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T N Krasnova

Publications and source records attributed to T N Krasnova.

At least 19 recordsLinked to original sources
PubMed2002

[The course and prognosis of mesangioproliferative glomerulonephritis].

AIM: A retrospective analysis of a clinical course of mesangioproliferative glomerulonephritis (MPGN) in patients with glomerular deposition of IgA (IgA nephropathy--IgA-N), with glomerular deposition of other Ig to determine prognostic factors of MpGN progression including IgA-N and to examine the patients' sensitivity to immunodepressive therapy. MATERIAL AND METHODS: 2000 patients with primary MPGN followed up from 1980 to 1999 from the disease onset to development of chronic renal failure (creatinine > 2.5 mg%). Factors affecting kidney survival were studied using the Cox regression model, factors predicting sensitivity to immunodepressive therapy--using multiple logistic regression. RESULTS: IgA-N differed by the course and prognosis from other forms of MPGN. In IgA-N urinary syndrome and macrohematuria were encountered more frequently, in other forms of MPGN more frequent was nephrotic syndrome. Prognosis of patients with IgA-N was worse than in MPGN patients without IgA deposition: 10-year "renal survival" (creatinine < 2.5 mg%) was 64 and 97% (p < 0.05), respectively. Prognosis-deteriorating factors for MPGN patients were the following: male sex, nephritis onset in 40-year-olds and older subjects, acute nephritic syndrome (creatinine > 1.5 mg%), high proteinuria, hematuria (> 50 in sight), the presence of synechia and TIC in renal biopsy, location of immune deposits both in the mesangium and basal glomerular membranes. The responders to the immunodepressive therapy had 10-year renal survival 100%. Positive results of immunodepressive therapy were observed significantly more frequently in patients with normal level of creatinine, moderate hematuria, absence of synechias and TIC in renal biopsy, given large total course dose of corticosteroids and cytostatics. Efficiency of oral cyclophosphamide and its intravenous pulse-therapy did not differ significantly. In pulse therapy an average cumulative dose was lower 6 times, side effects occurred 3 times less frequently. CONCLUSION: The importance of morphological information for prognosis and predicting sensitivity of MPGN patients to immunosuppressive therapy necessitates renal biopsy before therapy. Intravenous pulse therapy with cyclophosphamide is preferable as an active treatment in patients with sclerosis in renal biopsy.

Administration, Oral↗
PubMed2000

[Primary focal segmental glomerulosclerosis: clinical and morphological prognostic factors].

AIM: To retrospectively analyze clinical course and results of immunodepressive therapy of patients with primary focal-segmental glomerulosclerosis (FSGS), to reveal prognostic factors of the disease progression and patients' sensitivity to immunosuppressive therapy. MATERIAL AND METHODS: Morphological diagnosis was specified, morphological indices of activity and sclerosis were estimated, renal survival was analysed, mono- and multivariate analysis of prognostic factors was made by the evidence obtained in the study of 135 biopsy specimens from CRF patients meeting the criteria of FSGS. RESULTS: At the moment of the disease onset only age of the patients was related to FSGS: 5- and 10-year survival was 100% if the disease started under 16 years of age, if older--the survival was 80 and 65%, respectively. Nephrotic syndrome, hematuria, high creatinine, racemose alterations in the glomeruli worsened the disease prognosis. When cytostatics and corticosteroids were used in combination they produced better results and were associated with better prognosis than each of them in monotherapy. Patients with marked hematuria and low proteinuria were less sensitive to therapy than those with weak hematuria and high proteinemia. Patients with FSGS having high IA and SI required more aggressive therapy for response. CONCLUSION: Renal biopsy with quantitation of IA and IS increases the prognosis accuracy and is important for choice of the treatment policy in patients with primary FSGS.

Adolescent↗
PubMed1999

[Treatment of bone disorders in renal diseases].

AIM: To study possible correction of bone disorders (osteopenia, Ca/P-imbalance, bone pain, limited volume of indolent movements) which are still a serious complication associated with renal diseases and pathogenic therapy (steroids). MATERIALS AND METHODS: The bone disorders were treated in 10 uremic hemodialyzed patients (8 men, 2 women; group 1) with vitamin D3 (calcitriol made in Russia) + rhEPO (recormon; Boehringer Mannheim), in 15 patients (15 women, 0 men) with lupus-nephritis (group 2) with vitamin D3 (n = 5, group 2a) or miscalcic (Sandoz) (n = 10, group 2b), in 2 patients (2 men, 0 women) with glomerulonephritis (group 3) with vitamin D3 + miacalcic. Additionally all the patients received Ca salts. In groups 2 and 3 renal function was normal. The duration of the treatment was 3-6 months. RESULTS: In all the groups we obtained an analgetic effect (attenuation of bone pain and more indolent movements), improvement of life quality, diminished need in analgetics, elevation of serum Ca level (p > 0.05). CONCLUSION: Treatment of renal patients with bone affection with vitamin D3 and miacalcic has an analgetic effect, improves life quality.

Adult↗
PubMed1998

[Comparison of two cyclophosphamide treatment regimens in nephrotic patients with chronic glomerulonephritis].

AIM: Comparison of two cyclophosphamide (CPA) treatment regimens in chronic glomerulonephritis (CGN) patients: oral daily CPA versus intravenous CPA pulses (IV-CPA) MATERIALS AND METHODS: 31 nephrotic patients entered the trial: 12, 16 and 3 with membraneous, mesangial proliferative and mesangiocapillary CGN, respectively. The patients were randomized into two groups. 13 patients of group 1 received oral CPA (1.5-2.0 mg/kg/day for 6 months, while 18 patients of group 2 received IV-CPA pulses (20 mg/kg/monthly, at least 6 pulses) combined with oral prednisolone (40-6-mg/day during 1.5 mo with subsequent tapering). At entry, no statistical differences (p > 0.05) were found between groups 1 and 2 by age, gender, duration of the renal disease, serum creatinine levels, frequency of arterial hypertension. Mean duration of follow-up was 27.6 and 22.6 mo (p > 0.05) for group 1 and 2, respectively. RESULTS: After 6 months of follow-up there was no difference in the rate of complete and partial remission between the groups (69 and 83% for group 1 and 2, respectively). The rate of renal function deterioration was also similar. Side effects occurred 3 times more frequently in group 1 than group 2. The mean cumulative course dose of CPA per 1 patient in group 1 was 35.6 g, in group 2--5.6 g. CONCLUSION: The effectiveness of methods was similar irrespective of CGN morphological form, but in spite of similar rates of remission of nephrotic syndrome, pulse CPA is preferable being more safe as to possible complications.

Adolescent↗
PubMed1997

[Arterial hypertension in lupus nephritis].

Incidence of arterial hypertension (AH), its relation with activity of lupus nephritis (LN), other factors (antiphospholipid syndrome, old age, disturbances of purin and lipid metabolism), prognostic implication of AH were studied in a trial performed from 1957 to 1996. A total of 398 patients with LN were divided into 3 groups according to immunosuppressive therapy practiced in different time periods. Overall AH incidence and that of severe AH were similar at present and in the past. AH occurred frequently in patients with rapidly progressing LN and active LN with nephrotic syndrome. In remission of nephrotic syndrome AH incidence was on the decrease. This suggests that hypertension may be a criterion of LN activity. AH was also associated with the presence of antiphospholipid syndrome and old age. AH was a separate prognostic indicator in respect to overall and renal survival. Hemodynamic mechanisms may contribute to LN progression.

Adult↗
PubMed1997

[Sandimmun in the treatment of chronic glomerulonephritis with the nephrotic syndrome].

Sandimmun was given to 11 patients (7 males and 4 females) aged 16-34 years with chronic glomerulonephritis (CGN) and nephrotic syndrome (NS). Various morphological forms were revealed: minimal changes (MC), focal-segmentary glomerulosclerosis (FSGS), mesangiocapillary glomerulonephritis (MCGS), membraneous glomerulonephritis (MGN), mesangioproliferative glomerulonephritis (MPGN). They occurred in 1, 3, 2, 1 and 3 patients respectively. Biopsy was not made in 1 case. The duration of the disease varied from 1 to 4 years. Prior to this therapy 10 patients failed corticosteroids and cytostatics. Hypertension, high creatinine were registered in 3 and 5 patients, respectively. Sandimmun was given for 2-18 months in a daily dose 3-5 mg/kg. Serum concentration 70-180 ng/ml. After 1 to 18 months of treatment nephrotic syndrome relieved in 1 MGN, 3 MPGN, 2 FSGS, 2 MCGS patients. The recurrences were reported in 4 patients after the drug discontinuation. Serious complications were absent.

Adolescent↗
PubMed1995

[The treatment of nephrotic-type chronic glomerulonephritis with Sandimmun (cyclosporin A)].

Sandimmun (ciclosporin A) treatment of chronic glomerulonephritis with nephrotic syndrome in a dose 2.5-5 mg/kg for 6-10 months relieved nephrotic syndrome in 2 and resulted in clinical improvement in other 2 of 4 patients treated. In 3 cases the patients failed previous therapy with high-dose corticosteroids and cytostatics. The drug reduced proteinuria, elevated serum levels of albumin and total protein, had low nephrotoxicity.

Adult↗
PubMed1993

[Primary chronic glomerulonephritis with nephrotic syndrome. Treatment with prednisone and cyclophosphamide].

The authors present their long standing experience with immunosuppressive treatment of patients with nephrotic syndrome associated with primary chronic membranous, mesangioproliferative and mesangiocapillary glomerulonephritis. Of a total of 127 patients 99 were treated with prednisone and cyclophosphamide and 28 with cyclophosphamide only. Clinical remission developed in 89 patients (70%). Remissions developed independently on morphological findings and initial proteinuria, but more frequently in patients with a still normal glomerular filtration. In combined immunosuppression 77% of the treated patients developed remission, while only 48% treated with cyclophosphamide alone. 88% of the patients survive an average period of 10 years. From the investigation it is apparent that long-term and early combined immunosuppression has a favourable impact on the course of primary chronic glomerulonephritis with nephrotic syndrome.

Adult↗
PubMed1993

[The possible approaches to the theoretical validation of the use of cytostatics and corticosteroids in treating glomerulonephritis].

Cyclophosphamide (CP) and methylprednisolone (MP) were tried on rats with experimental nephrotoxic serum nephritis and mice with experimental acute serum nephritis. Pathological processes were analyzed simultaneously in vivo and in vitro. CP reduced the antibody impairment and stimulated glomerular infiltration by mononuclear leukocytes whose mediator spectrum was oriented to repair. MP failed to stop the impairment and aggravated the infiltration. The resultant chaotic accumulation of the extracellular matrix raised the risk of sclerosis. CP showed the advantages in experiment demonstrable also in the clinical setting.

Adrenal Cortex Hormones↗
PubMed1991

[The treatment of chronic glomerulonephritis with ultrahigh doses of cyclophosphane].

Pulse therapy with cyclophosphamide was administered to 44 patients with chronic glomerulonephritis of the nephrotic type with different morphological varieties. The treatment was effective in 59% of cases including 11 out of 24 patients resistant to oral treatment with immunosuppressors. The treatment results were better in patients with normal blood serum creatinine and normal arterial pressure. Remission of the nephrotic syndrome could be observed in mesangioproliferative glomerulonephritis, mesangiocapillary glomerulonephritis, mesangial glomerulonephritis and focal-segmentary hyalinosis. In fibroplastic nephritis, remission of the nephrotic syndrome was recorded in none of the cases. The only prognostically significant sign predicting the treatment effect was the activity index--the totality of the morphological signs reflecting nephritis activity. The sclerotic changes produced no significant effect on the treatment outcome.

Adolescent↗