EVALUATIONOFRENAL REPLACEMENT THERAPYQUALITY IN UKRAINE: TIME FOR ACTIONS

Background. Little is known about the status of renal replacement therapy (RRT) in the post-Soviet period of Ukraine. We therefore investigated the epidemiology and treatment outcomes of RRT in Ukrainian patients and put the results into an international perspective. Methods. Data from the Ukrainian National Renal Registry for patients on RRT between 1 January 2010 and 31 December 2012 were selected. We calculated the incidence and prevalence of RRT per million population (pmp) and the 3-, 12- and 24-month patient survival using the Kaplan— Meier method and Cox regression Results. There were 5985prevalent patients on RRT on 31 December 2012 (131,2 pmp). Mean age was 46,5 ± 13,8 years, 56% were men and 74% received haemodialysis (HD), while peritoneal dialysis and kidney transplantation both represented 13%. The most common cause of end-stage renal disease was glomerulonephritis (51%), while only 12% had diabetes. In 2012, 1129 patients started dialysis (incidence 24,8 pmp), with 80% on HD. Mean age was 48 ± 14 years, 58% were men and 20% had diabetes. Three, 12- and 24-month patient survival on dialysis was 95,1%, 86,0% and 76,4%, respectively. The transplant rate in 2012 was 2,1 pmp. Conclusions. The incidence and prevalence of RRT and the transplantation rate in Ukraine are among the lowest in Europe, suggesting that the need for RRT is not being met. Strategies to reduce the RRT deficit include the development and improvement of transplantation and home-based dialysis programs. Further evaluation of the quality of Ukrainian RRT care is needed

Ensuring the sustainable development of the Ukrainian agrarian sector in conditions of globalization

The agro-industrial complex of Ukraine with its basic component – agrarian sector is a system-forming element of the national economy. The Ukrainian agrarian sector has a production potential, which far exceeds the needs of the internal market. It is a link that can become the engine of development of the national economy and its effective integration into the world economic space. The purpose of this research is to determine the approaches to ensure sustainable development of the agrarian sector of Ukraine in the context of globalization and integration processes strengthening. The main task is to determine the problems of ensuring the sustainable development of the agrarian sector of Ukraine in the process of its integration into the world economic space. The category of “sustainability of agrarian sector development” has been considered and improved. It has been suggested to include in the classification of “sustainability of the agrarian sector” an element of the description of global integration processes. It has been proved that the sustainability of the agrarian sector development lies in the balanced combination of industrial, economic, social, environmental, intellectual and globalization processes

Pilot testing for long-term impact of glycerol-induced acute kidney injury on oxalate homeostasis in rats

Abstract. There is a general lack of research on the long-term effects of acute kidney injury (AKI) on oxalate-degrading bacteria (ODB) and their total oxalate-degrading activity (ODA) in fecal microbiota. In the present pilot study, we separately evaluated the changes in the ODB number and their total ODA in fecal microbiota at 3-time points after glycerol-induced AKI. In addition, we assessed the interactions between AKI-induced renal histopathological changes and ODB, total fecal ODA, and plasma and urine oxalate concentrations in rats. Methods. The male Wistar rats (200-300 g, n = 20) on oxalate-free diet were randomly divided into 2 groups. After 24-h of water deprivation, experimental group 1 (n = 10) received an intramuscular injection of 50% glycerol (10 ml/kg of body weight), and group 2 (n = 10) served as a control. The numbers of ODB (incubated in a highly selective Oxalate Medium and determined using the culture method), total fecal ODA and urinary oxalate (UOx) excretion were measured after injection on days 8, 22 and 70. The method of redoximetric titration with a KMnO4 solution was adopted to evaluate total ODA in fecal microbiota. Renal injury was assessed by histopathology examination, serum creatinine plasma oxalic acid (POx) concentration and daily proteinuria levels after removing the animals from the experiment on day 70. Results. After glycerol injection on days 8 and 22, no differences were found in the numbers of ODB, their total fecal ODA, and UOx excretion level between the experimental and control groups. However, after AKI initiation on day 70, the numbers of ODB, total fecal ODA, and daily UOx excretion were significantly lower in the experimental group as compared with the control group. In addition, in 10 weeks following AKI, the number of ODB had a direct correlation with UOx excretion and an inverse correlation with POx and serum creatinine concentrations and daily proteinuria. Total ODA in fecal microbiota was directly associated with the percentage of renal interstitial fibrosis and the average glomerular volumes in the experimental rats. Conclusions: AKI had long-term negative effects on the quantitative and qualitative characteristics of ODB in fecal microbiota in rats. Moreover, the results of our study confirmed an increasing trend in total fecal ODA according to the aggravation of renal interstitial fibrosis and glomerular volume in rats’ kidneys. Further studies are warranted to gain more insight into the mechanism of oxalate homeostasis impairment in AKI

The ERA-EDTA Registry Annual Report 2018 : a summary

Background. The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry collects data on kidney replacement therapy (KRT) via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article summarizes the 2018 ERA-EDTA Registry Annual Report, and describes the epidemiology of KRT for kidney failure in 34 countries. Methods. Individual patient data on patients undergoing KRT in 2018 were provided by 34 national or regional renal registries and aggregated data by 17 registries. The incidence and prevalence of KRT, the kidney transplantation activity and the survival probabilities of these patients were calculated. Results. In 2018, the ERA-EDTA Registry covered a general population of 636 million people. Overall, the incidence of KRT for kidney failure was 129 per million population (p.m.p.), 62% of patients were men, 51% were >= 65years of age and 20% had diabetes mellitus as cause of kidney failure. Treatment modality at the onset of KRT was haemodialysis (HD) for 84%, peritoneal dialysis (PD) for 11% and pre-emptive kidney transplantation for 5% of patients. On 31 December 2018, the prevalence of KRT was 897 p.m.p., with 57% of patients on HD, 5% on PD and 38% living with a kidney transplant. The transplant rate in 2018 was 35 p.m.p.: 68% received a kidney from a deceased donor, 30% from a living donor and for 2% the donor source was unknown. For patients commencing dialysis during 2009-13, the unadjusted 5-year survival probability was 42.6%. For patients receiving a kidney transplant within this period, the unadjusted 5-year survival probability was 86.6% for recipients of deceased donor grafts and 93.9% for recipients of living donor grafts.Peer reviewe

Исследование обработки отверстий в композиционных материалах и смешанных пакетах на основе имитационного моделирования рабочих процессов

В отчете рассмотрены различные аспекты технологии механической обработки отверстий в смешанных пакетах металл-углепластик. Затронуты вопросы влияния различных факторов на износ инструмента и качество обработанной поверхности при сверлении. Проведены исследования механизмов разрушения обработанной поверхности при различных схемах обработки ВПКМ. Выполнено имитационное моделирование процесса сверления ВПКМ в главной секущей плоскости главных режущих кромок и определены наиболее благоприятные схемы резания. При цитировании документа, используйте ссылку http://essuir.sumdu.edu.ua/handle/123456789/3525

Renal replacement therapy in Europe : A summary of the 2011 ERA-EDTA Registry Annual Report

BackgroundThis article provides a summary of the 2011 ERA-EDTA Registry Annual Report (available at www.era-edta-reg.org).MethodsData on renal replacement therapy (RRT) for end-stage renal disease (ESRD) from national and regional renal registries in 30 countries in Europe and bordering the Mediterranean Sea were used. From 27 registries, individual patient data were received, whereas 17 registries contributed data in aggregated form. We present the incidence and prevalence of RRT, and renal transplant rates in 2011. In addition, survival probabilities and expected remaining lifetimes were calculated for those registries providing individual patient data.ResultsThe overall unadjusted incidence rate of RRT in 2011 among all registries reporting to the ERA-EDTA Registry was 117 per million population (pmp) (n = 71.631). Incidence rates varied from 24 pmp in Ukraine to 238 pmp in Turkey. The overall unadjusted prevalence of RRT for ESRD on 31 December 2011 was 692 pmp (n = 425 824). The highest prevalence was reported by Portugal (1662 pmp) and the lowest by Ukraine (131 pmp). Among all registries, a total of 22 814 renal transplantations were performed (37 pmp). The highest overall transplant rate was reported from Spain, Cantabria (81 pmp), whereas the highest rate of living donor transplants was reported from Turkey (39 pmp). For patients who started RRT between 2002 and 2006, the unadjusted 5-year patient survival on RRT was 46.8% [95% confidence interval (CI) 46.6-47.0], and on dialysis 39.3% (95% CI 39.2-39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2-87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6-95.0) for kidneys from living donors.publishersversionPeer reviewe

Renal replacement therapy in Europe: a summary of the 2012 ERA-EDTA Registry Annual Report

BACKGROUND: This article summarizes the 2012 European Renal Association-European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). METHODS: Data provided by 45 national or regional renal registries in 30 countries in Europe and bordering the Mediterranean Sea were used. Individual patient level data were received from 31 renal registries, whereas 14 renal registries contributed data in an aggregated form. The incidence, prevalence and survival probabilities of patients with end-stage renal disease (ESRD) receiving renal replacement therapy (RRT) and renal transplantation rates for 2012 are presented. RESULTS: In 2012, the overall unadjusted incidence rate of patients with ESRD receiving RRT was 109.6 per million population (pmp) (n = 69 035), ranging from 219.9 pmp in Portugal to 24.2 pmp in Montenegro. The proportion of incident patients ≥75 years varied from 15 to 44% between countries. The overall unadjusted prevalence on 31 December 2012 was 716.7 pmp (n = 451 270), ranging from 1670.2 pmp in Portugal to 146.7 pmp in the Ukraine. The proportion of prevalent patients ≥75 years varied from 11 to 32% between countries. The overall renal transplantation rate in 2012 was 28.3 pmp (n = 15 673), with the highest rate seen in the Spanish region of Catalonia. The proportion of patients ≥65 years receiving a transplant ranged from 0 to 35%. Five-year adjusted survival for all RRT patients was 59.7% (95% confidence interval, CI: 59.3-60.0) which fell to 39.3% (95% CI: 38.7-39.9) in patients 65-74 years and 21.3% (95% CI: 20.8-21.9) in patients ≥75 years

The European Renal Association - European Dialysis and Transplant Association Registry Annual Report 2014 : a summary

Background: This article summarizes the European Renal Association - European Dialysis and Transplant Association Registry's 2014 annual report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2014 within 35 countries. Methods: In 2016, the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD, from 51 national or regional renal registries. Thirty-two registries provided individual patient level data and 19 provided aggregated patient level data. The incidence, prevalence and survival probabilities of these patients were determined. Results: In 2014, 70 953 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 133 per million population (pmp). The incidence ranged by 10-fold; from 23 pmp in the Ukraine to 237 pmp in Portugal. Of the patients commencing RRT, almost two-thirds were men, over half were aged >= 65 years and a quarter had diabetes mellitus as their primary renal diagnosis. By day 91 of commencing RRT, 81% of patients were receiving haemodialysis. On 31 December 2014, 490 743 individuals were receiving RRT for ESRD, equating to an unadjusted prevalence of 924 pmp. This ranged throughout Europe by more than 10-fold, from 157 pmp in the Ukraine to 1794 pmp in Portugal. In 2014, 19 406 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 36 pmp. Again this varied considerably throughout Europe. For patients commencing RRT during 2005-09, the 5-year-adjusted patient survival probabilities on all RRT modalities was 63.3% (95% confidence interval 63.0-63.6). The expected remaining lifetime of a 20-to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 21.9 and 44.0 years, respectively. This was substantially lower than the 61.8 years of expected remaining lifetime of a 20-year-old patient without ESRD.Peer reviewe

Механізми вартісно-орієнтованого управління підприємством

Об’єкт дослідження: механізми оптимізації структури капіталу підприємства, що трансформуються з урахуванням факторів вартості екологічного характеру при здійсненні вартісного управління. Метою роботи є удосконалення теоретико-методичних основ вартісного управління підприємством на основі викоОб’єкт дослідження: механізми оптимізації структури капіталу підприємства, що трансформуються з урахуванням факторів вартості екологічного характеру при здійсненні вартісного управління. Метою роботи є удосконалення теоретико-методичних основ вартісного управління підприємством на основі використання механізмів оптимізації структури капіталу. Методами дослідження є: системно-структурний метод, логічний метод, порівняльний аналіз, метод прогнозування, метод економіко-математичного моделювання, графічний аналіз. Результатом роботи є удосконалення методичного апарату вартісно-орієнтованого управління підприємств на основі використання вартісних розривів, що сприятиме підвищенню ефективності їх діяльності в сучасних умовах господарювання. Новизна результатів роботи: розроблено методичні засади оцінки розриву середньозваженої вартості капіталу; обгрунтовано місце методу вартісного розриву (зокрема оцінювання та прогнозування розриву WACC) в механізмах управління фінансовою діяльністю підприємства; запропоновано матрицю вибору важелів управління вартісним розривом залежно від величини вартісного розриву та фінансових можливостей підприємства ристання механізмів оптимізації структури капіталу. Методами дослідження є: системно-структурний метод, логічний метод, порівняльний аналіз, метод прогнозування, метод економіко-математичного моделювання, графічний аналіз. Результатом роботи є удосконалення методичного апарату вартісно-орієнтованого управління підприємств на основі використання вартісних розривів, що сприятиме підвищенню ефективності їх діяльності в сучасних умовах господарювання. Новизна результатів роботи: розроблено методичні засади оцінки розриву середньозваженої вартості капіталу; обгрунтовано місце методу вартісного розриву (зокрема оцінювання та прогнозування розриву WACC) в механізмах управління фінансовою діяльністю підприємства; запропоновано матрицю вибору важелів управління вартісним розривом залежно від величини вартісного розриву та фінансових можливостей підприємства

Фінансово-економічне обгрунтування екологічно спрямованого інноваційного розвитку

Об’єкт дослідження: процеси екологічно спрямованого інноваційного розвитку (ЕСІР). Метою роботи є розвиток та вдосконалення науково-методичних засад економічного обґрунтування екологічно спрямованого інноваційного розвитку (ЕСІР) на різних рівнях управління. Методами дослідження є методи наукового пізнання, зокрема діалектичний, фундаментальні положення сучасної економічної теорії, сучасні концепції економіки природокористування та теорії інноваційного розвитку. Результатом роботи є формування науково-методичних засад та практичних рекомендацій щодо економічного обґрунтування ЕСІР як основи прийняття управлінських рішень на різних рівнях. Новизна результатів роботи: розроблено комплексний підхід до наукового обґрунтування варіанта ЕСІР на макро-, мезо- та мікрорівні, що передбачає дослідження соціо-еколого-економічної та комерційної ефективності з урахуванням ринкової оптимальності, визначеної за критерієм відповідності етапів еволюційного розвитку екоінновації, підприємства та ринку, та забезпечує зменшення інноваційних та інвестиційних ризиків на різних рівнях, а також сприяє підвищенню економічної безпеки ЕСІР; Взаємозв’язок з іншими роботами: окремі результати доповідалися на науково-практичних конференціях, публікувалися в наукових виданнях