The aim of our study was to determine the effectiveness of prebiotic lactulose as a means immunocorrective during exacerbation of chronic pyelonephritis in pregnant women with functional constipation. Methods. We examined and treated 37 pregnant women with exacerbation of chronic pyelonephritis and functional constipations. Results of the study. It was found that patients treated with lactulose normalized indicators of antiendotoxin immunity Ig classes A, M and G to lipopolysaccharide of Escherichia coli and the expression level of receptors on granulocytes and monocytes of peripheral blood. Also increased phagocytic activity of peripheral blood granulocytes, as nonspecific defense factor, and significantly reduced activity of inflammatory reactions. Conclusions. Use of prebiotic lactulose in the complex treatment of chronic pyelonephritis in pregnant women with functional constipation leads to normalization of parameters antiendotoxin immunity, and to increase phagocytic activity of peripheral blood granulocytes.

Purpose of research: studying of frequency of chronic renal failure development (CRF) depending on the duration of hematuric form of chronic glomerulonephritis (HFHGN), revealing of unfavorable disease outcome factors and development of mathematical model to forecast the CRF forming. Methods. Retro- and prospective analysis of nephrological examination results in patients was performed in the debut of glomerulonephritis (95 children), at duration of HFCGN less than 5 years (95 children), from 6 until 10 years (65 children), more than 10 years (45 patients). Intravital morphological research of renal tissue was carried out in 43 patients. Results.The relative value of CRF occurrence intensity at duration of HFCGN less than 5 years was 3,6, from 6 until 10 years - 8,9, more than 10 years - 24,2 cases for 100 patients-years. Mainly CRF of the first stage developed. Unfavorable prognostic factors of HFCGN course were family history of nephropathy, proteinuria, ?H, loss of cortico-medullary differentiation in kidneys according to ultrasonic research data, increase of creatinine in blood serum, presence of hyalinosis and sclerosis in glomuluses, macrofocal infiltration of interstitium. Conclusions. Prognostic mathematical models depending on the duration of HFCGN and on the data of intravital morphological research of renal tissue are developed.

This is a draft of national clinical guidelines of diagnosis, treatment and prevention of urinary tract infection in women

The purpose of our study was to analyze the intensity of oxidative process in patients with recurrent pyelonephritis and to determine the relationship between indicators of lipid peroxidation / antioxidant and the number of renal scars. Methods. The study involved 117 women with chronic pyelonephritis and 30 conditionally healthy persons. We studied the parameters of oxidant / antioxidant balance of blood. In addition, we used DMSA renal scintigraphy. After the examination patients were divided into II groups: I (n=65) – women with recurrent pyelonephritis and II (n=52) – patients without frequent recuring of the disease (up to 2 times per year). Results. For all patients with pyelonephritis, is higher than conventionally healthy donors were characterized by growth in production of malondialdehyde (MDA) in serum and in red blood cells, against a background of reducing the total peroxidase activity (SPA) and transferrin (TR) (3,4±0,9 and 5,2±1,0 respectively, p0.001). In patients with recurrent pyelonephritis was defined the highest level of MDAs (p=0,01) and decrease of antioxidant proteins: TR (p=0.02) and ceruloplasmin (CP) (p=0.03). We found inverse correlation between the number of recurrences of pyelonephritis per year and the activity of CP and TP (r=-0,36; p=0,008 and r=-0,38; p=0,004 respectively). Conclusions. In all examined patients identified an imbalance of lipid peroxidation and antioxidant systems, which was accompanied by activation of lipid peroxidation against deficiency of antioxidant. In patients with recurrent pyelonephritis determined significantly higher intensity of oxidative process and the lowest of antioxidant protection, which can be one of the risk factors for the formation of renal "scars". Further studies are needed to finally resolve this issue.

The aim of the our work was to study the prevalence of secondary hyperparathyroidism (SHPT) in patients with non-dialysis CKD and efficacy of treatment SHPT using low doses of the active metabolite of vitamin D - alphacalcidol. Materials and methods. The study involved 45 patients with non-dialysis CKD. We studied the levels of parathyroid hormone (PTH), total and ionized calcium, and phosphorus in serum, as determined by anthropometric indicators. The results are compared with target levels and depending on the stage of CKD as recommended NKF-K/DOQI 2003. The results of the study. PTH level in the examined patients ranged from 0.3 to 953.8 pg/ml, the average was - (234,49±34,99) pg/ml, the average level of total calcium was (2,08±0,06) mmol/L, ionized calcium - (0,74±0,07) mmol / l, phosphorus - (1,62± 0,11) mmol/ l. The analysis of calcium-phosphorus homeostasis before and after treatment with the main group of patients under the influence of treatment alphacalcidol showed significant increase of ionized calcium and PTH levels decrease by 51%. Conclusions. It is ascertained that secondary hyperparathyroidism occurs in about 65% cases among patients with chronic kidney disease in predialisis period. The efficiency of low doses of alphacalcidol in comparison with standard therapy of calcium carbonate in the generally accepted doses in treatment of secondary hyperparathyroidism was found. The positive dynamics of clinical and biochemical manifestations of hyperparathyroidism influenced by treatment with low doses of alphacalcidol were developed.

Aims: The purpose of the present study was to estimate the levels of microalbuminuria (MAU) as the markers of pyelonephritis progression in children. Materials and methods: We investigated 85 children with different types of pyelonephritis (from 6 months to 17 years old). Patients were divided into 4 groups depending on the level of MAU: group1- MAU from 0 to 10 mg/day, group 2 – 10- 20 mg/day, group 3 – 20-30 mg/day, group 4 – more than 30 mg/day. Results: It was determined that MAU levels were optimal (the 1 gr.) in patients with acute non obstructive pyelonephritis (71,4%, 0,033); MAU levels were increased in children with chronic pyelonephritis (3,4 gr.), they were detected in 25% and 45% of patients (0,015). A significant correlation was found between MAU levels and glomerular filtration rate (GFR): the increased MAU levels were associated with decreased GFR. It was determined that the i-ATF effectively decrease the microalbuminuria levels. Conclusions: We believe that MAU levels could be an early marker of the endothelial dysfunction in close relationship with the pyelonephritis progression that might become relevant targets for novel therapeutic strategies.

The article includes a project of national guidelines on best practice peritoneal dialysis.

Nephrological morbidity and disability are important indicators of the state of the health of children’s population. The aim of this study is detection the regional characteristics of morbidity and prevalence of nephrological pathology among children of Kharkiv region and analysis of the activity of nephrological service care for children’s population of the Kharkiv region. Methods.The material for this study is reporting documentation about the condition of the nephrological service care for children’s population of the Kharkiv region in 2009-2011 and the data of The Center of medical statistics of Ministry of Health of Ukraine. Results. The structure of the incidence and prevalence of major diseases of the urinary tract in children. Analyzes the main indicators of child nephrology service in Kharkov region. Conclusions.The research, carried out by authors, will allow to hold the correct and reasoned medical and rehabilitation events in all stages of rendering of specialized medical care for children with nephrological pathology and to develop the programs, directed on improvement of indicators of health and prevention of disability in children.