TThe main symptoms he main symptoms and syndromes in and syndromes in kidney diseases. kidney diseases. SSymptomatolymptomatolgy ofgy of acute and chronic acute and chronic glomerulonephritis glomerulonephritis and pyelonephritisand pyelonephritis..

renal functionrenal function

cleansing - excretion of metabolic cleansing - excretion of metabolic products, salts, dyes, chemicalsproducts, salts, dyes, chemicals

Homeostatic - maintaining a constant Homeostatic - maintaining a constant internal environment by regulating the internal environment by regulating the blood, osmotic pressure, KLRblood, osmotic pressure, KLR

erytropoetychnaerytropoetychna vnutrishnosekretornavnutrishnosekretorna regulation of blood pressureregulation of blood pressure

creening methods in creening methods in nephrology (the first nephrology (the first stage of the survey)stage of the survey) blood testblood test urinalysisurinalysis with suspected renal dysfunction - the with suspected renal dysfunction - the

content of creatinine in the bloodcontent of creatinine in the blood

the second phase of the the second phase of the surveysurvey

clarifying the main syndrome installation clarifying the main syndrome installation nosology, determining the degree of nosology, determining the degree of activity of the process, clarification of activity of the process, clarification of kidney function.kidney function.

llaboratory aboratory mmethodsethods

Microscopic methods of quantitative urine,Microscopic methods of quantitative urine, biochemical methods of blood and urinebiochemical methods of blood and urine     bacteriological,bacteriological, some (test for amyloid, search LE cells in some (test for amyloid, search LE cells in

the blood)the blood) immune methods (CIC, antinuclear immune methods (CIC, antinuclear

antibodies, antibodies to DNA)antibodies, antibodies to DNA)

Instrumental methodsInstrumental methods

ultrasoundultrasound radiologicalradiological radionuclideradionuclide kidney biopsy.kidney biopsy.

UrinalysisUrinalysis

color (from straw yellow to amber-yellow)color (from straw yellow to amber-yellow) transparency (clear, after settling may transparency (clear, after settling may

become turbid)become turbid) reaction (pH 5.5-6.5)reaction (pH 5.5-6.5) proportion (morning urine ranges from proportion (morning urine ranges from

1015 to 1025). Proteinuria 4 g / l 1015 to 1025). Proteinuria 4 g / l increases the proportion of 0.001 and 10 increases the proportion of 0.001 and 10 g / l glucose - 0,004.g / l glucose - 0,004.

Bacteriological Bacteriological examination of urineexamination of urine

microbial count (the number of bacteria in 1 ml microbial count (the number of bacteria in 1 ml of urine) (low to 20 thousand, the critical 20-of urine) (low to 20 thousand, the critical 20-100 thousand, truth more than 100 thousand)100 thousand, truth more than 100 thousand)

sensitivity to antibiotics and chemotherapysensitivity to antibiotics and chemotherapy special bacteriological tests (detection of L-special bacteriological tests (detection of L-

forms of bacteria, mycoplasma, fungi)forms of bacteria, mycoplasma, fungi) for the diagnosis of tuberculosis of the kidneys for the diagnosis of tuberculosis of the kidneys

(urine for 12 h in enriched environment or (urine for 12 h in enriched environment or biological sample)biological sample)

Evaluation ability of the Evaluation ability of the kidneys to urine dilution kidneys to urine dilution and concentrationand concentration

proportion morning urine (not below 1018-1022)proportion morning urine (not below 1018-1022) test on Zimnitskiy (urine collected during the day test on Zimnitskiy (urine collected during the day

in 3 hours 8 times. determine in each serving in 3 hours 8 times. determine in each serving size, proportion, ratio of night to day diuresis)size, proportion, ratio of night to day diuresis)

sample of deprivation for 12 hours (from 19.00 to sample of deprivation for 12 hours (from 19.00 to 07.00). If the proportion rises to 1024 and more 07.00). If the proportion rises to 1024 and more concentration of kidney function considered concentration of kidney function considered satisfactorysatisfactory

Score azotovydilnoyi function - serum Score azotovydilnoyi function - serum creatinine and urea in serumcreatinine and urea in serum

involved in renal electrolyte metabolism involved in renal electrolyte metabolism as an indicator of kidney function (Na, K, as an indicator of kidney function (Na, K, Ca, Mg, Cl).Ca, Mg, Cl).

X-ray of the kidneys. Survey urography - to determine the size and Survey urography - to determine the size and

shape of the kidney, the presence of shape of the kidney, the presence of concretions.concretions.

Urotomohrafiy - gives a three-dimensional Urotomohrafiy - gives a three-dimensional image of kidneyimage of kidney

Excretory urography - helps to determine not Excretory urography - helps to determine not only morphological but also functional status only morphological but also functional status of the kidneys and urinary tract.of the kidneys and urinary tract.

Infusional urographyInfusional urography Retrograde (ascending pyelography) - Retrograde (ascending pyelography) -

reveals asymmetry Wire cup-pelvic, strain the reveals asymmetry Wire cup-pelvic, strain the kidneys.kidneys.

Renal angiographyRenal angiography CTCT

Methods of radionuclide Methods of radionuclide studystudy

isotope renografiy - to determine isotope renografiy - to determine vascularization, activity of proximal vascularization, activity of proximal tubules and evacuation capacity of each tubules and evacuation capacity of each kidney.kidney.

Apply hipuran, it is nontoxic, quickly Apply hipuran, it is nontoxic, quickly moves from the blood to the kidneys and moves from the blood to the kidneys and urinary excretion. Kidneys excrete about urinary excretion. Kidneys excrete about 80% due to its secretion in the proximal 80% due to its secretion in the proximal tubule, and only 20% - by KF.tubule, and only 20% - by KF.

Normal renohramaNormal renohrama Phase 1 - vascular (blood) Phase 1 - vascular (blood)

duration of 20-60 seconds.duration of 20-60 seconds.

Phase 2 - secretory Phase 2 - secretory (tubular) 2-3 min after (tubular) 2-3 min after injection Contrast agents to injection Contrast agents to 5 min.5 min.

Phase 3 - excretory - Phase 3 - excretory - falling curve (expressing falling curve (expressing Contrast excretion of Contrast excretion of substances from the substances from the kidney. Duration curve is kidney. Duration curve is steep fall in 5 min., A steep fall in 5 min., A plateau from 5 to 8 minutes.plateau from 5 to 8 minutes.

Scanning kidneyScanning kidney visual kidney using radionuclides visual kidney using radionuclides

(neohidrynu) indicates localization, shape (neohidrynu) indicates localization, shape and size of the kidneys, the degree of and size of the kidneys, the degree of local functional activity of the local functional activity of the parenchyma, focal and diffuse lesions, parenchyma, focal and diffuse lesions, abnormalities. Lets differentiate renal abnormalities. Lets differentiate renal tumors, abdominal and extraperitoneal tumors, abdominal and extraperitoneal space.space.

thermographythermography

registration of spontaneous infrared registration of spontaneous infrared radiation of human skin.radiation of human skin.

Diffuse Diffuse glomerulonephritisglomerulonephritis

inflammatory infectious and allergic inflammatory infectious and allergic disease with predominant and primary disease with predominant and primary involvement in the pathological process involvement in the pathological process of glomerular apparatus of the nephronof glomerular apparatus of the nephron

Classifications of Classifications of glomerulonephritis glomerulonephritis (L.A. Pyrig)(L.A. Pyrig) acute diffuse glomerulonephritisacute diffuse glomerulonephritis urinary syndromeurinary syndrome nephrotic syndrome (mainly hematurinary, nephrotic syndrome (mainly hematurinary,

hypertensive, edematous component)hypertensive, edematous component) subacute (malignant) glomerulonephritissubacute (malignant) glomerulonephritis quickly progressing glomerulonephritisquickly progressing glomerulonephritis

chronic glomerulonephritischronic glomerulonephritistypetype primary chronicprimary chronic secondary chronicsecondary chronicsyndromesyndrome urinaryurinary nephroticnephroticstagestage anhipertenziveanhipertenzive hypertensivehypertensive chronic renal failurechronic renal failurephasephase aggravationaggravation remissionremission

Acute glomerulonephritisAcute glomerulonephritis

infectious-allergic disease, mainly infectious-allergic disease, mainly affecting vascular renal glomeruli with affecting vascular renal glomeruli with available also changes in the tubules and available also changes in the tubules and interstitial tissueinterstitial tissue

ClinicalClinical

course optionscourse optionsrapid onset, severity of symptoms.rapid onset, severity of symptoms.mono asymptomatic - gradual onset, mono asymptomatic - gradual onset, uclearness of symptoms. uclearness of symptoms.

SyndromesSyndromes bladder - the presence of protein in the urine bladder - the presence of protein in the urine

(proteinuria to 3.5 g per day) formal blood (proteinuria to 3.5 g per day) formal blood elements (red blood cells), cylinderselements (red blood cells), cylinders

nephrotic - proteinuria greater than 3.5 g per nephrotic - proteinuria greater than 3.5 g per day, hypoproteinemia, dysproteinemia, day, hypoproteinemia, dysproteinemia, hyperlipidemia, edemahyperlipidemia, edema

Facies nephriticaFacies nephritica

pale skin, swelling of the face and pale skin, swelling of the face and eyelids, puffiness under the eyes.eyelids, puffiness under the eyes.

Chronic diffuse Chronic diffuse glomerulonephritisglomerulonephritis

inflammation in the glomerulus, tubular inflammation in the glomerulus, tubular epithelial degeneration and progressive epithelial degeneration and progressive proliferation of connective tissue, which proliferation of connective tissue, which leads to the development of secondary leads to the development of secondary wrinkled kidney.wrinkled kidney.

Principles of treatmentPrinciples of treatment considering clinical variant phase, stage of the disease.considering clinical variant phase, stage of the disease. diet number 7 (restriction of salt to 4-5 g, nephrotic diet number 7 (restriction of salt to 4-5 g, nephrotic

version - salt-free diet.version - salt-free diet. medicationsmedications pathogenetic therapy: corticosteroids, cytotoxic agents, pathogenetic therapy: corticosteroids, cytotoxic agents,

aminoquinoline drugsaminoquinoline drugs antihypertensive therapy in the presence of hypertension: beta-antihypertensive therapy in the presence of hypertension: beta-

blockers, clonidineblockers, clonidine diuretics edema syndrome: furosemide, urehit, hypothiazidediuretics edema syndrome: furosemide, urehit, hypothiazide anticoagulants and antiplatelet: heparin, fraksyparyn, Courant, anticoagulants and antiplatelet: heparin, fraksyparyn, Courant,

tyklid, clopidogreltyklid, clopidogrel antibiotics in infectious complicationsantibiotics in infectious complications

PyelonephritisPyelonephritis

Nonspecific infectious inflammatory Nonspecific infectious inflammatory process, which is localized in mostly at process, which is localized in mostly at cup-pelvic kidney and its tubulo-cup-pelvic kidney and its tubulo-interstitial area.interstitial area.

Chronic pyelonephritis Chronic pyelonephritis (CPN)(CPN)

Running across a sluggish, periodically Running across a sluggish, periodically exacerbated bacterial inflammation of exacerbated bacterial inflammation of renal parenchyma (cup-pelvic and renal renal parenchyma (cup-pelvic and renal tubules with subsequent damage tubules with subsequent damage glomeruli and renal vessels)glomeruli and renal vessels)

Etiology of CPNEtiology of CPN

Saprophytes and pathogenic flora Saprophytes and pathogenic flora (Escherichia coli, Enterococci, (Escherichia coli, Enterococci, Streptococcus, Proteus, Pseudomonas Streptococcus, Proteus, Pseudomonas aeruginosa)aeruginosa)

mycoplasmamycoplasma viruses (Coxsackie, adenovirus)viruses (Coxsackie, adenovirus) fungi (Candida)fungi (Candida)

Pathogenesis of CPNPathogenesis of CPN

microbial factormicrobial factor violation of the passage of urine violation of the passage of urine

(mechanical and functional abnormalities (mechanical and functional abnormalities of the urinary tract)of the urinary tract)

neurogenic bladder disorderneurogenic bladder disorder state of nonspecific immune reactivitystate of nonspecific immune reactivity state of cellular and humoral immunity: state of cellular and humoral immunity:

T-immunity level of Ig A, Ig GT-immunity level of Ig A, Ig G

Ways of infection in CPNWays of infection in CPN

ascending urynohennousascending urynohennous hematogenoushematogenous lymphogenouslymphogenous

ClassificationClassification

localizationlocalization one-sidedone-sided two-sidedtwo-sided pyelonephritis single kidneypyelonephritis single kidney

phase of the diseasephase of the disease aggravationaggravation partial remissionpartial remission complete remissioncomplete remission

Major syndromes and Major syndromes and complicationscomplications

hypertensionhypertension CRF (renal failure)CRF (renal failure) paranefrytparanefryt hydronephrosishydronephrosis urosepticuroseptic dystrophydystrophy anemiaanemia

Examples of formulations Examples of formulations diagnosisdiagnosis

Secondary bilateral chronic Secondary bilateral chronic pyelonephritis, recurrent course, acute pyelonephritis, recurrent course, acute phase. Secondary symptomatic phase. Secondary symptomatic hypertension. CRF 1 stage.hypertension. CRF 1 stage.

Left secondary chronic pyelonephritis, Left secondary chronic pyelonephritis, latent, non-remission phase. latent, non-remission phase. Nephrolithiasis, stones of left kidney. Nephrolithiasis, stones of left kidney. CRF 0 stage.CRF 0 stage.

Clinic CPNClinic CPN

Pain (aching pain, positive Pain (aching pain, positive Pasternatskys’ s-m)Pasternatskys’ s-m)

syndrome of endogenous intoxication syndrome of endogenous intoxication (subfebrile, weakness headache, fatigue)(subfebrile, weakness headache, fatigue)

bladder syndrome (nocturia, dysuria, bladder syndrome (nocturia, dysuria, polakiuriya, pyuria, bacteriuria)polakiuriya, pyuria, bacteriuria)

Laboratory studies in Laboratory studies in CPNCPN

low proteinuria (up to 1 g / l)low proteinuria (up to 1 g / l) leukocyturialeukocyturia bacteriuriabacteriuria

Instrumental studies in Instrumental studies in CPNCPN

asymmetry curves with radioisotope asymmetry curves with radioisotope studystudy

according to ultrasound and radiography according to ultrasound and radiography lesions cup-pelviclesions cup-pelvic

Diagnosis of CPNDiagnosis of CPN

A historyA history clinical examination dataclinical examination data typical changes of urinary sedimenttypical changes of urinary sediment availability dizuricheskie phenomenonavailability dizuricheskie phenomenon combination of dysuria and urinary signs combination of dysuria and urinary signs

of feverof fever identify predisposing factors and diseasesidentify predisposing factors and diseases

Treatment of chronic renal Treatment of chronic renal failure (principles of failure (principles of pathogenetic therapy)pathogenetic therapy)

Stages of treatmentStages of treatment treatment of acutetreatment of acute maintenance therapy (Antirecurrent maintenance therapy (Antirecurrent treatment)treatment)

Recovery passage of urine (neurogenic, Recovery passage of urine (neurogenic, Dysfunctional or urological)Dysfunctional or urological)

anti-inflammatory therapy (antibiotics)anti-inflammatory therapy (antibiotics)

AntibioticsAntibioticsfluoroquinolonesfluoroquinolones zanotsyn (ofloxacin) - blocks the bacterial enzyme zanotsyn (ofloxacin) - blocks the bacterial enzyme DNA hidratazu, damages the cell membrane of DNA hidratazu, damages the cell membrane of bacteria is well into the fabric of the urinary systembacteria is well into the fabric of the urinary system

macrolidesmacrolides Wilprafen (josamycin) 0.5 2 times (12-14 days)Wilprafen (josamycin) 0.5 2 times (12-14 days) flurenisid (ie 0, 05 and 0.15, capsules 0.3, candle flurenisid (ie 0, 05 and 0.15, capsules 0.3, candle 0.1) destroys chlamydia, corrects immunity.0.1) destroys chlamydia, corrects immunity.

uroseptics group Nitroxoline (5-NOC) to uroseptics group Nitroxoline (5-NOC) to 0.1 to 4 times a day or nalidixic acid 0.1 to 4 times a day or nalidixic acid (negram, nevihramon) by 0.5-1.0 4 (negram, nevihramon) by 0.5-1.0 4 timestimes

correction of microcirculation and blood flow correction of microcirculation and blood flow in the kidney (aminophylline, pentoxifylline, in the kidney (aminophylline, pentoxifylline, stugeron, heparin, fraksyparyn)stugeron, heparin, fraksyparyn)

effect on free radicals - antioxidants: unitiol, effect on free radicals - antioxidants: unitiol, halaskorbin, emoksypin, Essenciale, halaskorbin, emoksypin, Essenciale, vitamin E, tiotriazolin.vitamin E, tiotriazolin.

immunocorrection (prohydiozan, pirogenal. immunocorrection (prohydiozan, pirogenal. pentoxyl, methyluracil, echinacea)pentoxyl, methyluracil, echinacea)

correction syndrome EIcorrection syndrome EI enzyme: vobenzim (3-9 table. 3 times), enzyme: vobenzim (3-9 table. 3 times),

flohenzym (2-4 table. 3 times)flohenzym (2-4 table. 3 times)

Pharmaceutical Pharmaceutical preparations of plant preparations of plant materialmaterial

Hofitol - artichoke leaves drug (2% solution Hofitol - artichoke leaves drug (2% solution for injection)for injection) diuretic, zhovchehinnyy, detoxification, diuretic, zhovchehinnyy, detoxification, solerozchynnyy impactsolerozchynnyy impact shows: Diabetic nephropathy and shows: Diabetic nephropathy and dismetabolic, chronic renal failuredismetabolic, chronic renal failure

lespenefryl (lespyflan) - a drug with stems lespenefryl (lespyflan) - a drug with stems and leaves lespedezy capitate (3-6 and leaves lespedezy capitate (3-6 spatulas of tea a day for 15 minutes spatulas of tea a day for 15 minutes before eating, drinking a small amount of before eating, drinking a small amount of water)water)accelerates the excretion of nitrogenous accelerates the excretion of nitrogenous substances in the urinesubstances in the urine indications: chronic renal failureindications: chronic renal failure

Canephron - contains lovage, rosemary, Canephron - contains lovage, rosemary, centaury, hips. (due to the able 3-4 times a centaury, hips. (due to the able 3-4 times a day)day) anti-inflammatory, antiseptic, diuretic, anti-inflammatory, antiseptic, diuretic, antihypertensive effectantihypertensive effect indications: chronic pyelonephritis, urate indications: chronic pyelonephritis, urate nephrolithiasis, chronic renal failurenephrolithiasis, chronic renal failure

Chronic renal failure Chronic renal failure (CRF)(CRF)

This is a consequence of many chronic renal This is a consequence of many chronic renal diseases, gradual and steady deterioration of diseases, gradual and steady deterioration of glomerular and tubular kidney function such an glomerular and tubular kidney function such an extent that the kidneys can not maintain the normal extent that the kidneys can not maintain the normal composition of the internal environment. composition of the internal environment.

The main property CRF - exhaustive compensatory The main property CRF - exhaustive compensatory abilities kidney impossibility (as opposed to acute abilities kidney impossibility (as opposed to acute renal failure) regeneration of the parenchyma.renal failure) regeneration of the parenchyma.

Etiology and Etiology and pathogenesis of chronic pathogenesis of chronic renal failurerenal failure

Chronic glomerulonephritis, subacute, progressive Chronic glomerulonephritis, subacute, progressive GNGN

CRFCRF Collagen (SLE, scleroderma, polyarteritis nodosa)Collagen (SLE, scleroderma, polyarteritis nodosa) metabolic diseases (diabetes, gout, amyloidosis)metabolic diseases (diabetes, gout, amyloidosis) congenital kidney disease (polycystic, kidney congenital kidney disease (polycystic, kidney

hypoplasia syndrome, Fanconi syndrome, Alportahypoplasia syndrome, Fanconi syndrome, Alporta

primary vascular lesions (renal artery primary vascular lesions (renal artery stenosis, malignant hypertension, stenosis, malignant hypertension, essential hypertension)essential hypertension)

obstructive nephropathy (urolithiasis, obstructive nephropathy (urolithiasis, hydronephrosis, tumors of the urinary hydronephrosis, tumors of the urinary system)system)

Major disturbances of Major disturbances of homeostasis in CRFhomeostasis in CRF

excretion of nitrogenous toxins (urea, excretion of nitrogenous toxins (urea, creatinine, uric acid)creatinine, uric acid)

support water and electrolyte balance support water and electrolyte balance (urine output less than 600 ml per day)(urine output less than 600 ml per day)

Classification CRF Classification CRF S.I.Ryabova (1976)S.I.Ryabova (1976)

latent (creatinine level in serum below latent (creatinine level in serum below 0.18 mmol / l, Cp above 50% of 0.18 mmol / l, Cp above 50% of predicted)predicted)

azotemic (cock kraetyninu from 0.19 to azotemic (cock kraetyninu from 0.19 to 0.71 mmol / l KF 50-10% of predicted)0.71 mmol / l KF 50-10% of predicted)

uremic (content creatinine 0.72 mmol / l uremic (content creatinine 0.72 mmol / l and above, cf 10% and below)and above, cf 10% and below)

Each stage is divided into A and BEach stage is divided into A and B

Classification of chronic Classification of chronic renal failure by Ratnerrenal failure by Ratner

I - increase in plasma creatinine 0,17-I - increase in plasma creatinine 0,17-0,44 mmol / l0,44 mmol / l

II - 0,45-0,88 mmol / lII - 0,45-0,88 mmol / l III - 0,89-1,32 mmol / lIII - 0,89-1,32 mmol / l IV - 1,32 and aboveIV - 1,32 and above

Clinic CRF (initial period)Clinic CRF (initial period)

fatigue, drowsiness, lethargy, loss of fatigue, drowsiness, lethargy, loss of appetiteappetite

polyuria, nocturiapolyuria, nocturia myazeva weakness, twitchingmyazeva weakness, twitching osteomalacia, osteoporosis, bone painosteomalacia, osteoporosis, bone pain itching, paresthesia, epistaxis, itching, paresthesia, epistaxis,

subcutaneous hemorrhagesubcutaneous hemorrhage "Uremic gout", nausea, vomiting, diarrhea"Uremic gout", nausea, vomiting, diarrhea

Clinic CRF (expanded Clinic CRF (expanded period)period)

pale yellow complexion, dry skin, pale yellow complexion, dry skin, soluable, tongue dry, brown, mouth odor soluable, tongue dry, brown, mouth odor of ammoniaof ammonia

hypertension, retinopathy, cardiac hypertension, retinopathy, cardiac asthma, gallop rhythm, congestive heart asthma, gallop rhythm, congestive heart failurefailure

Clinic of CRF (end stage)Clinic of CRF (end stage)

pericarditis with retrosternal pain, pericarditis with retrosternal pain, dyspnea, pericardial friction noise ("toll")dyspnea, pericardial friction noise ("toll")

twitching, encephalopathy, uremic coma twitching, encephalopathy, uremic coma with acidotic breathingwith acidotic breathing

anemia, leukocytosis, thrombocytopeniaanemia, leukocytosis, thrombocytopenia impotence, amenorrhea, gynecomastia impotence, amenorrhea, gynecomastia

(due to delays prolactin)(due to delays prolactin)

Laboratory diagnosis of Laboratory diagnosis of CRFCRF

serum creatinine and blood ureaserum creatinine and blood urea relative density of urinerelative density of urine glomerular filtration and tubular glomerular filtration and tubular

reabsorptionreabsorption

Treatment of chronic Treatment of chronic renal failure (task)renal failure (task)

maintenance of homeostasismaintenance of homeostasis slowing progressionslowing progression treatment of complications of uremiatreatment of complications of uremia KF at 35 to 10 ml / min treatment with KF at 35 to 10 ml / min treatment with

conservative methodsconservative methods with more severe disorders - software with more severe disorders - software

hemodialysis, kidney transplanthemodialysis, kidney transplant

Conservative treatment Conservative treatment of chronic renal failureof chronic renal failure

diet (table 7a, 20-25 grams of protein a diet (table 7a, 20-25 grams of protein a day, 7b, 40 - g protein per day)day, 7b, 40 - g protein per day)

adequate fluid intakeadequate fluid intake control input electrolytes - sodium and control input electrolytes - sodium and

potassium, with hiperpotassemia - 20-30 potassium, with hiperpotassemia - 20-30 ml of 10% calcium gluconate or 200 ml of ml of 10% calcium gluconate or 200 ml of 5% sodium bicarbonate, 5% glucose with 5% sodium bicarbonate, 5% glucose with insulininsulin

reduce delays end products of protein reduce delays end products of protein metabolism (sorbents, siphon enema, metabolism (sorbents, siphon enema, laxatives - sorbitol, xylitol)laxatives - sorbitol, xylitol)

antihypertensive therapy - dopehit, antihypertensive therapy - dopehit, hemiton (Clonidine) - do not reduce renal hemiton (Clonidine) - do not reduce renal blood flow.blood flow.

treatment of anemiatreatment of anemia treatment of uremic osteodystrophytreatment of uremic osteodystrophy

correction of acidosiscorrection of acidosis treatment of infectious complicationstreatment of infectious complications med. physsical culturemed. physsical culture treatment of the underlying disease that treatment of the underlying disease that

led to uremialed to uremia

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