bluuebunny/crossref_metadata_2025 huggingface dataset:
A SINGLE LC TANK BASED ACTIVE VOLTAGE BALANCING CIRCUIT FOR BATTERY MANAGEMENT SYSTEM
Authors: HABIB AKM AHASAN , Motakabber S.M.A , IBRAHIMY MUHAMMAD IBN , Alam AHM Zahirul
Published: June 2018

A single series resonant converter has been designed to balance the voltage level of nowadays, battery operated vehicles and machine power tools are becoming popular due to their simple and compact structure, low operating and maintenance costs, moreover renewable energy utilization facility etc. In order to obtain the necessary operating voltage and current of these devices, many electric cells are combined together in series and parallel combination. A series battery balancing circuit can be used to improve the efficiency of each cell charging and discharging process and consequently increase the lifespan of it. A battery management system (BMS) needs an efficient balancing circuit. This paper presents a high-speed single LC-tank DC to DC converter based electric cell balancing schemes. Since the supercapacitors are equivalent of rechargeable battery; in this research two supercapacitors have been used instead of rechargeable batteries. The voltage balance has been maintained by charging and discharging the supercapacitors through a single LC-tank circuit. As a result, the overall voltage balancing time has been reduced and improved the circuit performance. Experimental result shows that the proposed balancing circuit can reduce the voltage difference between the two supercapacitors from 350 mV to 0 V in 284 seconds, which is less time than the existing system.
PROJECT OF NATIONAL CLINICAL GUIDELINES OF DIAGNOSIS, PREVENTION AND TREATMENT OF ACUTE KIDNEY INJURY
Authors: Kolesnyk M. , Zakon K. , Dudarenko V.
Published: June 2018

This is a draft of national clinical guidelines of diagnosis, prevention and treatment of acute kidney injury.
DIFFERENTIAL APPROACH OF CONTINUOUS AND INTERMITTENT RENAL REPLACEMENT THERAPY APPLYING IN CARDIAC SURGERY ACUTE KIDNEY INJURY
Authors: Zakon K. , Romanova V. , Dudarenko V. , Arbuzova I. , Radchenko G.
Published: June 2018

Background: In-hospital mortality of cardiac surgery patients with AKI is 3-7 times higher than those without AKI. This prospective observational study was dedicated to evaluate a differential approach ofapplying continuous and intermittent modalities of RRT in cardiac surgery patients.

Methods. One hundred and six adult cardiac surgery patients admitted hospital in 2008-2011 years, who had AKI and met inclusion criteria were allocated in CRRTor IRRTgroup.

Results. Observed in-hospital mortality of CRRT patients was significantly lower than predicted by APACHE II (р=0,01), in contrast with IRRT group. The in-hospital mortality of cardiac surgery patients with AKI and multiorgan dysfunction treated with CRRT was significantly lower than in patients treated with IRRT (32,5% vs 67,6%, р=0,012) and lower than predicted by APACHE II (32,5% vs 50%, р=0,025), while in IRRT group observed in-hospital mortality was significantly higher (67,6% vs 46%, р=0,012) than predicted.

Discussion. The complexity of the treatment of cardiac surgery patients with AKI and, especially, the subset with critical illness, could explain the lack of association between RRT modality and renal recovery and the in-hospital mortality of whole cohort, as well. This is a basis for differential and complementary applying ofdifferent RRT modalities according to the specific clinical situation.

Conclusions. Differential applying of continuous RRT modalities for the treatment of cardiac surgery patients with

AKI, as a component of MOF, and intermittent RRT for the patients, who have not multiorgan dysfunction, could contribute to reducing in-hospital mortality in this cohort.
NON-SPECIFIC PROTECTION FACTORS AND INFLAMMATORY MEDIATORS IN URINE OF CHILDREN WITH GLOMERULONEPHRITIS IN THE PRESENCE OF HERPESVIRAL INFECTION. NOTICE I. DETERMINATION OF SIGA AND MCP-1
Authors: Bagdasarova I. , Kruglikova I. , Kornilina E. , Kruglikov V.
Published: June 2018

The aim of this work was the study of indicators characterizing the local immunity in patients with various forms of glomerulonephritis by presence of herpesviral infection.

Materials and methods. A quantitative estimation of the content of sIgA and MCP-1 in urine of 47patients with glomerulonephritis and 10 apparently healthy individuals was conducted.

Results. The decrease of sIgA level and reliable increase ofMCP-1 level were observed in urine of patients with glomerulonephritis. There was a significant increase in the level of these indices in hormone-resistant patients with nephrotic form of glomerulonephritis; in patients with severe course of the disease and also in the absence of remission. More such changes were found in children with active (reactivated) herpesviral infections.

Conclusion. There has been confirmed the importance of the study of immunologic parameters in the urine of patients with glomerulonephritis to characterize immunopathological process in the kidney and prognosis of the disease.
CORRECTION OF IRON DEFICIENCY IN CKD V HD PATIENTS WITH ANEMIA
Authors: Kolesnyk N.
Published: June 2018

Hemodialysys results in loss of15-20 ml of blood or 5-7 mg of iron during each session or at least 1 g/ year. Additional iron may be lost through the gastrointestinal tract and during the menstruation in women. Excluding others possible reasons (genitourinary issues, laboratory investigations iron losses can amount minimum 1.7g per year). Dietary iron intake (0.5 – 1.0 g/year) only partially offsets iron deficit.

According to KDOQI Anemia Guidelines (2006), “the average iv iron needed to maintain a stable serum ferritin (SF) level and in that way neutral iron balance, appears to be range 22-65 mg/week; this amount corresponds with SFl > 200 mg/ at but the same time there is no sufficient evidence to recommend routine administration of iron if SF > 500 mg/l.

KDIGO Guidelines (2012) do not recommend routine use of iron supplementation in patients with transferrin saturation (TSAT) > 30% and SF > 500 mg/1.

Thereby the target SF and TSAT levels in CKD VD patients remain controversial and in practice are determined by specific clinical tasks requiring resolution: to increase hemoglobin level without erythropoiesis stimulating agents (ESA) administration, or to decrease ESA dose in its turn depends on specific patient’s iron status (absolute or functional iron deficit) and treatment period, – predialysis or dialysis.
CARRIAGE OF OPPORTUNISTIC MICROORGANISMS AND SURVIVAL OF PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 5 D
Authors: Shifris I. M.
Published: June 2018

Despite of significant development of dialysis technology, mortality rates of CKD V D stage patients remain unsatisfactorily high. Next to cardiovascular diseases, infections are seems to be as a major causes of morbidity, hospitalization and mortality in this population. Staphylococcus aureus, especially MRSA, infections are a major cause of morbidity and hospitalization in CKD V D stage patients. Preceding MRSA colonization views as a risk factor for subsequent MRSA infections in future.

Aim. The aim of this study was to explore the effects of opportunistic pathogens colonization on survival in patients with CKD VD stage.

Materials and methods. This prospective cohort, open-label study included 255patients with CKD V D st. (198 HD and 57 PD patients). Patients were randomized into two groups, depending on the MRSA colonization history: first group (n=66) included patients with identified MRSA colonization and the second group (n=189) included patients with colonization of other opportunistic pathogens. The groups were representative according to gender, age, type of kidney affections and renal replacement therapy (RRT) modality. The endpoint was the total number of deaths. All cases, which took place from 01.08.2011 to 01.08.2016 year, were analyzed. The Kaplan-Meier method was perfomed for evaluation of survival.

 

Results. The analysis allowed to state that during analyzed period in total were 75 deaths: in the first group ofpatients - 32 (48.5%), and in the second - 43 (22.8%) cases; %2= 14,38, p = 0,000078; RR – 2,131, 95% ffl: 1,484-3,060.

The survival rate of patients was significantly lower in the first group, irrespective of RRT modality. The 3-years cumulative proportion surviving was 53% and 79% in the first (MRSApositive) and second groups, respectively; p< 0,001.

Conclusion. This study demonstrated that MRSA asymptomatic colonization has a significant negative effect on survival in the patient population with CKD VD stage
PHARMACO-ECONOMICBENEFITS OF CORRECTION OF ANEMIA WITH CONTINUOUS ERYTHROPOIETIN RECEPTOR ACTIVATOR:HEMODIALYSIS VSHEMODIAFILTRATION
Authors: Novakivskyy V.
Published: June 2018

Anemia is an integral component of CKD. The prescribing of erythropoiesis stimulating agents (ESA) for the treatment of anemia constitutes a significant burden on health budgets. Using of continuous erythropoietin receptor activator (CERA) and convective techniques can improve health indicators and economic results.

The aim of the study was to evaluate the effects of hemodiafiltration treatment (HDF) on the pharmaco-economic efficiency of anemia treatment in comparison with haemodialysis (HD).

Methods. A prospective cross-sectional study involving 40 patients with CKD stage V who receiving dialysis treatment at the LLC “Fresenius Medical Care Ukraine ” Medical center in Cherkasy city. The follow-up period was 2 years. First, data was analyzed while patients received HD over a period of twelve months. Then, the same patients were evaluated during treatment with HDF for at least another twelve months.

 

Result. The average dose of CERA reduced from 60 mg to 44 mg per month (p = 0.002) after the transferred ofpatients to HDF treatment. There were a significantly increased the levels of Kt / V (p = 0.04) and serum albumin (p = 0.04). A higher number of patients achieved the target hemoglobin results.

Conclusions. The comparison of pharmaco-economic component of anemia correction with CERA cross-sectional study demonstrates significant advantages of HDF treatment compared to HD.
THE ROLE OF GUT INDIGENOUS MICROBIOTA IN THE DEVELOPMENT OF OXIDATIVE STRESS IN WOMEN WITH RECURRENT PYELONEPHRITIS
Authors: Stashevskyi N. V. , King L. V. , Myhal L. , Stepanova N. M.
Published: June 2018

The aim of our study was to investigate the oxidative stress intensity depending on the content of Lactobacillus spp. in the colon of patients with recurrent pyelonephritis.

Material and methods. The observational study involved 60 women with chronic kidney disease (CKD) stage I-II: uncomplicated pyelonephritis, aged 39.5 ± 3.2 years. According to the quantitative content ofLactobacillus spp. in the patients’ intestine, the women were allocated into two groups: the first group of the patients (n = 34) had a deficit ofLactobacillus spp. in the intestine, and the second one (n = 26) had a normal content of Lactobacillus spp. Along with the standard diagnostic methods, we defined the content of malondialdehyde levels in the serum (MDAs) and erythrocytes (MDAe) spectrophotometrically as an indicator of lipid peroxidation. Such parameters as the concentration of ceruloplasmin (CP), transferrin (TR) and sulfhydryl groups (SH-groups) in the blood and total peroxidase activity (TPA) in erythrocyte were studied as the indicators of antioxidant system. In addition, we calculated of oxidative stress index (OSI).

Results. The analysis of lipid peroxidation defined a significant increase of MDA level in the serum (p = 0.008) and urine (p = 0.003) ofpatients with deficit of intestine lactobacillus spp. Moreover, in the patients ofGroup II we observed the high level of serum OSI (p = 0.03). By contrast, the TPA level was significantly reduced (p = 0.02).

Conclusions. The results of our work confirm the experimental studies data, which demonstrate the leading role of gut indigenous microbiota in the development of oxidative stress.
MORPHOFUNCTIONAL STATEOFKIDNEYS OF RATSAFTER INJECTIONOFPLACENTAL CRYOEXTRACT IN HEYMANN NEPHRITIS
Authors: Kondakov I.I. , Repin N.V. , Topchy I.I. , Marchenko L.N. , Vaskovich A.M. , Kirienko A.N. , Govorukha T.P.
Published: June 2018

Изучение иммунного механизма поражения почек на модели нефрита Хеймана (НХ), вызывающего изменения сосудов почечных клубочков, их морфологических и морфометрических показателей, представляют значительный интерес

Цель работы: изучить влияние введения криоэкстракта аллогенной плаценты (КЭП) на функциональные и морфологические показатели почек при экспериментальном НХ.

Материал и методы. Крысы-самцы 4-х месячного возраста были разделены на 3 группы: I – интактные; 2 – животные с моделью НХ; 3 – животные с моделью НХ, которым на 28 день после иммунизации 3 раза за неделю внутримышечно вводили КЭП. Животных 2-й и 3-й групп выводили из эксперимента на 45 и 60 сутки. Исследованы биохимические, функциональные и морфологические показатели почек на всех стадиях развития НХ и после введения КЭП.

Результаты и их обсуждение. У животных 2 и 3 группы на 28-е сутки возрастало количество циркулирующих иммунных комплексов (ЦИК) в крови и иммунных депозитов на базальных мембранах клубочков, что сопровождалось нарушением их структуры и выделительной функции почек. Выявлены морфометрические различия в размерах клубочков в динамике НХ. Через 60 суток в ткани почек экспериментальных животных наблюдались признаки фокального мезангиального пролиферативного гломерулонефрита как при введении КЭП, так и без него. При введении КЭП отложения депозитов иммунных комплексов не обнаруживалось.

Выводы: При НХ на 28 сутки отмечено возрастание ЦИК в крови, отложение депозитов иммунных комплексов на базальных мембранах капилляров клубочков, сужение их просвета и пролиферация мезангиоцитов, что сопровождалось нарушением выделительной функции почек. Введение КЭП нормализовывало функцію почек, снижало к 45 суткам уровни комплемента ЦИК до показателей нормы.
DISTURBANCES OF NUTRINIONAL STATUS IN PATIENTS TREATED BY PERITONEAL DIALYSIS: THE ROLE OF CHRONIC INFLAMMATION
Authors: Dudar I. , Shymova A. , Krasyuk E.
Published: June 2018

this work is devoted to the problem of malnutrition in patients who are treated by peritoneal dialysis, also the role of chronic inflammation was described.
TREATMENTOFRENAL ALLOGRAFTCHRONIC REJECTION
Authors: Shelest V.V. , Zograbian R.O.
Published: June 2018

The work is a literature review, which demonstrates the current strategies of the treatment of chronic renal allograft rejection
AGE AND GENDER-SPECIFICS OF CARDIOVASCULAR MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Shifris I.
Published: June 2018

Cardiovascular diseases are the leading causes of death in hemodialysis (HD) patients. An analysis of the epidemiological evidence is the basis for the development of the measures and recommendations directed on reducing prevalence of fatal events, including cardiovascular.

Aim. The study of cardiovascular mortality in patients who received treatment for renal replacement therapy, based on the demographic and gender characteristics, type of kidney damage and duration of HD treatment.

Methods. Cardiovascular mortality causes in 89 patients who received programmed hemodialysis from January 1, 2007 to December 31, 2011 in Kyiv City Scientific and Practical Center of Nephrology and Dialysis were analyzed.

Results. Cardiovascular disease was the primary cause of death in the study population (64, 96 %). The annual cardiovascular mortality rate has a significant positive trend in the HD patients. It was ascertained its declining from 10,26% in 2007 to 6,69% in 2011.

 About 40% of cardiovascular causes of death occurred during the first 90 days of HD treatment, 73,53% of them were among males.

The number of fatality authentically is higher for younger women with non- diabetic renal glomerular lesions and middle-aged patients with diabetes mellitus. CVD, as the cause of death, was significantly more often for males of middle age with the glomerular (diabetic and non-diabetic) diseases and of the elderly - with nonglomerular and non-diabetic glomerular origin.

Conclusion. According to the study the series of the regularities of the structure of cardiovascular mortality has been established. The significant association between the sex of the patient and the type of renal disease was identified in each age group.
STUDY OF INFLUENCE ZINC LEVEL IN BLOOD IN PATIENTS WITH CHRONIC PYELONEPHRITIS ON THE ACTIVITY OF INFLAMMATORY PROCESSES IN KIDNEYS
Authors: Lisnyanska I. S.
Published: June 2018

Materials and methods: examined 67 patients with chronic pyelonephritis. All patients were determined level of zinc in the blood and levels of inflammatory cytokines, C-reactive protein in the urine.

Results. We found a significant decrease in the level of zinc in the blood of patients with chronic pyelonephritis (p<0.05). As for the performance of proinflammatory cytokines and CRP, we found a significant increase in IL-6 (p<0.001), TNF-α (p<0.001) and CRP (p<0.05) in the urine, indicating that the activity of the inflammatory response in situ. In applying the basic therapy levels of zinc in the blood were not significantly changed (p>0.05), and the application of basic therapy in combination with zinc sulfate significantly increased (p<0.05) and almost no difference in the values of group norms. Analyzing changes in cytokines and CRP in urine during treatment, we found a significant decrease in these indicators as the application of basic care and the application tested therapy, but the application of the second we found a greater decrease in these indicators, in some cases reaching values of group norms.

Conclusions. The preparation of zinc may be a promising direction of the treatment of chronic pyelonephritis, since increases this microelement in the blood and reduces the activity of inflammatory response in the kidney.
CHANGES OF NONESSENTIAL TRACE ELEMENTS LEVELS IN WHOLE BLOOD OF END STAGE RENAL DISEASE ADULT PATIENTS
Authors: Makarov O. O. , Pisarev E. O. , Sheiman B. S. , Kulizkiy M. V. , Peretyatko D. V. , Vihor V. O. , Prodanchuk M. G.
Published: June 2018

Aims: Accumulation of trace elements occurs in conditions of decreased or termination of kidneys functions. In some conditions increased trace elements can obtain toxic features. On other hand, researches are showing that concentration of some trace elements could be decreased in ERSD patients, too. The most important factor affecting trace element concentration in ERSD patient is the degree of renal failure and using of replacement therapy.

Materials and methods: We determined the concentration of microelements (beryllium, boron, aluminum, vanadium, chromium, nickel, arsenic, rubidium, strontium, cadmium, cesium, barium, thallium and lead) in whole blood of 41 ESRD patients with chronic kidney disease stage VD, who were treated with hemodialysis / hemodiafiltration and in 61 conditionally healthy donors. Determination of whole bloods trace elements content was conducted using inductive coupled plasma mass- spectrometry (ICPMS).

 Results: It is determinate that levels of beryllium, boron, aluminum, vanadium, chromium, strontium, cadmium, barium, thallium and lead is reliable increased in ESRD patients. Decreased levels are observed for nickel, arsenic, cesium and rubidium.

Conclusions: ESRD is accompanied with substantial and multidirectional changes of trace elements blood levels. During researches has shown that in ESRD patients processes of trace elements accumulation are prevailing over elimination ones.
DYSLIPIDEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Loboda O. M. , Dudar I. O.
Published: June 2018

Summury. Data about lipid disorders at different stages of chronic kidney disease (CKD), including those on dialysis are presented in the review. The possible influence of dyslipidemia on the progression of CKD, as well as the onset and progression of cardiovascular complications in patients with CKD are discussed. The questions of lipid-lowering therapy use, including statins, in patients with CKD on dialysis and predialysis, are disclosed.
THE QUALITY OF SLEEP IN PATIENTS WITH CKD UNDERGOING HEMODIALYSIS
Authors: Gonchar Y.
Published: June 2018

The aim of study was to determine the quality of sleep and the quality of life in patients with CKD undergoing hemodialysis.

 

Український журнал нефрології та діалізу Оригінальні наукові роботи

Methods. This study included 70 patients undergoing hemodialysis (mean age 48,74+1,51 years, mean duration of dialysis 41,55+4,51 months). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Quality of life was measured using questionnaire SF–36.

Results. 41 (58,57%) patients with a global PSQI score >5 were considered as a “bad sleeper”. Poor sleep was associated with age (r 0,24, p <0,05), high BMI(r 0,27, p <0,05), low diuresis (r 0,25, p <0,05), increase interdialytic weight gain (r 0,26, p <0,05). There was relationship between the poor sleep and low scores of all scales SF–36.

Conclusions. Sleep disorders are common among patients with CKD undergoing hemodialysis. Poor sleep has a negative impact on quality of life.
INFLUENCE CHRONICKIDNEYDISEASEPROGRESSES TO QUALITYOFLIFE
Authors: Krasiuk I. V.
Published: June 2018

Aim. To determine the characteristics of quality of life in patients with chronic kidney disease (CKD ) II–Vst.

Methods. 171 patients with CKD II–IVst, except for routine clinical and laboratory examinations, have been studied the quality of life (QOL) using a questionnaire assessing quality of life SF– 36.

Results. It was found most of the QOL was significantly worse with the progression of CKD. Total QOL indicators and indicator “effect of kidney disease”. most significantly reduced. Correlation most QOL with age, hemoglobin, blood pressure levels was revealed.

Conclusions. QOL decrease with the progression of CKD. Age, hemoglobin level, blood pressure affect QOL.
PROBLEMS OF BECOMING AND DEVELOPMENT OF BIOETHICS CONSCIOUSNESS FOR THE STUDENTS OF MEDICAL UNIVERSITY
Authors: Semydotska ZH.D. , Cherniacova I.A.
Published: June 2018

In the article discussed sources and ways of forming of bioethics consciousness in modern society, basic strategies and complications of becoming of bioethics consciousness for the students of medical university.
NON-SPECIFIC PROTECTION FACTORS AND INFLAMMATORY MEDIATORS IN URINE OF CHILDREN WITH GLOMERULONEPHRITIS IN THE PRESENCE OF HERPESVIRAL INFECTION NOTICE 2. DETERMINATION OF THE LEVEL OF IL-8 AND SLPI
Authors: Bagdasarova I. , Kruglikova I. , Kornilina E. , Kruglikov V.
Published: June 2018

The aim of this work was the study of indicators characterizing the local immunity in patients with various forms of glomerulonephritis by presence of herpesviral infection.

Materials and methods. A quantitative estimation of the content of IL-8 and SLPI in urine of 47 patients with glomerulonephritis and 10 apparently healthy individuals was conducted.

Results. A insignificant increase of IL-8 level in urine was showed in patients with glomerulonephritis. The level of urinary SLPI was reliably higher than the control value, at the same time the majority ofpatients (74,0 %) did not exceed the upper limit of the physiological norm. The essential increase ofIL-8 level in urine was observed in 13 sick children, and of SLPI – in 12 patients. The increase of IL-8 and SLPI levels was observed more frequently in patients with hematuric form of glomerulonephritis, with nephrotic steroidoresistant variant of nephrotic form, in the absence of remission, and in the case of IL-8 - with severe course of the disease. More such changes were found in children with active (reactivated) herpesviral infections.

Conclusion. There has been confirmed the importance of the study of immunologic parameters in the urine of patients with glomerulonephritis to characterize immunopathological process in the kidney and prognosis of the disease.
PLASMID-INDUCED ANTIBIOTIC RESISTANCE AMONG PATHOGENS OF CHRONIC PYELONEPHRITIS: PREVALENCE OF GENES AND MAJOR RISK FACTORS
Authors: Chub О. , Bilchenko O.
Published: June 2018

The aim of the study is to determine the prevalence of plasmid-mediated resistance genes among uro- pathogens from hospitalized patients with chronic pyelonephritis.

Methods. A cross-sectional study of 105patients with chronic pyelonephritis and different stage of chronic kidney disease, was carried. Screening for the presence ofplasmid-mediated genes was performed by polymerase chain reaction. Determining the risk factors was performed by analysis of prevalence Odd-ratio.

Results. The prevalence of plasmid-mediated resistance mechanisms among uropathogens is 36.7%, mainly due to extended-spectrum p-lactamase (25%). The main factors related with appearance of plasmid-mediated resistance genes were age range above 55 years (OR 3.05), hypertension (OR 2.57), Chronic Kidney Disease stage ІІІ (OR 2,03) and V (OR 1,1), in-patient treatment history (OR 2.02), duration of CP more than 10 years (OR 1,97), history of using antibiotics last year (OR 1,41).

Conclusion. Isolation and detection of plasmid-mediated resistance mechanisms among urinary strains are essential for the selection of the most effective antibiotic for the empiric treatment.
DISTURBANCES OF NUTRINIONAL STATUS IN PATIENTS TREATED BY PERITONEAL DIALYSIS
Authors: Dudar I. , Shymova A. , Krasyuk E. , Burzhynska I.
Published: June 2018

this work is devoted to the problem of malnutrition in patients who are treated by peritoneal dialysis, the main causes of violations of nutritional status were observed, and also the classification of protein-energy malnutrition was described.
RATING SCORE SPECIALIZED MEDICAL CARE PATIENTS RENAL PROFILE IN UKRAINE 2016
Authors: Kolesnyk M. O. , Kozlyuk N I. , Nikolaenko S. S.
Published: June 2018

Rating evaluation of specialized medical care for patients with renal deceases in Ukraine is conducted on basis of analysis of main criteria’s of its organization and availability, of results of treatment of CKD patients stage 5 HD, PD, T and AKI patients. Regional rating was evaluated separately for every group of parameters and then the summary rating evaluation was conducted
ESTIMATION OF NEPHROPROTECTIVE EFFECT OF ANGIOTENSIN-CONVERTING ENZYME RAMIPRIL IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS
Authors: Dolinnayä M.A. , Shekhovtseva T.G.
Published: June 2018

Цель: изучить взаимосвязь между морфологическими показателями гломерулярного поражения почек и цистатином С (CysC) сыворотки крови у больных хроническим гломерулонефритом (ХТН) с сохраненной функцией почек, а также оценить терапевтическую коррекцию выявленных нарушений с помощью и АПФ рамиприла.

Материалы и методы исследования. Обследован 81 больной с ХТН. Пациенты были разделены на 2 клинические группы: больные ХТН с артериальной гипертензией (АТ), ХТН без АТ. Средняя суточная доза рамиприла у больных ХТН с АТ составила 12,8 ± 5,6 мг, у пациентов с ХТН без АТ – 2,5 мг.

Для анализа гломерулярного поражения почек у больных ХТН использовались данные нефробиопсий по следующим параметрам: пролиферация мезангиальных клеток, расширение мезангиального матрикса, гломерулосклероз, наличие фиброзных полумесяцев, утолщение капиллярных петель и/или их сращение с капсулой Боумена, утолщение и/или расщепление гломерулярной базальной мембраны, наличие экстракапиллярного компонента в просвете капсулы Боумена. Уровень Cys C в сыворотке крови определяли иммуноферментным методом.

Результаты и обсуждение. Нами статистически подтверждена прямая связь между cysC крови и гло- мерулосклерозом (r = 0,85; р < 0,05). Установлено, что метод диагностики гломерулосклероза почек с помощью определения маркера cysC в сыворотке крови является высокочувствительным и специфичным, с эффективностью 96,55%.

Выводы: сывороточный уровень cys C является чувствительным маркером гломерулосклероза почек у больных ХТН с диагностической эффективностью до 97%. Под влиянием 24-недельной терапии и АПФ рамиприлом у больных ХТН с наличием АТ и без наблюдается достоверное снижение маркеров поражения почек, в том числе и cysC сыворотки крови, что подтверждает нефропротекторное действие препарата.
FACTORS ASSOCIATED WITH INTRADIALYTIC HYPOTENSION IN HEMODIALYSIS PATIENTS AND WAYS OF ITS CORRECTION. CLINIC EXPERIENCE
Authors: Snisar L. , Liksunova L. , Aleksieieva N.
Published: June 2018

Results of studies in recent years show a worse survival rate of dialysis patients who have frequent episodes intradialytic hypotension (IDH), as opposed patients without IDH.

The purpose of this quality improvement project was to study the factors associated with intradialytic hypotension in these patients and institute appropriate measures to mitigate this issue.

Patients and methods. In our clinic, we identified that 14.3% of dialysis patients experienced a decrease in their systolic blood pressure (SBP) to below 80 during dialysis.

Results. The results were studied for 3 months. We found that 57.1% of patients experienced an improvement in their blood pressure profile over the period of the study.

Conclusions. Factors associated with IDH are hypocalcemia, heart failure with systolic dysfunction, increase mterdialytic body weight over 2.5 kg and hospitalizations more than 2 times/year. Suggesting that simple changes to dialysis prescription can result in a significant reduction in the incidence of IDH.
THE ASSOCIATION OF DYSLIPIDEMIA WITH INTRAPERITONEAL INFLAMMATION AND PERITONEAL DIALYSIS TECHNIQUE SURVIVAL
Authors: Stepanova N. , Burdeyna O. , Dudar I. , Driyanska V. , Snisar L. , Shifris I. , Krasyuk E. , Shimova A.
Published: June 2018

The aim of the study was to determine the relationship between the dyslipidemia, intraperitoneal inflammation and peritoneal dialysis (PD) survival.

Patients and methods. A total of 40patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis (PD) have been included in a prospective, observational study (average age was 49.3 ± 12.7). All patients were determined the blood lipid spectrum and IL-10, TNF-a, MCP-1 levels in peritoneal dialysis effluent (PDE). PD adequacy indicators evaluated by determining the concentration of urea and creatinine in plasma, urine and dialysate, calculated weekly creatinine clearance (CrCl), dialysis (Kt/ Vd), renal (Kt/ Vr) and total weekly urea clearance (Kt/ V).

Results. Dyslipidemia defined as increase of atherogenic lipoprotein fractions and inhibition ofHDL cholesterol was identified in 70% of the PD-patients. LDL cholesterol level and, accordingly, an atherogenic index (AI) were significantly dependent on the duration of PD treatment (R2 = 2.18 ± 0.15 (95% CI 1.87, 2.5), p < 0,0001 and R2 = 2.77 ± 0.27(95% CI 2.2, 3.3), p < 0,0001). The blood levels of total cholesterol, LDL-C and TG in the patients with diabetes were significantly higher compared with the diabetes-free patients (p = 0.007, p = 0.001 andp = 0.02, respectively).

Reducing the HDL cholesterol level was associated with high intraperitoneal production of pro-inflammatory mediators TNF-a (r = - 0.53;p = 0.001) and anti-inflammatory IL-10 (r = - 0.783;p <0.0001), whereas hypertriglyceridemia and high VLDL cholesterol are associated with an increase of MCP-1 (r = 0.6;p = 0.0003 and r = 0.55;p = 0.002, respectively).

The Cox proportional hazards regression analysis demonstrated the significant effect of VLDL cholesterol, LDL cholesterol and AI on the survival of PD technique survival (x2 = 24.8; p < 0.0001). The results of the Kaplan–Meier analysis and log-rank test also identified that there was a significant difference in the cumulative technical survival rate between the patients with AI level < 3.5 and > 3.5 (log-rank test: x2 = 19.8, P = 0.001.

Conclusions. Our results can be considered dyslipidemia in PD-patients not only as a traditional risk factor for CVD, but also as a predictor of chronic intraperitoneal inflammation and decrease of PD technical survival.
THE MEDICAL AND PREVENTIVE CARE TO PATIENTS OF A NEPHROLOGICAL PROFILE 2009-2012, WHAT TO DO NEXT ?
Authors: Kolesnyk M. O. , Saidakova N. O. , Kozlyuk N. I. , Nikolaenko S. S.
Published: June 2018

This is a study of the basic performance of nephrology care to the population of Ukraine during 2009-2012. The paper used the data from the National registry of patients with chronic kidney disease during 2009-2012, published by the "Institute of Nephrology of NAMS of Ukraine." The results of analysis testify to considerable lag on the size of basic parameters of medical help to the patients of nephrological profile from European.
INFLUENCE OF GLICEROL ON FUNCTIONAL-MORPHOLOGICAL INDICATORS OF KIDNEYS AT MODELLING RENAL INSUFFICIENCY IN RATS
Authors: Kondakov I. I. , Topchii I. I. , Kirienko O. M.
Published: June 2018

It is known, that after acute damage of kidney there is a risk of development of chronic kidney desease and death rate from its complications.

Material and methods. Research are spent on 40 not purebred rats at modelling of acute damage of the kidneys caused by toxic doses of glycerol. To evaluate histopathologal changes , we used cuts of fabrics painted gematoksilin- eozinom. Ultrathin preparations analyzed in electronic microscope PЕМ-125К.

Results. Administration of glycerol leads to uremia with dystrophic changes in tubular device and glomerular hypertrophy. At a stage of chronic renal insufficiency reduction of the glomerular sizes, tubulointerstitial fibrosis and glomerulosclerosis is observed.

Conclusion. At modelling of a nephritic pathology by introduction of 50 % glycerol infringement of function of kidneys has phasic character with probable development of chronic kidney desease in 8 weeks.
A SURVIVAL OF PATIENTS IN MAINTENCE HEMODIALYSIS DEPENDING ON EXPRESSED ANAEMIA AND CHARACTER OF DEFEAT OF KIDNEY
Authors: Savchuk V.
Published: June 2018

The aim of the present research was to study the survival of hemodialysis (HD) patients depending on of anemia and character of kidney damage, «hemoglobin variability”

Materials and methods: We have conducted a retrospective study of 183 hemodialysis patients who were treated from 2009. to 2012. The starting point of observation was defined the first hemodialysis session. The patients were divided in accordance of hemoglobin (Hb) levels for 4 groups: the level of Hb <70 g/l (n=32) – group I, Hb 70–89 g/l (n=68) - group II, Hb 90-110 g/l (n=65) – group III, Hb≥110g/l (n=28) - IV group.

Results. The cumulative survival of patients was 55% at the moment of the end of the study. The cumulative proportion surviving of patients with diabetes mellitus was significantly lower compared to non-diabetic patients – 18% and 57%, respectively.

The survival of patients I & II groups was significantly lower than the patients of  groups III & IV: 83.64% and 63.75% versus 31.7% and 29.28%, respectively (criteria Geha-Wilcoxon, Cox-Mantel test, Wilcoxon-Peto, F-criterion Cox log-rank test).

The survival of patients with "stable hemoglobin" was significantly higher than in patients with "low of hemoglobin variability " and "high of hemoglobin variability"(р<0,005).

Conclusions. Hb level and its variability had a significant effect on the survival of patients who are treated with hemodialysis. The survival of hemodialysis patients with diabetes mellitus was significantly lower than in non-diabetic kidney failure.
EXPEDIENCY USING OF LOW-PROTEIN UKRAINIAN DISHES AND KETO/AMINO ACIDS IN THE TREATMENT OF CHRONIC KIDNEY DISEASE STAGE IV-V
Authors: Nykula T. D. , Moyseyenko V. O. , Naumova O. O.
Published: June 2018

Through the analysis of literature, the results of own research and development, 48-year-old experience in the nephrologìcal clinic outlines the dietary treatment of chronic kidney disease (CKD). Common issues with dietary interventions in CKD, optimal protein diet lowprotein quota must provide, culinary food processing of dietary interventions in patients with CKD. Particular attention is drawn to the use of Ukrainian low-protein dishes, which were developed by the author, and their combination with ketoacids including Ketosteril.
ANTIOXIDANT EFFECTOF NUCLEINAT SODIUM IN PATIENTS WITH CHRONIC KIDNEYDISEASE І–II STAGES: UNCOMPLICATED PYELONEPHRITIS
Authors: Stepanova N. , Korol L. , Migal L. , Romanenko O.
Published: June 2018

Objective: to determine the antioxidant effects of Nucleinat sodium in patients with uncomplicated recurrent pyelonephritis.

Material and methods. We have analyzed the indicators of oxidant/ antioxidant (O/ A) balance in the blood of 55 patients with uncomplicated recurrent pyelonephritis. Women were randomized into 2 groups: I (n=30) consisted of patients treated with Nucleinat sodium at a dose of 0.25 mg 4 times daily for 14 days to II (n=25) included patients who used only antibacterial therapy (according to the set sensitivity identified pathogens). The control group consisted of 20 conditional healthy donors, matched for sex and age.

Results. In the blood ofpatients prior to treatment were observed reduction of total peroxidase activity of red blood cells (p<0.0001), ceruloplasmin (p=0,03), SH–groups (p=0.001) and increase in serum MDA, and oxidative stress index (p<0.0001) compared with the conditionally healthy donors. Comprehensive treatment with Nucleinat sodium statistically significantly led to normalization of these parameters and decrease of urine N–acetyl–p–D– glucosaminidase and p–galactosidase (p<0,001 and p=0.04, respectively).

Conclusions. For the treatment of uncomplicated recurrent pyelonephritis appropriate to apply Nucleinat sodium at a dose of 0.25 mg 4 times / day, which helps to reduce the activity of oxidative processes and the negative impact of oxidative stress on the patient, and increases of antioxidant protection.
HYPEROXALURIA AND BIOMARKERS OF MUCOSAL IMMUNITY IN PATIENTS WITH RECURRENT PYELONEPHRITIS
Authors: Kolesnyk M. , Stashevska N. , Stepanova N. , Dryyanskaya V. , Rudenko A. , Kruglykov V. , Kornylina O.
Published: June 2018

Summary: The aim of our study was to compare the performance of mucosal immunity in urine and saliva of patients with chronic recurrent pyelonephritis subject to availability of hyperoxaluria.

Material and methods. To observational cross–sectional study included 40 women with chronic recurrent pyelonephritis, aged 21 to 48 years (31.6±7.7). Depending on the availability hyperoxaluria (oxalate excretion in the urine than 0.45 mmol per day) patients were divided into II Groups: for I (n=29) included women with hyperoxaluria, to II (n=11) – includes patients with normal excretion oxalate (7.2±2.4 vs 43.8±5.2; p <0.001). State of mucosal immunity was assessed by determining the content of lysozyme, lactoferrin, secretory immunoglobulin A (sIg A) and tumor necrosis factor alpha (TNF– a) in urine samples and content sIg A and class antibodies sIg A to lipopolysaccharide (LPS) of gram–negative bacteria (anti–LPS–sIgA) in saliva.

Results. We have identified significantly higher levels of sIg A and anti–LPS–sIgA in the saliva ofpatients with recurrent pyelonephritis with hyperoxaluria (298±104 vs 150.1±79.3 mg/1, p<0.001) and (0.353±0.16 vs 0.211±0.09, p<0.001), respectively. In the urine ofwomen of group I we havefound a statistically significant increase in the content of TNF– a 44 [16.2–130.5] vs 21 [14.2–3.45] pg/ml (p=0.04) and lysozyme 14.0[2.5– 36.5]vs 1.45[0.12–7.5]ng/ml (p=0.002). All the studied parameters (anti–LPS–sIg A in saliva and sIg A, lactofer– rin and lysozyme urine) had a direct correlation with the level of daily oxalate excretion.

 

Conclusions. Overproduction of indicators of mucosal immunity may be explained by the formation of intestinal dysbiosis under the influence of continuous antibiotic therapy. The imbalance of intestinal microflora, in turn, leads to the formation of hyperoxaluria and increases the production of antibodies to LPS, sIg A, lactoferrin and lysozyme.
BIOMARKERS OF KIDNEY DAMAGE IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Kraydaschenko O.V. , Dolinnaya M.A.
Published: June 2018

Involving of renal tubulointerstitial tissue (TIT) with fibrosis development plays an important role in the persistent renal dysfunction. This circumstance gave rise to the attempts of neutrophil gelatinase–associated lipocalin (NGAL), interleukin–18 (IL–18) use to estimate kidney TIT lesion in chronic glomerulonephritis (CGN) and essential hypertension (EH).

Aim. To study the relationship between the biomarkers and clinical, morphological parameters reflecting renal TIT damage in CGN and EH patients.

Materials and methods. We examined 44 hypertensive patients and 49 patients with CGN and hypertension. We used data of the kidney morphological study for the analysis of renal TIT lesion in CGN patients. Levels of blood and urine NGAL and IL–18 were determined using immunoassay kits.

Results. All patients had preserved renal function. In hypertensive patients microalbuminuria (MAU) was detected in 32%. Patients with CGN had average daily proteinuria 0,5 (0,1:1,2) g/day. Morphologically tubular epithelium dystrophy was observed in 98% ofpatients with CGN. Interstitial fibrosis (IF) was seen in all patients with CGN, and 45% had focal character, while 55% – diffuse. Necrotic changes in the tubular epithelium were observed in 69% of cases, thickening of tubular basement membrane – 61% of patients. Correlation analysis found an association between the level of serum NGAL and IF(r=0,35, p=0,05), tubular basement membrane thickening (r=0,42, p=0,05); urinary NGAL levels and tubular epithelium dystrophy (r=0,29, p=0,05). Serum IL–18 was correlated with tubular epithelium dystrophy (r=0,69, p=0,05); tubular epithelium necrosis (r=0,37, p=0,05), IF (r=0,31, p=0,05). Despite normal renal function and absence of MAU (in 64% of cases), the indicators of renal TIT damage in hypertensive patients are increased.

Conclusions. Serum, urine NGAL and serum IL–18 can be used as markers of renal TIT lesion in CGN and EH patients. Serum NGAL reflects most accurately IF and tubular basement membrane changes; urine NGAL – tubular epithelium dystrophy. Serum IL–18 is an indicator of tubular epithelium necrosis, IF.
EFFECT OF CRYO PLACENTA EXTRACT ON THE STRUCTURE AND FUNCTION OF KIDNEYS RATS WITH ACUTE OR CHRONIC RENAL FAILURE
Authors: Topchii I.I. , Kondakov I.K. , Kirienko O.M.
Published: June 2018

Summary. Material and methods. On an experimental material at modelling of acute and chronic nephritic insufficiency at 75 white not purebred rats action research a crioextract ofplacenta (CEP) on morphology and functional indicators of kidneys is carried out.

Results and discussion. Introduction CEP in early terms of damage of kidneys leads to fast elimination of changes of an epithelium of the tubular device and prevents development a CKI. The effect from introduction CEP remains about 16 weeks.

Conclusions. Under the influence ofCEP in the beginning of development of acute kidney insufficiency function of kidneys remains. At the generated chronic insufficiency function of kidneys improves for short term and introduction ofCEP does not influence on development CKI.
PENTOSAN POLYSULPHATE INFLUENCEON THE COURSE OF CHRONICKIDNEYDISEASE ST'. II - IV
Authors: Dudari O. , Shifrisi M. , Driyanska V.Ye. , Krot V.F. , Loboda O.M. , Krasiuke K. , Krylova M.H. , N.G. Alexeeva , Bryzhachenko T.P.
Published: June 2018

The aim is to determine the effect of the drug pentosan polysulphate at the rate of disease progression in patients with CKD II - IVst., to confirmation of lipid - lowering action and setting of the drug on indicators of chronic inflammation.

Materials and methods. Tests conducted in one center for 12 weeks. The study included 60patients with CKD II - IV st. Patients were divided into 2 groups: group 1 (basic) - 30patients in addition to standard therapy receiving study medication, pentosan polysulphate, group 2 - 30 patients received only standard therapy. The drug pentosan polysulphate was administered for 8 - weeks: 100 mg. a day intramuscularly or intravenously for 3 weeks, followed by oral administration of 50 mg two times a day. The survey studied the dynamics ofdaily proteinuria, GFR, lipids, indicators of tumor necrosis factor, IL - 18 and vascular endothelial growth factor (VEGF) before and after treatment (12 week observation).

Results. It was found a significant decrease in total cholesterol and atherogenic ratio after 3 months of treatment in the study group, hypolipidemic effect is more significant than in the comparison group. The group used pentosan polysulphate proteinuria reduction was more pronounced, and was 65% against 38% in the comparison group. Pentosan polysulphate in the treatment ofCKDpatients in stages II - IV contributes to significant decrease in inflammatory cytokines (IL - 18 and TNF - a) in contrast to the comparison group.

Conclusions. The use of pentosan polysulphate in the treatment of patients with CKD stages II - IV had positive effect on lipid metabolism. Purpose pentosan polysulphate patients with CKD stages II - IV contributes to a significant reduction of the daily proteinuria and eGFR improvement, reduces levels of inflammatory cytokines: IL - 18 and TNF - a.
INFLUENCE OF ACECLOFENAK ON THE LEVEL OF PROAND ANTIINFLAMMATORY CYTOKINES IN THE PATIENTS WITH RHEUMATOID ARTHRITIS AND CHRONIC KIDNEY DISEASE
Authors: Zubl O. , Roborchuks W. , Dotsyukl G.
Published: June 2018

The purpose - to investigate the effect of aceclofenac on the level of proand anti - inflammatory cytokines in patients with rheumatoid arthritis and chronic kidney disease.

Material and Methods: The research included 88patients: 45 with rheumatoid arthritis (RA) without chronic kidney disease (CKD), 43 with RA and CKD stage I without nephrotic syndrome. In a complex therapie of patients it is included nonsteroid anti - inflammatory drug aceclofenac. Influence of aceclofenac was compared with meloxicam. It is investigated to patients the content IL - 1$, IL - 10, TNFa, TGF$1, MCP - 1 is the urine with an immunofermental method.

Results. After two weeks of therapy with aceclofenac was revealed reduction IL - 1$ levels (p<0,05) and urinary (p<0,05), TNFa levels (p<0,05) in patients with RA and RA with CKD. Level of pro - sclerous cytokin TGFf>1 of blood (p<0,05) and urine (p<0,001) at patients with RA with CKD is reduced. Decrease in the MCP - 1 level in blood (in 1,5 times) and in urine (in 2 times) at patients with RA and CKD is revealed.

Conclusion. Application of therapy with aceclofenac for complex treatment ofpatients with RA and CKD improves efficiency of treatment for these patients through improvement cytokines of blood and urine.
PREDICTION OF UNFAVORABLE COURSE OF NEPHROTIC SYNDROME IN CHILDREN: THE MULTIMARKER PARALLEL CASCADE SYSTEM
Authors: Fomina S.
Published: June 2018

The aim of study was to investigate the possibility of using the results of different diagnostic tests in children with nephrotic syndrome (NS) asprognostic markers during disease course.

Materials and methods. The operating characteristics of values derived in dynamic renoscintigraphy and indirect renangiography with 99mTc-DTPA, static renoscintigraphy with 99mTc-phosphate, levels of urine renospecific enzymes (N-acethyl-$-D-glucosaminidase and $-galactosidase) were estimated in 480NS children depending on disease activity.

Results. Different levels of prognostic valuefor studiedparameters were confirmed depend ofNS outcome.

Conclusion. Renoscintigraphy indexes and urine renospecific enzymes activity levels should be used as markers of the progression in NS children with the glance to optimal terms of studies' conduction and range parameters. The multimarker parallel cascade Systemfor prediction of unfavorable NS course has been initiated. This System can be regarded as the start ofa new strategic goalfordetermination ofrelevant unfavorable disease courseparameters in any branch ofmedicine.
HYPEROXALURIA: FORMATION MECHANISMS AND CONSEQUENCES
Authors: Stepanova N.
Published: June 2018

The work is a literature review, which demonstrates the current view on the mechanisms underlying the formation of hyperoxaluria and possible outcomes. The article includes detailed information on the biochemistry of oxalate, exogenous and endogenous resources in the human body, mechanisms of oxalate absorption in the gastrointestinal tract and renal excretion. Thefinal sectionfocuses on existing andpromising approaches to the treatment ofhyperoxaluria.