[Enzymotherapy in urology and nephrology (a review of the literature)].
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Biomedical subjects
Publications and source records attributed to L A Pyrig.
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A study was made of the effect of the treatment with glucocorticoids (GC), cyclophosphamide and indocide on the prekallikrein-kallikrein system (PKKS) of the blood in 108 patients with glomerulonephritis. It was revealed that in patients with acute and chronic GN, the PKKS was activated before treatment. The PKKS activation was marked by a decrease in the content of prekallikrein and elevation of the alpha 2-macroglobulin content, particularly in patients with the nephrotic syndrome. The efficacy of GC therapy was more pronounced the higher the basic activation of the PKKS. The clinical effect of indocide and cyclophosphamide did not depend on the initial characteristics of the PKKS.
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The results of integrated estimations of a complex of lipid indices are presented. Their abnormalities are considered to be atherosclerosis risk factors in the evolution of glomerulonephritis and its different variants, types and stages. The quantitative and qualitative peculiarities of the indicated abnormalities are revealed, in particular, their major expressiveness in chronic form, nephrotic variant and in the stage of renal failure. Two aspects of correction of actual abnormalities are singled out: 1. indirect, i.e. treatment of the renal pathologic process with preparation of pathogenetic therapy (glucocorticoids, indomethacin), and 2. direct, i.e. with medications exerting a corrective influence on lipid metabolism (clofibrate, nicotinic acid, curantil). The selection of corrective methods is determined by the stage of disease and by the character of the changes in lipid metabolism.
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Results of complex and integral investigations dedicated to the study of laws of glomerulonephritis evolution are presented, including retrospective analyses, statistical data, and longitudinal observations according to clinical, functional, immunological and morphological indices. The most important factors (etiology, variant, prolonged course, hypertension, morphological type, relative percentage of involved glomeruli) determining the evolution of acute and chronic forms of glomerulonephritis, such as clinical type, variant, morphological type, relative percentage of involved glomeruli, are pointed out. Further determining factors are sex, age of the patients, irrational treatment, intercurrent infections and nidi. The authors believe that the evolution of glomerulonephritis is determined by the state of the immune system and also by metabolic and functional disturbances.
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