DYSLIPIDEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Summury. Data about lipid disorders at different stages of chronic kidney disease (CKD), including those on dialysis are presented in the review. The possible influence of dyslipidemia on the progression of CKD, as well as the onset and progression of cardiovascular complications in patients with CKD are discussed. The questions of lipid-lowering therapy use, including statins, in patients with CKD on dialysis and predialysis, are disclosed

Activation of chronic inflammation and comorbidity in end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

The aim of the work was to determine the blood serum pro-inflammatory cytokine profile and to study their relationship with comorbidity and mortality in end-stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD). Ninety three ESRD patients treated with CAPD during 2012-2019 were included in the cohort prospective open study. The study was conducted in two stages. At the first stage, the determination of TNF-α and IL-6 levels was conducted and study of comorbidity, its quantitative assessment, baseline clinical and laboratory parameters was made. A modified polymorbidity index (MPI) which determined the quantitative assessment of comorbidity was calculated as the number of diseases per one patient excluding ESRD and its reasons. At the second stage, considering the baseline values of the studied cytokines, a prospective study of the dynamics of the prevalence of comorbid pathology, the value of MPI and mortality rate was carried out. The average duration of prospective follow-up was 26.4±6.8 months. Serum cytokines levels were determined by ELISA. Statistical analysis was performed by using "MedCalc", version 19.1.7. (Ostend, Belgium). Serum levels of TNF-α and IL-6 were significantly higher in PD-patients with 5 or more comorbid diseases. Levels of TNF-α>13.0 pg/ml have a negative effect on the dynamics of prevalence of heart failure (HF) and coronary heart disease (CHD), number of comorbid conditions in CAPD-patients. The proportion of the dead with a level of TNF-α>13.0 pg/ml was by three times higher, and deaths from cardiovascular events are almost by 10 times higher than patients who had a level of TNF-α≤13.0 pg/ml. Serum levels of IL-6>23.4 pg/ml are associated with a significant increase in number of comorbid conditions, prevalence of bacterial infections and overall and infectious mortality. Independent predictors of comorbidity and overall mortality in patients with ESRD who are treated with CAPD are serum levels of TNF-α, IL-6 and albumin. Serum levels of TNF-α and albumin are predictors of fatal cardiovascular events, and serum levels of IL-6 are predictors of fatal infectious events

HEART RATE VARIABILITY IN HEMODIALYSIS PATIENTS

There are a small number of works that have studied heart rhythm variability parameters in patients treated with hemodialysis. Aim. To investigate the peculiarities of heart rhythm variability parameters in patients treated with hemodialysis. Methods. The observational controlled study included 55 patients treated with hemodialysis, aged 24 to 75 years, including 29 men and 26 women. The control group consisted of 20 healthy individuals of comparable age and sex. Heart rhythm variability parameters were investigated in all patients. Results. In the study of heart rhythm variability in patients treated with hemodialysis comparatively with the control group time parameters and most of frequency indexes were decreased. Conclusions. Our study found the diminishment of the total power of neurohumoral regulation in patients treated hemodialysis, as evidenced by the low values SDNN, rNN50, CV

The research of antibacterial properties of decamethoxin, decasan, horosten

The study of Staphylococcus resistance to the antibacterial drugs Decamethoxin, Decasan, Horosten remains an important medical problem. The aim of this study was to investigate the antistaphylococcal properties of Decamethoxin, Decasan, Horosten. It has been proven that qaterinary ammonium antiseptic drugs (Decamethoxin, Decasan, Horosten) have high antistaphylococcal properties. The bactericidal activity of Decamethoxin has been shown to be stable under adverse pH conditions of different microbial loading. Different concentrations of Decamethoxine have been shown to cause the formation of resistant variants of Staphylococcus, which lose the ability to form pigments and enzymes

Blood vitamins status in patients with stages 2-5 chronic kidney disease

Patients with chronic kidney disease (CKD) are prone to development hypovitaminosis due to dietary constraints, diseases of the gastrointestinal tract, comorbid conditions, etc. Determination of vitamins level in patients with CKD will allow timely correction of their deficiency, prevent the development of hypervitaminosis and reduce oxidative stress. The purpose of the study was to examine the level of vitamins depending on the stage of CKD. Methods. Vitamin D levels (level 25-hydroxyvitamin D), A, E, B12, K, folic acid were determined in 44patients with CKD stages II-V(mean age 54,63 ± 2,63 years, 24 men 55%). According to the study, patients should not have received any drugs or biologically active additives containing vitamins for 3 months. Results. There was no significant difference in the level of studied vitamins in CKD st. II-III. There was a significant decrease in the levels of vitamin K, folic acid, and vitamin D levels with the progression of CKD. Vitamin A levels in CKD st. IV, V compared to CKD st. II were significantly higher. Considering large number drugs containing vitamins and trace elements and wide uncontrolled use in the population, in particular in patients with CKD, it is important to continue to study the levels of vitamins and trace elements in patients at different stages of the CKD, depending on the CKD nosology. Study of efficiency and safety applying vitamins in patients with CKD, particularly in the late stages of CKD, are appropriate. Conclusions. For patients with CKD characteristic of vitamins deficiency (in our study vitamin K, folic acid), but also an increase in their levels (vitamins A and E). Progression of CKD is accompanied by a change in the levels of vitamins. A significant decrease in the level of vitamin K, folic acid, vitamin D was notedfor patients with GFR <30 ml/min/1.73 m2

Energy Efficiency of the Extrusion Process and its Effect on Output of Biogas during the Fermentation of Maize and Rape Straw

The purpose of the research is determining the influence of pre-treatment by extrusion of rape and maize straw on the output of biogas and the energy efficient mode of the extrusion process. The set goal is achieved by solving the following problems: pre-treatment of rape and maize straw by grinding and various versions of extrusion; carrying out experimental researches of the fermentation of rape and maize straw in the mesophilic mode of fermentation for 42 days; carrying out numerical modeling to determine the power inputs on the process of extrusion during change the frequency rotation of screw conveyer of the extruder. The most significant results: it was experimentally proven that the output of biogas from rape and maize straw increases when the size of their particles is reduced to a certain value, which is reached after 2-times extrusion, and further reduction of the size of the particles does not give a positive effect and, vice versa, reduces gas release. Extrusion provides not only grinding, but also thermo-baro processing, which additionally grinds lignin-cellulosic raw material. It was determined that the energy efficient mode of operation, the necessary level of pressure and temperature in the die, which exclude the burning of organic raw materials, is ensured at the rotation frequency of screw conveyer of the extruder at 110 r/pm. The significance of the obtained results is that the extrusion with the proposed technological and mode parameters of the extruder can be used as an effective method of pre-treatment of lignin-cellulosic raw material to increase the productivity of bioreactors and biogas output

D-dimer as a potential predictor of thromboembolic and cardiovascular complications in patients with chronic kidney disease

The aim of the study was to evaluate the relationship between D-dimer levels and different biomarkers­ of renal diseases to identify the relationship between hypercoagulation and chronic kidney disease (CKD). To achieve this aim, we conducted a one-step prospective observational study involving 140 patients with CKD who were hospitali­zed in Ivano-Frankivsk Regional Clinical Hospital in Ukraine during 2018-2019. Of these patients, 100 patients (71.4%; 95% CI 53.4-76.7) had glomerulonephritis (GN) and 40 patients (28,6%; 95% CI 21.3-36.8) had diabetic nephropathy (DN). All patients underwent standard examination, which included general clinical, biochemical and instrumental research methods. D-dimer was quantitatively determined in blood serum by enzyme-linked immunosorbent assay (ELISA). The 140 patients were divided into two groups according to the level of D-dimers: normal level (<0.5 mg/l) and elevated level (≥0.5 mg/l). Elevated D-dimer levels were associated with an increased age of patients, decreased glomerular filtration rate, decreased blood albumin level, increased daily protein excretion and a tendency to develop thromboembolic complications during 1 year of monitoring. D-dimer is a biological marker that can detect hypercoagulation at an early preclinical stage in patients with CKD and identify patients with an increased cardiovascular risk, thereby promoting the earliest use of antiplatelet agents and anticoagulants and, consequently, it can reduce mortality­

Cost comparison of treating chronic hepatitis C genotype one with pegylated interferons in Ukraine

Based on the pivotal trial showing no clinicallyrelevant differences between pegylated interferon α-2b (Peg-α-2b) and α-2a (Peg-α-2a) combined with ribavirin for treatment of chronic hepatitis C virus (HCV) genotype 1 infection in Ukraine, a cost-minimization analysis was performed using a 1 year time horizon and both a health care and patients' perspective. A decision tree reflects treatment pathways. Drug costs were based on drug labeling and adjusted to the average body mass in Ukraine. Subgroup analysis was applied to deal with heterogeneity of patient's weight causing dose changes. A break-even price of Peg-α-2a and Peg-α-2b (based on the average dose) was calculated. Univariate sensitivity analyses and probabilistic sensitivity analysis were carried out to reflect decision uncertainty. For an average body weight, total medical costs per patient differ from US$9220 for Peg-α-2b to US$9513 for Peg-α-2a from a health care perspective, and from US$15,212 to US$15,696 from a patients' perspective. Sensitivity analyses show these results are robust. With average body weight, the break-even price of Peg-α-2b may be 7.3% higher than Peg-α-2a to have similar total costs