Ceftaroline fosamil achieved high clinical cure and microbiological response rates in patients hospitalized with CAP of PORT risk class III or IV. Ceftaroline fosamil was well tolerated, with a safety profile that is similar to that of ceftriaxone and other cephalosporins. Ceftaroline fosamil is a promising agent for the treatment of CAP.

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%.

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%.

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 study links between morphological glomerular kidney lesion parameters and serum cystatin C (CysC) in patients with chronic glomerulonephritis (CGN) with saved renal function, and to assess therapeutic correction of identified changes using ACE inhibitor ramipril. Methods: eighty one patients with CGN were enrolled in the study. Blood samples of the biomarker were collected. The diagnosis of "chronic glomerulonephritis" was verified on the basis of clinical, laboratory and morphological data. Patients were divided into 2 clinical groups: patients with CGN and arterial hypertension (AH) and without AH. We used data of renal biopsies to analyze the indicators of glomerular kidney lesion in patients with CGN. The level of serum CysC was measured using ELISA kits. Treatment of patients was carried out over 24 weeks using the ACE inhibitor ramipril. The average daily dose of ramipril for the entire treatment period for patients with AH was 12.8±5.6 mg, patients of the second group-8 Oleg Kraydaschenko et al. without AH, were treated with ramipril at a dose of 2.5 mg. Results: according to the results of renal microscopy 88% patients had mesangial proliferative glomerulonephritis, 7%membranous nephropathy, 5%membranous proliferative glomerulonephritis. On the basis of rank correlation analysis we proved that the level of serum CysC directly correlated with glomerulosclerosis (r = 0.85, p < 0.05). Levels of blood creatinine, proteinuria and CysC reduced under the influence of 24-week ramipril treatment. Conclusion: serum CysC is the most sensitive marker of glomerular kidney lesion with diagnostic efficiency up to 97%. The 24-week treatment with ACE inhibitor ramipril in patients with CGN with and without AH reduced levels of glomerular kidney lesion markers that confirmed nephroprotective effect of the drug.