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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]

Rating score of renal medical care in Ukraine 2017
- Authors: M. Kolesnyk, N. Kozliuk, S. Nikolaenko
  Pages: 3 - 8
  Abstract: The aim of the work was to conduct a rating evaluation of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Materials and methods. Evaluation of nephrological services in the regions of Ukraine was made by using indicators that characterize the structure, use of health care resources, quality and efficiency of its provision submitted to National Register of patients with chronic kidney disease and patients with acute kidney injury (2017). Results. The sum of integral indicators in different areas of our analytical research has identified Top-3 regions by number: nephrologists; hemodialysis (GD) machines, patients receiving GD; patients treated with peritoneal dialysis (PD); patients with functional transplanted kidney and in the prevalence of acute kidney damage (GFR) per million population. Summary. By using rating evaluation methodology, it was identified place of relevant region by each indicator of nephrological care in the region as a whole.
  PubDate: 2018-05-14
The level of chorionic gonadotropin in postmenopausal women with CKD V
stage treated with hemodialysis
- Authors: K. Abrahamovych, I. Dudar, V. Savchuk, Y. Gonchar, V. Krot, I. Shifris, O. Loboda
  Pages: 9 - 12
  Abstract: The chorionic gonadotropin (CGT) test is used to diagnose and monitor the course ofpregnancy, including ectopic, to detect fetal abnormalities, trophoblastic diseases, preeclampsia, ovarian tumors, lungs, stomach, intestine, bladder, kidneys, prostate. The level of CGT is often elevated in postmenopausal women treated with hemodialysis (HD). Its significance is still not well understood, and therefore requires further study. The aim of our work was to investigate the level of CGT in postmenopausal women treated with HD. Methods. The determination of the level of CGT in 23 postmenopausal women treated with HD. The main inclusion criteria were as follows: oral informed consent of the patient to participate in the study, the presence of CKD stage VD and treatment of HD for at least 6 months. Exclusion criteria: severe functional disorders (liver, heart, respiratory failure), cancer processes, smoking, taking substitution hormonal therapy, lack of consent of the patient. The results were compared with the CGT levels in 20 healthy menopausal women (group II). Results. A statistically significant difference was found between the I group (postmenopausal women treated with HD) and II group (women without chronic kidney disease (CKD) (t = 3.62, p = 0.001). It was also found that CGT was increased in 9 (39%) of 23 women treated with HD. The norm of CGT in postmenopausal women is <14.0 IU/L, therefore the deviation of the index in the I group (13.63 ± 2.83 IU/L) is within the reference values. However, it does not explain the statistically significant difference between the CGT indices in the I group compared to the II group (p<0.01). Possibly, the presence of CKD contributes to the increase in HGT. Conclusions. Authentically higher rates of CGT in postmenopausal women treated with HD compared with women without CKD were detected. Thus, CKD can affect the serum level of CGT, probably due to disruption, but this issue has not been studied, and requires further investigation.
  PubDate: 2018-06-11
Structural, functional and endothelial peculiarities of diabetic
nephropathy in patients with arterial hypertension
- Authors: О. M. Chernatska, N. V. Demikhova
  Pages: 13 - 17
  Abstract: The aim of our one-stage observational study was the detail analysis of structural, functional, endothelial peculiarities of diabetic nephropathy in patients with coexistent arterial hypertension. Methods. Our study involved 96people with arterial hypertension and type 2 diabetes mellitus (I group), 25 patients with arterial hypertension (II group), 15 practically healthy persons (III group) treated and obtained in Sumy City Clinical Hospital №1. Cardiovascular complications were determined in all patients from I and II groups. The average age of the patients was 62.31 ± 0.2 years. The level of glycosylated hemoglobin (HbAlc) was determined by the biochemical method, albuminuria by immunoassay. The level of endothelin-1 (ET-1) in serum was studied using ELISA. Results. It was found that the level of ET-1 was significantly higher in patients with diabetes compared with only hypertensive patients. In the patients with urine albumin excretion rate category A2 the level of endothelin-1 was significantly higher compared with the category A1 patients and less compared with category A3 patients (11.42 ± 49 vs 25 ± 0.57pg/ml, p = 0.0329 and 11.42 ± 0.49 vs 2.25 ± 1.04pg/ml, p <0.0001, respectively. So, the level of ET-1 increased in proportion to albuminuria. In patients with the albuminuria category A2, the endothelin-1 level was higher than in subjects with the A1 category and lower than in patients with the A3 category. In addition, we identified a moderate direct correlation between the blood level of ET-1 in the patients with diabetes and blood glucose level (r = 0.29;p = 0.004). Conclusion. Finally, it is the confirmation of greater endothelial function disorders for arterial hypertension and type 2 diabetes mellitus. In conclusion, endothelial dysfunction promotes diabetic nephropathy progression.
  PubDate: 2018-05-29
Antioxidant effects of immunomodulators in patients with recurrent
pyelonephritis
- Authors: M. Kolesnyk, L. Korol, N. Stepanova, V. Driianska, L. Migal, V. Savchenko
  Pages: 18 - 28
  Abstract: The purpose of our work was to investigate the effect of immunomodulatory medicines on the intensity of oxidative stress (OS), the cytokines level and the activity of renospecific enzymes in patients with recurrent pyelonephritis (rPN). Methods. A prospective, randomized, open-label study involved of 100 women aged 33.4 ± 8.8 year old. According to the sensitivity of the detected pathogens all patients received antibacterial therapy for two weeks. Along with the main course of antibiotic therapy, 25 patients were assigned Sodium nucleinate at a dose of 0.25 g 4 times per day during 14 days, 18 patients were prescribed Galavit intramuscularly 2 ml per dayfor 10 days, and 27patients were prescribed Proteflazid according to the manufacturer’s instructions. The comparison group consisted of 30 women with rPN who received antibiotic therapy exclusively.Women were screened before and after the treatment. The content of malondialdehyde (MDA), ceruloplasmin (CP), transferrin (TF) and sulfhydryl groups (SH-groups) were determined in the blood by colorimetric method. Oxidative stress index (OSI) was calculated. The concentration of interleukins (IL) -1f, -4, -8, -10, -17, tumor necrosis factor a (TNF-a), transforming growth factor f (TGF-f), monocytic chemoactive protein-1 (MCP-1) and interferon y (IFN-y) were analyzed in the blood of the women using an ELISA. To evaluate the functional state of the renal parenchyma the activity of tubular lysosome enzymes a total f-N-acetylhexosaminidase and f-galactosidase were determined in urine. Results. The use of Sodium nucleinate decreased of the OS activity by reducing MDA level (p <0.001) and increasing the concentration of CP (p < 0.03). The serum levels ofIL-4 (p = 0.007), lL-17 (p = 0.04), TGF-f (p = 0.02) and MCP-1 (p = 0.03) were decrease. The use of Galavit contributed to a statistically significant decrease in the concentration of TNF-a (p <0.001), IL-8(p <0.001), IFN-y (p = 0.001) and TGF-f (p <0.001). The administration of Proteflazid resulted in a decrease in the concentrations of IL-8 and IFN-y, with a decrease in OSI (p =0.04) compared to pre-treatment. All applied immunomodulators partially reduced the activity of renospecific enzymes markers of kidney damage. Conclusions. The use of immunomodulators in the complex therapy of patients with rPN contributes to the partial normalization of functional activity of immune system by the decreasing ofthe production ofcytokines as its mediators and the reducing ofthe OS intensity.
  PubDate: 2018-06-17
Blood vitamins status in patients with stages 2-5 chronic kidney disease
- Authors: I. Dudar, Y. Gonchar, V. Savchuk, O. Loboda
  Pages: 29 - 33
  Abstract: Patients with chronic kidney disease (CKD) are prone to development hypovitaminosis due to dietary constraints, diseases of the gastrointestinal tract, comorbid conditions, etc. Determination of vitamins level in patients with CKD will allow timely correction of their deficiency, prevent the development of hypervitaminosis and reduce oxidative stress. The purpose of the study was to examine the level of vitamins depending on the stage of CKD. Methods. Vitamin D levels (level 25-hydroxyvitamin D), A, E, B12, K, folic acid were determined in 44patients with CKD stages II-V(mean age 54,63 ± 2,63 years, 24 men 55%). According to the study, patients should not have received any drugs or biologically active additives containing vitamins for 3 months. Results. There was no significant difference in the level of studied vitamins in CKD st. II-III. There was a significant decrease in the levels of vitamin K, folic acid, and vitamin D levels with the progression of CKD. Vitamin A levels in CKD st. IV, V compared to CKD st. II were significantly higher. Considering large number drugs containing vitamins and trace elements and wide uncontrolled use in the population, in particular in patients with CKD, it is important to continue to study the levels of vitamins and trace elements in patients at different stages of the CKD, depending on the CKD nosology. Study of efficiency and safety applying vitamins in patients with CKD, particularly in the late stages of CKD, are appropriate. Conclusions. For patients with CKD characteristic of vitamins deficiency (in our study vitamin K, folic acid), but also an increase in their levels (vitamins A and E). Progression of CKD is accompanied by a change in the levels of vitamins. A significant decrease in the level of vitamin K, folic acid, vitamin D was notedfor patients with GFR <30 ml/min/1.73 m2.
  PubDate: 2018-06-05
Fibroblast growth factor 23 and lipid metabolism association in chronic
kidney disease
- Authors: M. I. Chaikovska, L. P. Martynyuk
  Pages: 34 - 40
  Abstract: Recent scientificstudies have demonstrated the effect of fibroblast growth factor 23 (FGF-23) on the volume and distribution of body fat. The aim of our study was to investigate of lipid metabolism in patients with chronic kidney disease (CKD) and its relationship with FGF-23. Methods. We conducted a single-center, cohort retrospective study involved 106 patients with CKD 1-5 stages. Among the patients were 47 women (44%) and 59 men (56%) aged (49.6±13.9) years. All patients were determined the blood lipid spectrum: total cholesterol level (LDL), high density lipoproteins (HDL) and triglycerides (TG). The lipid profile was examined using a biochemical analyzer Cobas Integra 400 Plus. The C-terminal FGF-23 fragment was determined using a set of reagents for the enzyme immunoassay “Biomedica” (Astria). The glomerular filtration rate (GFR) was calculated using the CKD EPI formula (KDIGO 2012). All the statistical analyses were performed using Statistica 10.0. Results. In patients with CKD, progressive decrease in the level of total cholesterol, LDL cholesterol, HDL cholesterol and the increase in TG concurrent with the fall in GFR was detected (p<0.001). The concentration of the C-terminal FGF-23 fragment progressively increased in parallel with the fall in GFR, reaching the highest values at CKD stage 5 (p<0.001). A significant relationship was found between FGF-23 and total cholesterol (r =-0.45, p<0.05), LDL (r=-0.29, p<0.05), HDL (r=-0.54, p<0.05), FGF-23 and TG (r=0.28, p<0.05).
  Conclusions. CKD is characterized by a significant growth in TG levels, which increases with progression of renal dysfunction. The level of FGF-23 in CKD steadily increases in parallel with the decrease in GFR. The parameters of lipid metabolism, namely, total cholesterol, LDL, TG and HDL, have a reliable relationship with FGF-23 in CKD.
  PubDate: 2018-05-29
The evaluation of residual kidney function in patients with ckd vd and
approaches of its preservation
- Authors: L. Surzhko
  Pages: 41 - 48
  Abstract: The work is a literature review. Residual kidney function (RKF) is one of the crucial indicators of mortality and quality of life in patients with chronic kidney disease. Residual renal function provides better control of hydration, blood pressure, clearance of substances with low and middleweight, anemia, Ca/P metabolism, chronic inflammation. However, approaches to preservation of RKF in dialysis patients have been studied not enough, the importance of RKF preservation is underlined. The wide range of predictors of RKF loss are presented in the article, approaches to measurement of RKF, the relationship between level and presence of RKF with survival and mortality of patients with CKD 5D were analyzed. The possibility of RKF preservation and extension using different approaches by correction of dialysis prescription were estimated. There is no standardized method for applying incremental hemodialysis in practice. Onceto twice-weekly hemodialysis regimens are often used randomly, without knowing the benefit for current patient or how to escalate the dialysis dose if RKF declines over time. It is important to change the HD/HDF prescription according to the range of RRF using objective data.
  PubDate: 2018-06-04
Skryninh, diahnostyka ta menedzhment patsiientiv z khvoroboiu Fabri:
zakliuchennia dyskusiinoi konferentsii «Khvoroba nyrok: pokrashchennia
hlobalnykh rezultativ» (KDIGO). Per z anhl Fomina SP, Pichkur NO
- Authors: S.P. Fomina, N.O. Pichkur
  Pages: 49 - 61
  Abstract: Пацієнтів з хворобою Фабрі (ХФ) відносять до групи високого ризику розвитку хронічної хвороби нирок та серцево-судинних захворювань. Застосування специфічної високовартісної терапії покращує перебіг цього рідкісного захворювання. Дана конференція KDIGOрозглянула суперечливі питання діагностики, скринінгу та менеджменту ХФ, включаючи ферментозамісну терапію та неспецифічну терапію супроводу для різних форм ХФ. Незважаючи на значні досягнення медичної допомоги та поліпшення наслідків захворювання, поглиблення знань щодо патогенезу цього глікосфінголіпідозу та визначення оптимального віку пацієнтів для початку лікування залишаються актуальними, а пошук більш ефективних специфічних методів лікування доцільним.
  PubDate: 2018-03-28