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Approaches to predicting the risk of acute cerebrovascular accident in patients with stage 5 chronic kidney disease and bone mineral disorders 5期慢性肾脏疾病及骨矿物质紊乱患者急性脑血管意外风险的预测方法
Pub Date : 2022-09-10 DOI: 10.36485/1561-6274-2022-26-3-66-71
A. Mambetova, Sh. N. Gutarаeva, I. L. Semyonova
   BACKGROUND. Among the causes of death in patients with chronic kidney disease (CKD) on dialysis, cardiovascular complications play a leading role. One of them is acute incidences of cerebral circulation (AICC). The assessment of the impact of mineral and bone disorders on the risk of developing AICC is interesting and on par with the assessment of the impact of traditional risk factors.   THE AIM: to evaluate the effects of bone mineral disorders on the risk of acute cerebrovascular accident in patients with stage 5 D CKD.   PATIENTS AND METHODS. A single-center cohort prospective (three-year) study of 85 patients with stage 5D CKD on program hemodialysis was conducted. In the first stage, we evaluated traditional risk factors (blood pressure, echocardiography parameters) and parameters that reflect bone mineral disorders (parathyroid hormone, blood phosphate, calcium levels, 1.25 (OH) D, fibroblast growth factor-FGF-23, a-klotho of blood). Signs of calcification of the heart valves (CHV) and the aortic wall (CAW) were also recorded. In the second stage, three years later, patients were re-examined with the registration of the endpoint, which was identified as cases of fatal and non-fatal AICC.   RESULTS. Within three years, 10 cases of AICC were registered. Mineral and bone disorders in patients on hemodialysis, such as hyperphosphatemia, CKD and its severity are risk factors for the development of AICC. It is shown that the severity of CCS and pulse pressure levels determined before the dialysis procedure and intradialytic have a positive effect on the risk of AICC. Factors such as FGF-23 and α-Klotho of blood have not demonstrated their effect on the risk of AICC.
背景。在慢性肾脏疾病(CKD)透析患者的死亡原因中,心血管并发症起主导作用。其中之一是急性脑循环发病率(AICC)。评估矿物质和骨骼疾病对发生AICC风险的影响是有趣的,与评估传统风险因素的影响是一样的。目的:评价骨矿物质障碍对5期CKD患者急性脑血管意外发生风险的影响。患者和方法。对85例5D期CKD患者进行了一项单中心队列前瞻性(三年)研究。在第一阶段,我们评估了传统的危险因素(血压、超声心动图参数)和反映骨矿物质疾病的参数(甲状旁腺激素、血磷酸盐、钙水平、1.25 (OH) D、成纤维细胞生长因子- fgf -23、血a-klotho)。同时记录心脏瓣膜(CHV)和主动脉壁(CAW)的钙化征象。在第二阶段,三年后,对患者进行重新检查并登记终点,确定为致命性和非致命性AICC病例。结果。在三年内,共有10宗AICC个案被登记在案。血液透析患者的矿物质和骨骼疾病,如高磷血症、CKD及其严重程度是AICC发生的危险因素。研究表明,透析前和透析中测定的CCS严重程度和脉压水平对AICC的风险有积极影响。血液中FGF-23和α-Klotho等因子对AICC风险的影响尚未得到证实。
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引用次数: 0
Еvaluation the functional reserve of the kidneys in patients with chronic heart failure who have had the COVID-19 infection Еvaluation感染COVID-19的慢性心力衰竭患者肾脏的功能储备
Pub Date : 2022-09-10 DOI: 10.36485/1561-6274-2022-26-3-59-65
A. Gadaev, R. Turakulov, N. V. Pirmatova, F. I. Hudjakulova
   THE AIM: to evaluate the functional reserve of the kidneys (FRK), and the effectiveness of empagliflozin (EMPA), a selective reversible inhibitor of sodium-glucose cotransporter type 2 (SGLT 2), in patients with chronic heart failure who have had COVID-19 infection.   PATIENTS AND METHODS: To assess the state of renal function in patients with coronary heart disease (CHF), the most accessible and convenient method for determining FRK using 0.45 % saline was chosen. The study involved 110 patients with CHF developed as a result of coronary artery disease and hypertension. The first group consisted of 40 patientswith CHF who have had COVID-19 infection (16 (40 %) men and 24 (60 %) women, mean age 63.2 ± 1.2 years). They received EMPA in addition to standard therapy. The second group consisted of 40 patients with CHF who have also had COVID-19 (24 (60 %) men and 16 (40 %) women, mean age 64.1 ± 1.2 years). They received only standard therapy (ACE inhibitors or ARB,beta-blockers, AMCR). The control group consisted of 30 CHF patients who haven’t had COVID-19 infection (16 (53.33 %) men and 14 (46.67 %) women, mean age 61.8 ± 1.2 years). They received only standard therapy.   RESULTS. In patients of the first group (standard treatment+ EMPA) the FRK was 2.9 ± 0.2 % before and 8.1 ± 0.2 % after the treatment, which indicates a significant increase (p<0.001). The creatinine level before the treatment and exercise was 147.7±2.7 μmol/l, and after the exercise, it decreased to 144.7±2.5 μmol/l. After the standard therapy, a decrease in its index by 102.5±1.4 μmol/l and 99.7 ± 1.3 μmol/l, respectively, was established. The glomerular filtration rate before treatment and exercise was 56.8 ± 1.5 ml/min, and after exercise, it increased to 54.3 ± 1.6 ml/min. After the treatment, these values were 60.3 ± 2.01 ml/min and 62.7±2.08 ml/min, respectively. In patients of the second group (standard treatment), FRK was 4.4 ± 0.1 % before and 3.0 ± 0.2 % after treatment.   CONCLUSION: Thus, in patients of the first group, who received EMPA along with standard CHF treatment, an increase in FRK by 2.8 times was found (p < 0.01). In the group of patients with CHF who did not receive an inhibitor of sodium-glucose transporter type 2 EMPA in combination with standard therapy, a decrease in FRK by 1.3 times was found (p > 0.05). While in the control group, FRK increased by 1.1 times (p > 0.05). Thus, the results show that in the first group, the FRK index was 2.9 %, which indicates the absence of a reserve, while after complex therapy in combination with EMPA, this increased to 8.1 %, which indicates the presence of a reserve. However, in the second group, the decrease in these indicators from 4.4 % to 3.3 %, respectively, suggests the absence of FRK. In the control group, this figure increased from 6.7 % before treatment to 7.1 % after.This indicates a decrease in FRK in this group of patients. Thus, the decrease in the FRK in patients of the first group compared with the
目的:评估肾功能储备(FRK)和恩格列净(EMPA)在COVID-19感染的慢性心力衰竭患者中的有效性。恩格列净是一种选择性可逆的钠-葡萄糖共转运蛋白2型(SGLT 2)抑制剂。患者和方法:为了评估冠心病(CHF)患者的肾功能状态,我们选择了使用0.45%生理盐水测定FRK的最简便易行的方法。该研究纳入了110例因冠状动脉疾病和高血压而发展为CHF的患者。第一组包括40例感染COVID-19的CHF患者(男性16例(40%),女性24例(60%),平均年龄63.2±1.2岁)。除了标准治疗外,他们还接受了EMPA。第二组包括40例合并COVID-19的CHF患者(男性24例(60%),女性16例(40%),平均年龄64.1±1.2岁)。他们只接受标准治疗(ACE抑制剂或ARB, β受体阻滞剂,AMCR)。对照组为30例未感染COVID-19的CHF患者,其中男性16例(53.33%),女性14例(46.67%),平均年龄61.8±1.2岁。他们只接受标准治疗。结果。第一组(标准治疗+ EMPA)患者的FRK治疗前为2.9±0.2%,治疗后为8.1±0.2%,差异有统计学意义(p < 0.05)。对照组FRK升高1.1倍(p > 0.05)。因此,结果显示,在第一组中,FRK指数为2.9%,表明缺乏储备,而在综合治疗联合EMPA后,该指数上升至8.1%,表明存在储备。然而,在第二组中,这些指标分别从4.4%降至3.3%,表明FRK不存在。在对照组中,这一数字从治疗前的6.7%增加到治疗后的7.1%。这表明在这组患者中FRK降低。因此,与对照组相比,第一组患者FRK的下降表明COVID-19对肾脏的不良影响。大量的研究证实了这一点,这让我们思考它的长期作用,不仅在感染的急性期,而且在临床恢复期之后。
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引用次数: 0
Polymorphism of genes of immune-inflammatory response, thrombophilia, and arterial hypertension in kidney diseases in children (literature review) 儿童肾脏疾病免疫炎症反应、血栓形成、动脉高血压基因多态性(文献综述)
Pub Date : 2022-09-09 DOI: 10.36485/1561-6274-2022-26-3-40-51
A. Vyalkova, I. V. Zorin, G. K. Karymova, S. A. Chesnokova
   Modern scientific data and the emergence of new opportunities for the development of pediatrics and nephrology are inextricably linked with medical genetics, the role of which is especially important for understanding the etiology and pathogenesis of many diseases of the urinary system. In 35–80 % of children with diffuse connective tissue diseases, kidney damage is formed, which is one of the leading causes of comorbidity of pathology and mortality of patients. Modern genetic research will allow not only to decipher the nature of diseases but also to scientifically substantiate adequate therapy. The active development of methods for the molecular diagnosis of kidney diseases opens up a large section of medicine, which can be called "molecular nephropathology". Further study of kidney diseases from the standpoint of molecular biology will allow us to take a fresh look at the pathogenesis of many diseases and solve a number of problems from the standpoint of personalized therapy, which takes into account the genetic characteristics of the patient. The active development of genetic research in nephrology has led to an understanding of the role of genetic mutations and polymorphisms leading to the occurrence of nephropathies in children. Correct clarification of the causes of the development of the disease can radically change the tactics of managing a patient by a nephrologist and rheumatologist. Determination of the genetic cause of the development of nephropathy is important in children since it justifies the need to examine other family members, it will allow predicting the risk of developing kidney pathology in diffuse connective tissue diseases, which is very important, predicting the response to immunosuppressive therapy. The development of molecular diagnostic methods is increasingly opening up prospects for a personalized approach to the study of pathology at various levels of interaction; these achievements provide a qualitative assessment of DNA, RNA, proteins, and their metabolites, which makes it possible to determine new biomarkers. The article deals with gene polymorphisms in secondary nephropathies in children with diffuse connective tissue diseases (systemic lupus erythematosus, systemic microthrombovasculitis, rheumatoid arthritis).
现代科学数据的出现以及儿科学和肾脏病学发展的新机遇与医学遗传学有着千丝万缕的联系,医学遗传学的作用对于了解泌尿系统许多疾病的病因和发病机制尤为重要。35 - 80%的弥漫性结缔组织病患儿会形成肾脏损害,这是导致患者病理合并症和死亡的主要原因之一。现代基因研究不仅可以破译疾病的本质,而且可以科学地证实适当的治疗方法。肾脏疾病分子诊断方法的积极发展开辟了一大片医学领域,可称为“分子肾病理学”。从分子生物学的角度进一步研究肾脏疾病,将使我们对许多疾病的发病机制有新的认识,并从考虑患者遗传特征的个性化治疗的角度解决许多问题。肾脏病学中基因研究的积极发展已经导致了对基因突变和多态性导致儿童肾病发生的作用的理解。正确澄清疾病发展的原因可以从根本上改变肾科医生和风湿病学家管理病人的策略。确定儿童肾病发展的遗传原因很重要,因为它证明了检查其他家庭成员的必要性,它将允许预测弥漫性结缔组织疾病发生肾脏病理的风险,这是非常重要的,预测对免疫抑制治疗的反应。分子诊断方法的发展日益开辟了个性化的方法来研究病理在不同层次的相互作用的前景;这些成果提供了DNA、RNA、蛋白质及其代谢物的定性评估,使确定新的生物标志物成为可能。本文探讨了弥漫性结缔组织疾病(系统性红斑狼疮、系统性微血栓血管炎、类风湿性关节炎)患儿继发性肾病的基因多态性。
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引用次数: 0
Atypical hemolytic-uremic syndrome: evolution of treatment and impact of clinical and genetic characteristics on possibility of eculizumab withdrawal 非典型溶血性尿毒症综合征:治疗的演变和临床和遗传特征对eculizumab停药可能性的影响
Pub Date : 2022-09-09 DOI: 10.36485/1561-6274-2022-26-3-19-29
E. Prokopenko
   Atypical hemolytic uremic syndrome (aHUS) is a rare variant of thrombotic microangiopathy (TMA) associated with uncontrolled activation of alternative complement pathway due to mutations in complement regulatory protein genes or antibodies formation to regulators. Clinical manifestations of aHUS can be triggered by infections, sepsis, pregnancy, autoimmune diseases, organ transplantation, and other complement-activating conditions. Previously, the only treatment option for aHUS was plasma therapy – fresh frozen plasma infusions or plasma exchange, but its effectiveness was insufficient. Currently, targeted treatment available – recombinant monoclonal antibodies against complement C5 protein – eculizumab with high efficiency in achieving aHUS remission, renal function recovery, and preventing TMA at kidney transplantation. For a long time, the question of the optimal duration of treatment and the possibility of eculizumab discontinuing remained unresolved. It was shown that aHUS relapses developed in 20-35 % of patients after discontinuation of complement-blocking therapy. The article presents an overview of a large number of studies of eculizumab treatment outcomes and the possibility of its withdrawal, including a French prospective multicenter study that identified risk factors for aHUS relapse after eculizumab discontinuation: the presence of rare variants of complement genes, female gender, increased soluble C5b-9 plasma level. In patients who did not have rare genetic variants, the risk of relapse was less than 5 %. In general, eculizumab discontinuation after achieving complete remission of aHUS and renal function recovery in patients with low risk of recurrence can provide better tolerability of maintenance treatment, and decrease the incidence of infectious complications and the financial burden on the healthcare system.
非典型溶血性尿毒症综合征(aHUS)是一种罕见的血栓性微血管病(TMA)变体,与补体调节蛋白基因突变或对调节剂形成抗体导致替代补体途径不受控制的激活有关。感染、败血症、妊娠、自身免疫性疾病、器官移植和其他补体激活条件可引发aHUS的临床表现。以前,治疗aHUS的唯一选择是血浆治疗-新鲜冷冻血浆输注或血浆交换,但其有效性不足。目前,针对补体C5蛋白的重组单克隆抗体eculizumab在实现aHUS缓解、肾功能恢复和预防肾移植TMA方面具有高效的靶向治疗。长期以来,eculizumab的最佳治疗时间和停药可能性的问题一直没有解决。研究表明,在补体阻断治疗停止后,20- 35%的患者出现aHUS复发。这篇文章概述了大量关于eculizumab治疗结果和停药可能性的研究,包括法国的一项前瞻性多中心研究,该研究确定了eculizumab停药后aHUS复发的危险因素:补体基因的罕见变异、女性性别、可溶性C5b-9血浆水平升高。在没有罕见基因变异的患者中,复发的风险小于5%。总的来说,对于低复发风险的患者,在aHUS完全缓解和肾功能恢复后停用eculizumab可以提供更好的维持治疗耐受性,并减少感染并发症的发生率和医疗保健系统的经济负担。
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引用次数: 0
Cryoglobulinemic vasculitis associated with HCV infection: still a problem? 与HCV感染相关的冷球蛋白性血管炎:仍然是一个问题吗?
Pub Date : 2022-09-09 DOI: 10.36485/1561-6274-2022-26-3-30-39
S. Milovanova, L. Lysenko (Kozlovskaya), L. Milovanova, D. T. Abdurahmanov, M. Taranova, A. V. Volkov
   The review presents the main data on the problem of cryoglobulinemic vasculitis associated with HCV infection. The options for the course are considered, and modern diagnostic criteria, the choice of tactics, and the effectiveness of various treatment regimens are presented. The use of modern antiviral drugs makes it possible to achieve the eradication of the virus in 95 % of patients. However, in some patients, clinical and immunologic markers of vasculitis persist despite viral clearance. The article discusses the concept that the persistence of B-cell clones after achieving a sustained virological response may underlie the pathogenesis of HCV-independent CV reactivation.
这篇综述介绍了与HCV感染相关的冷球蛋白性血管炎问题的主要数据。课程的选择被考虑,和现代诊断标准,战术的选择,和各种治疗方案的有效性提出。现代抗病毒药物的使用使95%的患者有可能根除病毒。然而,在一些患者中,尽管病毒清除,血管炎的临床和免疫标志物仍然存在。本文讨论了b细胞克隆在获得持续病毒学应答后的持久性可能是hcv非依赖性CV再激活的发病机制的基础。
{"title":"Cryoglobulinemic vasculitis associated with HCV infection: still a problem?","authors":"S. Milovanova, L. Lysenko (Kozlovskaya), L. Milovanova, D. T. Abdurahmanov, M. Taranova, A. V. Volkov","doi":"10.36485/1561-6274-2022-26-3-30-39","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-3-30-39","url":null,"abstract":"   The review presents the main data on the problem of cryoglobulinemic vasculitis associated with HCV infection. The options for the course are considered, and modern diagnostic criteria, the choice of tactics, and the effectiveness of various treatment regimens are presented. The use of modern antiviral drugs makes it possible to achieve the eradication of the virus in 95 % of patients. However, in some patients, clinical and immunologic markers of vasculitis persist despite viral clearance. The article discusses the concept that the persistence of B-cell clones after achieving a sustained virological response may underlie the pathogenesis of HCV-independent CV reactivation.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"60 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86778764","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
Anti–glomerular basement membrane disease with rapidly progressive glomerulonephritis and hemorrhagic alveolitis in pediatric patients (reviev of literature) 小儿抗肾小球基底膜病伴快速进行性肾小球肾炎和出血性肺泡炎(文献综述)
Pub Date : 2022-09-09 DOI: 10.36485/1561-6274-2022-26-3-9-18
N. Savenkova, K. A. Papayan
   The article is devoted to controversial issues of autoimmune small vessel vasculitis with kidney and lung damage. Modern data on the features of pathogenesis, clinical manifestation, treatment, outcome, and prognosis of the disease with AT to GBM have presented: an idiopathic disease with AT of class IgG (IgG1 and IgG3) against non-collagen domain-1 (NC1) α3-chain ofcollagen type IV GBM (Goodpasture autoantigen); with the simultaneous increase in AT to GBM and ANCA; "de novo" diseases with AT to the α5(IV) and α3(IV) chains of GBM type IV collagen in renal graft with Alport syndrome in pediatric patients.
本文致力于自身免疫性小血管炎伴肾、肺损害的争议性问题。关于AT致GBM的发病机制、临床表现、治疗、结局和预后的现代资料显示:针对IV型GBM (Goodpasture自体抗原)的非胶原结构域-1 (NC1) α3链,具有IgG类AT的特发性疾病(IgG1和IgG3);随着AT对GBM和ANCA的同时增加;Alport综合征患儿移植肾中α5(IV)和α3(IV)链发生AT的“新生”疾病
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引用次数: 0
PROFESSOR ANDREY VLADIMIROVICH VATAZIN (to the 65-th birthday) 安德烈·弗拉基米罗维奇·瓦塔津教授(65岁生日)
Pub Date : 2022-06-24 DOI: 10.36485/1561-6274-2021-26-2-114-115
A. Editorial
.
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引用次数: 0
TO THE FORENSIC MEDICAL SUPPORT OF KIDNEY TRANSPLANTATION IN ST. PETERSBURG 致圣彼得堡肾移植的法医支持
Pub Date : 2022-06-24 DOI: 10.36485/1561-6274-2022-26-2-93-98
O. D. Yagmurov, V. D. Isakov, V. V. Vasilenko
{"title":"TO THE FORENSIC MEDICAL SUPPORT OF KIDNEY TRANSPLANTATION IN ST. PETERSBURG","authors":"O. D. Yagmurov, V. D. Isakov, V. V. Vasilenko","doi":"10.36485/1561-6274-2022-26-2-93-98","DOIUrl":"https://doi.org/10.36485/1561-6274-2022-26-2-93-98","url":null,"abstract":"","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81893041","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
НEMODIALIASIS AND COVID-19 (ANALYSIS OF THE FIRST YEAR OF THE PANDEMIC IN MAKHACHKALA) Нemodialiasis和COVID-19(对马哈奇卡拉大流行第一年的分析)
Pub Date : 2022-06-24 DOI: 10.36485/1561-6274-2022-26-2-85-92
P. G. Gadzhieva, Z. A. Agalavova, M. J. Gadzhiyavdibirova, L. B. Gasanova
BACKGROUND. Patients receiving treatment with programmed hemodialysis are at high risk for the incidence of COVID-19. THE AIM: to analyze the clinical picture, features of the course, risk factors and treatment options in COVID-19 patients treated with programmed hemodialysis in Makhachkala. PATIENTS AND METHODS. 162 patients (87 men and 75 women) were treated with HD for terminal renal failure were under observation in the GBU RD "RKB" of Makhachkala, repurposed to provide medical care to patients infected with SARS-CoV-2 from April 2019 to April 2020. The study was single-center, retrospective and uncontrolled. The end point of observation was considered to be the patient's discharge from the hospital or death. Patients who continued treatment at the end of the study were excluded from it. RESULTS. Infection with SARS-CoV-2 in 101 (62.3%) patients was confirmed by PCR results, and in the rest – by a characteristic pattern determined by CT of the chest organs. The fatal outcome of COVID-19 in patients with HD was associated with a more severe and widespread lung lesion (CT-3 and CT-4), which was diagnosed significantly more often compared to the surviving patients. In a significant number of patients with end-stage CKD treated with HD, it is characterized by a severe course and an unfavorable prognosis. In this regard, there is a need to search for effective and safe methods of prevention and treatment in groups at increased risk of infection and severe COVID-19. CONCLUSION. Patients with CKD have an increased risk of developing severe COVID-19. Concomitant cardiovascular diseases and diabetes mellitus may predispose to this. Given the availability of a vaccine or approved therapy, nephrologists should advise patients with CKD to follow the recommendations of social isolation. © 2022 Educational Autonomous Non-Profit Organization Nephrology. All rights reserved.
背景。接受程序性血液透析治疗的患者发生COVID-19的风险很高。目的:分析Makhachkala地区接受程序性血液透析治疗的COVID-19患者的临床情况、病程特点、危险因素和治疗方案。患者和方法。162名因终末期肾衰竭而接受HD治疗的患者(87名男性和75名女性)在Makhachkala的GBU RD“RKB”接受观察,该中心于2019年4月至2020年4月期间被重新用于为SARS-CoV-2感染的患者提供医疗护理。该研究为单中心、回顾性和非对照研究。观察的终点被认为是患者出院或死亡。在研究结束时继续治疗的患者被排除在外。结果。101例(62.3%)患者感染了SARS-CoV-2,其余患者通过胸部器官CT确定的特征性模式得到证实。COVID-19在HD患者中的致命结果与更严重和更广泛的肺部病变(CT-3和CT-4)相关,与存活患者相比,这种病变的诊断频率要高得多。在相当数量的终末期CKD合并HD治疗的患者中,其特点是病程严重,预后不良。在这方面,有必要在感染和严重COVID-19风险增加的群体中寻找有效和安全的预防和治疗方法。结论。CKD患者发生严重COVID-19的风险增加。伴随的心血管疾病和糖尿病可能易患此病。鉴于疫苗的可用性或批准的治疗方法,肾病学家应建议CKD患者遵循社会隔离的建议。©2022教育自治非营利组织肾脏病。版权所有。
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引用次数: 0
COMPREHENSIVE ASSESSMENT OF THE FUNCTIONAL STATE OF THE KIDNEYS AND HEMODYNAMICS IN THE PROGNOSIS OF CARDIOVASCULAR RISK IN PATIENTS WITH CHRONIC PYELONEPHRITIS AND ARTERIAL HYPERTENSION 慢性肾盂肾炎合并动脉性高血压患者肾脏功能状态及血流动力学在心血管危险预后中的综合评价
Pub Date : 2022-06-23 DOI: 10.36485/1561-6274-2022-26-2-72-76
S. A. Oskolkov, S. A. Paketov, V. A. Zhmurov, D. V. Zhmurov, P. Ivanova, M. V. Evseev
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引用次数: 0
期刊
Nephrology (Saint-Petersburg)
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