Nephrology (Saint-Petersburg)最新文献

{"title":"Myocardial effects of a low-protein diet in experimental kidney dysfunction","authors":"O. Beresneva, M. Parastaeva, G. Ivanova, M. Zaraiski, S. Orlova, A. Kucher","doi":"10.36485/1561-6274-2022-26-4-110-118","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-110-118","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82680858","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":"Fetuin A is assessing of developing bone mineral disorders and cardiovascular calcifi cation formation risk marker in patients with stage 5 chronic kidney disease","authors":"A. T. Makhieva, A. Mambetova","doi":"10.36485/1561-6274-2022-26-4-105-109","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-105-109","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80380254","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 effectiveness of Cyclosporine A use in children with Alport syndrome: single center study","authors":"K. V. Shebalkina, E. Petrosyan, P. Shumilov","doi":"10.36485/1561-6274-2022-26-4-66-73","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-66-73","url":null,"abstract":"BACKGROUND: Alport syndrome is a non-immune genetically determined glomerulopathy caused by mutation of genes encoding α3-5 chains of collagen type IV of the basement membranes. It manifests with hematuria and/or proteinuria, progressive renal functions decrease, often in combination with hearing and vision pathology. According to world statistics the incidence of Alport syndrome is less than 1:5000 people. THE AIM: We analyzed the effectiveness of combined Cyclosporine A and nephroprotective therapy in children with Alport syndrome in comparison with nephroprotectors only. PATIENTS AND METHODS: 35 patients were enrolled in retrospective controlled comparative non-randomized single-center longitudinal study: 9 girls (26 %) and 26 boys (74 %). The median age Me was 8,7 [5,4; 13,7] years old. The patients were divided into 2 groups. Group 1 (n=25) – patients receiving Cyclosporine A and nephroprotective therapy, group 2 (n=10) – patients receiving nephroprotective therapy only. The groups did not differ statistically significantly. The observation period was 24 months. The effectiveness of therapy was assessed by reducing proteinuria. RESULTS: In group 1, the level of proteinuria decreased significantly, especially in the first 6 months. Despite gradual increase in the level of proteinuria in this group, by 24 months of follow-up, there was statistically significant difference compared to baseline (1872.0 [1195.0; 2531.0] vs 805.0 [306.0; 1504.0]; p=0.0005). Use of nephroprotectors did not change significantly the dynamics of proteinuria. In general, after 2 years, the level of proteinuria remained practically the same (1812.0 [1508.0; 2093.0] vs 1080.0 [147.0; 3141.0]; p = 0.11). Glomerular filtration rate in two groups did not change significantly during the observation period: in group 1 – 133 [108; 146] vs 123 [106; 131]; p=0.1 and in group 2 – 124 [64; 133] vs 81 [40; 102]; p=0.18. CONCLUSION: The relative safety and efficacy of combined use of Cyclosporine A in low doses and nephroprotectors was shown in children with Alport syndrome with nephrotic proteinuria and glomerular filtration rate > 60 ml/min/1.73m2, if monocomponent nephroprotective therapy was ineffective.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"275 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76247693","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":"Factors of proteolysis in blood and urine as prognostic markers of progression of Alport syndrome in children","authors":"Z. Bashirova, I. Osmanov","doi":"10.36485/1561-6274-2022-26-4-80-88","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-80-88","url":null,"abstract":"BACKGROUND. Alport syndrome is a rare hereditary kidney disease that causes progressive renal failure. There are significant differences in the progression of the disease between patients with Alport syndrome. Identifying patients with a high risk of rapid progression in order to optimally balance benefits and risks for prescribing therapy has become particularly important at this time. In this study, we wanted to assess whether the factors of proteolysis in blood and urine are associated with the nature of the course and to assess their prognostic value for children with Alport syndrome. THE AIM: To determine the level in blood serum and urinary excretion of MMP-2, MMP-3 and MMP-9 and their inhibitors TIMP-1 and 2, PAI-I, to show the relationship of their changes with the character of the course of Alport syndrome in children as an additional criterion for progression. PATIENTS AND METHODS. The study included 32 children with Alport syndrome. The level of MMP-2, MMP-3 and MMP-9 and their inhibitors TIMP-1 and 2, PAI-I, in blood serum and urine was determined by ELISA. A decrease in eGFR of ≥ 30 % at 2 years from baseline was chosen to indicate a progressive course of Alport syndrome. RESULTS. 28.1 % of children with Alport syndrome had a progressive course of the dis ease, 71.9 % had a slowly progressive course. The frequency of a decrease in MMP-9 and an increase in TIMP-1 both in blood (88.9 versus 43.5 % and 77.8 versus 21.7 %; p = 0.044 and 0.006, respectively) and in urine (100 versus 47, 8 % and 88.9 versus 30.4 %; 0.012 and 0.005, respectively) were statistically significantly more often detected in children with Alport syndrome with a progressive course of the disease than in a slowly progressive course. CONCLUSION. Type 9 matrix metalloproteinase and type 1 tissue matrix metalloproteinase inhibitor can be considered as risk factors for the progression of Alport syndrome in children.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"180 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74507795","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":"Functional state of the kidneys in the neonatal period in children with very low and extremely low body weight","authors":"N. Korotaeva, T. L. Nastausheva, L. I. Ippolitova","doi":"10.36485/1561-6274-2022-26-4-89-96","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-89-96","url":null,"abstract":"BACKGROUND. Preterm birth is still associated with an increased risk of neonatal morbidity and mortality in the early neonatal period. There is strong evidence demonstrating an association between a decrease in the number of nephrons in preterm infants and an increase in blood pressure, the risk of developing chronic kidney disease, which undoubtedly negatively affects the quality of life. THE AIM: to assess the functional state of the kidneys in children with very low (VLBW) and extremely low body weight (ELBW) in the first 8 weeks of postnatal life. PATIENTS AND METHODS. The study involved 134 newborns less than 37 weeks of gestation, who were divided into three groups depending on birth weight. The levels of protein and fluid intake, serum creatinine concentration, GFR according to Schwartz were taken into account as evaluation parameters. The Python programming language, t-tests, ShapiroWilk and d'Agostino tests were used as statistical methods. A threshold level of 0.05 was chosen to interpret the value of p tests for normality testing. RESULTS. There were no differences in the amount of protein received by preterm infants in the study groups both in the first week and subsequent 2–8 weeks of life. The average level of incoming fluid in the first week of postnatal life increased from 1 to 7 days in all study groups. There was a trend towards a more significant decrease in serum creatinine in children born with a larger birth weight. Analyzing the level of glomerular filtration rate in the studied groups, there is a clear picture of a progressive increase in the rate with age. CONCLUSION. The values of diuresis, creatinine level and GFR in premature babies with birth weight less than 1500 grams in the first 2 months of life have been established, which can be used in practice for comparison in the study of various pathologies.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80490558","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 rate of chronic kidney disease progression in advanced stages and the dynamics of the uremic syndrome parameters","authors":"D. Sadovskaya, K. A. Vishnevsky, I. N. Konakova, N. Bakulina","doi":"10.36485/1561-6274-2022-26-4-50-65","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-50-65","url":null,"abstract":"Background. The current practice of patients with advanced CKD stages management is not optimal, as it leads to the risk of an emergency dialysis start with an unfavorable prognosis, does not utilize all the possibilities of nephroprotective therapy and does not provide optimal correction of the most important uremic syndromes before starting dialysis, which worsens the per spectives of long-term patient-oriented dialysis treatment. THE AIM. The obtained features of the standard practice will provide the possibility to assemble group carefully matched with intensive management group to compare outcomes in future prospective study and to assess the significance of the proposed program components of the intensive management of patients with advanced stages of chronic kidney disease in the \"transition center\". PATIENTS AND METHODS. A group with regular (at least 6 visits per year) follow-up of 540 patients with baseline CKD3B was retrospectively formed from the city nephrology center database (which included 7696 patients with CKD3 and higher) and was traced to the need for renal replacement therapy or to death. As part of the follow-up, patients underwent regular clinical and laboratory evaluation and received nephroprotective therapy, which were recorded in the database. RESULTS. The dynamics of an accelerating decrease in eGFR (according to CKD-EPICr) from median of -2.76 (-3.26÷-2.36) to -4.34 (-5.01÷-3.46) and further to -6.01 (-7.11÷-5.23) ml/min/1.73 m2/ year for the stages of CKD3B→CKD4→CKD5 in parallel with the dynamics of blood levels of hemoglobin (and iron), phosphate (and calcium), albumin, as well as proteinuria is described – factors that turned out to be significant in the multiple regression model with a dependent variable – the rate of eGFR reduction (the significance of the model F=2.864; p=0.015). CONCLUSION. The obtained detailed description of the progression of CKD in a typical regional population under standard management conditions will provide the possiblity to form a group from a cohort of regular monitoring in a nephrocenter, carefully compared with an intensive management group in the prototype of a transition center based on a large inpatient dialysis center to assess the significance of the components of the proposed control and interventions program.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88954339","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 effectiveness of various approaches to the use of renal replacement therapy in the treatment of toxic rhabdomyolysis complicated by acute kidney injury","authors":"S. V. Masolitin, D. Protsenko, I. N. Tyurin, O. Mamontova, M. Magomedov, T. G. Kim, M. V. Zakharov, A. V. Marukhov, N. V. Chubchenko","doi":"10.36485/1561-6274-2022-26-4-40-49","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-40-49","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88810071","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":"Glomerular fi ltration rate and erythrocyte sedimentation rate in various bronchial asthma variants","authors":"V. N. Mineev, T. Vasilieva, I. Nesterovich, T. M. Lalaeva","doi":"10.36485/1561-6274-2022-26-4-97-104","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-97-104","url":null,"abstract":"BACKGROUND. Previously, we postulated the common pathogenetic mechanisms in bronchial asthma (BA) and chronic kidney disease (CKD). Given that both the glomerular filtration rate and the erythrocyte sedimentation rate directly depend on the rheological properties of the blood, it was of interest to compare these two important characteristics in different types of bronchial asthma. At the same time, we considered the erythrocyte sedimentation rate (ESR) not only as a factor in systemic inflammation, but also as a model of erythrocyte aggregation and hemorheology. THE AIM: to compare the level of glomerular filtration rate and erythrocyte sedimentation rate in different types of BA. PATIENTS AND METHODS. 215 BA patients with various BA variants were examined. The glomerular filtration rate (eGFR) was calculated using CKD-EPI. Erythrocyte sedimentation rate (ESR) was determined by the Panchenkov method. The integral eGFR/ESR index was used as the ratio of eGFR and ESR values in each individual patient. RESULTS. The glomerular filtration rate is significantly reduced, and the ESR values are significantly higher in non-allergic and hormone-dependent BA compared with the allergic variant of the disease. In the same groups of patients, a significant decrease in the eGFR/ESR index was revealed. Factor analysis revealed that Factor 1, which characterizes the non-allergic variant of BA, had the component of the eGFR/ESR index with a very high negative factor load along with a high negative factor load of the FEV1 component. Factor 2 reflects the features of endothelial dysfunction in the allergic variant of BA, the allergic variant of BA, and the component of the eGFR/ESR index has practically no factor load in this factor. Factor 3, reflecting the manifestations of an atopic state, with a positive factor load, includes a component of the eGFR/ESR index. CONCLUSION. The data obtained suggest that the development of CKD in bronchial asthma depends primarily on the variant of the disease. The decrease in the eGFR/ ESR index in non-allergic and hormone-dependent variants of BA compared with the allergic variant of the disease indicates the involvement of blood microrheological properties to the development of CKD in these two variants of the disease. On the contrary, in the allergic variant of BA, the development of CKD under these conditions can be restrained.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79772818","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":"IgA-nephropathy in children with alport syndrome","authors":"M. Aksenova, E. Stolyarevich, P. Povilaitite","doi":"10.36485/1561-6274-2022-26-4-74-79","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-74-79","url":null,"abstract":"BACKGROUND. The widespread use of genetic methods in clinical practice has shown that pathogenic variants in COL4A3, COL4A4, COL4A5 genes associated with Alport syndrome (AS) are detected in 10 % of sporadic and in 20 % of familial cases of IgA nephropathy (IgAN), which suggested a relationship between the two diseases. THE AIM was to determine the frequency and characteristics of the course of IgAN in children with AS. PATIENTS AND METHODS. A single-centre retrospective pilot study included 102 patients with AS. The inclusion criteria were: age 2-18 years, genetic and/or morphological confirmation of AS, availability of morphological data of pts. The comparison group included children and adolescents 2-18 years with morphologically confirmed primary IgAN; the exclusion criterion was the presence of AS-specific glomerular basement membrane changes. IgAN was classified according to the MESTC scale. Demographic (gender, age), clinical (arterial hypertension, AH) and laboratory data (proteinuria (Pr, mg/m2/day), (Schwartz eGFR, ml/min/1.73m2) at the time of the biopsy and at the last examination of patients were assessed. Arterial pressure ≥95‰ for sex, age, height was defined as AH. Pr >100 mg/m2/day, Pr≥500 mg/m2/day and Pr>1000 mg/m2/day were defined as proteinuria, high-level proteinuria and nephrotic level proteinuria, respectively. The statistic parametric and nonparametric methods were used (\"Statistica 10\", StatSoft Russia). RESULTS. IgAN was detected in 3 of 102 children with AS (q=0.03): 2 girls had heterozygous variants in COL4A3 and COL4A4, a boy had X-linked AS. Two patients had nephrotic proteinuria, 1 had SRNS at onset of IgAN. The comparison group included 25 children with IgAN (17M). Baseline patients age (9±4.2 vs 13±2.7 years), frequency of AH (q1=0.66 vs q2=0.28), eGFR decrease (q1=0.33 vs q2=0.44), eGFR level (91±24 vs 90.8±24 ml/ min/1.73 m2), morphological characteristics of IgAN did not differ significantly by groups; patients with AS were more likely to have nephrotic proteinuria (q1=1 vs q2=0.32, p=0.023). At follow-up (3.8±1.4 years), the groups were comparable in age (12.3±5.2 vs 15±1.8 years), AH frequency (q1=0.66 vs q2=0.5), eGFR level (87±16 vs 91±13 ml/min/1.73m2); children with AS had higher grade Pr (800[0;1150] vs 30[10;100] mg/m2/day, p=0.048) and more often had high-level Pr (q1=0.66 vs q2=0.06, p=0.006) at follow-up observation. The AS was associated with the development of nephrotic-level Pr at onset (r=0.41, p=0.008) and with high-level Pr (r=0.38, p=0.012) during follow-up. CONCLUSION. IgAN was detected in 3 % of children with AS. The presence of COL4A3, COL4A4, COL4A5 genes variants is associated with more pronounced proteinuria at the onset of IgAN and its preservation in the follow-up, and may be a risk factor for more severe course glomerulonephritis. The main limitations of the study: small sample size and duration of follow-up.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90234190","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":"Are Probiotics Needed in Nephrology?","authors":"A. B. Kuznetzova, E. Prazdnova, V. Chistyakov, O. Kutsevalova, M. Batiushin","doi":"10.36485/1561-6274-2022-26-4-18-30","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-18-30","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88712716","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}