Nephrology (Saint-Petersburg)最新文献

{"title":"Prediction of COVID-19 course in patients with stage 3 chronic kidney disease and type 2 diabetes mellitus","authors":"N. Klochkova, M. A. Lysenko, E. Zeltyn-Abramov, T. Markova, N. Poteshkina, N. Belavina, S. Kondrashkina","doi":"10.36485/1561-6274-2023-27-4-64-77","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-4-64-77","url":null,"abstract":"BACKGROUND. Patients with Diabetes Mellitus 2 (DM2) and Chronic Kidney Disease (CKD) are at a high risk for severe clinical course of COVID-19. The high mortality rate due to COVID-19 and widespread distribution of DM2 and CKD all over the world make it necessary to determine the predictors of adverse outcome of novel coronavirus infection (NCI).AIM. The identification of predictors of NCI adverse outcome in patients with DM2 and CKD stage 3 due to diabetic kidney disease.Patients and Methods. The patients with NCI and CKD stage 3 were included in observational retrospective uncontrolled study during the follow-up period from 04.01. to 10.30.2020. The study endpoints were the outcome of NCI (survivors/nonsurvivors). Data were collected from electronic versions of case records. Demographic, DM2-related, CKD-related and NCI-related baseline parameters/signs were studied as independent variables.RESULTS. 90 patients with DM2 and CKD stages 3 (Me GFR 43[37; 49] ml/ min/1,73m2) were included, mean age 70 [69; 78] y, females – 56 %, the mortality rate – 21 %. The independent predictors of NCI adverse outcome were detected using a single factor analysis (odds ratio). Among them are: initial prandial glycemia ≥ 10 mmol/l (ОR 11,8; 95 % CI 3,13–44,9; р <0,001), albuminemia at admission ≤ 35 g/l (ОR 5,52; 95 % CI 1,85–16,55; р = 0,012), initial proteinuria ≥ 1 g/л (ОR 6,69; 95 % CI 1,95–23,00; р = 0,002), News2 ≥ 5 at admission (ОR 14,7; 95 % CI 3,15–48,8; р <0,001), lung damage CT 3–4 at admission (ОR 31,7; 95 % CI 6,59–52,85; р = 0,04). A prognostic model was constructed to determine the risk of lethal outcome using logistic regression method. The detected risk factors were used as variables. The predictive value of the model was 93 % according to ROC-analyses data.CONCLUSION. The detected predictors of adverse outcome are the part of routine screening available in pre-hospital setting and at hospital admission. Early identification of predictors allows optimizing patient routing and selecting the best treatment strategy for each patient.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"115 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138607515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical phenotypes and variants of mutations of the ALPL gene in children with hypophosphatasia, enzyme replacement therapy with Asfotase alfa: literature and clinical case data","authors":"N. Savenkova, Zh. G. Leviashvili, V. N. Barsukova","doi":"10.36485/1561-6274-2023-27-4-11-21","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-4-11-21","url":null,"abstract":"The article presents current literature data on clinical phenotypes and variants of ALPL gene mutations, the effectiveness of enzyme replacement therapy with asfotase alfa in children with hypophosphatasia (HPP). HPP is inherited disease ORPHA (436). The OMIM catalog contains forms of HPP: perinatal (lethal), infantile; hypophosphatasia of childhood; hypophosphatasia in adults; odontohypophosphatasia. M.E. Nunes (2023) considers 7 forms of HPP, taking into account the age and severity of the clinical manifestation. As a result of worldwide molecular genetic studies, fundamental information has been obtained on the phenotypic features of the manifestation and severity of HFF in pediatric patients, depending on the variants of the ALPL gene mutations. Molecular genetics diagnosis and enzyme replacement therapy with Asfotase alfa in our country are guaranteed for children with HPP at the expense of the «Krug Dobra Foundation», the founder of the foundation is the Ministry of Health of the Russian Federation. The article presents a clinical observation of a proband with hypophosphatasia receiving Asfotase alfa.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil Extracellular Traps (NETs) in Kidney Disease: Role in Pathogenesis and Possibilities of NET Regulatory Therapy","authors":"K. Aitbaev, I. Murkamilov, V. V. Fomin, Z. Murkamilova, F. Yusupov","doi":"10.36485/1561-6274-2023-27-4-22-33","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-4-22-33","url":null,"abstract":"Excessive uncontrolled inflammatory and immune reactions often lead to the development of acute and chronic forms of damage to various organs, including the kidneys. Neutrophils are the cells of the innate immune system, which are the first cellular effectors in protecting the host from a variety of pathogens, including bacteria, fungi and protozoa. As the most numerous leukocytes present in human blood, neutrophils migrate early to the foci of inflammation or tissue damage, where they play a significant role in the development of inflammation, recruitment of immune cells, removal of pathogens and tissue repair. Neutrophils also produce pro-inflammatory cytokines and release, in a process called netosis, a network of DNA and granular proteins known as neutrophil extracellular traps (NETs). NETs are potentially toxic, contribute to glomerular damage, activate autoimmune processes, cause vascular damage, and promote renal fibrosis. Numerous studies show that an imbalance between NET production and clearance is detrimental to kidney function. Therefore, strategies aimed at modulating the processes associated with NET may have a favorable prognostic effect. The review discusses the role of the netosis in the pathogenesis of kidney diseases, describes the mechanisms of tissue damage associated with NET, and the therapeutic potential of NET regulatory therapy.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of dapaglifl ozin in a comorbid patient: new perspectives","authors":"T. S. Panevin, M. Eliseev, A. O. Bobkova, A. E. Dimitreva, M. Urumova","doi":"10.36485/1561-6274-2023-27-2-109-115","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-109-115","url":null,"abstract":"The development of the modern world is manifested, inter alia, by an increase in the prevalence of obesity and cardiovascular diseases. Treatment of these conditions is associated with the need to prescribe multicomponent therapy, which complicates the control of drug interactions, leads to a decrease in compliance and polypharmacy. A large number of drugs taken in a particular patient dictates the need to search for drugs, the appointment of which contributes to the control of several diseases at once, can be successfully used in patients with reduced renal function, in the presence of cardiovascular diseases. The presented description of a clinical case demonstrates an example of the use of a type 2 sodium glucose cotransporter inhibitor – dapagliflozin in a patient with type 2 diabetes mellitus, chronic kidney disease, chronic heart failure and gout. ","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88199681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal excretory function in patients with resistant arterial hypertension after radiofrequency kidney denervation at three-year follow-up","authors":"N. Y. Savelieva, L. Gapon, E. Mikova, A. Zherzhova","doi":"10.36485/1561-6274-2023-27-2-91-97","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-91-97","url":null,"abstract":"It is generally accepted that the true-resistant hypertension (RH) currently remains critical issue. At present there is some published evidence that catheter renal denervation prosedure showed effectiveness at randomized clinical trials. The assessment of renal function after the technique is crucial.THE AIM of the study was to estimate renal function after renal artery denervation procedure in patients with uncontrolled hypertension in 3 – years follow-up.PATIENTS AND METHODS. The diagnosis of RH was made in the absence of any evidence of secondary hypertension. 40 patients (20 male and и 20 female), aged 55,5± 7,2 years, with office systolic blood pressure (BP) 180 ±26,1 mm Hg, and diastolic BP 107,4±13,9 mm Hg were examined. Glomerular filtration rate (GFR, MDRD) and microalbuminuria level was determined by averaging all measurements performed during hospitalization. Ambulatory blood pressure monitoring (BPM) was performed in all patients.RESULTS. BPM has revealed the significant decrease of systolic daytime blood pressure (at baseline 161,1±16,9 mm Hg and at follow-up 155,4±20,8 mm Hg; р= 0,024) and decrease of diastolic daytime BP (at baseline 95,6 ±11,8 mmHg and at follow -up 90,2 ±12,4 mm Hg; р=0,002). During 3 -year of follow-up the serum creatinine level has increased at baseline 69,5±16,4 μmol/l and at follow-up 78,7±19,5 μmol/l; р<0,0001). The Glomerular filtration rate has scaled down (at baseline 98,2±18,7 ml/min and at follow-up 85,1±17,9 ml/min; р< 0,0001). The level of daily excretion of albumin has also decreased (at baseline 30,4 [14,6; 52,9] mg and at follow-up 14,1 [11,9; 42,4] mg correspondingly; р= 0,03) .CONCLUSION. Although BP profile changes have demonstrated the effectiveness of RDN, therefore the future investigation of exact patho-physiological significance of glomerular filtration level after the treatment of RH should be of provided.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86697111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sclerostin in the formation of cardiovascular calcifi cation in chronic kidney disease C5D","authors":"A. T. Makhieva, A. Mambetova","doi":"10.36485/1561-6274-2023-27-2-78-84","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-78-84","url":null,"abstract":"THE AIM: to study the relationship of blood sclerostin with clinical parameters and its influence on the probability of detection of cardiovascular calcification in patients with CKD C5D.PATIENTS AND METHODS. The study was a single-stage, cohort study involving 84 patients with stage 5D CKD who received hemodialysis therapy, including 40 (47.6 %) female patients and 44 (52.4 %) male patients. The average age was 55.6±14.9 years. The examination included, in addition to routine studies, echocardioscopy with an assessment of calcification of the heart valves, abdominal radiography in the lateral projection with an assessment of aortic calcification, analysis of indicators that characterize phosphorus-calcium metabolism (serum sclerostin levels, 1.25(OH)D, FGF-23, A-klotho, PTH, P and Cа blood). Statistical analysis was performed using the computer program STATISTICA 12.6 (StatSoft Inc., USA).RESULTS. It was shown that the level of sclerostin is higher in the elderly, as well as those who have signs of hypoproteinemia and hypoalbuminemia, indirectly indicating the presence of protein-energy deficiency. There is an Association of blood sclerostin with FGF-23 and Alpha-klotho. From the point of view of the probable influence on the processes of cardiovascular calcification, this relationship shows its unidirectionality. Increased blood sclerostin levels have been shown to be associated with the risk of detecting signs of cardiovascular calcification. Moreover, it is shown that the higher the level of sclerostin in the blood, the more pronounced the degree of this calcification. Along with the increase in the level of sclerostin, the ability of a deficit of 1.25(OH)D to lead to the development of calcification was confirmed.CONCLUSION. A high level of sclerostin in the blood serum of more than 92.5 pmol / l in patients with CKD C5D increases the risk of detecting signs of cardiovascular calcification (calcification of the aortic wall and heart valves). An increase in sclerostin levels occurs in conjunction with an increase in FGF-23 and a decrease in 1.25(OH)D","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88883914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of remission of steroid-dependent nephrotic syndrome after cyclosporin and mycophenolate sodium therapy in children with and without clinical manifestation of allergy","authors":"P. A. Nyrkova, N. Savenkova","doi":"10.36485/1561-6274-2023-27-2-57-65","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-57-65","url":null,"abstract":"BACKGROUND. The problem of steroid-sensitive nephrotic syndrome is the developing of steroid dependency and toxicity.THE AIM: Evaluate duration of remission of steroid-dependent nephrotic syndrome (NS) after cyclosporine and mycophenolate sodium therapy in children with or without clinical manifestation of allergy.PATIENTS AND METHODS. Follow-up study with analysis of onset, clinical course and treatment includes 47 children ((31 boys (66 %) и 16 girls (34 %)) with steroid-dependent NS, 34 (72,3 %) had clinical manifestation of allergy, 13 (27,7 %) didn’t have clinical manifestation of allergy. The efficiency of therapy with cyclosporine in 16 patients and mycophenolate sodium in 27 patients with clinical manifestation of allergy is estimated in comparative study by analysis of 6, 12, 24 month remission rate after treatment. Median duration of remission of NS during 2 years after treatment is estimated. Out of 27 children 8 (29,6 %) had mycophenolate sodium treatment after cyclosporine and took part in both groups.RESULTS. Statistically significant differences in 6, 12, 24 month remission rates after cyclosporine and mycophenolate sodium treatment in children with clinical manifestation of allergy are established. Remission of NS during 6 months after mycophenolate sodium treatment was in 81,5 % (in 22 from 27 patients) unlike of that after cyclosporine – in 40 % (in 6 from 15 patients) in children with clinical manifestation of allergy (р<0,05). Remission of NS during 12 months after mycophenolate sodium treatment was in 55,6  % (in 15 from 27 patients) unlike of that after cyclosporine – 13,3 % (in 2 from 15 patients) (р<0,05) in children with clinical manifestation of allergy. Remission of NS during 24 months after mycophenolate sodium treatment was in 37 % (in 10 from 27 patients) unlike of that after cyclosporine – 6,7 % (in 1 from 15 patients) (р<0,05) in children with clinical manifestation of allergy. Median duration of remission during 2 years after treatment with cyclosporine and mycophenolate sodium in children with clinical manifestation of allergy was 7,0 [2,0-11,0] and 17,0 [6,0-24,0] months, retrospectively, (р<0,05).CONCLUSION. Remission of steroid-dependent NS during 6 months after therapy with mycophenolate sodium and cyclosporine in children was in 81,5 % and 40,0 % respectively, in children with clinical manifestation of allergy. Remission of steroid-dependent NS during 12 months after therapy with mycophenolate sodium and cyclosporine in children was in 55,6 % and 13,3 % respectively, in children with clinical manifestation of allergy. Remission of steroid-dependent NS during 24 months after therapy with mycophenolate sodium and cyclosporine in children was in 37 % and 6,7 % respectively, in children with clinical manifestation of allergy. Median duration of remission during 2 years after treatment with cyclosporine and mycophenolate sodium in children with clinical manifestation of allergy was 7,0 [2,0-11,0] and 17,0 [6,0-24","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79345323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of the development of experimental nephropathy in rats during the use of doxorubicin","authors":"Ya. F. Zverev, Y. Motin, O. Mazko, N. A. Mozgunova, N. V. Motina","doi":"10.36485/1561-6274-2023-27-2-102-108","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-102-108","url":null,"abstract":"BACKGROUND. One of the most frequently reproduced models of NS is doxorubicin (adriamycin) nephropathy in rats. However, the mechanisms of its development remain insufficiently studied, and it is not entirely clear to which form of NS the nephrotoxicity induced by doxorubicin should be attributed.THE AIM. Reproduction of doxorubicin nephropathy in rats in an attempt to morphologically identify the resulting pathology and determine the role of free radical oxidation (FRO) in the development of this model of nephrotoxicity.MATERIALS AND METHODS. Nephropathy was reproduced by a single intravenous administration of doxorubicin to male Wistar rats. In the urine, the content of creatinine, daily proteinuria, and albumin release were determined. Histological examination of the kidneys was performed using a Libra 120 electron microscope (Carl Zeiss, Germany). The total prooxidant activity, total antioxidant activity, the concentration of thiobarbiturate-reactive products, and the activity of antioxidant enzymes were assessed in the blood and kidney.RESULTS. Against the background of a gradual decrease in the glomerular filtration rate, a significant consistent increase in protein excretion was recorded, largely due to an increase in albumin excretion. Electron microscopic examination revealed a decrease in the number of small (foot) processes of podocytes, their fusion, sclerotic lesions of the elements of the capillary glomerulus, thinning of the GBM, sclerosis of the interstitium. There was a sharp activation of blood OPA and an increase in the content of TBRP. At the same time, such fast-responding antioxidant enzymes as CAT and SOD were activated. The blood TAA decreased in parallel with the decrease in GPO activity.CONCLUSION. Intravenous administration of doxorubicin to rats induced the development of toxic kidney damage with signs of NS. A characteristic indicator was the development of PU against the background of a decrease in GFR from day 5 and increased many times by the end of the observation period. The greatest contribution to the development of PU was made by an in-crease in albumin excretion. Morphological examination of the kidneys using electron microscopy made it possible to conclude with a high degree of probability that the developed pathology and FSGS are similar. At the same time, FRO activation was recorded, which was expressed in a sig-nificant pro-oxidant effect and a significant decrease in the antioxidant activity of the blood.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87123830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of uric acid in the development of infl ammation in kidney disease","authors":"N. Kunitskaya, A. Ariev, N. Kulaeva","doi":"10.36485/1561-6274-2023-27-2-39-46","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-39-46","url":null,"abstract":"Asymptomatic hyperuricemia is frequently seen in patients with kidney disease. A significant number of epidemiological studies suggest that elevated uric acid levels play a causal role in the development and progression of kidney disease. But whether hyperuricemia is simply the result of reduced renal excretion of uric acid or contributes to the progression of renal disease remains controversial. Over the past two decades, numerous experimental studies have expanded the knowledge of the biological effects of uric acid beyond its role in the development of gout. In particular, uric acid induces activation of the immune system and affects not only renal tissue cells but also endothelial cells.  All this has led to the presentation of uric acid as a potential and modifying risk factor for kidney disease. This review examines the effects of uric acid on the immune system and further on renal tissue during inflammation.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90303412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of stress reactions in the genesis of menstrual cycle disorders in recurrent urinary tract infections in minors","authors":"Y. Chebotareva, G. M. Letifov, Yu. A. Petrov","doi":"10.36485/1561-6274-2023-27-2-85-90","DOIUrl":"https://doi.org/10.36485/1561-6274-2023-27-2-85-90","url":null,"abstract":"BACKGROUND. Extragenital diseases, including recurrent urinary tract infections, have an adverse effect on the reproductive health of children and adolescents. Vaginitis and menstrual cycle disorders, including primary oligomenorrhea, predominate in the structure of gynecological morbidity of minors suffering from recurrent UTIs.THE AIM: to study the role of stress reactions in the genesis of various variants of menstrual cycle disorders in minors suffering from recurrent UTIs to improve the dispensary management of this cohort of patients. PATIENTS AND METHODS. A prospective study was conducted in 98 adolescent girls aged 16 to 18 years. Taking into account the nature of the clinical course of UTI, all the subjects were divided into 3 groups: group 1 (n=41) – patients with UTI; group 2 (n=27) patients with frequent recurrence of UTI (more than 3 times a year (rIMP); group 3 (n=30) – minors, 1, 2 health groups with no IPM episode. A specialized gynecological examination, functional diagnostic tests, ultrasound examination of the placemark and ovaries, determination of cortisol, norepinephrine, adrenaline by enzyme immunoassay were carried out. Statistical analysis was performed using the program \"SPSS Statistics 17.0 for Windows\".RESULTS. Anovulation was observed in patients with frequent recurrence of UTI. Copious and prolonged menstruation, uterine bleeding and primary oligomenorrhea were observed only in patients with recurrent UTIs. In this cohort, inflammatory gynecological diseases take a chronic course. Polycystic ovarian syndrome (40.7 %) and chronic salpingoophoritis (44.4 %) were often detected in patients with frequently recurrent UTI. In patients suffering from UTI, in contrast to the data of the comparison group, there were significant violations of the nature of adaptive reactions, and changes in antistress reactions and their levels differed depending on the variant of the course of the microbial-inflammatory process. In patients with rare relapses of UTI, antistress reactions of a high level of reactivity prevailed, but there were reactions of calm and increased activation, training that took place at low levels of reactivity.CONCLUSION. Adaptive-compensatory disorders were revealed in almost every patient with recurrent UTI. Considering that stress is especially pathogenic during puberty, when hormonal and psychophysiological restructuring of the body occurs, prevention and complex therapy of microbial-inflammatory diseases of the urinary system in this category of patients should be carried out taking into account the formation of reproductive function and the severity of adaptation reactions. ","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73563631","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}