[A renoprotective effect of enalapril in chronic transplantation nephropathy]. / Renoprotektivnii éffekt énalaprila pri khronicheskoi transplantatsionnoi nephropatii.

AIM: To study safety and efficacy of ACE inhibitor enalapril in chronic transplantation nephropathy (CTN) as well as nephroprotective efficacy of this drug in various clinical variants of CTN. MATERIAL AND METHODS: A retrospective study covered 220 recipients with CRF. The patients were divided into the study group (n = 103) and the control group (n = 117). The study group was given ACE inhibitor enalapril the efficacy of which was assessed by arterial pressure (systolic, diastolic, mean) dynamics, 24 h proteinuria and the rate of CTN progression. This rate was suggested by probability of plasm creatinin doubling (Kaplan-Meier technique). RESULTS: Enalapril significantly inhibited CTN progression running with minimal or marked proteinuria, had a pronounced hypotensive effect, promoted stabilization of minimal proteinuria (in CTN with minimal proteinuria) or reduction of protein excretion (in a proteinuric variant of CTN). CONCLUSION: Use of enalapril in CTN in a daily dose 10 mg maximum is safe and can be used for inhibition of CTN progression.

[Use of a three-component scheme of immunosuppression on morphologic and immunohistochemical changes of transplants in the early postoperative period]. / Primenenie trekhkomponentnykh skhem immunosupressii na morfologicheskie i immunogistokhimicheskie izmeneniia transplantata v blizhaishem posleoperatsionnom periode.

Three-component (cyclosporin A, corticosteroids and azathioprine) immunosuppression has been widely introduced in the treatment of recipients of renal transplants because it allows a significant reduction of the components' doses in greater effectiveness. The analysis of the results of 83 puncture biopsies obtained in the immediate postoperative period after kidney transplantation has shown that administration of an imidazole derivative allows raising therapeutic concentration of cyclosporin up to 200-300 ng/ml, thus preventing rejection crises. However, increased blood concentration of cyclosporin does not increase its toxicity as a result of a significant fall in the overall level of the metabolites.

[Kidney and pancreas transplantation in patients with insulin-dependent diabetes mellitus]. / Transplantatsiia pochki i podzheludochnoi zhelezy bol'nym insulinzavisimym sakharnym diabetom.

The article analyses the results of one-stage transplantation of the kidney and pancreas in three patients suffering from insulin-dependent diabetes mellitus with diabetic nephropathy in the stage of terminal renal failure which called for programmed hemodialysis. The specific features of early postoperative management of patients are described, particularly the various routes of drug administration.