[Middle molecule level and myocardial contractility in kidney patients]. / Prouchvaniia vurkhu nivoto na "srednite molekuli" i miokardniia kontraktilitet pri bubrechno bolni.

Myocardial contractility was studied in 50 patients, 30 of them in compensated stage and 20 with terminal chronic renal insufficiency via polycardiographic method, depending on the level of the substances with mean molecular weight in serum. No statistically significant changes in the parameters of polycardiogram were established in the patients with compensated renal function, nor in the level of "mean molecules" in serum, whereas a hypodynamic phase syndrome and energodynamic heart insufficiency were established in the terminal stage of chronic renal insufficiency, accompanied with significant increase of the level of the "mean molecules" in the serum of uremic patients.

[Porphyrin biosynthesis in patients with acute and chronic kidney failure treated by hemodialysis]. / Biosinteza na porfirini pri bolni s ostra i khronichna bubrechna nedostatuchnost, lekuvani s khemodializa.

Biosynthesis of porphyrin in erythrocytes was studied in 48 patients, 23 of them being with acute renal insufficiency (ARI) and 25--with terminal chronic renal insufficiency (CRI), after incubation of delta-aminolevulinic acid (synthesized uro- copro- and protoporphyrin), synthesized porphobilinogen, the activity of porphobilinogen-synthesis, erythropoietic activity of serum and hematological indices. The biosynthesis of porphyrins in both groups of patients was established to be reduced, more strongly in those with CRI that could serve as one of the criteria in the differentiation of ARI from CRI. After the discontinuation of the treatment, the biosynthesis of porphyrins in the patients with ARI approached that of the clinically healthy subjects. In the patients with CRI, included in the programmed hemodialysis treatment, the biosynthesis of porphyrins was intensified and that of synthesized protoporphyrins--considerably reduced.

[Chronic nephritis--porphyrin biosynthesis and nephrogenic anemia]. / Chronische Nephritis--Biosynthese von Porphyrinen und nephrogene Anämie.

Disturbances in the biosynthesis of porphyrins in erythrocytes were investigated in 50 patients with chronic nephritis after incubation with delta-aminolevulinic acid. A medium to strong correlation was found among the parameters of porphyrin metabolism and those of haemoglobin synthesis and the functional state of the kidneys. This gives rise to the assumption that the disturbances in porphyrin biosynthesis are to be classified among the pathogenetic mechanisms of anaemia in the course of chronic nephritis.

[Diabetes mellitus and the biosynthesis of porphyrins]. / Sakharnyi diabet i biosintez porfirinov.

The blood and urine porphyrin content and porphyrin biosynthesis in the red blood cells after delta-amino levulinic acid (ALA) incubation, porphobilinogen and non-consumed ALA levels, porphobilinogen-synthetase activity were studied in 86 patients divided into 3 groups depending on diabetes severity. Porphyrin separation was investigated by means of thin-layer chromatography. It was found that porphyrin biosynthesis decreases in all diabetics at the early periods of the disease, not depending on its severity. Porphyrin biosynthesis is lowered during a phase of chronic renal insufficiency in patients with diabetic nephropathy. Porphyrin metabolic disorder is caused by hepatic dysfunction and diabetic nephropathy development.

[Nephrogenic anemia and porphyrin biosynthesis]. / Nefrogenna anemiia i biosinteza na porfirini.

Porphyrin biosynthesis in erythrocytes, after incubation with delta-aminolevulinic acid (DALA) was studied in 180 patients with renal diseases. A decrease of porphyrin synthesis was confirmed as early as the compensated stage of the disease with normal hematological indices. With the advancement of the renal insufficiency the biosynthesis of porphyrin and porphobilinogen was progressively decreased, as well as the percentage of DALA used in porphyrins synthesis and the activity of porphobilinogen synthesis in erythrocytes, accompanied by a progressive deterioration of the hematological indices. The correlation between the functional state of the kidneys, the indices of porphyrins metabolism and hematological indices in the patients with chronic renal diseases is underlined.

Studies on the biosynthesis of porphyrins in erythrocytes after incubation with delta-aminolevulinic acid: an attempt to investigate the pathogenesis of nephrogenic anemia.

The biosynthesis of porphyrins after incubation with 6.25 mmoles/l delta-aminolevulinic acid (ALA) for 4 h, the synthesis of porphobilinogen, the residual ALA, and the activity of the porphobilinogen synthase were determined in erythrocytes. Examined were 568 individuals: healthy males and female, normal pregnancy and nephropathy of pregnancy, newborn infants and various diseases of the kidney. The biosynthesis of porphyrin in erythrocytes after incubation with ALA and the activity of porphobilinogen synthase in erythrocytes in chronic renal disorders progressively decreased depending on the stages of the pathologic process and the development of chronic renal insufficiency. The high correlation between the level of synthesized porphyrins and hemoglobin led us to assume that disorders in porphyrin biosynthesis represent in fact one of the pathogenetic mechanisms of nephrogenic anemia.