Репозиторий Университета

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Steady increase in the prevalence of chronic kidney disease (CKD) is a serious public health problem, since CKD potentially leads to the development of end-stage renal disease (ESRD) that requires high-cost replacement therapy and is closely associated with increased risk of developing cardiovascular diseases (CVD), which are the cause of death in most patients. Progression of renal dysfunction and development of CVD are significantly affected by hyper- and dyslipidemia. This review contains results of studies evaluating the effect of hypolipidemic therapy on reduction of cardiovascular risk and slowdown of renal dysfunction in patients with CKD at pre-dialysis and dialysis stages of renal failure, as well as in patients with kidney transplant. In addition, recommendations on nutrition and new therapeutic approaches to lipid-lowering therapy in patients with CKD, as well as prospects for the usage of new hypolipidemic drugs are also presented.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study a role of cystatin C in the nephrocerebral risk in chronic kidney disease at the initial stage of the disease. Material and methods. One hundred and twenty-eight patients (63 men and 65 women) with chronic kidney disease (CKD) were examined at the pre-dialysis stage of the disease. All patients underwent a complex clinical and laboratory examination with determination of the lipid spectrum, uric acid, fibrinogen, calcium and cystatin C, and subsequent calculation of the glomerular filtration rate (GFR). To assess structural changes in carotid arteries, ultrasound dopplerography was performed. Depending on the thickness of the intima-media (TIM), the entire sample is divided into CKD groups with no signs of carotid atherosclerosis (SC), n=70 and on CKD with SC, n=58. Results. Patients of the second group (CKD with SC), had higher body mass index (p<0.05), systolic (p<0.05) and central (p<0.05) arterial pressure (BP) and blood cystatin C (p<0.05). In the same group, there was a significant decrease in the concentration of high-density lipoprotein cholesterol (p<0.05) compared with those of the first group (CKD). The age of patients and the content of cystatin C (p<0.05) influenced the increase in TIM. Significant positive correlations between cystatin C content and TIM, systolic and diastolic blood pressure (p<0.05), and a negative correlation cystatin C content and GFR were noted in patients of the second group. Conclusion. The increase in the level of cystatin C in blood plasma in CKD indicates the development of structural changes in the carotid arteries, the increase in the levels of systolic and central arterial pressure, the decrease in the concentration of HDL cholesterol, which is associated with significant inhibition of GFR.

© 2018 Izdatel'stvo Meditsina. All rights reserved. The purpose of the study was to investigate gender features of abnormalities of blood serum lipid composition and their relationship with clinical and functional manifestations in patients with chronic kidney disease (CKD). The study covered patients with CKD at pre-dialysis stage of disease, aged 17-71 years (average age 37.3±13.0 years). All patients underwent complex clinical and laboratory examination. Depending on gender, the sample (n = 417) was divided into 2 groups: group I - males (n = 277) and group II-females (n = 140). Blood sampling was implemented using venipuncture of ulnar vein after 12-14 hours of fasting in morning time. The lipid analysis of blood serum was performed using the auto-analyzer "Respons 920" (Germany), including detection of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). The atherogenic index (AI) was calculated according formula: AI = (TC - HDL-C)/HDL-C. At analysis of the results of lipidogram, the levels of TC (hypercholesterolemia), LDL-C (hyper-beta-cholesterolemia) and TG (hypertriglyceridemia) were considered as increased when their values were ≥5.0 mmol/L, ≥3.0 mmol/L and > 1.7 mmol/L respectively. The level of HDL cholesterol (hypo-alpha-cholesterolemia) was considered as decreased when its concentration was ≤1.0 mmol/L in males and ≤1.2 mmol/L in females. In the group of male patients, hypo-alpha-cholesterolemia was detected in 135 patients (48.7%), hypertriglyceridemia - in 162 (58.4%), and average value of atherogenic index was significantly higher - 3.49 (2.43-5.08) as compared with 3.12 (2.12-3.74) in female patients (p=0.001). The laboratory signs of anemia were significantly more frequent in group of females - 53 (37.8%) as compared with 63 (22.7%) than in males (p = 0.001). In males, average values of HDL cholesterol and total serum protein were significantly lower (1.07 ± 0.44 mmol/L vs. 1.23 ± 0.42, p = 0.000 and 53.3 ± 14.6 g/L vs. 57.4 ± 11.9 g/L. p = 0.007, respectively. The levels of TG - 1.92 (1.23-2.74) mmol/L vs. 1.85 (1.04-2.37);p = 0.034], sodium (140.3 ± 6.20 mmol/L vs. 138.3 ± 6.01 mmol/L, p = 0.010) and uric acid in blood serum were significantly higher (0.38 ± 0,09 mmol/L vs. 0.34 ± 0.01 mmol/L, p = 0.003) as compared with females. In the group II (females), a noticeable slowing of the glomerular filtration rate (GFR) - 68,4 (43,6-98,1) ml/min vs. 87,6 (55,0-117,6) ml/min; (p = 0.001) was detected as compared with group I (males). Among male patients, a reliably significant positive relationship was established between TC and BMI, level of diastolic blood pressure and proteinuria; LDL cholesterol level and proteinuria; concentration of TG - and BMI, level of diastolic blood pressure and level of proteinuria. No correlation was established between the concentration of HDL-cholesterol and aforementioned laboratory markers of CKD. In contrast with males, in females, TC demonstrated an inverse relationship with the concentration of Hb, values of GFR and proteinuria, and level of HDL cholesterol - with indices of BMI, thrombocytes and uric acid of blood serum. In females a positive relationship was established between LDL cholesterol and level of diastolic blood pressure, GFR and daily proteinuria, and also between concentration of serum TG and volume of daily proteinuria and BMI. In general group, a reliable positive relationship was detected between TC and BMI and proteinuria, between LDL-C level and proteinuria, and between TG concentration and BMI, level of diastolic blood pressure, sodium content and proteinuria. The negative relationship was established between concentration of HDL cholesterol and BMI and uric acid in blood plasma, and TG level with Hb concentration. In male patients with CKD at pre-dialysis stage of disease, decreasing of level of HDL cholesterol was established as an increased concentration of TG and increasing atherogenic index. The content of triglyceride of blood serum is closely related to body mass index, level of diastolic blood pressure and proteinuria. In females, slowing of glomerular filtration rate is accompanied by development of anemia and atherogenic dyslipidemia.

© 2018 Bentham Science Publishers. Urotensin II (UT II) is an important factor of cellular homeostasis. This regulatory peptide is involved in the pathophysiology of many disorders. For example, it plays an important role in the pathogenesis of acute and chronic diseases, stressful and adaptive reactions of the body, in the development of cardiovascular pathologies, metabolic syndrome, inflammation, liver cirrhosis, renal failure, diabetic nephropathy, reproductive dysfunction, progression of psychosomatic, psychoendocrinal and psychiatric disorders. In this concern, the involvement of UT II in the pathophysiology of many processes determines the perspectives for the development of blockers of urotensin receptors for the treatment of the aforementioned diseases. It is important that even today this kind of perspective is feasible due to the synthesis of a series of GPR14 blockers. The objective of this review is to discuss current molecular mechanisms of biological activity, regulatory functions of UT II, its role in the pathogenesis of different nosologies, as well as analysis of the possible routes of exposure to GPR14 as potential therapeutic targets.