Journal Ukrainian Journal of Nephrology and Dialysis-
Published: 8 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 30-36; doi:10.31450/ukrjnd.4(56).2017.02
Abstract:The aim of the study was to determine the clinical features and molecular genetic patterns of patients with Fabry disease (FD) to optimize the diagnostic stepwise. Object and methods. The comparison of clinical features was performed and the activity of lysosomal enzyme a–galactosidase A in the peripheral blood leukocyte homogenate was studied in 120 male with the neuropathic pain or acroparesthesia who contacted the Center of Orphan Diseases of NSCH “Ohmatdyt” in years 2002–2016. The cascade family screening (in 8 people) at low enzyme levels and molecular genetic analysis for the presence of mutations in the GLA gene were performed. Results. The activity of –galactosidase A was decreased (range 0.5–12.6 nM/mg/h with median 2.0 nM/mg/h) in nine cases (7.5%). All these patients had additional clinical signs (angiokeratoma, hypertrophic cardiomyopathy, coarse facial features, and compromised family tree). The diagnosis of FD were confirmed by the molecular genetic analysis in the GLA gene; there were identified two new mutations (p.739 740delAA and C.945 946delinsTTGA). The other mutations in 6 out of 8 examined families were revealed by the screening of the first kinship degree female relatives, but the activity of –galactosidase A in leukocytes was only reduced in 4 of them. Conclusion. The multisystem lesions and the difference in the clinical signs of FD complicate the timely formulation of diagnosis. Selective screening among patients with renal insufficiency, cardiac pathology, and ischemic stroke in the anamnesis increases the possibility of FD diagnosis. Cascade family screening of FD patients relatives is highly effective in identification new patients with non–classical form of FD. Inclusion in the selective group of persons with chronic diseases, compromised pedigree, acroparesthesia and additional FD probable clinical signs reduces the range ofpatients for further high–cost testing and optimizes the diagnosis of FD.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 141-160; doi:10.31450/ukrjnd.2(38).2013.11
Abstract:Sympathetic nervous system plays a crucial role in the development of cardiovascular complications in chronic kidney disease (CKD) patients. The aim of this review is to summarize up-to-date knowledge of the sympathetic hyperactivity in the pathogenesis of CKD, its clinical relevance, and as the options of current treatment.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 21-38; doi:10.31450/ukrjnd.2(38).2013.02
Abstract:The pro- and antiinflammatory cytokines participate in antiinfective immunity, that is why it is necessary study their peculiarities in determination of the role in the immunopathogenesis of pyelonephritis, including complications of diabetes mellitus (DM). The purpose of the work is to study the immune status and levels of pro- and antiinflammatory blood cytokines in the patients with chronic pyelonephritis (CPN), to determine the peculiarities in cases of DM. Materials and methods. The immuno-enzymic method ELISA and the corresponding test-systems were used to study the levels of cytokines in blood and also standard immunity indices. Results. The analysis showed the significant increase in levels of all studied pro- (TNF-б, MCP-1, IL-17, -23) and antiinflammatory (IL-4, TGF-в) cytokines in all patients with CPN and in every group – with (2) and without DM (3). In 3 gr. (CPN+DM) the CD4+/CD8+ are significantly lower, while in IgM, МСР-1 and TNF-б levels – higher than in the 1 gr. (DM without CPN), and IL-4 , NGAL – than in 2 gr. (CPN without DM). Conclusion. The high level of cytokines (TNF-б, MCP-1 and IL-23) in blood confirms their important role in CPN+DM and CPN without DM. In patients with CPN+DM marked reduction in regulatory index (CD4+/CD8+) and higher levels of proinflammatory cytokines (TNF-б, MCP-1). Our investigation showed that NGAL level in serum was increased more significantly in 3 gr.; this fact may confirm that renal disfunction was more severe in patients with CPN+DM.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 19-24; doi:10.31450/ukrjnd.2(42).2014.04
Abstract:Summary. Introduction. The aim of the work is the determination of functioning of the single kidney (SK) by complex scintigraphic research with using nephrotrophic radiopharmaceuticals (NRP) of different mechanisms of elimination and the detection of its diagnostic significance. Materials and methods. 90 children (range 5-16 years) with SK were examined: dynamic (DRSG) and static (SRSG) scintigraphy with angiography was made them. 150 scintigraphic examinations with different NRP were made: 99mTc-DTPA (diethyleneaminopentacetate) – 51, 99mTc – PP (pyrophosphate) – 40,99mTc – DMSA (dymethylenesuccinateacetate) – 34, 99mTc MAG3 (mer- captoacetyle-3-glycine) – 15, 99mTc-EC (ethylenedicysteine) – 10. Time options of renal blood flow and transport of NRP, SGF, ERP were determined. Control group consists of15 children. Results.The main scintigraphic features ofSK are: presence of single kidney on scintigraphic image; slowdown of time options of renal haemodynamic, increasing of SGF and ERP of SK on 50-60 %; decreasing of standard parameters SGF and ERP on 40-50%. The slowdown of SK excretion ability is associated with retention NRP in parenchyma. Proportions of SK increase on 2-3 sm average, and size of scintigraphic picture – on 40%. The main type of renographic curve in children with SK is parenchymatose, and it is found in 50% ofpatients. The accumulation and distribution of NRP in SK in 73,3 % is quite uniform. Conclisions. Thus, SK in children functions in strain way of all compensation mechanisms that provide blood purification from products of vital functions, which shows the slowdown of main options of the SKfunctioning.
Published: 16 August 2013
Ukrainian Journal of Nephrology and Dialysis pp 42-47; doi:10.31450/ukrjnd.1(41).2014.08
Abstract:Aim of work it was to conduct the analysis of frequency and testimonies to application of auxiliary technologies of экстракорпорального treatment of children with ARFof the different age–related groups.
Published: 14 February 2014
Ukrainian Journal of Nephrology and Dialysis pp 33-36; doi:10.31450/ukrjnd.1(41).2014.06
Abstract:To investigate indexes ofdaily blood pressure (BP) in patients with chronic glomerulonephritis (CGN) and normal renal function.
Published: 23 November 2015
Ukrainian Journal of Nephrology and Dialysis pp 21-26; doi:10.31450/ukrjnd.4(48).2015.03
Abstract:The aim of the study was to examine the osmoregulatory state of renal function in patients with type 2 diabetes in a water - salt load with 0,5% NaCl in the amount of 0.5% of body weight. Materials and methods. The study involved 56patients with insulin - dependent diabetic nephropathy,24 men (42.9%) and 32 women (57.1%), aged from 38 to 81 years. The osmolality was measured by freezing point depression on osmomat 030 - D (USA). Glomerular filtration rate (GFR) was calculated by the formula GFR - EPI with subsequent determination of renal functional reserve. Results. It demonstrated that renal osmoregulatory function provides effective regulation of osmotic homeostasis even in a reduced amount of nephrons, but as the glomerular filtration rate decreses to 30 ml/min, the excretion of osmotically active substances gradually decrease too. Conclusion. Osmoregulatory disturbances in the renal function in patients with 2 types diabetes depend both on the reduction in GFR, - and on changes in the functional capacity of nephron's tubules.
Published: 8 January 2014
Ukrainian Journal of Nephrology and Dialysis pp 19-29; doi:10.31450/ukrjnd.1(41).2014.04
Abstract:The pro- and antiinflammatory cytokines, SLPI participate in antiinfective immunity, that is why it is necessary study their peculiarities in determination of the role in the immunopathogenesis of pyelonephritis and efficiency of treatment.
Published: 12 January 2014
Ukrainian Journal of Nephrology and Dialysis pp 29-33; doi:10.31450/ukrjnd.1(41).2014.05
Abstract:Aim of the work was to evaluate the possibility of determining the oxidative stress index (OSI) in blood serum of women with pyelonephritis as prognostic marker of recurrent pyelonephritis.
Published: 12 September 2017
Ukrainian Journal of Nephrology and Dialysis pp 48-67; doi:10.31450/ukrjnd.4(56).2017.05
Abstract:Pediatric urinary tract infection (UTI) is the current problem of pediatrics, urology and nephrology. Its clinical features are varied and age–dependent associated with the inflammation activity, the presence of urinary system abnormalities, and comorbidity. Professional associations and experts initiated creation of one field UTI definitions, diagnostic and therapeutic approaches according to different specialties requirements. This study proposes to revise UTI and pyelonephritis classifications in children, to clarify patients routes from the assumed diagnosis to its confirmation, therapeutic management, multilevel prevention and rehabilitation based on the national protocols modification according evidence–based approach.
Published: 15 August 2017
Ukrainian Journal of Nephrology and Dialysis pp 42-47; doi:10.31450/ukrjnd.4(56).2017.04
Abstract:In this survey of contemporary foreign literature presents the results of recent studies on acute kidney damage in children. Present modern system of stratification by severity degrees ofacute kidney injury and their comparison (RIFLE and AKIN – criteria). For this reason recently there has been a great surge of interest in identifying biomarkers ofacute and chronic kidney injury which help to detect early pathological changes in kidneys, to differentiate the injury of different parts of the nephron, to accurately determine the stage of the process, to assess the severity of inflammation and fibrogenesis intensity. The most important new markers which are currently studied include KIM–1, VEGF–А, L–FABP, TGF–b1, NGAL and NAG. This review highlights the results of major recent studies in this area.
Published: 2 August 2017
Ukrainian Journal of Nephrology and Dialysis pp 41-43; doi:10.31450/ukrjnd.3(51).2016.06
Abstract: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.
Published: 7 November 2016
Ukrainian Journal of Nephrology and Dialysis pp 52-58; doi:10.31450/ukrjnd.4(52).2016.04
Abstract:Peritonealfibrosis (PF) is a common morphological change in peritoneal dialysis (PD) patients. With the progression of PF, peritoneal membrane function is impaired, which leads to ultrafiltration failure. Results of studies in recent years show the crucial role of high production monocytic chemoattractant protein -1 (MCP-1) of peritoneal fibrosis in PD-patients. The aim was to determine intraperitoneally production ofIL-10 and MCP-1 and its relationship with clinical and laboratory parameters of adequacy of dialysis. Patients and methods. A prospective observational study involved 18patients with CKD stage Vwith non-diabetic nephropathy, were treated with continuous ambulatory peritoneal dialysis (PAPD). The limits of the normal range (reference range) were obtained from the survey results of 10 conditionally healthy individuals. ELISA method in serum and peritoneal dialysis effluent (PDE) investigated levels ofIL-10 and MSP-1. PAPD adequacy indicators evaluated by determining the concentration of urea and creatinine in plasma, urine and dialysate, calculated weekly creatinine clearance (CrCl), dialysis (Ш/ Vd), renal (Ш / Vr) and шА weekly urea clearance (Kt/ V). [email protected] Results. In all of the PD-patients compared to healthy donors conventionally, there was a significant increase in concentration of the cytokines. We determined the positive regression relationship between the concentration of MCP-1 and IL-10 in PDE and the level of total weekly (Kt / V) and renal (Kt / Vr). Conclusions. We determined the regression dependence, which allowed to identify clinical parameters that are most closely (statistically significant) related to intraperitoneal production of MCP-1 and IL-10.
Published: 6 September 2016
Ukrainian Journal of Nephrology and Dialysis pp 28-31; doi:10.31450/ukrjnd.3(51).2016.03
Abstract:Antibiotic therapy and long-term antibiotic prophylaxis affect the normal flora of the gastrointestinal tract in the patients with recurrent pyelonephritis. It may disturb the balance in oxalate-degrading bacteria in colon and induce hyperoxaluria. The aim of this study was to investigate the level of colon oxalate-degrading bacteria colonization inpatients with recurrentpyelonephritis and its association with administration ofantibiotics. Patients and methods. The pilot observational cross-sectional study, involving 12 patients with uncomplicated recurrent pyelonephritis, non-stone formers. Oxalate-degrading bacteria in feces were identified by bacteriological culture method in the sodium oxalate reach medium. Results. Oxalate-degrading bacteria were detected in feces of 6 (50%) surveyed patients. The number of oxalatedegrading bacteria ranged from 2,0 to 7,0 lg CFU/g in feces and depended on the time after the last administration of antibiotics (F = 4,6; P = 0.05). The levels of oxalate-degrading bacteria colonization and urinary oxalate excretion in surveyed women had a moderate inverse correlation (p =-0,6;P = 0.03). Conclusions. The significantly higher urinary oxalate excretion in women non stone-formers with recurrent pyelonephritis may be associated with the application of antibiotics and a subsequent decolonization of oxalate-degrading bfcteria: must befurther confirmed in ranaomizea study.
Published: 23 February 2016
Ukrainian Journal of Nephrology and Dialysis pp 26-31; doi:10.31450/ukrjnd.1(49).2016.01
Abstract:The article are covering problems for the organization of nephrological care in Kyiv. Regulations according to which nephrological assistance is provided to city residents are listed. Proposals to improve the nephrological aid in Kншv are presented
Published: 27 January 2014
Ukrainian Journal of Nephrology and Dialysis pp 49-51; doi:10.31450/ukrjnd.1(41).2014.09
Abstract:The review contains information about modern conception ofautosomal–dominant polycystic kidney disease, its genetics, epidemiology, pathogenesis, course, clinical presentation and the results of recent clinical studies
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 14-19; doi:10.31450/ukrjnd.4(40).2013.01
Abstract:The aim of study was to investigate the possibility of using the detection of urine renospecific enzymes activity in children with nephrotic syndrome (NS) as biomarkers of unfavorable disease course prognosis. Materials and methods. The operating characteristics of urine activity values of N-аcethyl- β-D-glucosaminidase (NAG) and β-galactosidase (β-Gal) were estimated in 209 nephrotic children depending on disease course. Results. The high activity of NAG and β-Gal confirms the active participation of renal tubules in pathological process in NS. Likelihood of NS progression increased while saving NAG activity >50 Units and β-Gal >30 Units in 8-10 weeks of therapy and at 1.5-3 years of follow-up after treatment withdrawal; increasing of enzymes levels in 6-9 months on tapering treatment period (NAG >100 Units, β-Gal >60 Units). Changing the enzymes activity in the disease active stage before treatment does not have the prognostic defense. The enzymuric fragment of multimarker parallel cascade system for prediction unfavorable NS course has been created. Conclusion. Urine renospecific enzymes activity (NAG and β-Gal) should be used as markers of the progression in NS children with the optimal terms studies and range parameters as summarized in the proposed prediction system.
Published: 27 January 2014
Ukrainian Journal of Nephrology and Dialysis pp 52-57; doi:10.31450/ukrjnd.1(41).2014.10
Abstract:In recent years peritoneal dialysis is gaining an increasing prevalence in the treatment of patients with chronic stage V kidney disease. The possibility of long–term use of this technique of renal replacement therapy remains limited. This article provides insight onto possible causes of peritoneal dialysis failure in patients with terminal renal insufficiency.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 100-113; doi:10.31450/ukrjnd.2(38).2013.08
Abstract:The purpose of study was to analize the correlation between the rate of syndrom of endogenic intoxication (EI) and the markers of immunity in patients with chronic pyelonephritis (PN). To research the effectiveness of different schemes of treatment chronic pyelonephritis. Methods. Researched were the syndrom of EI and the some markers of immunity in 135 patients with chronic PN. The correlation analysis was performed. For estimate of effectiveness of different schemes of treatment the patients were divided into 4 groups. Results. A growing of deficit of T-cells immunity markers such as CD3+, CD4+ та CD8+ was found and the rising of rate Ig А, G and the circulated immune complexes with increasing of EI. The research showed the rising of spontaneous production TNF- ά and decrease of rate IL-10 with deepening of intoxication. Conclusions. Decreasing of cell-mediated and increasing of humoral immunity markers in patients with exacerbation of chronic PN were found. It was found that there was faster regress of clinical symptomatic in patients that got prescriptions treatment including Kanephron and Chophytol.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 93-99; doi:10.31450/ukrjnd.2(38).2013.07
Abstract:There are a small number of works that have studied heart rhythm variability parameters in patients treated with hemodialysis. Aim. To investigate the peculiarities of heart rhythm variability parameters in patients treated with hemodialysis. Methods. The observational controlled study included 55 patients treated with hemodialysis, aged 24 to 75 years, including 29 men and 26 women. The control group consisted of 20 healthy individuals of comparable age and sex. Heart rhythm variability parameters were investigated in all patients. Results. In the study of heart rhythm variability in patients treated with hemodialysis comparatively with the control group time parameters and most of frequency indexes were decreased. Conclusions. Our study found the diminishment of the total power of neurohumoral regulation in patients treated hemodialysis, as evidenced by the low values SDNN, rNN50, CV.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 58-64; doi:10.31450/ukrjnd.1(37).2013.10
Abstract:This article is a review of the literature. Peritoneal dialysis (PD) was the first method of dialysis renal replacement therapy (DRRT), used for the treatment of patients with acute kidney injury (AKI). PD is able to correct metabolic, electrolyte, acid-alkali disorders and hypervolemia in patients with AKI. Continuous equilibration PD and continuous flow PD can provide of dialysis dose compared with extracorporeal methods of DRRT. However, PD is considered less effective than hemodialysis. In this regard, PD has used in patients with AKI, especially those who are hemodynamically unstable or at risk of bleeding because of severe coagulation abnormalities, in infants and children with AKI, and in patients with circulatory failure.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 10-14; doi:10.31450/ukrjnd.1(37).2013.02
Abstract:All over the world the increase in quantity of patients with vascular complications of chronic inflammatory diseases of kidneys is marked. The interrelation of morphological and biochemical markers of atherosclerotic lesions were studied in 41 patients with coronary artery disease (CAD) (group 1) and 62 - with CAD and chronic glomerulonephritis (CGN) (group 2). An extracranial carotid artery (CA) status was investigated by duplex ultrasonography. VE-cadherin content determined by ELISA. States of the antioxidant system was evaluated by the concentration of malondialdehyde (MDA) and sulfhydryl groups (SH-groups) in the blood plasma by the photometric method. The levels of nitric oxide stable metabolites – NO2 and total (NO2+NO3) in plasma was determined by the photometric method. There was found that the frequency of CA plaques detection in groups 1 and 2 did not differ (27,6% and 31,0%, respectively), but patients of group 2 were reliably younger. Pronounced VE-cadherin increase (3,6-fold, p
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 4-9; doi:10.31450/ukrjnd.1(37).2013.01
Abstract:Work of department of HD of GI "Institute of nephrology of NAMSU" is analyzed and compared to mean for Ukraine and some regions according National register of patients with chronic kidney diseases 2011.
Published: 3 March 2017
Ukrainian Journal of Nephrology and Dialysis pp 58-69; doi:10.31450/ukrjnd.1(53).2017.09
Abstract:The report presented the current approach to diabetes and chronic kidney disease relationship, the problem of nutritional carbohydrates and their role in the diabetes epidemiological situation. The relevant diagnostic and genetic tests in diabetic nephropathy, particularly in children, were outlined. Evidence based treatment was considered according to renal function and pediatric specification.
Published: 1 March 2017
Ukrainian Journal of Nephrology and Dialysis pp 7-12; doi:10.31450/ukrjnd.2(54).2017.02
Abstract: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...
Published: 27 February 2017
Ukrainian Journal of Nephrology and Dialysis pp 42-52; doi:10.31450/ukrjnd.1(53).2017.07
Abstract:Despite medical advances, cardiovascular complications continue to dominate in patients treated with hemodialysis. Therefore, the search for new methods of diagnosis and treatment is advisable. The objective of our research was to study the effectiveness of combination therapy with Fosinopril and Meldonium in patients with stage У chronic kidney disease (CKD) with the signs of chronic heart failure. Materials and methods of the research: 60 patients with stage У CKD were examined and treated. They were on out-patient treatment with program hemodialysis at the Department of extracorporal methods ofdetoxification and chronic dialysis. Results. Significant decrease in left ventricular mass (LVM) by 17.20% (p
Published: 28 February 2017
Ukrainian Journal of Nephrology and Dialysis pp 52-57; doi:10.31450/ukrjnd.1(53).2017.08
Abstract: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...
Published: 15 February 2017
Ukrainian Journal of Nephrology and Dialysis pp 31-35; doi:10.31450/ukrjnd.1(53).2017.05
Abstract: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.
Published: 27 November 2015
Ukrainian Journal of Nephrology and Dialysis pp 3-8; doi:10.31450/ukrjnd.4(48).2015.04
Abstract:The aim of the work was to conduct a comparative analysis of indicators of the performance of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Materials and methods. Evaluation of the performance of the system of provision of nephrological services in the regions of Ukraine was made by studying the indicators that characterize the structure, use of health care resources, quality and efficiency of its provision submitted to National Register ofpatients with chronic kidney disease and patients with acute kidney injury (2015). Results. By using rating evaluation methodology, it was identified place of relevant region by each indicator, by each area and by all areas of provision of nephrological services in the region as a whole. Conclusions. As a result of a comprehensive study of the condition of the system of providing nephrological service in the regions, there were identified ranking places of the administrative territories.
Published: 15 December 2016
Ukrainian Journal of Nephrology and Dialysis pp 42-46; doi:10.31450/ukrjnd.4(52).2016.02
Abstract:The Aim of our study was to determine the intra- and interobserver variation of the automated quantitative evaluation if cortical interstitial fibrosis performed on kidney biopsy samples stained with Sirius red compared to conventional approaches. Materials and methods. The range of fibrosis was evaluated on 15 renal biopsies obtained from adult patients with minimal change nephropathy, focal segmental glomerulosclerosis and membranous nephropathy. Different methods of fibrosis measurement were used: the automated quantification of Sirius red stained areas with and without polarization, the computerized quantification of the fibrotic interstitium on trichrome-stained samples and the visual assessment offibrotic tissues using quantitative and semiquantitative approaches on trkhrome and PAMS-stained slides. The intra- and interobserver variation of these methods was performed. Results. The quantitative evaluation of interstitial fibrosis with Sirius red stain under both polarized and unpolarized light demonstrated nearly perfect inter- and intraobserver reproducibility (ICC=0,85-0,99). Whereas, visual methods had relatively high variance between observations (ICC=0,48-0,66). Conclusions. The automated quantification of cortical interstitial fibrosis as performed on renal biopsy samples stained with Sirius red has been shown to be a highly accurate approach that could be used as a routine method of the kidney biopsy evaluation.
Published: 23 November 2015
Ukrainian Journal of Nephrology and Dialysis pp 15-20; doi:10.31450/ukrjnd.4(48).2015.02
Abstract:Introduction. Full - term newborns with clinical signs of severe perinatal pathology constitute a high risk group of the formation of urinary system functional disorders, the diagnostic of which in the early neonatal period is complicated. Objective of the research was to study the condition of renal functions in critically ill full - term newborns during the first week of their life by means of detection of specific biomarkers level in the blood serum and urine. Materials and methods. A comprehensive clinical - paraclinical examination of 36 critically ill newborns (the main group) and 37 conditionally healthy newborns (the control group) has been conducted. Laboratory methods ofexamination included detection of the levels of creatinine, urea, sodium and potassium ions in the blood and urine, as well as protein, albumin, immunoglobulin G, a - - microglobulinand $ - microglobulinin urine. Results and discussion. The neonates of the main group as compared to the control one presented statistically significant higher levels of creatinine (р
Published: 13 January 2017
Ukrainian Journal of Nephrology and Dialysis pp 20-26; doi:10.31450/ukrjnd.1(53).2017.03
Abstract:The aim: to examine the relations between morphological tubulointerstitial (TIT) parameters of kidney damage and neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) of blood serum in patients with chronic glomerulonephritis (CGN) with saved renal function, and to estimate the therapeutic correction of identified changes using ACE inhibitor ramipril.. Materials and methods. The study included 81 patients with CGN. Patients were divided into 2 clinical groups: CGN patients with arterial hypertension (AH), CGN without AH. The average daily dose of ramipril in patients with AH was 12,8 ± 5,6 mg, in patients without hypertension – 2,5 mg. We used kidney biopsy data for the analysis of renal damage on the following parameters: dystrophic and necrotic changes in tubular epithelium, thickening and/or cleavage of tubular basement membrane, presence ofcellular infiltration, interstitial fibrosis (IF). The level of NGAL and IL-18 in serum were determined by ELISA. Results. We statistically confirmed a direct link between blood NGAL and IF (r=+0,65;p
Published: 13 April 2015
Ukrainian Journal of Nephrology and Dialysis pp 61-67; doi:10.31450/ukrjnd.2(46).2015.10
Abstract:The article presents the analysis of the native and foreign literature data and also the results of our own research devoted to studying the role of herpes virus infection in the appearance and course of glomerulonephritis in children. There has been described pathogenesis and clinical aspects of virus associated glomerulonephritis in children. Much attention has been paid to the diagnostic methods of herpes virus infection in glomerulonephritis. The importance of association of immunosuppressive and antiviral therapy has been underlined.
Published: 13 December 2016
Ukrainian Journal of Nephrology and Dialysis pp 3-8; doi:10.31450/ukrjnd.4(52).2016.01
Abstract: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.
Published: 26 January 2015
Ukrainian Journal of Nephrology and Dialysis pp 21-25; doi:10.31450/ukrjnd.1(45).2015.04
Abstract:The aim of this work is to investigate the level of mononuclear cells, expressing intercellular adhesion molecule (CD54+), pro- (IL-1, TNF-a) and antiinflammatory (IL-4, TGF-в) blood cytokines in the patients with pyelonephritis PN, to determine the peculiarities in acute and chronic its course. Materials and methods. The immuno-enzymic method ELISA and the corresponding test-systems (“Diaclone”, “DRG”) were used to study the levels of blood cytokines and immuno-fluorescent with “Coltage” (USA) – the level of CD54+-cells. Results. It has been demonstrated that CD54+-lymphocytes, IL-1, TNF-a, IL-4 and TGF-ft in blood were increased in patients with acute and chronic pyelonephritis, compared with healthies. The number of lymphocytes expressing CD54 and the level of TGF-ft were higher in patients with chronic pyelonephritis. Conclusion. The high level of cytokines and CD54+-lymphocytes in blood ofpatients confirm their important role in immunogenesis of pyelonephritis, the interrelation is especially interesting between CD54+-cells and TGF-ft in chronic process.
Published: 12 December 2016
Ukrainian Journal of Nephrology and Dialysis pp 47-51; doi:10.31450/ukrjnd.4(52).2016.03
Abstract:Introduction. Cytokines play the corresponding role in the inflammatory processes and the development of endothelial dysfunction and therefore take an important place in the problem of systemic chronic inflammation (SCI) in patients with chronic kidney disease (CKD), stage V, who are treated with methods of the renal replacement therapy (RRT). Aim of the work was to determine the features ofpro- and anti-inflammatory cytokines, VEGF in patients with CKD stage V D, depending on the method of RRT (HD, HDF, PD). Materials and methods. There were examined 56 patients with CKD, st. V treated with methods of RRT: gr.1 received hemodialysis (HD) (15 p), gr. 2 - hemodiafiltration (HDF) (28 p) and gr. 3 – peritoneal dialysis (PD) (13p). The cytokines levels (IL-6, -8, -10, -18, TNF-a, VEGF) were determined in blood serum by means of ELIZA. Results. The CKD, st. V patients treated with RRT showed really increased levels of pro-inflammatory blood cytokines (TNF-a, IL-8, IL-18) (p < 0.001) and VEGF as important factor of endothelial dysfunction, in dependence on RRT the groups 1-3 did not differ (p > 0.05). In comparison with healthy donors, in patients of gr. 3 the level of antiinflammatory IL-10 was the highest (p < 0.001) in comparison with gr.1 (p = 0.080) andgr.2 (p = 0,043) (corresponding HD and HDF), and the ratio IL-18/IL-10 was really more low in comparison with both other groups (p = 0.035). Conclusion. The high level of serum cytokines confirms the SCI availability in patients with CKD,st.V; the patients treated with PD showed the lower degree of inflammatory reactions by the data of balance between pro/anti-inflammatory immunity mediators.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 37-44; doi:10.31450/ukrjnd.1(37).2013.07
Abstract:The purpose of study was determination of HLA -antigens I and II classes as predictors of ineffectiveness of initial steroid therapy, and according prognozonegative markers of chronic glomerulonephritis with nephrotic syndrome. Methods. In 59 chronic glomerulonephritis with nephrotic syndrome patients (steroid sensitive n=33 (1 gr.) and steroid resistant’s n= 26 (2 gr.)) and 350 healthy donors( control group) studied HLA antigens I and II classes of the special anti- HLA-antigens panel (20 antigens of locus A, 31 – of locus B and 9- of locus DR). Result. In patients with chronic glomerulonephritis, nephrotic syndrome with hormone sensitivity relative risk is high at the presents of A28 (RR=8,5, r р 2 for antigens A11 (RR=2,23), A23 (RR=4,28), A24 (RR=3,3), A29 (RR=10,78) that A30 (RR=11,23); attributive risk more than 0,1 for the antigen A11 (=0,16) ; A24 (=0,13), other did not differ from control. Subzero connection is exposed for the antigens of A2 (р
Published: 12 December 2014
Ukrainian Journal of Nephrology and Dialysis pp 25-30; doi:10.31450/ukrjnd.1(45).2015.05
Abstract:Introduction. Recent studies suggest that visfatin participates in pathogenesis of vascular diabetic complications, in particular diabetic nephropathy (DN). The aim of the present research - definition of visfatin level in peripheral blood of type 2 diabetic patients taking to account renal function disturbances and body mass index (BMI). Materials and methods. 94 type 2 diabetic patients with different stages of DN and 10 healthy subjects (control group) were observed. Visfatin concentration in blood plasma was determined using immunoassay kit. Results. An essential increase of visfatin level in blood plasma took place already in initial stages of the DN. Progressing of the disease was accompanied by more expressed growth of visfatin concentration. In patients with high BMI substantial increase of visfatin level when compared with those with normal IMT was determined. We established strong correlations between visfatin concentrations, urinary albumin levels and blood creatinine concentrations and negative correlations with glomerular filtration rate. Conclusions: Our findings testify that visfatin level displays a functional kidney state and may be used as addition to traditional methods of patients examination.
Published: 12 December 2017
Ukrainian Journal of Nephrology and Dialysis pp 14-20; doi:10.31450/ukrjnd.1(37).2013.03
Abstract:Studies of the mortality structure in patients receiving hemodialysis (HD) remain relevant and are the basis for developing measures and recommendations directed to increase the lifetime of patients. Aim. The aim was to study the assessment of death causes in patients who received programmed hemodialysis, based on the demographic and gender characteristics, the duration of dialysis treatment. Methods. Mortality causes in 137 patients who received programmed hemodialysis from 2007 to 2011 years in Kyiv City Scientific and Practical Center of Nephrology an Dialysis were analyzed. Results. The leading cause of death was cardiovascular complications, but their decreasing has been observed since 2008. Fatality rate in young and middle- aged women with cardiovascular diseases (CVD) was almost two times higher than that of men. At the same time CVD is a predominant cause of men’s death at the age older than 44. Cerebrovascular complications were permanently in the second place of the mortality structure. About 30% of deaths occurred during the first 90 days of HD treatment, 72,5% of them were among males. Conclusion. Gender characteristics influence the structure of death causes in patients received programmed hemodialysis depending on age.
Published: 27 June 2014
Ukrainian Journal of Nephrology and Dialysis pp 22-27; doi:10.31450/ukrjnd.3(43).2014.04
Abstract:In Ukraine the increase of amount of teenagers registers with the infection of the urinary system. Materials and methods. A bacteriological investigation of urine of324 teenagers is undertaken in the Chernivtsi region. Family and specific belonging of the distinguished stamms in the standards of urine was conducted by the generally accepted microbiological methods. Results. The dynamic increase ofpercent of selection is educed etiologfc and clinically meaningful stamms among the teenagers of both sexes. Selection ofpercent etiologfc and clinically meaningful stamms among girls–teenagers (3,75% – 18,52%) prevails by comparison to their coevals (1,02% – 12,50%). A negative dynamics is marked in megascopic percent of results of bacteriological investigation of urine (1,46% – 14,81%) in a group «Height it is not educed». Conclusions. Infections of the urinary system children have the issue of the day of nephrology, and needs complex going near the study of the age–related and gender factors of prevalence of Infections of the urinary system among child’s population of the different age–related groups.
Published: 3 March 2017
Ukrainian Journal of Nephrology and Dialysis pp 26-31; doi:10.31450/ukrjnd.1(53).2017.04
Abstract: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.
Published: 3 March 2017
Ukrainian Journal of Nephrology and Dialysis pp 70-73; doi:10.31450/ukrjnd.1(53).2017.10
Abstract: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.
Published: 29 August 2016
Ukrainian Journal of Nephrology and Dialysis pp 32-37; doi:10.31450/ukrjnd.3(51).2016.04
Abstract:Chronic kidney diseases are etiology of complications in cardiovascular system. Structural and functional changes ofendothelium on a background ofimmunoreactions lies in basis ofthese disorders and complications. The aim of research was to study of morphologicalfeatures of kidneys and immune reactions in the vessels of kidneys, heart, aorta inpatients with CDK. Materials and methods. An autopsy material of the 20 dead’s age from 45 to 55 was investigated . The deceased had signs ofchronic desease of kidneys (CDK). Theprimary monoclonal antibody (PMA) company ofDAKO (Denmark) Rady - to - Use were used to reveal of features of cellular immunoreactions in the zones of inflammatoryprocess. We used microscope Primo Star (Carl Zeiss) with theprogram AxioCam (ERc 5s). Results and discussion. Changes of kidneys vessels, coronary arteries and aorta were characterized of transformation similar with immune inflammation. Condition of endothelium was characterized disorder of endothelization and manifest irregularity, lumpiness with outcrop of wide intercellular connections. All this proses bring to activation of apoptosis. Conclusion. Disturbance of vessel morphology and activity of immunoinflammatory reaction can be one of main cause ofdeveloping cardio-vascular complication.
Published: 23 June 2014
Ukrainian Journal of Nephrology and Dialysis pp 42-48; doi:10.31450/ukrjnd.3(43).2014.07
Abstract: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
Published: 3 June 2016
Ukrainian Journal of Nephrology and Dialysis pp 52-55; doi:10.31450/ukrjnd.2(50).2016.04
Abstract: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.
Published: 16 February 2016
Ukrainian Journal of Nephrology and Dialysis pp 32-41; doi:10.31450/ukrjnd.1(49).2016.02
Abstract:Background and objective. Knowledge of local antimicrobial resistance pattern is very important for evidence-based empirical antibiotic prescribing. The main objective of the present study was to evaluate the prevalence and the antimicrobial resistance pattern of the main bacteria responsible for uncomplicated urinary tract infection (UTI) in Kyiv region (Ukraine), throughout a ten year period, in order to establish an appropriate empirical therapy. Materials and methods. A retrospective analysis of the etiological spectrum and antimicrobial resistance of uropathogens in urine samples isolated over the 10-year period, 2005 to 2015, in a single center was performed. Results. In total 380positive urine samples processed at our laboratory of which 193/380 (51 %) had E. coli as the infecting organism. Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed increasing the share of Enterococcus spp. - 82/380 (21.6%). Ampicillin and trimethoprim were the least-active agents against E. coli with resistance rates of 75% and 70%, respectively. Significant trends of increasing resistance over the 10-year period were identified for trimethoprim, fluoroquinolones ІІ and III generations, penicillins, and carbapenems. Nitrofuran derivative remains a reasonable empirical antibiotic choice in this community with a 10-year resistance rate of 8.3 %. Was determined that recurrent UTI is an independent risk factor for bacterial multidrug-resistance. Conclusions. Over the last 10 years, the proportions of fluoroquinolones resistant E. coli and multidrug-resistant bacteria have significantly increased. The fluoroquinolones shall not be used in the empirical treatment of uncomplicated UTI in Kyiv region patients. For the empirical treatment of uncomplicated UTI in women should be used nitrofuran derivative (furazydyn K). If required of parenteral administration of antibiotics should be used cephalosporins IVgeneration. This data will enable evidence-based empirical prescribing which will ensure more effective treatment and lessen the emergence of resistant uropathogens in the community.
Published: 28 November 2014
Ukrainian Journal of Nephrology and Dialysis pp 54-64; doi:10.31450/ukrjnd.1(45).2015.08
Abstract:The basic features of different clinical studies types and their hierarchy considering strength of the evidence were considered. The quality assessment examples of information in medicine and data presentation options to form of evidence were presented. The role of a clinician as a participant in evidence process was underlined.
Published: 21 November 2014
Ukrainian Journal of Nephrology and Dialysis pp 70-74; doi:10.31450/ukrjnd.4(44).2014.08
Abstract:Renal damage in patients with rheumatoid arthritis (RA) is the most frequent and serious among other systemic manifestations and holds a special place in connection with a significant impact on prognosis and approaches to therapy. Today we know that one of the main possible factors of occurrence and development of RA are external trigger factors, among which the most important factor are infectious, and its pathogenic effect on the body can be done in different ways. Based on the latest scientific evidence on the importance of infectious trigger factors in the manifestation of RA, chronic pyelonephritis among these triggers is one of the leaders. Great interest is also the probability of pyelonephritis manifestation while presence of RA. The aim: to identify predictors ofpyelonephritis manifestation in patients with rheumatoid arthritis. Materials and methods. The authors examined 31 patients with RA with presence of chronic pyelonephritis (CP), 31 patients with RA without presence of CP and 20 healthy individuals. Was used clustering and classification methods of Data Mining on indicators of lipid peroxidation of blood and urine, р2–microglobulin blood and urine, immune factors, that defined progressive CKD on the results of our previous studies (IL–1p,IL–10, TGF–р). Results. Found that patients with diagnosed RA only, mainly are included in the cluster «1» (18patients). Some of them (3 persons) classified as belonging to the cluster «2». Thus, these individuals should have two signs of disease, RA and CP, despite the fact that they have only diagnosed RA. It means that these patients are at risk of developing CP. This analysis gives grounds to consider that RA may be signs of a factor that causes manifestation of CP. It is proved that the main factor that characterizes the individuals belonging to the cluster of healthy is 2– microglobulin in the urine with the same threshold value, but factor in determining membership of a type of disease is a factor MDA of urine. Conclusion. The main predictors of pyelonephritis manifestation in patients with rheumatoid arthritis were 2– microglobulin and MDA in urine and TGF– 1 in blood. A new method of diagnosing ofprognostic factors of CP manifestation in patients with RA which is based on cluster and classification analysis makes it possible to establish the interrelation between a diagnosis of RA and caused by it manifestation of CP.
Published: 3 March 2017
Ukrainian Journal of Nephrology and Dialysis pp 3-12; doi:10.31450/ukrjnd.1(53).2017.01
Abstract:We used the data of “National Register of CKD Patients ” which is formed annually by SI “Institute of Nephrology NAMS of Ukraine”. The results demonstrate the low level of availability of medical care
Published: 9 March 2018
Ukrainian Journal of Nephrology and Dialysis pp 24-32; doi:10.31450/ukrjnd.1(57).2018.01
Abstract:The aim of the study was to estimate the nutritional status of patients with chronic kidney disease who are treated by CAPD, the prevalence of its disorders according to functional methods. To study the relationship between nutritional status and hydration. Materials and Methods: During the observational one-stage study, 105 patients with CKD 5D stage who were treated by CAPD were included. To assess the NS, serum albumin and body mass index were determined, functional methods were used, namely, SGA and dietary diary analysis. The status of hydration was assessed by clinical examination and bioimpedance analysis. The study was carried out in two stages. At the first, the definition of laboratory and functional indicators of the National Assembly, assessment of the balance of water sectors was carried out. At the second stage, for further analysis, the patients were divided into four groups according to the condition of the NS, determined on the basis of the SGA: the first group (n = 54) consisted of patients without disturbance of nutrition, the second (n = 27) with mild disruption of nutrition, the third (n = 13) — with an average degree, and the fourth (n = 11) - with a severe degree of malnutrition. Results: Weight loss and subcutaneous fat mass for the past 6 months were detected in 43.8% and 37.14% of patients, respectively. Gastrointestinal disorders and loss of muscle mass were detected in 58.1% and 74.3% of patients, respectively. According to the SGA, nutritional disorders were detected in 51 (48.6%) patients. An easy degree of malnutrition was diagnosed in 25.71% of patients, medium and severe — in 12.38% and 10.48% of patients, respectively. For compare of the data obtained from the survey on the composition of water sectors with reference values allows one to assert the presence of hyperhydration in the examined population. A statistically significant difference is achieved by the volume of extracellular fluid, the volume of circulating blood and plasma. These parameters significantly increase depending on the degree of disturbance of the NS (p