Terapevt Arkh
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Historical Article
[On the history of specialization in the clinic of internal diseases: the role of S.S. Zimnitsky (Kazan) in the formation of nephrology in the USSR].
Russian nephrology, like most clinical disciplines, has passed through two stages in its historical development: at the first stage, it became isolated as an important area of scientific research within the framework of the Soviet clinic of internal diseases, at the second stage it became an independent scientific and educational clinical discipline and medical specialty. The article shows the role of Kazan internist S. S. Zimnitsky as one of the founders of nephrology in the USSR at the first stage of its formation and as one of the leaders of the functional direction in Soviet clinical medicine.
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Observational Study
[Impact of kidney biopsy on the management of patients in the rheumatology department: retrospective study].
Kidney involvement is a common manifestation of the systemic autoimmune rheumatic diseases. Kidney biopsy is the gold standard for the diagnosis of kidney diseases, however this method has not yet become the standard-of-care in rheumatology practice. ⋯ Our study demonstrates significant value and safety of kidney biopsy in the patients with autoimmune rheumatic conditions. We suggest that kidney biopsy should be implemented in the management of this category of patients.
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To analyze the outcomes of C3-glomerulopathy (C3-GP) and determine the associated factors. ⋯ C3-GP is a variant of severe complement-mediated glomerular damage with unfavorable renal prognosis, which requires timely personalized expert-level diagnostics with clarification of etiopathogenesis of the disease followed by therapy aimed at achieving remission to improve outcomes.
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To determine the incidence and risk factors of acute kidney injury (AKI) in Russian cohort of patients with COVID-19. ⋯ The clinical course of COVID-19 was complicated by AKI in 29% cases. The independent risk factors of AKI in patients with COVID-19 are underline chronic kidney disease, circulatory disorder and the highest level of C-reactive protein during hospitalization.
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Lupus nephritis (LN) is the most common organ lesion in systemic lupus erythematosus (SLE), developing in 4050% of patients. Due to immunosuppressive therapy, the survival of patients with SLE has increased significantly over the past 50 years, and the proportion of severe kidney damage in the death structure has decreased. However, LN relapses and complications of immunosuppression, accelerated atherogenesis, concomitant diseases lead to the accumulation of organ damage and an increased risk of death. The article consideres the place of kidney damage in the SLE, the risk factors for LN development, the main renal histopathological changes, it identifies a number of issues that need to be addressed to optimize treatment and improve LN long-term outcomes, including, the revision of pathogenetic therapy regimens with restriction of glucocorticosteroids and prescribing drugs with steroid-sparing activity, the integration of new drugs for LN treatment, wider use of modern nephroprotection capabilities.