[Annexin-5 as a biochemical marker of early vascular disorders under chronic disease of kidneys].

The study evaluated the significance of annexin-5 as a biochemical marker of atherosclerosis in patients with chronic disease of kidneys. The sample consisted of 46 patients with chronic disease of kidneys without clinical symptoms of atherosclerosis. The indicators of lipidogram, intima-media complex of carotid artery reactivity of vessels of microcirculatory channel and concentration of annexin-5 are determined. The decrease of velocity of glomerular filtration is accompanied by the increase of concentration of annexin-5 related to indicators of lipidogram. The increase of concentration level of annexin-5 is accompanied by the most expressed dysfunction of endothelium. The increase 3a level of annexin-5 in blood of patients with chronic disease of kidneys is especially informative in case of lacking of clinical symptomatic of atherosclerosis and it testifies the presence of vasomotor endothelial dysfunction. The dynamic detection of concentration of annexin-5 can ameliorate the prognosis of possibility of development of cardio-vascular complications under diseases of kidneys.

[Endothelial dysfunction and apoptosis at early stage of chronic kidney disease].

AIM: To study changes in apoptosis and endothelial function in patients with chronic kidney disease (CKD) stage I-IIIb (CKDsI-IIIb). MATERIAL AND METHODS: A complex of biochemical, enzyme immunoassay and device investigations was used to examine 128 patients with CKDsI-IIIb. RESULTS: In CKD stage I reduction of endothelium-dependent vasodilation (EDV) was detected in 34% patients, in stage II -- in 52 %, in stage IIIa -- y 52 %, in stage IIIb - in 70%. An EDV decrease was associated with glomerular filtration rate (GFR), a homocysteine level and hemodynamic factors. Elevation of endothelin-1 (ET-1) level was seen in CKDsI in 41 %, in CKDsII - in 54 %, in CKDsIIIa - in 70 %, in stage IIIb - in 83% patients. A negative correlation was observed between the level of ET-1 and GFR and positive - with diurnal proteinuria. A significant rise of annexin A5 concentration versus normal was detected as early as in CKDsI (1,14 +/- 0,68 ng/ml). In CKDsII annexin A5 was 2,61 +/- 0,75 ng/ml, in CKDsIIIa - 3,75 +/- 0,93 ng/ml and in CKDsIIIb - 5,16 +/- 1.01 ng/ml. Negative correlations were found between annexin A5 level and GFR, a maximal growth of volumetric blood flow rate in skin vessels in the acetylcholine test, positive correlations with systolic blood pressure, body mass index. CONCLUSION: The levels of ET-1 and annexin A5 are factors having an independent impact on EDV in patients with CKDsI-II.

[The level of endothelin-1 and reactivity of skin microvessels in patients with early stages of chronic kidney disease].

AIM: To evaluate endothelin-1 (ET-1) levels and to characterize reflex vasomotor reactions of skin vessels in distant exposure to cold in patients with chronic kidney disease (CKD) of stage I and II. MATERIAL AND METHODS: Glomerular filtration rate (GFR) was calculated by MDRD formula for 40 healthy subjects (mean age 39.2 +/- 2.0 years) and 147 CKD patients (mean age 41.4 +/- 1.8 years). All the patients were also exposed to the cold test (a modified variant). RESULTS: Patients with CKD stage I demonstrated a 35.1% fall in blood flow rate (Qas) in response to cold stimulus, patients of stage II--a 42.2% fall, healthy patients--a 19.3%. CKD patients of stage I and II retained a Qas fall for 3 min after exposure to cold, while healthy subjects resumed skin blood circulation immediately after exposure to cold. Blood plasma ET-1 concentration in healthy subjects was 0.239 +/- 0.055 fmol/ml, in stage I CKD patients--0.334 +/- 0.066 fmol/l, in stage II CKD patients--0.422 +/- 0.041 fmol/l. Relationships were found between ET-1 level and GFR (Rs = 0.242; p < 0.05), 24 h proteinuria (Rs = 0.375; p < 0.003) and Qas% in the cold test (Rs = -0.389; p < 0.003) as well as time of recovery of the background Qas (Rs = -0.311; p < 0.003). CONCLUSION: Dysfunction of autonomic nervous system at early stages of CKD may arise by means of activation of ET-1 synthesis in response to enhancement of sympathetic impacts.

[The practical experience of quality control organization in the laboratory of Municipal consultative diagnostic center 1 of St. Petersburg].

The article specifies the functioning of quality control system in the laboratory of Municipal consultative diagnostic center i 1 of St. Petersburg. Initially, on the basis of interpretations of biological variations of every analyte, the requirements to analytical quality are developed. Subsequently, the actually attainable reproducibility of measurements and their bias is examined. The real analytical characteristics of 27 biochemical analytes are presented. The aggregate laboratory ratings are quoted based on the results of involvement in three EQAS programs since 2005, concerning biochemistry, immunochemistry and hematology. The important quality of laboratory research on its analytical stage is maintained by the interaction between inter-laboratory and regular external control.

[Evaluation of D-dimer in outpatients: clinical value and specific features].

D-dimer as an activation marker of coagulation and fibrinolysis is a recognized diagnostic criterion of deep vein thrombosis, pulmonary thromboembolism, and disseminated intravascular coagulation. In recent years, this laboratory test has been most frequently used for other purposes: to detect the activation of coagulation, to predict the course of diseases, and to determine the duration of anticoagulant therapy. Our investigation examined 1514 D-dimer measurements in 1370 outpatients without acute abnormalities, including 72 patients receiving warfarin and 32 patients after myocardial revascularization. 36.1% of cases were found to have values of more than 0.5 mkg/ml. Adequate anticoagulant therapy (INR 2-3) caused a reduction in the level of D-dimer that is an important additional laboratory test for the evaluation of antithrombotic defense. Further investigations are needed to determine cutoff values for various clinical situations.

[Possibility of determining the urinary content of albumin by capillary electrophoresis].

An assay has been developed to determine urinary albumin by capillary electrophoresis. The detection limit for albumin is 6.0 mg/l; its correlation coefficient is 5.3%; the calibration dependence is linear in the range of albumin concentrations of up to 150 mg/l. The findings are in good agreement with the results of immunoturbidimetry (r = 0.996). In addition of albumin, the proposed procedure can detect the presence of other proteins in urine.

[Epidemiology and risk factors of chronic renal diseases: a regional level of the problem].

AIM: Assessment of chronic renal disease (CRD) prevalence and morbidity rate and approaches to early CRD in one of the regions of the RF (Tyva Republic). MATERIAL AND METHODS: A population study in the Tyva Republic performed from 01.07.2003 to 30.06.2004 included patients with glomerular filtration rate (GFR) < 30 ml/min, nephrosclerosis signs at autopsy, terminal GFR < 30 ml/min, on replacement renal therapy (RRT). CRD prevalence and morbidity were estimated (stage IV-V). Examination of 374 Tyva citizens was made for estimation of early CRD and risk factors of developing CRD (the sectional study). The participants of the sectional study were examined clinically and biochemically with measurement of albuminuria, calculation of urine albumin/creatinine (ACR) and study of some molecular-genetic characteristics. RESULTS: Prevalence of CRD stage IV-V in Tyva population was 493 cases per million, prevalence of RRT--126 cases per million. Elevated ACR was found in 4.7% of healthy subjects and 15.9% of hypertensive subjects. Initial lowering of GFR occurred in some healthy subjects and in 1 of 12 hypertensive patients. Significant predictors of albuminuria were serum albumin concentration (p < 0.00001), GFR (p < 0.0002), a male sex (p < 0.004), diabetes mellitus (DM) (p = 0.0057) and left ventricular myocardial mass index (p = 0.0253). GFR depended significantly on age (p < 0.000001), male sex (p < 0.000001), uric acid concentration in the serum (p < 0.000001), presence of DM (p = 0.000019), ACR (p = 0.0059), diastolic pressure (p = 0.0347), triglyceridemia (p = 0.0369). Citizens of Tyva had more frequently than citizens of other regions of Russia IlI-genotype of angiotensin 1-converting enzyme (ACE) (p < 0.0001), T-allele of methylentetrahydrofolatereductase (p < 0.0001), E3-allele of gene of apoprotein E (p < 0.0001). Prevalence of aa, ab, bb genotypes of eNO-synthetase was 82.3%, 15% and 2.7% in the group of Tyva examinees vs 62, 31 and 7% in European Russians (p < 0.01). CONCLUSION: Prevalence of both early and advanced stages of CRD among population of Tyva Republic is rather high. CRD morbidity may depend, besides conventional risk factors, some genetic specific features. Screening studies require continuation for early detection of CRD and timely planning of therapeutic and preventive measures.

[Prognostic value of some biochemical and immunologic factors in the management of multiple myeloma]. / Prognosticheskaia tsennost' nekotorykh biokhimicheskikh i immunologicheskikh faktorov pri mnozhestvennoi mielome.

The results of examination of 58 patients in the course of multiple myeloma (MM) are discussed. Prognosis for LDH, beta2-m and FNO-alpha administration was evaluated versus immunochemical pattern, tumor mass and response to different chemotherapeutic regimens. High prognostic value of serum levels of LDH, beta2 and FNO-alpha in MM patients was observed. The method may be useful in carrying out chemotherapy and detecting recurrences and chemoresistance.

[Antiphospholipid activity of the blood in patients with ischemic heart disease and thrombogenic complications]. / Antifosfolipidnaia aktivnost' krovi u bol'nykh ishemicheskoi bolezn'iu serdtsa s trombogennymi oslozhneniiami.

The authors propose a method of estimating antiphospholipid activity of blood by phospholipids (PL) assays in circulating immune complexes (CIC). Screening of PL in CIC is an additional test in examination of patients with ischemic heart disease associated with thrombogenic complications and suspected antiphospholipid syndrome.

[Semiautomatic potentiometric titration of gastric juice]. / Poluavtomaticheskoe potentsiometricheskoe titrovanie zheludochnogo soka.

Using commercial equipment manufactured in this country, the authors have assembled a unit for semiautomatic potentiometric titration and developed a method for such titration, permitting a rapid determination of free and bound HCl and the total acidity of the gastric juice. The equipment and method are recommended for wide use at laboratories of therapeutic institutions, of biologic factories manufacturing medicinal commercial gastric juice, and of research institutes.