. A. Paketov, V. A. Zhmurov, D. V. Zhmurov, P. Ivanova, M. V. Evseev","doi":"10.36485/1561-6274-2022-26-2-72-76","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-2-72-76","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83857689","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}