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Biomedical subjects

N B Gordovskaia

Publications and source records attributed to N B Gordovskaia.

At least 19 recordsLinked to original sources
PubMed2004

[Chronic glomerulonephritis and pregnancy].

AIM: To clarify factors of risk for unfavourable variants of gestational chronic glomerulonephritis (CGN) and poor pregnancy outcomes in CGN; to determine prognostic implications of changes in some renal and uteroplacental indices. MATERIAL AND METHODS: Variants of CGN gestational course and pregnancy outcomes have been analysed for 156 CGN patients. The women were examined before pregnancy, in the course of pregnancy and 3-24 months after the delivery. Measurements were made of 24 h proteinuria, glomerular filtration rate, blood transaminases activity, functional renal reserve (FRR), uricemia, blood level of alpha-phetoprotein. Placentas were studied morphologically, uterine and umbilical artery circulation was assessed by dopplerometry. RESULTS: The following abnormalities were registered: high proteinuria (34.6%), progression of hypertension (29.5%), renal function deterioration (15.4%), fetal and neonatal losses (15.4%), fetal underdevelopment (25%), preterm delivery (17.3%), preeclampsia (7.7%), preterm placental detachment (1.9%). There is morphological, dopplerometric and biochemical evidence for placental insufficiency in CGN pregnant women. CONCLUSION: Activity of CGN (nephritic or acute nephritic syndromes), hypertension, renal failure, disorders of renal hemodynamics are factors of risk for unfavourable gestational course of CGN and pregnancy complications. Placental insufficiency deteriorates pregnancy outcomes in CGN, but changes in uterine and umbilical circulation as well as blood levels of alpha-fetoprotein are not prognostically significant.

Adolescent↗
PubMed2004

[Endothelium and platelets in pregnant women with chronic glomerulonephritis and therapeutic efficacy of acetylsalicylic acid and dipiridamol].

AIM: To estimate platelet and endothelial condition in pregnant women with chronic glomerulonephritis (CGN), prognostic value of these changes and efficacy of acetylsalicylic acid (ASA) and dipiridamol in prevention of unfavourable outcomes of pregnancy in CGN. MATERIAL AND METHODS: The examination covered 74 CGN pregnant patients, 14 non-pregnant CGN patients, 11 pregnant women with preeclampsia, 19 healthy pregnant women. The levels of fibronectin, endothelin-1,2, 6-keto-PGF1a, thromboxane B2 (TxB2) secretory beta-thromboglobulin in the blood, activity of intrathrombocytic lactate dehydrogenase (LHG), platelet aggregation. ASA (125 mg/day) was given to 33 CGN pregnant women in combination with dipiridamol (150-225 mg/day). Control group consisted of 32 CGN pregnant women. RESULTS: Content of fibronectin, endothelin, TxB2 and beta-thromboglobulin in blood plasm, aggregation with ADP in CGN pregnant women were higher than in healthy pregnant women and nonpregnant CGN patients. Plasmic 6-keto-PGF1a was low. Preeclampsia was accompanied with elevated fibronectin, TxB2 and beta-thromboglobulin, hyperactive LDH. Platelet aggregation was suppressed. Blood beta-thromboglobulin directly correlated with systolic and diastolic arterial pressure, 24-h proteinuria and blood creatinine. Reverse Correlation was seen in blood beta-thromboglobulin with albuminemia, glomerular filtration rate, body mass of the newborn and term of labor. A direct correlation was found between the activity of intrathrombocytic LDH and systolic and diastolic arterial pressure, a weak reverse correlation--between platelet count in capillary blood and systolic pressure, platelet aggregation with ADP and terms of labor. Of the highest prognostic value were the level of beta-thromboglobulin and fibronectin, the activity of intrathrombocytic LDH and platelet aggregation in response to ADP. ASA and dipiridamol reduced the risk of fetal retardation and fetal loss. CONCLUSION: Pregnant women with CGN have endothelial-thrombocytic dysfunction because of unidirectional influence of both CGN and pregnancy. We think that endothelial-platelet dysfunction connects renal impairment and placental failure in pregnant women with CGN deteriorating a gestational CGN and pregnancy complications. Correction of endothelial-platelet state with ASA and dipiridamol is effective in prevention of fetal retardation and fetal loss in pregnant women with CGN.

Administration, Oral↗
PubMed2001

[Cryoapheresis in the treatment of patients with cryoglobulinemic mesangiocapillary glomerulonephritis and acute kidney failure].

AIM: To assess cryoapheresis (CA) efficacy in the treatment of cryoglobulinemic glomerulonephritis (CG) with acute renal failure (ACR). MATERIAL AND METHODS: Ten 34-64-year-old CG patients with associated HCV infection and symptoms of ACR (diuresis under 500 ml/day, serum creatinin 1.6-8.1 ml/dl). All the patients were examined clinically, for serum cryoglobulins, HCV, HBV markers, morphologically (renal and hepatic biopsies in 8 patients). All the patients received therapy with CA, immunodepressants. Three patients with virus replication received, in addition, antiviral drugs (alpha-interferon in a dose 3,000,000-5,000,000 IU 3 times a week intramuscularly for 6 months). RESULTS: CA in combined CG therapy led to fast elimination of cryoglobulins from the body, stabilization of renal function with arrest of rapid progression of renal failure, normalization of diuresis with subsequent lowering of serum creatinin. The course of CA normalized renal function fully in 3 patients, partially in 7 patients. Later, these 7 patients developed chronic renal failure. Complete elimination of the virus and remission of CG were achieved in 2 of 3 patients who had undergone the antiviral treatment for a year. CONCLUSION: CA can be added to combined therapy of CG aggravation as it improves renal function.

Acute Kidney Injury↗
PubMed2001

[Risk factors of progression in cryoglobulinemic glomerulonephritis associated with hepatitis C virus].

The article reviews literature and original data on renal affections associated with mixed cryoglobulinemia (MCG), discuss etiology, clinical and morphological features of renal damage, variants of the clinical course and prognosis. Among 50 patients with mixed MCG selected by the presence of cryoglobulinemia (> 100 mg/dl) and in 75% with markers of hepatitis c virus infection, renal lesion was found in 14(28%). 7 of them had moderate urinary syndrome, 4 had nephrotic syndrome and 3--acute nephritic syndrome with subsequent rapid progression. 5 patients had cryoglobulinemic mesangiocapillary glomerulonephritis. A clinical case is reported illustrating complications and difficulties of treatment of cryoglobulinemic glomerulonephritis.

Chronic Disease↗
PubMed2000

[Lupus nephritis and pregnancy].

AIM: To evaluate effects of pregnancy on the course and prognosis of lupus nephritis and fetal outcome, in particular, in patients with lupus nephritis (LN) and antiphospholipid syndrome (APS). MATERIAL AND METHODS: A retrospective analysis was made of the course of LN in 31 females (44 pregnancies). RESULTS: A favorable outcome of pregnancy is possible in LN women if they had a persistent remission at conception. However, one third of these women had exacerbations of LN in pregnancy and early postpartum period. Pregnancy developing in active LN aggravated LN course in all the women. Fetal outcome was unfavorable. LN was especially severe if it arose in the course of pregnancy or early postpartum period. It seems that the presence of APS affected pregnancy outcome in a less degree than LN activity. CONCLUSION: Both in pregnancy and postpartum period, LN showed frequent exacerbations, but if the conception takes place during a persistent remission of LN, under adequate care and treatment, a delivery of a viable child is possible without an extraordinary risk for the mother.

Adolescent↗
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

[The characteristics of the clinical course of nephritis in patients with cryoglobulinemia].

Cryoglobulins were measured spectrophotometrically in the sera of 40 patients with renal diseases. 18 of them had chronic glomerulonephritis, 14 lupus nephritis and 8 nephritis. 20 patients with high concentration of cryoglobulins (100-600 micrograms/ml) exhibited high incidence of nephrotic syndrome (80%), arterial hypertension (90%), creatininemia (70%) and, respectively, 25, 25 and 15% of patients free of cryoglobulinemia. There was a correlation between cryoglobulins level and creatininemia (r = 0.468), proteinuria (r = 0.478), ESR (r = 0.393), systolic and diastolic arterial pressure (r = 0.393 and r = 342, respectively). An inverse relation existed with serum albumins (r = -0.526). Progression of renal failure was associated with high cryoglobulinemia. In decline of cryoglobulins content there was clinical improvement, lowering or normalization of blood creatinin levels.

Adolescent↗
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↗
PubMed1990

[Kidney involvement in cryoglobulinemia].

The authors provide the reported data on renal impairment in mixed cryoglobulinemia (CGE) and 3 own CGE case reports. Renal impairment by the type of rapid-progressing nephritis with episodes of acute renal failure was the major sign in the clinical picture of those cases.

Adult↗
PubMed1989

[Treatment of chronic glomerulonephritis with cytostatics].

A retrospective analysis was made of the efficacy of oral treatment with cytostatics (azathioprin, batriden, cyclophosphamide) in 109 patients with chronic glomerulonephritis (CGN) (with a known morphologic appearance in 94 patients) and with excessive doses of cyclophosphamide i. v. in 32 patients with CGN depending on the nephritis standing, its clinical pattern and morphologic variant. The best results were recorded with nephritis lasting up to 2 years in patients suffering from the nephrotic pattern of CGN or at the stage of the nephrotic syndrome formation in patients with latent CGN, in membranoproliferative, membranous and membranocapillary versions of CGN, during pulse therapy, and in patients with focal segmental glomerulohyalinosis. No remissions were observed in mixed CGN. The experimental data are also provided concerning the influence of a single oral cyclophosphamide administration on the morphologic signs of nephritis in GBA and C57BL mice.

Animals↗