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The article summarises data on the activity of tubular enzymes having marked organ-specific characteristics related to kidneys. They are N-acetyl-beta-D-glucosaminidase (NAG), its thermostable isoenzyme NAG B and beta-galactosidase localised in lysosomes. L-canavinine, ornithine aminotransferase having mitochondrial localization have also been discussed in the article. The authors have dealt also with the activity of lipoperaxidation processes having been assessed by an ammount of malonic dialdehyde in blood serum, erythrocytes and urine of 51 patients with progressive diabetes mellitus at the late stages of diabetic nephropathy.

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Activity of tubular lysosomic (N-acetyl-beta-D-glucosaminidase--NAG, its thermostable isoenzyme NAG B and B-galactosidase--beta-GAL) and mitochondrial (L-canavanine: ornithine amidinetransferase--COAT) enzymes were measured in urine of 30 patients with diabetes complicated by diabetic nephropathy (DN). It was shown that activity of NAG, especially its thermostable isoenzyme NAG B and also beta-GAL in urine of DN patients was higher compare to those in healthy subject. Moreover COAT activity was registered in urine of DN patients while it is not presented in healthy persons. The precise dependence of NAG, NAG B, beta-GAL levels and COAT activity on the functional state of renal parenchyma in particular on tubular nephron nephrocytes was found that allows us to consider the given parameters as markers of diabetic process progressing in kidneys in patients with diabetes.

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The clinical and laboratory investigation was done on 40 patients with kidney disfunction (glomerulonefritis), treated by standard medicines with regulary infrared total body heating (from 15-20 to 40 min) daily during 10 days. Control group of 37 patients, was treated only by standard medicines. The thermochambers construction forces the possibility of normal temperature air breathing under the radial skin heating to 50-60 degrees C. It was shown, that hypertensions, dropsy manifestation and nitrogen contents in blood significantly decreased in comperison with the control group of patients. The positive effects in laboratory dates was shown in 65%; the subjective reports--in 100% patients. These data may be conformed to widley using infrared chamber procedures for combinative drugs and thermal treating patients with kidney disfunction.

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Abnormalities were studied of lipid metabolism in patients with glomerulonephritis (GN) depending on the presence of herpes infection (antibodies to herpes simplex virus and cytomegalovirus) versus similar indices in GN patients free from this infection (n = 75). Of these, 34 presented with the urinary syndrome (US), 41 had nephrotic syndrome (NS). Abnormalities of lipid metabolism in GN patients (irrespective of the syndrome) were shown to be more manifest in the presence of herpes infection. GN severity (in comparative evaluation within one entity) was not found to be dependent on the viral infection but disturbances in functional indices for the liver in patients in its presence occurred far more frequently. More profound abnormalities of lipid metabolism in GN patients in the presence of herpes virus infection can be a factor in GN chronization, affect the rate of progression of not only atherosclerotic lesions of kidneys but of glomerulosclerosis as well.

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Overall, 138 patients at teen age and youths were studied for the clinical course of their glomerulonephritis. In adolescence, the onset of glomerulonephritis presents as urinary syndrome with hematuria and nephrotic syndrome. Acute glomerulonephritis with hematuria is accompanied by a low level of proteinuria and slow progression. Apparent benefit from the treatment occurred in 73 +/- 5% of patients (complete and partial clinical and laboratory remission), unsatisfactory results of treatment were recorded in 27 +/- 5% of patients. Persistence of nephrotic syndrome in patients demonstrating unsatisfactory results of treatment coincide with far greater frequency of unfavourable morphological forms of glomerulonephritis (mesangiocapillary and focal-segmentary glomerulosclerosis (hyalinosis), changes in canaliculi and interstitium, with loss of the functional reserves of the kidneys and effect of plasmapheresis on hyperlipidemia being recordable.

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A total of 846 patients with glomerulonephritis were examined. Of these, 219 were diagnosed as having developed acute glomerulonephritis (AGN), 627 were patients with chronic glomerulonephritis (ChGN). AGN is marked by a debut predominantly in the pubertal period and early adulthood, the incidence of the uric syndrome gets decreased with aging while that of the nephritis syndrome is noted to be on the increase in AGN patients. The course of ChGN depends on the age of the patient having developed the illness: the older the age group that such a patient belongs in, the more unfavourable the disease course is expected to be: developed early in the course of the disease is the hypertonic stage and that of chronic renal insufficiency as well, with the average length of life getting shortened beginning with the onset of the illness.

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Results are analyzed of a prolonged treatment with inhibitors of the angiotensin-converting enzyme (captopril, Capoten, 100 to 150 mg daily, Renitec, 10 to 20 mg daily) in 53 patients with chronic glomerulonephritis. Of these, 23 patients presented with nephrotic syndrome in prehypertensive stage, 30 were in the stage of chronic renal insufficiency. The time-related course of proteinemia was studied as were indices for systemic hemodynamics, azotemia. Shown in the study was a significant effect of ACE inhibitors on proteinuria, indicators of systemic hypertension. A tendency toward decline in indices for creatinemia was noted. A concept is considered of multifactor effect of ACE inhibitors resulting in inhibition of progression of renal insufficiency.

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Effects were studied of hemosorption on the system of homeostasis in patients with chronic glomerulonephritis presenting with nephrotic syndrome. An optimum graphic express method of control of the homeostasis system state was found, permitting predicting thrombohemorrhagic complications after single-session hemosorption (significance 99.9%). Strategies were identified for correction of changes in coagulogrammes in such patients along with devising measures to prevent the above complications.

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As many as 159 patients with chronic pyelonephritis and 100 those with glomerulonephritis residing in ecologically favourable, and on contaminated territories for 6-8 years after Chernobyl accident, were examined for indices of lipid peroxidation, antioxidant system and energy exchange. The above renal disease were found to be accompanied by a rise in the activity of lipid peroxidation and accumulation of excess of their products in cellular membranes and urine. In the antioxidant system, the activity of NAD-H2-dependent factors and an inhibitor of free radical oxidation of superoxiddismutase tends to decrease. There occur changes in isoenzyme spectrum of lactate and malatedehydrogenases. The above shifts appear to be manifest in those persons having been exposed to low radiation doses. Antioxidants and stabilizers of the biological membranes were shown to be useful in correcting the above metabolic processes.

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Hyperfibrinogenaemia, hyperthrombinaemia, slowed down lysis of euglobulin clot, increased level of plasminogen, delayed aggregation of thrombocytes were observed in 20 patients with glomerulonephritis with haematuria. Membrane-stabilizing therapy reduced trends to hypercoagulation, significantly improved aggregating abilities of thrombocytes. Considerable impact of membrane-stabilizing therapy on indices of haemostasis in patients with hematuric glomerulonephritis evidences close link to exist between activation of lipid peroxidation, changes of structural and functional parameters of membranes and mechanisms of blood coagulation and thrombocyte aggregation.

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Measures of lipid peroxidation (malonaldehyde contents in blood, erythrocyte membranes and urine), parameters of the antioxidant system, structural and functional indices of cell membranes (cholesterol level, general content of phospholipids and phospholipid spectrum) were studied in patients with acute and chronic (stable and advancing) hematuric glomerulonephritis. Glomerulonephritis chronization was established to be associated with the activation of lipid peroxidation, predominantly on the level of damaged organ, while the condition of the antioxidant system showed a trend to normalization. Advancing glomerulonephritis when compared to stable one revealed more pronounced processes of membrane destabilization as well as accumulation of lipid peroxidation products in membranes, erythrocytes, blood plasma and urine.

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Plasmapheresis was carried out by the continuous method in 10 patients with active forms of glomerulonephritis with the nephrotic syndrome and was found to positively affect hemostasis (reduction of hyperfibrinogenemia, thrombinemia, enhancement of fibrinolysis). Antiaggregants completely controlled negative effect of plasmapheresis on the thrombocyte status. The positive effect was paralleled by clinical improvement.

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Plasmapheresis (P) was used in the complex treatment of 16 patients with chronic glomerulonephritis (CHG) and nephrotic syndrome. Before P. 12 patients were treated ineffectively with prednisolone and curantyl. After 3-5 sessions of P detoxication was observed in all patients, increased diuresis (15 patients). Renal function normalized in 4 of 5 patients, proteinuria reduced by 50-80%. The authors discuss indications of including P into the complex treatment of patients in whom chronic glomerulonephritis with the nephrotic syndrome was present.

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Results are reported of 83 patients with glomerulonephritis with the hematuria syndrome and 75 patients without hematuria syndrome. 19 clinico-laboratory signs were analyzed. Data indicate that hematuric nephritis may be signaled out in a separate nosological entity necessitating differentiated treatment.

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A study of 86 patients with glomerulonephritis, urinary syndrome, presence of the hematuric component is characterized by an activation of lipid peroxidation as a result of disbalance the antioxidant system, that causes corresponding changes in the lipid phase of the cell membranes, reduction of the phospholipid and cholesterol level in the membranes, increase of its deformability capacity that may be of significance for the development of the hematuric component in patients with glomerulonephritis. The data stimulate the necessity of searching treatment directed to reduction of lipid peroxidation activation, normalization of the antioxidant system, stabilization of renal cell membranes.

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UNLABELLED: A clinical evaluation was carried out of treatment efficacy of patients suffering of glomerulonephritis with hematuria component. TREATMENT: membrane stabilizing therapy including unithiol, dimephosphon (delagil) and alpha-tocopherol acetate. Duration of this treatment was 1 month; 2 months--with alpha-tocopherol and delagil; 6 months--with delagil. TREATMENT was carried out in 80 patients. Six-month follow-up was evaluated in 62 patients. In 48 patients the treatment was effective as concerns proteinuria and in 4--only hematuria. Comparing the results of such treatment with indomethacin treatment where a positive dynamics was observed in 10 of 38 patients and only in 2 patients improvement concerned proteinuria and erythrocyturia. CONCLUSION: membrane stabilizing therapy is the method of choice in comparison with traditional indomethacin treatment.

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