Among mechanisms which define the time course and an outcome of the kidney diseases the mostly interesting has been such processes as the formation of cellular inflammatory infiltrate, the release of inflammatory cytokines, eicosanoids, oxygen radicals, activation of complement cascade and others. However, the balance between local offense factors and the defense machinery determines the fate of tissue injury (its prolongation or resolution); that has a special interest for understanding of kidney diseases progression. This review outlines how the kidney, when faced with injurious cells oris exposed to pathogenic mediators, defends itself via intrinsic system of various protective molecules, which counteract the damage on multiple levels (intracellular, extracellular, cell-surface). Some of the protective factors are expressed in kidney constantly (constitutive defense), and local synthesis of others is amplified in response to environmental perturbation (inducible defense). In the review the role of some defense factors are considered in detail (cytokine inhibitors, anti-inflammatory cytokines, protein inhibitors, lipoxins, and the heat shock proteins). The results of effective application of some defense molecules in experimental models of glomerulonephritis are presented. This approach has a special interest as a perspective therapeutic direction in human progressive kidney diseases.

Acute kidney injury (AKI) is a common, serious, costly and deadly disease involving critically ill patients. Over the last decade, the attention of researchers and clinicians was focused on the search for biomarkers AKI which are potent for early and adequate monitoring of impaired kidney function, necessary for the timely initiation of renal replacement therapy and improve prognosis. In the review we present the results of the application of modern AKI biomarkers in clinical practice in various categories of patients with AK. The authors summarized the results of the use of evidence-based studies employing applying modern statistical methods (AUC-ROC) to assess their information content, meta-analysis to evaluate the clinical utility of the AKI markers and prospects for their further use.

The review is devoted to organ and tissue changes of the oral cavity at the chronic renal insufficiency (CRI). The number of patients at the end-stage of CRI constantly increases and the patients receiving renal replacement therapy including hemodialysis, peritoneal dialysis or renal transplantation will comprise an enlarging segment of the dental patient population. Owing to CRI and its treatment there is a set of changes of teeth and oral cavity fabrics which remain even in an end-stage. Renal replacement therapy can affect periodontal tissues including gingival hyperplasia in immune suppressed renal transplantation patients and increased levels of bacterial contamination, gingival inflammation, formation of calculus, and possibly increased prevalence and severity of destructive periodontal diseases. Besides, the presence of undiagnosed periodontitis may have significant effects on the medical management of the patients in the end-stage of CRI.

The paper presents the summary of various data related to physical rehabilitation in transplantation. An increase of the number of cases which require organ transplantation and its quantity extension has been noticed. The role of physical rehabilitation in gradual adaptive reserves of the body before and after the transplantation in improvement of life quality has been noted. The article shows the importance of additional methods of research for allowance for physical trainings and sports for the patients, the need of individualization while choosing the dosage of physical trainings sand engagement of the attending transplantology doctor in the forming of the program of such remedial gymnastics.

The nephrological manifestations of the «early» and «late» pre-eclampsia (PE) in relation comparison with the markers of placental angiogenesis: VEGF and sFlt-1 are presented. It was found that women with «early» PE with gestation age of Me 32 [29; 34] weeks had higher rates of blood pressure (the mean systolic BP was 170 ± 16,8 mm Hg vs. 156 ± 6,56 mm Hg and the mean diastolic BP of 105 ± 8,9 mm Hg vs. 99 ± 6,9 mm Hg). They 4 times more often showed renal dysfunction as manifested by a decrease in the glomerular filtration rate (Ме 70 [51; 80] ml/min) or an increase in serum creatinine (Ме 90 [78; 102] mol/l), 7 times more often developed nephrotic syndrome and a three-fold excess of sFlt-1 as compared with the patients developed a «late» PE-gestation age Me 38 [36; 39] weeks. An inverse correlation was found between GFR and sFlt-1 (rs = –0,42; р = 0,050) and direct correlation between GFR and VEGF (rs = 0,47; р = 0,038) among women with preeclamptic pregnancies. The role of the imbalance of placental angiogenesis markers in the formation of proteinuria, hypertension and renal disfunction are discussed, and the contribution of thrombophilia to the development of the PE is considered.

Urinary NGAL levels may be a valid predictor of acute kidney injury (AKI) and cardiac surgery outcomes. The aim of the study was a comparative evaluation of urine NGAL and factors in cardiovascular surgery as a predictor of adverse outcome AKI in elderly patient after cardiac surgery. A prospective cohort study was performed in 81 patients 65 to 80 years. Researching material was urine from catheter immediately before surgery and 4 hours after cardiac surgery. Analysis of NGAL in urine was performed by quantifying immuno-hemilumiscest method. In a result ROC-analysis showed that the level of postoperative urinary NGAL is an early marker of AKI after cardiac surgery in elderly patients (AUC 0,75; 93% CI 0,60–0,90). The time of surgery and cardiopulmonary bypass are the main factors in predicting dialysis-dependent AKI (AUC 0,86, 95% CI 0,75–0,97; AUC 0,85, 95% CI 0,75–0,95, respectively). Urinary NGAL is a useful predictor of duration RRT above 5 days in elderly patients undergoing cardiac surgery with AKI (AUC 0,89, 93% CI 0,64–1,0). Determination of urinary NGAL may be useful in predicting death in the postoperative period of cardiac surgery in elderly patients (AUC 0,82, 94% CI 0,69–0,95).

A review of current classification of amyloidosis, pathogenesis and clinical settings in the most common and rare variants of systemic amyloidosis, and cases of AH-amyloidosis in patient with lymphoplasmacytic lymphoma, AL-amyloidosis in patient with Castleman’s disease and AA-amyloidosis in patient with hyper-IgD-syndrome are presented.

The paper describes a rare clinical case of a patient with tubulointerstitial nephritis with uveitis (TINU syndrome). Specific features of natural history of the tubulointerstitial nephritis in the TINU syndrome and its clinical manifestations are discussed as well as approaches to its diagnosis. We also discuss the causes, pathogenesis, diagnosis and treatment of the TINU syndrome.

We report a case of recurrent atypical hemolytic uremic syndrome presented in pancreas injury. The possible interactions between the thrombotic microangiopathy and occurrence of acute pancreatitis are discussed.

The case report describes paraneoplastic nephropathy in a patient with three cancer tumors of different localizations (lymphoma, renal carcinoma, lung cancer). Clinical peculiarities and diagnostic difficulties are described.