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Ukrainian Journal of Nephrology and Dialysis
Number of Followers: 1

This is an Open Access Journal

Open Access journal
ISSN (Print) 2304-0238 - ISSN (Online) 2616-7352
Published by Institute of Nephrology NAMS of Ukraine

[1 journal]

Management of chronic kidney disease patients during the COVID-19
pandemic: Adapted clinical guidelines of the Ukrainian Association of
Nephrologists and Kidney Transplant Specialists
- Authors: M. Kolesnyk, N. Stepanova, I. Dudar, E. Krasyuk, L. Liksunova, L. Snisar
  Pages: 4 - 9
  Abstract: During the global COVID-19 pandemic, there was an urgent need to make complex clinical decisions about the management of chronic kidney disease (CKD)patients. Since a significant number of CKD patients have impaired renal function or receive immunosuppressive (IS) therapy, they belong to a high-risk group for adverse effects of COVID-19 infection. In addition, the overwhelming majority of CKD patients have co-morbidities, which not only increases the risk of SARS-CoV-2 infection, but also the formation of life-threatening complications of COVID-19. Currently, there are no data on the best practices for the management of CKD patients during the COVID-19 pandemic. However, based on the existing research presented by leading renal associations (ERA-EDTA, Kidney Care UK, The Renal Association), NICE Rapid Guidelines on this topic, and our own experience, the expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the Adapted Clinical Recommendations for the Management Of Patients with CKD stages 1-4 during the COVID-19 pandemic. The proposed clinical guidelines aimed to classify all CKD patients at risk for SARS-CoV-2 infection and hospitalization. The key characteristics of each class of kidney disease are the kidney functional level, determined by the glomerular filtration rate (GFR), daily urinary protein excretion, hypertension, medication intake and other additional characteristics. All of the following clinical guidelines have a level of evidence of 2C.
  PubDate: 2020-08-20
  DOI: 10.31450/ukrjnd.3(67).2020.01
Management of hemodialysis facilities and services during the COVID-19
pandemic: Adapted clinical guidelines of the Ukrainian Association of
Nephrologists and Kidney Transplant Specialists
- Authors: M. Kolesnyk, N. Stepanova, I. Dudar, E. Krasyuk, L. Liksunova, L. Snisar, T. Moroz
  Pages: 10 - 14
  Abstract: The global COVID-19 pandemic is a critical time for hemodialysis patients as hypertension, diabetes or other co-morbidities, as well as hemostasis disorders, are risk factors for adult distress syndrome, the formation of which significantly worsens the prognosis. Several national associations of nephrologists have created expert working groups to prepare constantly updated clinical guidelines for the management of dialysis patients in the context of the COVID-19 pandemic. According to the experts, to minimize COVID-19 infection of patients and health care workers, the medical staff of dialysis units should undergo training and further retraining, following changes in constantly updated practical recommendations. The expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has also created the Adapted Clinical Guidelines for the Management of Hemodialysis Facilities and Services During the COVID-19 pandemic. All of the following clinical guidelines have a level of evidence of 2C.
  PubDate: 2020-08-20
  DOI: 10.31450/ukrjnd.3(67).2020.02
Management of peritoneal dialysis facilities and services during the
COVID-19 pandemic: Adapted clinical guidelines of the Ukrainian
Association of Nephrologists and Kidney Transplant Specialists
- Authors: M. Kolesnyk, N. Stepanova, I. Dudar, E. Krasyuk, L. Liksunova, L. Snisar
  Pages: 15 - 19
  Abstract: In Ukraine, about 12% of end-stage renal disease patients are treated by peritoneal dialysis (PD). In contrast to the hemodialysis population, PD patients receive treatment at home, which reduces the likelihood of SARS-CoV-2. However, older age, diabetes, hypertension and many other comorbid conditions of PD patients significantly increase the risk of infection. Therefore, maximum adherence to preventive measures for COVID-19 by PD patients and medical staff is an urgent and mandatory task. Based on the published research on COVID-19, the expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the Adapted Clinical Guidelines for the Management of Peritoneal Dialysis Facilities and Services During the COVID-19 pandemic. All of the following clinical guidelines have a level of evidence of 2C.
  PubDate: 2020-08-20
  DOI: 10.31450/ukrjnd.3(67).2020.03
Management of acute kidney injury in patients with COVID-19 or CKD stage
1-4 patients with acute kidney injury in the COVID-19 pandemic: Adapted
clinical guidelines of the Ukrainian Association of Nephrologists and
Kidney Transplant Specialists
- Authors: M. Kolesnyk, I. Dudar, N. Stepanova, E. Krasyuk, Yu. Gonchar, O. Loboda
  Pages: 20 - 27
  Abstract: Acute kidney injury (AKI) is diagnosed in 1–40% of the COVID-19 patients; from 2% to 10% of the patients are required renal replacement therapy (RRT). The mortality rate in this category of patients reached 88%. Early AKI detection in the patients with COVID-19, followed by the use of preventive and therapeutic measures to minimize the incidence or progression is a significant key to reduce the mortality rate and transformation of AKI into chronic kidney disease (CKD). The expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the adapted clinical guidelines for the management of acute kidney injury in patients with COVID-19 or CKD stage 1-4 patients with acute kidney injury in the COVID-19 pandemic. These guidelines are intended for family physicians, general practitioners, physicians, cardiologists, nephrologists, intensivists, endocrinologists, infectious disease specialists and other professionals involved in the provision of specialized medical care to the patients with COVID-19. Specialized medical care for AKI patients infected COVID-19 should be provided by a multidisciplinary team, which has to involve nephrologists, infectious disease specialists and intensivists.
  PubDate: 2020-08-20
  DOI: 10.31450/ukrjnd.3(67).2020.04
Tumor lysis syndrome associated with acute kidney injury as the first
manifestation of essential thrombocytosis
- Authors: Zeki Kemeç, Abdülkadir Koçanoğlu, Mehmet Mahfuz Şıkgenç
  Pages: 28 - 32
  Abstract: In the present case, a 52-year-old female patient has no disease in her medical history. She was brought into the emergency department with muscle pain, nausea-vomiting, acute kidney injury (AKI), tumor lysis syndrome (TLS). Intensive hydration was performed. On the fourth day, venous blood gas, serum kidney function testing and electrolyte levels improved. Thrombocytosis was detected. Our patient with TLS-associated AKI was diagnosed with essential thrombocytosis. We have not previously observed such a case sample in the English literature in the extensive examination.
  PubDate: 2020-05-24
  DOI: 10.31450/ukrjnd.3(67).2020.05
Effect of classic soft drink Coca-Cola as a solvent in the administration
of tramadol and diazepam on biochemical and histological changes in liver
and kidney
- Authors: Omotayo B. Ilesanmi, Temitope T. Odewale
  Pages: 33 - 41
  Abstract: The objective of this study was to determine the biochemical and morphological changes in the liver and kidney as a result of the acute administration of tramadol and diazepam with classic soft drink Coca-Cola (Coke ). Method: Thirty-six (36) adult male Wistar rats were divided into six groups: Group A-control (distilled water), Group B (Coke ), Group C (tramadol, 50 mg/kg), Group D (tramadol dissolved in Coke, 50 mg/kg), Group E (diazepam, 10 mg/kg) and Group F (diazepam dissolved in Coke 10 mg/kg). All administrations were done intraperitoneal. Twenty-four hours after administration, blood samples were collected via cardiac puncture for evaluation of the liver (Aspartate aminotransferase [AST] and Alanine aminotransferase [ALT]), kidney (urea and creatinine [CREA]) function and the organs were excised and processed for histopathological examination. Result: A significantly increased in AST, creatinine and urea concentrations was observed in Tramadol and Coke Groups compared to control (P<0.05), while diazepam had no significant effect on AST, ALT (P>0.05), though it caused a significant increase in urea and CREA (P<0.05). Dissolving the tramadol in Coke aggravated its hepatotoxicity and nephrotoxicity, while Coke had no significant effect on diazepam. Histological examination also corroborated the biochemical result. Conclusion: The results showed that mixing drugs with Coke does not improve the toxicity of tramadol and has no significant effect on diazepam.
  PubDate: 2020-05-20
  DOI: 10.31450/ukrjnd.3(67).2020.06
The effect of APOL1 risk variants on emergent outcomes in kidney
disorders: A meta-analysis of individual participant data
- Authors: Fateme Shamekhi Amiri
  Pages: 42 - 59
  Abstract: Abstract. Kidney diseases associated with APOL1 polymorphisms are human immunodeficiency virus-associated nephropathy, idiopathic focal segmental glomerulosclerosis, hypertension-attributed chronic kidney disease, lupus nephritis and sickle cell nephropathy. This research aimed to investigate the risk of genetic variants on disease contribution. Methods. In this individual participant data meta-analysis, eighteen patients with kidney dysfunction and at risk of APOL1 genotype were investigated. Clinical features, laboratory data at initial presentation, management and outcomes were collected. The paper has written based on searching PubMed Central and Google Scholar to identify potentially relevant articles. Median, percentage, mean ± standard deviation (SD), two-tailed t and chi-square tests were used for statistical analyses. Moreover, relative risk, odds ratio for statistical analyses were used. Results: The average age of patients at the time of diagnosis in APOL1-associated kidney disorders was 41.09 ± 20.63 years (ranging from 8 years to 70 years). Relative risk for kidney failure and persistent hemodialysis therapy in APOL1-associated nephropathy patients with renal risk variants (RRVs) were assessed 1.13 and odds ratio of 1.5 with 95% CI of 0.08-26.86 and the value of 0.0764 by chi-square test but there was no significant statistical result in this research (p-value of 0.782). The relative risk for patients of allograft failure with RRVs was assessed 1,0 odds ratio of 1,0 95% CI of 0.06-15.99 and p-value of 0.81. Conclusion: The present study revealed the risk and odds of APOL1 gene effect on the onset of kidney failure with replacement therapy in patients at risk of APOL1 genotype but results were not significant statistically. Future clinical research is required for investigating APOL1 gene effect on non-African ancestry.
  PubDate: 2020-07-05
  DOI: 10.31450/ukrjnd.3(67).2020.07
Serum Klotho protein level in type 2 diabetic patients depending on the
renal function
- Authors: I. Topchii, P. Semenovykh, T. Shcherban, V. Galchinska, K. Savicheva
  Pages: 60 - 66
  Abstract: The study aimed to assess serum Klotho protein level in type 2 diabetic patients depending on kidney function. Methods. This observational study included 72 patients with diabetes mellitus (DM) and 26 patients with acute coronary syndrome. The control group consisted of 20 healthy subjects. Depending on the presence of albuminuria and glomerular filtration rate (GFR), the diabetics were divided into the following groups: group I included the patients with normal GFR and without albuminuria (n = 25); group ІІ consisted the patients with normal GFR and albuminuria (n = 23); group III – the patients with reduced GFR and albuminuria (n = 24) and group ІV included the patients with acute coronary syndrome (n = 26). The GFR was calculated using the CKD EPI formula (KDIGO 2012). The concentration of Klotho protein was determined by enzyme-linked immunosorbent assay. Results. The development of diabetic nephropathy in type 2 diabetic patients accompanied by a significant decrease of soluble Klotho compared with the controls and the patients of the1-st group. The level of Klotho protein in the group of patients with albuminuria decreased to (490.66 ± 58.76) pg/ml (p <0.05). The lowest concentration of Klotho (443.58 ± 46.92) pg/ml was found in the advanced stages of diabetic nephropathy, namely in patients with albuminuria and impaired renal function. Moreover, a significantly decreased serum Klotho was observed in acute coronary syndrome group in comparison with the control group (p <0.05). There were inverse correlations of Klotho concentration with urinary albumin and blood creatinine levels and a direct correlation between Klotho and GFR. Conclusions. The obtained data indicated the key role of Klotho protein in the formation of renal pathology in type 2 diabetes and the feasibility of practical use of Klotho determination as an early diagnostic marker of renal disorders and cardiovascular risk assessment. The strategies improving Klotho production may be useful in the reduction of both renal and vascular lesions progression in type 2 diabetic patients.
  PubDate: 2020-06-27
  DOI: 10.31450/ukrjnd.3(67).2020.08
Comparison of prophylactic versus preemptive treatments in the management
of cytomegalovirus infection in renal transplant recipients
- Authors: Cengiz Karaçin, Emre Yaşar, Özant Helvacı, Galip Güz
  Pages: 67 - 72
  Abstract: To prevent acute or chronic rejection in renal transplant recipients, immunosuppressive treatments are applied. However, immunosuppressive treatments increase the risk of cytomegalovirus (CMV) infection. The aim of this study was to evaluate the differences in efficacy and cost of prophylactic and preemptive treatment strategies applied in respect of CMV infection to renal transplant recipients. Methods. Patients who underwent renal transplantation in our center between 2010 and 2015, were retrospectively analyzed. The patients were allocated in two groups as those who received prophylaxis or preemptive treatment. A record was made of the kidney function tests (KFT), CMV PCR copy numbers, the presence of CMV infection, antiviral treatments received, and the costs were calculated of the tests and treatments. The groups were compared in respect of CMV infection and costs. Results. A total of 71 patients with a median age of 38 years (range, 19-74 years) were included in the study. The prophylaxis group included 43 patients and the preemptive group included 28 patients. CMV infection was detected in 7 (16.3%) of the prophylaxis group and 2 (7.1%) patients of the preemptive group (p=0.467). The cost per month of the tests and treatment was lower in the preemptive group than in the prophylaxis group (p<0.001). Conclusion. No significant difference was determined between the prophylactic and preemptive treatment protocols in respect of the CMV infection in the intermediate-risk group renal transplantation recipients. Preemptive treatment was seen to be a more cost-effective method than prophylactic treatment in Turkey.
  PubDate: 2020-05-05
  DOI: 10.31450/ukrjnd.3(67).2020.09
COVID-19 and kidney
- Authors: M. Kolesnyk
  Pages: 73 - 79
  Abstract: At the beginning of COVID-19 pandemic attention of healthcare professionals and scientists were already drawn to the appearance of markers of pathologic changes of the urinary system in SARS-CoV-2-infected patients, signs of acute kidney disease (AKD) (including acute kidney injury (AKI) or development of AKI in patients with chronic kidney disease (CKD). This necessitates verification of pathologic changes markers of the urinary system in SARS-CoV-2-infected patients and clarification of their nosologic relevance. The present study aimed to analyze the present information regarding the capacity of SARS-CoV-2 to cause kidney injury (acute kidney disease, including AKI) in patients without such changes before infecting or in patients with CKD, and to verify these changes according to the classification of urinary system disease and Nomenclature for kidney function and disease: report of Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference 2020. The presence of the pathologic changes markers of the urinary system in SARS-CoV-2-infected patients necessitates its verification via the use of tools of diagnostics of urinary system disease. Infecting with SARS-CoV-2 may cause (isolated) asymptomatic proteinuria, isolated erythrocyturia, hemoglobinuria; AKD (including AKI) in patients without preexisting urinary system injuries, AKI in patients with CKD, and may complicate hemodialysis and peritoneal dialysis. The frequency of AKI and mortality rate in patients with COVID-19 and CKD are much higher than without the last one. The AKI frequency is higher in ICU (18 – 37,5%) than in patients with moderate or mild COVID-19 (0,5 – 15%). Patients with all CKD stages with moderate or severe COVID-19 must be admitted to the hospital with further determination by a multidisciplinary team (infectionist, nephrologist, ICU physician, etc, according to the clinical situation) of necessary monitoring and treatment capacity for prevention of AKD progression and life-threatening complications or their adequate therapy. After confirmation of SARS-CoV-2 absence and release from the hospital, patients with AKD or all stages of CKD should be followed up, and monitoring frequency depends on AKD or CKD stage.
  PubDate: 2020-08-05
  DOI: 10.31450/ukrjnd.3(67).2020.10
3D printing and urology: Review of the clinical applications
- Authors: K. Wendo, R. Olszewski
  Pages: 80 - 93
  Abstract: Three-dimensional (3D) printing is a process that translates a 3D virtual model into its physical 3D replica. In medicine, Neurosurgery, Orthopedics and Maxillo-facial surgery were the first specialties to successfully incorporate this technology in their clinical routine, as an aid to surgical interventions. The study aimed to provide a clear overview of the potential areas of applications of 3D printing (3DP) for management of renal diseases, based on a review of the literature. Method. We carried out a review of the literature according to PRISMA recommendations. We searched three databases (Medline, Scopus and Cochrane) with two specific queries: one using MeSH-terms and the second one based on free terms, all terms were related to nephrology and three-dimensional printing technology. Results. 3D-printed models were mostly employed for the management of renal tumors and lithiasis. They provided enhanced visualization of structures and the possibility to perform procedures rehearsals which seemed to improve surgical procedures. Models were also reported to positively impact patients’ understanding of their condition and the interventions. Trainees and experienced urologists also benefited from the supportive role of 3D-printed models and reported improved confidence and efficiency. Rare reports discussed their use for kidney transplantation, ureteropelvic junction obstruction syndrome treatment, nuclear medicine or cultural issues. Due to a meager data amount and heterogeneity of studies, no advanced statistical analysis was possible. Conclusion. 3D-printed models of renal anatomical structures are feasible and are valuable tools to support renal disease management, and for educational purposes.
  PubDate: 2020-06-02
  DOI: 10.31450/ukrjnd.3(67).2020.11