Pub Date : 2023-08-15DOI: 10.31450/ukrjnd.3(79).2023.08
L. Denova
CKD is a global health concern with significant implications for patients' well-being, morbidity, and mortality. The underlying mechanism of CKD development often involves progressive interstitial fibrosis. Understanding the processes and factors influencing fibrogenesis is crucial. This review aims to analyze recent literature on the pathophysiological mechanisms, early diagnosis, prevention, and treatment of renal fibrosis in CKD patients. It explores various aspects of kidney fibrogenesis, highlighting key pathogenic factors and signaling pathways that warrant further investigation.
The review emphasizes the potential of urinary uromodulin (uUmod) as a biomarker for early renal fibrosis diagnosis and delves into the role of anemia, kidney hypoxia, vitamin D, and unique aspects of fibrosis development in diabetic kidney disease patients. Furthermore, it underscores the importance of inhibiting the renin-angiotensin-aldosterone system (RAAS) as a strategy for fibrosis prevention and attenuation.
{"title":"Development of renal fibrosis in patients with chronic kidney disease: Mechanisms, biomarkers, and clinical implications","authors":"L. Denova","doi":"10.31450/ukrjnd.3(79).2023.08","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.08","url":null,"abstract":"CKD is a global health concern with significant implications for patients' well-being, morbidity, and mortality. The underlying mechanism of CKD development often involves progressive interstitial fibrosis. Understanding the processes and factors influencing fibrogenesis is crucial. This review aims to analyze recent literature on the pathophysiological mechanisms, early diagnosis, prevention, and treatment of renal fibrosis in CKD patients. It explores various aspects of kidney fibrogenesis, highlighting key pathogenic factors and signaling pathways that warrant further investigation.
 The review emphasizes the potential of urinary uromodulin (uUmod) as a biomarker for early renal fibrosis diagnosis and delves into the role of anemia, kidney hypoxia, vitamin D, and unique aspects of fibrosis development in diabetic kidney disease patients. Furthermore, it underscores the importance of inhibiting the renin-angiotensin-aldosterone system (RAAS) as a strategy for fibrosis prevention and attenuation.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135164672","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 : 2023-08-05DOI: 10.31450/ukrjnd.3(79).2023.03
Khairullah M. Khallawi, Basim J. Hameed, Nadheerah F. Neamah
This research aimed to investigate the uricosuric effect of dandelion plant extracts in hyperuricemic rats induced by potassium oxonate (PO).
Methods. Hyperuricemia was induced in rats using PO, and dandelion root extracts were administered to observe their impact on uric acid (UA) levels. The study involved adult male Swiss rats weighing approximately 150–180 grams, randomly divided into five groups (n = 6). Group 1 served as the normal control group with no treatment. Group 2 received PO only. Group 3 received oral administration of 50 mg/kg of dandelion extract in 0.5 ml of distilled water (DW) daily. Group 4 was orally administered 100 mg/kg of dandelion powder in 0.5 ml of DW daily. Group 5 was orally treated with allopurinol.
After 12 days, the rats were euthanized using chloroform inhalation, and their sera were collected directly from the heart for biochemical analysis of serum UA, urinary uric acid (UUA), as well as other liver and renal biochemical parameters.
Results. The study revealed that hyperuricemic rats treated with the dandelion solution experienced a significant decrease in blood UA levels and a significant increase in UUA levels. Dandelion treatment also influenced xanthine oxidase activity, with no significant differences observed in liver and kidney functions.
Conclusion. Based on the findings of this study, it can be concluded that dandelion extract significantly reduces UA levels through uricosuric activity and demonstrates significant XO inhibitory effects.
{"title":"Uricosuric effect of dandelion root extract on oxonate-induced hyperuricemia in rats","authors":"Khairullah M. Khallawi, Basim J. Hameed, Nadheerah F. Neamah","doi":"10.31450/ukrjnd.3(79).2023.03","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.03","url":null,"abstract":"This research aimed to investigate the uricosuric effect of dandelion plant extracts in hyperuricemic rats induced by potassium oxonate (PO).
 Methods. Hyperuricemia was induced in rats using PO, and dandelion root extracts were administered to observe their impact on uric acid (UA) levels. The study involved adult male Swiss rats weighing approximately 150–180 grams, randomly divided into five groups (n = 6). Group 1 served as the normal control group with no treatment. Group 2 received PO only. Group 3 received oral administration of 50 mg/kg of dandelion extract in 0.5 ml of distilled water (DW) daily. Group 4 was orally administered 100 mg/kg of dandelion powder in 0.5 ml of DW daily. Group 5 was orally treated with allopurinol.
 After 12 days, the rats were euthanized using chloroform inhalation, and their sera were collected directly from the heart for biochemical analysis of serum UA, urinary uric acid (UUA), as well as other liver and renal biochemical parameters.
 Results. The study revealed that hyperuricemic rats treated with the dandelion solution experienced a significant decrease in blood UA levels and a significant increase in UUA levels. Dandelion treatment also influenced xanthine oxidase activity, with no significant differences observed in liver and kidney functions.
 Conclusion. Based on the findings of this study, it can be concluded that dandelion extract significantly reduces UA levels through uricosuric activity and demonstrates significant XO inhibitory effects.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136083966","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 : 2023-07-27DOI: 10.31450/ukrjnd.3(79).2023.09
S. P. Fomina, N. V. Reshetylo
The Immunization Schedule with additional vaccinations against certain infections is recognized as an effective strategy for preventing complications in children with Chronic Kidney Disease (CKD). The aim of this study is to highlight international experience regarding the immunization status of such patients in order to optimize the vaccinations process in Ukraine.
The current Immunization Schedule for pediatric CKD, approved in international practice, is presented and has been compared to the national one. The approaches to the use of live and inactivated vaccines, to the immunization of persons on immunosuppressive therapy and the additional protective measures are clearly outlined. The international experience in the major vaccine-controlled disease prevention in children with CKD includes routine immunization (tuberculosis, hepatitis B, diphtheria, whooping cough, tetanus, poliomyelitis, measles, mumps, rubella, hemophilic infection), additional vaccination of immunocompromised hosts (influenza, pneumococcal infection, chicken pox) and in groups with risk factors (meningococcal, papillomavirus, rotavirus infections, hepatitis A, etc.) are summarized. It is emphasized that the optimal window of opportunity for vaccinations is the early stages of CKD or at least the pre-transplant time. The key principles of vaccine control prior and after kidney transplantation have been given.
Increasing knowledge on protection from vaccine-controlled infections involved in children with CKD, including at the immunosuppressive therapy stage and kidney replacement therapy, makes implementation of current recommendations easier and advances the prevention strategy for this sensitive cohort. The process of harmonization of national recommendations on the vaccine status formation in this group of patients based on international experience and Ukrainian capabilities is proposed to initiate.
{"title":"Chronic kidney disease in children: Vaccination – strategy, current recommendations and potentialities","authors":"S. P. Fomina, N. V. Reshetylo","doi":"10.31450/ukrjnd.3(79).2023.09","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.09","url":null,"abstract":"The Immunization Schedule with additional vaccinations against certain infections is recognized as an effective strategy for preventing complications in children with Chronic Kidney Disease (CKD). The aim of this study is to highlight international experience regarding the immunization status of such patients in order to optimize the vaccinations process in Ukraine.
 The current Immunization Schedule for pediatric CKD, approved in international practice, is presented and has been compared to the national one. The approaches to the use of live and inactivated vaccines, to the immunization of persons on immunosuppressive therapy and the additional protective measures are clearly outlined. The international experience in the major vaccine-controlled disease prevention in children with CKD includes routine immunization (tuberculosis, hepatitis B, diphtheria, whooping cough, tetanus, poliomyelitis, measles, mumps, rubella, hemophilic infection), additional vaccination of immunocompromised hosts (influenza, pneumococcal infection, chicken pox) and in groups with risk factors (meningococcal, papillomavirus, rotavirus infections, hepatitis A, etc.) are summarized. It is emphasized that the optimal window of opportunity for vaccinations is the early stages of CKD or at least the pre-transplant time. The key principles of vaccine control prior and after kidney transplantation have been given.
 Increasing knowledge on protection from vaccine-controlled infections involved in children with CKD, including at the immunosuppressive therapy stage and kidney replacement therapy, makes implementation of current recommendations easier and advances the prevention strategy for this sensitive cohort. The process of harmonization of national recommendations on the vaccine status formation in this group of patients based on international experience and Ukrainian capabilities is proposed to initiate.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135755968","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 : 2023-06-29DOI: 10.31450/ukrjnd.3(79).2023.07
A. Nesen, P. Semenovykh, V. Galchiskaya, Yu. Yakymenko, V. Chernyshov
The present study aimed to evaluate the effect of sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin therapy on the prooxidant-antioxidant balance (PAB) in patients with diabetic kidney disease.
Methods. A total of 88 patients with type 2 diabetes mellitus (DM) and diabetic nephropathy (DN) were included in this single-center randomized open-label prospective study. All patients were randomly divided into 2 groups: 45 patients received a standard course of treatment, which included antidiabetic drugs, renin-angiotensin-aldosterone system blockers, and HMG-CoA reductase inhibitors (statins). In addition to the standard therapy, the remaining 43 patients were prescribed the SGLT2 inhibitor dapagliflozin 10 mg per day. Patients were re-examined after 6 months of treatment. The blood PAB was calculated as the ratio of total hydroperoxides (THP) to total antioxidant activity (TAA). The level of THP and TAA was determined by the colorimetric method.
Results. PAB was significantly elevated in type 2 DM patients with nephropathy due to TAA decrease and THP level increase when compared to the control group. The highest values of PAB were found in the late stages of DN in patients with glomerular filtration rates <60 ml/min/1.73m2. In patients who received dapagliflozin, significant PAB elevation by 30,55% (р < 0.05) was observed as well as THP decrease and TAA increase in blood. In the standard therapy group, no significant changes in PAB parameters were detected.
Conclusions. Add-on treatment with dapagliflozin resulted in a more significant improvement of the PAB in patients with DN in comparison with standard treatment.
{"title":"Correction of the prooxidant-antioxidant balance disorders in patients with diabetic kidney disease","authors":"A. Nesen, P. Semenovykh, V. Galchiskaya, Yu. Yakymenko, V. Chernyshov","doi":"10.31450/ukrjnd.3(79).2023.07","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.07","url":null,"abstract":"The present study aimed to evaluate the effect of sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin therapy on the prooxidant-antioxidant balance (PAB) in patients with diabetic kidney disease.
 Methods. A total of 88 patients with type 2 diabetes mellitus (DM) and diabetic nephropathy (DN) were included in this single-center randomized open-label prospective study. All patients were randomly divided into 2 groups: 45 patients received a standard course of treatment, which included antidiabetic drugs, renin-angiotensin-aldosterone system blockers, and HMG-CoA reductase inhibitors (statins). In addition to the standard therapy, the remaining 43 patients were prescribed the SGLT2 inhibitor dapagliflozin 10 mg per day. Patients were re-examined after 6 months of treatment. The blood PAB was calculated as the ratio of total hydroperoxides (THP) to total antioxidant activity (TAA). The level of THP and TAA was determined by the colorimetric method.
 Results. PAB was significantly elevated in type 2 DM patients with nephropathy due to TAA decrease and THP level increase when compared to the control group. The highest values of PAB were found in the late stages of DN in patients with glomerular filtration rates <60 ml/min/1.73m2. In patients who received dapagliflozin, significant PAB elevation by 30,55% (р < 0.05) was observed as well as THP decrease and TAA increase in blood. In the standard therapy group, no significant changes in PAB parameters were detected.
 Conclusions. Add-on treatment with dapagliflozin resulted in a more significant improvement of the PAB in patients with DN in comparison with standard treatment.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135155553","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 : 2023-06-28DOI: 10.31450/ukrjnd.3(79).2023.02
L. Surzhko, V. Nepomnyashchy
Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a group of rare uncommon genetic disorders characterized by tubular damage and interstitial fibrosis in the absence of glomerular lesions. It has autosomal dominant inheritance and inevitable progression to end-stage kidney disease (ESKD). In nephrological practice, we usually face glomerular diseases that have well-recognized symptoms. Therefore, when we see a patient with impaired kidney function but without any signs of glomerular disease, it is always more challenging to discover the reason for it. The present case illustrates tubulointerstitial lesions due to possible genetic reasons. A 38-year-old non-hypertensive female presented with impaired renal function, a family history of CKD, proteinuria 0,5 g/day, and urinary sediment unremarkable. Relying on her family history, the middle age of onset, the progression to the end-stage kidney disease, and laboratory and histological results, an autosomal dominant tubulointerstitial kidney disease was suspected. Initially, diagnosed tubulointerstitial kidney disease is likely to be secondary to a mutation in genes encoding mucin-1. Pathology findings in this case played a pivotal role in establishing the diagnosis. However, it still needs to be proven by genetic tests. The purpose of this manuscript was to summarize the case of ADTKD, discuss the challenges in diagnosing ADTKD without genetic testing, and emphasize the importance of genetic testing in confirming the diagnosis.
{"title":"Autosomal dominant tubulointerstitial kidney disease: Diagnostic challenges in the absence of genetic testing. A case report","authors":"L. Surzhko, V. Nepomnyashchy","doi":"10.31450/ukrjnd.3(79).2023.02","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.02","url":null,"abstract":"Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a group of rare uncommon genetic disorders characterized by tubular damage and interstitial fibrosis in the absence of glomerular lesions. It has autosomal dominant inheritance and inevitable progression to end-stage kidney disease (ESKD). In nephrological practice, we usually face glomerular diseases that have well-recognized symptoms. Therefore, when we see a patient with impaired kidney function but without any signs of glomerular disease, it is always more challenging to discover the reason for it. The present case illustrates tubulointerstitial lesions due to possible genetic reasons. A 38-year-old non-hypertensive female presented with impaired renal function, a family history of CKD, proteinuria 0,5 g/day, and urinary sediment unremarkable. Relying on her family history, the middle age of onset, the progression to the end-stage kidney disease, and laboratory and histological results, an autosomal dominant tubulointerstitial kidney disease was suspected. Initially, diagnosed tubulointerstitial kidney disease is likely to be secondary to a mutation in genes encoding mucin-1. Pathology findings in this case played a pivotal role in establishing the diagnosis. However, it still needs to be proven by genetic tests. The purpose of this manuscript was to summarize the case of ADTKD, discuss the challenges in diagnosing ADTKD without genetic testing, and emphasize the importance of genetic testing in confirming the diagnosis.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135360018","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 : 2023-06-19DOI: 10.31450/ukrjnd.3(79).2023.10
M. Kolesnyk
Acute kidney injury (AKI) is a common complication of cancer, occurring in up to 50% of neoplastic patients during the natural course of their disease. Furthermore, it has a significant impact on key outcomes, such as overall prognosis, length of hospitalization, and costs. AKI in cancer patients has various causes, including patient-related, tumor-related, or treatment-related factors.
Patient-related risk factors for AKI are similar to those in the general population. Tumor-related risk factors can involve compression, obstruction, direct kidney infiltration by the tumor, as well as precipitation, aggregation, crystallization, or misfolding of paraproteins in conditions like multiple myeloma. Treatment-related risk factors are the most commonly observed in clinical practice and can present as features of tumor lysis syndrome or, for example, immune checkpoint inhibitor-related AKI.
In the absence of validated biomarkers for AKI, a multidisciplinary clinical approach involving oncologists, intensivists, nephrologists, or onconephrologists is essential. This approach incorporates thorough assessment, the use of appropriate preventive measures, and early intervention to reduce the incidence of AKI in cancer patients. Understanding the essence of preventive measures, timely initiation of treatment, and knowing when to terminate treatment will reduce the frequency of this life-threatening condition and improve the effectiveness of cancer treatment and the quality of life and life expectancy of cancer patients.
This work aims to improve physicians' awareness of the latest data on the prevention, diagnosis, and treatment of AKI specifically related to oncopathology, tumor lysis syndrome, and acute kidney injury induced by cancer immunotherapy drugs.
{"title":"Onconephrology: Acute kidney injury in cancer patients","authors":"M. Kolesnyk","doi":"10.31450/ukrjnd.3(79).2023.10","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.10","url":null,"abstract":"Acute kidney injury (AKI) is a common complication of cancer, occurring in up to 50% of neoplastic patients during the natural course of their disease. Furthermore, it has a significant impact on key outcomes, such as overall prognosis, length of hospitalization, and costs. AKI in cancer patients has various causes, including patient-related, tumor-related, or treatment-related factors.
 Patient-related risk factors for AKI are similar to those in the general population. Tumor-related risk factors can involve compression, obstruction, direct kidney infiltration by the tumor, as well as precipitation, aggregation, crystallization, or misfolding of paraproteins in conditions like multiple myeloma. Treatment-related risk factors are the most commonly observed in clinical practice and can present as features of tumor lysis syndrome or, for example, immune checkpoint inhibitor-related AKI.
 In the absence of validated biomarkers for AKI, a multidisciplinary clinical approach involving oncologists, intensivists, nephrologists, or onconephrologists is essential. This approach incorporates thorough assessment, the use of appropriate preventive measures, and early intervention to reduce the incidence of AKI in cancer patients. Understanding the essence of preventive measures, timely initiation of treatment, and knowing when to terminate treatment will reduce the frequency of this life-threatening condition and improve the effectiveness of cancer treatment and the quality of life and life expectancy of cancer patients.
 This work aims to improve physicians' awareness of the latest data on the prevention, diagnosis, and treatment of AKI specifically related to oncopathology, tumor lysis syndrome, and acute kidney injury induced by cancer immunotherapy drugs.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135420104","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 : 2023-05-20DOI: 10.31450/ukrjnd.2(78).2023.07
N. Stepanova, V. Driianska, L. Korol, L. Snisar, S. Savchenko
Patients undergoing hemodialysis (HD) are at increased risk of severe complications from COVID-19 due to compromised immune function and comorbidities. This retrospective study aimed to investigate the association between pre-existing serum indoxyl sulfate (IS) concentrations and COVID-19 outcomes in HD patients.
Methods. Data on pre-existing IS and proinflammatory cytokines, such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-alpha (TNF-α) were extracted from an existing patient database. The patients were followed up for 1.5 years and compared according to median serum IS concentration: low-IS (< 22.2 μg/mL) and high-IS (≥22.2 μg/mL) groups. The primary outcomes focused on assessing the risk and severity of COVID-19 infection.
Results. A total of 56 patients aged 62 (56-67) years with a dialysis vintage of 37.5 (30-168) months were included in the analysis. Serum levels of IS were significantly correlated with Kt/V values (p = 0.043), arterial hypertension (p = 0.001), IL-6 (p = 0.023), MCP-1 (p = 0.023), and TNF-α (p = 0.033) concentrations. Elevated serum IS levels were significantly associated with an increased risk of COVID-19 infection (p < 0.0001) and a higher likelihood of hospitalization (p = 0.03). Patients with higher IS levels exhibited more severe lung involvement (p < 0.0001) and a greater need for respiratory support (p = 0.004). A serum IS concentration of 21.5 μg/mL was the optimal threshold for predicting COVID-19 infection in HD patients (sensitivity of 83.4% and specificity of 92.3%, p < 0.0001).
Conclusion: Our study highlights the detrimental impact of serum IS on COVID-19 infection and its clinical outcomes in patients undergoing HD. Further research is warranted to elucidate the underlying mechanisms and explore potential therapeutic strategies targeting IS in this population.
{"title":"Pre-existing serum indoxyl sulfate and COVID-19 outcomes in patients undergoing hemodialysis: A retrospective cohort study","authors":"N. Stepanova, V. Driianska, L. Korol, L. Snisar, S. Savchenko","doi":"10.31450/ukrjnd.2(78).2023.07","DOIUrl":"https://doi.org/10.31450/ukrjnd.2(78).2023.07","url":null,"abstract":"Patients undergoing hemodialysis (HD) are at increased risk of severe complications from COVID-19 due to compromised immune function and comorbidities. This retrospective study aimed to investigate the association between pre-existing serum indoxyl sulfate (IS) concentrations and COVID-19 outcomes in HD patients.
 Methods. Data on pre-existing IS and proinflammatory cytokines, such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-alpha (TNF-α) were extracted from an existing patient database. The patients were followed up for 1.5 years and compared according to median serum IS concentration: low-IS (< 22.2 μg/mL) and high-IS (≥22.2 μg/mL) groups. The primary outcomes focused on assessing the risk and severity of COVID-19 infection.
 Results. A total of 56 patients aged 62 (56-67) years with a dialysis vintage of 37.5 (30-168) months were included in the analysis. Serum levels of IS were significantly correlated with Kt/V values (p = 0.043), arterial hypertension (p = 0.001), IL-6 (p = 0.023), MCP-1 (p = 0.023), and TNF-α (p = 0.033) concentrations. Elevated serum IS levels were significantly associated with an increased risk of COVID-19 infection (p < 0.0001) and a higher likelihood of hospitalization (p = 0.03). Patients with higher IS levels exhibited more severe lung involvement (p < 0.0001) and a greater need for respiratory support (p = 0.004). A serum IS concentration of 21.5 μg/mL was the optimal threshold for predicting COVID-19 infection in HD patients (sensitivity of 83.4% and specificity of 92.3%, p < 0.0001).
 Conclusion: Our study highlights the detrimental impact of serum IS on COVID-19 infection and its clinical outcomes in patients undergoing HD. Further research is warranted to elucidate the underlying mechanisms and explore potential therapeutic strategies targeting IS in this population.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135543621","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 : 2023-03-31DOI: 10.31450/ukrjnd.3(79).2023.06
Ergün Parmaksız, Elif Torun Parmaksız
Low sleep quality is a prevalent health issue among patients undergoing kidney replacement therapy. Our objective was to assess and compare sleep quality between patients undergoing hemodialysis (HD) and kidney transplant recipients.
Methods. This observational, cross-sectional study recorded socio-demographic data and medical histories. The study comprised two groups: patients undergoing HD for at least one year and kidney transplant recipients with a successful renal transplant over six months. Each participant completed the Pittsburgh Sleep Quality Index (PSQI).
Results. The study encompassed 56 HD patients and 35 age and gender-matched renal transplant recipients. The mean age of the entire study population was 47.97±12.92 years (ranging from 23 to 77), with 49 (53.8%) being males. PSQI scores were ≥5 in 57 patients, including 21 transplant recipients and 36 undergoing HD patients. PSQI results exhibited no significant difference between the transplant and HD groups. The mean sleep quality score was 5.69±2.95 in the transplant group and 5.72±3.29 in the HD group, with no statistically significant difference.
Conclusions. PSQI scores were similar in patients undergoing HD and transplant recipients with well-preserved renal functions. Identifying low sleep quality is essential for enhancing the overall quality of life.
{"title":"Comparison of sleep quality in patients undergoing hemodialysis and renal transplant recipients","authors":"Ergün Parmaksız, Elif Torun Parmaksız","doi":"10.31450/ukrjnd.3(79).2023.06","DOIUrl":"https://doi.org/10.31450/ukrjnd.3(79).2023.06","url":null,"abstract":"Low sleep quality is a prevalent health issue among patients undergoing kidney replacement therapy. Our objective was to assess and compare sleep quality between patients undergoing hemodialysis (HD) and kidney transplant recipients.
 Methods. This observational, cross-sectional study recorded socio-demographic data and medical histories. The study comprised two groups: patients undergoing HD for at least one year and kidney transplant recipients with a successful renal transplant over six months. Each participant completed the Pittsburgh Sleep Quality Index (PSQI).
 Results. The study encompassed 56 HD patients and 35 age and gender-matched renal transplant recipients. The mean age of the entire study population was 47.97±12.92 years (ranging from 23 to 77), with 49 (53.8%) being males. PSQI scores were ≥5 in 57 patients, including 21 transplant recipients and 36 undergoing HD patients. PSQI results exhibited no significant difference between the transplant and HD groups. The mean sleep quality score was 5.69±2.95 in the transplant group and 5.72±3.29 in the HD group, with no statistically significant difference.
 Conclusions. PSQI scores were similar in patients undergoing HD and transplant recipients with well-preserved renal functions. Identifying low sleep quality is essential for enhancing the overall quality of life.","PeriodicalId":32650,"journal":{"name":"Ukrayins''kii Zhurnal Nefrologiyi ta Dializu","volume":"439 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135951268","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 : 2023-02-21DOI: 10.31450/ukrjnd.2(78).2023.02
Tetyana I. Yarmola, Olga O. Gutsalenko, Ivan P. Katerenchuk, Lidiya A. Tkachenko, Yulia А. Kostrikova, Viktoriia V. Talash
Microscopic polyangiitis (MPA) is one of the three clinical phenotypes of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA). Although MPA is considered a rare form of ANCA-associated vasculitis (AAV), clinical evidence shows that it is fairly common among nephrologists, as it manifests as a systemic, weak-immune vasculitis affecting glomerular capillaries, resulting in necrotizing glomerulonephritis (GN) diagnosed in nearly 100% of MPA patients. The issue of AAV in general, and MPA specifically, has gained significant importance in the context of the ongoing SARS-CoV-2 coronavirus pandemic, as both conditions share common anatomical sites of infection and inflammation. This study presents three new cases of MPA in post-COVID-19 patients. The analysis and presentation encompassed demographic data, patient history regarding comorbidities, details of follow-up care, chronology with COVID-19, and laboratory findings at the time of MPA diagnosis. A comparative analysis of the chronological progression of MPA in the documented clinical cases reveals the polymorphic nature of early-stage clinical manifestations, as well as diverse patterns of disease progression in the advanced stage. Additionally, we provide a brief literature review on diagnostic challenges, pathogenetic mechanisms underlying the relationship between SARS-CoV-2 and AAV, and peculiarities of clinical presentations in early and advanced stages of MPA.
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