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Kidneys (Počki)
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This is an Open Access Journal

Open Access journal
ISSN (Print) 2307-1257 - ISSN (Online) 2307-1265
Published by Publishing House Zaslavsky

[9 journals]

Appeal of Editor-in-Chief
- Authors: No authors
  Pages: 123 - 123
  Abstract: No abstract
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.411
  Issue No: Vol. 12, No. 3 (2023)
Chronic kidney disease (CKD). Early detection and intervention in primary
health care
- Authors: No authors
  Pages: 124 - 125
  Abstract: No abstract
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.412
  Issue No: Vol. 12, No. 3 (2023)
Hypertension in chronic kidney disease — treatment standard 2023
- Authors: Panagiotis I Georgianos, Rajiv Agarwal
  Pages: 126 - 127
  Abstract: No abstract
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.413
  Issue No: Vol. 12, No. 3 (2023)
Postoperative sequelae of percutaneous nephrolithotomy
- Authors: W.K. Yaseen
  Pages: 128 - 131
  Abstract: Background. Risk factors of postoperative complications during percutaneous nephrolithotomy (PCNL) include stone burden, the preoperative microbiological status of urine, comorbidity, age, operative time, intraoperative level of sterility, and antibiotic prophylaxis. The study aimed to assess the sequelae of these complications. Materials and methods. This retrospective study was conducted on patients treated by PCNL under fluoroscopic guidance for a one-year duration. The demographic data, body mass index, stone burden, stone density, number, duration of surgery, and postoperative complications were recorded. Results. Out of 50 patients, 32 (64 %) developed a fever. White blood cell count was significantly high among those patients. The age of the patients, gender, body mass index, and hospital stay were insignificant variables. Stone burden, prolonged surgery duration, prone position during surgery, and the use of pneumatic lithotripsy were significant variables. Conclusions. Increased stone burden, prolonged duration of surgery, prone position, and pneumatic lithotripsy during PCNL are significant risk factors for developing postoperative complications, mainly fever.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.414
  Issue No: Vol. 12, No. 3 (2023)
Rapidly progressive glomerulonephritis and ANCA-negative pauci-immune
vasculitis: an unusual presentation. A case report
- Authors: Zitlali Guadalupe Paulín Zepeda, Louis Fernando Robles Fernandes, Vianey Guadalupe Tellez Bolaños, José Carlos Ortiz Diaz, María Inés Gil Arredondo
  Pages: 132 - 135
  Abstract: Rapidly progressive glomerulonephritis corresponds to a clinical scenario of glomerular damage involving rapid deterioration of renal function with multiple etiologies. Within these, 85 % of cases are associated with pauci-immune vasculitis with antineutrophil cytoplasmic antibodies (ANCA). However, a remaining subgroup may present ANCA-negative results. The clinical presentation often involves a decline in the glomerular filtration rate, sometimes requiring renal replacement therapy, as well as extrarenal manifestations such as diffuse alveolar hemorrhage. Confirmatory diagnosis is achieved through renal biopsy, negative serology for ANCA, and exclusion of other etiologies. According to international clinical practice guidelines, the recommended treatment for both entities is the same, with the addition of renal replacement therapy if necessary. However, the prognosis tends to be unfavorable with little to no recovery of renal function. This case presents a female patient in the early decades of life with ANCA-negative, rapidly progressive, pauci-immune glomerulonephritis.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.415
  Issue No: Vol. 12, No. 3 (2023)
Correlation of urinary neutrophil gelatinase-associated lipocalin levels
as an early diagnostic marker for acute kidney injury in patients with
sepsis
- Authors: Srija Yadav Kadari, Swarna Deepak Kuragayala, Nagender Devulapally, Sivateja Kuruvada
  Pages: 136 - 143
  Abstract: Background. The exact association between urinary neutrophil gelatinase-associated lipocalin (uNGAL) and acute kidney injury (AKI) is unknown in a critical care setting, in which the population is heterogeneous and the aetiology of AKI is unclear. Aim of this study is to clarify if uNGAL level is an early diagnostic marker for AKI in patients with sepsis. Materials and methods. The current study was conducted on 86 sepsis patients. The prevalence of AKI was identified among them. The role of uNGAL in predicting AKI development, mortality rate and length of the intensive care unit (ICU) stay were analyzed. Sensitivity and specificity were calculated, and the area under the receiver operating characteristic curve was considered as the optimal uNGAL cut-off level for detecting all classifications of AKI. Results. Most patients belonged to the age group of 51–60 years and their mean age was 54.6 years. Most patients (65.11 %) were males. 26.75 % had both type 2 diabetes mellitus and hypertension. AKI was detected in 89 % of subjects in the current study, as per KDIGO definition. 15.12 % of patients had stage 1 CKD, 15.12 % had stage 2 CKD, and stage 3 CKD was diagnosed in 4.65 % of cases. Mortality rate was 11 %, and 89 % of patients were discharged. The mean ICU length of stay among patients with AKI is 8.9 days. There is significant association between the mean ICU length of stay and AKI presence (p = 0.03). 17.4 % (n = 15) of patients required renal replacement therapy. There is a very significant difference in mean baseline uNGAL in patients with and without AKI: 149.9 and 73.2 ng/ml, respectively (p = 0.0006). This indicated that baseline uNGAL levels predict AKI. The mean uNGAL in people with AKI was 356 ng/ml and in those without AKI, it was 95 ng/ml. There is a very significant difference in mean uNGAL 48 hours after in patients with and without AKI (p < 0.0001). At a cut-off value of 120, there were 69 true positive cases, 9 true negative cases, 0 false positive cases, and 8 false negative cases. Based on these, the sensitivity of uNGAL at baseline in detecting AKI is 89.61 %, specificity is 100 %, and accuracy is 90.70 %. At a cut-off point of 120, there were 77 true positive cases, 8 true negative cases, 1 false positive case, and 0 false negative cases. Based on these, the sensitivity of uNGAL 48 hours after was 100 %, specificity 88.89 %, and accuracy was 98.84 %. There is a significant association between uNGAL levels and the ICU length of stay (p = 0.00). Conclusions. Sensitivity analysis was done in cut-off value of 120 for urinary NGAL in predicting AKI. From these results we conclude that urinary NGAL at the time of ICU admission is a reliable marker of renal function in sepsis patients. There is a significant correlation between AKI presence and urinary NGAL, and the ICU length of stay. We recommend not to use uNGAL alone in predicting AKI. It should be combined with glomerular filtration rate to reliably detect AKI development. Study findings indicate that sepsis patients with elevated uNGAL require proper management with close monitoring of blood pressure, urine output and appropriate doses of diuretics to avoid the development of AKI.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.416
  Issue No: Vol. 12, No. 3 (2023)
Etiological features of urinary tract infections in pregnant women:
current state of the problem
- Authors: M.S. Myroshnychenko, Yu.M. Mishyn, N.M. Pasiyeshvili, N.V. Kapustnyk, M.M. Mishyna, Yu.A. Mozgova, I.A. Marchenko, S.O. Myroshnychenko
  Pages: 144 - 149
  Abstract: Background. Urinary tract infections in pregnant women occupy a leading place in the structure of extragenital pathology. The purpose of the study is to determine the etiological features of urinary tract infections in pregnant women. Materials and methods. The study included 89 pregnant women with urinary tract infections. The material for microbiological research was urine, the samples of which were collected on the day of hospitalization of a pregnant woman before treatment. Identification of microorganisms was carried out with the use of MIKROLATEST® test systems (Erba Lachema, Czech Republic). Preparation of bacterial suspensions with a certain concentration of microbial cells was carried out using Densi-La-Meter electronic device (PLIVA-Lachema a.s., Czech Republic) according to the McFarland scale. Optical density was measured using a Multiskan EX microplate reader (type 355). Results. Escherichia coli, Proteus mirabilis, Proteus vulgaris, Streptococcus pyogenes, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa are the leading pathogens of urinary tract infections in pregnant women of the Kharkiv region; Escherichia coli, Proteus mirabilis, Streptococcus pyogenes are predominant ones. The selected spectrum of etiological factors of urinary tract infections does not depend on the age of a pregnant woman. In the etiological structure of the urinary tract infections in pregnant women, Escherichia coli and Proteus mirabilis take the first and the second place during the first three trimesters of pregnancy. The third place in the first trimester belongs to Enterococcus faecalis, in the second trimester — to Proteus vulgaris and Streptococcus pyogenes, in the third trimester — to Streptococcus pyogenes. The etiological structure of urinary tract infections in pregnant women is determined by the topography of the inflammatory process. Thus, in women with asymptomatic bacteriuria, Proteus mirabilis takes the first place, Escherichia coli — the second place, Proteus vulgaris and Enterococcus faecalis — the third place; in acute pyelonephritis, the first place belongs to Escherichia coli, the second place to Streptococcus pyogenes, the third place to Proteus mirabilis, Enterococcus faecalis, Klebsiella pneumoniae; in urethritis, Escherichia coli takes the first place, Enterococcus faecalis, Klebsiella pneumoniae — the second place, Proteus mirabilis, Proteus vulgaris — the third place; in cystitis, the first place belongs to Escherichia coli, the second place to Proteus mirabilis, Proteus vulgaris, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa. Conclusions. The etiological features of urinary tract infections with different topography of the inflammatory process of bacterial etiology determined by the authors must be taken into account in the treatment of this category of pregnant women.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.417
  Issue No: Vol. 12, No. 3 (2023)
Renal dysfunction in general overheating (literature review)
- Authors: O.V. Kravets, V.V. Yekhalov, V.A. Sedinkin, O.V. Pylypenko, D.A. Martynenko
  Pages: 150 - 156
  Abstract: Over the past 30 years, climate change has taken one of the leading places among the ten main causes of death due to natural disasters. Rising temperatures have been shown to increase emergency department admissions for a wide range of kidney diseases, including acute kidney injury (AKI), chronic kidney disease, kidney stones, and urinary tract infections. The occupational effect of heat stress is also associated with AKI, which can quickly progress to acute kidney failure with high mortality. The basis of the pathogenetic mechanisms of heat-induced AKI is a decrease in the circulating blood volume and electrolyte disturbances due to increased perspiration. Water evaporation from the surface of the skin contributes to dehydration with an increase in serum osmolarity. In response to this, vasopressin is activated, the specific gravity of urine increases, and the amount of urine decreases. The glomerular filtration rate progressively decreases. Hypokalemia develops, which changes to hyperkalemia within 12 hours. Tubular endothelium is damaged, which leads to microthrombosis of afferent and efferent renal arteries, the development of an inflammatory response, and exhaustion of the renal interstitium. Possible rhabdomyolysis and myoglobinemia with subsequent tubular obstruction worsen existing kidney damage. According to the leading mechanism of damage, there are two types of acute heat damage to the kidneys: classical rhabdomyolysis and acute interstitial nephritis. Although modern medical advances have contributed to the development of effective treatment and management strategies (rapid cooling, extracorporeal detoxification methods, etc.), mortality in kidney damage due to general overheating has decreased slightly over the past decades. For health care and industry researchers, it is necessary to identify the harmful occupational conditions that lead to heat stress nephropathy and to develop certain occupational safety strategies.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.418
  Issue No: Vol. 12, No. 3 (2023)
Effect of ACE inhibitors on the course of SARS-CoV-2 in a patient with
pre-existing chronic kidney disease: a clinical case
- Authors: I.M. Zavalna
  Pages: 157 - 160
  Abstract: The presence of in combination with hypertension stage 1–2 and its medical correction using renin-angiotensin-aldosterone system (RAAS) inhibitors significantly affects the health of patients who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 uses RAAS as a tool to penetrate the cell, namely the receptor of angiotensin-converting enzyme (ACE) 2. The purpose of the work: to assess the dynamics of clinical and laboratory indicators in a patient with SARS-CoV-2-associated nephropathy against the background of taking ACE inhibitors. This article describes a clinical case from the author’s own practice. Timely prescription of etiotropic therapy for coronavirus disease 19 significantly reduces complications of chronic kidney disease course with hypertension.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.419
  Issue No: Vol. 12, No. 3 (2023)
The effect of antioxidant therapy on the course of predialysis chronic
kidney disease in a patient with comorbidity
- Authors: L.D. Denova
  Pages: 161 - 167
  Abstract: Chronic kidney disease (CKD) is almost always associated with comorbidities such as diabetes, hyperuricemia/gout, urolithiasis, often with urinary tract infection, hypertension, polycystic kidney disease, and other conditions. Autosomal dominant polycystic kidney disease is an inherited kidney disease (1/1000–1/400 worldwide) affecting mainly adults, caused predominantly by mutations in PKD1 (85–90 % of cases) and PKD2 genes (10–15 % of cases), which encode polycystin-1 and polycystin-2 proteins, respectively. In adults with preserved kidney function, the prevalence of gout increases from 1 to 2 % (hyperuricemia up to 11 %), in patients with CKD stage 4 — up to 32 % (hyperuricemia up to 80 %). 70 % of patients with gout and 50 % of patients with hyperuricemia have stage 2 CKD. CKD contributes to a decrease in the urinary excretion of uric acid. In patients with CKD, hyperuricemia is considered to be a serum uric acid level > 6 mg/dL in women and > 7 mg/dL in men. Hyperuricemia is very often observed in hypertension and type 2 diabetes. In patients with kidney disease, diabetes is a major factor of mortality and morbidity. Diabetic nephropathy can be suspected in a patient with type 2 diabetes in the presence of albuminuria and/or diabetic retinopathy. Signs of diabetic nephropathy: basement membrane thickening, mesangial expansion, and increased vascular permeability to albumin induced by nonenzymatic glycation of collagen and laminin. Comorbidity has a negative impact on patients’ health due to increased morbidity and mortality. Such patients are at risk of rapid progression of CKD into the end stage, which requires renal replacement therapy. Therefore, early diagnosis, treatment and prevention of CKD complications are important for such patients. This article highlights the impact of antioxidant therapy and phytoneering on the course of CKD in patients with comorbidities.
  PubDate: 2023-09-18
  DOI: 10.22141/2307-1257.12.3.2023.420
  Issue No: Vol. 12, No. 3 (2023)