Ukrainian Journal of Nephrology and Dialysis

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ISSN / EISSN : 23040238 / 26167352
Total articles ≅ 225
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R. R. J. Aal-Toma
Ukrainian Journal of Nephrology and Dialysis pp 18-23; doi:10.31450/ukrjnd.2(62).2019.03

Abstract:Перкутанна нефролітотомія (ПНЛТ) є основним методом лікування пацієнтів з сечокамʼяною хворобою. Сьогодні стандартне виконання ПНЛТ передбачає завершення операції шляхом встановлення черезшкірного нефростомного дренажу. Бездренажна ПНЛТ асоційована зі зменшенням післяопераційного болю та часу госпіталізації. Незважаючи на переваги, бездренажна ПНЛТ збільшує ризик залишення фрагментів конкременту, що вимагає застосування додаткових процедур та подовження часу госпіталізації. Метою дослідження було порівняти ефективність і безпечність бездренажної та стандартної ПНЛТ із застосуванням нефростомного дренажу. Методи. Проспективне порівняльне дослідження, проведене у відділенні урології Safeer Al-Imam Al-Hussein у Карбалі з січня 2013 року по 31 грудня 2017 року. 1434 пацієнтів з нирковими конкрементами, яким виконано ПНЛТ були розподілені залежно від застосованого хірургічного лікування: 1-й групі пацієнтів (n = 882) виконано ПНЛТ із застосуванням дренажу, у 2-й групі (n = 552) застосовувалась бездренажна ПНЛТ. Результати. Бездренажна ПНЛТ частіше застосовувалась у жінок молодого віку та у хворих з конкрементами лівої нирки з простим доступом, тоді як дренаж частіше використовувався за наявності конкременту правої нирки (р = 0,006). Післяопераційно, бездренажна ПНЛТ була статистично значущо асоційована з низькою частотою залишкових фрагментів конкременту (p = 0,005), кровотеч (p = 0,04) і сепсису (p = 0,01) порівняно із стандартною процедурою. Висновки. Бездренажний варіант ПНЛТ асоціюється з низькою частотою залишкових фрагментів каменів, післяопераційних кровотеч та сепсису, що обґрунтовує ефективність і безпечність його застосування.
A. Shymova, I. Shifris, I. Dudar
Ukrainian Journal of Nephrology and Dialysis pp 33-40; doi:10.31450/ukrjnd.2(62).2019.05

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M. O. Kolesnyk, N. I. Kozliuk, O. O. Razvazhaieva
Ukrainian Journal of Nephrology and Dialysis pp 3-9; doi:10.31450/ukrjnd.2(62).2019.01

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M. I. Chaikovska, L. P. Martynyuk
Ukrainian Journal of Nephrology and Dialysis pp 41-47; doi:10.31450/ukrjnd.2(62).2019.06

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L. Surzhko, A. Rysev, N. Molchanova
Ukrainian Journal of Nephrology and Dialysis pp 24-32; doi:10.31450/ukrjnd.2(62).2019.04

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S. Fomina, O. Ovska
Ukrainian Journal of Nephrology and Dialysis pp 48-53; doi:10.31450/ukrjnd.2(62).2019.07

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I. Topchii, T. Shcherban, V. Galchinska, P. Semenovykh, K. Savicheva
Ukrainian Journal of Nephrology and Dialysis pp 13-19; doi:10.31450/ukrjnd.1(61).2019.02

Abstract:The aim of the study was to assess a serum level of vascular endothelial growth factor (VEGF) in type 2 diabetic patients depending on kidney function. Methods: we examined 66 type 2 diabetic patients and 20 healthy control subjects. Depending on the presence of albuminuria and glomerular filtration rate (GFR) level, patients with diabetes mellitus (DM) were divided into the following groups: group I - patients with type 2 DM without signs of nephropathy – normal GFR without albuminuria (n = 26); group ІІ - patients with type 2 DM with normal GFR and albuminuria (n = 22); group III - patients with type 2 DM with reduced GFR and albuminuria (n = 18). ІV group - patients with acute coronary syndrome (n = 26). The concentration of the VEGF was determined by enzyme-linked immunosorbent assay. The glomerular filtration rate (GFR) was calculated using the CKD EPI formula (KDIGO 2012). Results: serum VEGF level in patients with diabetic nephropathy (DN) was significantly increased depending on kidney function. VEGF positively correlated with urine albumin and serum creatinine levels and the negative correlation with GFR was found. These findings prove the undeniable role of kidneys in the development of renocardial syndrome in patients with DN. VEGF levels positively correlated with glycosylated hemoglobin and total cholesterol, indicating an unconditional dependence of endothelial dysfunction on lipid and glucose metabolism disorders. Conclusions: Increased levels of VEGF in type 2 diabetic patients without clinical signs of kidney damage may indicate the development of subclinical renal dysfunction. Blood VEGF in patients with DN may be an integral marker of endothelial dysfunction and pathological angiogenesis. Our findings suggest that determination of serum VEGF level in patients with DN may have practical use as an early predictor of cardiac disruption, estimation of the prognosis, as well as improvement of cardionephroprotective strategy.
T. G. Shekhovtseva, M. A. Dolinna
Ukrainian Journal of Nephrology and Dialysis pp 53-59; doi:10.31450/ukrjnd.1(61).2019.07

Abstract:According to current presentations, primary AL-amyloidosis (AL-A) and multiple myeloma, associated and not associated with AL-A, are considered as a part of uniform β-lymphocytic dislocation that is characterized by proliferation of abnormal clone of plasma or β-cells in the bone marrow with excess production of monoclonal immunoglobulins. Objective: to describe our own observations of patients with AL-A, which is an example of complexity of the disease diagnostics, due to the polymorphism of clinical picture and need for immunological verification. It was presented 2 cases of late AL-A diagnostics. Amyloid depositing in different organs determined the diversity of clinical manifestations. AL-A had a consistently progressive character with the gradual involvement of various organs and systems. Results: case 1 demonstrated AL-A with damage of kidneys, heart, liver, spleen, lungs, pleura and subsequent development of ischemic stroke. In the second case AL-amyloidosis with damage of heart, kidneys, lungs, tongue and skin was diagnosed. The severity of the patient's condition was due to severe nephrotic syndrome. AL-A is a serious disease that leads to a lethal end if treatment is not timely. Our observations demonstrate the complexity of AL-A diagnostics, which requires the collaboration of doctors of various profiles. Modern morphological diagnostics of amyloidosis involves not only detection but also mandatory amyloid typing, which determines further therapeutic tactics. Diagnostics of AL-A diagnosis should be based on the morphological study results. The final diagnosis of amyloidosis is established after congolic masses detecting. Biopsy of the affected organ is the most effective diagnostic method. When there is a nephrotic syndrome, kidney biopsy is most appropriate, because amyloid will be detected in 80% of AL-A. The most effective method for AL-A typing is an immunohistological study using the immunoglobulin light chains antisera.
N. M. Voroshylova, M. D. Timchenko, S. V. Verevka
Ukrainian Journal of Nephrology and Dialysis pp 39-44; doi:10.31450/ukrjnd.1(61).2019.05

Abstract:The formation in β-structured protein aggregates in tissues and fluids of the body is one of the most dangerouse complications of various diseases. The most famous of them are amyloidoses, but they such deposits are observed at other, much more widespread, diseases. The generally accepted approach to amyloids’detectionis based on high-specific coloring by Congo Red dye. However, the Abbe's diffraction limit excludes the seeing of the objects smaller than 0.61 wavelengths (about 240 nm). Such nanoscale formations are capable to disrup the functioning of surrounding tissues, to causethe complications and recurrences of the disease, and to pass through biological barriers with the following accumulation in body’s fluids. It’s likely that these conditions are the cause of the urinary congophilia, that is associated with preeclampsia at pregnancy and chronic kidney disease. Nor the less suspicious object is the Bens-Jones protein that appears in the urine at multiple myeloma and some other diseases, which are in more or less extent,are related to the disturbance of protein metabolism. The purpose of this study was to clarify the aggregate state of the Bens-Jones protein as a possible β-structured supramolecular associate. Methods.The subject of the study was the freshly received urine from a patient with multiple myeloma. The presence of the Bens-Jones protein was checked by thermopacification of the acidified sample. For control, the urine was used by a healthy person with the addition of certain amounts of human serum albumin ("Reanal", Hungary) with a concentration of 0, 0.01, 0.1 and 1%. Result. The obtained data testify to the appropriateness of such a point of view and create preresquites for the expanding of diagnostic possibilities. Conclusions.The results obtained during the study testify to the peculiarity of the structure of the Bens-Jones protein, which is nano-sized beta-structured supramolecular
I. Shifris, L. Korol, O. Magas, E. Krasiuk, I. Dudar
Ukrainian Journal of Nephrology and Dialysis pp 20-28; doi:10.31450/ukrjnd.1(61).2019.03

Abstract:The aim of our study was to increase the effectiveness of treatment of comorbid pneumonia in patients with CKD VD stage. Materials and Methods. 73 patients with CKD VD st. (59 on HD and 14 on PD) with mild to moderate comorbid pneumonia who received renal replacement therapy (RRT) during 2013-2016 were included in the observational prospective open-label randomized trial. Patients were randomized into two groups: group 1 (n = 42) included patients who in addition to the conventional therapy of pneumonia received medication «Lipin» as a complex therapy; group 2 included patients (n = 31) who received only basic (traditional) therapy. The groups were representative by the main demographic, social and clinical-laboratory findings, severity of pneumonia, duration and modality of RRT. The primary endpoints were death from any cause and episodes of rehospitalization. The overall assessment of the clinical efficacy of the therapy was based on a comparison of the duration of hospitalization, antibiotic therapy, intoxication syndrome, and regression of X-ray changes. Survival in observation groups was determined by the Kaplan-Meier method. Analyzed cases were included to October 31, 2018. The markers of oxidative stress (OS) were determined in 29 patients of group 1 and 14 patients of group 2 before treatment and after 14 days while treatment of pneumonia was started. Results. The analysis demonstrated that during a 1-year period a 17 (25,76%) episodes of rehospitalization were recorded: 11 causes (35.5%) in group 1 and 6 (14.3%) in group 2 (χ² = 4.486, p = 0.035). In total, 29 deaths were recorded during the study period: 10 (23.8%) cases in group 1, and 19 (61.3%) - in group 2 (χ² = 8.957, p = 0.003, RR - 2.574, 95% CI: 1.400-4.733). The three- and five-year cumulative survival rates were 83% vs. 21% and 59% vs. 21%, in the group 1 and group 2, respectively (p = 0.00003). It was stated that the duration of hospitalization, antibiotic therapy, intoxication syndrome and X-ray regression were significantly lower in group 1 compared with group 2 (p