Alekseyenko R. The role of pro-inflammatory cytokines in diabetic nephropathy progression.

3. Object of the research: Type 1 and 2 diabetes mellitus. Purpose of the research: To improve the diagnosis and treatment of diabetic nephropathy with different functional state of the kidneys by means of investigation of anti-inflammatory cytokines (tumor necrosis factor ? and interleukin 1a). Methods of the research: Clinical, biochemical, immunological methods (anti-inflammatory cytokine amount in the blood serum, urine ?2 microglobulin excretion using immunoenzyme assay, the study of partial function of the kidneys (creatinine and urea in the blood serum, glomerular filtration rate and tubular reabsorption), instrumental and statistical methods. Theoretical and practical results: The study of anti-inflammatory cytokines TNF? and IL-1a in the blood serum will promote early prognosis of development and course of chronic renal failure. Control of ?2 -microglobulin excretion will allow to diagnose tubulointerstitial lesions in patients with diabetic nephropathy. The use of Ketosteril against a background of low-protein diet can be used in complex renoprotective therapy at early stages of CRF in patients with diabetic nephropathy. Novelty: The role of anti-inflammatory cytokines TNF? and IL-1a in development of diabetic nephropathy was determined. It was proved that the changes in the profile of anti-inflammatory cytokines (reduction of IL-1a and increase of TNF? amount in the blood serum) was a marker of the progress of chronic renal failure in patients with diabetic nephropathy. It was shown that ?2 microglobulin excretion increased even with a sufficient function of the kidneys, increases together with the changes of cytokine profile at development and progress of CRF which suggests early involvement of in patients with diabetic nephropathy and proves the significance of ?2 microglobulin excretion as a parameter of the progress of fibroplastic processes in the tubulointerstitium of the kidneys. It was proven that Ketosteril administration against a background of low-protein diet positivelyinfluences theamount of anti-inflammatory cytokines in the blood, the functional state of the kidneys and the course of DN at early stages of CRF. Degree of introduction: The findings of the research were introduced to the work of nephrology department and department of chronic hemodialysis of Kharkiv Regional Clinical Center of Urology and nephrology, city nephrology office and are used in the teaching process at therapy departments of Kharkiv State Medical University. Sphere of application: Medicine, therapy departments.