IgA-nephropathy (IgAN) is the most common form of glomerulonephritis. It is characterized by predominant mesangial polymeric IgA1 deposits and with increased plasma IgA1 level. The level of plasma IgA is determined by the rate of IgA production, its uptake by leucocytes and removal by hepatocytes. The catabolism of IgA depends on two factors: IgA receptors and immunochemical nature of the IgA molecules. Serum IgA in IgAN displays a number of unusual physical characteristics. The most important of them is a change in glicosilation. This IgA defect can influence IgA capacity to interact with matrix proteins, IgA receptors on mesangial cells, leucocytes and hepatocytes and with complement. It may play a key role in the pathogenesis of mesangial deposition of IgA1 and subsequent glomerular injury in IgAN.

In 38 children with various clinical and morphological types of glomerulonephritis morphological changes in renal tissue and the vascular resistance on renal vessels were correlated with the results of duplex ultrasonic scanning. There was a significant correlation between the disturbance of renal circulation causing ischemia of renal tissue and the intensity of scarring of renal parenchyma, as well as cellular infiltration of interstice, desquamation of tubule epithelium and widening of venous lumen. Interstitial sclerosis and widening of venous lumen were mostly observed in patients with normal characteristics of vascular resistance on the level of renal and segmental arteries.

In 60 children from 3 month to 14 years old with bladder-ureteral reflux (BUR) the level of some proteins (microalbumin, retinol-connecting protein, myoglobin) in urine was determined. The patients were divided into 2 groups: with primary and secondary BUR. A reciprocal correlation was found between the level of proteins in urine and the severity of BUR.

We investigated regional structure of left ventricle (LV) and its function in patients with left ventricle hypertrophy induced by uremia. Nine patients with end stage of renal disease (ESRD), 5 of whom had uremic cardiomyopathy, were examined with transesophageal echocardiographic imager before kidney transplantation. Two-dimensional sections of LV long axis in the course of whole cardiac cycle were obtained with transesophageal echocardiographic imager with rotation angle steps of 15 degrees. The endocardial and epicardial LV contours were outlined by hand. Using the data 3-D reconstruction of LV was carried out. We made quantitative estimation of LV form using the ratio between the LV long and short semi-axes. The regional thickness and elastic properties of LV wall were mapped using a surface mesh with the cell size of approximately 4×4 mm. We also analyzed myocardium regional motion using a frame-by-frame data processing with 40 ms time steps in the LV sections along the short and long axes. We found that LV in patients with ESRD has approximately spheric shape, a moderate hypertrophy and uniform wall thickness. Myocardium contractility and ejection fraction decreased accordingly, elastic wall properties worsen, and functional heterogeneity in myocardium motion and elastic properties increased. A development of pathological changes in myocardium due to uremia causes a functional heterogeneity in LV wall and a simplification of LV chamber shape. Myocardium remodeling due to chronic renal failure decreases LV structural heterogeneity and this process is closely linked with an increase in LV functional heterogeneity.

It is found that the basal levels of diuresis and natriuresis are decreased in hyperthyroid rats and alternatively increased in hypothyroid ones. Spontaneous diuresis decreased in hyperthyroid animals due to an increase in reabsorption of sodium and water in renal tubules while the reabsorption was significantly decreased in hypothyroid rats. These animals also demonstrated a suppression of potassium excretion. Acute sodium load with 2% NaCl solution (5% of body mass) stimulated excretion of sodium and potassium in hyperthyroid rats especially during the 1st hour after the load. In hypothyroid rats the acute sodium load lead to a decrease in sodium excretion. It is also found that condition of thyroid glands significantly affects the concentration of ions in tissues.

Aim. Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S) are the major steroid hormones secreted by the adrenal gland. The secretion normally decreases with age. Administration of DHEA has been reported to have beneficial effects on diabetes and atherosclerosis. The aim of this study was to investigate serum level of DHEA-S in haemodialysis (HD) patients. Methods. 124 haemodialysis patients (56M, 68F, mean age 47 ± 12 years) who received bicarbonate HD 3 times a week were studied. The mean duration of a HD session was 4 hours. Control group consisted of 30 healthy persons. Serum level of DHEA-S and of cortisol was detected by IFA-assay. Results. The serum level of DHEA-S did not differ in the HD patients and control group. The serum level of DHEA-S in male patients was higher than that in females: median - 5,7 (IQR 3,9-9,8) vs median 2,6 (IQR 1,3-4,2) µmol/l, resp., p < 0,001). There was negative correlation between the serum DHEA-S and age (r = -0,36; p < 0,001). Cortisol did not differ in male and female: median - 468,0 (IQR 365,5-587,0) vs median - 443,0 (IQR 323,0-609,5) nmol/l, resp., p = 0,6). We did not detect a correlation between DHEA-S and cortisol level (r = 0,04; p = 0,7). Multiple regression analysis has shown that age, gender and serum albumin levels were independent predictors of serum DHEA-S. Conclusions. The gender and age are the main determinants of serum level of DHEAS in HD patients and low level of DHEA-S is associated with low serum albumin level. Relationship between DHEA-S and albumin is unknown, but it is possible that worse prognosis in HD patients with hypoalbuminemia can be partially associated with low DHEA-S level.

Recent findings indicate that the Epstein-Barr virus can induce an associated nephritis. We describe a case of patient with steroid resistant nephrotic syndrome due to mesangiocapillary glomerulonephritis that was associated with the Epstein-Barr virus infection as revealed from electron microscopy, immunomorphological and virological data. Positive therapeutic effect was achieved after using valtrex and long-term treatment with of neoral (cyclosporine A). The role of the Epstein-Barr virus infection as an etiological factor and progressing factor of glomerulonephritis is discussed.

A rare clinical case of infantile galactosialidosis with nephrotic syndrome is described. Modern view on pathogenesis, clinical manifestations and diagnostics of this lysosomal storage disorder are presented.

In 31 kidney allograft recipients cyclosporine (CsA) dosage was gradually reduced below a ‘therapeutic window’ convoyed by MMF or Rapamycin administration. A graft biopsy performed before the start of the CsA withdrawal revealed a normal picture in 7 patients and different pathological disturbances in the rests. CsA was withdrawn in 23 patients who were followed up for further 284 ± 153 days. One graft was lost after the CsA withdrawal due to CAN progression. In other patients an increase in glomerular filtration rate (p < 0,05) and a decrease in blood urea, creatinine level, and blood pressure were found. The decrease in blood urea and arterial blood pressure were statistically significant.