Dysimmune polyneuropathies are the etiologically heterogeneous group of diseases with autoimmune damage to the peripheral nervous system. The rarity of these diseases doesn’t exclude the possibility of their development or exacerbation in patients infected with SARS‑CoV‑2, which will require timely differential diagnosis and urgent specific therapy. The article summarizes current information on the mechanisms of development, clinical features, diagnosis and management of acute and chronic dysimmune polyneuropathies in the context of the COVID‑19 pandemic.

The outcome of chronic kidney disease (CKD) is frequently development of end-stage kidney failure that requires program hemodialysis (PHD). Increase of the longevity of long-term PHD patients is associated with continuous somatic and psychic stress for the patient, which might adversely affect the quality of life (QoL) of an end-stage CKD patient.Purpose: to determine the influence of age and dialysis duration on the QoL of end-stage CKD patients receiving PHD.Materials and methods. 50 patients receiving PHD (23 men and 27 women), aged 31 to 79 years, were examined. The mean age was 56.72±11.26 years. The PHD duration ranged between 1 month to 20 years, the average figure being 5.26±4.82 years. The control group included 50 healthy subjects of comparable gender and age. The QoL evaluation data were gathered through survey using the Russian version of SF-36 Questionnaire (Short Form Medical Outcomes Study), validated by the Institute of Clinical and Pharmacological Studies (Saint Petersburg) and analysis of case records.Results. As regards the scales of physical health, a decrease of the QoL of PHD patients was found as follows: РF-physical functioning (54.1±25.6 vs. 85.0±21.4), RP-role functioning related to physical condition (38.5±35.4 vs. 74.5±29.7), Pbodily pain (64.7±32.1 vs. 70.5±24.8), GH-general health condition (51.3±15.9 vs. 65.1±21.7). A trend towards inter-group difference was also discovered as regards the scales of vitality (VT) (53.7±19.5 vs. 61.0±19.4), social functioning (SF) (72.5±18.0 vs. 79.5±23.5). Multiple regression analysis established inverse relationship between the patient’s physical health component (PH) and age (rs=-0.317, P<0.05).Conclusion. In PHD patients, the physical health component is the one that suffers most of all, namely: physical functioning, role functioning related to physical condition, pain intensity, and general health condition. The tendency to statistic differences is observed for the scales of vitality and social functioning of the mental health component. Increase of the age and dialysis duration affect adversely the physical health whereas render no influence on the mental health.

The aim of the investigation was to study the species composition of colon microbiocenosis in patients with chronic kidney disease receiving programmed hemodialysis treatment and to evaluate the efficacy of its correction using a new immobilized synbiotic. Materials and Methods. Samples of colon microbiota from 62 patients undergoing programmed hemodialysis were studied before and after a course of diet therapy that included probiotic components, in particular, the immobilized synbiotic LB-complex L. Isolation of microorganisms was carried out according to our original method; for bacteria identification, a MALDI-TOF Autoflex speed mass spectrometer (Bruker Daltonik, Germany) was used in the Biotyper program mode. The results were assessed using the criteria proposed by the authors and based on the OST 91500.11.0004-2003. The efficacy of the immobilized synbiotic was determined based on the clinical data, questionnaires, and bacteriological tests. Results. In patients receiving programmed hemodialysis (before the start of the diet therapy), chronic moderate inflammation and azotemia were found. Dysbiotic changes in microbiocenosis were revealed in all the examined patients; in the absence or suppression of lacto- and bifidoflora, the number and diversity of Bacteroides spp. , Clostridium spp. , Collinsella spp. , Eggerthella spp. and other bacteria increased, which was consistent with the theory of functional redundancy of gut microbiota. From the answers to the questionnaires, a decrease in the quality of life was found (up to 70 points out of 100) according to six of the eight scales used. After the combined therapy using the synbiotic LB-complex L in the study group, 56% of the examined patients showed their microbiocenosis restored to normal; no grade III dysbiosis was detected in any patient. There was a significant decrease in CRP and ESR in these patients and an improvement in the quality of life by criteria reflecting physical health. Conclusion. In patients receiving programmed hemodialysis, the addition of a probiotic component in the diet therapy restores the evolutionarily determined structure of the microbiocenosis, normalizes its functions, and leads to an overall improvement in health and quality of life.

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Objective: to study the cognitive status of patients in the pre-dialysis period depending on the stage of chronic kidney disease (CKD) and the category of cardiovascular risk (CVR). Materials and Methods. We examined 98 patients with CKD in the pre-dialysis period (mean age 47.1±11.2 years). The patients were divided into three groups according to the criteria of CVR stratification. Group 1 consisted of 32 patients with a low or moderate CVR, and CKD stage C1 or C2; Group 2 included 34 patients with a high CVR and CKD stage C3a or C3b; Group 3 comprised 32 patients with a very high CVR and CKD stage C4. We used the SAGE test (Self-Administered Gerocognitive Examination) to evaluate cognitive functions. Results. Cognitive impairment (CI) was detected in 57% of the patients: 37.5% in Group 1, 44.1% in Group 2, and 90.5% in Group 3. Dementia was diagnosed in 19% of patients with CI. A correlation was found between the severity of CI, the degree of decrease in glomerular filtration rate, and the education level of CKD patients in the pre-dialysis period (p≤0.001). We established that the examined subjects with CKD were characterized by memory, constructive, spatial and logical thinking disorders. Conclusion. Chronic kidney disease is an independent risk factor for the development of CI. The latter progressed with both CKD stage and the patient’s CVR category, and was detected in 37.5% of patients with a low or moderate CVR, 44.1% of patients with a high CVR, and 90.5% of patients with a very high CVR.