The cost of dialysis renal replacement therapy for end-stage renal disease patients in Ukraine

Kolesnyk, М.; Liksunova, L.; Селезнева, Т. Д.; Maistrenko, T.

doi:10.31450/ukrjnd.4(64).2019.01

Cited by 7 publications

(2 citation statements)

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“…This encourages the identification of new links in the pathogenesis of CKD, prognostic markers of progression to develop more effective, individualized treatments [8]. Diagnosis of CKD in the early stages may prolong the pre-dialysis period, and in some patients renal replacement therapy may be effectively prevented [9].…”

Section: на умовах ліцензії CC By 40mentioning

confidence: 99%

Urinary thrombin as a marker of local disseminated intravascular coagulation in patients with chronic kidney disease

Mykhaloiko

2021

Med. perspekt.

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The aim of this research was to study the diagnostic markers of nonovert local disseminated intravascular coagulation (DIC) syndrome in the urine of patients with chronic kidney disease (CKD). We conducted a prospective study involving 140 patients with CKD, of these patients, 100 patients (71.4%; 95% CI 53.4-76.7) had glomerulonephritis (GN) and 40 patients (28.6%; 95% CI 21.3-36.8) had diabetic nephropathy (DN). We diagnosed overt DIC syndrome on the International Society of Thrombosis and Haemostasis (ISTH) scale (>5 points) in 18.6 % of patients. We determined the level of thrombin in the urine of patients who had <5 points on ISTH scale for the diagnosis of local nonovert DIC syndrome in the kidneys. In the urine of healthy individuals, the level of thrombin did not exceed 1 ng/ml, so we found no thrombinuria at a thrombin level <1 ng/ml. In 56.1% of patients, we found urinary thrombin levels >1 ng/ml. The average level of thrombin in the urine of these patients was 6.5 (4.8; 10.6) ng/ml. In our opinion, the presence of thrombinuria indicates the intensity of monocytic-macrophage inflammation in the glomeruli and may be a criterion for nonovert, local DIC syndrome in the kidneys. The association of overt DIC syndrome with decreased blood albumin, reduced glomerular filtration rate (GFR), increased daily protein excretion (DPE) indicates its occurrence in severe underlying disease, in the presence of nephrotic syndrome and in the severe stages of CKD. Early diagnosis of nonovert local DIC syndrome would be more useful, since the process is still reversible and controlled, and timely use of antiplatelet and anticoagulant therapy would affect the course and the progression of CKD.

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Section: на умовах ліцензії CC By 40mentioning

confidence: 99%

Urinary thrombin as a marker of local disseminated intravascular coagulation in patients with chronic kidney disease

Mykhaloiko

2021

Med. perspekt.

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“…Аналіз гемодіалізних методик, які використовуються в Україні, свідчить про те, що залежно від ГД технологій вартість витратних матеріалів може варіювати (табл. 1) [20,21]. Таблиця…”

Section: школа нефролога Nephrology Schoolunclassified

Expanded hemodialysis: new opportunities and hopes

Surzhko

2020

Ukr. J. Nephrol. and Dial.

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In the field of hemodialysis technologies, as in other fields of medicine, evolutionary changes are constantly taking place. The innovations are driven by unachieved clinical outcomes and desire to improve the quality of care of patients with CKD 5D. Recent advances in dialysis techniques resulted in the possibility to expand the permeability of dialysis membranes for a wider spectrum of uremic toxins that lead to the enhancement of long-term outcomes improving quality of life and reducing the mortality rate of dialysis patients. The inadequacy of existent dialysis techniques, at least in part, is due to the chronic accumulation of organic retention solutes of middle and large molecules, which are poorly or even not removed during dialysis. A gradual improvement in the elimination of uremic toxins is observed as a result of the development of new alternative approaches of hemodialysis therapy, such as high-flux hemodialysis, hemodiafiltration, expanded hemodialysis (HDx). However, some techniques have had limited success due to a host number of organizational, technological, financial and human factors. Expanded hemodialysis offers a novel blood purification technology in removal of the large spectrum of uremic toxins, in particular large medium molecules, due to the new structure of the dialysis membrane. There are a number of studies that prove the potential benefits of a new method of dialysis therapy over the previous ones, suggesting a reduction in cardiovascular mortality, vascular calcification and inflammation. In addition, there is evidence of a positive effect of HDx on the quality of life in dialysis patients. In particular, to minimize the manifestations of skin itching, restless legs syndrome, asthenic syndrome.

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