Use of specific anti-HLA antibodies in clinical nephrology.

In order to optimize the regimen of pathogenetic therapy of glomerulonephritis with nephrotic syndrome we used transfusions of plasma containing specific anti-HLA antibodies against the patient's phenotype as a part of the treatment in the acute stages of disease. The method was theoretically based on the conception of autoimmune genesis of glomerular lesion as well as on the assumption that the highest expression of HLA-antigens are on the surface of activated immunocompetent cells. In previous experiments in vitro we demonstrated immunosuppressive activity of cytotoxic serum on lymphocytes in the absence of complement.

[The use of laser irradiation in nephrological practice].

The authors studied therapeutic potential and mechanism of action of low-intensity low-energy laser irradiating the skin at the site of the projection of the transplanted kidney poles through the development of chronic rejection or chronic pyelonephritis. The trial included 7 kidney recipients and 9 controls with primary chronic pyelonephritis. The treatment course implied 10 daily session of 20 minutes duration of He-Ne laser irradiation which was preceded by clinical-laboratory evaluation of the blood and urine, cellular and humoral immunity, hemostasis, central hemodynamics, local and mediator hormones, factors of nonspecific resistance, spin probe characteristics.

[Features of correction of phosphate-calcium metabolism disorders in terminal renal failure].

Mineral metabolism was studied in 27 hemodialyzed patients with terminal chronic renal failure (CRF). Because of progressing hyperparathyroidism the initial treatment included calcium drugs, active forms of vitamin D (videchol, oxidevit), almagel, bicarbonate hemodialysis and hemosorption. The condition improved in 8 and stabilized in 12 patients.

[A method of preparing an arteriovenous shunt for chronic hemodialysis].

The authors discuss their experience in forming arteriovenous fistulas for conducting chronic hemodialysis in 361 patients with accentuation placed on the features of performing repeated and multiple operations. The formation of arteriovenous fistulas in the lower third of the upper arm or the cubital fossa with retrograde blood flow into the venous system is the operal vessels, and a history of multiple operations on the forearm vessels. Hemodialysis in such cases should be started no sooner than two weeks after the operation.