Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Some pathologic processes compromise renal function and as result worsen glomerular filtration rate (GFR). The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation was developed in an effort to create a more correct formula to estimate GFR, however, it is not able to assess split renal function. Objective. This paper aims to present how numerical analysis of abdominal multispiral computed tomography (MSCT) results correlate with data of CKD-EPI equation. Materials and methods. In this Institutional prospective cohort study, MSCT scans of 16 patients undergoing multiphasic renal protocol with 3D-reconstruction and numerical estimation were reviewed. Comparison was made by means of Pearson coefficient and Youden index. Results. MSCT-based methods for the calculation of split renal function with 3Dmodels showed strong correlation with CKD-EPI (p<0.001). Conclusion. Data received using the 3D-MSCT in comparison with CKD-EPI equation are equally accurate with low bias in GFR-assessment. However new approach has great advantages, because allows for both acquiring detailed data on clinical anatomy and evaluation of renal function, that made it not only precise but also more informative for decision-making in clinical practice. Such application of high-tech imaging method applied to the field of radiology may alter the course of patients' management when pathologic process is just beginning to correct premorbid conditions.

© 2018 Media Sphera Publishing Group. All rights reserved. Obesity, including morbid obesity, is a growing worldwide problem. The adverse effect of obesity on the kidneys is associated with the development of comorbid conditions, such as insulin resistance (IR), metabolic syndrome (MS), diabetes mellitus (DM), arterial hypertension (AH), which are the recognized risk factors of chronic kidney disease (ÑKD). Obesity also causes direct kidney damage with the development of non-immune focal segmental glomerulosclerosis. The leading pathophysiological mechanisms of kidney damage in obesity are intrarenal hemodynamic disorders with the formation of hyperfiltration and damaging effects of adipokines produced by adipose tissue. Bariatric surgery (BS) has taken a leading position in the treatment of morbid obesity, demonstrating its effectiveness not only in long-term weight loss, but also in the correction of IR, MS, DM, AH. Nephroprotective effect of significant and persistent weight loss is caused by the elimination of hyperfiltration and damaging effect of adipokines. Results of the observational studies of the immediate and long-term effects of BS have demonstrated positive renal outcomes, in particular, the decrease in albuminuria/proteinuria, the improvement or stabilization of glomerular filtration rate, the delay of end-stage renal failure development; surgical correction of body weight in dialysis patients with morbid obesity lets them realize subsequent kidney transplantation. Large, randomized prospective studies with a longer follow- up are needed; analysis of the long-term renal consequences of BS in obesity patients with pre-existing renal impairment, including dialysis patients, is required; stratification of the BS risk of renal complications (acute kidney damage, nephrolithiasis, nephrocalcinosis) and effective strategy for managing these risks need to be developed.

© 2018 Nutritec. All Rights Reserved. The article presents modern approaches to dietary support of patients with diabetic nephropathy (DN) characterized by gradual sclerosis of the renal tissue, leading to a loss of filtration and nitrogen excretory function of the kidneys. An analysis of publications of domestic and foreign authors indicates a slowdown in the progression of chronic kidney disease against the background of low-protein diets. However, the role of protein restriction and its qualitative composition in the diet of patients with DN is the subject of comprehensive discussion. KDOQI (2007) Clinical Practice Guidelines and Clinical Practice Guidelines for Kidney Disease determine the target level of protein intake in individuals with diabetes and chronic kidney disease 1-4 stages at the level of 0.8 g/kg of body weight per day. In the recommendations on nutrition for patients with DN, along with a controlled reduction in protein content, great importance is attached to reducing sodium intake from food to 1.5-2.3 gperday. In recent years, close attention has been paid to the use of highly active natural antioxidants for the treatment and prevention of type 2 diabetes, including DN, which was determined by the results of studies demonstrating their beneficial effects on DN patterns. It has been shown that one of the ways to optimize the nutrition of patients with DN is the use of specialized foods modified by protein, fat and carbohydrate composition, including food ingredients with hypoglycemic, hypolipidemic and antioxidant effects.

© 2018 Media Sphera Publishing Group.All right reserved. Purpose: to study clinical-functional features of remodeling of carotid arteries and its relation to restructuring of the left ventricle (LV) in patients with chronic glomerulonephritis at pre-dialysis stage. Materials and methods. We examined 269 patients (189 men, 80 women) with chronic glomerulonephritis (CGN) aged 17-71 years, at pre-dialysis stages of the disease. We analyzed biochemical parameters of peripheral blood with the determination of daily proteinuria and glomerular filtration rate (GFR). For identification of structural changes of carotid arteries (CA) and LV we used Doppler ultrasound and echocardiography. Results. Atherosclerotic changes of CA were found in 79 patients (29.3 %). Four patients (1.4 %) had history of acute disturbance of cerebral circulation. Concentric type of left ventricular hypertrophy (LVH) was significantly more prevalent among patients with CA remodeling compared with those without (37.84 vs. 18.75 %; p=0.006). Eccentric variant of LVH was significantly more prevalent among patients without atherosclerotic lesions in CA compared with those with CA remodeling (81.25 % vs. 62.16 %; p=0.001). Increased CA intima media thickness positively correlated with body mass index (r=0.273; p=0.014) and negatively-with GFR (r=-0.222; p=0.048). Statistically significant relationships were also found between the presence of carotid atherosclerosis and structural rearrangements of the heart. Conclusion. We demonstrated a clear relationship between GFR, restructuring of CA and concentric type of change of LV geometry, regardless of the presence of traditional risk factors.