The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.

Translated to Russian by Alexey Denisov, ed. by Elena Zakharova Translation to Russian initiated by Russian Dialysis Society, supported by Fresenius Medical Care, and approved by ERBP NDT 2019 V34 Issue Supplement 2 (https://academic.oup.com/ndt/article/34/Supplement_2/ii1/5514502) Maurizio Gallieni, Markus Hollenbeck, Nicholas Inston et al, Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults, Nephrology Dialysis Transplantation 2019; 34 (suppl_2): ii1-ii42, doi:10.1093/ndt/gfz072. © The Author. Published by OUP on behalf of the ERA-EDTA This translated abridged reprint is published by Nephrology and Dialysis Journal (Russian) and consists of an item selected and translated by Nephrology and Dialysis Journal (Russian) from items originally published in the English language in Nephrology Dialysis Transplantation (the "Journal") by Oxford University Press on behalf of the ERA-EDTA (the "Society"). Nephrology Dialysis Transplantation © ERA-EDTA All rights reserved; no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of [insert customer name] in respect of the translation and Oxford University Press and/or Oxford Publishing Limited ("OPL") in respect of the underlying rights, or as expressly permitted by law. For permissions please email: journals.permissions@oup.com The opinions expressed in the Journal item reproduced in this reprint are those of the original authors and do not necessarily reflect those of Oxford University Press, OPL or the Society. All reasonable precautions were taken by Oxford University Press and the original editors to verify drug names and doses, the results of experimental work and clinical findings published in the Journal. The ultimate responsibility for the use and dosage of drugs mentioned in the Journal and reproduced in this reprint, and in interpretation of published material, lies with the medical practitioner. Oxford University Press, OPL and the Society cannot accept any liability whatsoever in respect of any claim for damages or otherwise arising therefrom. Please inform [Insert customer name] of any errors. The mention of trade names, commercial products or organizations, and the inclusion of advertisements in this reprint do not imply a guarantee or endorsement of any kind by Oxford University Press, OPL or the Society. The use of registered names, trademarks etc. in this reprint does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Oxford University Press, OPL and the Society are not responsible or liable for any errors, omissions or inaccuracies within the translation. Nephrology and Dialysis Journal (Russian) is solely responsible for the translation and this reprint.

Objective: to analyze the surgical correction of native arteriovenous fistula (AVF) aneurysms in patients on the program hemodialysis (HD). Materials and methods: a retrospective observational study included 158 patients who underwent various surgical interventions due the AVF aneurysms; 87 patients (55.1%) underwent pre-emptive surgeries; 71 patients (44.9%) underwent surgery after AVF thrombosis ("on-demand" surgery). Results: in the case of pre-emptive surgeries, secondary patency was 95.3% [95% CI 88; 98.2], 91.4% [95% CI 82.7; 95.8], 87.6% [95% CI 77.1; 93.5], after a year, two and three years, respectively, after 4.8 years (maximum follow-up) - 69% [95% CI 44.9; 84.2]. In the case of "on-demand" surgery, the secondary patency was 80.3% [95% CI 68.3; 88.1], 71.2% [95% CI 57.1; 81.4], 60.1% [95% CI 43; 73.6] at the same time points, respectively, and after 4.3 years (maximum follow-up) - 45.6% [95% CI 23.6; 65.2]. HR pre-emptive vs. "on-demand" surgeries 0.296 [95% CI 0.147; 0.592], p=0.0002. In patients who received "on-demand" surgery the risk of AVF function loss was higher (6.268 [95% CI 3.927; 9.49] versus 2.642 [95% CI 1.406; 4.519] 100 patient-years, incidence rate ratio (IRR)=2.372 [95% CI 1.2; 4.842], p=0.0127), the need for central venous catheter also was higher (2,821 [95% CI 2,292; 3.434] versus 1.728 [95% CI 1.38; 2.136] per 10 patient-years, IRR=1.633 [95% CI 1.222; 2.185], p=0.0009), and the number of operations was significantly less (2.963 [95% CI 2,421; 3.59] versus 4.207 [95% CI 3.654; 4.821] per 10 patient-years, IRR=0.704 [95% CI 0.555; 0.89], p=0.0031). The median volume blood flow (Qa) was 2.9 [interquartile range - IQR 1.9; 3.8] l/min, (minimum 1 l/min, maximum 4.5 l/min). Reconstruction in most cases lead to a significant change in Qa (p<0.0001). After reconstruction, the Qa median was 1.8 [IQR 1.6; 2.1] l/min (minimum 1.4 l/min, maximum 2.1 l/min). It is noteworthy that in patients with low Qa values, Qa increased slightly, and at high values, it decreased significantly. However, additional methods of blood flow reducing were not used. The median of the Qa difference was -1.2 [IQR -1.9; -0.2] l/min (minimum -2.7 l/min, maximum 1 l/min). Conclusions: the indication for surgical treatment is not an aneurism itself, but its complications, the risk of complications development or a combined pathology. Preventive surgical interventions can significantly extend the AVF patency and reduce the need for central venous catheters, however, this is achieved by significantly increasing the number of surgeries.

Chronic kidney disease (CKD) occupies a special place among chronic non-infection diseases because it is associated with a deterioration in the quality of life, high mortality and in the terminal stage with the need to use expensive methods of replacement therapy - dialysis and kidney transplantation. The principle of determining CKD was developed for the adult population and, despite the presence of clear recommendations for definition, classification, diagnosis and treatment, there are many unresolved issues for all stages of CKD diagnosis in pediatric patients. The article describes age-related changes in glomerular filtration rate (GFR) in children. The advantages and disadvantages of endogenous and exogenous markers of GFR are detailed. Particular attention is paid to modern methods of measuring of the creatinine and cystatin C concentrations in blood and their standardization. The criteria for definition and classification of CKD, the features of its use in children under 2 years of age are described in detail. The characteristics of the CKD causes in pediatric practice are given. Validated formulas for calculating GFR for pediatric patients with CKD are presented: “bedside” Schwartz equation (2009), Schwartz-Lyon equation (2012), creatinine and creatinine-cystatin C based CKiD equations, as well as screening equations for calculating the GFR for a healthy child population: simple, age-dependent and growth-dependent Q equations, FM (Flanders Metadata) equation, taking into account possible age ranges of their use, advantages and limitations. The sequence of using formulas for a more accurate determination of GFR and the stage of CKD in children is given. The article also describes age-related changes in albuminuria, stages of pathological albuminuria, the assessment of which contributes to predicting the progression and outcome of CKD, serves as a guide to the adequacy of renoprotective therapy. The presented data are aimed to make CKD diagnosis in children on time and accurate grading of CKD and albuminuria stages.

Introduction: the term chronic kidney disease (CKD) is widely used in scientific studies and clinical practice and has generally accepted definition and classification. Acute kidney injury (AKI) has been studied for long time, its criteria have been modified several times. The last KDIGO recommendation was approved by a majority of the international nephrological societies. In 2012, the KDIGO Work Group also proposed the term acute kidney disease and disorders (AKD), defining this condition as a structural damage or damage of kidneys function lasting less than 3 months, including at least one of the following criteria: AKI, a glomerular filtration rate (GFR) <60 ml/min/1.73 m2, a decrease in GFR by ≥35%, an increase in serum creatinine by >50%, or any kidney damage lasting less than 3 months. Subsequently, changes to the conceptual AKD model were proposed. Up to now, the AKD term has remained relatively new not only to clinicians, but also to researchers. In order to study the formation of AKD concept, we performed a scoping review. The following research question was formulated: what definitions and/or criteria of AKD are presented in the published literature? Methods: the scoping review was performed in accordance with the recommendations of the Joanna Briggs Institute (2015) and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search of English-language publications was made by using the PubMed search engine, Russian-language publications were found in the scientific electronic library eLIBRARY.RU. Manual search was performed to find additional publications. The following search queries were formulated: “acute kidney diseas*” (with an asterisk (*) at the end of the string) and “острая болезнь почек”. Screening of publication titles and their summaries was performed in the EPPI-Reviewer 4 Software. Results: 45 articles were included in this scoping review from 443 previously identified publications. The definition and criteria of AKD, first developed by KDIGO, were used in almost half of the literary sources. Authors indicated the definition recommended by the ADQI working group in 2016 in 14 articles. There were used authors’ definitions and criteria of AKD in 11 publications, which in varying degrees differed from the proposed by KDIGO and ADQI. Conclusion: the scoping review demonstrates the lack of a unified conceptual model and a generally accepted definition of AKD. The Review results can be used to raise awareness and continue discussions on this topic in order to obtain consensus.

Typical hemolytic-uremic syndrome is a severe disease of thrombotic microangiopathies. Its pathogenesis is associated with Stx-induced damage to the endothelium and the release of pro-inflammatory and prosclerotic cytokines by activated leukocytes and macrophages. Markers of systemic inflammation, in particular, proinflammatory cytokines and their soluble receptors, may have prognostic value for tHUS as predictors of disease severity. Objective: to determine serum concentrations of TNFα and rTN, IL-6 and rIL-6, IL-10 in children with the acute phase of tHUS and to evaluate their informativeness as predictors of the disease’s severity and duration. Materials and methods: The serum concentration of the above cytokines and their receptors was measured by ELISA in 30 patients in the acute phase of tHUS. The comparison group consisted of 21 children in the follow-up period of tHUS. Results: serum concentration of TNFα and rTNF, IL-6 and rIL-6, IL-10 was significantly higher in children with acute-phase tHUS than in the follow-up group. In the subgroup of patients with severe tHUS, the serum concentration of IL-6 was significantly higher, as well as leukocytosis, the serum concentration of CRP and LDH, and the level of complement component C3 was lower. A statistically significant relationship with tHUS course was found for leukocytosis more than 13.5×109/L (OR 13.75, 95% CI 1.45-130.25), CRP level >9 mg/L (OR 7.80, 95% CI 1.48-41.22), a decrease in C3 <90 mg/L (OR 28.60, 95% CI 2.89-283.07), as well as increase in the level of any of the cytokines IL-6, IL-10, rTNF (OR 7.86, 95% CI 1.41-47.04). Conclusion: prominent leukocytosis and increased CRP level, low C3 level, as well as increased levels of IL-6 and/or IL-10 and / or rTNF in patients with tHUS were statistically significantly associated with the severe course of the disease, which allows us to consider these factors as predictors of the severity of tHUS.

Long-term therapy with corticosteroids of patients with steroid-dependent nephrotic syndrome (SDNS) causes significant side effects. For this reason, patients with signs of steroid toxicity need to alternative immunosuppressive therapy. Currently, there is no consensus about the most appropriate first-line steroid-sparing agent in children with steroid-dependent nephrotic syndrome. This study aimed to investigate the efficacy and safety of mycophenolate mofetil (MMF) compared with cyclosporine A (CsA) in children with SDNS. Methods. We conducted a retrospective analysis of treatment outcomes of patients with steroid-dependent nephrotic syndrome who were treated with CsA and MMF at the nephrology department between 2003 and 2018. The efficacy of reducing the cumulative steroid dosages and time without steroids have been accessed. Results. During the CsA therapy, the maximal duration of remission without steroids was 14 [6; 24] months, the cumulative steroid dosage was reduced from 183.4 [122.9; 216.2] to 63.6 [35.5; 85] mg/kg/year, persistent remission during the year was in 60% of children, mean relapse rates decreased from 2.2 [1.3; 3.6] to 0.7 [0.4; 1.6]. 88.8% of children treated with MMF had no relapses during the time of observation, the maximal duration of remission after corticosteroids withdrawal was 19.69±10 month, steroid dosage decreased from 191.3 [122.4; 241.5] to 46.7 [25.8; 63.6] mg/kg/year. MMF demonstrated similar efficacy, with no adverse effects, while 12% of children receiving CSA were revealed tubulointerstitial changes on repeated nephrobiopsy, in another 12% therapy was discontinued due to hyperazotemia. Conclusion. The effectiveness of MMF as a steroid-sparing agent is comparable to CSA, but a potential nephrotoxicity of CsA allows to recommend mycophenolate mofetil as an alternative to cyclosporine A for the first-line therapy of patients with steroid-dependent nephrotic syndrome.

Relevance: endovascular correction of renal artery stenosis (ECRAS) is currently insufficiently implemented in clinical practice due to the lack of uniform indications and contraindications for intervention and patient management protocols. Today, prediction of the results of ECRAS are also not well understood. Objective: to identify significant predictors of outcomes of endovascular correction of hemodynamically significant renal artery stenosis using methods of univariate and multivariate analysis. Materials and methods: ECRAS results were analyzed in 167 patients (62.93±0.69 years old, from 25 to 82 years old, 44.9% men) who underwent 205 interventions. The observation time was 29.15±1.62 months. Using the methods of univariate (Kaplan-Meier) and multivariate analysis (Cox-regression), the effect of various prognostic factors on the survival of the renal artery (RA) was studied. RA survival was understood as maintaining its patency. The cessation of patency of the RA was observed in the event of hemodynamically significant restenosis or occlusion of the RA. Results and conclusions: patient survival rate after ECRAS was: 1-year-old - 99%, 3- and 5-year-old - 93%, and RA survival: 92%, 90%, and 79%, respectively. According to univariate analysis, significant (p<0.05) predictors of ECRAS results before the intervention were age (over 70 years), multifocal atherosclerosis, glomerular filtration rate (GFR) and stage of chronic kidney disease (CKD), a single functioning kidney; on the third day after the intervention - blood pressure (BP) control group; after 1 month - GFR; after 12 months - GFR, stage of CKD, control group and average blood pressure, number of antihypertensive drugs (AHD). According to multivariate analysis, the significant independent predictors of ECRAS results before the intervention were: the CKD stage and a single functioning kidney, and after 12 months - a single functioning kidney and the number of AHD.

2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides defines polyarteritis nodosa as a medium vessels vasculitis - a necrotizing arteritis of medium or small arteries, and Takayasu arteritis as large vessel vasculitis, often granulomatous, affecting aorta and its primary branches. Polyarteritis nodosa typically affects skin, joints, peripheral nervous system, digestive tract and kidneys. Kidney involvement, observed in up to 60% of cases, includes multiple infarctions, aneurisms formation and glomerular ischemia, clinically presenting mostly with arterial hypertension and decline of kidney function; proteinuria usually absent or mild, but if present - is a hallmark of worse outcome. Takayasu arteritis in more than 50% of cases presents with arterial hypertension due to the narrowing or occlusion of renal arteries and/or aorta, accompanied by the clinical features of skin, joints, muscles, heart, digestive tract and nervous system ischemic damage. Here we present a literature review, including diagnostic criteria and other common features, differential diagnostics, and treatment of polyarteritis nodosa and Takayasu arteritis. We illustrate the review with three cases, two of polyarteritis nodosa and one of Takayasu arteritis with unusual and severe kidney damage - main renal artery aneurism and kidney pseudotumors in polyarteritis nodosa, and secondary focal segmental glomerulosclerosis in Takayasu arteritis, demonstrating diagnostic difficulties and efficacy of immunosuppressive treatment in these rare conditions. All three patients presented with arterial hypertension, reversible decline of kidney function, and multiple systemic signs and symptoms, which we discuss in details in our comments. We also discuss pathology findings; kidney histology study performed after nephrectomy in both cases of polyarteritis nodosa, in the case of Takayasu arteritis kidney biopsy was available.