In this revue a modern view on etiology of Acute Kidney Injury (AKI), mechanisms of its onset, including their classification are presented. Also clinical features of different AKI symptoms, metabolic disorders and their clinical manifestations are described. A number of figures and tables present the algorithms of differential diagnosis of AKI and the list of the most typical nephrotoxic drugs.

The aim of this study was to analyze the efficiency of different kinds of RRT: kidney transplantation (KT), hemodialysis (HD) and CAPD. Retrospective analysis was performed in 2986 patients: 1817 KT recipients, 646 HD patients and 523 CAPD patients. No significant difference was found in the 5-year survival rate between the HD and CAPD patients (44 and 54% respectively, р = 0,19). Age of dialysis patients strongly correlated with the 5-year survival rate. In patients under 50 and older than 50 it was 58 and 25%, respectively, in the CAPD patients and 63 and 28%, respectively, in the HD group. Dialysis patients with diabetes mellitus had significantly worse outcome then non-diabetic patients (р = 0,0029 in CAPD and р < 0,0001 in hemodialysis patients). Age and diabetes mellitus are the risk factors of death in both the renal transplant and the dialysis patients. The late results of KT were significantly better then in dialysis patients in all periods of study. The 5-year survival rate was 83% in KT recipients, 44% in CAPD patients and 54% in HD patients (р < 0,0001).

Potential use of microalbuminuric test for early diagnostics of reflux nephropathy and its follow up was studied in 45 children with vesico-ureteral reflux (VUR). A decrease of renal functions was found in 61% of patients, 21% had hypertension, 14% had proteinuria, and 61% had microalbuminuria. Children with microalbuminuria had stage 2 of chronic kidney disease significantly more often than those without microalbuminuria. Children with most severe renal scarring had highest level of microalbuminuria. High frequency of microalbuminuria allows us to recommend this test for early diagnostics of reflux nephropathy and for monitoring of its progression.

The aim of the work was to study correlation between the treatment efficiency of CML patients with glivec and the initial kidneys filtration rate. 62 patients with chronic or accelerating phase of CML receiving glivec were examined. The efficiency was assessed by achievement of remission and by gaining of cytogenetic reaction. A majority (56%) of patients with glomerular filtration rate (GFR) below 60 ml/min had high risk of CML progress. Patients with initial GFR <60 ml/min had no hematologic reaction to a 6 month long treatment significantly more frequently than those with GFR ³90 ml/min. Complete cytogenetic reaction (CGR) was achieved after 12 months of glivec therapy in 89% patients with initial GFR ³90 ml/min. CGR was not achieved in 92% of patients with initial GFR <60 ml/min. The initial GFR correlates with the risk level of disease progressing on glivec treatment. Glivec toxicity also correlates with the initial GFR.

The aim of this study was to evaluate the relationship between nutritional disorders, kidney dysfunction and severity of asthma. Methods. 109 patients (67 females, 42 males, mean age 50 ± 16 years) with asthma were studied. Asthma severity was classified according to the GINA (2005) guidelines. Nutritive status was estimated by skinfold method. The body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) for each individual were calculated. Hemoglobin concentration, serum creatinine and albumin were measured. Glomerular filtration rate (GFR) was calculated with the Modification of Diet in Renal Disease (MDRD) study equation. Results. BMI was higher in patients with severe asthma, than in those with mild or moderate asthma (28,3 ± 5,6 vs 25,9 ± 4,7 kg/m², respectively, p = 0,02). Patients with severe asthma have higher fat mass (26,2 ± 9,6 vs 19,7 ± 8,5 kg, respectively, p = 0,007), but lean mass (49,6 ± 10,1 vs 52,7 ± 10,7 kg, respectively, p = 0,3) and waist circumference did not differ (101,5 ± 13,4 vs 96,0 ± 13,8 cm, respectively, p = 0,2). GFR was lower in patients with severe asthma, than in those with mild or moderate asthma (88,0 ± 22,6 vs 71,5 ± 19,2 ml/min/1,73 m², respectively, p = 0,006). Hemoglobin concentration correlated significantly with GFR (r = 0,30, p = 0,002), FMI (r = -0,41, p = 0,00002), but not with BMI or FFMI. We conclude that increased total fat mass correlates with chronic kidney disease in patients with asthma. The severity of asthma also correlates with the presence of chronic kidney disease.

The patients of specialized hospitals of the Rostov area have been surveyed to analyse medicinal lesions of kidneys treated with non-steroid anti-inflammatory drugs. At the first stage, anamnesis, clinical features and laboratory parameters were analyzed. At the second stage we analyzed morphological changes in kidney biopsy. At the third stage we developed a forecast system of morphological changes to estimate of the risk of the pathology. 21 patients were surveyed (12 M/9 F). The middle age was 39,5 years. 19 patients (90,5%) had high blood pressure; 8 (38,1%) had edema; 9 (42,9%) had delicacy; 7 ones (33,3%) had nausea; 6 (28,6%) had lumbar pains; 2 (9,5%) had headaches; 4 (19,0%) had the high fever; 10 (47,6%) had polyuria. The duration of the disease varied from 2 months to 22 years. The changes of the laboratory parameters were as follows: 14 people (66,7%) had decreased hemoglobin; 7 (33,3%) had a decrease in erythrocytes; 15 (71,4%) had increased the ESR; 17 (81,0%) had hematuria; 19 (90,5%) had proteinuria; 11 ones (52,4%) had leukocyturia; 11 (52,4%) had decreased urea density in the Zimnitsky test. Changes in urine were found in all patients; 14 patients (61,7%) had renal dysfunction estimated by creatinine level. Morphological changes were found in glomeruli, intersticial tissue, tubules and blood vessels. We have obtained equations which allow one to estimate the risk of the development of pathological changes and developed a system of forecasting the risk of morphological changes due to medicinal kidney lesions treated with non-steroid anti-inflammatory drugs.

Psychopathological features were studied in 116 patients with chronic renal diseases taking into account disease severity and treatment approach (hemodialysis). Influence of psychological disorders on the life quality in patients with chronic renal failure was investigated before and after treatment with psychotropic drugs. Reduction of psychiatric disorders and improvement of life quality were found after complex treatment with psychotropic drugs.

Primary Sjogren’s syndrome (PSS) is an autoimmune disease characterized by lymphocytic infiltration of the salivary and lacrimal glands. PSS is common in adults, especially in middle aged women, but rare in children. The most common form of renal involvement in PSS is a tubulointerstitial nephritis. Renal dysfunction is usually mild or subclinical. Glomerulonephritis (GN) is rare in patients with PSS and most patients have membranous or membranoproliferative GN. We report a 12-year-old girl with PSS who developed a pauci immune crescentic GN. To our knowledge, this association has not been previously described in children.