Search PubMed⌕ Search

Biomedical subjects

M Ia Ratner

Publications and source records attributed to M Ia Ratner.

At least 19 recordsLinked to original sources
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

[Implication of clinical and morphological types of chronic glomerulonephritis, tubulointerstitial changes in prognosis of disease progression].

A highly significant relationship has been established between rapid progression of chronic glomerulonephritis and belonging to unfavorable category of clinical types according to classification of M. Ya. Ratner et al. (chi-square = 84.3, p < 0.001), to unfavorable category of morphological types (chi-square = 13.2, p < 0.01) and the presence of tubulointerstitial changes (chi-square = 32, p < 0.0001).

Adolescent↗
PubMed1999

[Prediction of accelerated progression of chronic glomerulonephritis basing on clinical and histomorphological data].

AIM: To find out predictive value of three factors in progression of chronic glomerulonephritis (CGN): unfavorable clinical course, unfavorable morphological type and tubulointerstitial changes. MATERIALS AND METHODS: 150 CGN patients entered the trial. Frequency of onset of chronic renal failure (CRF) within 7 years after the diagnosis was chosen as a criterium of accelerated progression of CGN (AP CGN). Chi-square criterium was used for testing relationships between AP CGN and the parameters under study. RESULTS: The findings support previously published data on statistically more frequent occurrence of AP CGN in unfavorable clinical types (active nephritic and nephrotically-hypertensive), in unfavorable morphological types (mesangiocapillary CGN and focal-segmental hyalinosis/sclerosis and tubulointerstitial lesions). In unfavorable clinical types there was a significantly more frequent occurrence of AP CGN irrespective of unfavorable morphological changes. In contrast, both in unfavorable and favorable clinical types, frequency of AP CGN in unfavorable morphological types of CGN and tubulointerstitial changes was the same. CONCLUSION: Clinical type of CGN is a valuable prognostic criterium for AP CGN.

Adolescent↗
PubMed1998

[Prognostic factors of chronic glomerulonephritis and chronic non-inflammatory glomerulopathies rapid progression].

AIM: To determine relationships between prognosis of rapid progression of chronic glomerulonephritis (CGN), chronic non-inflammatory glomerulopathies (CNG) with development of chronic renal failure and clinical, morphological types of the disease and tubulointerstitial component (TIC). MATERIALS AND METHODS: 137 CGN and CNG patients were followed up for 7 years. Favorable clinical types were found in 89, unfavorable ones in 48 patients. Favorable and unfavorable morphological types occurred in 87 and 50 patients, respectively. TIC was identified in 56 patients. RESULTS: Rapid progression of CGN and CNG appeared to associate with the unfavorable clinical type (active nephritic types of CGN and nephrotic-hypertensive type of CNG), the unfavorable morphological type (mesangiocapillary glomerulonephritis and focal segmentary sclerosis/hyalinosis) and TIC. CONCLUSION: Prognosis of rapid progression of CGN and CNG is most reliable in combination of the above three predictors or of the unfavorable clinical type with TIC.

Adolescent↗
PubMed1997

[The prognostic significance of the morphological type of chronic glomerulonephritis and of the tubulointerstitial changes depending on the clinical type of the disease].

The review of 200 cases of chronic glomerulonephritis (CG) led the authors to the conclusion that there is a statistically significant relationship between rapid progression (RP) of the disease (onset of chronic renal failure within 7 years since the diagnosis) and its morphological type (chi 2 = 37), tubulointerstitial changes (chi 2 = 34; p < 0.0000), clinical disease types according to M. Ia. Ratner, V. V. Serov et al. (chi 2 = 115; p < 0.0000). In both prognostically favourable and unfavorable morphological types RP occurred more frequently in concurrent unfavorable clinical types (chi 2 = 19; p < 0.0001). In prognostically unfavorable morphological types there were, as a rule, unfavorable clinical types, whereas in favorable ones-favorable clinical types. In the presence of tubulointerstitial changes RP occurred primarily in unfavorable clinical types which are encountered in these morphological changes significantly more frequently than in their absence (chi 2 = 48; p < 0.01). RP of CG in prognostically unfavorable morphological types and tubulointerstitial changes depends mainly on accompanying clinical types of CG.

Adolescent↗
PubMed1996

[The importance of the clinical classification of chronic glomerulonephritis for the prognosis of its progression and of the efficacy of therapy].

A significant correlation exists between clinical types of chronic glomerulonephritis (CGN) in a new clinical classification and morphological CGN types according to classification of WHO experts. Rapid progression is significantly correlated with clinicomorphological variants of CGN represented by unfavorable clinical types and unfavorable morphological types. No rapid progression occurred in combination of clinically favourable types and morphologically favourable and unfavorable types. The above classification is recommended for practice.

Adolescent↗
PubMed1995

[The therapy of mesangiocapillary glomerulonephritis].

Follow-up of 7 patients with nephritically active mesangiocapillary chronic glomerulonephritis which received for 22 months combined therapy with prednisone (60 mg), chlorambucil (0.2 mg/kg), curantyl (400 mg), heparin or fenilin has found a significant lowering of proteinuria, hypercreatinemia, a rise in osmotic concentration. A complete remission was achieved in 2 patients, partial in 3 patients, a progression occurred after 8 years in one.

Chlorambucil↗
PubMed1993

[Glomerular permeability for serum proteins in different morphological types of primary chronic glomerulopathy].

Membranous glomerulonephritis (MGN), mesangiocapillary (MCGN), membranoproliferative glomerulonephritis (MPGN) and focal segmental sclerosis or hyalinosis (FSSH) were studied for glomerular filter permeability to serum albumins, IgA and IgG. In MGN the permeability for large-molecular globulins is not dependent on that for albumin, permeabilities for the globulins appeared correlated. In MPGN permeability for IgG depends on albumins permeability, correlations between that for IgA and IgG are similar to relevant findings in MGN. In MCGN glomerular permeability for IgA depends on that for albumins, and IgG depends on IgA permeability. In FSSH better albumin permeability implies increased permeability for both globulins, while enhanced permeability for IgA entails the same trend for albumins and IgG. Variable permeability of the glomerular filter for serum proteins in different morphological forms of chronic glomerulopathy may result from dissimilar defects in diverse layers of the filter and in interaction of basal membrane structures with cells responsible for glomerular impermeability for serum proteins.

Adolescent↗
PubMed1992

[The prognosis of the accelerated progression of chronic glomerulonephritis].

Based on the data of the 20-year follow-up of 146 patients suffering from intracapillary chronic glomerulonephritis (CGN) verified with the aid of nephrobiopsy, the conclusion was made about the necessity of distinguishing rapid-progressing CGN. In such pattern of CGN, chronic renal failure may occur for up to 5 years since the disease onset. A significant relationship was established between the incidence of rapid-progressing CGN and the morphological and clinical types as well as tubulointerstitial alterations. The clinical types included the active and inactive nephritic, nephrotic and nephrotic-hypertonic types. A regressive analysis made according to the Cox method permitted one to establish that the clinical type of CGN is the most reliable factor of predicting rapid-progressing disease.

Age Factors↗
PubMed1991

[The tubulointerstitial component of chronic glomerulonephritis: its clinico-functional diagnosis].

Tubulointerstitial alterations associated with chronic glomerulonephritis (CGN) are definitely dependent on the clinical type of CGN and are accompanied by a decrease of homeostatic functions (the rate of glomerular filtration, osmotic concentration and dilution of urine, hydruresis, the magnitude of CH2O, excretion of ammonium and hydrogen ions, the ratio of ammonium excretion to hydrogen ion excretion). Maximal osmotic concentration and ammonium excretion show an especially considerable decrease. The clinical type permitting one to diagnose rather than to reject the presence of alterations and the status of certain tubular functions, osmotic concentration in particular and, to a less degree, ammonium excretion, permitting to reject the presence of the tubulointerstitial component (TIC) are of known but restricted importance for TIC recognition. The TIC can be diagnosed more adequately in exploring definite pairs of renal functions, particularly osmotic concentration of urine and ammonium excretion and maximal hydruresis and excretion of hydrogen ions. This approach is both helpful in confirming and rejecting the presence of the TIC. Of special value is the combined assessment of the clinical type and maximal osmotic urine concentration data.

Adolescent↗
PubMed1990

[Functional and morphological characteristics of a hematuric form of chronic glomerulonephritis].

Clinical evidence has been analyzed for 325 patients with chronic glomerulonephritis confirmed histologically. It was established that chronic glomerulonephritis (CG) associated with hematuria exhibits some specific characteristics: great ability for maximal osmotic concentration and partial ability for ammonium excretion in membranoproliferative CG without sclerotic lesions, maximal occurrence in membranoproliferative form of the disease; fibroplastic transformation of the glomeruli is a rare finding. CG with hematuria is worth mentioning in CG diagnosis.

Adolescent↗