A. I. Gozhenko

The role of additional correction methods of insufficient adherence to treatment for effective blood pressure control in patients with resistant arterial hypertension

The article considers the results of applying the different correction methods of insufficient adherence to treatment in patients with resistant and pseudo-resistant arterial hypertension on the background of the optimization of antihypertensive therapy in the effective blood pressure control by a doctor and a patient.

Physiological Bases in Definition of Leukocyturia and Erythrocyturia

Background: In amount of leukocyturia and erythrocyturia has been used to diagnose renal diseases for a long time. In addition the mentioned features are the ones among principal criteria to identify urinary syndrome. The aim of the research work was to define such the proper physiological regimen of kidneys functioning working that permits to meet stability of the conditions in kidneys and the blood cells preservation in urine for further improvement of the urinary syndrome diagnostic methodology. Methods and materials: There were examined 24 healthy volunteers at the age of 19–25 without clinical and laboratory signs of kidneys pathology. Research work was carried out in the monitoring from 9–11 on an empty stomach. The general investigation scheme included the emptying of the urinary bladder after that hydrosaline loading was carried out per os in volume of 0.5 % from the body mass. In an hour examinee the person under the test emptied his bladder and the volume of diuresis was measured precisely up to 1 ml. They used photometric method to find out creatinine concentration by Popper’s methodology, also photometric method was used to find out protein concentration according to the reaction with sulfosalicylate acid on the spectrophotometer SF – 46 (Russia) and urine osmolality applying crioscopic method on osmometer, model 3D3 made by “Advanced Instrument Inc.� (USA). We have also carried out the four-serial investigation: with running water loading (1st group) and with natrium chloride solutions loading, 0.1 % (2nd group), with 0.25 % (3rd group) and with 0.5 % (4th group). The achieved results were up statistically applying the Student criteria. Results: The achieved data prove that the running water loading and the 0.1 %, 0.25 %, and 0.5 % natrium chloride solutions loading considerably rise diuretic level and diuresis amount per 1 min exceeds diurnal diuresis level 2 – 3 times with recount for 1 minute. On the whole it is excreted from 25 % up to 90 % of the drunk liquid volume. Withal, diuresis amounts don’t differ greatly from each other with all types of loading. That is, the proposed by us volume of hydrosaline loading provides equal diuresis exceeding. Mechanism of diuresis increase differs greatly: with water loading kidneys are functioning in regimen of urine dissolving what is proved by decreasing of urine osmolality to the level which is typical of blood plasma and below. Urine osmolality of some tested volunteers was fluctuating between 120 – 200 mosmol/kg. There is no doubt that such a dynamic causes depression of kidneys’ concentration ability due to supplying an organism with considerable amount of running water, osmolality of which is not more than 5 mosmol/kg. Conclusions: 1. Hydrosaline loading in 0.5 % volume of body mass with water and 0.1 %, 0.25 % and 0.5 % solutions of natrium chloride maintains diuresis speed keeping on the level of 2 – 3 ml per 1 min, but differs in urine osmolality amount. 2. After hydrosaline loading with 0.5 % solution of natrium chloride urine osmolality forms physiologically more optimum conditions and could be recommended for leukocyturia and erythrocyturia determination.