[Blood volumes in patients with chronic glomerulonephritis].
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Biomedical subjects
Publications and source records attributed to A I Diadyk.
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The efficiency of frequent asynchronous transesophageal electrical stimulation (TEES) of the left atrium in atrial flutter of various origin was analyzed in 62 patients. It was found to be depended on the etiology and duration of arrhythmia and on the frequency of atrial waves. The best results were obtained in patients with postmyocardial cardiosclerosis and coronary heart disease in acute arrhythmias and at a low (less than 300 per min) frequency of flutter waves.
Upon the analysis of qualitative and quantitative characteristics of hematuria in renal and urinary tract affections it was established that whatever the red blood cell count in the urine, hematuria is primarily glomerular in contrast to nonglomerular in chronic glomerulonephritis and nonglomerular diseases of the kidneys and urinary tracts, respectively. Morphologic studies of urinary red blood cells using phase-contrast microscopy proved a valuable tool for identification of hematuria origin.
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The authors analyze the course and outcomes of 33 pregnancies in 26 women suffering from systemic lupus erythematosus (SLE). In patients with active SLE the incidence of gestoses and abnormalities of the newborns is significantly higher than in those with inactive SLE, whose gestational and neonatal complication rate is almost the same as in healthy women. Pregnancy course and outcomes are particularly unfavorable in cases with lupus glomerulonephritis.
The authors studied the content of beta 2-microglobulin (beta 2-MG) in the blood serum and its excretion with the urine in 85 patients with chronic and 35 with lupoid glomerulonephritis (CGN and LGN) depending on the activity of the disease and state of the renal function. In active CGN and LGN one could observe a distinct increase of the content of beta 2-MG in the blood serum and an increase of its excretion with the urine that may be related to presence of marked dystrophic changes of the canalicular apparatus of the kidneys leading to disorders of reabsorption and beta 2-MG catabolism as well as disorders of the immune homeostasis revealed in these diseases. Results indicate that the beta 2-MG levels in the blood serum and urine may be considered as criteria of CGN and LGN activity.
The efficacy was studied of using allopurinol in 68 patients with primary podagra. The obtained results were compared with the treatment of 118 other patients who received similar treatment but without allopurinol (zanthinoxidase inhibitor). Allopurinol increased essentially the efficacy of therapeutic measures though positive dynamics concerning the renal process was achieved in 1/3 of patients.
The study of urinary sediment is essential in laboratory diagnosis. Conventional clinical methods are now used in line with computer-aided techniques and additional microscopy of the sediment elements. The paper provides a brief analysis of clinical situations characterized by appearance in the urine of abnormal numbers of leukocytes, erythrocytes, casts; provides clinical assessment of additional microscopic methods able to accentuate qualitative characteristics of the urinary syndrome; considers possibilities of application of the urinary sediment data in follow-up to improve diagnosis and control on-going treatment.
As many as 96 patients with chronic glomerulonephritis (CGN) and 25 with lupus glomerulonephritis (LGN) were examined for chromosomal aberrations (CA) in peripheral blood lymphocytes in different clinical variants and morphological forms of CGN and LGN as well as for their dynamics under the influence of cytotoxic drugs. In patients with active CGN and LGN, chromosomal instability may develop. The treatment with cyclophosphamide in a dose of 2.0-2.5 mg/kg/day appreciably increases chromosomal instability the level of which rises progressively with the treatment period increase. The treatment with azathioprine in a dose of 1.5-2.0 mg/kg/day is not associated with a noticeable increment of the rate of CA. The studies of the level of CA can be used for estimating CGN and LGN activity. Chronic renal failure did not change the level of CA either in CGN or in LGN. In different morphological forms of glomerulonephritis, the rate of CA was determined by the clinical variant of the disease. In order to reduce potential complications provoked by the treatment with cytotoxic drugs, dynamic studies of the CA rate should be carried out in addition to the conventional tests.
An analysis was made of some immunological indices in patients with podagra. It was established that women showed a more pronounced reduction of T-lymphocytes in the peripheral blood and their functional activity in tests with phytohemagglutinin and concanavalin as well as a deficit of B-lymphocytes, hyperproduction of C-immunoglobulin and antibodies to DNA in the blood serum. Males showed an increased level of B-lymphocytes. M-immunoglobulin and antirenal antibody titers. The concentration of circulating immune complexes in the blood rose equally independent of age.
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Diurnal Holter ECG monitoring (HM) was used to examine 53 patients with different cardial pathology accompanied by syncopal conditions whose arrhythmogenic genesis was confirmed by long recording of the ECG. Based on the results of comparing the cardiorecorder readings and the diaries of patients' subjective sensations, the authors have demonstrated HM and thorough anamnestic studies to be highly significant in the diagnosis of the syncopal syndrome.
Results are presented of an investigation of birefracting fatty bodies in the urine of patients with primary chronic lupoid and Henoch glomerulonephritis. There was a close correlation between the presence of birefracting fatty bodies and severity of glomerulonephritis independent of the morphological picture of the disease and state of renal function. Reduction of the activity of the disease in the course of pathogenetic treatment characterized by a decrease or disappearance of proteinuria was accompanied by a distinct reduction of the level of birefracting fatty bodies or their disappearance.
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The total and fractional content of blood bile acids (BA) was studied by the method of thin-layer chromatography and rheohepatography was performed in 87 patients with rheumatic mitral disease (mitral stenosis and associated mitral heart disease with prevalence of stenosis). There was a direct dependence between the degree of clinical and rheohepatographic signs of disorders of the hemodynamics and increase of the level of serum BA, a more pronounced therapeutic effect with normalization of BA, concentration in the blood after complex treatment using hepatotropic drugs than with use of traditional drugs (non-steroid antiinflammatory, cardiac glycosides, diuretics and others.).
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.