Dyadyk I. The clinical and morphological characteristics and treatment of idiopathic membranous glomerulonephritis.

Object of the study: idiopathic membranous glomerulonephritis. Purpose: Improvement of quality of life and decreasing of mortality in patients with idiopathic membranous glomerulonephritis due to the optimization of diagnostics, prediction of clinical course and efficacy of immunosuppressive therapy. Methods of investigation and equipment: Clinical, laboratory, biochemical and morphological investigations. Equipment: photoelectrocolorimeter, spectrophotometer, torsion scales, tools for histological investigations. Theoretical and practical results: The clinical, laboratory and morphological features of idiopathic membranous glomerulonephritis were determined. Significant relation of systolic and diastolic blood pressure, levels of serum creatinine and proteinuria with the presence and severety of extracapillary proliferation, tubulointerstitial and fibroplastic changes was found. The risk factors for progression of the disease were revealed and proved based on stepwise multiple logistic regression. Better results of treatment with intramuscular cyclophosphamide as compared with oral prednisolone and azathioprine were illustrated using 10-year survival rates in patients with idiopathic membranous glomerulonephritis. According to analysis of factors that influence the efficacy of immunosuppressive therapy optimal treatment regimens including administration of intramuscular cyclophosphamide and intravenous pulse-therapy with methylprednisolone and cyclophosphamide were grounded and statistically validated. Degree of introduction: The results of the study were introduced into the practice of the therapy and nephrology departments of the central city clinical hospital N1 of Donetsk, nephrology department of Donetsk regional consultative territorial medical unit, therapy department of the central city clinical hospital N5 of Donetsk, nephrology department of the Main army clinical hospital of Ministry of Defence of Ukraine (Kiev), nephrology departments of the Kharkov regional center of urology and nephrology and of the city hospital N26 of Kharkov, therapeutic department of the city hospital №1 of Enakievo. Field of Application: Medicine, therapy, nephrology.