Being one of the key representatives of the group of biologically significant gases, along with nitrogen oxide and carbon monoxide, hydrogen sulfide demonstrates pronounced antioxidant properties, suppressing inflammatory processes and exerting a protective effect on tissues in various diseases. THE AIM : to study the effect of sodium thiosulfate on filtration and reabsorption processes in rats with acute renal injury (AKI). MATERIALS AND METHODS : AKI was modeled by a single intramuscular injection of 50% glycerol solution (10 ml/kg). Sodium thiosulfate was administered intraperitoneally at a dose of 0.1 g/kg every other day for three days. RESULTS : Experimental data show that the use of sodium thiosulfate significantly reduces the negative effects of intoxication caused by the administration of glycerol to animals. After administration of the drug, the damaged structures of the renal epithelium were restored, signs of inflammation and oxidative stress were eliminated, and creatinine and urea levels returned to normal. Our results demonstrate an increase in the levels of sodium and chlorine ions in the blood plasma of animals treated with sodium thiosulfate, which reflects an improvement in kidney condition and restoration of the main transport processes. CONCLUSION : Thus, sodium thiosulfate, due to its antioxidant properties, neutralizes free radicals and suppresses oxidative stress caused by glycerol, as evidenced by changes in the concentration of urea nitrogen, creatinine in plasma and daily diuresis and restoration of electrolyte balance in plasma and urine in rats treated.
BACKGROUND . Tuberous sclerosis is an orphan systemic disease with an autosomal dominant inheritance characterized by the formation of tumor–like benign nodular hamartomas with lesions of the skin, nervous system, retina, kidneys, heart, and lungs. In 50–70 % of children and adolescents with tuberous sclerosis, the renal phenotype is more often diagnosed in the form of angiomyelitis and kidney parenchymal cysts. The presence of kidney damage complicates the course and prognosis of tuberous sclerosis due to the risk of acute kidney injury and the progression of chronic kidney disease. OBJECTIVE : To describe familial tuberous sclerosis (ORPHA:805) due to a pathogenic mutation of the TSC2 gene with an autosomal dominant type of inheritance. PATIENTS AND METHODS . The features of the clinical phenotype and genotype of tuberous sclerosis in a 16–year-old proband girl and her 45-year-old male father are described. Genealogical, clinical, imaging, functional, and molecular genetic research methods have been applied. The molecular genetic research method was performed in the laboratory of molecular pathology of the medical and genetic center of Genomed. RESULTS . A 16-year–old patient was diagnosed with tuberous sclerosis at an early age in the presence of 2 major criteria (1. rhabdomyoma of the heart prenatally and at birth, 2. cortical tubers of the frontal and parietal regions, foci of calcification in the cerebellum, decreased hypocampus manifested by delayed speech development and epilepsy with atonic and generalized tonic-clonic seizures in infancy and early age). Manifestations of the renal phenotype (increased kidney volume and parenchymal cysts) They were detected at the age of 6 years, liver angiomyolipomas were noted at the age of 8, and kidneys at the age of 16. A molecular genetic study identified a pathogenic mutation of the TSC2 gene in the proband (c.1052AG, p.Lys351Arg). The renal function in proband at the age of 16 years corresponds to stage 2 of chronic kidney disease (GFR 84ml/min/1.73 m2). A similar mutation was detected in Proband's father, who has a normal glomerular filtration rate (134ml/min/1.73 m2), a single kidney cyst, tuberous sclerosis was diagnosed at the age of 45 according to 2 major criteria (3 periarticular fibroids and 3 hypopigmented spots over 5 mm on the skin). СONCLUSION . The features of the clinical phenotype of familial orphan tuberous sclerosis due to a previously undescribed mutation of the TSC2 gene in a proband girl and father are described.
Currently, the leading factors in the development and progression of chronic kidney disease (CKD) are type 2 diabetes mellitus and arterial hypertension, which are often caused by obesity resulting from overeating. The literature clearly shows that a properly selected diet has a beneficial effect not only on blood pressure and carbohydrate metabolism, but also on kidney function. The presence of CKD in most cases assumes comorbidity, and therefore requires the selection of an optimal diet that includes correction of all existing metabolic disorders. Today, there are more than 100 diets known, but it remains unclear which one is best for these patients. Moreover, the effect of major macronutrients on renal function remains controversial and has not been fully studied. The article describes three clinical cases of a low-carbohydrate diet (LCD) with moderate carbohydrate intake and its effect on renal function and metabolic parameters. This dietary option in patients with metabolic disorders, combined with high patient adherence to the diet, led to improved kidney function and carbohydrate, lipid and purine metabolism indicators, weight loss, a reduction in the doses and number of medications used, and in some cases helped to normalise blood pressure.
The pathogenetic approach to metaphylaxis of urolithiasis is a widespread, socially significant healthcare issue due to the increasing incidence and, particularly, its recurrent nature, despite advances in pharmacotherapy and the application of lithotripsy. Pathological crystal genesis is viewed as a consequence of exceeding the solubility threshold of various urinary mineral components on one hand, and as a result of post-translational defects in the main proteome of urine formation – uromodulin (UMOD), which demonstrates a sanogenetic system in healthy individuals for maintaining biophysical homeostasis stability: the colloidal properties of urine. However, in addition to this, UMOD, by binding mannose-dependent pili of infectious agents, blocks bacterial contact with urothelial cells, given that urinary tract infection is a known factor in urolithiasis. By modeling the urine of healthy individuals through co-incubation with E. coli bacteria, a decrease in the concentration of polymerized uromodulin in urine has been demonstrated as a factor increasing the risk of calcium oxalate crystal formation.
BACKGROUND . Acute kidney injury (AKI) and comorbidities including cardiovascular disease, diabetes mellitus (DM), metabolic disorders, and other factors exacerbate the severity of the novel coronavirus infection (COVID-19). We studied 769 patients with COVID-19. In all cases, the novel coronavirus infection was severe and accompanied by organ dysfunction. We assessed the incidence of AKI, risk factors, and mortality in hospitalized patients with severe COVID-19. THE AIM : to study the risk factors, incidence of AKI, need for renal replacement therapy (RRT), and mortality among patients with complicated COVID-19. PATIENTS AND METHODS . The study included adult patients transferred to the Vladimirsky Regional Clinical Institute from hospitals in the Moscow Region with severe COVID-19 in 2020–2024. The COVID-19 diagnosis was confirmed using polymerase chain reaction (PCR) testing of nasopharyngeal samples. Patient characteristics and laboratory test results were assessed using an electronic database. RESULTS . Analysis of the obtained results shows that mortality increased with the progression of lung disease (from 34 % with stage 2 lung disease to 76 % with stage 4) and the need for mechanical ventilation. AKI was observed in almost half of patients (46 %), but the incidence of AKI did not statistically significantly increase with lung disease progression. AKI was most often observed in stage 3 lung disease (52 % of patients). Gender did not statistically significantly affect mortality. Older patients were significantly more likely to die (mean age 56 years among survivors and 64.4 years among deaths). The need for mechanical ventilation was a significant risk factor for death. Thus, the mortality rate among patients without mechanical ventilation was 8.4 %, compared to 91.6 % among those receiving mechanical ventilation. The mortality rate was higher in patients with hypertension (87 %), chronic kidney disease (40.6 %), diabetes (36 %), and among patients receiving RRT (68 %). CONCLUSION . In addition to the stage of lung disease, factors aggravating the course of COVID- 19 included comorbid cardiovascular diseases, chronic kidney disease and acute kidney injury, metabolic disorders, age, and the need for RRT.
