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Generalized data on nephroprotective efficacy of pentoxifylline in chronic kidney disease (CKD) are presented. The potential of this drug in treating people suffering from CKD and cardiovascular diseases (CVD) with a high risk of developing the terminal stage of renal dysfunction is considered. Antiproteinuric, antifibrotic and anti-inflammatory effects of pentoxifylline significantly reduce the risk of progression of CKD and joining of CVD in the future. Efficacy in preventing the onset of the uremic stage of CKD, safety andapplicability at all stages of renal dysfunction development make pentoxifylline a very appealing drug not only for nephrologists but also for physicians. Keywords: chronic kidney disease, progression, pentoxifylline, nephroprotection, cardiovascular diseases.

Aim: To evaluate the 5-year results of renal denervation (RDN) in patients with resistant arterial hypertension (AH)., Materials and Methods: The study included 14 patients to whom, during the 2011-2013 period RDN has been completed. Before and after the intervention, office blood pressure, quality of life indicators according to the EQ-5D questionnaire, mass index bodies, indicators of kidney function were duly assessed., Results: Five years after RDN, office BP decreased from 165/110 to 139/95 mm Hg. Art. (p<0.05), with the average number of of drugs decreased from 4.6 to 3.1. 12 months after the RDA, the quality of Life, based on the questionnaire EQ-5D has increased from 60 to 80 points, by the fifth year the indicator fell to 74 points. Body mass index during 5 years decreased from 33.8 ± 3.5 to 30.9 ± 3.0 kg/m2. Mean plasma creatinine initially and after 5 years remained within the normal range, the mean the GFR score after 5 years being decreased by 9.5 ml/min/1.73 m2., Conclusion: RDN can be regarded as effective and safe method of additional treatment of patients with resistant hypertension.

Ischemic renal disease (IRD) is one of leading causes of terminal renal insufficiency, characterized by very high risk of cardiovascular complications. Approaches to IRD diagnostics and treatment, use of preventive and invasive strategies are considered in the article.

The study included 105 patients (63 men and 42 women) aged 34-84 (mean 63.8 +/- 5.1) years with ischemic renal disease (IRD). All of them underwent routine medical examination, blood homocysteine was measured in 30 patients. IRD was always associated with other manifestations of disseminated atherosclerosis and cardiovascular risk factors. Plasma homocysteine increased with decreasing glomerular filtration rate (GFR) that was especially low in patients with isolated systolic arterial hypertension, smoking, and type 2 diabetes. In 34.3% of the patients, IRD associated with other chronic conditions and in 49% with cardiovascular complications and/or the development of terminal renal insufficiency. It is concluded that IRD is characterized by a large number of concomitant manifestations of disseminated atherosclerosis and a high probability of irreversible deterioration of renal functions related to cardiovascular risk factors. IRD may be associated with other chronic renal diseases and a high risk of cardiovascular complications and terminal renal insufficiency.

Aim: To characterize clinical features and course of ischemic renal disease (IRD) combined with other chronic nephropathies., Material and Methods: We examined 102 patients with IRD treated in the E. M. Tareev clinic of the I. M. Sechenov Moscow Medical Academy in 2001-2006. We made a general clinical examination, clinical and biochemical blood tests. Glomerular filtration rate (GFR) was calculated according to Cockroft-Gault formula. Arterial hypertension was assessed according to ESH., Results: IRD associated with other chronic nephropathies was detected in 35 (34.3%) patients. Association of atherosclerotic stenosis of the renal arteries (ASRA) with diabetic, urate nephropathies was diagnosed in 9 and 8 patients, respectively; chronic pyelonephritis--in 7 cases, chronic glomerulonephritis--in 4 patients. The age of IRD patients associated with other chronic renal diseases was younger than of those with isolated IRD. Systolic arterial pressure was significantly higher in patients with isolated IRD, body mass index and total cholesterol--in the groups of IRD association with other chronic nephropathies. Aggravation of renal failure in patients with CRD association with other chronic nephropathies was provoked by ACE inhibitors and blockers of angiotensin II receptors. Revascularization of the kidneys in IRD associated with other chronic nephropathies leads to significant lowering of systolic blood pressure and stabilization of creatininemia., Conclusion: Development of IRD is possible in the presence of other chronic nephropathies. Diagnosis of IRD arising in patients suffering from other chronic renal diseases often requires radical change of therapeutic policy, but renal revascularization is not contraindicated.