Nephrology and Dialysis最新文献

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Nephropathy associated with the E3/E4 allelic variant of the APOE gene. Case 2 肾病与APOE基因的E3/E4等位变异相关。案例2

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-4-895-897

O. Vorobyeva, T. E. Nichik, S. I. Popova

引用次数: 0

The modern concept of etiology, pathogenesis, the role of anticytokine therapy and methods of extracorporeal treatment for new coronavirus infection (SARS-CoV-2). Review 介绍新型冠状病毒感染(SARS-CoV-2)的病因、发病机制、抗细胞因子治疗的作用及体外治疗方法。审查

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-292-300

S. Masolitin, T.G. Kim, A.V. Yaralian, E. Y. Kalinin, D. V. Losev

"The review highlights the relevance and significance of the new coronavirus infection, characterizes the virus, the route of invasion, and organ damage. The attention is focused on the risk factors of viral invasion, and the premorbid background of patients. Special attention is paid to the virus interaction with the ACE-2 receptors and the role of the latter in multiorgan dysfunction. The role of the immune system in the antiviral response is covered. We also considered independent predictors of death in new coronavirus infection. The mechanisms of lung damage in COVID-19 are reviewed with particular attention to the pathophysiological mechanism of the synthesis of pro-inflammatory cytokines and the role of the latter in organ dysfunction. A definition of the ""cytokine storm"" that is usually understood as an overactive immune response with the release of a large number of interferons, interleukins, chemokines, and other mediators is given. The review highlights the most significant and currently known pathogenetic chains of cytokine production. Among them are proinflammatory cytokines, the most significant are Il-1, Il-6, TNF. High cytokine levels are associated with poor outcomes. Special attention is paid to the feasibility and role of anti-cytokine therapy with drugs tocilizumab and sarilumab. It has been noted that treatment aimed at the pathogenetic mechanisms of the development of the ""cytokine storm"" by antagonists of the Il-6 receptor can interrupt this life-threatening inflammatory response and, consequently, multiorgan dysfunction. The main pathogenetic pathways and risk factors for the development of acute kidney injury (Acute Kidney Injury – AKI) in SARS-CoV-2 have been analyzed. The use of extracorporeal treatment methods, possibly the main methods of combating the massive release of the pool of medium-molecular compounds during the development of a ""cytokine storm"" are reviewed. It is noted that along with anti-cytokine therapy, extracorporeal methods can effectively reduce the level of proinflammatory cytokines and prevent multiple organ damage. The main issues of expediency, role and place of application of various extracorporeal methods in complex intensive care for new coronavirus infection (SARS-CoV-2) are highlighted. © 2022 JSC Vidal Rus. All rights reserved."

该综述强调了新型冠状病毒感染的相关性和重要性，描述了病毒的特征、入侵途径和器官损伤。关注的重点是病毒入侵的危险因素，以及患者的发病前背景。特别关注病毒与ACE-2受体的相互作用以及后者在多器官功能障碍中的作用。涵盖了免疫系统在抗病毒反应中的作用。我们还考虑了新型冠状病毒感染中死亡的独立预测因素。本文综述了新冠肺炎肺损伤机制，重点关注促炎细胞因子合成的病理生理机制及其在器官功能障碍中的作用。“细胞因子风暴”通常被理解为一种过度活跃的免疫反应，释放大量干扰素、白细胞介素、趋化因子和其他介质。这篇综述强调了目前已知的最重要的细胞因子产生的致病链。其中促炎因子以Il-1、Il-6、TNF最为显著。高细胞因子水平与不良预后相关。本文特别关注tocilizumab和sarilumab抗细胞因子治疗的可行性和作用。已经注意到，针对Il-6受体拮抗剂产生的“细胞因子风暴”的发病机制的治疗可以中断这种危及生命的炎症反应，从而导致多器官功能障碍。分析了SARS-CoV-2急性肾损伤(acute kidney injury - AKI)发生的主要发病途径和危险因素。本文综述了体外治疗方法的使用，可能是对抗“细胞因子风暴”发展过程中大量释放中分子化合物池的主要方法。值得注意的是，与抗细胞因子治疗一起，体外方法可以有效降低促炎细胞因子水平，防止多器官损伤。重点介绍了各种体外方法在新型冠状病毒感染(SARS-CoV-2)复杂重症监护中的便利性、作用和应用地位等主要问题。©2022 JSC Vidal Rus。版权所有。”

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引用次数: 0

COVID-19 and virus-associated skin diseases in patients after kidney transplantation 肾移植术后患者的COVID-19和病毒相关性皮肤病

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-322-328

I. Dymkov, A. Perlina, I.V. Terentiev, E. Prokopenko, P. Kulikov, D. Perlin

Background: COVID-19 in solid organ transplant recipients is usually characterized by a more severe disease course and is often associated with life-threatening complications. Identification of additional factors that may affect the risk and severity of the new coronavirus infection could have a significant impact on choosing a management strategy for renal graft recipients. Aim: to evaluate the possibility of cross-immunity between skin manifestations of viral etiology and COVID-19. Materials and methods: from May 2020 to February 2021 we examined 180 renal graft recipients with a history of transplantation from 2 months to 26.5 years. All patients were categorized into two groups: group I, those who had confirmed moderate or severe COVID-19 disease, and group II, and those without any history of clinical manifestations of the new coronavirus infection (including those with potentially asymptomatic disease). During the study period which lasted for 71 months on average (range, 2 to 318 months), laboratory workup was performed on all patients (on average, twice): dermatological examination and detection of serum antibodies to herpes simplex virus 1, 2, cytomegalovirus, Epstein-Barr virus, COVID-19. Results: in recipients with HPV-associated skin manifestations, the incidence of COVID-19 was significantly lower than in recipients who did not have them: – 30.4% and 50%, respectively, p=0.011. The incidence of new coronavirus infection did not differ in the groups of patients with cutaneous manifestations caused by herpes simplex viruses type 1 and 2 and without them. Among recipients with Epstein-Barr virus seropositivity, there were significantly fewer cases of COVID-19 compared to seronegative patients – 26.2% and 54.8%, respectively, p=0.0002. Conclusion: HPV-associated dermal manifestations of serum EBV-seropositivity in recipients after kidney transplantation is associated with a lower incidence of moderate and severe COVID-19. Further studies are needed to confirm the possibility of cross-immunity against COVID-19 with other infections. © 2022 JSC Vidal Rus. All rights reserved.

背景:实体器官移植受者的COVID-19通常以更严重的病程为特征，并常伴有危及生命的并发症。确定可能影响新型冠状病毒感染风险和严重程度的其他因素可能对肾移植受者选择管理策略产生重大影响。目的:探讨病毒病原学皮肤表现与COVID-19交叉免疫的可能性。材料和方法:从2020年5月到2021年2月，我们检查了180例移植史从2个月到26.5年的肾移植受者。将所有患者分为两组:ⅰ组为确诊中、重度新冠肺炎患者，ⅱ组为无新冠肺炎感染临床表现史患者(包括潜在无症状患者)。在平均71个月(2 ~ 318个月)的研究期间，对所有患者进行了实验室检查(平均2次):皮肤检查和单纯疱疹病毒1、2、巨细胞病毒、eb病毒、COVID-19的血清抗体检测。结果:在有hpv相关皮肤表现的受者中，COVID-19的发病率显著低于无hpv相关皮肤表现的受者:分别为- 30.4%和50%，p=0.011。单纯疱疹病毒1型和2型引起皮肤表现的患者与无皮肤表现的患者之间新型冠状病毒感染的发生率无差异。在eb病毒血清阳性的患者中，COVID-19病例明显少于血清阴性患者，分别为26.2%和54.8%，p=0.0002。结论:肾移植术后受者血清ebv血清阳性的hpv相关皮肤表现与中重度COVID-19发病率较低相关。需要进一步的研究来证实COVID-19与其他感染交叉免疫的可能性。©2022 JSC Vidal Rus。版权所有。

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引用次数: 0

Abstracts of the Young nephrologist's competition, XVII Conference of Russian Dialysis Society 俄罗斯透析学会第十七届青年肾病专家竞赛摘要

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-388-402

引用次数: 0

Predictive biomarkers in elderly patients with chronic cardiorenal syndrome 老年慢性心肾综合征患者的预测性生物标志物

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-357-365

E. Efremova, A. Shutov

引用次数: 1

Stone formation on the ureteral stent during pregnancy 妊娠期间输尿管支架上的结石形成

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-374-376

N. Bychkova, E. Prokopenko, I. Nikolskaya

引用次数: 0

Features of the course and diagnosis of lupus podocytopathy 狼疮足细胞病的病程特点及诊断

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-4-898-906

D.V. Starikov, N. Kozlovskaya, E. Stolyarevich, T. Bondarenko, O. Volkova

引用次数: 0

The management of medical care with dialysis methods in outpatients during the COVID-19 pandemic COVID-19大流行期间门诊透析医疗管理

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-301-321

A. Ilyin, K. Gurevich, A.Yu. Denisov, E. Shilov, M. Shilova, N.A. Brygina, O.A. Kodyusheva

Introduction: The COVID-19 pandemic has changed the health care system for patients with CKD5. Dialysis patients are at particularly high risk of COVID-19, severe infection, and poor outcomes. Materials and methods: In 2020, in 86 FME RF clinics, 11 331 patients (54.1% – men) received dialysis treatment, 21.8% had DM, 10 717 patients were treated with HD and HDF methods, 614 patients were on PD, and 2854 employees provided medical care. The data were collected using the EuCliD database and statistically processed online at sites https://molbiol.kirov.ru and https://medstatistic.ru. Results: COVID-19 is more often detected in men, patients 40 to 79 y.o., in patients with DM. The rate of sick patients <50 y.o. (31.2% of all treated) was 22.8% of all infected and in the group>50 y.o. (68.8% of all treated), the rate of patients was 77.2%. There were no significant differences between the incidence of COVID-19 infection in groups ≥50 and <60 y.o., ≥60 and <70 y.o., ≥70 and <80 y.o., ≥80 y.o. COVID-19 positive patients (on HD and PD) who died in 2020 – 324 people, were 2.9% of all treated in 2020 and 31.6% of all infected dialysis patients. In FME RF clinics 18.6% and 18.4% of all patients in the RF were treated by HD and PD respectively, but the proportion of mortality from COVID-19 in FME RF clinics was 10.5% at HD and 11.0% at PD respectively. In dialysis centers, FME RF patients with COVID-19 on HD were 2.2 times less than in the dialysis population of RF as a whole (p<0.001), and on PD – 1.98 times less than in RF (p<0.001). In RF patients with COVID-19 on PD and HD, it was found that the mortality rate was significantly lower in patients on PD vs HD (p<0.001). There was no significant effect on the outcomes in COVID-19 patients depending on the method of treatment in FME RF clinics (p=0.349). Conclusion: Patients on dialysis are at greater risk of COVID-19 and fatal outcomes. The administrative, organizational, and medical work of FME RF led to positive results both in the prevention of infection and in treatment outcomes. © 2022 JSC Vidal Rus. All rights reserved.

COVID-19大流行改变了CKD5患者的医疗保健系统。透析患者感染COVID-19、严重感染和预后不良的风险特别高。材料与方法:2020年，在86家FME RF诊所中，接受透析治疗的患者11331例(男性占54.1%)，糖尿病患者占21.8%，HD和HDF治疗的患者为10717例，PD治疗的患者为614例，2854名员工提供了医疗服务。数据使用EuCliD数据库收集，并在https://molbiol.kirov.ru和https://medstatistic.ru网站上进行在线统计处理。结果:新型冠状病毒肺炎多见于男性，40 ~ 79岁的患者多见于糖尿病患者。50岁的患者患病率(占所有治疗患者的68.8%)，患者患病率为77.2%。≥50岁和<60岁组、≥60岁和<70岁组、≥70岁和<80岁组、≥80岁组的COVID-19感染发生率无显著差异。2020年死亡的COVID-19阳性患者(HD和PD)为324人，占2020年所有治疗患者的2.9%，占所有感染透析患者的31.6%。在FME RF诊所中，接受HD和PD治疗的患者分别占所有RF患者的18.6%和18.4%，但FME RF诊所中COVID-19死亡率在HD和PD中的比例分别为10.5%和11.0%。在透析中心，FME RF中患有COVID-19的HD患者比整个RF透析人群少2.2倍(p<0.001)， PD患者比RF少1.98倍(p<0.001)。在患有PD和HD的RF患者中，发现PD患者的死亡率明显低于HD患者(p<0.001)。FME - RF门诊不同治疗方法对COVID-19患者预后无显著影响(p=0.349)。结论:透析患者感染COVID-19和死亡的风险更高。FME RF的管理、组织和医疗工作在预防感染和治疗结果方面都取得了积极成果。©2022 JSC Vidal Rus。版权所有。

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引用次数: 0

Using the modified Charlson comorbidity index to predict the risk of death in elderly and senile patients with chronic kidney disease 应用改良Charlson合并症指数预测老年及老年慢性肾病患者的死亡风险

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-2-349-356

E. Efremova, A. Shutov, I. M. Efremov, V. Midlenko

引用次数: 1

Mineral-bone disorders and extra-bone calcification in a patient on maintenance hemodialysis 维持性血液透析患者的骨矿物质紊乱和骨外钙化

Nephrology and Dialysis

Pub Date : 2022-01-01 DOI: 10.28996/2618-9801-2022-3-506-509

O. Manchenko, N. Belavina, A. Zhdanova, G. Volgina, E. Zeltyn-Abramov

引用次数: 0

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