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Number of patients with progressive chronic kidney disease (CKD) is increasing all over the world. One of the risk factors for CKD development and progression is increased serum uric acid (sUA) level. Possibly, control of hyperurcemia with urate lowering therapy drugs can slow the decline in kidney function. The objective: to determine efficacy and safety of allopurinol and febuxostat in treatment of patients with CKD and hyperurcemia to reduce the sUA level and analyze its influence on glomerular filtration rate (GFR). Materials and methods. The study included 45 CKD patients (stages 3b-5) without other severe/decompensated diseases and contraindications to the allopurinol/febuxostat. All patients underwent a comprehensive clinical and laboratory examination, and were divided into the study groups: Group I (28 patients, 61.3±3.2 y.o., CKD3b-12, CKD4-10, on hemodialysis-6 patients) received febuxostat, Group II (24 patients, 60.7Ѓ}4.1 y.o., CKD3b-9, CKD4-10, on hemodialysis – 5 patients) took allopurinol. Results. Achievement of the target level of sUA was significantly often registered in Group I: after 1 month – in 45.5% (in group II – in 15.9%, p

Osteoarthritis (OA) is the most common joint disease that significantly affects the patients’ quality of life and requires significant medical and social investments for treatment and rehabilitation. There are no therapeutic agents which would be able to regenerate lost or damaged hyaline cartilage. The objective: to assess the efficacy and safety of the chondroprotective parapharmaceutical agent Flexogial in the complex treatment of patients with initial stages of the knee ОА. Materials and methods. 12-weeks study was conducted with the participation of 60 patients with knee OA aged 53,7±2,9 years, women – 36 (60%), men – 24 (40%) with the initial stages of the disease (I–II radiological stage). The main clinical group consisted of 30 patients who took the chondroprotective complex agent Flexogial 15 ml once a day; the comparison group included 30 patients who were administered glucosamine sulfate 1500 mg in a monopreparation taken once a day. Efficacy of the treatment was evaluated using the VAS scale, Tegner’s scale, Lisholm scale at the beginning of treatment, after 6 and 12 weeks in dynamics with subsequent statistical processing of the results. Results. The study demonstrated better indicators of functional activity and less pain intensity in the affected joints in patients of the main group who took the parapharmaceutical agent Flexogial compared to the group of patients who took glucosamine monopreparation with the same number of registered adverse events in both groups of patients (5%). Conclusions. The results of the presented clinical study proved the advantage of use of the combined chondroprotective drinking complex Flexogial in comparison with the monopharmaceutical preparation glucosamine sulfate in the treatment of patients with early stages knee OA in terms of the effect on the intensity of pain and improvement in the parameters of the functional activity of patients after 6 and 12 weeks with the same frequency of registered adverse events.

The article considers the mechanism of action, indications for use and analysis of efficiency of using the macrolides, in particular spiramycin, in case of respiratory tract infections in the outpatient setting.

The diagnostic criteria and treatment strategy, which are used for patients with acute gouty arthritis in primary health care practice is given in the article. The algorithm of primary medicine doctor’s action in the management of patients with the acute gout attack is represented.

In the structure of causes of the end1stage chronic kidney disease is essential hypertension (EH) which takes the leading role. One of the pathogenic mechanisms of hypertensive nephropathy is a violation of intrarenal blood flow, which clinically manifesting with hyperfiltration. The objective: of the frequency of subclinical renal damage of patients with stage I EAH by water and salt loading and comparing these data with the standard criteria of essential nephropathy with hypertension. Patients and methods. The study involved 30 patients aged 27 to 59 years with diagnosed grade 1 essential hypertension who did not receive medical treatment and did not have the disease (lesions) of the kidneys. Mean albumin/creatin ratio of patients constituted 15,12±5,02 mg/g. According to the analysis of outpatient cards hypertension duration do not exceed during 5 years. All patients underwent 241hour blood pressure monitoring and determining the method RFR water and salt load (under patent Ukraine 42,860) [9]. The results of daily monitoring of blood pressure (DMAT) were patients divided into two groups: the 1st group included patients who had been diagnosted the I step and I stage of EH, it comprised 22 patients (73.3%). Second group included patients who had been diagnosted the II stage of EH – 8 patients (26.7%). Results. Subclinical kidney damage were found in 8 patients (26.7%) in determining the method of water-salt load. (RFR 10±2,01% in 8 patients (26.7%) 1st group and RFR 22,31±3,9% in 22 patients (73.3%) significant difference between groups (p

The article shows the main current evidence on the diagnosis, course and treatment of chronic heart failure on an outpatient basis.

Inflammation, edema and local vascular permeability changes are essential features of the complex regional pain syndrome type I (CRPS I). The role of kallikrein-kinin system components as the major mediators in the development of these symptoms is poorly investigated. The objective: to investigate the role of kallikrein-kinin system in pathophysiologic mechanisms of CRPS I. Patients and methods. We have investigated level of prekallikrein (PK), activity of fast-reacting (FRI) and time-dependent (TDI) inhibitors of plasma kallikrein, and blood plasma proteolytic activity (BPPA) in 45 patients with CRPS I and 15 healthy volunteers. Results. Analysis of kininogenesis activity and sympathetic-adrenal system revealed their close interdependence. Our data corresponds well with the literature information about depressive effect of sympathetic nervous system on kininase activity. This leads to the accumulation of vasoactive peptides in the injures segment of the extremity. Decrease of neurogenic effects at the later stages of CRPS I leads to the fall of the basal kininogenesis level. Conclusion. Local humoral factors such as the components of kallikrein-kinin system play an important role in CRPS I pathophysiologic mechanisms and are dependent on sympathetic-adrenal system activity.