Incidence degree of congenital urinary system abnormalities and conjunctive tissue dysplasia among terminal chronic renal failure patients


DOI: https://dx.doi.org/10.18565/therapy.2020.6.18-26

Druk I.V., Nechaeva G.I., Ambartsumyan D.B., Kotova L.I., Drokina O.V., Bilevich O.A.

1) Omsk State Medical University of the Ministry of Healthcare of Russia; 2) Regional сlinical hospital, Omsk
Aim of the research: to estimate the prevalence of congenital urinary system abnormalities (CUSA) and connective tissue dysplasia (CTD) among patients with end-stage chronic renal failure (ECRF) on hemodialysis.
Material and methods. The cross-sectional study included patients with ECRF who received renal replacement therapy and signed an informed consent: 72 patients (41 males; age – 60 years (LQ 48.5; UQ 65,0)), divided into two groups (group 1 – patients with (CUSA, n=14; group 2 – patients without congenital urinary tissue abnormalities and conjunctive tissue dysplasia (CUSA, n=58). The level p <0,05 was considered to be statistically significant.
Results. In the general group, CUSA as the main pathology leading to the development of CKD occurred in 14 patients (19,4%), the Charlson comorbidity index was 5,0. Group 1 had a significantly lower comorbidity index (p=0,004), a higher frequency of tubulointerstitial pathology (p=0,005), a lower frequency of primary glomerular lesions (p=0,019) and vascular pathology (p=0,031). In group 1, there were significantly more occured minor developmental anomalies (MDA) and malformations of the cardiovascular system (χ2 5,013; p=0,026), polycystic liver disease (χ2 17,077; p=0,001), CTD was more common (2/14 and 0/58; p=0,044).
Conclusion. In the examined group of patients, CUSA as the main pathology that led to the development of ESRF occurred in every fifth patient. The group of patients with CUSA was characterized by a higher incidence of tubulointerstitial pathology and secondary pielonephritis, lower incidence of primary glomerular lesions and vascular pathology, a lower Charlson comorbidity index, a higher incidence of MAP and malformations of internal organs and CTD.
It seems promising to search for additional clinical, molecular genetic markers of the risk of poor prognosis in CUSA patients. The role of systemic connective tissue dysmorphogenesis in the renal continuum requires further studies.
Keywords: terminal stage, abnormalities of urinoexcretory system development, connective tissue dysplasia, chronic renal failure
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About the Autors

Inna V. Druk, MD, associate professor, professor of the Department of internal medicine and family medicine of postgraduate education of Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenin Str. Tel.: +7 (381)249-20-85. E-mail: drukinna@yandex.ru. ORCID: 0000-0001-8317-7765
Galina I. Nechaeva, MD, professor, head of the Department of internal medicine and family medicine of postgraduate education of Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenin Str. Tel.: +7 (913) 978-83-83. E-mail: profnechaeva@yandex.ru
David B. Ambartsumyan, urologist of urologic Department of Regional clinical hospital. Address: 644099, Omsk,
3 Berezovaya Str. Tel.: +7 (3812) 23-26-74. E-mail: davidovski84@mail.ru
Lidia I. Kotova, PhD, head of the Department of therapeutic nephrology and dialysis of Regional clinical hospital. Address: 644099, Omsk, 3 Berezovaya Str. Tel.: +7 (3812) 23-26-74. E-mail: Likotova@mail.ru
Olga V. Drokina, PhD, associate professor of Department of internal diseases propedeutics of Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenin Str. Tel.: +7 (913) 975-67-15.
E-mail: amans@bk.ru. ORCID: 0000-0002-3637-3146
Olga A. Bilevich, PhD, associate professor of Department of internal diseases propedeutics of Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenin Str. Tel.: +7 (3812) 73-33-37.
E-mail: bilewich@mail.ru. ORCID: 0000-0003-2583-5648


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