[A course of chronic glomerulonephritis and constitutional features]. / Techenie khronicheskogo glomerulonefrita i konstitutsioanl'nye osobennosti.

AIM: To evaluate correlations between the course of chronic glomerulonephritis (CG) and the patients' constitution. MATERIAL AND METHODS: 30 men and 33 women with chronic CG were divided into four groups: group 1--chronic latent GN, group 2--chronic nephrotic GN without renal failure, group 3--chronic mixed GN including rapidly progressive GN, group 4--chronic GN with renal failure. Constitution fell into 3 standard types of diathesis: dyscrasic (DD), arthritic (AD), psoric (PD). RESULTS: Most of the patients with chronic GN exhibited prevalence of DD symptoms over AD and PD ones, especially in groups 3 and 4. In less favourable course of GN, DD signs appeared the first, became more and more pronounced while AD and PD were minimal. In a favourable course of GN symptoms of AD and PD were as pronounced as of DD or even more apparent. CONCLUSION: Constitutional characteristics of the patients are essential for the course and prognosis of chronic GN as well as for assessment of GN progression pattern and response to treatment.

[Clinical varieties of chronic glomerulonephritis and psychic characteristics of patients]. / Varianty klinicheskogo techeniia khronicheskogo glomerulonefrita i osobennosti psikhicheskogo sostoianiia bol'nykh.

AIM: To clarify correlations between clinical variants of chronic glomerulonephritis (CGN) and psychic status of CGN patients. MATERIAL AND METHODS: 10 patients with latent nephritis, 17 patients with nephrotic nephritis, 8 patients with mixed nephritis and 7 patients with rapidly progressive nephritis have undergone clinical and psychic examination both in the disease exacerbation and remission. RESULTS: No significant correlations were found between the severity of CGN and severity of mental disorders though it was noticed that with deterioration of CGN the rate of mental deviations grows. This necessitates psychological correction for improving the results of combined treatment of chronic renal diseases. CONCLUSION: Further studies of correlations between somatic and mental status of patients will clarify the effects of mental status on the progress of somatic pathology.

[Course of chronic hepatitis B and C and constitutional characteristics of the patients]. / Techenie khronicheskikh gepatitov B i C i konstitutsional'naia kharakteristika bol'nykh.

The relationship between hepatitis course and constitution assessed by the signs of 3 major diatheses (dyscrasic--DD. arthritic--AD and psoriatic--PD) was studied in 41 patients with HBV infection (low active-25 patients, moderate activity-6 patients, cirrhosis-10 patients) and 62 patients with NCV infection (low active-23, moderate-13, cirrhosis-26). In both infections domination of DD over AD and PD was associated with more severe course of the disease while Ad domination over DD and PD indicated a mild course. It is suggested that constitutional characteristics should be taken in consideration when assessing the course and prognosis of HBV- and HCV-infection.

[The course of peptic ulcer in relation to patients' constitution]. / Techenie iazvennoi bolezni v zavisimosti ot konstitutsional'nykh osobennostei bol'nykh.

Sixty one patients with peptic ulcer (PU) were examined to assess the specific features of its condition in relation to their affiliation to the type of morphological constitution (diathesis). Patients with PU were found to have most commonly dyscrasic diathesis. With predominant dyscrasic diathesis, there were more frequently complications of PU (rough scarring deformations of the gastric or duodenal walls, ulcer bleeding, perforation without clear association with the advance of PU, patient compliance, and the adequacy of antiulcerous therapy. Arthritic diathesis was next to dyscrasic one in its prevalence. Other diatheses (tuberculinic, psoriatic) were encountered much less frequently. Analysis of the diatheses manifested in a patient allows one to predict the course of PU, which is determined not only by the activity and duration of conventional antiulcerous treatment, as evidenced by these studies.

[Treatment of bone disorders in renal diseases]. / Lechenie patologii kostnoi sistemy pri zabolevaniiakh pochek.

AIM: To study possible correction of bone disorders (osteopenia, Ca/P-imbalance, bone pain, limited volume of indolent movements) which are still a serious complication associated with renal diseases and pathogenic therapy (steroids). MATERIALS AND METHODS: The bone disorders were treated in 10 uremic hemodialyzed patients (8 men, 2 women; group 1) with vitamin D3 (calcitriol made in Russia) + rhEPO (recormon; Boehringer Mannheim), in 15 patients (15 women, 0 men) with lupus-nephritis (group 2) with vitamin D3 (n = 5, group 2a) or miscalcic (Sandoz) (n = 10, group 2b), in 2 patients (2 men, 0 women) with glomerulonephritis (group 3) with vitamin D3 + miacalcic. Additionally all the patients received Ca salts. In groups 2 and 3 renal function was normal. The duration of the treatment was 3-6 months. RESULTS: In all the groups we obtained an analgetic effect (attenuation of bone pain and more indolent movements), improvement of life quality, diminished need in analgetics, elevation of serum Ca level (p > 0.05). CONCLUSION: Treatment of renal patients with bone affection with vitamin D3 and miacalcic has an analgetic effect, improves life quality.

[Azoospermia in patients with kidney diseases taking immunosuppressants long term]. / Azoospermiia u bol'nykh s zabolevaniiami pochek, flitel'no prinimavshikh immunodepressanty.

Ten sterile males of reproductive age previously treated with immunodepressants were examined andrologically. Azoospermia in them was treated with zinc sulfate (30-90 mg/day, 2-12 months), which was replaced by clomifen citrate in 6 of them (100 mg/day, 2-6.6 months). The response was recorded only in one male: zinc sulfate administration induced subnormal spermatogenesis improved by clomifen citrate as a result of which the patient became a father. In the rest cases azoospermia did not improve. Testicular biopsy performed in 3 patients detected the absence of cells of spermatogenic epithelium (del Castillo syndrome). The absence of response to stimulating therapy may indicate bad prognosis in azoospermia patients with renal diseases treated with immunodepressants.

[Calcitriol: role in the regulation of erythropoiesis, use in the treatment of renal anemia]. / Kal'tsitriol: rol' v reguliatsii éritropoéza, primenenie v lechenii pochechnoi anemii.

The efficiency of combined therapy (erythropoietin + calcitriol) used in 8 patients with chronic renal failure on programmed hemodialysis was comparatively evaluated with erythropoietin monotherapy employed in 9 patients with the same disease on hemodialysis which represented a control group. The anti-anemia effect was achieved on the average of 5 weeks earlier in the group of patients given the combined therapy than that in the controls. The differences between the two groups were statistically significant in the rate of anti-anemia effect achievement. Possible mechanisms by which calcitriol enhances the anti-anemia effect of erythropoietin, i.e. the mediated effects and direct action of calcitriol on erythropoiesis, are discussed in the paper.

[The efficacy of an erythropoietin-calcitriol combination in patients with chronic kidney failure on programmed hemodialysis]. / Effektivnost' sochetaniia éritropoétin-kal'tsitriola u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu, nakhodiashchikhsia na programmnom gemodialize.

In 8 patients with chronic renal failure (CRF) on hemodialysis combined therapy (erythropoietin+calcitriol) effect was evaluated versus control group of 9 hemodialysis patients on erythropoietin monotherapy. In patients on the combined regimen the antianemic effect occurred sooner, this effect of calcitriol coming prior to correction of uremic defects in phosphoric-calcium metabolism. Calcitriol mechanisms of action in renal anemia and benefits of potential calcitriol+erythropoietin combination use in CRF patients suffering from uremic osteodystrophy, hypercatabolic conditions, uremic hypogonadism and infection complications are discussed.

[The endocrine status of men with lupus nephritis]. / Endokrinnyi status muzhchin s volchanochnym nefritom.

Renal function was assessed in 8 males at reproductive age suffering from lupus nephritis (LN). Normal renal function was registered in 5 patients, hypofunction in 3 males. Endocrinological examinations (evaluation of secondary sexual characters, of hypophyseal and sex hormone profile, sexological questionnaires, spermograms) failed to distinguish significant differences between SLE males and renal patients without SLE suffering from hypogonadism (13 males with uremic hypogonadism, 10 males with azoospermia induced by cytostatics). Endocrinological changes revealed may result from uremia and immunodepressive therapy. In 5 patients these abnormalities were corrected by parlodel and zinc sulfate. The authors came to the conclusion that feminization is not universal in LN males.

[Nephropathy-related disorders of physical and sexual development in girls: experience with successful stimulation by zinc, parlodel and norcolut]. / Sviazannoe s nefropatiiami narushenie fizicheskogo i polovogo razvitiia u devushek: opyt uspeshnoi stimuliatsii tsinkom, parlodelom i norkolutom.

The paper reports 3 cases of physical and sexual retardation in girls aged 14-22 with nephropathy: 1 girl had uremia in a conservative stage, 1 patient was put on a chronic hemodialysis for terminal uremia, 1 girl received a renal transplant. In response to combined treatment (zinc sulfate+parlodel) in the former two patients and norcolute therapy in the latter one body mass and growth increased in all the 3. The discussion is concerned with mechanisms of developmental defects in nephropathies, comparative efficacy of the drugs used and social rehabilitation of nephropathy girls with small height and sexual infantilism.

[The effect of treatment with human recombinant erythropoietin on the functional status of patients on maintenance hemodialysis]. / Vliianie lecheniia rekombinantnym chelovecheskim éritropoétinom na funktsional'noe sostoianie bol'nykh na podderzhivaiushchem gemodialize.

As many as ten patients with terminal uremia on maintenance hemodialysis (MH) performed from 11 to 52 months (28 +/- 4 on the average) were treated with recombinant human erythropoietin (rhERP) manufactured by Cilag (Switzerland). The preparation was injected i.v. in the initial dose 65 U/kg bw thrice a week after each session of MH. If the effect was lacking for 2 weeks, the doze was augmented by 25 U/kg (maximally up to 218 U/kg). Provided the Hb content increased to 100-120 g/l, the maintenance therapy was initiated (108 +/- 13 U/kg). The treatment lasted 17 +/- 2 weeks. As a result, the Hb content in the patients rose from 63.0 to 102.0 g/l, the hematocrit index from 21.2 to 34.4%, the red blood cell count from 2.09 to 3.18 x 10(12)/l; there was a transitory increase of the reticulocyte and platelet counts (from 2.2 to 3.3% and from 172.0 to 284.0 x 10(9)/l) whereas the leukocyte count remained unchanged. It has been demonstrated by the bicycle ergometry data that in addition to the amelioration of the hematological parameters, the patients showed an increase of oxygen consumption at rest, rise of the economy of energy losses at exercise, and a decline of oxygen "cost" of work. According to echocardiography, the patients manifested a reduction of the size of the left heart, of the minute and stroke volumes. In men, the treatment with rhERP brought about libido elevation in the absence of significant alterations in the blood gonadotrophin and testosterone concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pathospermia in patients with glomerulonephritis and rheumatoid arthritis treated by immunodepressants: the possibilities of its correction with zinc and parlodel]. / Patospermiia u bol'nykh glomerulonefritom i revmatoidnym artritom, lechivshikhsia immunodepressantami: vozmozhnosti korrektsii tsinkom i parlodelom.

Two groups of patients aged 16.5-31 years with pathospermia given immunodepressants (IDS) for glomerulonephritis (group I) or rheumatoid arthritis (group II) before and/or at the moment of examination were examined. Five out of 6 patients of group I and all the patients of group II showed azoospermia. As a result of the treatment with zinc (30-90 mg of elementary zinc a day) and parlodel (2.5 mg/day) for 2-23 months, spermatogenesis improved or returned to normal in 2 patients of group I and in 2 patients of group II. It should be mentioned that out of 8 patients who turned out refractory to the treatment, 7 received glucocorticoids and cytostatics (CT) whereas among those who responded to the treatment, only 2 patients out of 4 were given CT. The reported data on the gonadotoxic dose of CT are discussed. The conclusion is made about the necessity of carrying out active treatment policy for pathospermia in patients who received IDS.