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Today, the term "malabsorption syndrome" is widely used in medical practice as a general term to describe the symptoms of indigestion, absorption, and transport by the intestinal mucosa of adequately digested foods, including vitamins and trace elements, resulting in a variety of metabolic disorders.The purpose of this review is to analyze scientific data that highlight information on modern views on the etiology, mechanisms of development and clinical manifestations of malabsorption syndrome.Conclusion. Today, data on the mechanisms of development and progression of the malabsorption syndrome have been significantly expanded. This makes it possible to develop methods of prevention of the trigger factors, timely correct treatment and prevention of complications of this syndrome.

Abstract.  Recent data on the role of digestive pathology in the progression of chronic kidney disease (CKD) remain scarce. Calcium homeostasis plays an important role in the progression of renal pathology, especially in patients with malabsorption syndrome (MAS). The research aimed to evaluate calcium homeostasis in CKD patients with MAS. Methods. In this cross-sectional observational study, 99 CKD patients with MAS were enrolled. The patients were divided into 4 groups according to the CKD stage and the presence of MAS. Group I included 25 patients with CKD stages 1 and 2 without MAS; Group II consisted of 26 patients with CKD stages 1 and 2, and MAS; Group ІІІ (n = 23) and Group ІV (n = 25) included patients with CKD stage 3 without and with MAS, respectively. According to the morphological study of in vivo biopsies of the small intestinal mucosa, mild and moderate morphological changes were observed among all patients. The levels of calcium, phosphorus, parathyroid hormone, osteocalcin, and calcitonin in the blood, as well as urinary calcium levels, were detected. Results. Pathological changes in calcium metabolism were observed among CKD patients with MAS. The severity of calcium homeostasis disorders was more evident among patients with CKD stage 3 compared with stages 1 and 2. Urinary calcium levels were reduced in the patients of Groups III and IV. No changes were detected in phosphorus levels. Changes in parathyroid hormone and osteocalcin are caused primarily by combined renal pathology with impaired renal calcium absorption. Conclusion. MAS in CKD patients leads to deep violations of calcium homeostasis resulting in rapid CKD progression and bone tissue violation.

The purpose of this work was to investigate renal blood supply disturbance in patients with chronic renal disease stage I-II (pyelonephritis, glomerulonephritis, diabetic nephropathy). Material and methods. The authors carried out 131 complex ultrasonic investigations using ultrasonic duplex color kidney scanning. 47patients with chronic pyelonephritis (ChPN), 48patients with diabetic nephropathy stage IV (DN) and 36patients with chronic glomerulonephritis (ChGN) were involved into investigation. Each group consisted of 2 subgroups – with arterial hypertension (AH) and without AH. 20 healthy persons were examined as well. Results. Scantyintrarenal blood flow which is characterized with a decrease of maximal systolic (Vs), minimal diastolic blood velocity(Vd), as well as a decrease of indices of the averaged, according to time, maximal blood velocity (TAMX) and volumetric blood velocity (Vvol) and an increase of index resistance (IR) have been revealed in patients with chronic renal disease (ChRD) stage I-II with the presence of AH stage II. Indices of the vascular renal blood flow under study correlated with the main factors of ChRD progression – glomerular filtration rate (GFR) and daily proteinuria. Conclusion. Reliable Vs, Vd, TAMX and Vvol decrease and a reliable IR increase may be considered as early noninvasive criteria of ChRD progression with the presence of AH stage II.

Renal damage in patients with rheumatoid arthritis (RA) is the most frequent and serious among other systemic manifestations and holds a special place in connection with a significant impact on prognosis and approaches to therapy. Today we know that one of the main possible factors of occurrence and development of RA are external trigger factors, among which the most important factor are infectious, and its pathogenic effect on the body can be done in different ways. Based on the latest scientific evidence on the importance of infectious trigger factors in the manifestation of RA, chronic pyelonephritis among these triggers is one of the leaders. Great interest is also the probability of pyelonephritis manifestation while presence of RA. The aim: to identify predictors ofpyelonephritis manifestation in patients with rheumatoid arthritis. Materials and methods. The authors examined 31 patients with RA with presence of chronic pyelonephritis (CP), 31 patients with RA without presence of CP and 20 healthy individuals. Was used clustering and classification methods of Data Mining on indicators of lipid peroxidation of blood and urine, р2–microglobulin blood and urine, immune factors, that defined progressive CKD on the results of our previous studies (IL–1p,IL–10, TGF–р). Results. Found that patients with diagnosed RA only, mainly are included in the cluster «1» (18patients). Some of them (3 persons) classified as belonging to the cluster «2». Thus, these individuals should have two signs of disease, RA and CP, despite the fact that they have only diagnosed RA. It means that these patients are at risk of developing CP. This analysis gives grounds to consider that RA may be signs of a factor that causes manifestation of CP. It is proved that the main factor that characterizes the individuals belonging to the cluster of healthy is 2– microglobulin in the urine with the same threshold value, but factor in determining membership of a type of disease is a factor MDA of urine. Conclusion. The main predictors of pyelonephritis manifestation in patients with rheumatoid arthritis were 2– microglobulin and MDA in urine and TGF– 1 in blood. A new method of diagnosing ofprognostic factors of CP manifestation in patients with RA which is based on cluster and classification analysis makes it possible to establish the interrelation between a diagnosis of RA and caused by it manifestation of CP.