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SARCOPENIC OBESITY IN PATIENTS RECEIVING TREATMENT WITH PROGRAMMED HEMODIALYSIS 接受计划性血液透析治疗的患者的肌肉减少性肥胖
Pub Date : 2022-06-23 DOI: 10.36485/1561-6274-2022-26-2-77-84
A. Rumyantsev, P. Filinyuk, A. Jakovenko, M. Khasun, N. Y. Korosteleva, I. Panina, N. Kulaeva
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引用次数: 1
STRUCTURAL AND FUNCTIONAL INTESTINAL BARRIER ABNORMALITIES AND CHRONIC KIDNEY DISEASE. LITERATURE REVIEW. PART II 结构和功能性肠屏障异常与慢性肾脏疾病。文献综述。第二部分
Pub Date : 2022-06-22 DOI: 10.36485/1561-6274-2022-26-2-46-64
M. O. Pyatchenkov, A. Rumyantsev, E. Sherbakov, A. Markov
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引用次数: 5
PARAMETERS OF LIPID METABOLISM IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND THYROID DYSFUNCTION 慢性肾病和甲状腺功能障碍患者的脂质代谢参数
Pub Date : 2022-06-22 DOI: 10.36485/1561-6274-2022-26-2-65-71
I. M. Abramova, G. G. Allamova, O. Dygun, K. Azizova, A. Volkova, E. Volkova
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引用次数: 0
BIOMARKERS OF ACUTE POST-CONTRAST KIDNEY INJURY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTIONS 经皮冠状动脉介入治疗患者急性造影后肾损伤的生物标志物
Pub Date : 2022-06-20 DOI: 10.36485/1561-6274-2022-26-2-34-45
Y. Lavrishcheva, A. Konradi, A. Jakovenko, A. Rumyantsev
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引用次数: 1
RATIONAL MAINTENANCE IMMUNOSUPPRESSION FOR ELDERLY RENAL TRANSPLANT RECIPIENTS. THE LITERATURE REVIEW 老年肾移植受者合理维持免疫抑制。文献综述
Pub Date : 2022-06-20 DOI: 10.36485/1561-6274-2022-26-2-25-33
V. Fedulkina, A. Vatazin, A. V. Kildyushevskiy, A. B. Zulkarnayev, D. V. Gubina
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引用次数: 0
Structural and functional intestinal barrier abnormalities and chronic kidney disease. Literature review. Part I 结构和功能性肠屏障异常与慢性肾脏疾病。文献综述。第一部分
Pub Date : 2022-02-18 DOI: 10.36485/1561-6274-2022-26-1-10-26
M. O. Pyatchenkov, A. Markov, A. Rumyantsev
The gut microbiota is an essential part of the human organism, which plays a crucial role in maintaining its homeostasis. Peaceful coexistence with trillions of microorganisms mainly depends on the normal functioning of cellular and extracellular components of the intestinal mucosa, often called the "intestinal barrier". This barrier protects the organism against pathogenic infections while and at the same time satisfying its requirements for digestion and absorption of nutrients. It is not surprising that structural and functional intestinal barrier abnormalities are involved in the pathogenesis of many diseases including various nephropathies. The pathogenetic interconnection between the intestine and the kidneys is bidirectional. On the one hand, uremia affects the microbiota composition and the integrity of the intestinal epithelium. On the other hand, uremic toxins translocation, formed as a result of abnormal microbial metabolism, from the intestine into circulation through the ultra-permeable barrier contributes to the progression of renal dysfunction. Furthermore, according to a number of researchers, dysbiosis and the leaky gut syndrome are considered as one of the possible causes of anemia, nutritional disorders, cardiovascular and many other complications, often diagnosed in patients with chronic renal disease. The first part of the review reflects modern data about normal intestinal barrier structure and physiology, as well as methods for studying the intestinal wall integrity and permeability. The significant role of microbiota in the regulation of the barrier properties of the intestinal mucous and epithelial layer is emphasizing. The main differences between the intestinal microflora of patients with nephropathies from healthy people are presented, possible causes of their occurrence are discussed.
肠道菌群是人体机体的重要组成部分,在维持机体内稳态中起着至关重要的作用。肠道与数万亿微生物的和平共处,主要取决于肠道粘膜细胞和细胞外成分的正常功能,通常被称为“肠道屏障”。这个屏障保护生物体免受致病性感染,同时满足其消化和吸收营养物质的需要。肠屏障的结构和功能异常参与了包括各种肾病在内的许多疾病的发病机制,这并不奇怪。肠和肾之间的致病联系是双向的。一方面,尿毒症影响肠道菌群组成和肠上皮的完整性。另一方面,由于微生物代谢异常而形成的尿毒症毒素易位,通过超透性屏障从肠道进入循环,有助于肾功能障碍的进展。此外,据一些研究人员称,生态失调和漏肠综合征被认为是贫血、营养失调、心血管和许多其他并发症的可能原因之一,通常在慢性肾病患者中被诊断出来。第一部分综述了正常肠道屏障结构和生理的现代资料,以及研究肠壁完整性和通透性的方法。微生物群在调节肠粘膜和上皮屏障特性中的重要作用正在得到强调。介绍了肾病患者肠道菌群与健康人的主要差异,并讨论了可能的原因。
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引用次数: 7
The effectiveness of on-line hemodiafiltration in patients with chronic kidney disease: risk factors and improving the assessment of fluid excretion values 慢性肾脏疾病患者在线血液滤过的有效性:危险因素和改善液体排泄值的评估
Pub Date : 2022-02-18 DOI: 10.36485/1561-6274-2022-26-1-57-68
Y. Zarya, K. Gurevich, S. L. Plavinskii
Hemodiafiltration on-line (HDF OL) cannot be considered sufficiently studied in terms of its effect on the outcome. THE AIM. To identify the possible relationship of individual anthropometric, laboratory data and parameters of the prescribed treatment regimen with better survival when using the HDF OL. PATIENTS AND METHODS. A retrospective study of the EuCliD database of patients treated with HDF OL in 27 Fresenius Medical Care centers in the Russian Federation during 2014 was conducted. All patients received postdilution HDF OL procedures at least 3 times a week, lasting at least 12 hours a week, with adequacy of Kt/V procedures of at least 1,4. Data from survivors (9616) and deceased (370) patients were compared. The analyzed indicators were: gender, age, treatment experience, body weight, body mass index (BMI), body surface area (BSA), total body water volume (TBW), the volume of distribution (V Urea BCM), presence of diabetes mellitus, coronary heart disease, heart failure, as well as the parameters of the procedure: effective weekly dialysis time, Kt/V, effective in-fusion volume (EIV), effective convection volume (ECV). RESULTS. Risk factors for death in patients with CKD 5D treated with HDF OL include male gender, older age, con-comitant diseases, lower body weight, and BMI, shorter effective weekly dialysis time, lower EIV and ECV values, Kt/V, higher hypercalcemia, hypoalbuminemia, lower hemoglobin levels, higher b2-microglobulin levels, and CRP. Сomparing the normalized BMI, BSA, TBW, V Urea BCM indicators, we identified those that were associated with a high risk of mortality in the population of dialysis patients. CONCLUSION. As a result of this work, two normalized ratios were identified (the median ratio of effective infusion volume to body surface area and the median ratio of effective convection volume to body surface area), which were associated with a high risk of mortality in the population of dialysis patients.
在线血液滤过(HDF OL)对预后的影响尚未得到充分的研究。的目标。确定使用HDF OL时,个人人体测量、实验室数据和规定治疗方案参数与更好的生存率之间的可能关系。患者和方法。对2014年期间在俄罗斯联邦27个费森尤斯医疗中心接受HDF OL治疗的患者的EuCliD数据库进行了回顾性研究。所有患者每周至少接受3次稀释后HDF OL手术,每周持续至少12小时,Kt/V手术的充分性至少为1,4。来自幸存者(9616)和死亡患者(370)的数据进行了比较。分析指标为:性别、年龄、治疗经历、体重、体质指数(BMI)、体表面积(BSA)、总水量(TBW)、分布容积(V尿素BCM)、是否存在糖尿病、冠心病、心力衰竭,以及手术参数:每周有效透析时间、Kt/V、有效输液容积(EIV)、有效对流容积(ECV)。结果。HDF OL治疗的ckd5d患者死亡的危险因素包括男性、年龄较大、合并疾病、较低的体重和BMI、较短的每周有效透析时间、较低的EIV和ECV值、Kt/V、较高的高钙血症、低白蛋白血症、较低的血红蛋白水平、较高的b2微球蛋白水平和CRP。Сomparing标准化BMI, BSA, TBW, V尿素BCM指标,我们确定了那些与透析患者死亡率高风险相关的指标。结论。通过这项工作,我们确定了两个归一化比率(有效输液体积与体表面积的中位数比率和有效对流体积与体表面积的中位数比率),这两个比率与透析患者死亡率的高风险相关。
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引用次数: 0
Effect of COVID-19 on kidney function in patients with arterial hypertension grade 1-2 and CKD COVID-19对1-2级动脉高血压及CKD患者肾功能的影响
Pub Date : 2022-02-18 DOI: 10.36485/1561-6274-2022-26-1-34-43
D. Ivanov, A. Gozhenko, M. Ivanova, I. N. Zavalnaya
BACKGROUND. The presence and drug correction of arterial hypertension (AH) with inhibitors of the renin-angiotensin system (RAS), as well as chronic kidney disease (CKD) and its role in the regulation of RAS, can significantly affect the condition of a person with COVID-19. OBJECTIVE: to study the features of the functional state of the kidneys in patients with grade 1-2 hypertension who have fallen ill with COVID-19. PATIENTS AND METHODS. A subanalysis of patients with CKD, participants in the BIRCOV study (ARB, ACEi, DRi in COVID-19) is presented: 112 outpatient patients with grade 1-2 hypertension, 83 of whom had CKD. The participants were divided into groups receiving ACE inhibitors (group 1 – 39 %), ARBs (group 2 – 32 %), or a direct renin inhibitor (PIR) (group 3 – 29 %) as the main therapy of hypertension. The value of blood pressure, eGFR, albuminuria level were analyzed at the debut of COVID-19 and at 2, 4, 12, 24 weeks from the onset of the disease. RESULTS. In the first two weeks of COVID-19, there was a decrease in blood pressure with a gradual return to baseline values in patients of group 1 and group 3 (to a lesser extent). The use of ACE inhibitors in the treatment of hypertension increased the risk of withdrawal compared to PIR and ARBs due to COVID-19. In patients with CKD, higher values of mean blood pressure were obtained with similar dynamics. A synchronous decrease in eGFR and systolic blood pressure has been documented, more pronounced in patients with CKD, especially when taking aCEI. The decrease in eGFR correlated with the stage of CKD. With stable renal function in patients with CKD during the first 12 weeks of COVID-19, the urine albumin/creatinine ratio (UAC) increased without further normalization. By the second week of the disease, eGFR decreased with a reciprocal increase in the level of uric acid in the blood. The use of dexamethasone was accompanied by a decrease in eGFR in CKD stages 3b-4. CONCLUSION. When taking ACE inhibitors, the effect of lowering blood pressure was comparable to a double block of RAS: ACE inhibitors + ARBs.
背景。动脉高血压(AH)与肾素-血管紧张素系统(RAS)抑制剂的存在和药物纠正,以及慢性肾脏疾病(CKD)及其在RAS调节中的作用,可显著影响COVID-19患者的病情。目的:探讨1-2级高血压合并新冠肺炎患者肾脏功能状态的特点。患者和方法。BIRCOV研究(ARB, ACEi, DRi in COVID-19)的参与者CKD患者的亚分析:112例门诊1-2级高血压患者,其中83例患有CKD。参与者被分为接受ACE抑制剂(1 - 39%组)、arb(2 - 32%组)或直接肾素抑制剂(PIR)(3 - 29%组)作为高血压主要治疗的组。分析新冠病毒首次出现时和发病后2、4、12、24周时的血压、eGFR、蛋白尿水平。结果。在COVID-19的前两周,1组和3组患者的血压下降,并逐渐恢复到基线值(程度较轻)。与PIR和arb相比,在治疗高血压时使用ACE抑制剂增加了因COVID-19引起的停药风险。在CKD患者中,获得的平均血压值较高,具有类似的动态。eGFR和收缩压同步下降,在CKD患者中更为明显,尤其是服用aCEI时。eGFR的降低与CKD的分期相关。在COVID-19的前12周,CKD患者肾功能稳定,尿白蛋白/肌酐比值(UAC)升高,但未进一步正常化。在患病的第二周,eGFR随着血液中尿酸水平的增加而下降。在CKD 3b-4期,地塞米松的使用伴随着eGFR的降低。结论。当服用ACE抑制剂时,降低血压的效果与双重阻断RAS: ACE抑制剂+ arb相当。
{"title":"Effect of COVID-19 on kidney function in patients with arterial hypertension grade 1-2 and CKD","authors":"D. Ivanov, A. Gozhenko, M. Ivanova, I. N. Zavalnaya","doi":"10.36485/1561-6274-2022-26-1-34-43","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-1-34-43","url":null,"abstract":"BACKGROUND. The presence and drug correction of arterial hypertension (AH) with inhibitors of the renin-angiotensin system (RAS), as well as chronic kidney disease (CKD) and its role in the regulation of RAS, can significantly affect the condition of a person with COVID-19. OBJECTIVE: to study the features of the functional state of the kidneys in patients with grade 1-2 hypertension who have fallen ill with COVID-19. PATIENTS AND METHODS. A subanalysis of patients with CKD, participants in the BIRCOV study (ARB, ACEi, DRi in COVID-19) is presented: 112 outpatient patients with grade 1-2 hypertension, 83 of whom had CKD. The participants were divided into groups receiving ACE inhibitors (group 1 – 39 %), ARBs (group 2 – 32 %), or a direct renin inhibitor (PIR) (group 3 – 29 %) as the main therapy of hypertension. The value of blood pressure, eGFR, albuminuria level were analyzed at the debut of COVID-19 and at 2, 4, 12, 24 weeks from the onset of the disease. RESULTS. In the first two weeks of COVID-19, there was a decrease in blood pressure with a gradual return to baseline values in patients of group 1 and group 3 (to a lesser extent). The use of ACE inhibitors in the treatment of hypertension increased the risk of withdrawal compared to PIR and ARBs due to COVID-19. In patients with CKD, higher values of mean blood pressure were obtained with similar dynamics. A synchronous decrease in eGFR and systolic blood pressure has been documented, more pronounced in patients with CKD, especially when taking aCEI. The decrease in eGFR correlated with the stage of CKD. With stable renal function in patients with CKD during the first 12 weeks of COVID-19, the urine albumin/creatinine ratio (UAC) increased without further normalization. By the second week of the disease, eGFR decreased with a reciprocal increase in the level of uric acid in the blood. The use of dexamethasone was accompanied by a decrease in eGFR in CKD stages 3b-4. CONCLUSION. When taking ACE inhibitors, the effect of lowering blood pressure was comparable to a double block of RAS: ACE inhibitors + ARBs.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90278810","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}
引用次数: 2
Predicting the risk of fractures in kidney transplant recipients 预测肾移植受者骨折的风险
Pub Date : 2022-02-18 DOI: 10.36485/1561-6274-2022-26-1-44-49
S. Mazurenko, E. Semenova, O. Mazurenko, Y. A. Nakatis, K. M. Grinev, A. S. Gurkov, U. M. Gomon
BACKGROUND. Chronic kidney disease leads to a significant increase in the risk of fractures, which increases even more after kidney transplantation. THE AIM. The goal of this study was to develop simple, accessible criteria for predicting the risk of fracture in patients with a functioning kidney transplant. PATIENTS AND METHODS. The prospective study included 131 kidney transplant recipients (men-55, women-76) (average age 39.7±11.7 years). The duration of follow-up was 40.7±21.2 months. Bone mineral density was assessed using dual-energy x-ray absorptiometry. To determine the prognostic significance of variables, we used stepwise regression (Cox model) analysis. p < 0.05 was considered statistically significant. RESULTS. During the follow-up period, fractures were registered in 47 patients (35.9 %). Fractures were detected more often in women (42 %) than in men (27.3 %). All patients with fractures had lower bone mineral density and longer-term renal replacement therapy. Stepwise multivariate regression analysis showed that the combination of bone mineral density scores of lumbar vertebra and duration of renal replacement therapy best predicts the overall fracture risk. Adding the other variables to the analysis did not increase significantly their predictive value. A comparative analysis of the cumulative proportion of males and females with fractures confirmed a greater susceptibility of female transplant recipients to fractures. CONCLUSIONS. The combination of bone mineral density scores of the lumbar vertebra with the duration of renal replacement therapy best predict the risk of fracture in patients with kidney transplants and can be used in the choice of prevention measures.
背景。慢性肾脏疾病导致骨折风险显著增加,肾移植后骨折风险增加更多。的目标。本研究的目的是建立一个简单的、可接近的标准来预测功能正常的肾移植患者的骨折风险。患者和方法。前瞻性研究纳入131例肾移植受者(男55例,女76例)(平均年龄39.7±11.7岁)。随访时间40.7±21.2个月。采用双能x线吸收仪评估骨密度。为了确定变量的预后意义,我们使用逐步回归(Cox模型)分析。P < 0.05为差异有统计学意义。结果。在随访期间,47例(35.9%)患者发生骨折。骨折在女性中的发生率(42%)高于男性(27.3%)。所有骨折患者均有较低的骨密度和较长期的肾脏替代治疗。逐步多因素回归分析显示,腰椎骨密度评分与肾替代治疗持续时间相结合最能预测整体骨折风险。在分析中加入其他变量并没有显著增加它们的预测值。一项对男性和女性骨折累积比例的比较分析证实,女性移植受者对骨折的易感性更高。结论。腰椎骨密度评分与肾替代治疗持续时间的结合可以最好地预测肾移植患者骨折的风险,并可用于预防措施的选择。
{"title":"Predicting the risk of fractures in kidney transplant recipients","authors":"S. Mazurenko, E. Semenova, O. Mazurenko, Y. A. Nakatis, K. M. Grinev, A. S. Gurkov, U. M. Gomon","doi":"10.36485/1561-6274-2022-26-1-44-49","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-1-44-49","url":null,"abstract":"BACKGROUND. Chronic kidney disease leads to a significant increase in the risk of fractures, which increases even more after kidney transplantation. THE AIM. The goal of this study was to develop simple, accessible criteria for predicting the risk of fracture in patients with a functioning kidney transplant. PATIENTS AND METHODS. The prospective study included 131 kidney transplant recipients (men-55, women-76) (average age 39.7±11.7 years). The duration of follow-up was 40.7±21.2 months. Bone mineral density was assessed using dual-energy x-ray absorptiometry. To determine the prognostic significance of variables, we used stepwise regression (Cox model) analysis. p < 0.05 was considered statistically significant. RESULTS. During the follow-up period, fractures were registered in 47 patients (35.9 %). Fractures were detected more often in women (42 %) than in men (27.3 %). All patients with fractures had lower bone mineral density and longer-term renal replacement therapy. Stepwise multivariate regression analysis showed that the combination of bone mineral density scores of lumbar vertebra and duration of renal replacement therapy best predicts the overall fracture risk. Adding the other variables to the analysis did not increase significantly their predictive value. A comparative analysis of the cumulative proportion of males and females with fractures confirmed a greater susceptibility of female transplant recipients to fractures. CONCLUSIONS. The combination of bone mineral density scores of the lumbar vertebra with the duration of renal replacement therapy best predict the risk of fracture in patients with kidney transplants and can be used in the choice of prevention measures.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83218848","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}
引用次数: 1
Electrolyte concentration in blood serum as prognostic of severe course COVID-19 血清电解质浓度与重症COVID-19预后的关系
Pub Date : 2022-02-18 DOI: 10.36485/1561-6274-2022-26-1-27-33
Y. Natochin, O. B. Chernyshev
THE AIM. To study the key homeostatic physicochemical parameters of blood serum characterizing the patient's state with COVID-19 of varying severity. Patients and methods. The study involved 94 patients with COVID-19, age from 24 to 102 years, median – 67 years, men – 43, women – 51. Patients were divided into 3 groups: 1st – 40 patients with a relatively mild course, 2nd – 22 patients with a severe course of the disease, after treatment they were discharged from the clinic, the 3rd – 32 patients with a very severe course of COVID-19 and a fatal outcome. The concentration of ions in blood serum was measured on a Gem Premier 3000 (Instrumentation Laboratory, USA), clinical analysis was performed on a BC-5380c Mindray hematology analyzer (Mindray, China), biochemical studies were performed on an Architech c4000 analyzer (Abbott Laboratories, USA). RESULTS. The harbingers of a serious impairment in patients with COVID-19 were an increase in the Na+/K+ ratio in blood serum from 32,7±0,8 to 44,7 ± 2.1 (p<0,01), a decrease in the concentration of ionized Ca2+ from 1,08 ± 0,01 to 0,9 ± 0,03 mmol/l (p<0,01), a sharp increase in the concentration of C-reactive protein from 43,6±8,6 to 175 ± 14,7 mg/l (p<0,01). Within the reference values with COVID-19 the concentration of bilirubin and creatinine in the blood serum remained normal; the concentration of total protein was at the lower limits of the normal range, the glucose level was slightly higher than normal, and ferritin was increased compared to the reference values. CONCLUSION. Harbingers of a sharp impairment in COVID-19 are an increase in the Na+/K+ ratio in the blood serum, a decrease of the of ionized Ca2+ concentration, a sharp increase in C-reactive protein concentration.
的目标。研究表征不同严重程度COVID-19患者状态的血清关键稳态理化参数。患者和方法。该研究涉及94名COVID-19患者,年龄从24岁到102岁不等,中位年龄为67岁,男性43岁,女性51岁。患者分为3组:1 - 40例病程较轻的患者,2 - 22例病程较重的患者,治疗后出院,3 - 32例病程较重且死亡的患者。血清离子浓度测定采用Gem Premier 3000(仪器实验室,美国),临床分析采用BC-5380c迈瑞血液学分析仪(迈瑞,中国),生化研究采用Architech c4000分析仪(雅培实验室,美国)。结果。血清Na+/K+比值从32.7±0.8升高到44.7±2.1 (p< 0.01),离子Ca2+浓度从1.08±0.01降低到0.9±0.03 mmol/l (p< 0.01), c反应蛋白浓度从43.6±8.6急剧升高到175±14.7 mg/l (p< 0.01),是COVID-19严重损害的先兆。血清胆红素、肌酐浓度在新冠肺炎参考值范围内正常;总蛋白浓度处于正常范围的下限,葡萄糖水平略高于正常,铁蛋白较参考值升高。结论。血清Na+/K+比值升高、离子Ca2+浓度降低、c反应蛋白浓度急剧升高是COVID-19急性损伤的先声。
{"title":"Electrolyte concentration in blood serum as prognostic of severe course COVID-19","authors":"Y. Natochin, O. B. Chernyshev","doi":"10.36485/1561-6274-2022-26-1-27-33","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-1-27-33","url":null,"abstract":"THE AIM. To study the key homeostatic physicochemical parameters of blood serum characterizing the patient's state with COVID-19 of varying severity. Patients and methods. The study involved 94 patients with COVID-19, age from 24 to 102 years, median – 67 years, men – 43, women – 51. Patients were divided into 3 groups: 1st – 40 patients with a relatively mild course, 2nd – 22 patients with a severe course of the disease, after treatment they were discharged from the clinic, the 3rd – 32 patients with a very severe course of COVID-19 and a fatal outcome. The concentration of ions in blood serum was measured on a Gem Premier 3000 (Instrumentation Laboratory, USA), clinical analysis was performed on a BC-5380c Mindray hematology analyzer (Mindray, China), biochemical studies were performed on an Architech c4000 analyzer (Abbott Laboratories, USA). RESULTS. The harbingers of a serious impairment in patients with COVID-19 were an increase in the Na+/K+ ratio in blood serum from 32,7±0,8 to 44,7 ± 2.1 (p<0,01), a decrease in the concentration of ionized Ca2+ from 1,08 ± 0,01 to 0,9 ± 0,03 mmol/l (p<0,01), a sharp increase in the concentration of C-reactive protein from 43,6±8,6 to 175 ± 14,7 mg/l (p<0,01). Within the reference values with COVID-19 the concentration of bilirubin and creatinine in the blood serum remained normal; the concentration of total protein was at the lower limits of the normal range, the glucose level was slightly higher than normal, and ferritin was increased compared to the reference values. CONCLUSION. Harbingers of a sharp impairment in COVID-19 are an increase in the Na+/K+ ratio in the blood serum, a decrease of the of ionized Ca2+ concentration, a sharp increase in C-reactive protein concentration.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"358 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80765238","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}
引用次数: 0
期刊
Nephrology (Saint-Petersburg)
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