Patients with chronic kidney disease stage 5 belong to the group of patients with the highest risk of complicated course of COVID-19. The purpose of the study was to study the prevalence and clinical and laboratory features of the COVID-19 infection among patients with end-stage of chronic kidney disease who receive renal replacement therapy. Materials and methods. The study included 172 patients with chronic kidney disease stage 5, who were receiving renal replacement therapy and who were diagnosed with COVID-19 for the period from April 2020 to April 2021. According to the type of renal replacement therapy all patients were divided into 3 groups: group 1 – 98 (56.9%) patients who received hemodialysis, group 2 – 60 (34.8%) patients who were on peritoneal dialysis, group 3 – 14 (8.1%) patients with kidney transplantation. The main clinical and laboratory parameters that characterize the course of the COVID-19 infection such as fever, diarrhea, anosmia, the percentage of oxygen saturation, the percentage of lung damage, levels of total protein, albumin, C-reactive protein, urea, creatinine, D-dimer, hemoglobin, leukocytes, platelets were evaluated. Results and discussion. The COVID-19 infection was diagnosed in 172 (38.2%) patients, the vast majority of whom – 110 (63.9%) patients were women with a mean age of 47.4±4.6 years. The analysis of clinical and laboratory parameters revealed the most severe course of the disease in patients with a kidney transplant and in patients who were on hemodialysis. In the group of renal transplant recipients there was a significant increase in the level of D-dimer, as well as a higher percentage of lung damage, compared with the average values of these indicators among patients on hemodialysis and peritoneal dialysis, but mortality in this group was 13.3% and was significantly lower than in the group of hemodialysis patients – 27.5%. It should be noted that in patients on renal replacement therapy by the method of hemodialysis, the adequacy of dialysis therapy was insufficient, which led to a more pronounced overall inflammatory response, which was characterized by the highest level of C-reactive protein (64.4±5.1 mg/l), compared with patients in the other study groups. The course of the disease in patients on hemodialysis was also complicated by anemia. In patients on renal replacement therapy by peritoneal dialysis, the COVID-19 infection was characterized by a mild course, with the lowest percentage of lung damage (22.0±2.8%) and fatalities (11.6%). Conclusion. According to our study, the incidence of COVID-19 among patients receiving renal replacement therapy is 38.2%. A more severe course of the disease was registered in the group of patients with a kidney transplant, due to the nature of comorbid pathology, as well as immunosuppressive therapy. The data obtained allow us to consider patients with a transplanted kidney as a risk group for severe COVID-19 infection

Проведено изучение частоты кальцификации брюшного отдела аорты и роли плазменной фракции остеопонтина в её развитии, а также взаимосвязи между степенью нарушения фосфорно-кальциевого обмена у пациентов с хронической болезнью почек 5-й Д стадии на перитонеальном диализе. Выявлено, что кальцификация брюшного отдела аорты встречается у 73,3 % пациентов данной группы. Предикторами развития сосудистой кальцификации является возраст больных и длительность диализной терапии. С прогрессированием степени сосудистой кальцификации наблюдается ухудшение показателей костно-минерального обмена в виде статистически достоверного увеличения уровней сывороточного фосфора, фосфорно-кальциевого произведения и паратиреоидного гормона. Концентрация остеопонтина в плазме крови коррелирует со степенью тяжести кальцификации брюшной аорты и может быть маркером сосудистой кальцификации у диализных пациентов.

The purpose of the study was to identify the components of the metabolic syndrome most characteristic of different clinical variants of ischemic heart disease in patients with chronic kidney disease on peritoneal dialysis. Materials and methods. 114 patients took part in the study. The average duration of peritoneal dialysis therapy was 53 months. Clinical variants of ischemic heart disease were determined by angina attacks, by painless myocardial ischemia detected by ECG-load cycle ergometer test, by increasing phenomena of ischemic dilated cardiomyopathy (diastolic dysfunction, calcification and atheromatosis of aorta and heart valves) by echocardiographic study in dynamics and by the previous myocardial infarction episodes. All patients were accordingly divided into 5 clinical groups, one of which was patients with no evidence of coronary heart disease (comparison group). The data were processed using the SPSS 19.0 for Windows statistical software package. Results and discussion. Considering different components of metabolic syndrome: body weight, arterial hypertension, dyslipidemia, the highest body mass index in patients on peritoneal dialysis was found in the group of patients suffering from ischemic dilated cardiomyopathy. High-density lipoproteins were lowest in the group of patients who underwent myocardial infarction. Hypertriglyceridemia was most pronounced in the group of patients with painless myocardial ischaemia. Low-density lipoproteins were highest in the group of patients with stable angina pectoris. Mean arterial pressure was highest in the group of patients with stable angina and in the group of patients with painless myocardial ischaemia. Conclusion. The highest number of patients with metabolic syndrome was found in the groups of patients with non-painful myocardial ischemia and ischemic dilated cardiomyopathy (67% and 51% respectively). In the group of patients with non-painful myocardial ischaemia (high acute coronary risk group), metabolic syndrome was diagnosed by four features: visceral obesity, raised blood sugar, arterial hypertension, raised very low density of lipoproteins and triglycerides. In the group of patients with ICDMP (group of patients with severe diastolic heart failure), metabolic syndrome was diagnosed by three features: visceral obesity, elevated blood sugar and low density lipoproteins. Thus, a vector for further research may be to investigate the effect of complexly corrected components of the metabolic syndrome on the occurrence of acute coronary risks or progression of chronic heart failure in patients with chronic kidney disease on peritoneal dialysis