Pub Date : 2024-03-14DOI: 10.22141/2307-1257.13.1.2024.437
No Authors
No abstract
无摘要
{"title":"KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis","authors":"No Authors","doi":"10.22141/2307-1257.13.1.2024.437","DOIUrl":"https://doi.org/10.22141/2307-1257.13.1.2024.437","url":null,"abstract":"No abstract","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"30 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140242131","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}
Pub Date : 2024-03-14DOI: 10.22141/2307-1257.13.1.2024.436
V. Bezruk, T. Andriychuk, D. Ivanov, S. P. Fomina, І. Shkrobanets
Glomerulonephritis is one of the most common kidney diseases in children, which leads to the development of chronic kidney disease, chronic kidney failure, and early disability. According to statistical data (2022), glomerulonephritis is the second most common among acquired kidney childhood diseases after urinary tract infections in Ukraine. The system of standardization of medical care is focused on the development and implementation of medical and technological documents that help a doctor to act effectively in specific clinical situations, avoiding ineffective actions and interventions. The article considers the approaches to improving the quality of medical care for children at the regional level — a local clinical protocol of medical care for children with glomerulonephritis (coordination of the patient’s clinical route and standardization of diagnostic, therapeutic and preventive measures in health care facilities at the level of the hospital district).
{"title":"Standardization of medical care provision to children: local clinical protocol of medical care for children with glomerulonephritis at the level of the hospital district","authors":"V. Bezruk, T. Andriychuk, D. Ivanov, S. P. Fomina, І. Shkrobanets","doi":"10.22141/2307-1257.13.1.2024.436","DOIUrl":"https://doi.org/10.22141/2307-1257.13.1.2024.436","url":null,"abstract":"Glomerulonephritis is one of the most common kidney diseases in children, which leads to the development of chronic kidney disease, chronic kidney failure, and early disability. According to statistical data (2022), glomerulonephritis is the second most common among acquired kidney childhood diseases after urinary tract infections in Ukraine. The system of standardization of medical care is focused on the development and implementation of medical and technological documents that help a doctor to act effectively in specific clinical situations, avoiding ineffective actions and interventions. The article considers the approaches to improving the quality of medical care for children at the regional level — a local clinical protocol of medical care for children with glomerulonephritis (coordination of the patient’s clinical route and standardization of diagnostic, therapeutic and preventive measures in health care facilities at the level of the hospital district).","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"46 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244547","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}
Pub Date : 2024-03-14DOI: 10.22141/2307-1257.13.1.2024.442
А.Yu. Shymova, I. Shifris, Е. Krasiuk
Background. The aim of the work was to determine the cost of treating patients with stage 5D chronic kidney disease (CKD) by dialysis methods of renal replacement therapy (RRT) in 2023 based on the analysis of the costs of using hemodialysis (HD) and peritoneal dialysis (PD) in one medical institution. Materials and methods. An open single-center study was conducted at the Кyiv City Center of Nephrology and Dialysis. During 2023, 779 patients with stage 5D chronic kidney disease received renal replacement therapy by dialysis methods in this institution. Among them, 718 participants were treated by hemodialysis and 61 patients by peritoneal dialysis (36 by continuous ambulatory peritoneal dialysis (CAPD) and 25 by automated peritoneal dialysis (APD)). Direct medical and non-medical costs were included in the calculation of the cost of treating chronic kidney disease patients using both dialysis methods. The estimate of the cost of treatment for one patient during the year was calculated according to the formula: when using hemodialysis/hemodiafiltration (HDF) method — the cost of 1 session × 156 sessions, in case of CAPD/APD — the cost of 1 treatment day × 365 days. Results. The analysis of the costs for the treatment of patients with stage 5D CKD allowed us to state that the average cost of one HD/HDF session in 2023 was 3,626.20 UAH, one day of CAPD and APD treatment was 1,539.78 and 1,829.12 UAH, respectively. The average cost of treatment of one patient by HD/HDF method during 2023 was 565,687.20 UAH, CAPD — 562,019.70 UAH, APD — 667,628.80 UAH. In the structure of the cost of treatment, regardless of the modality of RRT, the most expensive component is the cost of consumables. State reimbursement under the Program of Medical Guarantees in 2023 for the treatment of one patient with stage 5D CKD during the year was 385,788 UAH when using GD/GDF, 412,085 UAH for CAPD, 662,110 UAH for APD. That is, based on the data we received, the Program of Medical Guarantees covers only 68.2 % of the costs of medical institution for the treatment with HD/HDF, 73.3 % for the treatment with CAPD and almost 100 % for the treatment with APD. Conclusions. The real cost of treating patients with stage 5D CKD using dialysis methods of RRT is higher than the rate of state reimbursement. The Program of Medical Guarantees doesn’t fully cover the costs of medical institutions for the treatment of patients with stage 5D CKD using RRT methods. CAPD has indisputable advantages in terms of both medical and economic benefit. In addition, the advantage of using CAPD over other dialysis modalities during the war is the absence of dependence on water and electricity supply, the number and workload of medical personnel, the need for patients to constantly visit the dialysis center.
{"title":"Economic issues of treating patients with stage 5D chronic kidney disease by dialysis methods of renal replacement therapy in Ukraine: a single-center study","authors":"А.Yu. Shymova, I. Shifris, Е. Krasiuk","doi":"10.22141/2307-1257.13.1.2024.442","DOIUrl":"https://doi.org/10.22141/2307-1257.13.1.2024.442","url":null,"abstract":"Background. The aim of the work was to determine the cost of treating patients with stage 5D chronic kidney disease (CKD) by dialysis methods of renal replacement therapy (RRT) in 2023 based on the analysis of the costs of using hemodialysis (HD) and peritoneal dialysis (PD) in one medical institution. Materials and methods. An open single-center study was conducted at the Кyiv City Center of Nephrology and Dialysis. During 2023, 779 patients with stage 5D chronic kidney disease received renal replacement therapy by dialysis methods in this institution. Among them, 718 participants were treated by hemodialysis and 61 patients by peritoneal dialysis (36 by continuous ambulatory peritoneal dialysis (CAPD) and 25 by automated peritoneal dialysis (APD)). Direct medical and non-medical costs were included in the calculation of the cost of treating chronic kidney disease patients using both dialysis methods. The estimate of the cost of treatment for one patient during the year was calculated according to the formula: when using hemodialysis/hemodiafiltration (HDF) method — the cost of 1 session × 156 sessions, in case of CAPD/APD — the cost of 1 treatment day × 365 days. Results. The analysis of the costs for the treatment of patients with stage 5D CKD allowed us to state that the average cost of one HD/HDF session in 2023 was 3,626.20 UAH, one day of CAPD and APD treatment was 1,539.78 and 1,829.12 UAH, respectively. The average cost of treatment of one patient by HD/HDF method during 2023 was 565,687.20 UAH, CAPD — 562,019.70 UAH, APD — 667,628.80 UAH. In the structure of the cost of treatment, regardless of the modality of RRT, the most expensive component is the cost of consumables. State reimbursement under the Program of Medical Guarantees in 2023 for the treatment of one patient with stage 5D CKD during the year was 385,788 UAH when using GD/GDF, 412,085 UAH for CAPD, 662,110 UAH for APD. That is, based on the data we received, the Program of Medical Guarantees covers only 68.2 % of the costs of medical institution for the treatment with HD/HDF, 73.3 % for the treatment with CAPD and almost 100 % for the treatment with APD. Conclusions. The real cost of treating patients with stage 5D CKD using dialysis methods of RRT is higher than the rate of state reimbursement. The Program of Medical Guarantees doesn’t fully cover the costs of medical institutions for the treatment of patients with stage 5D CKD using RRT methods. CAPD has indisputable advantages in terms of both medical and economic benefit. In addition, the advantage of using CAPD over other dialysis modalities during the war is the absence of dependence on water and electricity supply, the number and workload of medical personnel, the need for patients to constantly visit the dialysis center.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"20 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243789","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}
Pub Date : 2024-03-14DOI: 10.22141/2307-1257.13.1.2024.440
Funmilayo A. Ibitoba, O. Akpor, Agatha O. Ogunkorode, Aderemi Y. Bello, Omotomilola O. Ogunyemi
The prevalence of chronic kidney disease (CKD) has surged to approximately 13 % in the past two decades due to an increase in associated risk factors. Poorly managed CKD can progress to end-stage renal disease, necessitating renal replacement therapy, with hemodialysis being the most common form. This study examines a 5-year record of hemodialysis in a healthcare facility in southwest Nigeria. Study data were collected from dialysis register and case study of patients that were consecutively dialyzed at the dialysis centre of Ekiti State University Teaching Hospital between January 2017 and December 2021. Unstructured proforma was used to extract data for the study. There was a total of 152 patients and 1600 hemodialysis sessions between January 2017 and December 2021. More than a quarter of the patients were civil servants and there were more males than females (p = 0.3325). CKD was the major indication for hemodialysis with hypertension as its main cause while post-partum hemorrhage was the most common cause of acute kidney injury. Only 3.3 % of the patients had permanent access of arteriovenous fistula. Notably, 47.2 % of the patients were lost to follow-up, 29.8 % left to other centres by either referral or self-decision, while 18.6 % died of CKD-related complications. Nevertheless, 4.4 % patients were still dialyzing in the Centre as of December 2021. Comparatively fewer hemodialysis sessions occurred, yet they led to improved patient outcomes. Regular follow-ups and government subsidies are recommended to ease patient burdens.
{"title":"Hemodialysis as a treatment option for chronic kidney disease in Ekiti State University Teaching Hospital: a retrospective study","authors":"Funmilayo A. Ibitoba, O. Akpor, Agatha O. Ogunkorode, Aderemi Y. Bello, Omotomilola O. Ogunyemi","doi":"10.22141/2307-1257.13.1.2024.440","DOIUrl":"https://doi.org/10.22141/2307-1257.13.1.2024.440","url":null,"abstract":"The prevalence of chronic kidney disease (CKD) has surged to approximately 13 % in the past two decades due to an increase in associated risk factors. Poorly managed CKD can progress to end-stage renal disease, necessitating renal replacement therapy, with hemodialysis being the most common form. This study examines a 5-year record of hemodialysis in a healthcare facility in southwest Nigeria. Study data were collected from dialysis register and case study of patients that were consecutively dialyzed at the dialysis centre of Ekiti State University Teaching Hospital between January 2017 and December 2021. Unstructured proforma was used to extract data for the study. There was a total of 152 patients and 1600 hemodialysis sessions between January 2017 and December 2021. More than a quarter of the patients were civil servants and there were more males than females (p = 0.3325). CKD was the major indication for hemodialysis with hypertension as its main cause while post-partum hemorrhage was the most common cause of acute kidney injury. Only 3.3 % of the patients had permanent access of arteriovenous fistula. Notably, 47.2 % of the patients were lost to follow-up, 29.8 % left to other centres by either referral or self-decision, while 18.6 % died of CKD-related complications. Nevertheless, 4.4 % patients were still dialyzing in the Centre as of December 2021. Comparatively fewer hemodialysis sessions occurred, yet they led to improved patient outcomes. Regular follow-ups and government subsidies are recommended to ease patient burdens.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"24 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140242640","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}
Pub Date : 2023-12-30DOI: 10.22141/2307-1257.12.4.2023.428
S. Kushnirenko, L. Savytska, T. Bevzenko, S. Rotova, O. Lysianska, O. Kushnirenko
Chronic kidney disease (CKD) has become one of the most common non-infectious chronic diseases in the world. The World Health Organization predicts that CKD will become the 5th most common chronic disease in 2040. The causes of CKD are multifactorial and varied, but early symptoms are often subtle and silent. For most patients with CKD, pharmacological treatment involves a more general approach that does not depend on the nephrosclerosis. It is believed that in addition to the renoprotective effect, the issue of correcting azotemia in patients with CKD remains relevant. Azotemia is a biochemical abnormality defined as an increase or accumulation of nitrogenous products, creatinine in the blood and other secondary waste products in the body. An increase in the level of nitrogenous wastes is associated with the inability of the renal system to adequately filter waste products. This is a typical sign of both acute kidney injury and CKD. For the correction of azotemia in patients with CKD, it is advisable and pathogenetically justified to use Duonefril® (Lespedeza capitata extract in combination with silymarin), which contains a scientifically based combination of substances of plant origin with nephroprotective properties. Duonefril® in combination with traditional approaches helps preserve and improve the filtration function of the kidneys, due to an increase in the estimated glomerular filtration rate and a hypoazotemic effect in CKD against the background of diabetes mellitus, hypertension and other kidney conditions
{"title":"Correction of azotemia in patients with chronic kidney disease","authors":"S. Kushnirenko, L. Savytska, T. Bevzenko, S. Rotova, O. Lysianska, O. Kushnirenko","doi":"10.22141/2307-1257.12.4.2023.428","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.428","url":null,"abstract":"Chronic kidney disease (CKD) has become one of the most common non-infectious chronic diseases in the world. The World Health Organization predicts that CKD will become the 5th most common chronic disease in 2040. The causes of CKD are multifactorial and varied, but early symptoms are often subtle and silent. For most patients with CKD, pharmacological treatment involves a more general approach that does not depend on the nephrosclerosis. It is believed that in addition to the renoprotective effect, the issue of correcting azotemia in patients with CKD remains relevant. Azotemia is a biochemical abnormality defined as an increase or accumulation of nitrogenous products, creatinine in the blood and other secondary waste products in the body. An increase in the level of nitrogenous wastes is associated with the inability of the renal system to adequately filter waste products. This is a typical sign of both acute kidney injury and CKD. For the correction of azotemia in patients with CKD, it is advisable and pathogenetically justified to use Duonefril® (Lespedeza capitata extract in combination with silymarin), which contains a scientifically based combination of substances of plant origin with nephroprotective properties. Duonefril® in combination with traditional approaches helps preserve and improve the filtration function of the kidneys, due to an increase in the estimated glomerular filtration rate and a hypoazotemic effect in CKD against the background of diabetes mellitus, hypertension and other kidney conditions","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"110 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140647","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}
Pub Date : 2023-12-30DOI: 10.22141/2307-1257.12.4.2023.426
D. Ivanov, Isa Shadoglan Ogli Jabbarli, I. Zavalna, L.D. Denova
Background. All the research data available in the world literature on this problem are mostly unpublished and relate to the provision of hemodialysis care in Syria, Afghanistan and Serbia during military conflicts, as well as extreme natural phenomena, for example, in Turkey, Japan and the USA. During this time, technical and information support and methods of treatment with pharmaceuticals have changed significantly. Therefore, new realities and extreme conditions of providing nephrology care in the conditions of martial law require new views and algorithms to preserve the life and health of patients with chronic kidney disease (CKD). The purpose: to present data on clinical observation and treatment of patients with CKD stage 1–5 D/T in Ukraine during martial law. The object of the study is CKD stage 1–5 D/T in patients in Ukraine during martial law. The subject of the research is the organization of providing nephrology care to patients with CKD stage 1–5 D/T in Ukraine during martial law. Materials and methods. The study is retro- and prospective; the primary documentation of patients who applied for nephrology care from February 24, 2022 to October 24, 2023 was examined. To study the obtained results, we used data available in open sources, which were subject to SWOT analysis and, if possible, statistical processing using online calculators. Results. According to the United Nations, the population of Ukraine during the military operations decreased by more than 6 million, of which at least 25 % were children. In addition, internal migration is documented, which objectively also negatively affected the ability to provide qualified nephrology care. Regarding the provision of medical care, nephrology patients, who make up an average of 10 % of the population, form a fairly significant group. The most available statistics during the martial law in Ukraine are on patients receiving renal replacement therapy. In the first 6 months from the beginning of hostilities, emigration in the form of refugees to the European Union amounted to 602 patients receiving dialysis, more than 400 remained in the territories temporarily not controlled by Ukraine. However, from the entire pre-war registry, we still do not have reliable information about more than 1,000 patients who received renal replacement therapy. During the military operations, we proposed to distinguish 4 zones, which differ in their characteristics in terms of the possibilities of providing nephrology care. Conclusions. With the beginning of martial law in Ukraine, primary difficulties arose in the provision of nephrology care. The results of the study showed that these difficulties are related to the unpreparedness of specialized medical care for current challenges and to solve issues that arise in wartime, and are due to a shortage of personnel, medicines and consumables. However, martial law gave impetus to the development of new solutions that proved to be quite successful in improving th
{"title":"Features of nephrology care in Ukraine during martial law","authors":"D. Ivanov, Isa Shadoglan Ogli Jabbarli, I. Zavalna, L.D. Denova","doi":"10.22141/2307-1257.12.4.2023.426","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.426","url":null,"abstract":"Background. All the research data available in the world literature on this problem are mostly unpublished and relate to the provision of hemodialysis care in Syria, Afghanistan and Serbia during military conflicts, as well as extreme natural phenomena, for example, in Turkey, Japan and the USA. During this time, technical and information support and methods of treatment with pharmaceuticals have changed significantly. Therefore, new realities and extreme conditions of providing nephrology care in the conditions of martial law require new views and algorithms to preserve the life and health of patients with chronic kidney disease (CKD). The purpose: to present data on clinical observation and treatment of patients with CKD stage 1–5 D/T in Ukraine during martial law. The object of the study is CKD stage 1–5 D/T in patients in Ukraine during martial law. The subject of the research is the organization of providing nephrology care to patients with CKD stage 1–5 D/T in Ukraine during martial law. Materials and methods. The study is retro- and prospective; the primary documentation of patients who applied for nephrology care from February 24, 2022 to October 24, 2023 was examined. To study the obtained results, we used data available in open sources, which were subject to SWOT analysis and, if possible, statistical processing using online calculators. Results. According to the United Nations, the population of Ukraine during the military operations decreased by more than 6 million, of which at least 25 % were children. In addition, internal migration is documented, which objectively also negatively affected the ability to provide qualified nephrology care. Regarding the provision of medical care, nephrology patients, who make up an average of 10 % of the population, form a fairly significant group. The most available statistics during the martial law in Ukraine are on patients receiving renal replacement therapy. In the first 6 months from the beginning of hostilities, emigration in the form of refugees to the European Union amounted to 602 patients receiving dialysis, more than 400 remained in the territories temporarily not controlled by Ukraine. However, from the entire pre-war registry, we still do not have reliable information about more than 1,000 patients who received renal replacement therapy. During the military operations, we proposed to distinguish 4 zones, which differ in their characteristics in terms of the possibilities of providing nephrology care. Conclusions. With the beginning of martial law in Ukraine, primary difficulties arose in the provision of nephrology care. The results of the study showed that these difficulties are related to the unpreparedness of specialized medical care for current challenges and to solve issues that arise in wartime, and are due to a shortage of personnel, medicines and consumables. However, martial law gave impetus to the development of new solutions that proved to be quite successful in improving th","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141855","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}
On September 28 — October 1, 2023, the European Society for Paediatric Nephrology (ESPN) 55th Annual Meeting was held in Vilnius, Lithuania, where new achievements in the world of pediatric nephrology were presented. The program included 66 sessions with reports, continuing medical education courses, 117 invited speakers, meetings of working groups on various issues of pediatric nephrology were held, about 450 abstracts were printed and 292 poster presentations were discussed, including two by authors from Ukraine. Courses for young doctors, preparing them for the international exam, and 5-minute reports by well-known specialists became interesting in the organization of continuing medical education, which significantly increased the amount of presented material. Among the innovative approaches in pediatric nephrology, the following drugs have been considered: finerenone (a selective non-steroidal mineralocorticoid receptor antagonist), sparsentan (an angiotensin/endothelin receptor antagonist) for Alport syndrome, focal segmental glomerulosclerosis, IgA nephropathy, dapagliflozin (a sodium-glucose cotransporter 2 inhibitor) for chronic kidney disease and pioglitazone for proteinuria. New approaches have been introduced: to IgA nephropathy — proteinuria control with angiotensin-converting enzyme inhibitors (ACEi), tonsillectomy, rituximab, eculizumab; to focal segmental glomerulosclerosis — plasmapheresis, rituximab (CD20), ofatumumab (CD20), abatacept (CD80/86), belatacept (CD80/86), daratumumab (CD38); to membranous nephropathy — proteinuria control with ACEi, rituximab, calcineurin inhibitors, glucocorticoids, cyclophosphamide; to membranoproliferative glomerulonephritis — proteinuria control with ACEi; to C3 glomerulopathy — proteinuria control with ACEi, eculizumab. Specific provisions of the BK polyomavirus (BKPyV) guidelines were considered, in particular, monthly screening for BKPyV-DNAemia in blood plasma is suggested until month 9, then every 3 months until month 24, after which additional screening every 3 months until the end of the third year after transplantation in pediatric kidney recipients (C, weak). In pediatric patients with stable renal function and high BKPyV-DNAemia, despite reduction in immunosuppressive therapy, we suggest consideration of renal allograft biopsy, as creatinine elevation may be decreased in children with significant renal involvement, including rejection (A, strong).
{"title":"New advances in pediatric nephrology: ESPN 2023 results","authors":"G.Yu. Zvenigorodska, Yu.O. Kislova, R.R. Andrunevich","doi":"10.22141/2307-1257.12.4.2023.427","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.427","url":null,"abstract":"On September 28 — October 1, 2023, the European Society for Paediatric Nephrology (ESPN) 55th Annual Meeting was held in Vilnius, Lithuania, where new achievements in the world of pediatric nephrology were presented. The program included 66 sessions with reports, continuing medical education courses, 117 invited speakers, meetings of working groups on various issues of pediatric nephrology were held, about 450 abstracts were printed and 292 poster presentations were discussed, including two by authors from Ukraine. Courses for young doctors, preparing them for the international exam, and 5-minute reports by well-known specialists became interesting in the organization of continuing medical education, which significantly increased the amount of presented material. Among the innovative approaches in pediatric nephrology, the following drugs have been considered: finerenone (a selective non-steroidal mineralocorticoid receptor antagonist), sparsentan (an angiotensin/endothelin receptor antagonist) for Alport syndrome, focal segmental glomerulosclerosis, IgA nephropathy, dapagliflozin (a sodium-glucose cotransporter 2 inhibitor) for chronic kidney disease and pioglitazone for proteinuria. New approaches have been introduced: to IgA nephropathy — proteinuria control with angiotensin-converting enzyme inhibitors (ACEi), tonsillectomy, rituximab, eculizumab; to focal segmental glomerulosclerosis — plasmapheresis, rituximab (CD20), ofatumumab (CD20), abatacept (CD80/86), belatacept (CD80/86), daratumumab (CD38); to membranous nephropathy — proteinuria control with ACEi, rituximab, calcineurin inhibitors, glucocorticoids, cyclophosphamide; to membranoproliferative glomerulonephritis — proteinuria control with ACEi; to C3 glomerulopathy — proteinuria control with ACEi, eculizumab. Specific provisions of the BK polyomavirus (BKPyV) guidelines were considered, in particular, monthly screening for BKPyV-DNAemia in blood plasma is suggested until month 9, then every 3 months until month 24, after which additional screening every 3 months until the end of the third year after transplantation in pediatric kidney recipients (C, weak). In pediatric patients with stable renal function and high BKPyV-DNAemia, despite reduction in immunosuppressive therapy, we suggest consideration of renal allograft biopsy, as creatinine elevation may be decreased in children with significant renal involvement, including rejection (A, strong).","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138764","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}
Pub Date : 2023-12-30DOI: 10.22141/2307-1257.12.4.2023.425
Safaa Gatea, Mezban, M. F. Albadran, S. G. Mezban, E. B. Alfadli, K. H. Jareh
Background. Nephrectomy, a performance surgery in urology practice, may lead to an irreversibly kidney injuries during surgical removal. This study aims to describe 10-years of experience with nephrectomy, its indications and complications in kidney diseases. Materials and methods. Data for all the patients who underwent nephrectomy were collected including demographics, age, sex, education, smoking, alcohol consumption, aetiology, past medical and surgical history and comorbidity. Indications for nephrectomy were stones, obstruction, tumors, pyelonephritis and autosomal dominant polycystic kidney disease. Among complications, thrombocytopenia, fever, hyperkalemia, hypertension, ileus, pneumonia, pneumothorax, septic shock, surgical site infection, hyperglycemia, bleeding and postoperative nausea and vomiting were recorded. Preoperative preparation included laboratory tests such as complete blood count, renal function test and liver function test. It is reasonable to perform renoscintography before nephrectomy to consider partial nephrectomy. However, in our study we performed it routinely because nearly all patients underwent ultrasonography or/and computed tomography scan of abdomen/pelvis to detect pathologies. A percutaneous polyurethane catheters or stents were placed. A guidewire was inserted into the kidney via the rigid cystoscope. Results. A total of 50 nephrectomies were performed. The median age of patients was 45 years ranging from 14 to 73 years. About 60 % of the patients were females and 40 % were males. Patients were educated (48 %), smoking (56 %), alcoholic (12 %), with past medical and surgical history (50 %), comorbidities (46 %) and lived in rural region (44 %) and urban areas (56 %). Stones and obstruction accounted for the majority of cases, 52 and 36 %, respectively. Most of the nephrectomies were performed with laparoscopic approach (58 %). Open surgery was done in 15 cases (30 %) because of adhesions and emphysema. Complications related to laparoscopy and open surgery occurred in 17 (34 %) of patients. Thrombocytopenia, fever, hyperkalemia, hypertension, ileus, pneumonia, pneumothorax, septic shock, surgical site infection, hyperglycemia, bleeding and postoperative nausea and vomiting were recorded. Conclusions. Stone disease and obstruction were the most common benign conditions requiring nephrectomy. The laparoscopic approach can be feasible for most benign kidney diseases requiring nephrectomies with adequate expertise. Сomplication rate in it is comparable with that of open surgery.
{"title":"Nephrectomy indications in kidney diseases: 10-years’ experience study","authors":"Safaa Gatea, Mezban, M. F. Albadran, S. G. Mezban, E. B. Alfadli, K. H. Jareh","doi":"10.22141/2307-1257.12.4.2023.425","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.425","url":null,"abstract":"Background. Nephrectomy, a performance surgery in urology practice, may lead to an irreversibly kidney injuries during surgical removal. This study aims to describe 10-years of experience with nephrectomy, its indications and complications in kidney diseases. Materials and methods. Data for all the patients who underwent nephrectomy were collected including demographics, age, sex, education, smoking, alcohol consumption, aetiology, past medical and surgical history and comorbidity. Indications for nephrectomy were stones, obstruction, tumors, pyelonephritis and autosomal dominant polycystic kidney disease. Among complications, thrombocytopenia, fever, hyperkalemia, hypertension, ileus, pneumonia, pneumothorax, septic shock, surgical site infection, hyperglycemia, bleeding and postoperative nausea and vomiting were recorded. Preoperative preparation included laboratory tests such as complete blood count, renal function test and liver function test. It is reasonable to perform renoscintography before nephrectomy to consider partial nephrectomy. However, in our study we performed it routinely because nearly all patients underwent ultrasonography or/and computed tomography scan of abdomen/pelvis to detect pathologies. A percutaneous polyurethane catheters or stents were placed. A guidewire was inserted into the kidney via the rigid cystoscope. Results. A total of 50 nephrectomies were performed. The median age of patients was 45 years ranging from 14 to 73 years. About 60 % of the patients were females and 40 % were males. Patients were educated (48 %), smoking (56 %), alcoholic (12 %), with past medical and surgical history (50 %), comorbidities (46 %) and lived in rural region (44 %) and urban areas (56 %). Stones and obstruction accounted for the majority of cases, 52 and 36 %, respectively. Most of the nephrectomies were performed with laparoscopic approach (58 %). Open surgery was done in 15 cases (30 %) because of adhesions and emphysema. Complications related to laparoscopy and open surgery occurred in 17 (34 %) of patients. Thrombocytopenia, fever, hyperkalemia, hypertension, ileus, pneumonia, pneumothorax, septic shock, surgical site infection, hyperglycemia, bleeding and postoperative nausea and vomiting were recorded. Conclusions. Stone disease and obstruction were the most common benign conditions requiring nephrectomy. The laparoscopic approach can be feasible for most benign kidney diseases requiring nephrectomies with adequate expertise. Сomplication rate in it is comparable with that of open surgery.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141132","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}
Pub Date : 2023-12-30DOI: 10.22141/2307-1257.12.4.2023.429
V. Bezruk, D. Ivanov, I.D. Shkrobanets, I. Jabbarli
The article provides an analysis of theoretical and practical results of comprehensive studies on the problem of the emergence and development of psychosomatic disorders, in particular, in patients with renal pathology (genitourinary system). The article focuses on the issues of autonomic dysfunctions and the possibility of using chronopsychological prediction of psychosomatic disorders in patients with renal pathology.
{"title":"Psychosomatic aspects of renal pathology (literature review)","authors":"V. Bezruk, D. Ivanov, I.D. Shkrobanets, I. Jabbarli","doi":"10.22141/2307-1257.12.4.2023.429","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.429","url":null,"abstract":"The article provides an analysis of theoretical and practical results of comprehensive studies on the problem of the emergence and development of psychosomatic disorders, in particular, in patients with renal pathology (genitourinary system). The article focuses on the issues of autonomic dysfunctions and the possibility of using chronopsychological prediction of psychosomatic disorders in patients with renal pathology.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137288","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}
Pub Date : 2023-12-30DOI: 10.22141/2307-1257.12.4.2023.430
PhD Vasyl Yekhalov, O. V. Kravets, V. V. Gorbuntsov, D. Krishtafor
Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with serious adverse outcomes, including increased length of hospital stay, development of chronic kidney disease, and increased risk of mortality. The incidence of AKI among burn patients in the intensive care units is 38 (30–46) %. A high percentage of the total burn surface area and a number of individual predisposing factors are considered to be the leading risk factors for AKI. Pathophysiological and morphological changes in the body under the combination of burn disease and kidney damage have certain discrepancies with the classical course of the pathological process in some nosological forms. Despite significant progress in the technologies of fluid resuscitation, intensive care and renal replacement therapy in recent years, the morbidity and mortality rate in such patients remain quite significant. A better understanding of clinical characteristics, early detection and prevention of risk factors for kidney damage in burns, as well as timely medical intervention can effectively reduce morbidity and progression of the pathological process, and also optimize the prognosis in the long run.
急性肾损伤（AKI）是烧伤重症患者常见的并发症，与严重的不良后果相关，包括住院时间延长、发展为慢性肾病以及死亡风险增加。重症监护室中烧伤患者的 AKI 发生率为 38（30-46）%。烧伤总面积的高比例和一些个体易感因素被认为是导致 AKI 的主要风险因素。在烧伤疾病和肾脏损伤的共同作用下，机体的病理生理和形态变化与某些病理学形式的经典病理过程存在一定差异。尽管近年来液体复苏、重症监护和肾脏替代治疗技术取得了重大进展，但此类患者的发病率和死亡率仍然相当高。更好地了解临床特征，早期发现和预防烧伤肾损伤的危险因素，并及时进行医疗干预，可以有效降低发病率和病理过程的进展，从长远来看还能优化预后。
{"title":"Kidney damage in burn disease. Part 1. Pathomorphophysiology (literature review)","authors":"PhD Vasyl Yekhalov, O. V. Kravets, V. V. Gorbuntsov, D. Krishtafor","doi":"10.22141/2307-1257.12.4.2023.430","DOIUrl":"https://doi.org/10.22141/2307-1257.12.4.2023.430","url":null,"abstract":"Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with serious adverse outcomes, including increased length of hospital stay, development of chronic kidney disease, and increased risk of mortality. The incidence of AKI among burn patients in the intensive care units is 38 (30–46) %. A high percentage of the total burn surface area and a number of individual predisposing factors are considered to be the leading risk factors for AKI. Pathophysiological and morphological changes in the body under the combination of burn disease and kidney damage have certain discrepancies with the classical course of the pathological process in some nosological forms. Despite significant progress in the technologies of fluid resuscitation, intensive care and renal replacement therapy in recent years, the morbidity and mortality rate in such patients remain quite significant. A better understanding of clinical characteristics, early detection and prevention of risk factors for kidney damage in burns, as well as timely medical intervention can effectively reduce morbidity and progression of the pathological process, and also optimize the prognosis in the long run.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139832","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：