RU2197288C2 - Method for treating patients for chronic glomerulonephritis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves transcutaneously supplying negative electric charge of 10^-4Q. Internal or intravenous injection of 5% sodium hydrocarbonate solution is carried out under acid-alkaline state values control until alkaline urine reaction and signs of slight completely compensated alkalosis takes place. EFFECT: enhanced effectiveness of treatment.

Description

 The method relates to medicine, namely to kidney disease.

 The problem of chronic glomerulonephritis, accounting for about 37% of all kidney diseases, is central to clinical nephrology. The presence of protein / proteinuria / in the urine of patients is not only a symptom, but also a pathogenetic factor of the disease. The most important cause of proteinuria in patients with chronic glomerulonephritis is a decrease in the negative charge of the glomerular polyanionic filter due to strength acids and glycosaminoglycans. Reducing proteinuria is one of the goals of treating patients and a criterion for the effectiveness of therapy.

 An analogue of the proposed method are the conventional methods of treating chronic glomerulonephritis with prednisone (0.8-1.0 mg / mg / day), cytostatics: azathioprine (1.5-3 mg / kg / day), cyclophosphamide (1.5-3 mg / kg / day), chlorambucil (6-10 mg / kg / day), as well as cyclosporine (3 mg / kg / day). Prednisone is often prescribed in combination with cytostatics.

 Serious disadvantages of treatment with these drugs are the high incidence of side effects and complications caused by immunosuppression (Nephrology, Guide for doctors. In 2 volumes. Volume 2 / Edited by I.E. Tareeva. - M.: Medicine. - 1995. - p. 78-82).

 The prototype of the proposed method is the pathogenetic treatment of chronic glomerulonephritis with heparin - subcutaneously at a dose of 15000-40000 U / day. It has been shown that heparin, being a carrier of a negative charge, "... can reduce proteinuria by restoring a negative charge of the glomerular basement membrane (ibid., P. 84). Almost always, heparin is used in combination with other drugs.

 The disadvantages of the prototype are the low efficiency of heparin monotherapy and the possibility of side effects in the form of allergic reactions, selective hypoaldosteronism syndrome with hyperkalemia, osteoporosis, bone pain, thrombocytopenia.

The author proposes a method for treating patients with chronic glomerulonephritis, which is based on the constant transdermal supply of a negative electric charge to the patient’s organism at a dose of ^10-4 pendant while alkalizing the patients to mildly completely compensated alkalosis and alkaline urine reaction.

The device with which a negative charge is generated and applied to the skin of patients consists of the following elements:
1 - power source (electric network, galvanic cell, battery);
2 - an electric motor with an eccentric or crank mechanism on the shaft or a solenoid with a reciprocating motion of the core;
3 - speed controller of the electric motor or the reciprocating movements of the solenoid;
4 - a piezoelectric element.

 Negative charges are generated by periodically compressing a piezoelectric crystal. Its surfaces are connected through a diode, closed to a negative charge. In this case, a negative charge arising on one surface of the crystal during its deformation is supplied to the patient’s skin through a diode open for a negative charge, and the positive charge is grounded in a stationary version of the device design or dissipated in the environment in a portable version of the design with an autonomous power source. The place of contact with the patient’s skin and the method of contact are not significant. We supplied the charge through a conductor connected to a metal watch bracelet worn on the arm, however, in some cases (for bedridden seriously ill patients) the bracelet was worn on the leg for convenience.

 The basis of the proposed method is information about the possibility of restoring and increasing the negative charge on the endothelium of blood vessels, the surface of blood cells and biological membranes using electron donors: aero ions, heparin (M.S. Machabeli, V.A. Polesky, V. B. Khvatov and other General coagulology. - M .: EPP. - 1995. - 230 p.). With any method of delivering negative charges to body tissues, it should be borne in mind that the charge carriers in solutions are not elementary particles, but ions. When electrons are bound to molecules, they determine ionic shifts: anionic increase and cationic potential decrease.

 Unlike other methods of treatment with negative charge carriers, the claimed method takes into account the fact that negative charges on the surfaces of tissues of the internal environment are the result of dissociation of weak organic acids (sialic, heparan sulfate, free carboxyl groups of proteins, etc.) and the degree of their dissociation sharply affects the acid-base state of the environment. Acidification of the medium suppresses this dissociation, and alkalization enhances, potentiating the ionic effects caused by the influx of a negative charge.

 The alkalization was carried out with sodium bicarbonate orally or intravenously in the form of a 5% solution under the control of acid-base conditions until an alkaline reaction of urine and signs of mild fully compensated alkalosis (normal blood pH, standard bicarbonate 25-27 Mmol / L).

 The proposed method does not have any side effects or adverse reactions from the body.

 The proposed method is used independently with low activity of chronic holomerulonephritis, or in combination with pharmacotherapy with its high activity.

 The claimed method was used in the treatment of 18 patients with chronic glomerulonephritis (11 women, 7 men) who were examined and treated in the nephrology department of the Tver Design Bureau in 1998-1999. The diagnosis of the disease was verified by nephrobiopsy. In 13 patients, the method was used as an adjunct to pharmacotherapy, in 5 it was used independently. In 4 patients, the disease progressed with nephrotic syndrome, in 5 with arterial hypertension, in 7 there was a nephrotic-hypertensive form, in 2 - an inactive latent form. 3 patients had chronic renal failure 1-A Art. (according to Ryabov's classification).

 In all patients, the independent use of the proposed method or its addition to traditional pharmacotherapy led to a clear - by an average of 32% - decrease in daily proteinuria after 2 weeks of treatment. This decrease was especially pronounced in the mesangioproliferative and mesangiocapillary forms of nephritis, and relatively mild in focal segmental glomerulosclerosis. When patients alkalized before the appearance of an alkaline reaction of urine, proteinuria decreased faster and was more significant.

Example 1
Medical history 771 from 1999

 Smirnov M.E., 34 years old, was admitted with complaints of swelling of the face, legs, fatigue. 2 years ago he suffered acute glomerulonephritis in a cyclic form, which developed after a sore throat. A year after discharge from the hospital, I began to notice the appearance of edema on the face and legs, a decrease in the amount of urine. An examination in the Central District Hospital revealed a clinical and laboratory picture of the nephrotic form of chronic glomerulonephritis. After the treatment, there was a remission of the disease, followed by an exacerbation with the previous clinical picture after 6 months.

 Upon admission to the design bureau, a nephrobiopsy was performed. Conclusion: chronic glomerulonephritis, mesangiocapillary, with a predominance of capillary changes. clinical blood tests at admission and at discharge without deviations from the norm. There are no signs of renal failure. Blood cholesterol 8.6 mmol / L. Daily proteinuria upon receipt of 4.2 g, at discharge 0.01 g

 The patient was treated with the claimed method.

 Dynamics of proteinuria when determined every other day in a single morning urine: 9.4% - 6.6% - 3.3% - 1.76% - 1.8% - 0.42% - 0.18% - 0.01 % - 0.02%.

 The patient was discharged in satisfactory condition without clinical and laboratory signs of disease activity.

Example 2
Medical history 1996 of 1999

 Rumyantsev V.E. 25 years old he entered the nephrology department with complaints of severe headaches, moderate swelling of the legs, weakness. These complaints began to be noted about 1 month ago, when I contacted the polyclinic of the Republican Central Hospital, proteinuria was detected (3.5% in a single urine test), arterial hypertension (200/110) and a referral was made to the OKB for examination and treatment in a hospital.

Upon receipt: wedge. an. blood: erythr. 4.2x10 ¹² / l, GB. 137 g / l, C.p. 0.9. thrombus. 445x10 ⁹ / l, leukoc. 7.1x10 ⁹ / l, B-O, E-1, P-1, S-68, L-26, M-4. ESR-35 mm / h, blood creatinine 131 μmol / L, urea 10.3 mmol / L, cholesterol 8.0 mmol / L, blood protein 68 g / L. Clinical analysis of urine at admission: protein 2.4%, erythro. 0-1, leukoc. 2-3, cylinders 0-1-2 in p / sp. HELL 175/100 mm RT. Art.

 Nephrobiopsy performed. Conclusion: diffuse fibroplastic glomerulonephritis.

 The patient received atenolol 1 tablet. x 3 and treatment of the claimed method.

 Dynamics of proteinuria in the morning gas portions of urine every other day: 2.4% - 2.6,% - 0.06% - 0.04% - 0.03% - 0.03% - 0.02% - 0.02% . The dynamics of daily proteinuria during treatment: 5.7 g - 2.1 g - 0.88 g - 0.15 g. At discharge, blood pressure 130/85 mm RT. Art., blood creatinine 126 μmol / L, urea 6.4 mmol / L.

Claims (1)

A method for treating patients with chronic glomerulonephritis, including treatment with negative electric charges, characterized in that a negative electric charge of 10 ^-4 C is delivered percutaneously with simultaneous internal or intravenous administration of 5% sodium bicarbonate solution under the control of acid-base conditions until an alkaline urine reaction appears and signs of mild fully compensated alkalosis.