Vitamin E as adjuvant treatment for urinary tract infection in girls with acute pyelonephritis.

INTRODUCTION: Vitamin E is a fat-soluble vitamin that functions as an antioxidant. The aim of this study was to investigate the effects of vitamins E supplementation in combination with antibiotics for the treatment of girls with acute pyelonephritis. MATERIALS AND METHODS: This double-blinded randomized controlled trial was conducted on 152 girls aged 5 to 12 years with a first acute pyelonephritis episode based on technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA). They were randomized to receive a 14-day treatment with only antibiotics (control group; n = 76) and 14-day treatment with supplements of vitamin E (intervention group; n = 76) in addition to the antibiotics. Patients' clinical symptoms were monitored for 14 days and urine culture was performed 3 to 4 days and 7 to 10 days after the start of the treatment and its completion, respectively. All of the girls once underwent DMSA scan 4 to 6 months after the treatment. RESULTS: During the follow-up days, the mean frequency of fever (P = .01), urinary frequency (P = .001), urgency (P = .003), dribbling (P = .001), and urinary incontinence (P = .006) were significantly lower in the intervention group compared to the control group. There was no significant difference in the results of urine culture 3 to 4 days after the start of treatment (P = .16) and 7 to 10 days after its termination (P = .37). There was also no significant difference between the results of DMSA scan 4 to 6 months after the start of treatment (P = .31). CONCLUSIONS: Vitamin E supplementation has a significant effect in ameliorating sign and symptoms of UTI. However, further studies are recommended to confirm these findings.

[Impact of dietotherapy with enterosorbent of marine origin on the indices of mineral and lipid metabolism for patients suffering from kidney diseases].

It is described the effectiveness of application of dietotherapy including enterosorbent of marine origin at the stage of rehabilitation of patients having kidneys pathology. Application of this enterosorbent favors the positive clinic-biochemical dynamics with correction of electrolyte and lipid imbalance.

Conservative long-term treatment of chronic renal failure with keto acid and amino acid supplementation.

In a group of 119 patients with advanced chronic renal failure (serum creatinine level 733 +/- 186 mumol/l) the effect of a low-protein diet supplemented with essential amino acids (EAA) or their keto analogues (KA) on uremic metabolism and rehabilitation status was investigated. The protein intake amounted to 0.4 g/kg B.W./day, the phosphorus intake 0.4-0.6 g/day and the energy supply 120-150 kJ/kg B. W./day. In 51 patients there was a substitution with EAA and in 68 patients with their KA. The mean duration of dietary treatment in this study was 19 months (6-64 months). During this time, the serum creatinine increased from 733 +/- 186 to 1,220 +/- 256 mumol/l, whereas the urea nitrogen values remained relatively constant at between 26 and 30 mmol/l. There were no signs of protein malnutrition (nitrogen balance, serum transferrin and serum protein were normal). The hemoglobin concentration remained at greater than 5 mmol/l with creatinine levels of 1,220 +/- 256 mumol/l. During the substitution with KA, there was a significantly greater decrease in serum phosphate (p less than 0.05) and parathyroid hormone (PTH) (p less than 0.01) as compared with the uremics given EAA. In addition, we found a significant increase in testosterone (p less than 0.01) in patients supplemented with KA. Despite advanced chronic renal failure there was a good degree of rehabilitation (full-time work: 21%; part-time work: 66.4%). It can be concluded that a low-protein diet supplemented with EAA or KA can improve the uremic metabolism, rehabilitation status and safely postpone the start of maintenance dialysis.

Influence of diet and underlying renal disease on the rate of progression of chronic renal failure.

The data presented demonstrate that the underlying renal disease and the type of diet used are considerably influencing the rate of progression of chronic renal failure. In relative terms the course of the renal disease is mostly changed in patients suffering from glomerulonephritis, while in absolute terms patients suffering from polycystic kidney disease exhibit the slowest rate of progression. The comparison suggests that a low-protein diet purely based on vegetarian food might considerably slow down the overall rate of progression of chronic renal failure. This finding is supported by results obtained in animal experiments.

[Evaluation of the effect of canned diet foods on the course of pyelonephritis in children]. / Otsenka vliianiia lechebnykh konservov na techenie pielonefrita u detei.

The biochemical and immunological indicators were examined in 109 pyelonephritis children kept on the diet which included therapeutic preserves containing, apart from certain food ingredients, a complex of vitamins and tinctures of medicinal grasses. Therapeutic preserves were discovered to have a beneficial effect on the time course of the clinical symptoms of pyelonephritis, vitamin balance, lipid metabolism and immunity status. The results attest to advisability of applying therapeutic preserves as part of a complex of therapeutic measures to the management of children with pyelonephritis.

Progression rate of residual renal function in conservative treatment and early dialysis.

A retrospective comparative study was carried out in patients with chronic renal failure on conservative treatment (26 cases) and early dialysis (23 cases). The two groups were well matched for age, sex, etiology of renal disease and residual Ccr. In contrast with other papers, patients on dialysis showed a gentler deterioration rate of residual renal function than those on conventional low protein diet regimen. Between the two groups statistically significant differences concerned the control of blood pressure, serum phosphate and uric acid.

Modulated nitrogen intake for patients on low-protein diets.

In order to overcome malnutrition and poor palatability associated with long lasting low-protein intakes, a diet was devised based on modulated nitrogen intake and energy supply of at least 155 KJ/kg a day. Each patient underwent three different regimens (A, B, C) of protein intake. In period A, the protein intake was 0.33 g/kg a day. In period B, the patients were given 0.33 g/kg a day during day 1, 2, 3, 5, 6 and 1.00 g/kg a day during day 4 and day 7 of the week. In period C the daily protein intake was the mean of the weekly value from day 1 to 7 of period B. Data obtained show that in period A the urea appearance rate was equal to that in period B and lower than that in period C.

Preservation of peripheral nerve function in severe uremia during treatment with low protein high calorie diet and surplus of essential amino acids.

Twelve patients with severe chronic renal failure (serum creatinine 7.0-27 mg %), and marked uremic symptoms on a 40 g protein diet, were treated with a caloric-rich diet containing 16-20 g protein, supplemented with the 8 essential amino acids (1.1-2.2 g N) and histidine (0.23-0.45 g N)in the form of tablets for periods between 3 and 34 months. During the treatment the serum urea-N fell, and the uremic symptoms subsided or diminished without the patient exhibiting signs of malnutrition. The nerve function was followed with quantitative and semiquantitative neurological tests (among others, determination of vibratory perception thresholds and nerve conduction times). Initially all patients but 2 had signs of neuropathy as measured by these methods. During the course of treatment no deterioration of peripheral nerve function was recorded in any of the patients, several of whom had had serum creatinine conceptrations above 15 mg % for long periods. We conclude that conservative treatment with N-poor diet in far advanced chronic renal failure may prevent the further development of peripheral neuropathy provided that adequatecaloried and essential amino acids (2-3 times the minimal requirements) are supplied. The results suggest that, in addition to uremic toxines, malnutrition is a factor of importance for the developments of of uremic neuropathy.