The second part of the report of the Russian Renal Replacement Therapy Registry is dedicated to peritoneal dialysis and kidney transplantation. It covers period from year 1998 to year 2011. The data on the availability of the kidney replacement therapy on the national and regional levels are presented. Optimization of individual patient treatment is discussed on the basis of incidence, prevalence, survival, mortality, and quality of treatment indicators.

In the review the capacity of dietary control of hyperphosphatemia in patients with CKD on dialysis and at predialysis stages of nephropathy are discussed. The review mainly focuses on the food with a low ratio of phosphate to the protein (Pi/P, mg/g), the role of food additives and drugs in the reduction of phosphate adsorption in the gastrointestinal tract.

The review presents up-to-date data about genetic heterogeneity of steroid-resistant nephrotic syndrome in children including sporadic cases and inherited syndromes with kidney involvement. Different spectrum of genes associated with pediatric steroid-resistant nephrotic syndrome is manifested depending on the age of onset, family history of disease, histological types and the presence of typical extra-renal signs. The genotype-phenotype associations and potential link with efficacy of immunosuppressive treatment of steroid-resistant nephrotic syndrome in children are discussed.

Currently, continuous renal replacement therapy is widely used method for the treatment of acute kidney injury. Dialytrauma caused by negative side effects of continuous renal replacement therapy can significantly counteract its advantages. The main side effects of continuous renal replacement therapy both from the membrane mass transfer and from the extracorporeal circuit are reviewed. The main approached for the prevention and treatment of various dialytrauma types are outlined.

The purpose of the study was to assess the structure and complications of permanent vascular access in patients on chronic hemodialysis, to calculate the five-year cumulative patency of arteriovenous fistulas (AVF) of various types and to determine the most preferred vascular access. Materials and methods 521 medical cases have been analyzed; 306 patients were at ESRD, 408 had permanent vascular access (PVA) formed between January 2000 and December 2011. Three groups were selected: group I of 307 patients with distal AVF; group II of 55 patients with proximal autovenous AVF (PAVF); group III of 46 patients with proximal AVF using synthetic vascular prostheses (AVG) was divided to subgroups IV and V. Results The structure of primary permanent vascular access (PVA): AVF - 87.8 %, PAVF - 6.8%, AVG- 5.4%. Secondary PVA: PAVF - 31.5%, AVG - 24.7%, AVF - 43.8%. Tertiary PVA: PAVF - 45.8 %, AVG - 45.8%, AVF - 8.3%. Patients of I group had 136 complications: 123 thrombosis (26 reconstructions, 22 thrombectomy), 3 aneurysms (resection), 6 stenosis (reconstruction), 4 insufficiency of blood flow, ligation of tributaries. Patients of group II had 26 complications: 23 thrombosis (10 thrombectomy), 2 aneurysms (resection), 1 case insufficiency of blood flow (ligation of tributaries). Patients of group III had 48 complications: 36 thromboses (26 thrombectomy, 1 reconstruction), 4 false aneurysm (resection), 6 cutaneous fistulas (excision), infection 2 (removal of the prosthesis). Cumulative fistula patency after 61 months: I gr. 37,79 %, II gr . 37,08%, III gr. 24,73%, IV gr. (brachial - subclavian AVG) 33,94%, V gr. (lower arm loop graft ) after 43 months - 0% . Conclusions: Among the primary vascular access the distal one dominated while for the secondary and tertiary access proximal arteriovenous fistulas dominated. The most frequent complication during the use of AVF fistula was thrombosis. The distal AVF and PPF have the best five-year cumulative patency.

We have established the prevalence, etiology and evaluated physical development of children with chronic renal failure (CRF) in the Voronezh region. Twenty-one children with CRF (3-5 stage chronic kidney disease, CKD) were analyzed in 2012 (13 boys, 8 girls). The mean age of patients was 11.0±4.8 years (from 8 months to 17 years). The prevalence of CRF (CKD 3-5 stage) was 56.7 per million age-related population (p.m.a.r.p.), it was higher in Voronezh than in children living in rural areas (76.6 and 43.7 p.m.a.r.p., respectively, p<0.05). The main causes of CRF were congenital anomalies of kidney and urinary tract and hereditary nephropathies (n=13; 61.9%), mostly obstructive uropathies (n=6; 46.2%). Analysis of physical development of children with CRF showed that the children growth decreased with the progression of CKD from the 3rd to the 5th stage. We found the relationship of physical development in children with etiology of CKD: height and weight were lower for congenital and hereditary diseases.

We report a case of atypical haemolytic uremic syndrome with chronic course: slow progression of chronic renal failure, resistant arterial hypertension and stable hematologic parameters during 9 years after the first manifestation. After the initiation of eculizumab therapy hypertension resolved and renal function partially improved. A new term «subclinical thrombotic microangiopathy» is suggested for the definition of this variant of aHUS. The possibility of subclinical course of thrombotic microangiopathy due to thrombotic occlusion of renal microcirculation in aHUS as well as diagnostic methods and treatment options are discussed.

Article describes chromophobe renal cell carcinoma and multiple renal cysts in a young patient with tuberous sclerosis complex in the absence of the typical for this disease central nervous system and other organs lesions. Key symptoms of the disease, variants of renal damage and prospects for treatment are discussed.

The article discusses the about problem of kidney cancer and a case of kidney cancer in a patient on dialysis, clinical features and diagnostic difficulties.