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Biomedical subjects

I V Vasilenko

Publications and source records attributed to I V Vasilenko.

At least 55 records · Page 3Linked to original sources

[Substantiation and effectiveness of the use of purine antagonists in gouty nephropathy].

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.

Adult↗

[Clinico-laboratory pattern and effectiveness of glucocorticoid therapy of patients with primary diffuse mesangioproliferative glomerulonephritis].

The paper is concerned with clinico-laboratory correlations and assessment of short- and long-term results of glucocorticoid therapy (GCT) in 137 patients with diffuse mesangioproliferative glomerulonephritis (DMPGN). It may have different clinical variants and is characterized by a relatively favorable course in the first 10 yrs. A good clinical effect of GCT was observed only in some patients with the nephrotic variant of DMPGN in the absence or presence of insignificant fibroplastic changes, and in the absence or presence of the moderate tubulointerstitial component. In patients with a latent variant of DMPGN GCT made no considerable effect on the clinical symptoms of disease. The 15-year survival in patients on GCT was slightly higher (insignificant statistical difference) than that in patients receiving symptomatic treatment only.

Adolescent↗

[Course and prognosis of nephropathy in gout].

Proceeding from the results of a study of 139 patients suffering from primary gout with kidney involvement the authors have defined 4 clinicomorphological types of nephropathy which differed both in their course and prognosis. The I proteinuric type was characterized by early signs of stable proteinuria, sometimes with the development of the nephrotic syndrome in which a morphological study revealed mainly glomerular changes. The II urolithic type was characterized by the appearance of renal colics at the onset of nephropathy, frequently with the passage of concrements (a morphological study revealed mainly tubular and stromal lesions). The III hypertensive type was characterized by the appearance of persistent arterial hypertension (a morphological study revealed mainly vascular and interstitial changes). The IV latent type was characterized by the absence of or a transient urinary syndrome (a morphological study showed mainly interstitial changes). The first signs of renal failure in these types of nephropathy developed, on an average, 7, 15, 11 and 12 years later, the 20-year survival was 24, 92, 68 and 100%, respectively.

Adult↗

[Morphological changes in the kidney glomeruli in gout].

Kidney biopsies from 18 patients with primary gout were studied. Glomerular changes were found in all cases along with alterations in tubuli and vessels and stromal sclerosis. They were characterized by local thickening of basal membranes of capillaries, increase in the mesangial matrix, focal or diffuse proliferation of mesangial and endothelial cells of various degree of severity. Proliferation and activation of endothelial cells, mesangiocytes, podocytes, signs of podocyte damage, were found electron-microscopically. Subendothelial lucid zones were observed in the basal membrane, possibly at the site of uric acid deposits. The above described alterations resemble those in focal mesangio-capillary or mesangial proliferative glomerulonephritis.

Adult↗

[Familial gout].

The authors observed 10 patients from 4 families with hereditarily determined gout and detected some specific features in its course. The familial disease was sex-unrelated, its first signs manifested themselves early acquiring a subsequent severe course; purine metabolic derangement was of a metabolic type, a urolithic form of nephropathy was seldom observed. A morphological picture was characterized by a glomerular lesion looking like focal segmental mesangiocapillary or mesangioproliferative glomerulonephritis with noticeable changes in the tubules, stroma and vessels causing early renal insufficiency. Pathogenetic therapy with uricodepressants made it possible to improve the course of nephropathy. The authors described a pedigree of 3 generations of a family in which gout developed in its 10 out of 17 members, in 6 with chronic renal insufficiency.

Adolescent↗