Aim: to analyze the histological kidney features in patients with chronic glomerulonephritis (CGN) and arterial hypertension (AH) and without it, to assess the relationship between serum interleukin-18 (IL-18) and histological signs of tubulo-interstitial kidney lesion in patients with CGN and saved renal function. Methods: eighty one patients with CGN. Blood samples for biomarkers were collected. The diagnosis of "chronic glomerulonephritis" was defined by the clinical, laboratory data and renal biopsies. Patients were divided into 2 clinical groups: patients with AH and without AH. We used data of renal biopsies to analyze the signs of kidney tubulo-interstitial tissue lesion in patients with CGN. Levels of serum IL-18 were measured by Bender Medsystems kits (Аustria). Results: according to the results of renal microscopy 88% patients had mesangial proliferative glomerulonephritis, 7%membranous nephropathy, 5%membranous proliferative glomerulonephritis. Patients with CGN and AH have more severe histological tubulo-interstitial lesion parametres than patients with CGN without AH. On the basis of rank correlation analysis we proved that serum IL-18 directly correlates with indicators of of tubulo-interstitial kidney tissue lesion 186 Oleg Kraydaschenko et al. in patients with CGN, strong direct relationship was found between the level of serum IL-18 and dystrophic changes in epithelial tubules (r = 0.81, p < 0.05). Diagnostics of dystrophic changes in epithelial tubules by determining of the serum IL-18 level is a highly sensitive and specific method, with the efficiency of 96.6%.

Involving of renal tubulointerstitial tissue (TIT) with fibrosis development plays an important role in the persistent renal dysfunction. This circumstance gave rise to the attempts of neutrophil gelatinase–associated lipocalin (NGAL), interleukin–18 (IL–18) use to estimate kidney TIT lesion in chronic glomerulonephritis (CGN) and essential hypertension (EH). Aim. To study the relationship between the biomarkers and clinical, morphological parameters reflecting renal TIT damage in CGN and EH patients. Materials and methods. We examined 44 hypertensive patients and 49 patients with CGN and hypertension. We used data of the kidney morphological study for the analysis of renal TIT lesion in CGN patients. Levels of blood and urine NGAL and IL–18 were determined using immunoassay kits. Results. All patients had preserved renal function. In hypertensive patients microalbuminuria (MAU) was detected in 32%. Patients with CGN had average daily proteinuria 0,5 (0,1:1,2) g/day. Morphologically tubular epithelium dystrophy was observed in 98% ofpatients with CGN. Interstitial fibrosis (IF) was seen in all patients with CGN, and 45% had focal character, while 55% – diffuse. Necrotic changes in the tubular epithelium were observed in 69% of cases, thickening of tubular basement membrane – 61% of patients. Correlation analysis found an association between the level of serum NGAL and IF(r=0,35, p=0,05), tubular basement membrane thickening (r=0,42, p=0,05); urinary NGAL levels and tubular epithelium dystrophy (r=0,29, p=0,05). Serum IL–18 was correlated with tubular epithelium dystrophy (r=0,69, p=0,05); tubular epithelium necrosis (r=0,37, p=0,05), IF (r=0,31, p=0,05). Despite normal renal function and absence of MAU (in 64% of cases), the indicators of renal TIT damage in hypertensive patients are increased. Conclusions. Serum, urine NGAL and serum IL–18 can be used as markers of renal TIT lesion in CGN and EH patients. Serum NGAL reflects most accurately IF and tubular basement membrane changes; urine NGAL – tubular epithelium dystrophy. Serum IL–18 is an indicator of tubular epithelium necrosis, IF.

Aim: to analyze the histological kidney features in patients with CGN and arterial hypertension (AH) and without it, to assess the relationship between serum CysC and NGAL and histological signs of glomerular and tubular kidney lesion in patients with CGN with saved renal function. Methods: eighty one patients with CGN were enrolled in the study. Blood samples for biomarkers were collected. The diagnosis of "chronic glomerulonephritis" was defined by the clinical, laboratory data and renal biopsies. Patients were divided into 2 clinical groups: patients with AH and without AH. We used data of renal biopsies to analyze the signs of kidney glomerular apparatus and tubulo-interstitial tissue lesion in patients with CGN. Levels of serum CysC and NGAL were measured by ELISA kits. 148 Oleg Kraydaschenko et al. Results: according to the results of renal microscopy 88% patients had mesangial proliferative glomerulonephritis, 7%membranous nephropathy, 5%membranous proliferative glomerulonephritis. Patients with CGN and AH have more severe histological glomerular and tubular lesion parameters than patients with CGN without AH. On the basis of rank correlation analysis we proved that serum cysC directly correlates with all indicators of glomerular apparatus kidney lesion in patients with CGN, strong direct relationship was found between the level of serum cysC and glomerulosclerosis (r = 0.85, p < 0.05). Level of serum NGAL directly correlates with indicators of tubulo-interstitial kidney tissue lesion in patients with CGN, strong direct relationship was found between the level of serum NGAL and interstitial fibrosis (r = 0.65, p < 0.05). Conclusion: glomerulosclerosis has determined of the serum cysC level with the efficiency of 96.55%. Diagnostics of interstitial fibrosis by determining of the serum NGAL level is a highly sensitive and specific method, with the efficiency of 95.3%.

To investigate indexes ofdaily blood pressure (BP) in patients with chronic glomerulonephri­tis (CGN) and normal renal function.

Determining of serum creatinine level, glomerular filtration rate and albuminuria gives us no information about tubulointerstitial kidney damage. So it is especially important to search for non - invasive diagnostic methods that allow to diagnose early stages of tubulointerstitial kidney damage and start adequate treatment. This circumstance attempts to use neutrophil gelatinase - associated lipocalin (NGAL) to assess tubulointerstitial kidney damage in patients with chronic glomerulonephritis (CGN). The aim: to analyze the morphological picture of the kidneys in patients with CGN with arterial hypertension (AH) and without, to investigate the relationship between serum NGAL and histological indexes of tubulointerstitial kidney damage in CGN patients with saved renal function. Materials and methods. We examined 81 patients with CGN. Patients were divided into two clinical groups: CGN patients with AH, CGN without AH. We analyzed indicators of tubulointerstitial kidney damage according to vivo morphological study, level of serum NGAL. Conclusion: there is a correlation of varying strength between serum NGAL and indexes of tubulointerstitial kidney damage in CGN patients, strong direct relationship is found between serum NGAL and IF. Diagnostics of IF by determing ofserum NGAL is a highly sensitive and specific method with the efficiency of95.3%. Increase ofserum NGAL above 5ng/ ml indicates a high probability of the IF in CGN patients.Results. Patients with AH have more pronounced histological damage of tubulointerstitial tissue than CGNpatients without AH. Serum NGAL levels are higher in CGN patients with AH and without than in the control group. We find a correlation between serum NGAL and indicators of tubulointer - stitial kidney damage. Analysis of the diagnostic operating characteristics of interstitial fibrosis (IF) by determining of serum NGAL shows that this method is highly sensitive and specific, with an efficiency of95,3%. Constructing ofa non - linear model revealed that increase of serum NGAL level above 5 ng/ml indicates a high probability of the IF in CGN patients.