Effects of ischemic and hypoxic preconditioning on the state of mitochondria and function of ischemic kidneys.

Laser confocal microscopy showed that fluorescence of tetramethylrhodamine ethyl ether probe specifically accumulating in energized mitochondria significantly decreased in renal tubular epithelium after 40-min thermal ischemia, while fluorescence of dichlorodihydrofluorescein and diaminofluorescein probes in the same structures increased under these conditions, which attests to increased generation of ROS and NO, respectively. These forms were generated predominantly in mitochondria of tubular epitheliocytes. Hypoxic preconditioning (a series of sessions of breathing hypoxic mixture) preserved functional activity of mitochondria and prevented activation of ROS and NO generation. Ischemic preconditioning of the kidney consisting of three preliminary episodes of vascular clamping (5 min with 5 min reperfusion periods) also increased the percentage of functionally active mitochondria and prevented activation of NO synthesis without appreciably modifying ROS production. Both protective methods significantly reduced the severity of postischemic dysfunction of the kidney.

Experimental intravenous cell therapy of acute and chronic renal failure.

The therapeutic effect of intravenous injection of human fetal bone marrow mesenchymal stem cells or summary culture of kidney cells were studied on models of chronic or acute renal failure in outbred albino rats. Both cell types promoted improvement and normalization of the renal function in rats with stable chronic renal insufficiency (2 weeks after kidney cell injection, 1 month after bone marrow mesenchymal stem cell injection). Renal function remained normal or subnormal during the delayed period (3-3.5 months after injection). In rats with latent stage of chronic renal insufficiency, exacerbation was induced by additional 40-min ischemia. All rats receiving intravenous injection of saline died. Improvement of the functional parameters started 2 weeks after injection of kidney cells or bone marrow mesenchymal stem cells, and normalization was observed after 1.1-5 months. During the delayed period (after 3-4 months), functional parameters retained at normal or subnormal levels. In experimental series III, all rats with acute renal failure intravenously injected with saline (control) died from uremia on days 2-4. After injection of kidney cells 50% rats survived and renal function in these animals returned to normal after 2 weeks. After injection of bone marrow mesenchymal stem cells 83% rats survived, functional parameters returned to normal after 3 weeks.

Functional aftereffects of intraparenchymatous injection of human fetal stem and progenitor cells to rats with chronic and acute renal failure.

Chronic renal insufficiency was modeled in rats by unilateral nephrectomy and electrocoagulation of both poles of the remaining kidney; acute renal failure was induced by 90-min clamping of the vascular pedicle of the only kidney. Injection of unfractionated culture of human fetal kidney cells or bone marrow mesenchymal stem cells into damaged kidney restored its function in rats with chronic renal insufficiency (observation period up to 2 months). After 2.5 months a relapse of chronic renal insufficiency was observed in 1 of 3 rats receiving human fetal kidney cells and in 1 of 2 animals receiving bone marrow mesenchymal stem cell culture. Injection of bone marrow mesenchymal stem cell culture to rats with acute renal failure improved recovery of renal function and prevented the death from uremia, while injection of total culture of human fetal kidney cells had virtually no effect on the course of acute renal failure.

[The role of phytotherapy in pre- and postoperative period in patients with urolithiasis].

Effects of a biologically active food additive Prolit (PT Industry Djamu Borobudur, Indonesia) on the urinary system and metabolic status of patients with urolithiasis were studied. Total urinalysis, biochemical blood and urine tests by 12 indices, ultrasonic investigation of the kidneys, excretory and plain urography were made in 30 patients aged 23 to 70 years (7 females, 23 males). Prolit was given in a dose 1125 mg three times a day for 1-6 months. Prolit decreased hypercalciuria and urinary pH. A trend was observed to lowering of the degree of leukocyturia, hyperuricemia, hyperuria and hyperoxaluria. Urolithiasis recurrences were absent in 10 cases of 12 (83%), in 18 of 20 patients (90%) concrements did not increase in size. Prolit had no side effects.

[Effects of mineral water TIB-2 on metabolic processes in urolithiasis patients]. / Vliianie mineral'noi vody "TIB-2" na obmennye protsessy u bol'nykh mochekamennoi bolezn'iu.

Natural low-mineralized hydrocarbonate-calcium-magnesium mineral water (total mineralization 2 g/l) in bottles has been examined for therapeutic effects on metabolism in urolithiasis patients. The complex of biochemical blood and urine indices indicative of the renal function and concentration of lithogenic components was studied in 52 patients (age 23-68 years, 23 males and 29 females). Ten of them had nephrostoma. All the patients have undergone extracorporeal lithotripsy or other operations for renal or ureteric calculi. In nephrostoma patients urine samples were obtained both from nephrostoma and urinary bladder. The tests were made before the treatment and on the treatment day 3-5 and 10-12. TIB-2 mineral water was taken 3 times a day in a dose 200 ml 30-45 minutes before meal. The data were statistically processed. From the data obtained it was concluded that mineral water TIB-2 normalizes azotemia and clearance of endogenic creatinine, plasma values of calcium and uric acid, enhances urinary elimination of uric acid and calcium oxalate microcrystals that is TIB-2 improves metabolism of lithogenic substances and ions. Indications to drinking mineral water TIB-2 for urological patients are formulated.

[Accumulation of vitamin E in dimethylnitrosamine-induced kidney tumors in rats with various levels of alpha-tocopherol supplementation]. / Nakoplenie vitamina E v opukholiakh pochek krys, indutsirovannykh dimetilnitrozoaminom, pri razlichnom obespechenii zhivotnykh alpha-tokoferolom.

The effect of a long-lasting loading with alpha-tocopherol on the development of dimethylnitrosamine-induced kidney tumors was investigated in 55 non-bred white male rats. The carcinogen was repeatedly introduced into the stomach by means of a gastric tube. Starting 24 days after the last administration of the carcinogen the alpha-tocopherol loading began and lasted up to the end of the experiment. 21 rats were loaded with vitamin E introduced into the stomach, 5 times a week at a dose of 70 mg/kg body weight. 17 rats received sunflower seed oil--the vitamin E solvent; other 17 rats received only standard ration. The control group (20 rats) were not treated with the carcinogen. One part of these rats received alpha-tocopherol by the above schedule while another part--sunflower oil alone. It was shown that the alpha-tocopherol loading had no effect on the incidence of renal tumors. Nevertheless it enhanced to some extent the rate of their development as well as the incidence of blastomes in other organs. Based on histological examination, tumors developed in kidneys were of epithelial and mesenchymal origins with the mesenchymal tumors occurring more frequently (63-69% of the total). Vitamin E content in tumor tissue of rats, loaded or not loaded with alpha-tocopherol, was much higher than that in intact kidneys of corresponding control animals, suggesting a high tumor tropism of this vitamin. Total lipid concentration of tumor tissue was 1.5 times lower than that of intact kidneys. Histological nature of tumors had no visible effect on their vitamin E and total lipid content.

[Lipid peroxidation and the antioxidant system of patients with urolithiasis after extracorporeal lithotripsy]. / Lipidnaia peroksidatsiia i antioksidantnaia sistema u bol'nykh mochekamennoi bolezn'iu posle distantsionnoi litotripsii.

Activity of superoxide dismutase (SOD) in red cell membranes, levels of malonic dialdehyde (MDA) and dienic conjugates (DC) in blood plasma, red cells and urine were studied in 53 nephrolithiasis patients. A session of extracorporeal shock wave lithotripsy stimulated lipid peroxidation (LPO) in renal parenchyma manifesting with increased DC excretion with urine (an 89% increase). In red cell membranes SOD activity fell by 18%, DMA concentration rose by 16%. A two-week intake of vitamin E in a dose 100 mg/day elevated plasma alpha-tocopherol, diminished plasma MDA by 55% and prevented LPO activation in red cell membranes and renal parenchyma.

[The dynamic level of beta 2-microglobulin, the basic lipid peroxidation indices and middle molecules in the blood and urine in patients with acute calculous pyelonephritis against a background of endovascular helium-neon laser therapy]. / Dinamika urovnia beta 2-mikroglobulina, osnovnykh pokazatelei perekisnogo okislennia lipidov, srednikh molekul v krovi i moche u bol'nykh ostrym kal'kuleznym pielonefritom na fone éndovaskuliarnoi gelii-neonovoi lazernoi terapii.

The authors present the effect of intravenous He-Ne laser therapy on the changes in beta 2-microglobulin, lipid peroxidation, middle-size molecules in the blood and urine of patients with acute calculous pyelonephritis. Endovascular He-Ne laser therapy was found an effective treatment of acute calculous pyelonephritis. The authors propose to combine hemosorption with endovascular He-Ne laser radiation.

[The evaluation of the efficacy of efferent therapy in patients with acute and chronic kidney failure by the spectrum of blood middle-molecule fractions]. / Otsenka éffektivnosti éfferentnoi terapii bol'nykh s ostroi i khronicheskoi pochechnoi nedostatochnost'iu po spektru srednemolekuliarnykh fraktsii krovi.

Blood serum endotoxins were studied in patients with acute and chronic renal failure in order to correlate this spectrum with the treatment efficacy. Gel [correction of Liquid] chromatography tests of the serum samples were made in 106 patients on hemodialysis, hemodiafiltration and hemosorption. Hemodialysis was found to significantly reduce concentration of middle-mass molecular fraction (C, D, F with molecular mass from 300 to 2000 D). Hemodiafiltration produced the same effect, but more rapidly. A single procedure of hemosorption was able to improve the patients condition in the course of 2 postprocedure weeks. The authors attribute this effect to removal of the molecular fraction A which is highly toxic.

[Changes in the beta 2-microglobulin level during hemodialysis]. / Izmenenie urovnia beta 2-mikroglobulina vo vremia gemodializa.

The authors studied changes of the beta 2-microglobulin level during hemodialysis with dialyzers AIP-02-02 (cuprophane membrane), E2 (cuprophane membrane), AIP-03-02 (polysulfone membrane), F60 (polysulfone membrane), and hemodiafiltration with dialyzer F60. The following data were obtained. The beta 2-microglobulin level in patients undergoing hemodialysis is approximately 20 times the normal level. No essential fluctuations of the level of this protein occurs during hemodialysis and hemodiafiltration. The cuprophane membrane does not cause increase of beta 2-microglobulin generation during hemodialysis. Standard hemodialysis with the cuprophane membrane and the highly-permeable polysulfone membrane does not lead to decrease of the beta 2-microglobulin level. Hemodiafiltration with the highly-permeable polysulfone membrane is an effective method for the elimination of this protein.

[The use of liquid exclusion chromatography for evaluating methods of treating urologic diseases]. / Ispol'zovanie zhidkostnoi ékskliuzionnoi khromatografii dlia otsenki metodov lecheniia urologicheskikh zabolevanii.

Gel chromatography was used for measuring medium-molecular levels in the blood sera of urologic patients: (1) low-pressure chromatography in Sephadex G-15 packed columns with fractionation range less than 1500 dalton or in Toyopearl HW-40 packed columns with fractionation range from 100 to 100,000 dalton; (2) high-pressure chromatography in LKB (Sweden) blue columns. Liquid exclusion chromatography was employed to assess the efficacy of blood extracorporeal detoxication of urologic patients by means of hemoperfusion, hemodiafiltration, hemodialysis, plasma perfusion, plasmapheresis. The highest correlation between patients' state of health and blood levels of medium molecules was observed in hemodiafiltration.

[The development of calcium metabolic disorders in patients in the terminal stage of chronic kidney failure receiving hemodialysis treatment]. / Razvitie narushenii obmena kal'tsiia u bol'nykh s terminal'noi stadiei khronicheskoi pochechnoi nedostatochnosti, poluchaiushchikh lechenie gemodializom.

To follow calcium metabolism in patients with a terminal stage of chronic renal failure who are on hemodialysis treatment is necessary for the assessment of phosphorus/calcium metabolism in a whole, efficiency of conservative treatment, indications to surgical intervention (parathyroidectomy, renal allotransplantation). The investigation included the assessment of total and ionized calcium blood plasma levels with regard to hemodialysis duration; the correlation of clinical and roentgenological picture of secondary hyperparathyroidism. A total of 222 patients were observed, and with regard to hemodialysis duration allocated into 5 groups: in the first hemodialysis lasted for not more than 3 mos; in the second--from 3 mos to 1 yr; third group with its duration from 1 to 2 yrs; fourth, when it lasted from 2 to 3 yrs; and the fifth group--hemodialysis lasted for more than 3 yrs. It was documented that disorders in calcium metabolism were increasing in parallel with the duration of hemodialysis. Clinical and roentgenological picture of hyperparathyroidism was accompanied by an evident increment of blood plasma ionized calcium while the levels of total blood calcium were but slightly changed. As a part of combined diagnosis ionized calcium assessment is helpful in early prevention and management of calcium metabolism disorders.