The review of publication about the hemodiafiltration which includes the history of the hemodiafiltration, types of HDF and their advantages is presented. The general features of paired filtration dialysis (PFD), biofiltration, acetate free biofiltration, ready made substituat HDF, high-flux HDF, push-pull HDF, on-line HDF are discussed. Despite the absence of statistical proof of influence of HDF on patients survival rate, HDF increases «middle molecules» removal (β2-M), helps to control the anaemia with lower EPO doses and improves hemodynamic stability in the HDF session.

Analysis were carried 450 patients with varicocele aged 8 to 17 years. The function of left and right kidney were separately evaluated. In 302 patients aortomesenteric compression of the left renal vein was diagnozed, 15 patients had stenosis of the left renal vein, 6 patients had retroaortal compression and 127 - were is not compression of the left renal vein. Of 450 patients 195 hed left-sidad phleborenal hypertension: pressure varied from 10/8 (mean 9) to 30/28 (mean 29) mm Hg. Left and right testicular estradiol levels 45,47 and 25,88 pg/l. The levels of xantinoxydase, of 5-hydroxyeicozotetraenic acid, of oxygen radicals, alkaline phosphatase, pCO2 in the left kidney were higher then those in the right kidney. Left renal venous hypertension, hypoxy, metabolic disturbances and other changes are interpreted as phleborenal nephropaty. Evidence is provided for indications for two-directional proxymal-distal (by A.A. Spiridonov’s procedure) testiculoiliacal (185) and renocaval (10) anastomosis, respectively. There was recidives no. Sclerotherapy - 35; o. Ivanissevich - 220.

Nephrogeneous arterial hypertension is both a nephroangiosclerosis progress factor. It favors the development of various cardiovascular complications (infarction, insult). Short but very sharp increases and drops of arterial blood pressure (AP) are particularly adverse. Pathogenesis of such AP leaps is not yet completely understood. An assessment of vegetative nervous system (VNS) activity before and in the moment of AP short increases has been carried out in this research by the way of spectral analysis of the heart rate variability. 20 patients having a hypertonic variant of chronic glomerulonephritis have been examined. It is revealed that at chronic glomerulonephritis the arterial hypertension is not always stable. In most cases a sharp increase of the VNS sympathetic part’s activity occurs just before AP sharp fluctuations.

52 non-diabetic pre-dialysis patients (28 females, 24 males, mean age 47 ± 12 years) were studied. Serum creatinine was 275,6 ± 176,2 µmol/l, hemoglobin - 116,3 ± 21,5 (range 73-160) g/l. M-mode and Doppler echocardiography was performed. Left ventricular hypertrophy was detected in 43 (82,7%) patients. Early and atrial peak filling velocities ratio (E/A) was decreased in 20 (38,5%), and isovolumic relaxation time of left ventricular was increased in 38 (73,1%) patients. Negative correlation between hemoglobin concentration and early peak filling velocity was revealed (r = -0,50; p < 0,001). The correlation was not detected between hemoglobin concentration and atrial peak filling velocity. We conclude that anemia impact on transmitral flow in pre-dialysis patients. Anemia increase the speed of early filling of the left ventricular. An atrial filling velocity is not change. In this connection the E/A ratio is not reflect the real degree of diastolic dysfunction in patients with chronic renal failure and anemia.

85 patients, having different stages of renal insufficiensy in the result of chronic glomerulonephritis were studied. During the development and deterioration of chronic renal insufficiensy, endothelium disfunction has being discovered. It was manifested not only in the disturbances of fibrinolytic and anticoagulant activitys, but also in vasoactive activity. Some correlation between the disturbances in endothelium vasoactive disfunction and the fibrinolytic activity of blood vessel wall as well as between the changes in blood lipid profile and factors of blood pressure monitoring was revealed.

Three-year prospective follow-up of patients (n = 90) with various urologic diseases was aimed at the revealing early manifestations of the deteriorated renal function. The initial nitrogen-excretory renal function was normal in every patient. The start point for assigning the patient to the examined group was the high risk of renal failure occurrence. Early in the study, 9 of 12 patients with urolithiasis displayed microalbuminuria or proteinuria outside the periods of active urinary infection and the obstruction of urinary tracts; the functional renal reserve (FRR) was decreased. In 3 years, in 7 of those patients uremia was detected. In patients with the sole kidney pathology, polycystic kidney, the findings proved that FRR lowering and hyperfiltration precede the developement of renal failure in urologic and glomerular diseases.

Retrospective analysis in the method of a «random-control» influence of various factors on the course of renal failure in 88 patients with urolithiasis, polycystic kidney, and pathology of the sole kidney allowed us to reveal the risk factors of accelerated progress of chronic renal failure (CRF). The determining factors are those associated with the nature, severity and activity of the main kidney disease. In urolithiasis, the hydronephrosis plays the key role, in polycystic kidney - macrohematuria cases in medical history, in sole kidney pathology, the ever-recurring pyelonephritis of the sole kidney is of vital importance. The universal factors of the accelerated CRF developement in urologic patients are the severe arterial hypertension, particularly DAP ≥ 120 mm Hg; daily proteinuria > 1 g.

Between 1996 and 2001 669 patients with end stage of renal disease, treated in four Moscow Hemodialysis Units were observed. Markers of in past or current infection, caused by hepatitis В virus (HBV) were revealed in 411 patients (61%). In 16 patients (2%) the signs of acute hepatitis В (AHB) were found. 80 patients (12%) proved to be carriers of HBsAg, and in 21 of them (3%) there was a combination with HCV-infection. Among the patients with detected specific antibodies to HBV antigens, the isolated HBcoreAb were found most often (in 55%). HBsAb were revealed in 21% of patients, and their combination with HBcoreAb - in 24%. The linkage between the duration of hemodialysis treatment and HBV-infection was confirmed. Most of patients (76%) proved to be infected during the first year of replacement renal therapy. But we did not succeed in establishing a connection between frequency of infection and sex, age of patients, the character of renal disease which caused uremia, and the quantity of hemotransfusions. The course of AHB in hemodialysis patients was characterized by preferentially subclinical manifestations. Some patients, in spite of vaccination, proved to be infected by HBV. In this group AHB was characterized by higher frequency of jaundice. Hepatitis В chronification was established in 37% of patients. In 77% of patients with persistence of HBsAg, the signs of viral replication were found.

Proximal and distal calcium (Ca) reabsorption was studied in 24 recipients with cronic rejection of kidney allograft (CR) and 86 recipients with well functioning renal transplant (WR). All recipients received CyA, azatyoprin and corticosteroids. Total Ca reabsorption in normocalcaemic patients was indicated by its excretory fraction (CCa/GFR), and in hypercalcaemic state - by shift from nomogramm of CaE/GFR and ultrafiltrable Ca; proximal Ca reabsorption - by excretory fraction of lithium (CLi/GFR); distal Ca reabsorption - by its distal excretory fraction (CCa/CLi); distal gradient Ca reabsorption - by distal excretore fraction of sodium (CNa/GFR). Active Ca reabsorption was calculated by T-score shift of exponential curve with confidence intervals (p = 0,95) of dependence between Ca and Na excretion in healthy persons at different levels of calcaemie. Total Ca reabsorption was normal in 17, decreased in 5 and elevated in 2 recipients with CR. Proximal Ca reabsorption at CR was decreased in comparison with WR, but did not differ from healthy persons. Distal gradient of Ca reabsorption at CR was lower and active - higher than in WR. Paratyroid hormone at CR was increased significantly more often than in WR. The normal response of active Ca reabsorption on parathyroid hormone was observed with similar frequences at CR and WF being significantly higher in CR following hyperparathyroidism.

During the last years in clinical practice has used a few new drug formulations of cyclosporine A (CsA).The aim of this study was to describe pharmacokinetic properties of Cs microemulsion, bioral (Panimmune Bioral TM Panacea Biotech).We determined in 24 patients after kidney transplantation C0, Cmax, Tmax, AUC0-12, AUC0-4. These results suggests that bioral have the same FK properties that neoral.