Klapouch V. Calcium metabolism and factors of its regulation in patients, suffered from chronic glomerulonephritis.

Object of the study: chronic glomerulonephritis. Purpose of the study: To improve the diagnosis of glomerulonephritis basing on determining the role of phosphorus-calcium metabolism and disturbances of its regulation. Methods of research: general clinical, biochemical (calcium, magnesium, phosphorus amount in the blood and urine, calcitriole level in the blood), radioimmune (amount of parathyroid hormone and calcitonine in the blood) statistical methods. Theoretical and practical results: The distinguished variants of calcium-phosphorus metabolism disturbance can be used for differential correction of calcium hemostasis irrespective of the functional state of the kidneys. The indices for monitoring phosphorus-calcium metabolism in chronic glomerulonephrirtis were suggested with the purpose of timely and adequate treatment. Novelty: Basing on clinical laboratory findings, disturbances of phosphorus-calcium metabolism were determined to develop in patients with chronic glomerulonephritis even at sufficient renal function. The amount of ionized calcium in the blood was shown to decrease in CGN, which is more marked in hypertonic and nephrotic forms of the disease. The amount of total calcium in the blood serum decreases in CGN, especially in NF and HF of CGN. Hypocalciemia is preserved in stage 1 and 2 CRF. Hyperphosphatemia was established to develop at primary stages of CGN and to progress with CRF development. CGN was determined to be characterized by hypomagnesiemia at all stages of the disease development and CRF progression. The idea that disturbances of phosphorus-calcium metabolism in renal diseases are due to decreased calcitriole synthesis in the renal tubules resulting in hypocalciemia, stimulation of parathyroid glands, development of secondary hyperparathyroidism, was further developed. One of compensation mechanisms is increase of calcitonine amount in the blood. Four pathogenetic types of calcium metabolism disturbance in chronic glomerulonephritis were distinguished, which may be the groundsfor scientifically substantiated correction of these disturbances. Degree of introduction: The findings of the research were introduced to the practice of nephrology department and department of chronic hemodialysis of Kharkiv Regional Clinical Center for Urology and Nephrology, nephrology department of Clinical Hospital No. 26 (Kharkiv), City nephrology office of Kharkiv Regional Clinical Center for Urology and Nephrology Sphere of application: Medicine, therapy.