Ukrainian Journal of Nephrology and Dialysis
ISSN / EISSN : 2304-0238 / 2616-7352
Current Publisher: State Institution "Institute of Nephrology NAMS of Ukraine" (10.31450)
Total articles ≅ 280
Latest articles in this journal
Published: 17 November 2020
Ukrainian Journal of Nephrology and Dialysis pp 59-66; doi:10.31450/ukrjnd.4(68).2020.09
The paper presents the summary of recommendation statements of the "KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease" translated into Ukrainian.
Published: 6 November 2020
Ukrainian Journal of Nephrology and Dialysis pp 4-10; doi:10.31450/ukrjnd.4(68).2020.01
Flu is the cause of up to 650,000 deaths worldwide each year. According to CDC USA in 2019-2020 the flu caused 86,000 deaths. Patients with chronic kidney disease (CKD) are at high risk for serious complications and adverse effects of influenza infection. A feature of this year is the possibility of combining influenza with COVID-19, which can significantly complicate treatment and worsen the prognosis of CKD patients. Therefore, prevention and adequate management of influenza in this patient cohort are obvious. In this regard, the Expert Group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created adapted clinical guidelines for the prevention, diagnosis and management of influenza in CKD patients.
Published: 22 October 2020
Ukrainian Journal of Nephrology and Dialysis pp 11-17; doi:10.31450/ukrjnd.4(68).2020.02
The work aimed to conduct a rating of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Methods. Evaluation of nephrological services in the regions of Ukraine was made by using indicators of the structure, health care resources, quality and efficiency of renal medical care of patients with chronic kidney disease and patients with acute kidney injury. Results. The place of each province in the national rating of the state of renal medical care was identified. Conclusions. The organization, availability and quality of medical care for nephrological patients in Ukraine do not meet existing needs. The significant differences in the specialized nephrological care between the regions of Ukraine can be solved out through the implementation of appropriate management and financial decisions.
Published: 19 October 2020
Ukrainian Journal of Nephrology and Dialysis pp 23-28; doi:10.31450/ukrjnd.4(68).2020.04
Membranoproliferative glomerulonephritis (MPGN) is a heterogeneous disease characterized by a morphological injury pattern that can be seen under various disease conditions that share common pathogenic mechanisms. In this study, we analyzed clinical features, pathological findings, long-term kidney outcomes according to the new pathohistological classification of MPGN. Methods. This retrospective study included 20 CKD patients with biopsy-proven MPGN that had been diagnosed between 2011 and 2019. We reclassified the patterns of MPGN as immune-complexes mediated (ICM) and complement-mediated (CM) according to the new classification. Results. The level of daily proteinuria was lower in the ICM MPGN than the CM MPGN group but was not statistically significant at the end of the study. Histopathologically, the difference in C3 staining was found between the patients with ICM and CM MPGN. At the end of the follow-up period, no patients developed end-stage renal disease, and no death occurred in response to treatment in the ICM MPGN group. In the CM MPGN group, 2 patients evolved to end-stage renal disease and 1 of them had renal transplantation. Conclusion. Larger sample size and longer follow-up may change the relationship between histological factors, treatment strategies, and kidney outcomes. We believe that the use of the new diagnostic approach that applies to the ICM MPGN and CM MPGN will help nephrologists to improve treatment options and renal outcomes for patients with MPGN.
Published: 16 October 2020
Ukrainian Journal of Nephrology and Dialysis pp 29-37; doi:10.31450/ukrjnd.4(68).2020.05
Anemia is a common complication of chronic kidney disease (CKD). The most common cause of anemia in CKD is erythropoietin deficiency; and the most important cause of mortality in CKD patients is atherosclerotic vascular complications which are associated with endothelial damage. One of the methods evaluating vascular integrity is the cytometric measurement of circulating endothelial cells and endothelial progenitor cells in peripheral blood. The study aimed to investigate the effects of erythropoietin therapy on endothelial dysfunction by evaluating circulating endothelial cells and endothelial progenitor cells in peripheral blood using the technique of flow cytometry. Methods. A total of 55 hemodialysis patients were evaluated in three groups; those having erythropoietin therapy for at least last 3 months (n = 20) / not having erythropoietin for at least the last 3 months (n = 20) and the patients who started erythropoietin treatment during the study (n = 5). The control group consisted of 20 people. Blood values of the 3rd Group were investigated three times as baseline, 2nd week and 8th week CD34 +, CD105 + cells were evaluated as activated circulating endothelial cells; CD133 +, CD146 + cells were evaluated as activated endothelial progenitor cells. Results. There was no difference between the patients and healthy individuals in terms of circulating endothelial cells and endothelial progenitor cells. In the third group, no differences were observed in circulating endothelial cells / endothelial progenitor cell levels at baseline / 2nd and 8th weeks. There was no correlation between erythropoietin and circulating endothelial cells / endothelial progenitor cells. Conclusion. A correlation is not available between the therapeutic doses of erythropoietin used in hemodialysis patients and circulating endothelial cells / endothelial progenitor cell levels; supratherapeutic doses could change the results.
Published: 11 September 2020
Ukrainian Journal of Nephrology and Dialysis pp 67-73; doi:10.31450/ukrjnd.4(68).2020.10
Chronic kidney disease (CKD) is a global health problem. Patients with CKD have an increased risk of thromboembolic complications and bleeding. It remains difficult to determine the benefits and risks of antiplatelet and anticoagulant therapy in patients with CKD, so an individualized risk assessment of each patient should be mandatory. To date, there are no specialized scales for assessing the risk of thromboembolic events and bleeding, which are focused on patients with CKD and take into account all the features of the course of CKD and the specific factors of their occurrence. In this work, we decided to conduct a detailed assessment of the accuracy of the currently accepted risk scales for thromboembolic events and bleeding in patients with CKD.
Published: 20 August 2020
Ukrainian Journal of Nephrology and Dialysis pp 4-9; doi:10.31450/ukrjnd.3(67).2020.01
During the global COVID-19 pandemic, there was an urgent need to make complex clinical decisions about the management of chronic kidney disease (CKD)patients. Since a significant number of CKD patients have impaired renal function or receive immunosuppressive (IS) therapy, they belong to a high-risk group for adverse effects of COVID-19 infection. In addition, the overwhelming majority of CKD patients have co-morbidities, which not only increases the risk of SARS-CoV-2 infection, but also the formation of life-threatening complications of COVID-19. Currently, there are no data on the best practices for the management of CKD patients during the COVID-19 pandemic. However, based on the existing research presented by leading renal associations (ERA-EDTA, Kidney Care UK, The Renal Association), NICE Rapid Guidelines on this topic, and our own experience, the expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the Adapted Clinical Recommendations for the Management Of Patients with CKD stages 1-4 during the COVID-19 pandemic. The proposed clinical guidelines aimed to classify all CKD patients at risk for SARS-CoV-2 infection and hospitalization. The key characteristics of each class of kidney disease are the kidney functional level, determined by the glomerular filtration rate (GFR), daily urinary protein excretion, hypertension, medication intake and other additional characteristics. All of the following clinical guidelines have a level of evidence of 2C.
Published: 20 August 2020
Ukrainian Journal of Nephrology and Dialysis pp 10-14; doi:10.31450/ukrjnd.3(67).2020.02
The global COVID-19 pandemic is a critical time for hemodialysis patients as hypertension, diabetes or other co-morbidities, as well as hemostasis disorders, are risk factors for adult distress syndrome, the formation of which significantly worsens the prognosis. Several national associations of nephrologists have created expert working groups to prepare constantly updated clinical guidelines for the management of dialysis patients in the context of the COVID-19 pandemic. According to the experts, to minimize COVID-19 infection of patients and health care workers, the medical staff of dialysis units should undergo training and further retraining, following changes in constantly updated practical recommendations. The expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has also created the Adapted Clinical Guidelines for the Management of Hemodialysis Facilities and Services During the COVID-19 pandemic. All of the following clinical guidelines have a level of evidence of 2C.
Published: 20 August 2020
Ukrainian Journal of Nephrology and Dialysis pp 15-19; doi:10.31450/ukrjnd.3(67).2020.03
In Ukraine, about 12% of end-stage renal disease patients are treated by peritoneal dialysis (PD). In contrast to the hemodialysis population, PD patients receive treatment at home, which reduces the likelihood of SARS-CoV-2. However, older age, diabetes, hypertension and many other comorbid conditions of PD patients significantly increase the risk of infection. Therefore, maximum adherence to preventive measures for COVID-19 by PD patients and medical staff is an urgent and mandatory task. Based on the published research on COVID-19, the expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the Adapted Clinical Guidelines for the Management of Peritoneal Dialysis Facilities and Services During the COVID-19 pandemic. All of the following clinical guidelines have a level of evidence of 2C.
Published: 20 August 2020
Ukrainian Journal of Nephrology and Dialysis pp 20-27; doi:10.31450/ukrjnd.3(67).2020.04
Acute kidney injury (AKI) is diagnosed in 1–40% of the COVID-19 patients; from 2% to 10% of the patients are required renal replacement therapy (RRT). The mortality rate in this category of patients reached 88%. Early AKI detection in the patients with COVID-19, followed by the use of preventive and therapeutic measures to minimize the incidence or progression is a significant key to reduce the mortality rate and transformation of AKI into chronic kidney disease (CKD). The expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the adapted clinical guidelines for the management of acute kidney injury in patients with COVID-19 or CKD stage 1-4 patients with acute kidney injury in the COVID-19 pandemic. These guidelines are intended for family physicians, general practitioners, physicians, cardiologists, nephrologists, intensivists, endocrinologists, infectious disease specialists and other professionals involved in the provision of specialized medical care to the patients with COVID-19. Specialized medical care for AKI patients infected COVID-19 should be provided by a multidisciplinary team, which has to involve nephrologists, infectious disease specialists and intensivists.