[Prevention of progression in nephropathies]. / Prevencia progresie nefropatií.

Intermittent dialysis is excessively expensive and pretentious psychologically and socially. As a result the research is concentrated on the prevention of kidney disease progression. Preventive measures: a) Protein restriction forms the basis of nonpharmacologic measures. b) Consequent antihypertensive therapy, with the aim to decrease blood pressure < 17.5/11.25 kPa (140/90 Torr), is the most effective prevention. The basic drugs are ACEI eventually in combination with Ca antagonists. They even reverse kidney disease progression in early phases. c) Antiaggregation therapy prevents the formation of fibrin deposits in glomeruli and the thrombogenesis. d) Insulin resistance correction prevents the development of glomerulosclerosis and atherosclerosis. e) Antihyperlipemic therapy is required only in a small number of patients. f) Correction of mineral balance prevents or corrects osteodystrophy. These measures could decrease kidney disease progression and the entrance of patients into intermittent dialysis by 10-20% and a further decrease to 50% is expected to be reached until the year 2000. (Fig. 3, Tab. 3, Ref. 43.).

[The primary importance of the kidneys in the development of essential hypertension]. / Primárny význam obliciek pre vznik a vývoj esenciálnej hypertenzie.

The participation of the kidneys in the development of renovascular and renoprivic hypertension has been known for a long time. The kidneys are, however, important also in the development of essential hypertension: these views are based on transplantation studies on various types of hypertensive and normotensive rats and their hybrids and transplantation studies in patients. In the genesis of hypertension participates the dual regulation of blood pressure by the kidneys: a) the renin-angiotensin-aldosterone system in the renal cortex which is manifested by two mechanisms (high- and low-renin hypertension resp.) with a number of functional and metabolic effects of angiotensins and aldosterone, b) the medullipine system with the production of medullipine I by interstitial cells in the renal medulla and its transformation into effective medullipine in the liver. The latter prevents the vasoconstrictor effect of pressor factors. Some other vasopressor and vasodilatating factors participate in the regulation of blood pressure by acting as mediators. These findings have not only a theoretical but also an immediate impact on evaluation of the prognosis and selection of treatment of essential hypertension.

[Diuretics in the treatment of hypertension]. / Diuretiká v liecbe hypertenzie.

Diuretics are one of the basic groups of antihypertensive drugs. They have also certain limitations and undesirable effects which are better defined than in other more recently developed antihypertensives. Undesirable effects can be prevented by early combination of saluretics with K+ sparing diuretics or other antihypertensive drugs and by prevention of metabolic disorders (in particular insulin resistance and dyslipoproteinaemia) and by prescription of small doses. Only prospective intervention studies will show whether the advantages of other groups of antihypertensives, as compared with diuretics, will influence the prognosis of patients with essential hypertension in a substantial way. Several studies along these lines are under way.

[Angiotensin-converting enzyme inhibitors in the diagnosis and treatment of kidney diseases]. / Inhibítory angiotenzín konvertujúceho enzýmu v diagnostike a v liecbe chorôb obliciek.

The authors describe in a review the use of inhibitors of the angiotensin converting enzyme, in particular enalapril, in the treatment of nephrogenic hypertension, glomerulopathies without hypertension, renovascular hypertension with unilateral or bilateral stenosis of the renal artery and diabetic nephropathy. They draw attention to specific traits in the treatment of different disorders, risk of treatment and the ensuing tactics of indication, dosage and monitoring.

[Pharmacokinetic modeling in clinical practice: pefloxacin]. / Farmakokinetické modelovanie v klinickej praxi: pefloxacín.

Pharmacokinetic modelling allows to set up a therapeutic plan for administering a drug. The advances of this procedure are particularly remarkable in drugs discharged by the liver. The principles of this approach are presented and illustrated on the treatment with pefloxacin. The potential causes of the adverse effect of the drug observed in one patient of the series studied could thus be suggested.

[Pefloxacin in the treatment of recurrent urinary tract infections]. / Pefloxacín v liecbe recidivujúcich infekcií mocových ciest.

Thirty-seven patients with relapsing infections of the urinary tract were treated with pefloxacine, 400 mg/12 h for a period of 7-28 days. The clinical success of treatment was 100%, the bacteriological success 95%. Within 3-4 weeks after termination of treatment 63% of the patients did not develop a relapse, in particular those who did not have morphological changes of the kidneys. Side-effects-gastrointestinal, nervous, dermatological--during treatment were not severe. The results are comparable with results of the effect of ofloxacine in a similar group of patients.