Ukrainian Journal of Nephrology and Dialysis
ISSN / EISSN : 23040238 / 26167352
Current Publisher: State Institution "Institute of Nephrology NAMS of Ukraine" (10.31450)
Total articles ≅ 232
Latest articles in this journal
Published: 4 September 2019
Ukrainian Journal of Nephrology and Dialysis pp 53-61; doi:10.31450/ukrjnd.3(63).2019.08
Abstract:Cardiovascular complications are a leading cause of morbidity and mortality in dialysis patients. Cardiovascular mortality is more than 40% of the total mortality in this cohort of patients. Recently, there has been an increase in publications on the role of uremic toxins, including “middle molecules”, in the development and progression of cardiovascular complications in dialysis patients. Conventional low-flux (LF) hemodialysis well removes small molecular weight uremic toxins not bound with protein. Evidence for the role of "middle molecules" in the development of many complications, including cardiovascular complications, has contributed to the emergence and development of such dialysis therapy methods as high-flux (HF) hemodialysis, hemofiltration (HF) and hemodiafiltration (HDF). Further evolution of membrane technology has led to the development of protein-leaking membranes or super-flux or high cutoff (HCO) membranes. These membranes are capable of removing molecules in excess of the molecular weight of albumin. The use of these membranes is limited because of the risk of hypoalbuminemia. Today, the closest approximation to the natural glomerular membrane is the so-called Middle Cut-Off (MCO) membrane. The use of MSO membranes is implemented in a new method of dialysis therapy - expanded hemodialysis (HDx). The method is defined as a treatment where diffusion and convection are conveniently combined inside a hollow-fibre dialyser equipped with an MCO membrane. A standard hemodialysis machine is used for the HDx. Increased removal of large medium molecules in HDx may lead to an improvement of clinical outcomes, including a decrease of the cardiovascular events incidence, an all-cause and cardiovascular mortality reduction in dialysis patients.
Published: 4 September 2019
Ukrainian Journal of Nephrology and Dialysis pp 22-26; doi:10.31450/ukrjnd.3(63).2019.03
Abstract:Immunosuppressive drugs predispose the kidney transplant recipient to reactivation of сytomegalovirus (CMV) infections. Prophylaxis given to these patients is very important for the prevention of opportunistic CMV infections. The objective of this study was to evaluate the short term and standard-dose valganciclovir prophylaxis for CMV infections in living donor kidney transplantation. Methods. This study is retrospective one. Between April 2014 and April 2019 100 patients after living donor kidney transplantation with results CMV PCR-DNA and prophylactic treatment were studied retrospectively at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey. Results.The mean age was 38.3±15.6 years. 68 (68%) patients were males and 32 (32%) patients were females. All patients were treated with 900 mg daily and 90 days valganciclovir prophylaxis. Mean follow-up was 29.1±15 months. There were not detected CMV infections during the follow-up period. Conclusions: Short term and standard-dosevalganciclovir prophylaxis appears to be successful prevention CMV infections in living donor kidney transplantation.
Published: 4 September 2019
Ukrainian Journal of Nephrology and Dialysis pp 27-30; doi:10.31450/ukrjnd.3(63).2019.04
Abstract:HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a severe and rapidly progressing condition that requires distinct diagnostic considerations. The clinical presentation varied within all of the classes, and the only objective means of diagnosis and evaluation of progression of the condition are laboratory tests. HELLP syndrome may result in severe morbidity and mortality to both the mother and fetus. In this case, we reported that a patient with chronic glomerulonephritis was diagnosed with HELLP syndrome.The case was collected in Institute of Nephrology of the National Academy of Medical Sciences, Kyiv, Ukraine.
Published: 20 August 2019
Ukrainian Journal of Nephrology and Dialysis pp 40-46; doi:10.31450/ukrjnd.3(63).2019.06
Abstract:Residual kidney function (RKF) is a powerful indicator of residual renal functional capacity that eliminates uremic toxins and fluid in hemodialysis patients. The purpose of our study was to investigate the influence of hydrating status on residual renal function in patients with CKD 5HD. Methods. A prospective observational study included 60 hemodialysis patients with CKD VD. All patients were examined - taken general and biochemical blood tests, determined the level of urea and creatinine in the daily urine. RKF was evaluated by urine volume, residual KT / V and KRU. Water balance was measured and evaluated using BCM-monitor. Results.During the analysis of BCM data, hyperhydration (OH / ECW above 15%) was revealed in 15 among all patients included in the study, which amounted to 25%. A statistically significant difference between patients who were hyperhydrated and normohydrated was found in relative (OH / ECW) and absolute hydration (OH), ECW, and ultrafiltration rates. Thus, in the group of hyperhydrated patients, the average relative hydration rate was 14.3% lower compared to normohydrated patients (p < 0.001) and absolute hydration by 2.6 l (p < 0.001). In further analysis, no significant difference between two groups was found in the indicators characterizing the RKF, namely, between the level of urine output, KRU, KT / Vren. The level of ultrafiltration in the group with normal hydration is 900 ml lower than that with hyperhydration (p < 0.005). In study the influence of indicators of hydration status such as OH, OH / ECW, TBW, ECW, ICW on RKF indices no reliable correlation of the above mentioned values with diuresis, KRU, KT / Vren (p > 0.05) was found. A positive correlation was found between KRU, diuresis and KT / Vren, indicating that with increasing diuresis the KRU value and KT / Vren increase (p < 0.001). The same relationship was found between diuresis and KT / Vren, p < 0.001. An analysis of the relationship between absolute and relative hydration with dialysis efficacy (eKT / V) revealed that dialysis efficacy decreases with increase of hydratation in CKD 5HD patients (p < 0.05). Conclusions. The results obtained in our study indicate that the indicators of hydration status at baseline do not allow to find out an influence of them on the baseline level of RKF (diuresis, KRU and KT / Vren) in patients with CKD 5HD. Issues of the influence of hydration status on changes in RKF during the observation will be addressed in the following reports.
Published: 4 August 2019
Ukrainian Journal of Nephrology and Dialysis pp 47-52; doi:10.31450/ukrjnd.3(63).2019.07
Abstract:Infections associated with peritoneal dialysis (infection of the catheter, tunnel infection and peritonitis) are the most common complications of this method. Despite significant progress in the methodological approaches to the prevention, diagnosis and treatment of PD associated infections, peritonitis remains the main risk factor for mortality in PD patients (up to 6%) and plays a significant role in more than 1/6 of the deaths associated with non-infectious complications such as cardiovascular and / or cerebrovascular disease. Besides, PD-associated infections are the most common cause of loss of peritoneal function and the patients’ transition to hemodialysis treatment. About 5% of PD patients are converted to hemodialysis treatment in the first year after postponed peritonitis.
Published: 4 August 2019
Ukrainian Journal of Nephrology and Dialysis pp 17-21; doi:10.31450/ukrjnd.3(63).2019.02
Abstract:Kidney transplantation is the treatment of choice for end-stage kidney disease.The double J stent is commonly used in kidney transplantation.The incidence of urologic complications varies between 0.22 % and 30 %. Ureteral strictures and urinary leakage are the most common urological complications after kidney transplantation. Use of the double J stent can decrease urological complications after kidney transplantation. However, the double J stent can increase urinary tract infections, suprapubic pain and urinary incontinence. This study aimed to evaluate the outcomes of the use of double J stent in kidney transplantation. Methods. Between April 2014 and April 2019 130 patients with the use of double J stent were studied retrospectively at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey. In these patients, demographic features, clinical features and urologic complications were evaluated. Results. The mean age of the patients was 38.3 ± 15.6 years. 84 (67 %) patients were males and 46 (33 %) were females. Mean follow-up was 29.1 ± 15 months. Mean double J stent removal time was 31.3 ± 2.2 days. During follow-up, there were no ureteral strictures and urinary leakage. Urinary infections were diagnosed in 5 (3.8 %) patients. Conclusions. Use of double J stent appears to be successful to prevent the urological complications in kidney transplantation.
Published: 14 July 2019
Ukrainian Journal of Nephrology and Dialysis pp 31-39; doi:10.31450/ukrjnd.3(63).2019.05
Abstract:The importance of the problem of acute kidney injury in children is due to the high risk of developing chronic kidney disease as a consequence. Lysosomal enzymes of β-galactosidase (GAL) and N-acetyl-β-D-hexozoaminidase (NAG) in urine are considered to be informative markers of renal parenchyma damage. The objective of this study - to determine the activity of lysosomal enzymes in urine as markers of progression of interstitial nephritis in children after acute kidney injury. Methods. 41 children were examined after acute kidney injury, achievement of self-diuresis and improvement. Group I included 22 patients with a disease period of up to 2 years after acute kidney injury, group II - 19 patients with a disease period of 2 years or more. The control (reference) group consisted of 28 children who were conditionally healthy, without kidney disease, as well as without acute diseases and severe metabolic disorders and anatomical defects. Results. NAG and GAL activity were found to exceed 8 and 3 times parameters in the reference group of healthy children, respectively, in patients who had acute kidney injury during the year (p
Published: 13 June 2019
Ukrainian Journal of Nephrology and Dialysis pp 3-16; doi:10.31450/ukrjnd.3(63).2019.01
Abstract:Institute of Nephrology of the AMS of Ukraine was established in 2001. Today the Institute constitutesserves as national center in nephrology field. Scientific achievements of the institute staff are known both in Ukraine and abroad scientific achievements of the institute. The aim. Analysis of results and forecast of activities of SI "Institute of Nephrology of the NAMS of Ukraine".
Published: 6 June 2019
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.
Published: 4 June 2019
Ukrainian Journal of Nephrology and Dialysis pp 33-40; doi:10.31450/ukrjnd.2(62).2019.05
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