[Immunologic aspects of renal involvement in patients with type II diabetes mellitus]. / Immunologicheskie aspekty porazheniia pochek u bol'nykh sakharnym diabetom II tipa.

Besides the known factors contributing to the pathogenesis of diabetic nephropathy, the role of immune mechanisms in types I and II diabetes is discussed of late; the contribution of autoimmune mechanisms to pathogenesis of noninsulin-dependent diabetes (NIDDM) is virtually unknown. Seventy-six patients with NIDDM and 48 with insulin-dependent condition were examined. Under study were levels of antibodies to FxIA and renal glomerular basal membrane antigens in the blood sera of donors and patients with types I and II diabetes, as well as concentrations, size, and pathogenicity of immune complexes. Antibodies to FxIA antigen were detected in patients with both types of diabetes with diabetic nephropathy. Detection of circulating antibodies to FxIA antigen in more than 70% of diabetics in the absence of protein in the urine may be used as a test system for the laboratory diagnosis of diabetic nephropathy prestage and as a criterion for prescription as early as at the initial stages of nephroprotective agents.

[The age-related aspects of gouty nephropathy]. / Vozrastnye aspekty podagricheskoi nefropatii.

The incidence of podagric nephropathy in different age groups was studied on a large populational material (41,452 persons over 30 years). The number of patients suffering from podagra was shown to increase with each decade of life. In 122 patients with podagric nephropathy, deviations in urinalyses were recorded in 80 cases (65.5%). Of these, 53 patients (72.6%) were ot 60 years of age and older. In patients over 60, derangement of nitrogen-excretory renal function was seen more frequently (in 64.4%) than in other age groups. The greater incidence of podagra and podagric nephropathy over the recent decade may be related not to the changes in the nutrition pattern and hypodynamia but also, and possibly to a larger measure, with deterioration of the environmental conditions and alterations in radiation background.

[Senile pyelonephritis with the arterial hypertension syndrome: the use of trental]. / Starcheskii pielonefrit s sindromom arterial'noi gipertenzii: primenenie trentala.

Eighteen patients with senile pyelonephritis and nephrogenic arterial hypertension were examined for the effect of trental monotherapy (600 mg/day) on intrarenal hemodynamics, the rate of glomerular filtration (effective renal blood flow, the intensity of blood flow in the medullary layer of the kidney), activity of the renin-angiotensin-aldosterone system (plasma renin activity, plasma and urine aldosterone), prostaglandin synthetic capacity of the kidneys (PGE and PGF2 alpha), water-electrolyte balance (circulating blood volume, sodium content in the serum and its excretion with urine), and on arterial pressure and general vascular peripheral resistance. Prolonged administration of the drug (from 3 weeks to 6 months) led to a significant improvement of the medullary blood flow, increase (p less than or equal to 0.05) of excretion of natriuretic PGE [correction of RGE] and lowering (p less than or equal to 0.05) of diurnal excretion of PGF2 alpha, which was accompanied by a rise of natriuresis (p less than or equal to 0.05) and diuresis.

[The determination of the separate intrarenal hemodynamics and its place in the diagnosis of nephrogenic arterial hypertension]. / Opredelenie razdel'noi vnutripochechnoi gemodinamiki i ee mesto v diagnostike nefrogennoi arterial'noi gipertenzii.

Differential diagnosis between essential hypertension and secondary arterial hypertension (AH) that developed in the presence of chronic pyelonephritis was made in 12 patients with AH and the urinary syndrome (leukocyturia and bacteriuria). With that purpose in view for revealing functional renal asymmetry, a study was made of the effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in each kidney separately based on computation of 99Tc-DTPA and 131I-hippuran clearances. Some patients in whom AH was later regarded as essential manifested practically equal values of the ERPF and GFR from both sides, with the real characteristics of the latter ones being little different from the respective populational values calculated by computer bearing in mind the body surface of those patients. The other patients' group showed, along with a decrease of the total ERPF and GFR, a dramatic asymmetry of the intrarenal hemodynamics of both ERPF and GFR, which is fairly characteristic of chronic pyelonephritis. This allows the syndrome of AH to be regarded in those patients as secondary.

[Arterial hypertension in senile pyelonephritis: the renal hemodynamics]. / Arterial'naia gipertoniia pri starcheskom pielonefrite: pochechnaia gemodinamika.

Eighteen patients aged 60 to 80 years suffering from chronic pyelonephritis (CPN) and nephrogenous arterial hypertension (AH) were examined for intrarenal hemodynamics: effective renal blood flow (ERBF), glomerular filtration rate (GFR), filtration fraction (FF), renal vascular resistance (R). Renal hemodynamics in patients with senile pyelonephritis and AH was found to be characterized by a decrease of ERBF, GFR, FF, an increase of R (p less than 0.01), with the alterations being related to the AH intensity, mass of the functioning renal parenchyma (for GFR) and partly (for R) to the pyelonephritis and AH standing. R which is dependent on the duration and course (number of exacerbations) of CPN is one of the factors that determine the development and gravity of AH in senile pyelonephritis.

[Acute renal insufficiency in middle-aged and aged patients]. / Ostraia pochechnaia nedostatochnost' lits pozhilogo i starcheskogo vozrasta.

An analysis of a course of acute renal insufficiency (ARI) in middle-aged and old patients (aged over 60) is based on a follow-up of 123 patients. Attention is drawn to multifactorial development of ARI in middle-aged persons, to disturbances of water-electrolyte balance and the blood coagulation system. Various aspects of therapeutic tactics for middle-aged ARI patients are considered.

[Disordered repair processes in patients with gouty nephropathy]. / Narushenie protsessov reparatsii u bol'nykh podagricheskoi nefropatiei.

The reparation activity in lymphocytes using the DNA reparative synthesis test was assessed in 18 patients: 10 suffering from primary gout with renal involvement, 6 suffering from chronic nephritis with hyperuricemia, 1 with hyperuricosuria and 1 with systemic lupus erythematosus. Inhibition of the DNA reparative synthesis was noted in 15 patients (deep in 11 patients and partial in 4). A degree of synthesis inhibition did not depend on renal function and uricemia value. An opportunity of the use of reparation activity as a criterion of the development of disease even at the premorbid stage was discussed.