Pub Date : 2022-11-23DOI: 10.36485/1561-6274-2022-26-4-31-39
I. T. Murkamilov, I. Sabirov, Z. Murkamilova, V. Fomin, P. Astanin, F. Yusupov
{"title":"Structural and Functional State of the Left Parts of the Heart in Chronic Kidney Disease Stage C4-C5","authors":"I. T. Murkamilov, I. Sabirov, Z. Murkamilova, V. Fomin, P. Astanin, F. Yusupov","doi":"10.36485/1561-6274-2022-26-4-31-39","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-4-31-39","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76865746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-11DOI: 10.36485/1561-6274-2022-26-3-72-79
N. G. Malakhova, F. Dzgoeva, O. Remizov, V. H. Botsieva, Z. R. Ikoeva, V. G. Goloeva, E. Y. Gireyeva, L. Tsallagova, A. Gurina
{"title":"Estradiol and follicle-stimulating hormone imbalance associated with mineral-bone metabolism disturbances and cardiovascular complications in women on hemodialysis","authors":"N. G. Malakhova, F. Dzgoeva, O. Remizov, V. H. Botsieva, Z. R. Ikoeva, V. G. Goloeva, E. Y. Gireyeva, L. Tsallagova, A. Gurina","doi":"10.36485/1561-6274-2022-26-3-72-79","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-72-79","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"5 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73346575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-11DOI: 10.36485/1561-6274-2022-26-3-80-87
E. S. Rusakova, E. Petrosyan, M. Molchanova, V. Gavrilova, A. V. Ryzhova, B. Kushnir, P. Povilaitite, P. Shumilov
BACKGROUND. Steroid-dependent nephrotic syndrome (SDNS) treatment is still an important problem in pediatric nephrology since the proper use of steroid-sparing agents can reduce the frequency of relapses and avoid steroid toxicity. THE AIM of our study was to compare the efficacy of cyclosporine A (CsA) and mycophenolic acid (MPA) in children with SDNS. PATIENTS AND METHODS. We observed 91 children (30 girls, 61 boys) with SDNS in 2015-2020. Age at the disease debut was 3 years [2,1; 5,0]. The age at steroid-sparing therapy debut was 8 years [4,0; 16,0]. All children received standard clinical and laboratory examinations and kidney biopsy. RESULTS: 25 children were treated with CsA, and 66 children were treated with MPA. The steroid-sparing therapy duration was 36 months [29; 44]. The frequency of relapses before the steroid-sparing therapy onset was 1,32 ± 0,62 (0,5; 4,3)/year, during steroid-sparing therapy it became 0,5 ± 0,58 (0; 2)/year (р < 0,05). Relapse rate in the MPA group was 0,36 ± 0,49 (0; 1,76)/year compared to 0,85 ± 0,66 (0; 2)/year in the CsA group (p < 0,05). Withdrawal of prednisolone was achieved in 44 (48,4 %) children. The relapse-free period during steroid-sparing therapy with steroid withdrawal was 25 months [6; 120]. 15 children (16,5 %) showed long–term stable remission with no immunosuppressive therapy. 14 of them were treated with MPA and only one with CsA (χ2=9,7, р = 0,0021). The remission duration was 7-32,9 months. There were no severe side effects of CsA and MPA requiring discontinuation of therapy. CONCLUSION: steroid-sparing therapy of SDNS with CsA and MPA significantly reduces relapse frequency. Relapse risk in patients treated with CsA was significantly higher than with MPA. So, it is justified to prescribe MPA as a first-choice immunosuppressive therapy in patients with SDNS.
{"title":"Comparative efficacy of mycophenolic acid and cyclosporine A in treatment of children with steroid-dependent nephrotic syndrome","authors":"E. S. Rusakova, E. Petrosyan, M. Molchanova, V. Gavrilova, A. V. Ryzhova, B. Kushnir, P. Povilaitite, P. Shumilov","doi":"10.36485/1561-6274-2022-26-3-80-87","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-80-87","url":null,"abstract":" BACKGROUND. Steroid-dependent nephrotic syndrome (SDNS) treatment is still an important problem in pediatric nephrology since the proper use of steroid-sparing agents can reduce the frequency of relapses and avoid steroid toxicity. THE AIM of our study was to compare the efficacy of cyclosporine A (CsA) and mycophenolic acid (MPA) in children with SDNS. PATIENTS AND METHODS. We observed 91 children (30 girls, 61 boys) with SDNS in 2015-2020. Age at the disease debut was 3 years [2,1; 5,0]. The age at steroid-sparing therapy debut was 8 years [4,0; 16,0]. All children received standard clinical and laboratory examinations and kidney biopsy. RESULTS: 25 children were treated with CsA, and 66 children were treated with MPA. The steroid-sparing therapy duration was 36 months [29; 44]. The frequency of relapses before the steroid-sparing therapy onset was 1,32 ± 0,62 (0,5; 4,3)/year, during steroid-sparing therapy it became 0,5 ± 0,58 (0; 2)/year (р < 0,05). Relapse rate in the MPA group was 0,36 ± 0,49 (0; 1,76)/year compared to 0,85 ± 0,66 (0; 2)/year in the CsA group (p < 0,05). Withdrawal of prednisolone was achieved in 44 (48,4 %) children. The relapse-free period during steroid-sparing therapy with steroid withdrawal was 25 months [6; 120]. 15 children (16,5 %) showed long–term stable remission with no immunosuppressive therapy. 14 of them were treated with MPA and only one with CsA (χ2=9,7, р = 0,0021). The remission duration was 7-32,9 months. There were no severe side effects of CsA and MPA requiring discontinuation of therapy. CONCLUSION: steroid-sparing therapy of SDNS with CsA and MPA significantly reduces relapse frequency. Relapse risk in patients treated with CsA was significantly higher than with MPA. So, it is justified to prescribe MPA as a first-choice immunosuppressive therapy in patients with SDNS.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"739 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76822603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-11DOI: 10.36485/1561-6274-2022-26-3-88-94
I. Sokolova, G. Ivanova
BACKGROUND. Chronic kidney disease (CKD) is accompanied by the development of endothelial dysfunction, leading to a decrease in arterial reactivity to vasoactive agents. Uremia causes a change in the dilatation of arteries in various vascular regions, incl. and arteries of the pial membrane of the brain. The action of hydrogen sulfide (H2S), which can induce relaxation of smooth muscle cells of blood vessels, is currently considered a possible route of vasoprotection in various diseases, particularly, in CKD. THE AIM. To evaluate the role of calcium-activated potassium channels of large (BKCa) and intermediate (IKCa) conductance in H2S-induced dilatation of pial arteries in nephrectomized (NE) rats. MATERIAL AND METHODS. In Wistar rats nephrectomy (NE) was performed by resection of 5/6 of the renal tissue mass. Sham-operated (LO) animals served as control. The reaction of the pial arteries of the sensomotor cortex of NE and control SO rats to the application of H2S under physiological conditions and against the background of the use of BKCa channel blockers – tetraethylammonium (TEA) and IKCa – channels – TRAM-34. RESULTS. 4 months after NE, the application of H2S led to the dilatation of a smaller number of pial arteries (1.4 – 1.7 times) compared with SO rats. The preliminary exposure to TEA led to a decrease in the number of pial arteries responding by dilatation to the action of H2S in NE and SO rats. Against the background of the action of TRAM-34, the number of dilated arteries decreased under the action of H2S in SO rats, while in NE rats it practically did not change. CONCLUSION. Under physiological conditions, dilatation of the pial arteries in rats under the action of H2S is realized (at least in part) through the activation of the BKCa and IKCa channels of the membrane of endothelial and smooth muscle cells. Uremia, caused by nephrectomy, leads to impairment of the mechanism of dilatation of pial arteries, mediated by activation of calcium-activated potassium channels intermediate conductance apparently due to dysfunction of endothelial cells.
{"title":"The role of ВKСа and IKСа channels in H2S-induced dilatation of pial arteries in rats after nephrectomy","authors":"I. Sokolova, G. Ivanova","doi":"10.36485/1561-6274-2022-26-3-88-94","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-88-94","url":null,"abstract":" BACKGROUND. Chronic kidney disease (CKD) is accompanied by the development of endothelial dysfunction, leading to a decrease in arterial reactivity to vasoactive agents. Uremia causes a change in the dilatation of arteries in various vascular regions, incl. and arteries of the pial membrane of the brain. The action of hydrogen sulfide (H2S), which can induce relaxation of smooth muscle cells of blood vessels, is currently considered a possible route of vasoprotection in various diseases, particularly, in CKD. THE AIM. To evaluate the role of calcium-activated potassium channels of large (BKCa) and intermediate (IKCa) conductance in H2S-induced dilatation of pial arteries in nephrectomized (NE) rats. MATERIAL AND METHODS. In Wistar rats nephrectomy (NE) was performed by resection of 5/6 of the renal tissue mass. Sham-operated (LO) animals served as control. The reaction of the pial arteries of the sensomotor cortex of NE and control SO rats to the application of H2S under physiological conditions and against the background of the use of BKCa channel blockers – tetraethylammonium (TEA) and IKCa – channels – TRAM-34. RESULTS. 4 months after NE, the application of H2S led to the dilatation of a smaller number of pial arteries (1.4 – 1.7 times) compared with SO rats. The preliminary exposure to TEA led to a decrease in the number of pial arteries responding by dilatation to the action of H2S in NE and SO rats. Against the background of the action of TRAM-34, the number of dilated arteries decreased under the action of H2S in SO rats, while in NE rats it practically did not change. CONCLUSION. Under physiological conditions, dilatation of the pial arteries in rats under the action of H2S is realized (at least in part) through the activation of the BKCa and IKCa channels of the membrane of endothelial and smooth muscle cells. Uremia, caused by nephrectomy, leads to impairment of the mechanism of dilatation of pial arteries, mediated by activation of calcium-activated potassium channels intermediate conductance apparently due to dysfunction of endothelial cells.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77746505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-11DOI: 10.36485/1561-6274-2022-26-3-102-109
A. Gozhenko, D. Ivanov
The presented material raises the most important question in practical nephrology – how to correctly assess kidney function to understand the prognosis and duration of the predialysis period in a particular patient with chronic kidney disease (CKD)? From the standpoint of onto- and phylogenesis, the hierarchy of kidney functions was assessed. It is noted that the existing approaches to such an assessment are convenient for practice, but do not sufficiently take into account individual characteristics and are devoid of a load component that can show kidney reserves. The authors focused on the functional renal reserve (FRR) and the possibility of its detection. The above technique with 0.45 % saline allows revealing the true functional capabilities of the kidneys and understanding the patient's capabilities in the pre-dialysis period. Conclusions are drawn about the convenient use of the KDIGO scale, a more individual approach when using the QxMD calculator, and the possibility of a personalized approach when assessing the FRR.
{"title":"How to determine the prognosis of renal function in CKD?","authors":"A. Gozhenko, D. Ivanov","doi":"10.36485/1561-6274-2022-26-3-102-109","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-102-109","url":null,"abstract":" The presented material raises the most important question in practical nephrology – how to correctly assess kidney function to understand the prognosis and duration of the predialysis period in a particular patient with chronic kidney disease (CKD)? From the standpoint of onto- and phylogenesis, the hierarchy of kidney functions was assessed. It is noted that the existing approaches to such an assessment are convenient for practice, but do not sufficiently take into account individual characteristics and are devoid of a load component that can show kidney reserves. The authors focused on the functional renal reserve (FRR) and the possibility of its detection. The above technique with 0.45 % saline allows revealing the true functional capabilities of the kidneys and understanding the patient's capabilities in the pre-dialysis period. Conclusions are drawn about the convenient use of the KDIGO scale, a more individual approach when using the QxMD calculator, and the possibility of a personalized approach when assessing the FRR.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72990977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-11DOI: 10.36485/1561-6274-2022-26-3-95-101
Z. S. Kochoyan, O. B. Bystrova, V. Dobronravov
Primary membranous nephropathy (PMN) typical cause of nephrotic syndrome in adults. The key point in its pathogenesis is the production of IgG4 subclass autoantibodies (IgG4) against podocytic transmembrane phospholipase A2 M-type receptor (anti-PLA2R), followed by the deposition of subepithelial immune complexes (IC) in situ. We present a case of a 37-year-old young man with PMN associated with demyelinating polyneuropathy and idiopathic inflammatory lesions of skeletal muscles demonstrating a possible variant of extrarenal effects of IgG4-anti-PLA2R with an extended analysis of diagnostics and probable mechanisms of imbalance of secreted and intracellular phospholipases.
{"title":"Case report of primary membranous nephropathy associated with muscle and peripheral nerve damage","authors":"Z. S. Kochoyan, O. B. Bystrova, V. Dobronravov","doi":"10.36485/1561-6274-2022-26-3-95-101","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-95-101","url":null,"abstract":" Primary membranous nephropathy (PMN) typical cause of nephrotic syndrome in adults. The key point in its pathogenesis is the production of IgG4 subclass autoantibodies (IgG4) against podocytic transmembrane phospholipase A2 M-type receptor (anti-PLA2R), followed by the deposition of subepithelial immune complexes (IC) in situ. We present a case of a 37-year-old young man with PMN associated with demyelinating polyneuropathy and idiopathic inflammatory lesions of skeletal muscles demonstrating a possible variant of extrarenal effects of IgG4-anti-PLA2R with an extended analysis of diagnostics and probable mechanisms of imbalance of secreted and intracellular phospholipases.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74853743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-10DOI: 10.36485/1561-6274-2022-26-3-52-58
N. Kuprienko, N. N. Smirnova
The term "microbiota" refers to a group of bacteria, as well as viruses, protozoa, fungi, and archaea associated with a specific niche of macroorganism. In recent years, interest in the viral component of the microbiota, virome, has increased. The gut microbiome is best studied. The study of the microbiome and urine virome and urinary organs has just begun. The review presents data on eukaryotic viruses and bacteriophages in the urinary system organs under physiological and pathological conditions. In the future, the study of urobiome and urovirome will allow revising approaches to therapy of nephro-urological pathology.
{"title":"Bacteria and viruses in urine in normal and pathology (urobiome and urovirome)","authors":"N. Kuprienko, N. N. Smirnova","doi":"10.36485/1561-6274-2022-26-3-52-58","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-52-58","url":null,"abstract":" The term \"microbiota\" refers to a group of bacteria, as well as viruses, protozoa, fungi, and archaea associated with a specific niche of macroorganism. In recent years, interest in the viral component of the microbiota, virome, has increased. The gut microbiome is best studied. The study of the microbiome and urine virome and urinary organs has just begun. The review presents data on eukaryotic viruses and bacteriophages in the urinary system organs under physiological and pathological conditions. In the future, the study of urobiome and urovirome will allow revising approaches to therapy of nephro-urological pathology.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74496240","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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