Нефрология最新文献

{"title":"Dynamics of biophysical characteristics of albumin in patients on programmed hemodialysis","authors":"A. S. Pushkin, A. V. Martynov, A. V. Arutyunyan, V. L. Emanuel, D. P. Piskunov, A. V. Iakovleva, V. S. Emanuel, A. A. Roshkovskaya","doi":"10.36485/1561-6274-2023-27-3-32-43","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-3-32-43","url":null,"abstract":"Background . One of the components of the metabolome that performs multifaceted functions in homeostasis is blood albumin. The albumin molecule has a pronounced hydrophilicity, due to which it plays an important role in maintaining oncotic blood pressure. Thus, the expansion of knowledge about the interrelationships of traditional biochemical information about the concentration of albumin and the biophysical properties of its derivatives complements the idea of the pharmacological effect of albumin transfusions. THE AIM: to study of the biophysical properties of albumin in patients with chronic kidney disease on programmed hemodialysis. Patients and Methods . The study included 29 patients with chronic renal failure treated with programmed bicarbonate hemodialysis for an average of 110 months. To assess the condition of patients, a complex of laboratory studies was used, including hematological examination on Beckman Coulter analyzers; clinical assessment of nutritional status based on data from the analysis of medical histories; assessment of colloidal osmotic blood pressure by calculation, as well as by direct measurement on a BMT 923 oncometer; measurement of particle size in blood plasma by dynamic light scattering on a Photocor Compact spectrometer- Z. Statistical analysis of the material was performed using the Statistica for Windows v.6.0 software package. The null statistical hypothesis of the absence of differences and connections was rejected at p<0.05. RESULTS. The average correlation coefficient of oncotic pressure was 0.94 for total protein and 0.90 for albumin. Measurement of colloidal osmotic pressure showed a significant increase in pressure in each of the postdialysis samples. The hydrodynamic radius of the albumin peak for the predialysis sample is significantly higher, which may indicate a change in the sorption properties of the albumin surface. CONCLUSION. The calculation of oncotic pressure by the concentration of total protein, as a rule, provides clinical needs, however, with a significant concentration of toxins, clinical situations are possible in which a moderate decrease in the concentration of the \"total protein\" of the blood is detected, hence the main oncotic component – albumin is noted but there is a development pronounced edematous syndrome due to a significant decrease in oncotic pressure as a result of a conformational change in albumin molecules. In such situations, it is necessary to directly determine the oncotic pressure of the blood. Keywords: albumin, oncotic pressure, hydrodynamic radius, dialysis&gt;˂0.05. Results . The average correlation coefficient of oncotic pressure was 0.94 for total protein and 0.90 for albumin. Measurement of colloidal osmotic pressure showed a significant increase in pressure in each of the postdialysis samples. The hydrodynamic radius of the albumin peak for the predialysis sample is significantly higher, which may indicate a change in the sorption properties of the albumin su","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136023987","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":"Testosterone deficiency in patients with chronic kidney disease: prevalence and clinical significance (literature review)","authors":"A. S. Litvinov, A. A. Kukhtina, Yu. V. Kuznetsova, V. V. Khatlamadzhiyan, T. Yu. Ryabokoneva","doi":"10.36485/1561-6274-2023-27-3-11-22","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-3-11-22","url":null,"abstract":"There is an increase in the prevalence of chronic kidney disease in the world. This is primarily due to the increase in the incidence of diabetes mellitus and arterial hypertension as the main etiological factors. A progressive decline in the excretory function of the kidneys is associated with metabolic disorders such as metabolic acidosis, hyperuricemia, hyperparathyroidism, oxidative and inflammatory stress, etc. This leads, in turn, to a decrease in the body weight of patients, primarily due to the loss of muscle mass. Such changes have an adverse effect, including on the synthesis of sex hormones, in particular, on the level of testosterone, the production of which decreases in the cohort of patients under discussion. Hormonal imbalance in the form of hypogonadism can play a significant role in increasing cardiovascular risk. Renal replacement therapy may be an independent risk factor for the development and progression of hypogonadism. At the same time, the problems of impaired regulation, synthesis and balance of sex hormones, as well as the issues of correction of secondary hypogonadism in patients with chronic kidney disease remain poorly understood and are of scientific interest.","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136023844","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":"The role of serum immunoglobulin e in patients with immunoglobulin А-nephropathy","authors":"K. S. Komissarov, D. B. Nizheharodava, E. I. Minchenko, V. S. Pilotovich, M. M. Zafranskaya","doi":"10.36485/1561-6274-2023-27-2-47-56","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-47-56","url":null,"abstract":"THE AIM. To determine the frequency of elevated serum immunoglobulin E (IgE) levels in patients with immunoglobulin A nephropathy (IGAN) and to establish its relation to clinical and morphological, laboratory manifestations and disease course. PATIENTS AND METHODS. The study enrolled 47 patients with primary IGAN, age 32 (27 ÷ 39) years. Daily proteinuria (PU), hematuria, serum creatinine, degree of arterial hypertension (AH) and glomerular filtration rate (GFR) were analyzed. Blood concentration of total IgE was determined by enzyme immunoassay, and allergen-specific IgE antibodies to 57 allergens (domestic, epidermal, fungal, vegetable, food) using a commercial kit \"EUROLINE Atopy Screen (IgE)\" (\"Euroimmun\", Germany). RESULTS . In patients with IGAN, serum total IgE was found to exceed the normal value in 55 % of cases, with a concentration of 89.4 (47.5 ÷ 198.7) IU/ml and correlation with GFR (R=0.32, p=0.02) and creatinine (R=-0.40, p=0.01) was detected. Patients with elevated IgE levels showed a reduced incidence of AH (p=0.01), tubular atrophy and interstitial fibrosis (T1) (p=0.03). A correlation analysis revealed that the severity of endothelial proliferation decreased with increasing IgE concentration (R=– 0.40, p=0.02). The highest prevalence among allergens was shown for specific IgE to domestic mites Dermatophagoides farinae (42,1 %), specific activity of 31,4 (1,7 ÷ 71,3) u.u. was noted to Dermatophagoides pteronyssinus. There was a correlation between IgE concentration to Dermatophagoides pteronyssinus and PU (R=-0.51, p=0.01) and between the amount of IgE to Dermatophagoides farinae and the percentage of half moon (R=-0.55, p=0.01). The five-year event-free survival rate was 67 ± 19 % in the IgE group within normal limits and 100 % in the IgE group above normal limits (p=0.008). CONCLUSION. The presence of elevated concentrations of total and specific IgE indicated a more favourable course of IGAN.","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"11218 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135449460","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":"The role of interleukin-6 in the pathogenesis of protein-energy malnutrition in patients treated with haemodialysis","authors":"A. A. Jakovenko, Yu. V. Lavrischeva, A. Sh. Rumyantsev","doi":"10.36485/1561-6274-2023-27-2-66-71","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-66-71","url":null,"abstract":"BACKGROUND. Protein-energy malnutrition (PEM) often develops in patients receiving long-term treatment with programmed haemodialysis (HD). Its main causes are decreased intake of basic nutrients, increased losses, disorders inherent to the terminal renal failure itself (including chronic inflammation), as well as the influence of factors associated with the HD procedure. THE AIM: to clarify the role of interleukin-6 (IL-6 ) in the pathogenesis of BEN in patients treated with programmed haemodialysis. PATIENTS AND METHODS. We examined 645 patients receiving HD treatment, including 300 men and 345 women aged 56.8±12.8 years, the duration of renal replacement therapy was 8.4±5.3 years. Nutritional status was assessed according to International Society of Renal Nutrition and Metabolism (ISRNM) recommendations. Serum IL-6 levels were determined by a three-step \"sandwich\" version of a solid phase enzyme immunoassay using mono- and polyclonal antibodies to IL-6 using a commercial kit \"Interleukin-6-IFA-BEST\" from Vector-Best, Russia, under the manufacturer's instructions. The reference values for IL-6 are 0-7 pg/ml. RESULTS. The prevalence of BEN was 24.9 % (160 patients). Mean IL-6 concentration was 6.47±2.64 pg/ml in patients without evidence of BEN, and 23.20±10.40 pg/ml in patients with BEN, p<0.001. Elevated IL-6 levels revealed statistically significantly lower levels of total protein, albumin, prealbumin, total cholesterol, transferrin and blood lymphocyte counts. Patients with elevated IL-6 levels were also characterized by statistically significantly lower values of body mass index, skeletal muscle mass index and skeletal muscle mass index. CONCLUSION. The results of this study suggest that the high prevalence of PEM in patients treated with HD is closely related to an imbalance of pro- and anti-inflammatory cytokines. An increase in the duration of renal replacement therapy is accompanied by an increase in serum IL-6 levels. Therefore, this cytokine can be considered as a therapeutic target for prevention and treatment of sarcopenia in dialysis patients.","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"318 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135449463","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":"Problematic issues of optimizing the transfer of renal transplant recipients from pediatric to adult health care (literature review)","authors":"O. V. Raikevich-Liachovskaya, A. V. Sukalo, S. V. Baiko","doi":"10.36485/1561-62742023-27-2-21-28","DOIUrl":"https://doi.org/10.36485/1561-62742023-27-2-21-28","url":null,"abstract":"The transfer of kidney transplant recipients from pediatric to adult healthcare should be a planned process, as it involves various risks, including loss of the transplanted organ and death of the patient. The most critical age for the development of adverse events is the age of 17–24 years. This is because of the peculiarities of the maturation of the brain of adolescents, severe kidney disease and the need for constant medication. At this age, patients experience peer pressure, preoccupation with their appearance, personal development, pursuits and dreams for the future, which may not come true against the background of a long-term chronic illness and lead to low self-esteem, depression and anger. The result of these psycho-emotional experiences may be non-compliance with the regimen of immunosuppressive drugs with the development of rejection, and even loss of a kidney transplant. The transition process should ideally take several years and start early, usually between the ages of 12 and 14. The transfer should be carried out not only after the onset of a certain age, but also based on the existing skills and readiness of the patient. The patient must remain in the pediatric service if severe complications (rejection, infections) develop until they are treated and for at least 1 year after transplantation, even if this period is the age of transition to adult service. Following a transition readiness assessment, a structured plan should be drawn up requiring the integration of medical, educational, behavioral and social strategies both during and after the transition. Establishing transitional clinics or assigning a position of coordinator allows controlling the transition process and minimize possible risks and negative consequences. The development and implementation of programs for the transition of kidney transplant recipients to adult service are aimed at increasing the survival of the kidney transplant and patients, improving their quality of life.","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135557676","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":"Kidney health for all: preparedness for the unexpected in supporting the vulnerable","authors":"Li-Li Hsiao, Kavya M. Shah, Adrian Liew, Dina Abdellatif, Alessandro Balducci, A´gnes Haris, Latha A. Kumaraswami, Vassilios Liakopoulos, Siu-Fai Lui, Ifeoma Ulasi, Robyn G. Langham","doi":"10.36485/1561-6274-2023-27-2-12-20","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-12-20","url":null,"abstract":"As the rate of natural disasters and other devastating events caused by human activities increases, the burden on the health and well-being of those affected by kidney disease has been immeasurable. Health system preparedness, which involves creating a resilient system that is able to deal with the health needs of the entire community during times of unexpected disruptions to usual care, has become globally important. In the wake of the COVID-19 pandemic, there is a heightened awareness of the amplification of negative effects on the renal community. Paradoxically, the complex medical needs of those who have kidney diseases are not met by systems handling crises, often compounded by an acute increase in burden via new patients as a result of the crisis itself. Disruptions in kidney care as a result of unexpected events are becoming more prevalent and likely to increase in the years to come. It is therefore only appropriate that the theme for this year’s World Kidney Day will focus on Kidney Health for All: preparedness for the unexpected in supporting the vulnerable.","PeriodicalId":485489,"journal":{"name":"Нефрология","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135557672","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}