[Primary mesangiocapillary glomerulonephritis]. / Pervichnyi mezangiokapilliarnyi glomerulonefrit.

The etiology and clinical and histologic features of primary mesangiocapillary glomerulonephritis (PMCGN) are reviewed, as are its management and prognosis. The problem of PMCGN, which is a well-defined disease entity, is shown to be one of major concern for nephrology today. A number of issues concerning the etiology, natural history, morphology, and treatment of this disease remain unresolved or require closer study.

[Substantiation and effectiveness of the use of purine antagonists in gouty nephropathy]. / Obosnovanie i éffektivenost' primeneniia antagonistov purina pri podagricheskoi nefropatii.

Similarity of the morphological picture of gouty nephropathy and primary glomerulonephritides in which purine antagonists turned out to be effective, a positive effect of azathioprine (Az) and 6-mercaptopurine (MP) on purine metabolism, and changes in immunity indices revealed in gout (hyperproduction of immunoglobulins and circulating immune complexes) necessitates the use of antimetabolites in combined therapy of gout patients with proteinuric and latent types of nephropathy. A prolonged use of Az and MP at a daily dose of 50-100 mg often leads to the recovery or improvement of lowered renal function, disappearance of the urinary syndrome, and suppression of hyperuricemia. Uricosuppressors without purine antagonists produce a weaker effect on the course of a renal process, and the treatment of such patients without the use of basic drugs has proved to be utterly ineffective. Strict control over Az and MP therapy makes side-effects of the drugs rare, and they can be easily done away with after reducing a drug dose.

[The effect of pregnancy on the course of different clinical forms and morphological variants of primary chronic glomerulonephritis]. / Vliianie beremennosti na techenie razlichnykh klinicheskikh variantov i morfologicheskikh form pervichnogo khronicheskogo glomerulonefrita.

The author relates the data on the time-course of changes in diurnal proteinuria, diastolic arterial pressure and blood creatinine in 123 patients with primary chronic glomerulonephritis seen during 159 pregnancies. The dependence of the character of those changes on the respective parameters before conception was analyzed as was such a dependence, in part of the patients, on the morphological disease pattern. The rise of proteinuria and diastolic arterial pressure during gestation was seen more often in women with initial diurnal protein losses exceeding 1g and with arterial hypertension that occurred before pregnancy. The rise of blood creatinine before conception was a prognostically unfavourable sign. Mesangiocapillary glomerulonephritis occurring in the gestation period is viewed as less favourable as compared to mesangioproliferative glomerulonephritis.

[The prognosis of the nature of the course and outcome of infectious endocarditis]. / Prognozirovanie kharaktera techeniia i iskhoda infektsionnogo éndokardita.

Prognostic significance of various clinical and laboratory indices for predicting the course and outcome of infectious endocarditis (IE) has been analyzed for 139 IE patients aged 15-68 (77 males and 62 females). The unfavourable prognosis was associated with uncontrollable sepsis, persistence of circulating immune complexes and developing glomerulonephritis. The latter had also prognostic signs unfavourable for IE: moderate or severe proteinuria and/or cylindruria, reduced renal function, diffuse proliferation, pronounced extracapillary and/or tubulointerstitial components.

[Minimal change glomerulonephritis in adults]. / Glomerulonefrit s minimal'nymi izmeneniiami u vzroslykh.

Glomerulonephritis with minimal alterations presents one of the most complex problems of nephrology. The authors provide the data on the disease incidence and clinico-laboratory correlations in 33 adult patients, discuss problems of the treatment policy.

[The clinico-morphological characteristics and treatment of minimal-change glomerulonephritis and focal-segmental glomerulosclerosis-hyalinosis]. / Kliniko-morfologicheskaia kharakteristika i lechenie glomerulonefrita s minimal'nymi izmeneniiami, fokal'no-segmentarnogo glomeruloskleroza-gialinoza.

Clinical and morphological features were analysed of the morbid condition in 46 patients with glomerulonephritis presenting with minimal alterations (GNMA) and 12 those with focal-and-segmental glomerulosclerosis-hyalinosis (FSGH), of whom there were twenty nine males and twenty nine females ranging between 15 to 54 years. In all cases morphologic diagnosis was established on the basis of vital histologic investigation of renal tissue. Immediate results were assessed of glucocorticoid and cytostatic therapy instituted at different stages of the condition. High effectiveness was documented of glucocorticosteroids in GNMA patients along with the ability of cyclophosphamide to significantly decrease the frequency of exacerbations and make such patients free from steroid dependency. GSGH patients derived no benefit from glucocorticoids while cyclophosphamide was associated with complete GH patients azathioprine therapy had no positive effect on the course of the illness.

[The clinico-morphological characteristics of glomerulonephritis in infectious endocarditis]. / Kliniko-morfologicheskaia kharakteristika glomerulonefrita pri infektsionnom éndokardite.

Clinicomorphological characteristics of glomerulonephritis in infectious endocarditis (IEGN) were studied in 62 patients (with samples of autopsy material being used in 52 instances). IEGN presents with dissaminated and focal proliferative alterations involving extracapillary and/or tubulointerstitial components, and is characterized by a broad variability of indices for proteinuria, hematuria and cylindruria. In diffuse prolipherative glomerulonephritis the degree of proteinuria and cylindruria appear to be significantly higher than in focal segmental proliferative glomerulonephritis, as is the incidence rate of development of renal insufficiency and its gravity.

[Clinical aspects and treatment of primary focal segmental glomerulosclerosis and hyalinosis]. / Klinika i lechenie pervichnogo fokal'nogo segmentarnogo glomeruloskleroza i gialinoza.

The authors studied the clinico-laboratory values and efficacy of pathogenetic treatment in 8 patients with primary segmental glomerulosclerosis and hyalinosis (PSGH). The disease is characterized by distinct disorders in the T-system immunity. Glucocorticoid treatment did not essentially effect the course of PSGH. Cyclophosphane treatment allowed to achieve essential stable clinical improvement in certain patients.

[Clinico-morphologic comparisons in primary diffuse mesangio- proliferative glomerulonephritis]. / Kliniko-morfologicheskie sopostavleniia pri pervichnom diffuznom mezangioproliferativnom glomerulonefrite.

Data are reported of a clinical and morphological including electron microscopical study of 132 patients with primary diffuse mesangioproliferative glomerulonephritis (DMPGN). A comparison of morphological signs using methods of non-parametric statistics revealed a complex dependence between glomerulosclerosis and sclerosis of the stroma, tubular atrophy and dystrophy; sclerosis of stroma and its cellular infiltration. Comparison of morphological aspects and clinical manifestations of DMPGN allowed to establish that development of disorders of partial functions of the kidneys has a complex genesis as evidenced by dependence of disorders on the presence and severity of glomerulosclerosis, stroma sclerosis, tubular atrophy and frequency of crescents/microcrescents.