Pub Date : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-104-110
F. Yusupov, A. Yuldashev
Uric acid is a weak organic acid with a molecular weight of 168.112 g/mol. Most uric acid at normal blood pH circulates as urates, negatively charged weak salts derived from uric acid. Being the end product of the process of purine catabolism, uric acid is excreted from the human body in urine until kidney function is impaired. Hyperuricemia may occur due to decreased excretion, increased production, or a combination of both mechanisms. Over the past decades, several studies in the adult population have attempted to establish the correlation between the risk of stroke and serum uric acid concentrations, and how these levels influence the patient's neurological outcome after stroke. Our review is devoted to the study of the mechanisms of normal purine metabolism, disorders of purine metabolism and pathogenetic mechanisms of the development of ischemic stroke in hyperuricemia.
{"title":"Ischemic stroke: focus on hyperuricemia","authors":"F. Yusupov, A. Yuldashev","doi":"10.36485/1561-6274-2024-28-2-104-110","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-104-110","url":null,"abstract":"Uric acid is a weak organic acid with a molecular weight of 168.112 g/mol. Most uric acid at normal blood pH circulates as urates, negatively charged weak salts derived from uric acid. Being the end product of the process of purine catabolism, uric acid is excreted from the human body in urine until kidney function is impaired. Hyperuricemia may occur due to decreased excretion, increased production, or a combination of both mechanisms. Over the past decades, several studies in the adult population have attempted to establish the correlation between the risk of stroke and serum uric acid concentrations, and how these levels influence the patient's neurological outcome after stroke. Our review is devoted to the study of the mechanisms of normal purine metabolism, disorders of purine metabolism and pathogenetic mechanisms of the development of ischemic stroke in hyperuricemia.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648456","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-55-62
G. G. Allamova, O. Dygun, A. V. Karunnaya, A. M. Yesayan, B. G. Lukichev, A. Volkova, E. S. Krasnova, A. A. Mayer
The number of patients with end-stage renal disease (ESRD) is growing every year. Due to the high comorbidity of such patients, the search for factors that influence the course of the disease and outcome is of particular importance. Indications for studying the functional state of the thyroid gland, as well as recommendations for the treatment of thyroid dysfunction in patients with ESRD have not been developed.THE AIM: to study indicators of thyroid status and identify clinically significant variants of the euthyroid pathology syndrome in patients with ESRD on program hemodialysis (PHD).PATIENTS AND METHODS. The study included 123 patients with ESRD undergoing PHD. A cross-sectional study was conducted to examine thyroid function parameters in patients with ESCKD undergoing PHD. All patients were assessed for the levels of thyroidstimulating hormone (TSH), free triiodothyronine (free T3) and free thyroxine (free T4), the comorbidity index, which was calculated using the Charlson scale, the effectiveness of program hemodialysis using Kt/V, and the urea reduction coefficient (URR).RESULTS. Increased TSH levels were associated with higher body mass index in the studied patients. “Low T3” syndrome is associated with older age and high comorbidity. The high level of T4 in the examined patients is also associated with old age, high comorbidity and a KT/V index below the target values.CONCLUSION. The TSH level in patients with endstage renal insufficiency on programmed hemodialysis does not reflect the true functional state of the thyroid gland.
{"title":"Clinical signifi cance of various variants of euthyroid pathology syndrome in patients with end-stage chronic kidney disease on programmed hemodialysis","authors":"G. G. Allamova, O. Dygun, A. V. Karunnaya, A. M. Yesayan, B. G. Lukichev, A. Volkova, E. S. Krasnova, A. A. Mayer","doi":"10.36485/1561-6274-2024-28-2-55-62","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-55-62","url":null,"abstract":"The number of patients with end-stage renal disease (ESRD) is growing every year. Due to the high comorbidity of such patients, the search for factors that influence the course of the disease and outcome is of particular importance. Indications for studying the functional state of the thyroid gland, as well as recommendations for the treatment of thyroid dysfunction in patients with ESRD have not been developed.THE AIM: to study indicators of thyroid status and identify clinically significant variants of the euthyroid pathology syndrome in patients with ESRD on program hemodialysis (PHD).PATIENTS AND METHODS. The study included 123 patients with ESRD undergoing PHD. A cross-sectional study was conducted to examine thyroid function parameters in patients with ESCKD undergoing PHD. All patients were assessed for the levels of thyroidstimulating hormone (TSH), free triiodothyronine (free T3) and free thyroxine (free T4), the comorbidity index, which was calculated using the Charlson scale, the effectiveness of program hemodialysis using Kt/V, and the urea reduction coefficient (URR).RESULTS. Increased TSH levels were associated with higher body mass index in the studied patients. “Low T3” syndrome is associated with older age and high comorbidity. The high level of T4 in the examined patients is also associated with old age, high comorbidity and a KT/V index below the target values.CONCLUSION. The TSH level in patients with endstage renal insufficiency on programmed hemodialysis does not reflect the true functional state of the thyroid gland.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"19 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646268","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-85-93
N. A. Verlov, V. Burdakov, L. A. Ivanova, I. A. Kulakov, A. A. Bogdanov, V. Emanuel
The pathogenetic approach to the metaphylaxis of urolithiasis is universally a socially significant health problem due to the increase in morbidity and, especially, its recurrent course, despite the achievements of pharmacotherapy and the use of lithotripsy. Pathological crystallogenesis is considered as a consequence of exceeding the solubility threshold of a number of mineral components of urine, on the one hand, and as a consequence of posttranslational defects of the main proteome of urination - uromodulin (UMOD), demonstrating in healthy people a sanogenetic system for ensuring the stability of biophysical homeostasis: colloidal properties of urine. However, in addition, UMOD, by binding mannose-dependent pills of infectious agents, blocks the contact of bacteria with urotheliocytes, despite the fact that infection of the urinary tract is a known factor of urolithiasis. By modeling the urine of healthy individuals by coincubation with E. coli bacteria, a decrease in the concentration of polymerized uromodulin in urine was demonstrated as a factor in increasing the risk of formation of calcium oxalate crystals
{"title":"Role of urinary tract microbiota and urine proteome in urolithiasis pathogenesis","authors":"N. A. Verlov, V. Burdakov, L. A. Ivanova, I. A. Kulakov, A. A. Bogdanov, V. Emanuel","doi":"10.36485/1561-6274-2024-28-2-85-93","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-85-93","url":null,"abstract":"The pathogenetic approach to the metaphylaxis of urolithiasis is universally a socially significant health problem due to the increase in morbidity and, especially, its recurrent course, despite the achievements of pharmacotherapy and the use of lithotripsy. Pathological crystallogenesis is considered as a consequence of exceeding the solubility threshold of a number of mineral components of urine, on the one hand, and as a consequence of posttranslational defects of the main proteome of urination - uromodulin (UMOD), demonstrating in healthy people a sanogenetic system for ensuring the stability of biophysical homeostasis: colloidal properties of urine. However, in addition, UMOD, by binding mannose-dependent pills of infectious agents, blocks the contact of bacteria with urotheliocytes, despite the fact that infection of the urinary tract is a known factor of urolithiasis. By modeling the urine of healthy individuals by coincubation with E. coli bacteria, a decrease in the concentration of polymerized uromodulin in urine was demonstrated as a factor in increasing the risk of formation of calcium oxalate crystals","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"16 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646824","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-77-84
Kh.A. Rasulova, A. K. Abbasov
BACKGROUND. Endothelial dysfunction (ED) plays an important role in the development and progression of chronic kidney disease (CKD). However, there is insufficient information in the literature on changes in the expression of vascular wall endothelial adhesive molecules in patients with kidney disease.THE AIM: to study the content of P-selectin in the blood of patients with CKD and to evaluate its effect on the development of ED and atherosclerotic changes.PATIENTS AND METHODS. 128 patients with CKD (41% of men and 59% of women) were monitored, with an average age of 63.5±1.7 years. The diagnosis of CKD was made in accordance with the recommendations of KDIGO (2012). The concentration in serum of P-selectin was determined by solid-phase enzyme immunoassay using a set of reagents "Cloud-Clone Corp. P-selectin ELISA" (China).RESULTS. All patients were divided into 6 groups depending on the stage of CKD. In CKD C1 - C3a stage, an increase in the concentration of P-selectin in blood serum was revealed. Starting from the C3b stage of CKD, the values of P-selectin begin to decrease significantly, especially sharply at the C5d stage.CONCLUSION. An increase in the concentration of P-selectin in blood serum can serve as an indication for in-depth dynamic monitoring of coagulogram and lipidogram parameters, a decrease in the concentration of P-selectin in blood serum is highly likely to indicate adverse changes in the geometry of the arterial bed. In this regard, it is advisable to determine the pulse wave velocity and the Agatston index.
{"title":"The concentration of P-selectin in the blood serum of patients with chronic kidney disease","authors":"Kh.A. Rasulova, A. K. Abbasov","doi":"10.36485/1561-6274-2024-28-2-77-84","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-77-84","url":null,"abstract":"BACKGROUND. Endothelial dysfunction (ED) plays an important role in the development and progression of chronic kidney disease (CKD). However, there is insufficient information in the literature on changes in the expression of vascular wall endothelial adhesive molecules in patients with kidney disease.THE AIM: to study the content of P-selectin in the blood of patients with CKD and to evaluate its effect on the development of ED and atherosclerotic changes.PATIENTS AND METHODS. 128 patients with CKD (41% of men and 59% of women) were monitored, with an average age of 63.5±1.7 years. The diagnosis of CKD was made in accordance with the recommendations of KDIGO (2012). The concentration in serum of P-selectin was determined by solid-phase enzyme immunoassay using a set of reagents \"Cloud-Clone Corp. P-selectin ELISA\" (China).RESULTS. All patients were divided into 6 groups depending on the stage of CKD. In CKD C1 - C3a stage, an increase in the concentration of P-selectin in blood serum was revealed. Starting from the C3b stage of CKD, the values of P-selectin begin to decrease significantly, especially sharply at the C5d stage.CONCLUSION. An increase in the concentration of P-selectin in blood serum can serve as an indication for in-depth dynamic monitoring of coagulogram and lipidogram parameters, a decrease in the concentration of P-selectin in blood serum is highly likely to indicate adverse changes in the geometry of the arterial bed. In this regard, it is advisable to determine the pulse wave velocity and the Agatston index. ","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"41 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644995","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-94-103
M. H. Hasun, G. T. Ivanova, M. Parastaeva, E. O. Bogdanova, A. S. Rumyantsev, A. Kucher, S. A. Orlova, O. Beresneva
BACKGROUND. Dietary adjustment is an important point in the treatment of chronic kidney disease (CKD). However, at present, the effect of a diet with a high NaCl content on the state of the cardiovascular system in patients with early stages of CKD has not been sufficiently studied.The AIM: to evaluate blood pressure levels and changes in the myocardium of Wistar rats with early stage renal dysfunction fed a high-salt diet for a long time.MATERIALS AND METHODS: The study was performed on male Wistar rats. The control group consisted of sham-operated animals (LO-group), receiving a standard diet (0.34 % NaCl), the second – rats subjected to resection of ¾ of the kidney parenchyma, receiving a standard diet (NE-group), the third – rats, subjected to ¾ NE, receiving high sodium diet (4 % NaCl, NE+HSD). After 4 months, the rats were assessed for blood pressure (BP), levels of urea, creatinine, sodium in the blood serum, daily diuresis, albumin content in the urine, myocardial mass index (IMM) and left ventricular myocardial mass index (IMLV), and a histological examination of the myocardium was performed.RESULTS: In rats with kidney dysfunction, an increase in blood pressure was detected, most pronounced in the NE+HSD group. In rats of this group, albumin excretion, connective tissue volume, arterial diameter, thickness of the adventitia and media of myocardial vessels increased relative to the indicators of rats with NE receiving a standard diet. IMLV in NE+HSD rats was higher by 16.4 %, and IMM by 10.9 % than in animals with NE on a standard diet. The groups with NE did not differ from each other in the content of urea and creatinine in the blood serum, although these indicators were higher than in LO animals. There were no differences between groups in serum sodium levels.CONCLUSION: Prolonged consumption of a diet with a high content of table salt contributes to the development of the initial stages of CKD in Wistar rats, promotes blood pressure growth and myocardial remodeling, manifested primarily in the progression of cardiomyocyte hypertrophy and myocardial fibrosis.
背景。饮食调整是慢性肾脏病（CKD）治疗的一个重要方面。材料和方法：研究对象为雄性 Wistar 大鼠。对照组包括接受标准饮食（0.34 % NaCl）的假手术动物（LO 组），第二组--接受 3/4 肾实质切除的大鼠，接受标准饮食（NE 组），第三组--接受 3/4 NE 的大鼠，接受高钠饮食（4 % NaCl，NE+HSD）。4 个月后，对大鼠的血压（BP）、尿素水平、肌酐水平、血清中的钠、每日利尿量、尿液中的白蛋白含量、心肌质量指数（IMM）和左室心肌质量指数（IMLV）进行评估，并对心肌进行组织学检查。与接受标准饮食的 NE 大鼠相比，该组大鼠的白蛋白排泄量、结缔组织体积、动脉直径、心肌血管内膜和中膜厚度均有所增加。与标准饮食的 NE 大鼠相比，NE+HSD 大鼠的 IMLV 增加了 16.4%，IMM 增加了 10.9%。NE组与LO组在血清中尿素和肌酐含量方面没有差异，但这些指标高于LO组。结论：长期食用食盐含量高的食物会导致 Wistar 大鼠出现 CKD 的初期阶段，促进血压升高和心肌重塑，主要表现为心肌细胞肥大和心肌纤维化。
{"title":"Myocardial remodeling in wistar rats with renal dysfunction fed a high-salt diet","authors":"M. H. Hasun, G. T. Ivanova, M. Parastaeva, E. O. Bogdanova, A. S. Rumyantsev, A. Kucher, S. A. Orlova, O. Beresneva","doi":"10.36485/1561-6274-2024-28-2-94-103","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-94-103","url":null,"abstract":"BACKGROUND. Dietary adjustment is an important point in the treatment of chronic kidney disease (CKD). However, at present, the effect of a diet with a high NaCl content on the state of the cardiovascular system in patients with early stages of CKD has not been sufficiently studied.The AIM: to evaluate blood pressure levels and changes in the myocardium of Wistar rats with early stage renal dysfunction fed a high-salt diet for a long time.MATERIALS AND METHODS: The study was performed on male Wistar rats. The control group consisted of sham-operated animals (LO-group), receiving a standard diet (0.34 % NaCl), the second – rats subjected to resection of ¾ of the kidney parenchyma, receiving a standard diet (NE-group), the third – rats, subjected to ¾ NE, receiving high sodium diet (4 % NaCl, NE+HSD). After 4 months, the rats were assessed for blood pressure (BP), levels of urea, creatinine, sodium in the blood serum, daily diuresis, albumin content in the urine, myocardial mass index (IMM) and left ventricular myocardial mass index (IMLV), and a histological examination of the myocardium was performed.RESULTS: In rats with kidney dysfunction, an increase in blood pressure was detected, most pronounced in the NE+HSD group. In rats of this group, albumin excretion, connective tissue volume, arterial diameter, thickness of the adventitia and media of myocardial vessels increased relative to the indicators of rats with NE receiving a standard diet. IMLV in NE+HSD rats was higher by 16.4 %, and IMM by 10.9 % than in animals with NE on a standard diet. The groups with NE did not differ from each other in the content of urea and creatinine in the blood serum, although these indicators were higher than in LO animals. There were no differences between groups in serum sodium levels.CONCLUSION: Prolonged consumption of a diet with a high content of table salt contributes to the development of the initial stages of CKD in Wistar rats, promotes blood pressure growth and myocardial remodeling, manifested primarily in the progression of cardiomyocyte hypertrophy and myocardial fibrosis. ","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"116 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141647029","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-63-68
E. G. Zaripova, A. I. Almukhametova, A. Maksudova
BACKGROUND. The prevalence of CKD in the population of the elderly and geriatric patients is varies from 23.4% to 35.8%. Nutritional status was recognized as an important factor of CKD prognosis. One of the factors affecting their survival is nutritional status. There have not been many studies on the effect of eating disorders on the survival of elderly and senile patients with CKD.THE AIM: to assess the impact of nutritional status on the survival of elderly patients with CKD stages 3b-5.PATIENTS AND METHODS. We’ve studied 190 people with CKD stages 3b-5 (eGFR<45 ml/min/m2) with an average age of 76 [67;86]. Exclusion criteria’s: dialysis, acute cardiovascular disorders, oncology, and psychiatric disorders. Nutritional status was assessed by Subjective Global Assessment scale, the 5-year risk of the death was evaluated absolute by the Bansal scale. The duration of study - 36 month.RESULTS. In the group of elderly and geriatric patients with CKD stages 3b-5, normal nutritional status was determined in 40.1% of patients, mild to moderate malnutrition in 54.7%, and protein-energy wasting (PEW) in 5.2%; up to 2.8% of patients were underweight. The best 3-year survival rate was observed in patients with normal nutritional status, mild nutritional status disorders and obesity, the worst survival rate - in patients with PEW and underweight (p<0,001). In the group of patients with CKD stage 4 the average Bansal score scale was 8 points, which corresponds to 69% of the absolute risk of death within 5 years; in patients with CKD stage 5, the average score was also 8 [7, 8]. CONCLUSION. In the group of elderly and geriatric patients with CKD stage 3b-5 and PEW survival rate was significantly lower than in patients without nutritional disorders and mild nutritional disorders; we didn’t find correlation between the estimated absolute risk of death according to the Bansal scale and actual survival in 3-year observation period.
{"title":"Nutritional disorders and survival rate of elderly and geriatric patients with CKD 3B-5 stage","authors":"E. G. Zaripova, A. I. Almukhametova, A. Maksudova","doi":"10.36485/1561-6274-2024-28-2-63-68","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-63-68","url":null,"abstract":"BACKGROUND. The prevalence of CKD in the population of the elderly and geriatric patients is varies from 23.4% to 35.8%. Nutritional status was recognized as an important factor of CKD prognosis. One of the factors affecting their survival is nutritional status. There have not been many studies on the effect of eating disorders on the survival of elderly and senile patients with CKD.THE AIM: to assess the impact of nutritional status on the survival of elderly patients with CKD stages 3b-5.PATIENTS AND METHODS. We’ve studied 190 people with CKD stages 3b-5 (eGFR<45 ml/min/m2) with an average age of 76 [67;86]. Exclusion criteria’s: dialysis, acute cardiovascular disorders, oncology, and psychiatric disorders. Nutritional status was assessed by Subjective Global Assessment scale, the 5-year risk of the death was evaluated absolute by the Bansal scale. The duration of study - 36 month.RESULTS. In the group of elderly and geriatric patients with CKD stages 3b-5, normal nutritional status was determined in 40.1% of patients, mild to moderate malnutrition in 54.7%, and protein-energy wasting (PEW) in 5.2%; up to 2.8% of patients were underweight. The best 3-year survival rate was observed in patients with normal nutritional status, mild nutritional status disorders and obesity, the worst survival rate - in patients with PEW and underweight (p<0,001). In the group of patients with CKD stage 4 the average Bansal score scale was 8 points, which corresponds to 69% of the absolute risk of death within 5 years; in patients with CKD stage 5, the average score was also 8 [7, 8]. CONCLUSION. In the group of elderly and geriatric patients with CKD stage 3b-5 and PEW survival rate was significantly lower than in patients without nutritional disorders and mild nutritional disorders; we didn’t find correlation between the estimated absolute risk of death according to the Bansal scale and actual survival in 3-year observation period.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"19 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645949","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 : 2024-07-15DOI: 10.36485/1561-6274-2024-28-2-69-76
V. O. Bochkareva, M. M. Petrova, N. Shimokhina, I. V. Demko, I. A. Obukhova, E. V. Kozlov
BACKGROUND: CKD is one of the main comorbidities in those who die from COVID-19. Renal injury is the most common nonpulmonary infection of SARS-CoV-2 and has a wide range of manifestations, ranging from mild proteinuria and hematuria to progressive acute kidney injury (AKI) requiring renal replacement therapy (RRT).THE AIM: to study the features of the course of the new coronavirus infection COVID-19 in patients with chronic kidney disease.PATIENTS AND METHODS: The study included 79 patients with confirmed new coronavirus infection COVID-19 who hospitalized. The first group consisted of people with a history of CKD (44 people), the second group included people without a history of CKD (35 people). The diagnosis of CKD established based on the calculation of glomerular filtration rate using the CKD-EPI formula. The comorbidity index calculated using two scales: Charlson and CIRS-G. Statistical data analysis carried out using the Statistica 12.0 application package (StatSoft Inc., USA).RESULTS: Patients with COVID-19 and CKD had a higher comorbidity index: according to the Charlson index in one group of patients the indicator was 7 [5.0-9.0], and in group 2 it was 5 [4.0-6.0] (p<0.001). According to the CIRS-G index, in one group the indicator was 9 [7-11.5], in two group it was 4 [2-6] (p <0.001). Patients in one group had a greater degree of damage to the lung tissue according to MSCT of the OGK; in laboratory tests, the levels of CRP, ferritin, LDH, and d-dimer were higher; leukocytosis with a neutrophil shift in the leukocyte count observed.CONCLUSION: Patients with a history of chronic kidney disease (CKD) had more severe COVID-19 and higher mortality.
{"title":"Features of the course of the new coronavirus infection COVID-19 in patients with chronic kidney disease","authors":"V. O. Bochkareva, M. M. Petrova, N. Shimokhina, I. V. Demko, I. A. Obukhova, E. V. Kozlov","doi":"10.36485/1561-6274-2024-28-2-69-76","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-69-76","url":null,"abstract":"BACKGROUND: CKD is one of the main comorbidities in those who die from COVID-19. Renal injury is the most common nonpulmonary infection of SARS-CoV-2 and has a wide range of manifestations, ranging from mild proteinuria and hematuria to progressive acute kidney injury (AKI) requiring renal replacement therapy (RRT).THE AIM: to study the features of the course of the new coronavirus infection COVID-19 in patients with chronic kidney disease.PATIENTS AND METHODS: The study included 79 patients with confirmed new coronavirus infection COVID-19 who hospitalized. The first group consisted of people with a history of CKD (44 people), the second group included people without a history of CKD (35 people). The diagnosis of CKD established based on the calculation of glomerular filtration rate using the CKD-EPI formula. The comorbidity index calculated using two scales: Charlson and CIRS-G. Statistical data analysis carried out using the Statistica 12.0 application package (StatSoft Inc., USA).RESULTS: Patients with COVID-19 and CKD had a higher comorbidity index: according to the Charlson index in one group of patients the indicator was 7 [5.0-9.0], and in group 2 it was 5 [4.0-6.0] (p<0.001). According to the CIRS-G index, in one group the indicator was 9 [7-11.5], in two group it was 4 [2-6] (p <0.001). Patients in one group had a greater degree of damage to the lung tissue according to MSCT of the OGK; in laboratory tests, the levels of CRP, ferritin, LDH, and d-dimer were higher; leukocytosis with a neutrophil shift in the leukocyte count observed.CONCLUSION: Patients with a history of chronic kidney disease (CKD) had more severe COVID-19 and higher mortality.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646441","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 : 2024-07-12DOI: 10.36485/1561-6274-2024-28-2-37-42
E. N. Golovina, A. V. Vatasin
THE AIM: to study the incidence of mild to moderate acute kidney injury in patients with COVID-19.PATIENTS AND METHODS. The data of the case histories of 200 patients hospitalized in the infectious diseases department of the Naro-Fominsk Regional Hospital of the Moscow region for COVID-19 were analyzed, mainly with mild to moderate severity of lung damage according to computed tomography, which do not require respiratory support and renal replacement therapy.RESULTS. Despite the fact that the analyzed group of patients did not have the most severe course of COVID-19, the first stage of acute kidney injury was detected in 22.5% of patients, which was manifested by a temporary decrease in hourly diuresis, increased creatinine, urea, proteinuria and erythrocyturia.CONCLUSION. The development of acute kidney injury was most often associated with older age, coronary heart disease, arterial hypertension, diabetes mellitus and obesity.
{"title":"Acute kidney injury of mild to moderate severity in patients with COVID-19","authors":"E. N. Golovina, A. V. Vatasin","doi":"10.36485/1561-6274-2024-28-2-37-42","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-37-42","url":null,"abstract":"THE AIM: to study the incidence of mild to moderate acute kidney injury in patients with COVID-19.PATIENTS AND METHODS. The data of the case histories of 200 patients hospitalized in the infectious diseases department of the Naro-Fominsk Regional Hospital of the Moscow region for COVID-19 were analyzed, mainly with mild to moderate severity of lung damage according to computed tomography, which do not require respiratory support and renal replacement therapy.RESULTS. Despite the fact that the analyzed group of patients did not have the most severe course of COVID-19, the first stage of acute kidney injury was detected in 22.5% of patients, which was manifested by a temporary decrease in hourly diuresis, increased creatinine, urea, proteinuria and erythrocyturia.CONCLUSION. The development of acute kidney injury was most often associated with older age, coronary heart disease, arterial hypertension, diabetes mellitus and obesity.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"22 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655277","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 : 2024-07-12DOI: 10.36485/1561-6274-2024-28-2-43-54
M. G. Panchenko, M. Gasanov, M. M. Batyushin, A. A. Kazanskaya, G. I. Appakov
THE AIM: to study the clinical and pathogenetic features of the development of endothelial dysfunction (ED) in patients with chronic kidney disease stages 3A-5D and its contribution to the development of cognitive impairment.PATIENTS AND METHODS: The study included 80 patients with CKD stages 3A-5D aged from 26 to 79 years (average age 58.9 ± 1.4 years): 43 women (average age 60.1 ± 1.9 years) and 37 men (average age 57.4±2.3 years). The patients were divided into 2 groups: group 1 included 40 patients with CKD 3A-5 (average age 59.9 ± 2.1 years), group 2 included 40 patients with CKD 5D (average age 58.1 ± 2 years). All patients underwent common and biochemical blood tests, the levels of endothelial nitric oxide synthase 3 (eNOS-3) and endothelin-1 (END-1) were determined, an endothelium-dependent vasodilation test (EDVD) was performed, testing for the presence and severity of cognitive disorders using the Montreal Cognitive Assessment Scale (MoCA) and the Mini Mental State Examination (MMSE).RESULTS: The prevalence of ED in the overall cohort of patients based on the results of a positive test with EDVD was 55 % of cases. ED was statistically significantly more often detected in the group of patients receiving hemodialysis treatment compared to patients in group 1: 70 % versus 40 %, respectively (p=0.007). The level of eNOS-3 in group 1 was higher compared to group 2 and amounted to 1.01±0.5 ng/ml versus 0.76±0.3 ng/ml (p=0.008). While the level of END-1 was statistically significantly lower in patients of group 1 compared to group 2 and amounted to 45.4±9.1 pg/ml versus 54.9±4.7 pg/ml (p<0.001). Cognitive impairments were identified in the general cohort: according to MMSE – in 67.5 % of cases, according to MoCA – in 71.3 %, and were more common in group 2. There were no statistically significant relationships between the results of the EDVD test and testing on the MoCA and MMSE scales. The level of eNOS-3 was lower in the subgroup of patients with cognitive impairment according to MoCA compared to the subgroup without it: 0.73±0.1 ng/ ml versus 0.94±0.2 ng/ml (p=0.127). The content of END-1 was statistically significantly higher in the subgroup of patients with cognitive impairment according to MoCA – 52.98±1.2 pg/ml compared to the subgroup without it – 47.67±1.5 pg/ml (p=0.043). When assessing the relationship between the levels of eNOS-3 and END-1 and the results of the EDVD test, it was found that in patients with a positive test in group 1, the level of eNOS-3 was statistically significantly higher compared to group 2 (p=0.01). An inverse relationship was observed for END-1; its level was lower in patients of group 1 compared to group 2 (p<0.01).CONCLUSION. Thus, the study revealed a high prevalence of endothelial dysfunction in patients with CKD stages 3A-5D. Progressive loss of renal function leads to dysregulation of the molecular mechanisms controlling vascular tone and the development of ED. eNOS-3 and END-1 have demonstrated high
{"title":"Clinical and pathogenetic features of the development of endothelial dysfunction in patients with chronic kidney disease and its contribution to the development of cognitive impairments","authors":"M. G. Panchenko, M. Gasanov, M. M. Batyushin, A. A. Kazanskaya, G. I. Appakov","doi":"10.36485/1561-6274-2024-28-2-43-54","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-43-54","url":null,"abstract":"THE AIM: to study the clinical and pathogenetic features of the development of endothelial dysfunction (ED) in patients with chronic kidney disease stages 3A-5D and its contribution to the development of cognitive impairment.PATIENTS AND METHODS: The study included 80 patients with CKD stages 3A-5D aged from 26 to 79 years (average age 58.9 ± 1.4 years): 43 women (average age 60.1 ± 1.9 years) and 37 men (average age 57.4±2.3 years). The patients were divided into 2 groups: group 1 included 40 patients with CKD 3A-5 (average age 59.9 ± 2.1 years), group 2 included 40 patients with CKD 5D (average age 58.1 ± 2 years). All patients underwent common and biochemical blood tests, the levels of endothelial nitric oxide synthase 3 (eNOS-3) and endothelin-1 (END-1) were determined, an endothelium-dependent vasodilation test (EDVD) was performed, testing for the presence and severity of cognitive disorders using the Montreal Cognitive Assessment Scale (MoCA) and the Mini Mental State Examination (MMSE).RESULTS: The prevalence of ED in the overall cohort of patients based on the results of a positive test with EDVD was 55 % of cases. ED was statistically significantly more often detected in the group of patients receiving hemodialysis treatment compared to patients in group 1: 70 % versus 40 %, respectively (p=0.007). The level of eNOS-3 in group 1 was higher compared to group 2 and amounted to 1.01±0.5 ng/ml versus 0.76±0.3 ng/ml (p=0.008). While the level of END-1 was statistically significantly lower in patients of group 1 compared to group 2 and amounted to 45.4±9.1 pg/ml versus 54.9±4.7 pg/ml (p<0.001). Cognitive impairments were identified in the general cohort: according to MMSE – in 67.5 % of cases, according to MoCA – in 71.3 %, and were more common in group 2. There were no statistically significant relationships between the results of the EDVD test and testing on the MoCA and MMSE scales. The level of eNOS-3 was lower in the subgroup of patients with cognitive impairment according to MoCA compared to the subgroup without it: 0.73±0.1 ng/ ml versus 0.94±0.2 ng/ml (p=0.127). The content of END-1 was statistically significantly higher in the subgroup of patients with cognitive impairment according to MoCA – 52.98±1.2 pg/ml compared to the subgroup without it – 47.67±1.5 pg/ml (p=0.043). When assessing the relationship between the levels of eNOS-3 and END-1 and the results of the EDVD test, it was found that in patients with a positive test in group 1, the level of eNOS-3 was statistically significantly higher compared to group 2 (p=0.01). An inverse relationship was observed for END-1; its level was lower in patients of group 1 compared to group 2 (p<0.01).CONCLUSION. Thus, the study revealed a high prevalence of endothelial dysfunction in patients with CKD stages 3A-5D. Progressive loss of renal function leads to dysregulation of the molecular mechanisms controlling vascular tone and the development of ED. eNOS-3 and END-1 have demonstrated high ","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"22 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141652250","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 : 2024-07-12DOI: 10.36485/1561-6274-2024-28-2-31-36
N. Raimkulova, G. G. Kadirova, U. S. Usmanova
This article describes in detail: features of the clinical course of the disease, assessment of quality of life, diagnostic criteria and modern classification of chronic kidney disease. Various pathogenesis of chronic kidney disease is revealed, taking into account the correspondence of the stages of chronic kidney disease to the ICD-10 coding. The article also details the modern methods of antihypertensive therapy in patients with chronic kidney disease, taking into account the latest clinical recommendations. Various modern studies of assessing the quality of life of patients using the SF-36 questionnaire are described, which includes 8 scales, namely: physical functioning (PF), role functioning due to physical condition (RFPC), pain intensity (PI), general health status (GHS), vital activity (VA), social functioning (SF), role functioning due to emotional state (RFES) and mental health (MH).
{"title":"Assessment of the quality of life of patients suffering from chronic kidney disease depending on the clinical variability of the disease","authors":"N. Raimkulova, G. G. Kadirova, U. S. Usmanova","doi":"10.36485/1561-6274-2024-28-2-31-36","DOIUrl":"https://doi.org/10.36485/1561-6274-2024-28-2-31-36","url":null,"abstract":"This article describes in detail: features of the clinical course of the disease, assessment of quality of life, diagnostic criteria and modern classification of chronic kidney disease. Various pathogenesis of chronic kidney disease is revealed, taking into account the correspondence of the stages of chronic kidney disease to the ICD-10 coding. The article also details the modern methods of antihypertensive therapy in patients with chronic kidney disease, taking into account the latest clinical recommendations. Various modern studies of assessing the quality of life of patients using the SF-36 questionnaire are described, which includes 8 scales, namely: physical functioning (PF), role functioning due to physical condition (RFPC), pain intensity (PI), general health status (GHS), vital activity (VA), social functioning (SF), role functioning due to emotional state (RFES) and mental health (MH).","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"14 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655112","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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