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Rationale & Objective: It is unclear whether the effect of canagliflozin on adverse kidney and cardiovascular events in those with diabetic kidney disease varies by age and sex. We assessed the effects of canagliflozin among age group categories and between sexes in the Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study.Study Design: Secondary analysis of a randomized controlled trial.Setting & Participants: Participants in the CREDENCE trial.Intervention: Participants were randomly assigned to receive canagliflozin 100 mg/d or placebo.Outcomes: Primary composite outcome of kidney failure, doubling of serum creatinine concentration, or death due to kidney or cardiovascular disease. Prespecified secondary and safety outcomes were also analyzed. Outcomes were evaluated by age at baseline (Results: The mean age of the cohort was 63.0 ± 9.2 years, and 34% were female. Older age and female sex were independently associated with a lower risk of the composite of adverse kidney outcomes. There was no evidence that the effect of canagliflozin on the primary outcome (a composite of kidney failure, a doubling of serum creatinine concentration, or death from kidney or cardiovascular causes) differed between age groups (HRs, 0.67 [95% CI, 0.52-0.87], 0.63 [0.48-0.82], and 0.89 [0.61-1.29] for ages Limitations: This was a post hoc analysis with multiple comparisons.Conclusions: Canagliflozin consistently reduced the relative risk of kidney events in people with diabetic kidney disease in both sexes and across age subgroups. As a result of greater background risk, the absolute reduction in adverse kidney outcomes was greater in younger participants.Funding: This post hoc analysis of the CREDENCE trial was not funded. The CREDENCE study was sponsored by Janssen Research and Development and was conducted collaboratively by the sponsor, an academic-led steering committee, and an academic research organization, George Clinical.Trial Registration: The original CREDENCE trial was registered at ClinicalTrials.gov with study number NCT02065791.

Patients on maintenance dialysis treatment and kidney transplant recipients who survive coronavirus disease 2019 (COVID-19) are at higher risk of post-COVID syndrome compared to the general population. However, a detailed assessment of the causes, features, and clinical outcomes of the post-COVID syndrome in this patients’ cohort does not yet been established. In this review, we summarize published research on this issue to use these available data to predict the development, treatment and prevention of the post-COVID syndrome in dialysis patients and kidney transplant recipients.

During conflicts, people with kidney disease, either those remaining in the affected zones or those who are displaced, may be exposed to additional threats because of medical and logistical challenges. Acute kidney injury developing on the battlefield, in field hospitals or in higher-level hospital settings is characterized by poor outcomes. People with chronic kidney disease may experience treatment interruptions, contributing to worsening kidney function. Patients living on dialysis or with a functioning graft may experience limitations of dialysis possibilities or availability of immunosuppressive medications, increasing the risk of severe complications including death. When patients must flee, these threats are compounded by unhealthy and insecure conditions both during displacement and/or at their destination. Measures to attenuate these risks may only be partially effective. Local preparedness for overall and medical/kidney-related disaster response is essential. Due to limitations in supply, adjustments in dialysis frequency or dose, switching between hemodialysis and peritoneal dialysis and changes in immunosuppressive regimens may be required. Telemedicine (if possible) may be useful to support inexperienced local physicians in managing medical and logistical challenges. Limited treatment possibilities during warfare may necessitate referral of patients to distant higher-level hospitals, once urgent care has been initiated. Preparation for disasters should occur ahead of time. Inclusion of disaster nephrology in medical and nursing curricula and training of patients, families and others on self-care and medical practice in austere settings may enhance awareness and preparedness, support best practices adapted to the demanding circumstances and prepare non-professionals to lend support.

In December 2021, the State Institution "Institute of Nephrology of the National Academy of Medical Sciences of Ukraine celebrates its 20th anniversary. It is a modern research, medical-diagnostic and organizational-methodical institution that ensures the implementation of state policy in Nephrology. Scientific topics performed by the staff of the institute are aimed at improving diagnostic methods and improving the treatment of patients with glomerulonephritis, pyelonephritis, inhibiting the progression of chronic kidney disease, improving quality of life and prolonging its duration in dialysis patients, providing comprehensive differentiated care of patient acute kidney injuire. The Institute was iniciation of establish and functioning of the National Register of Chronic Kidney Diseases, Acute Kidney Injure and Transplanted Kidney, the data of which are the basis for management decisions to develop specialized nephrological care in Ukraine and are published annually in materials European Renal Register. The Institute conducts training and postgraduated education doctors in the field of nephrology. Ukrainian Journal of Nephrology and Dialysis is published quarterly. The scientific works are examination. The staff of the Institute directs its activities to solving current problems of nephrology, improving the quality of specialized nephrological care, training of qualified personnel, who will be able to provide it. Key words: Institute of Nephrology, history, nephrology assistance.

The present study aimed to evaluate the changes in oxidative stress markers according to the concentration of plasma oxalic acid (POx) in end-stage renal disease (ESRD) patients. Methods. We conducted a cross-sectional observational study involving 72 ESRD patients and 30 relatively healthy individuals who served as a control reference group for evaluation of POx concentration. Among ESRD patients there were 32 hemodialysis (HD) patients and 40 peritoneal dialysis (PD). POx concentration was measured spectrophotometrically using a commercially available kit (MAK315, Sigma, Spain). Malonic dialdehyde (MDA), ceruloplasmin (CP), transferrin (TR), sulfhydryl groups (SH-groups), antioxidant blood capacity (AOC) and total peroxidase activity of erythrocytes (TPA) were measured and the oxidative stress index (OSI) was calculated in all examined patients. Results. A significant increase in POx concentration was observed in ESRD patients compared with healthy volunteers (p < 0.0001). The concentrations of MDA in serum, OSI in erythrocytes and serum of the examined patients were gradually increased, while serum levels of CP, AOC, SH-groups and TPA in erythrocytes, on the contrary, were decreased in accordance with the increasing trend of POx concentrations. Correlation analysis demonstrated a statistically significant direct relationship between POx concentration and MDA (r = 0.57; p

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.

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.

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.

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.

Коронавірусна хвороба – інфекційне, висококонтагіозне захворювання, яке дебютує лихоманкою (44%-98%), кашлем (68%-76%), міалгією (18%). Серед недіалізної популяції смертність складає 1,4%-3,6%. Пандемія COVID-19 є особливо небезпечною для хворих на хронічну хворобу нирок (ХХН) VД, оскільки артеріальна гіпертензія, цукровий діабет, інші коморбідні стани та порушення системи гемостазу є факторами ризику дистрес-синдрому дорослих, формування якого суттєво погіршує прогноз. Декілька національних асоціацій нефрологів сформували робочі групи експертів для підготовки постійно оновлюваних клінічних рекомендацій щодо роботи відділень діалізу в умовах пандемії COVID-19. На думку експертів медичний персонал відділень діалізу повинен пройти тренінг та у подальшому ретренінги, відповідно до змін постійно оновлюваних практичних рекомендацій для мінімізації інфікування хворих та медичних працівників. Експертна група Української асоціації нефрологів і фахівців з трансплантації нирки також створила адаптовані клінічні рекомендації щодо організації роботи відділень діалізу в умовах пандемії COVID-19. Усі нижче подані положення клінічних рекомендацій мають рівень доказовості 2С.

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.

At the beginning of COVID-19 pandemic attention of healthcare professionals and scientists were already drawn to the appearance of markers of pathologic changes of the urinary system in SARS-CoV-2-infected patients, signs of acute kidney disease (AKD) (including acute kidney injury (AKI) or development of AKI in patients with chronic kidney disease (CKD). This necessitates verification of pathologic changes markers of the urinary system in SARS-CoV-2-infected patients and clarification of their nosologic relevance. The present study aimed to analyze the present information regarding the capacity of SARS-CoV-2 to cause kidney injury (acute kidney disease, including AKI) in patients without such changes before infecting or in patients with CKD, and to verify these changes according to the classification of urinary system disease and Nomenclature for kidney function and disease: report of Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference 2020. The presence of the pathologic changes markers of the urinary system in SARS-CoV-2-infected patients necessitates its verification via the use of tools of diagnostics of urinary system disease. Infecting with SARS-CoV-2 may cause (isolated) asymptomatic proteinuria, isolated erythrocyturia, hemoglobinuria; AKD (including AKI) in patients without preexisting urinary system injuries, AKI in patients with CKD, and may complicate hemodialysis and peritoneal dialysis. The frequency of AKI and mortality rate in patients with COVID-19 and CKD are much higher than without the last one. The AKI frequency is higher in ICU (18 – 37,5%) than in patients with moderate or mild COVID-19 (0,5 – 15%). Patients with all CKD stages with moderate or severe COVID-19 must be admitted to the hospital with further determination by a multidisciplinary team (infectionist, nephrologist, ICU physician, etc, according to the clinical situation) of necessary monitoring and treatment capacity for prevention of AKD progression and life-threatening complications or their adequate therapy. After confirmation of SARS-CoV-2 absence and release from the hospital, patients with AKD or all stages of CKD should be followed up, and monitoring frequency depends on AKD or CKD stage.

The branch of historical science of numismatics (from the Latin "numisma" - coin) originated in the 19th century and became closely connected with economics, politics, culture and law, it includes a thematic study of coins, medals and plaque. Best of all, the history of uronephrology is illustrated by various forms of the medalist educational art (exonum or paranumismatics), and the medal became the prototype of the memorial coin. This work presents a catalog of more than 400 numismatic materials (including some unique, first cited), reflects the stages of development of the study of the structure and function of the kidneys, methods for diagnosing and treating diseases, there are links to significant historical events, brief biographies of physicians who have made an invaluable contribution are mentioned into the formation of this scientific discipline. The development of urology over 520 years of historical epochs of the New and Modern times were presented, portraits on 60 numismatic materials of well-known specialists-urologists and kidney transplantologists were presented, scientific forums of urologists were reflected on commemorative medals.

The branch of historical science of numismatics (from the Latin "numisma" - coin) originated in the 19th century and became closely connected with economics, politics, culture and law, it includes a thematic study of coins, medals and plaque. Best of all, the history of uronephrology is illustrated by various forms of medalist educational art (exonum or paranumismatics), and the medal became the prototype of the memorial coin. This work presents a catalog of more than 400 numismatic materials (including some unique, first cited), reflects the stages of development of the study of the structure and function of the kidneys, methods for diagnosing and treating diseases, there are links to significant historical events, brief biographies of physicians who have made an invaluable contribution are mentioned into the formation of this scientific discipline. The work presents a role in the origin of the study of kidney and urinary tract diseases of ancient physicians (Aretea, Aristotle, Galen, Hippocrates, Rufus, Sushruta, Empedocles) and doctors of the Middle Ages (Avicenna, Da Carpi, Panaskerteli, Paracelsus, Sun Simiao).

Hepatorenal syndrome (HRS) is a unique form of acute kidney injury (AKI) developing in patients with end‐stage liver disease. AKI is a frequent complication in advanced cirrhosis patients which is associated with increased hospital admissions and decreased survival. The definition of AKI in cirrhosis has been recently modified and the new diagnostic criteria are based on small changes in serum creatinine with respect to previous values, occurring within a short period of time. Systemic circulatory dysfunction and marked kidney vasoconstriction play a key role in the development of HRS. The modification of the AKI definition has also led to a change in the diagnostic criteria of HRS. The new diagnostic criteria are based on AKI stages and there is no need to reach a specific serum creatinine threshold. The use of the new HRS definition may lead to an earlier identification of renal impairment and better prognostic stratification. According to these new criteria, treatment with vasoconstrictors and albumin for the management of HRS will be started at lower serum creatinine values, with expected higher response rates. There are consistent data showing that some urine biomarkers, particularly NGAL (neutrophil gelatinase‐associated lipocalin), may be useful in daily clinical practice for the differential diagnosis of the cause of AKI in cirrhosis. Various HRS treatment regimens are available worldwide and all are designed to increase the mean arterial pressure by increasing the central blood volume and decreasing splanchnic vasodilation, and to serve as bridge to liver transplantation.

Since 2011, at the Department of Industrial and Biomedical Electronics, NTU "KHPI" together with KNPE of KRC "RMCCUN n. a. V. I. Shapoval” with the participation of State Institute “Institute of Nephrology of the National Academy of Medical Sciences of Ukraine” is carrying out research aimed at improving patient safety the hemodialysis (HD)or hemodiafiltration (HDF) procedure. Especially prepared water ensures the safety and quality of the HD or HDF procedure. For the carrying-out, one HD session is necessary more than 150 liters of permeate. Poor quality permeates causes various complications, even can lead to fatal consequences. Therefore a constantly guaranteed qualitative permeate is an important component of safe HD or HDF.

Expenses for the treatment of end-stage renal disease (ESRD) patients with dialysis renal replacement therapy (DRRT) during the 2018 year constituted 2 billion 922 million 460 thousand UAH. Reimbursement from the state budget constituted 1 billion 44 million 800 thousand UAH. Expendable materials were the main component of DRRT. The share of the expendable materials price from total cost for hemodialysis and hemodiafiltration constituted 66%, for continuous ambulatory peritoneal dialysis and automatic peritoneal dialysis was 86.3% and 92.2%, respectively. The results of the investigation can be used for the development of a diversification model (state budget – local budgets – other sources) of financial expenses for the provision of dialysis treatment in ESRD patients as a part of the state program (strategy) health care finance and service delivery.

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".

The aim of the work was 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 performed via 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 national rating of state of renal medical care was identified. Conclusions. Dramatic differences in the specialized nephrological care between the regions of Ukraine are primarily due, in our opinion, to the understanding of its medical and social importance and, hence, the funding level.

Background and Aims Gut microbiota is considered an important factor affecting oxalate handling in the intestine. It has been demonstrated that intestinal oxalate secretion provides a complementary route of excretion, and it becomes more evident when kidney function declines. A diversity of gut oxalate-degrading bacteria (ODB) has been hypothesized to play a role in this process. However, there is a general lack of research on the long-term effects of acute kidney injury (AKI) on ODB and their total oxalate-degrading activity (ODA) in fecal microbiota. In this study, we evaluated whether renal dysfunction could affect intestinal ODB and their total ODA in a rat model of glycerol-induced AKI. Method The Male Wistar rats (200-300 g, n=20) on oxalate-free diet were randomly divided into 2 groups. After 24-h of water deprivation, Group 1 (n=10) received an intramuscular injection of 50% glycerol (10 ml/kg of body weight), and Group 2 (n=10) served as control. The numbers of ODB (incubated in a highly selective Oxalate Medium and determined using culture method) and total fecal ODA were measured after injection on days 7 and 70. The method of redoximetric titration with a KMnO4 solution was adopted to evaluate total ODA in fecal microbiota; the results were expressed as % of oxalate degradation per 0.01 g of feces. Renal injury was assessed by histopathological examination, serum creatinine and daily proteinuria levels after removing the animals from the experiment on day 70. Cortical interstitial fibrosis was measured by computerized image analysis on sections stained with picrosirius red. The median (Me) and the interquartile ranges (Q25; Q75) were calculated and compared using the nonparametric Mann-Whitney test. The Spearman correlation coefficient was used to evaluate association between the examined parameters. Results The obtained results demonstrated: 1) after glycerol injection on day 7, no differences were found in the numbers of ODB and total fecal ODA between the experimental and control groups: 5.9 (5.4-6.0) vs 6.0 (5.4-6.4) CFU/g, p=0.65 and 2.0 (0.1-5.0) vs 2.5 (2.0-9.0) %/0.01g, p=0.24, respectively; 2) after AKI initiation on day 70, the numbers of ODB and total fecal ODA were significantly lower in Group I compared with control Group II (Fig. 1); 3) the higher percentage of renal interstitial fibrosis was, the higher total fecal ODA occurred in the experimental rats (Fig. 2). In addition, the number of ODB in feces in Group 1 had an inverse association with serum creatinine (r=-0.52, p=0.006) and 24-h proteinuria levels (r=-0.86, p Conclusion AKI had the long-term negative effects on the quantitative and qualitative characteristics of ODB in fecal microbiota in rats. Moreover, the results of our study confirmed an increasing trend in total fecal ODA according to the aggravation of renal interstitial fibrosis in rats.

Background The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry collects data on kidney replacement therapy (KRT) via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article summarizes the 2018 ERA-EDTA Registry Annual Report, and describes the epidemiology of KRT for kidney failure in 34 countries. Methods Individual patient data on patients undergoing KRT in 2018 were provided by 34 national or regional renal registries and aggregated data by 17 registries. The incidence and prevalence of KRT, the kidney transplantation activity and the survival probabilities of these patients were calculated. Results In 2018, the ERA-EDTA Registry covered a general population of 636 million people. Overall, the incidence of KRT for kidney failure was 129 per million population (p.m.p.), 62% of patients were men, 51% were ≥65 years of age and 20% had diabetes mellitus as cause of kidney failure. Treatment modality at the onset of KRT was haemodialysis (HD) for 84%, peritoneal dialysis (PD) for 11% and pre-emptive kidney transplantation for 5% of patients. On 31 December 2018, the prevalence of KRT was 897 p.m.p., with 57% of patients on HD, 5% on PD and 38% living with a kidney transplant. The transplant rate in 2018 was 35 p.m.p.: 68% received a kidney from a deceased donor, 30% from a living donor and for 2% the donor source was unknown. For patients commencing dialysis during 2009–13, the unadjusted 5-year survival probability was 42.6%. For patients receiving a kidney transplant within this period, the unadjusted 5-year survival probability was 86.6% for recipients of deceased donor grafts and 93.9% for recipients of living donor grafts.

The history of Ukrainian nephrology started in 1927 when the Ukrainian therapist, one of the founders of the Kyiv therapeutic school, Professor Feofil Yanovskiy wrought out the first textbook used for studying nephrology Diagnostics of Kidney Diseases According to their Pathologies.

Background and Aims Cardiovascular disease (CVD) remains the leading cause of morbidity and death in end-stage renal disease (ESRD) patients. Thus, the accumulation of oxalate due to ESRD can increase the risk of CVD. Also, the ability of fecal oxalate-degrading activity (ODA) to reduce plasma oxalate levels has been discussed. On the other hand, despite a key role of atherogenic dyslipidemia in the development of CVD, only a few studies have shown a potential role of microbiota in the regulation of blood lipid profiles in the general population. However, at present, there is a general lack of research on this topic in dialysis patients. The present study aimed to investigate the association between oxalate-degrading activity (ODA) in fecal microbiota and blood lipid profiles in ESRD patients. Method We represented the data of a cross-sectional pilot study examining ODA in fecal microbiota, plasma oxalate concentration (POx) and blood lipid profile markers in 32 ESRD patients. Among the patients, there were 21 hemodialysis (HD) patients and 11 peritoneal dialysis (PD) patients. The average age of the patients was 52.5 [39; 65] years. The redoximetric titration with KMnO4 was adopted to evaluate total ODA in fecal microbiota. The results were expressed in % oxalate degradation per 0.01 g of feces. The blood lipid spectrum was determined in all patients: total cholesterol level (TC), high (HDL), low (LDL) and very low (VLDL) density cholesterol, triglycerides (TG) and atherogenic index of plasma (AIP). The median (Me) and interquartile ranges [Q25; Q75] were calculated using the nonparametric Kruskal-Wallis test. The Spearman test was used for the correlation analysis. Chi-square tests were used for comparison of 2 proportions. All statistical analyses were performed using MedCalc. Results Dyslipidemia defined as an increase in atherogenic lipoprotein fractions and inhibition of HDL cholesterol was identified in 13/32 (40.6%) ESRD patients. Negative ODA in fecal microbiota (≤ 0 % /0.01 g) was observed in 14/32 (43.7%) patients. Among them, there were 5/21 (23.8%) HD patients and 7/11 (63.6%) PD patients (χ2=3.9, p=0.04). Significantly lower ODA in fecal microbiota was observed in the patients with atherogenic dyslipidemia in comparison with dyslipidemia-free patients (-5.0 [-8.7; 3.7] vs 3.0 [0.5; 9] %/0.01 g of feces, p=0.02) (Fig. 1). Less ODA in fecal microbiota was, higher levels of TG (r=-0.5, p=0.004) (Fig. 2), VLDL (r=-0.34, p=0.05) (Fig. 3) and, accordingly, AIP (r=-0.38, p=0.03) (Fig. 4) occurred. Conclusion The results of our study have provided preliminary evidence on the fact that a decrease in total ODA in fecal microbiota is associated with atherogenic dyslipidemia. Further studies are needed to determine the role of fecal ODA in the formation of dyslipidemia.

Background and Aims Primary glomerulonephritis (PGN) is one of the leading causes of end-stage renal disease worldwide. Preservation of renal function is a crucial global goal in the management of patients with chronic kidney disease (CKD) in general and PGN in particular. In addition to classical risk factors, hyperuricemia is regarded to be an independent risk factor for CKD development and progression. However, only a few studies have investigated the impact of hyperuricemia on PGN progression. Therefore, this study aimed to analyze the association between serum uric acid (SUA) concentration and renal prognosis in PGN patients during a 5-year follow-up. Method A total of 344 patients with CKD 1-3 stages were included in this retrospective observational single-center study. Among them, there were 194 (56.4 %) patients with biopsy-proven PGN and 150 (43.6 %) patients with a clinical diagnosis of PGN. All patients were treated according to the KDIGO Practice Clinical Guidelines for Glomerulonephritis. eGFR (milliliters per minute per 1.73 m2) was calculated using the CKD-EPI formula and its baseline value was based on the first available eGFR in PGN diagnosed patients. The patients with eGFR< 30 mL//min/1.73 m2 were excluded from the study at the time of PGN diagnosis. None of the patients was on urate- or lipid-lowering therapy at the time of baseline data. Hyperuricemia was defined as SUA concentration ≥420 μmol/L (7 mg/dL) for males and ≥360 μmol/L (6 mg/dL) for females. The rate of eGFR fall per year was used to assess CKD progression. It was calculated as the difference between eGFR (mL/min/1.73m2) at baseline and the last values: (Last eGFR – Baseline eGFR) / Follow-up period per year). For the analysis, the patients were gender-stratified into 3 SUA quartiles according to average SUA levels at baseline: Q1- < 265 μmol/L for men and Results Hyperuricemia was found in 72/206 (35 %) men and 38/138 (27.5 %) women (p = 0.0003). During the average 5-years follow-up period (5.3 [3.8-6.2]), there were 114 (33.1%) patients who eventually progressed to eGFR The highest renal progression level was observed in Q3 patients: -5.5 [-15.4; -1.8] mL/min/1.73 m2 versus -3.5 [-6.4; -1.7] and -4.6 [-10.6; -2.7] mL/min/1.73 m2 in Q2 and Q1 patients, respectively. In multivariate logistic regression analysis, SUA level in men (≥ 447 μmol/L) and women (≥ 370) was determined as an independent risk factor for rapid CKD progression (OR: 2.5, 95% CI: 1.47-4.23, P = 0.0007). Conclusion. Our study showed that a higher SUA level was associated with a significant rapid eGFR decline during a 5-year follow-up. The study findings suggest that hyperuricemia is a potentially modifiable factor for CKD progression.

Background and Aims Despite evidence suggesting that a lack of fecal oxalate-degrading bacteria colonization is a risk factor for calcium oxalate stone formation, little is known about the oxalate-degrading activity (ODA) in fecal microbiota in end-stage renal disease (ESRD) patients. In addition, to date, there has been a general lack of research on the effect of fecal ODA on oxalate homeostasis in dialysis patients. The present pilot cross-sectional study was performed to compare the oxalate homeostasis profiles depending on ODA in fecal microbiota in ESRD patients. Method The data of a cross-sectional pilot study examining ODA in fecal microbiota, plasma oxalate concentration (POx) and urinary oxalate excretion (UOx) in 32 ESRD patients were represented in this study. Among the patients, there were 21 hemodialysis (HD) patients and 11 peritoneal dialysis (PD) patients. The average age of the patients was 52.5 [39; 65] years. The redoximetric titration with KMnO4 was adopted to evaluate total ODA in fecal microbiota. The results were expressed in % oxalate degradation per 0.01 g of feces. POx concentration and UOx excretion were measured spectrophotometrically using a commercially available kit (MAK-315, Sigma, Spain) and an oxalate oxidase/peroxidase reagent (BioSystems, Spain), respectively. Predialysis plasma samples were collected from HD patients. For further analysis, the patients were allocated to 2 groups according to ODA in feces. Group 1 included the patients with ≥ 1 % oxalate degradation per 0.01 g of feces. Group 2 included the patients with negative ODA (≤ 0 % /0.01 g). For the statistical analysis, we used the nonparametric Kruskal-Wallis test. The median (Me) and interquartile ranges [Q25; Q75] were calculated. The Spearman test was used for the correlation analysis. Univariate logistic regression analysis was used for predicting hyperoxalemia. All statistical analyses were performed using MedCalc. Results ODA in fecal microbiota ranged from -23 to 24 %/0.01 g of feces in ESRD patients and was statistically higher in HD patients compared with PD patients (3.2 [-0.5; 16] vs -4 [-6.5; 6.2], p=0.05). Negative ODA in fecal microbiota (≤ 0 % /0.01 g) was observed in 5/21 (23.8%) HD patients and 7/11 (63.6%) PD patients (χ2=3.9, p=0.04). Consequently, it might be associated with the negative effects of peritoneal dialysis solution. High POx concentration and low UOx excretion were diagnosed in patients with negative ODA in fecal microbiota (Group 2): 30.7 [25.5; 41.5] vs 50 [43.3; 75.5] μmol/L, p=0.01 and 60.9 [51; 65] vs 34.2 [24.4; 39] mg/d, p=0.0002, respectively (Fig. 1). Fecal ODA was directly associated with daily UOx excretion (r=0.85; p Conclusion Our pilot cross-sectional study firstly demonstrated a close association between ODA in fecal microbiota and oxalate homeostasis in ESRD patients: less ODA in fecal microbiota was, higher POx concentration and lower UOx excretion occurred. We suppose that the potential significance of our findings provides preliminary information on the feasibility and necessity of further research in this area.

Наукові дані щодо дозозалежного впливу тривалого активатора рецепторів еритропоетину (ТАРЕ) на показники оксидативного стресу та перекисного окислення ліпідів мембран еритроцитів у хворих на хронічну хворобу нирок V, які лікуються гемодіалізом (ГД), є обмеженими. Метою нашої роботи було оцінити взаємозв’язок між застосованою дозою ТАРЕ та інтенсивністю оксидативних процесів у ГД пацієнтів. Матеріал та методи. 38 ГД пацієнтів були включені до одномоментного обсерваційного дослідження. Протокол дослідження був схвалений локальною етичною комісією ДУ «Інститут нефрології НАМН України». Усі пацієнти надали письму інформовану згоду на участь у досліджені. Пацієнти були стратифіковані за квартилями (≤ 25% та ≥ 75%) відповідно до середньої дози ТАРЕ і розподілені наступним чином: I групу склали хворі, які отримували ТАРЕ більше 6 місяців у дозі ≤ 50 мкг/міс (n = 20), до II групи увійшли хворі, у яких доза ТАРЕ склала ≥ 125 мкг/міс (n = 18). Поряд із стандартними діагностичними методами досліджували концентрацію малонового діальдегіду у сироватці (МДА) й еритроцитах (MДAe), вміст у крові церулоплазміну (ЦП) та трансферину (ТР). Крім того, визначали загальну пероксидазну активність (ЗПА) у еритроцитах, проникність еритроцитарних мембран (ПЕМ), підрахували відсоток гемолізу. Результати. У ГД пацієнтів, які лікувались ТАРЕ у дозі ≥ 125 мкг/міс визначено підвищення концентрації ЦР (р = 0,007) та ТР (р = 0,0003), тоді як ЗПА була статистично значуще зниженою порівняно з ІІ групою (р = 0,02). Крім того, У пацієнтів І групи встановлено вищий відсоток гемолізу (р = 0,03) та ПЕМ (р ˂ 0,0001). Використовуючи модель пробіт-регресії, ми визначили дозозалежний вплив ТАРЕ на рівень ПЕМ: χ2 = 21; р ˂ 0,0001. Висновки. Таким чином, застосування ТАРЕ у дозі понад 125 мкг на місяць покращує антиоксидантний статус ГД хворих, але разом з тим, підвищує гемоліз еритроцитів та ПЕМ. Отримані нами дані потребують подальшого підтвердження.

The purpose of our work was to investigate the effect of immunomodulatory medicines on the intensity of oxidative stress (OS), the cytokines level and the activity of renospecific enzymes in patients with recurrent pyelonephritis (rPN). Methods. A prospective, randomized, open-label study involved of 100 women aged 33.4 ± 8.8 year old. According to the sensitivity of the detected pathogens all patients received antibacterial therapy for two weeks. Along with the main course of antibiotic therapy, 25 patients were assigned Sodium nucleinate at a dose of 0.25 g 4 times per day during 14 days, 18 patients were prescribed Galavit intramuscularly 2 ml per dayfor 10 days, and 27patients were prescribed Proteflazid according to the manufacturer’s instructions. The comparison group consisted of 30 women with rPN who received antibiotic therapy exclusively.Women were screened before and after the treatment. The content of malondialdehyde (MDA), ceruloplasmin (CP), transferrin (TF) and sulfhydryl groups (SH-groups) were determined in the blood by colorimetric method. Oxidative stress index (OSI) was calculated. The concentration of interleukins (IL) -1f, -4, -8, -10, -17, tumor necrosis factor a (TNF-a), transforming growth factor f (TGF-f), monocytic chemoactive protein-1 (MCP-1) and interferon y (IFN-y) were analyzed in the blood of the women using an ELISA. To evaluate the functional state of the renal parenchyma the activity of tubular lysosome enzymes a total f-N-acetylhexosaminidase and f-galactosidase were determined in urine. Results. The use of Sodium nucleinate decreased of the OS activity by reducing MDA level (p Conclusions. The use of immunomodulators in the complex therapy of patients with rPN contributes to the partial normalization of functional activity of immune system by the decreasing ofthe production ofcytokines as its mediators and the reducing ofthe OS intensity.

This article is a review of the literature. Peritoneal dialysis (PD) was the first method of dialysis renal replacement therapy (DRRT), used for the treatment of patients with acute kidney injury (AKI). PD is able to correct metabolic, electrolyte, acid-alkali disorders and hypervolemia in patients with AKI. Continuous equilibration PD and continuous flow PD can provide of dialysis dose compared with extracorporeal methods of DRRT. However, PD is considered less effective than hemodialysis. In this regard, PD has used in patients with AKI, especially those who are hemodynamically unstable or at risk of bleeding because of severe coagulation abnormalities, in infants and children with AKI, and in patients with circulatory failure.

The aim of our research was to identify the peculiarities of the microbial spectrum urogenital system of the women with recurrent pyelonephritis. Materials and methods. We have conducted a comprehensive micro-biological examination different biological material (urine, vaginal swabs, scraping of urethral and cervical canal’s) of 175 women with recurrent pyelonephritis. The patients were divided in accordance with frequency of recurrent. The microbial spectrum urogenital system of 98 women with recurrent pyelonephritis (group 1) was compared with 77 women with sporadic pyelonephritis (up to 2 times per year) (group 2). The research included the process of identification of bacterial agents, mollicutes, chlamydia as well as yeasts. Results. In the women with recurrent pyelonephritis had the significant increase of frequency of identification of E. faecalis in urine (p=0.03), in urethral canal (p=0.05), and vaginal scraping (p=0.02). 48 women from 1st group had bacterial mix-infection. At the same time, the women from comparative group had only in 25 (32.6%) cases (p=0.027). The direct associative relationship was found between existence of S. epidermidis in urethral canal, in cervical canal, in vagina and the frequency of recurrent pyelonephritis (ρ=0.2, р=0.009; ρ=0.23, р=0.004 and ρ=0.19, р=0.01 respectively); E. faecalis in the urethral canal (ρ=0.19, р=0.02); Candida albicans in the vagina (ρ=0.17, р=0.03). 79.6% examined patients were infected by mollicutes, viruses and chlamydia. Conclusions. Consistent high level of urethral’s and vaginal’s bacterial weight of the women with recurrent pyelonephritis leads to the migration of causative agents into bladder and to activates formation of recurrent of the disease. Identified peculiarities of microbial spectrum prove the necessity mandatory micro-biological research not only urine, but urethra, cervical canal, and vagina.

The aim - to examine the state of mucosal immunity and microbiocenosis of the genitourinary tract in patients with chronic pyelonephritis (PN) and determine their significance as risk factors of recurrences. Material and methods. In this research some 36 women mucosal immunity with recurrent PN had been investigated. Its peculiarities with the patients with recurrent PN (n=22) in comparison with relatively-healthy donors (n=12) as well as in comparison with sporadic disease (n=14). Some 16 females were investigated of biocenosis of vagina by the PLR real-time method. The material of the research was urine as well as scrapes of urethra and the cervical channel. The results of the research. The analysis of the quantity of microflora of vagina has indicated decreasing of Lactobacillus spp. In majority – 12 (75%) of the patients. During the investigations of hypostatis liquid of vagina the patients with PN, decreasing of intensity of phagocytosis of neutrophiles and macrophagus was indicated (р

This is a study of the basic performance of nephrology care to the population of Ukraine during 2009-2012. The paper used the data from the National registry of patients with chronic kidney disease during 2009-2012, published by the "Institute of Nephrology of NAMS of Ukraine." The results of analysis testify to considerable lag on the size of basic parameters of medical help to the patients of nephrological profile from European.

The aim of the study was to evaluate retrospectively the survival of the peritoneal dialysis (PD) technique survival and identify the factors that affect it. Patients and methods. A total of 38 patients with end-stage renal disease treated with PD from 2005 to May 2017 have been included in retrospective, study (average age 49.6 ± 5.6). Data were collected from medical records. Results. The average survival rate of the PD method in our center was 53.3 ± 7.4 months, and in patients with nondiabetic kidney disease it was significantly higher. During the follow-up only 11/38 (28.9 %) patients continue treatment of PD, 12/38 (31.6 %) were changed to HD, 4/38 (10.6 %) patients kidney transplantation was performed and 11/38 %) died. The main reason of the letal cases was cardiovascular complications (36.6 %). The patient mortality was significantly depended on the diuresis volume and the level of GFR at the time of PD initiation. Conclusions. PD technique survival in our center correlate with the results of the PD treatment patients worldwide.

Rating evaluation of specialized medical care for patients with renal deceases in Ukraine is conducted on basis of analysis of main criteria’s of its organization and availability, of results of treatment of CKD patients stage 5 HD, PD, T and AKI patients. Regional rating was evaluated separately for every group of parameters and then the summary rating evaluation was conducted

We used the data of “National Register of CKD Patients ” which is formed annually by SI “Institute of Nephrology NAMS of Ukraine”. The results demonstrate the low level of availability of medical care

The current study aimed to evaluate whether serum uric acid (SUA) level is associated with the risk of kidney failure in primary glomerulonephritis patients (PGN) with nephrotic syndrome. Methods. During 2019, 38 patients with newly-diagnosed PGN and the nephrotic syndrome were prospectively considered for the study which is a fragment of the ongoing study "To evaluate the effect of oxalates and urates metabolism on the evolution of renal diseases". In addition to routine clinical and laboratory examination, the concentration of serum (SUA) and urine uric acid was determined. According to the CKD-EPI formula, the glomerular filtration rate (GFR) was calculated. Hyperuricemia was considered to be a uric acid concentration ≥420 μmol / l (7 mg/dl) in men and ≥360 μmol / l (6 mg/dl) in women. All patients enrolled in the study underwent a lifetime renal biopsy under ultrasound. Results. There were 26/38 (68.4%) men and 12/38 (31.6%) women. The patients’ age ranged from 18 to 69 years and averaged 37 [28-48] years. The CKD duration at the time of hospitalization and carrying out the kidney biopsy was 11.0 [5,2-37,4] months. Hyperuricemia was defined in 14/38 (37%) patients. SUA had an inverse correlation with the patients’ GFR (r = -0.44; p = 0.003). Uraturia level was associated with the chronic changes’ gradе on the kidney biopsy specimens (r = 0.66; p ˂ 0.00013). A multivariate logistic analysis (adjustment for albumin, serum creatinine, total blood protein, daily proteinuria, patient age, and hypertension) SUA had an effect on the GFR level (OR 19.2 (95% CI 1.8; 209.5), χ2= 8.4; p = 0.003). Conclusions. Hyperuricemia was observed in 37% of PGN patients with nephrotic syndrome and was an independent risk factor for CKD progression. Recruitment of patients continues to complete the statistical analysis and confirm our hypothesis. Patient recruitment is still ongoing to finalize the statistical analyses and to confirm our hypothesis.

Introduction. It has been demonstrated that residual diuresis (RD) in peritoneal dialysis (PD) patients is an independent risk factor for technique failure, chronic inflammation and mortality. Hyperuricemia plays a causal role in hypertension, cardiovascular disease and progression of chronic kidney disease. But, at present, the association between serum uric acid (UA) and residual urine volume has not been reported yet. The aim of our work was to study the influence of serum UA level on residual diuresis in PD patients. Methods. The data of 58 PD patients from a single center were analyzed retrospectively. The data on baseline levels of serum UA and the urine volume were collected from the patients’ medical records between 2010 and 2017. All patients had been undergoing continuous ambulatory PD for more than 3 months (median was 43.4 [28.3-64] months). Among the examined patients, there were 37/58 (63.8%) men and 21/58 (36.2 %) women. Average age was 47.1[30.7-56.2] at the start of CAPD. Нyperuricemia was defined as serum UA concentrations above 7 mg/dL (measured by automated enzymatic methods). The status of RD (urine volume ≥ 300 ml/day or ˂ 300 ml/day, or anuria after 3 years of PD therapy) was considered as the outcomes of interest in the study. The patients who were transferred to hemodialysis or transplantation were excluded from the study. The predictive value of hyperuricemia in RD decline was estimated using multi-factor regression analysis (the Cox proportional hazard model) with adjustments for age, gender, comorbidities and diabetes mellitus. The hazard ratio (HR) and 95% confidence interval (SI) were calculated. Results. 16/58 (27.6%) PD patients had hyperuricemia at baseline. The average urine volume before PD initiations was 800 [600-1600] ml/day. After 3 years of PD treatment, the decline of RD was observed in 22 patients: 12/16 (75%) patients with hyperuricemia and 10/42 (23.8%) in the normouricemic one (χ2 = 12.7; p = 0.0004). In the multivariate Cox regression models, hyperuricaemia at baseline was significantly associated with a higher risk of RD decline: log-rank test: χ2 = 5.1; р = 0.02 (HR 2.52; 95% CI 1.96 to 10.2) (Fig. 1). Conclusions. Hyperuricemia is an independent risk factor for RD decline in PD patients.

Introduction & Objectives: Lack of scientifically proven information on clinical relevance of hyperoxaluria in patients with recurrent pyelonephritis (rPN) stipulates the objective of our work. The purpose of the present study was to assess the relationship between the hyperoxaluria and markers of kidney damage in non-stone formers patients with recurrent pyelonephritis. Materials & Methods: A cross-sectional study involved 97 women with recurrent pyelonephritis caused by E. coli or S. faecalis, non-stone formers. Patients with diabetes, pregnancy, urolithiasis, concomitant decompensated diseases or acute conditions were excluded. The average age of the women was 34 ± 4.8 years. The duration of the disease was between 6 months and 16 years (6.0 [4.1-8.7] years). The average number of recurrences was 6.4 ± 1.9 per year. According to the presence of hyperoxaluria (? 44 mg in 24 hours), the women were stratified into 2 groups: the 1st group of the patients (n = 58) had hyperoxaluria and the 2nd one (n = 39) didn’t have any hyperoxaluria. Glomerular filtration rate (GFR) level and the blood concentration of neutrophil gelatinase-associated lipocalin (NGAL) were evaluated in all patients. Urinary levels of β2 microglobulin (β2M) and N-acetyl-β-D-glucosamidase (NAG) were measured as the markers of renal tubular damage. All the statistical analyses were performed using MedCalc. For the statistical analysis we used the Student's t-test and nonparametric (U-test) Mann-Whitney test. Linear regression analysis was used to correlate the values of hyperoxaluria and kidney damage markers. Results: The level of daily urinary oxalate excretion in the patients of the 1st Group was significantly increased compared with the women of the 2 nd Group: 81.5 [53.9-101.8] vs 42 [37-41.9] mg (p ? 0.0001). The women with hyperoxaluria had a significantly lower GFR, higher level of the blood concentration of NGAL and higher urinary levels of β2M and NAG (table 1). Table 1. The comparative analysis of the kidney damage markers according to the oxaluria status. Linear regression analysis demonstrated a significant correlation of the daily oxalate excretion with the blood level of NGAL (R = 0.9; p ? 0.0001) and the GFR (R = -0.69; p ? 0.0001), which is indicative of oxalate-induced renal damage. Conclusions: Accordingly, our findings have accurately demonstrated a potential power of hyperoxaluria to cause of kidney damage in the women with recurrent pyelonephritis, which can be due to proximal tubular injury.

Introduction: End-stage renal disease (ESRD) patients have significant differences in plasma oxalic acid (POx) concentration under the same treatment conditions. Objectives: In the present study, we adopted the method of redoximetric titration with a KMnO4 solution to evaluate the effect of total fecal oxalate-degrading activity (ODA) on oxalate homeostasis in ESRD patients which has never been reported before. Patients and Methods: A total of 56 participants were enrolled in this cross-sectional pilot study, including 24 healthy volunteers (a control reference group) and 32 ESRD patients. Among the ESRD patients, there were 21 hemodialysis (HD) and 11 peritoneal dialysis (PD) patients. Total ODA in fecal samples as well as POx concentration, daily urinary oxalate (UOx) and PD effluent oxalate excretion were determined. Cohen’s d was computed to calculate the effect size using post-hoc analysis. Results: Total ODA in fecal microbiota ranged from -23 to 24%/0.01 g of feces and was statistically higher in healthy volunteers compared with the ESRD patients. The ESRD patients with positive total fecal ODA status had higher UOx excretion level and lower POx concentration compared with the patients with negative total fecal ODA status. Cohen’s d effect size was 1.99 and 1.05, respectively. Total fecal ODA was an independent risk factor associated with POx elevation in the ESRD patients. Conclusion: Our pilot study firstly demonstrated a potential role of total fecal ODA in oxalate homeostasis in ESRD patients. The results might be useful for determining sample size considerations and providing groundwork for future research projects.

Rating evaluation of specialized medical care for patients with renal deceases in Ukraine is conducted on basis of analysis of main criteria’s of its organization and availability, of results of treatment of CKD patients stage 5 HD, PD, T and AKI patients. Regional rating was evaluated separately for every group of parameters and then the summary rating evaluation was conducted.

Peritonealfibrosis (PF) is a common morphological change in peritoneal dialysis (PD) patients. With the progression of PF, peritoneal membrane function is impaired, which leads to ultrafiltration failure. Results of studies in recent years show the crucial role of high production monocytic chemoattractant protein -1 (MCP-1) of peritoneal fibrosis in PD-patients. The aim was to determine intraperitoneally production ofIL-10 and MCP-1 and its relationship with clinical and laboratory parameters of adequacy of dialysis. Patients and methods. A prospective observational study involved 18patients with CKD stage Vwith non-diabetic nephropathy, were treated with continuous ambulatory peritoneal dialysis (PAPD). The limits of the normal range (reference range) were obtained from the survey results of 10 conditionally healthy individuals. ELISA method in serum and peritoneal dialysis effluent (PDE) investigated levels ofIL-10 and MSP-1. PAPD adequacy indicators evaluated by determining the concentration of urea and creatinine in plasma, urine and dialysate, calculated weekly creatinine clearance (CrCl), dialysis (Ш/ Vd), renal (Ш / Vr) and шА weekly urea clearance (Kt/ V). nmstep@ukr.net Results. In all of the PD-patients compared to healthy donors conventionally, there was a significant increase in concentration of the cytokines. We determined the positive regression relationship between the concentration of MCP-1 and IL-10 in PDE and the level of total weekly (Kt / V) and renal (Kt / Vr). Conclusions. We determined the regression dependence, which allowed to identify clinical parameters that are most closely (statistically significant) related to intraperitoneal production of MCP-1 and IL-10.

The aim of the research was to study the effect ofoxidative factors impact and modality of renal replacement therapy (BBT) on indices ofoxidative stress (OS) and resistance of erythrocytes membranes in patients with chronic kidney disease stage V(CKD VD) and anemie. Material and methods. The study involved 68 patients with CKD VD: 14 patients were treated by hemodiafiltration (HDF), 25 patients by hemodialysis (HD) and 29 patients by peritoneal dialysis (PD). The severity ofanemia was assessed according to the KDIGO (2012) criteria. The control group consisted of 30 healthy people of the same age and sex. Along with the standard diagnostic methods, we defined the content of malonic dialdehyde in serum (MDAs) and in erythrocytes (MDAe), the content of ceruloplasmin (CPs), transferrin (TBs) and SH-groups in the blood serum, the index of the OS (IOS), catalase activity in serum (CATs), glucose-6-phosphate dehydrogenase (G-6-PDHe) and total peroxidase activity (TPA) in erythrocyte, peroxide resistance (PR) of red blood cells and erythrocyte membrane permeability (EMP). Statistical analysis was performed using the programs of Microsoft Excel 7.0. Results. It has been stated that in the CKD VD patients in compatison with control group the MDAs content increased by 3.3 times and MDAe - 1.2 times, TBs content reduced by 34%, SH-groups - by 31%, TPAe - by 41% and G- 6-FDGe - by 58%, PB-by 60%; 4.6 times increased CATs activity and OSI; 2 times grew peroxide hemolysis (PH) and 1.3 times - EMP. The analysis (depending on the BBT modality) showed that the patients treated by HDF had typical MDAs increase by 3.9 times on a background of CPs by 24%, TBs - 33%, SH-groups - 25%, TPAe - 51%, G-6-PDHe - 42%; the increase in serum OSI - 5.4 times and 2.6 times in erythrocytes, PB - by 3.6 times and CATs activity by 3.5 times; HD group was characterized by the highest value of MDAe, OSI, PH and CATs, along with more expressed decrease of TBs indices, SH-groups, TPA and G-6-FDHe activity compared with rates in patients with HDF. The patients treated with PD had the lowest content of MDAs and the highest values on the background ofTPAe, the significant increase of CPs by 1.7 times and lowest TBs and G-6-PDHe. The patients with PD showed twice lower OS activity by OSI. Conclusion. Thus, in patients with CKD VD, who had HD, HDF or PD an anemie was associated with high OS activity and the increased degree of hemolysis. These changes are stipulated by BBT methods: for patients receiving HDF were typical the lowest rates of hemolysis and the highest degree ofprotection for erythrocytes, and for patients treated with HD - the highest OS.

Introduction: The role of serum uric acid (SUA) concentration in primary glomerulonephritis (PGN) aggravation is currently under active discussion. Objectives: This study primarily aimed to analyze the association between SUA concentration and renal survival prognosis in PGN patients and secondarily to determine whether hyperuricemia is an independent risk factor for reduced glomerular filtration rate (GFR) in the presence of nephrotic syndrome. Patients and Methods: We performed a retrospective observational single-center study involving 344 patients with biopsy-proved or clinically diagnosed PGN with the mean follow-up period of 5.3 [3.8-6.2] years. The rate of annual decline in estimated GFR (eGFR) was used to assess chronic kidney disease progression. Primary outcome measures were eGFR decline or transfer to renal replacement therapy (RRT) during the 5-year follow-up period. Results: There were 78/344 (22.7%) patients who eventually progressed to eGFR

INTRODUCTION AND AIMS:Cardiovascular disease is the most important complication and the main reason for the mortality in hemodialysis (HD) patients. L-type dihydropyridine calcium channel blockers (L-TCCs) are frequently used to control blood pressure in HD patients. The main cause of anemia in HD patients is erythropoietin (EPO) and iron deficiency. It was demonstrated that, L-TCCs impeded the calcium influx and blocked the effect of EPO in vitro. In addition, in recent years, it has been shown a significant effect of L-TCCs on the increase in cellular iron uptake. We hypothesized that the use of amlodipine in HD patients could inhibit the activity of EPO and lead to the need for increasing doses of erythropoiesis stimulating agents (ESA). The purpose of our work was to investigate whether amlodipine use was associated with increasing dose of intravenous iron and ESA. METHODS:It was a regional multicenter retrospective observational study. A total of 88 adult HD patients were classified into 2 groups based on amlodipine usage: the 1st group (n = 27) received amlodipine for at least 6 months and the 2nd one (n = 61) received no any treatment of amlodipine. The patients of the both groups did not differ by such parameters as sex difference (χ2 = 0.14; p = 0.71), age (p = 0.35), duration of HD treatment (p = 0.23) and comorbidity index (p = 0.59). The hemoglobin level (Hb), the dose of intravenous iron and continuous erythropoietin receptor activator (CERA) were analyzed. Statistical analysis included Student's t-test, nonparametric (U-) Mann-Whitney’s test and Fisher's exact test. Relative risk (RR) and odds ratio (OR) were calculated using logistic regression. RESULTS:A total, intravenous iron was used in 43/88 (49 %) HD patients, CERA was prescribed to 68/88 (77 %) patients. The prescribing of intravenous iron was in 22/27 (81.5%) patients of the amlodipine group and in 21/61 (34.4%) patients of the 2nd group (χ2 = 16.4; р = 0.0001). CERA was administered to 25/27 (92.6%) patients in the 1st group and 43/61 (70.5%) patients in non-user group (χ2 = 5.2; р = 0.02). The Hb level in the patients of Group I tended to decrease, but, it did not differ statistically from the patients of Group II: 106.5 [100.1-110] g / l vs 111 [107-113] g / l (p = 0.09). However, in order to achieve the target Hb level in the patients of amlodipine group, iron was used in a dose 200 [100-400] vs 50 [0-200] mg / month in the non-user patients (p = 0.002). CERA was prescribed in a dose (85 [70-100] vs 50 [50-75] μg / month, respectively (p = 0.02). Logistic regression analysis showed a significant effect of amlodipine treatment on the need for iron and CERA supplements: OR = 3.9; 95% CI (1.27-12.06), p = 0.002, and OR = 5.2; 95% СІ (1.2-24.4), р = 0.03. RR = 1.3 95% СІ (1.08-1.6), р = 0.006, respectively. CONCLUSIONS:Our results suggest that amlodipine administration significantly increase the dose of intravenous iron and CERA in HD patients with anemia. Further studies, devoted to the mechanism of the L-TCCs effect on anemia will avoid unreasonable prescriptions in the treatment of HD patients.

INTRODUCTION AND AIMS:Antibacterial treatment and long-term antibiotic prophylaxis can disrupt the normal of gut microbiota and lead to violate of oxalate metabolism. But, there are a limited number of studies that have analyzed the effects of gut microbiota composition on the systemic inflammation and formation of hyperoxaluria in the patients with recurrent pyelonephritis. The purpose of the present study was to investigate the intestinal colonization resistance in the patients with recurrent pyelonephritis depending on the presence of hyperoxaluria. METHODS:An observational cohort study involved 70 women with recurrent pyelonephritis caused byE. colior S. faecalis, non-stone formers. The mean age in the patient population was 21-48 yrs (32.3 ± 8.2). According to the presence of hyperoxaluria, the women were allocated into two groups: the first group of the patients (n = 38) had hyperoxaluria (> 44 mg in 24 hours) and the second one (n = 32) didn’t have any hyperoxaluria. The state of the patients’ intestinal colonization resistance was evaluated by bacteriological study of feces, determination of secretory immunoglobulin A (sIg A) and myeloperoxidase (MPO) in feces, and levels of interleukins (IL) -4 - 17, -23 and monocytic chemotactic protein-1 (MCP-1) in the serum. For the statistical analysis, we used the Student's t-test, nonparametric (U-test) Mann-Whitney and Pearson's rank correlation test. All the statistical analyses were performed using MedCalc. RESULTS:The comparative analysis of the fecal microbiota composition depending of the presence of hyperoxaluria identified a significant decrease of bifidobacteria (10 [5-900] vs 800 [10-1000] CFU/g, p = 0.03) and lactobacteria (0.14 [0.1-0.5] vs 4 [0.2-20] CFU/g, p = 0.0001) in the women of the first group. The patients with the deficit of intestinelactobacillus spp.had the high level of hyperoxaluria (110.8 ± 39 vs 55.5 ± 29 mg/day, p < 0.0001). The quantitative content ofLactobacillus spp.in the patients’ intestine was significantly correlated with the level of daily urinary oxalate excretion (R = - 0.72; P < 0.0001). In addition, the women with the deficit of intestine lactobacilli had elevated levels of the sIg A (7.67 [4.08-23.7] vs 4.04 [3.1-4.9] mg/g, p = 0.02) and MPO (1.93 [1.36-2.45] vs 1.43 [0.69-1.19] U/g , p = 0.01) in the faeces. The blood levels of MCP-1, IL-4, IL-17 and IL-23 in the women with hyperoxaluria were significantly higher compared with the non-hyperoxaluria patients (Table 1). CONCLUSIONS:The antibiotic-associated deficit ofLactobacillus spp.disrupts the intestinal colonization resistance, violates the immune response and oxalate metabolism with formation of hyperoxaluria. Hyperoxaluria in the women with recurrent pyelonephritis is associated with increased serum levels of IL-4, -17, -23, and MCP-1. The blood cytokines concentration in the patients with recurrent pyelonephritis and hyperoxaluria has not been scrutinized before. The further studies are needed to determine the role of these cytokines in the progression of urolithiasis in hyperoxaluric conditions.