Pub Date : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.372
L.D. Denova, D. Ivanov, R.R. Andrunevich, O. Korzh, E. Krasyuk
During armed conflicts (AC) and other disasters, the elderly, women, children, the infirm and the chronically ill patients are the most vulnerable population, with a high risk to health and life. Chronically ill people with kidney diseases, including those with kidney failure, deserve special attention due to their complete dependence on available functional infrastructure, and access to vital drugs and well-trained personnel. Currently, there is little information on the effects of AC on patients with kidney damage compared to the available data about the effects of other disasters. Mechanisms of injuries in AC and natural or man-made disasters have similar and distinctive features. Distinctive features: during AC — mainly gunshot and mine blast injuries, bleedings, poisonings by toxic substances, during disasters — hypothermia or burns, mechanical injuries, etc. Similar features include damage to infrastructure, particularly health care facilities, shortage of medicines, medical personnel, humanitarian and other crises, and a large number of injured and traumatized people in the hospitals. In this article, we systematized the material obtained during the military conflict, as well as reviewed domestic and foreign articles on this topic in order to optimize the work of nephrologists in the conditions of martial law and limited resources.
{"title":"Nephrological care in the conditions of martial law in Ukraine","authors":"L.D. Denova, D. Ivanov, R.R. Andrunevich, O. Korzh, E. Krasyuk","doi":"10.22141/2307-1257.11.3.2022.372","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.372","url":null,"abstract":"During armed conflicts (AC) and other disasters, the elderly, women, children, the infirm and the chronically ill patients are the most vulnerable population, with a high risk to health and life. Chronically ill people with kidney diseases, including those with kidney failure, deserve special attention due to their complete dependence on available functional infrastructure, and access to vital drugs and well-trained personnel. Currently, there is little information on the effects of AC on patients with kidney damage compared to the available data about the effects of other disasters. Mechanisms of injuries in AC and natural or man-made disasters have similar and distinctive features. Distinctive features: during AC — mainly gunshot and mine blast injuries, bleedings, poisonings by toxic substances, during disasters — hypothermia or burns, mechanical injuries, etc. Similar features include damage to infrastructure, particularly health care facilities, shortage of medicines, medical personnel, humanitarian and other crises, and a large number of injured and traumatized people in the hospitals. In this article, we systematized the material obtained during the military conflict, as well as reviewed domestic and foreign articles on this topic in order to optimize the work of nephrologists in the conditions of martial law and limited resources.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76158015","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.376
I.S. Kalymanov
In this article, the author considers distance learning as a new stage in the development of education. The author focuses on the latest achievements in the educational process, as well as the impact of the self-isolation process on the introduction of distance learning. The main advantages and disadvantages of distance learning technology are determined. The basic principles that a teacher needs to master for conducting distance learning of students are considered. The main educational platforms and services are presented, such as Microsoft Teams, Moodle, Zoom, Cisco Webex, Google Classroom. The main features of each platform and service for distance learning are highlighted. The strengths and weaknesses of each of the above platforms and services are considered.
{"title":"Distance learning in the system of higher education in Kazakhstan (based on main platforms and services)","authors":"I.S. Kalymanov","doi":"10.22141/2307-1257.11.3.2022.376","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.376","url":null,"abstract":"In this article, the author considers distance learning as a new stage in the development of education. The author focuses on the latest achievements in the educational process, as well as the impact of the self-isolation process on the introduction of distance learning. The main advantages and disadvantages of distance learning technology are determined. The basic principles that a teacher needs to master for conducting distance learning of students are considered. The main educational platforms and services are presented, such as Microsoft Teams, Moodle, Zoom, Cisco Webex, Google Classroom. The main features of each platform and service for distance learning are highlighted. The strengths and weaknesses of each of the above platforms and services are considered.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"70 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91505033","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.374
N. Saidakova, S. Pasiechnikov, M. Mitchenko, G. Kononova, V.I. Hrodzinskyy, V.G. Bieliakova
Background. The purpose of the work: to study the structure and features of the dynamics of primary disability among the adult population of Ukraine as a result of non-oncological urological diseases. Materials and methods. The reporting form No. 14 of the State Statistics Service of Ukraine, the statistical sources of the Ukrainian State Research Institute of Medical and Social Problems of Disability, documentation of regional centers for medical and social expertise are used. Results. There is a tendency to reduce the number of people recognized as disabled for the first time due to genitourinary diseases. It has been confirmed that prolonging temporary disability contributes to this. The official reporting of the causes of disability by the class of genitourinary diseases is presented only for chronic glomerulonephritis and chronic pyelonephritis; for 5 years, the incidence of the first nosology increased by 13.0 % (to 43.8 % among 1,549 registered), the second — decreased by 37.4 % (to 20.0 % in all regions except Kyiv). At the same time, there was a tendency to reduce the incidence of disability retirement for reasons classified as “others” (36.2 ± 2.0 % vs. 39.0 ± 1.8 % in 2016, and in the Central and Northeastern regions it reached 49.2 ± 2.8 % and 49.6 ± 4.7 %, respectively). Apart from the two above-mentioned pathologies, the structure of disability causes is as follows: the first three places belonged to urolithiasis, polycystic kidney disease, single kidney, the next three — hydronephrosis, congenital malformations and urethral stricture. With age, the incidence of urolithiasis, polycystic kidney disease, hydronephrosis, urethral stricture increases and the incidence of congenital malformations and a single kidney decreases. Over the years, the assignment of the second group of disability decreases (18.1 ± 3.1 % in 2020 vs. 20.4 ± 2.6 % in 2016), with an increase of the third group (67.8 ± 3.8 % vs. 65.3 ± 3.1 %), and stabilization of the first group (14.1 vs. 14.3 %). Conclusions. During the 5-year observation period, 12.9 % more patients avoided disability and 4.7 % less received groups I and II. A decrease by 37.4 % (to 20.0 %) in the share of chronic pyelonephritis as a cause of disability was observed in all regions except Kyiv. Structure of other causes of disability: urolithiasis — 45.0 %, polycystic kidney disease — 22.1 %, single kidney — 18.8 %, hydronephrosis — 15.4 %, congenital defects — 12.1 %, urethral stricture — 4.7 %. Against the background of the general increase in disability assignments with age, group III disability among others was more common (7.7 % — at the age of up to 39 years, 63.1 % — at pre-retirement age, 67.8 % — at retirement age).
{"title":"Structure and features of the dynamics of primary disability in the adult population of Ukraine as a result of non-oncological urological diseases","authors":"N. Saidakova, S. Pasiechnikov, M. Mitchenko, G. Kononova, V.I. Hrodzinskyy, V.G. Bieliakova","doi":"10.22141/2307-1257.11.3.2022.374","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.374","url":null,"abstract":"Background. The purpose of the work: to study the structure and features of the dynamics of primary disability among the adult population of Ukraine as a result of non-oncological urological diseases. Materials and methods. The reporting form No. 14 of the State Statistics Service of Ukraine, the statistical sources of the Ukrainian State Research Institute of Medical and Social Problems of Disability, documentation of regional centers for medical and social expertise are used. Results. There is a tendency to reduce the number of people recognized as disabled for the first time due to genitourinary diseases. It has been confirmed that prolonging temporary disability contributes to this. The official reporting of the causes of disability by the class of genitourinary diseases is presented only for chronic glomerulonephritis and chronic pyelonephritis; for 5 years, the incidence of the first nosology increased by 13.0 % (to 43.8 % among 1,549 registered), the second — decreased by 37.4 % (to 20.0 % in all regions except Kyiv). At the same time, there was a tendency to reduce the incidence of disability retirement for reasons classified as “others” (36.2 ± 2.0 % vs. 39.0 ± 1.8 % in 2016, and in the Central and Northeastern regions it reached 49.2 ± 2.8 % and 49.6 ± 4.7 %, respectively). Apart from the two above-mentioned pathologies, the structure of disability causes is as follows: the first three places belonged to urolithiasis, polycystic kidney disease, single kidney, the next three — hydronephrosis, congenital malformations and urethral stricture. With age, the incidence of urolithiasis, polycystic kidney disease, hydronephrosis, urethral stricture increases and the incidence of congenital malformations and a single kidney decreases. Over the years, the assignment of the second group of disability decreases (18.1 ± 3.1 % in 2020 vs. 20.4 ± 2.6 % in 2016), with an increase of the third group (67.8 ± 3.8 % vs. 65.3 ± 3.1 %), and stabilization of the first group (14.1 vs. 14.3 %). Conclusions. During the 5-year observation period, 12.9 % more patients avoided disability and 4.7 % less received groups I and II. A decrease by 37.4 % (to 20.0 %) in the share of chronic pyelonephritis as a cause of disability was observed in all regions except Kyiv. Structure of other causes of disability: urolithiasis — 45.0 %, polycystic kidney disease — 22.1 %, single kidney — 18.8 %, hydronephrosis — 15.4 %, congenital defects — 12.1 %, urethral stricture — 4.7 %. Against the background of the general increase in disability assignments with age, group III disability among others was more common (7.7 % — at the age of up to 39 years, 63.1 % — at pre-retirement age, 67.8 % — at retirement age).","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77313166","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.377
V. Bezruk, D. Ivanov, I. Shkrobanets
The paper examines the issues of circadian rhythms functioning and their significance in the regulation of physiological processes of the excretory system. The article deals with the issue of desynchronosis, its causes and effects on the physiological processes of the excretory system in children. The practical significance of chronobiological aspects, their dependence on both individual and population factors, the dynamism of such disturbances and their relevance in the age aspect are shown. The value of chronobiological aspects in the functioning of the excretory system and the expediency of continuing scientific and practical research in this direction of medical science were emphasized.
{"title":"Chronobiological aspects of the excretory system (review)","authors":"V. Bezruk, D. Ivanov, I. Shkrobanets","doi":"10.22141/2307-1257.11.3.2022.377","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.377","url":null,"abstract":"The paper examines the issues of circadian rhythms functioning and their significance in the regulation of physiological processes of the excretory system. The article deals with the issue of desynchronosis, its causes and effects on the physiological processes of the excretory system in children. The practical significance of chronobiological aspects, their dependence on both individual and population factors, the dynamism of such disturbances and their relevance in the age aspect are shown. The value of chronobiological aspects in the functioning of the excretory system and the expediency of continuing scientific and practical research in this direction of medical science were emphasized.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84779485","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.373
Fateme Shamekhi Amiri
Background. Fibrillary glomerulonephritis is a rare glomerular disease that presents with hypertension, hematuria, nephrotic syndrome and renal insufficiency. The purpose of this research was to assess effect of DNAjB9 staining marker in kidney biopsy specimens on kidney outcomes. Materials and methods. In this analytic (experimental) clinical study with randomized clinical trial design in meta-analysis article, 72 patients with biopsy-proven fibrillary glomerulonephritis were investigated. Clinical features, laboratory data at initial presentation, management and outcomes were collected. The paper has written based on searching PubMed Central and Google Scholar to identify potentially relevant articles. Median, percentage, mean ± standard deviation (SD), two-tailed t and Chi-square, two proportion difference meta-analysis and Kaplan-Meier analysis were used for statistical evaluation. Moreover, relative risk, odds ratio, Spearman’s correlation for statistical analyses were used. Results. The median and interquartile range of age of patients with fibrillary nephropathy at the time of diagnosis were 55 and 18 years, respectively. There was no statistically significant difference between two sex groups of males and females in current research (p-value: 0.35). There was significant statistical correlation between elevated serum creatinine level and time of last serum creatinine measurement with p-value of 0.01 and confidence interval (CI) of 0.7820 to –0.1258 during follow-up. Relative risk of kidney failure progression to kidney replacement therapy (↑ ≥ 2-fold in serum creatinine or dialysis or kidney transplant) in DNAjB9-positive (group I) and DNAjB9-negative patients (group II) was assessed 2.67 with 95% CI of 1.128 to 6.3044 and p-value of 0.025. Odds ratio of kidney failure progression to kidney replacement therapy (↑ ≥ 2-fold in serum creatinine or dialysis or kidney transplant) was assessed 4.33 with 95% CI of 0.9464 to 19.8417 and p-value of 0.058. There was statistically significant difference when comparing group I and group II for mortality probability (Kaplan-Meier analysis) during follow-up (P < 0.0001). Conclusions. The present study revealed high mortality in DNAjB9-negative (8/64, 12.5%) versus DNAjB9-positive patients (0/8) with statistically significant level. Relative risk and odds ratio of kidney failure progression to kidney replacement therapy were assessed 2.67 and 4.33, respectively.
{"title":"Effect size of Dna-j heat shock protein family B member 9 (DNAJB9) biomarker in kidney biopsy specimens on kidney outcomes in fibrillary glomerulonephritis","authors":"Fateme Shamekhi Amiri","doi":"10.22141/2307-1257.11.3.2022.373","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.373","url":null,"abstract":"Background. Fibrillary glomerulonephritis is a rare glomerular disease that presents with hypertension, hematuria, nephrotic syndrome and renal insufficiency. The purpose of this research was to assess effect of DNAjB9 staining marker in kidney biopsy specimens on kidney outcomes. Materials and methods. In this analytic (experimental) clinical study with randomized clinical trial design in meta-analysis article, 72 patients with biopsy-proven fibrillary glomerulonephritis were investigated. Clinical features, laboratory data at initial presentation, management and outcomes were collected. The paper has written based on searching PubMed Central and Google Scholar to identify potentially relevant articles. Median, percentage, mean ± standard deviation (SD), two-tailed t and Chi-square, two proportion difference meta-analysis and Kaplan-Meier analysis were used for statistical evaluation. Moreover, relative risk, odds ratio, Spearman’s correlation for statistical analyses were used. Results. The median and interquartile range of age of patients with fibrillary nephropathy at the time of diagnosis were 55 and 18 years, respectively. There was no statistically significant difference between two sex groups of males and females in current research (p-value: 0.35). There was significant statistical correlation between elevated serum creatinine level and time of last serum creatinine measurement with p-value of 0.01 and confidence interval (CI) of 0.7820 to –0.1258 during follow-up. Relative risk of kidney failure progression to kidney replacement therapy (↑ ≥ 2-fold in serum creatinine or dialysis or kidney transplant) in DNAjB9-positive (group I) and DNAjB9-negative patients (group II) was assessed 2.67 with 95% CI of 1.128 to 6.3044 and p-value of 0.025. Odds ratio of kidney failure progression to kidney replacement therapy (↑ ≥ 2-fold in serum creatinine or dialysis or kidney transplant) was assessed 4.33 with 95% CI of 0.9464 to 19.8417 and p-value of 0.058. There was statistically significant difference when comparing group I and group II for mortality probability (Kaplan-Meier analysis) during follow-up (P < 0.0001). Conclusions. The present study revealed high mortality in DNAjB9-negative (8/64, 12.5%) versus DNAjB9-positive patients (0/8) with statistically significant level. Relative risk and odds ratio of kidney failure progression to kidney replacement therapy were assessed 2.67 and 4.33, respectively.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78955801","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.375
D. Ivanov
Nowadays there is an emerging problem with renal replacement therapy in the world. Its main methods include dialysis and renal transplantation. However, many regions in the world do not have access to one or more therapy methods due to numerous economic, social, and other factors. Hemodialysis and peritoneal dialysis are shown to be equally efficient, however, it may be difficult to choose one. For each patient who is faced with the choice of a method of renal replacement therapy, the question is which way to choose. The moral and social aspects of such a choice are quite complex. Therefore, the role of a doctor, in addition to the qualified performance of renal replacement therapy, is largely advisory and requires patience and understanding of a patient. It is important to raise the awareness of patients and the level of medical staff education as well as provide equal access to all renal replacement therapy types in the world.
{"title":"Renal replacement therapy: does the patient have a choice?","authors":"D. Ivanov","doi":"10.22141/2307-1257.11.3.2022.375","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.375","url":null,"abstract":"Nowadays there is an emerging problem with renal replacement therapy in the world. Its main methods include dialysis and renal transplantation. However, many regions in the world do not have access to one or more therapy methods due to numerous economic, social, and other factors. Hemodialysis and peritoneal dialysis are shown to be equally efficient, however, it may be difficult to choose one. For each patient who is faced with the choice of a method of renal replacement therapy, the question is which way to choose. The moral and social aspects of such a choice are quite complex. Therefore, the role of a doctor, in addition to the qualified performance of renal replacement therapy, is largely advisory and requires patience and understanding of a patient. It is important to raise the awareness of patients and the level of medical staff education as well as provide equal access to all renal replacement therapy types in the world.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"391 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91470712","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.380
T. Saliba, H. Salame, D. Tack
Urolithiasis is a condition which is commonly encountered in practice, however retrograde migration of a calculus within the ureter has only recently been documented with few cases reported in the literature. We present the case of a 47-year-old woman presenting with symptomatic urolithiasis confirmed by CT who recovered from her symptoms only for it to be discovered that the calculus had undergone retrograde migration into the renal calyx on a follow up CT examination. We theorise that retrograde urolithiasis migration may be an innate safety mechanism that evolved to prevent complications and/or death from urolithiasis impaction by attempting to return a migrated lithiasis to the renal calyx.
{"title":"Spontaneous retrograde urolithiasis migration in a woman: a case report and possible mechanism","authors":"T. Saliba, H. Salame, D. Tack","doi":"10.22141/2307-1257.11.3.2022.380","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.380","url":null,"abstract":"Urolithiasis is a condition which is commonly encountered in practice, however retrograde migration of a calculus within the ureter has only recently been documented with few cases reported in the literature. We present the case of a 47-year-old woman presenting with symptomatic urolithiasis confirmed by CT who recovered from her symptoms only for it to be discovered that the calculus had undergone retrograde migration into the renal calyx on a follow up CT examination. We theorise that retrograde urolithiasis migration may be an innate safety mechanism that evolved to prevent complications and/or death from urolithiasis impaction by attempting to return a migrated lithiasis to the renal calyx.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89022235","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 : 2022-09-24DOI: 10.22141/2307-1257.11.3.2022.378
N. Filipets, A. Gozhenko, D. Ivanov, O. Filipets, L. Gabunia
According to general scientific recognition, the content of sodium ions in the body of a healthy person is quite constant, and among the multifaceted biological functions of this electrolyte, participation in maintaining water-salt homeostasis is the most important. Deviations from the normal level of concentration of sodium ions in the blood plasma are the most common electrolyte balance disorders in clinical medicine; however, dysionias still remain a relevant subject of research, in particular, their pathogenetic aspects and the possibilities of pharmacological correction. Sodium as an electrolyte is essential for the volume of extracellular fluid the content of which is inversely related to the urinary excretion of sodium ions. Sodium homeostasis is tightly regulated. In the reactions of ensuring the sodium balance in the body, the kidneys play a leading role, and the changes in their functional state are mediated through the action of the basic neurohumoral regulatory systems. The main renal homeostatic processes — glomerular filtration, tubular reabsorption and secretion — are of decisive importance for the removal of excess ions of sodium or its retention in the body. At the same time, it was found that there are also extrarenal mechanisms that are still being studied. Moreover, a number of studies have suggested that sodium ions can be stored in body tissues without adequate retention of water to buffer the electrolyte. Given the participation of the kidneys in maintaining normal functional and metabolic relationships and in pathological syndromes related to other organs, it is possible to predict the correlation of the activity of established and new markers of extrarenal mechanisms with reducers of water-electrolyte exchange the final effects of which are mediated through changes in the functional state of the kidneys. Evaluation of additional sodium-regulatory systems is a promising current direction for expanding ideas about mechanisms of stability of electrolytes and water.
{"title":"Regulatory mechanisms for maintaining homeostasis of sodium ions","authors":"N. Filipets, A. Gozhenko, D. Ivanov, O. Filipets, L. Gabunia","doi":"10.22141/2307-1257.11.3.2022.378","DOIUrl":"https://doi.org/10.22141/2307-1257.11.3.2022.378","url":null,"abstract":"According to general scientific recognition, the content of sodium ions in the body of a healthy person is quite constant, and among the multifaceted biological functions of this electrolyte, participation in maintaining water-salt homeostasis is the most important. Deviations from the normal level of concentration of sodium ions in the blood plasma are the most common electrolyte balance disorders in clinical medicine; however, dysionias still remain a relevant subject of research, in particular, their pathogenetic aspects and the possibilities of pharmacological correction. Sodium as an electrolyte is essential for the volume of extracellular fluid the content of which is inversely related to the urinary excretion of sodium ions. Sodium homeostasis is tightly regulated. In the reactions of ensuring the sodium balance in the body, the kidneys play a leading role, and the changes in their functional state are mediated through the action of the basic neurohumoral regulatory systems. The main renal homeostatic processes — glomerular filtration, tubular reabsorption and secretion — are of decisive importance for the removal of excess ions of sodium or its retention in the body. At the same time, it was found that there are also extrarenal mechanisms that are still being studied. Moreover, a number of studies have suggested that sodium ions can be stored in body tissues without adequate retention of water to buffer the electrolyte. Given the participation of the kidneys in maintaining normal functional and metabolic relationships and in pathological syndromes related to other organs, it is possible to predict the correlation of the activity of established and new markers of extrarenal mechanisms with reducers of water-electrolyte exchange the final effects of which are mediated through changes in the functional state of the kidneys. Evaluation of additional sodium-regulatory systems is a promising current direction for expanding ideas about mechanisms of stability of electrolytes and water.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90244437","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 : 2022-07-13DOI: 10.22141/2307-1257.11.2.2022.365
L. Vakulenko, O. Lytvynova, I.V. Posmitjuha
Background. High recurrence rates of nephrotic syndrome in children and consequences in the form of steroid dependence and a high risk of side effects from corticosteroids as a result involve immunosuppressive steroid-preserving agents that would increase long-term remission. Rituximab, a chimeric anti-CD20 monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation, has been identified as a possible alternative treatment. The purpose of the study — to estimate the efficacy and safety of treatment recurrence of nephrotic syndrome in children using rituximab like we did it on three clinical cases. Materials and methods. The experience of rituximab in children was analyzed according to the databases of Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health and our own study of the treatment of three children with steroid-sensitive nephrotic syndrome was presented. Results. Treatment of nephrotic syndrome in three children who are 5 to 7 years with rituximab was conducted. One child had a second recurrence, two children had a first recurrence. The previous episode of nephrotic syndrome in all children was treated according to the recommendations of KDIGO 2021. All patients received rituximab (two intravenous injections two weeks apart) at a dose of 15 mg/kg for 5–6 hours with prior administration of methylprednisolone at a dose of 7–10 mg/kg. One child had side effects to the first administration of rituximab in the form of hypotension 70/40 and tachycardia 116–118. Reducing the speed of administration helped to eliminate side effects. The next injection in two weeks the child endured well. The other two children had no side effects to both rituximab injections. Moreover after 1 month of rituximab administration was without side effects or hematological changes. The next administration of rituximab is scheduled in 6 months after the last administration with prior control of CD20 level. Conclusions. In general a review of studies of rituximab confirms the high efficacy of the medication in nephrotic syndrome in children and the requirement for long-term evaluation. Rituximab can be considered as a first-line treatment for recurrence of nephrotic syndrome, including in resource-limited settings. Our own experience with rituximab in recurrent nephrotic syndrome has revealed slight short-term side effects.
{"title":"Rituximab use in the treatment of children with nephrotic syndrome","authors":"L. Vakulenko, O. Lytvynova, I.V. Posmitjuha","doi":"10.22141/2307-1257.11.2.2022.365","DOIUrl":"https://doi.org/10.22141/2307-1257.11.2.2022.365","url":null,"abstract":"Background. High recurrence rates of nephrotic syndrome in children and consequences in the form of steroid dependence and a high risk of side effects from corticosteroids as a result involve immunosuppressive steroid-preserving agents that would increase long-term remission. Rituximab, a chimeric anti-CD20 monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation, has been identified as a possible alternative treatment. The purpose of the study — to estimate the efficacy and safety of treatment recurrence of nephrotic syndrome in children using rituximab like we did it on three clinical cases. Materials and methods. The experience of rituximab in children was analyzed according to the databases of Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health and our own study of the treatment of three children with steroid-sensitive nephrotic syndrome was presented. Results. Treatment of nephrotic syndrome in three children who are 5 to 7 years with rituximab was conducted. One child had a second recurrence, two children had a first recurrence. The previous episode of nephrotic syndrome in all children was treated according to the recommendations of KDIGO 2021. All patients received rituximab (two intravenous injections two weeks apart) at a dose of 15 mg/kg for 5–6 hours with prior administration of methylprednisolone at a dose of 7–10 mg/kg. One child had side effects to the first administration of rituximab in the form of hypotension 70/40 and tachycardia 116–118. Reducing the speed of administration helped to eliminate side effects. The next injection in two weeks the child endured well. The other two children had no side effects to both rituximab injections. Moreover after 1 month of rituximab administration was without side effects or hematological changes. The next administration of rituximab is scheduled in 6 months after the last administration with prior control of CD20 level. Conclusions. In general a review of studies of rituximab confirms the high efficacy of the medication in nephrotic syndrome in children and the requirement for long-term evaluation. Rituximab can be considered as a first-line treatment for recurrence of nephrotic syndrome, including in resource-limited settings. Our own experience with rituximab in recurrent nephrotic syndrome has revealed slight short-term side effects.","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"191 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77490746","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 : 2022-07-13DOI: 10.22141/2307-1257.11.2.2022.366
V. Bezruk, D. Ivanov, S. Fomina, T. Andriychuk, O. I. Pervozvanska, T. R. Andriychuk
In the modern development of medicine, the issue of providing medical care on the basis of evidence-based and personalized medicine becomes especially relevant. The system of standardization of medical care is focused on the development and implementation of medical and technological documents that help the doctor to act effectively in specific clinical situations, avoiding ineffective actions and interventions. The article highlights the approaches to improving the quality of medical care for children at the regional level - a joint agreed local clinical protocol for medical care for children with urinary tract infections (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).
{"title":"Standardization of provision of medical care for children: joint agreed local clinical protocol of medical care for children with urinary tract infections at the level of the hospital district","authors":"V. Bezruk, D. Ivanov, S. Fomina, T. Andriychuk, O. I. Pervozvanska, T. R. Andriychuk","doi":"10.22141/2307-1257.11.2.2022.366","DOIUrl":"https://doi.org/10.22141/2307-1257.11.2.2022.366","url":null,"abstract":"In the modern development of medicine, the issue of providing medical care on the basis of evidence-based and personalized medicine becomes especially relevant. The system of standardization of medical care is focused on the development and implementation of medical and technological documents that help the doctor to act effectively in specific clinical situations, avoiding ineffective actions and interventions. The article highlights the approaches to improving the quality of medical care for children at the regional level - a joint agreed local clinical protocol for medical care for children with urinary tract infections (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).","PeriodicalId":17874,"journal":{"name":"KIDNEYS","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81056039","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}
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