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THE INFLUENCE OF SORPTION THERAPY ON
ENDOTOXICOSIS, URINE MICROFLORA AND BLOOD GLUCOSE
LEVELS DURING ACUTE BACTERIAL PURULENT
INFLAMMATION OF THE KIDNEYS (PYELONEPHRITIS)
K. M. Arbuliyev, F. M. Abdurakhmanova, M. G. Arbuliyev,
M. G. Magomedov, A. M. Idrisova, M. O. Azizov
Urology Department at the Dagestan State Medical Academy,
Makhachkala
55 patients with acute pyelonephritis were studied. Of these, 28 patients underwent standard
conservative therapy and for 27 patients the standard therapy was paired with sorption therapy
using polymethylsiloxane polyhydrate (Enterosgel). As a result, an expressed detoxifying, bactericidal
action by Enterosgel was recorded, with use in patients with pyelonephritis against a background of
associated diabetes leading to a reduction in blood glucose levels. The use of Enterosgel during
comprehensive treatment of acute pyelonephritis allowed a reduction in the severity of illness and
number of complications, and to shorten the duration of treatment.
Keywords: acute pyelonephritis (acute bacterial purulent inflammation of the kidneys),
enterosorption, Enterosgel, microcirculation.
The study included 55 patients with acute pyelonephritis. 28 patients had received standard medical
therapy. 27 patients in combination with standard therapy had received sorption therapy with
polymethylsiloxane polyhydrate (Enterosgel). As a result, a marked detoxification and bactericidal
actions of Enterosgel were noted; the use of Enterosgel leads to a decrease of serum glucose levels in
patients with pyelonephritis with concurrent diabetes mellitus. Using of Enterosgel in the treatment
for acute pyelonephritis allowed to reduce the severity of the disease and number of complications,
and shorten the duration of treatment.
Key words: acute pyelonephritis, enterosorption, Enterosgel, microcirculation
Introduction
Pyelonephritis is one of the most frequent kidney diseases [1]. Pyelonephritis frequently
complicates already existing urological illnesses such as bladder stones, benign prostatic hyperplasia,
developmental abnormalities of the urinary tract and genital organs, and diabetes mellitus (DM) [2,
5, 8].
Current the treatments used most frequently for pyelonephritis are antibacterial and antiinflammatory drugs and immunomodulators.
Regardless of the diversity of conservative treatment methods and medicines, however, the
results cannot be called satisfactory, as according to the data of many authors, complete recovery is
rather infrequent [2, 3, 4, 9-12].
Meanwhile the number of cases of acute pyelonephritis and recurrence of this disease is
increasing [13, 14]. It is also known that as a result of the inflammatory process ongoing in the renal
parenchyma, the body gradually becomes intoxicated due to the infiltration of microbes and their
toxins into the bloodstream. Circulation in the bloodstream leads to subsequent dissemination
thereof into the internal organs, including the gastrointestinal tract [9, 10], making it necessary to
perform a gastrointestinal dialysis [14, 15] in cases of pancreal inflammation (pancreatitis), hepatitis,
inflammation of the peritoneum (peritonitis), etc. In connection with this, polymethylsiloxane
polyhydrate (Enterosgel) caught our attention, having according to various authors [3 – 16] and
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adsorptive, covering and detoxifying properties, reducing symptoms of toxicosis, and acting on
microorganisms and their toxins in the gastrointestinal tract; Enterosgel blocks these from being
absorbed into the bloodstream. We are thus of the opinion, that the use of Enterosgel in therapeutic
dosages is safe and necessary for reducing intoxication.
The goal of this study was to investigate the influence of the enterosorbent on the indicators
for endotoxicosis, urine microflora, renal microcirculation, and blood glucose dynamics in patients
with acute secondary pyelonephritis as part of comprehensive conservative therapy.
Materials and methods
55 patients with acute pyelonephritis located in stationary treatment were studied. For 13
patients it was a left-sided process, 15 a right-sided one and for 17 acute pyelonephritis on both
sides, i.e. deterioration. The age of the patients ranged from 17 to 55 years of age; the average was
27 ± 1.6.
Of the 55 patients that took part in the study (Table 1), the majority of them suffered from
secondary pyelonephritis with urolithiasis and made undergone comprehensive conservative
treatment.
Using the method of typological selection, the patients included in the study were
randomised into two groups comparable in terms of age, sex, clinical symptoms and laboratory
instrumental indicators: Group 1 (control) – 28 patients who were administered antibacterial
treatment (fluoroquinolone series – Sparflo 200 mg 2 times in first 24 hours, then 200 mg once a day
in the evening for 9 days) and anti-inflammatory and detoxifying therapy; Group 2 (treatment) – 27
patients who, aside from the Sparflo therapy, were issued comprehensive treatment with Enterosgel
1.5 tablespoon (22g) 3 times a day 2 hours before a meal.
The criterion for inclusion of a patient in the groups was acute pyelonephritis or a worsening
of chronic pyelonephritis based on nephrolithiasis (calculi in the hollows of the kidneys measuring 0.3
– 1.0 cm).
At the same time, therapy to promote excretion of the calculi was indicated for all patients –
they used Kanefron N (Canephron) – (2 tablets 3 times daily for 7 – 14 days, sometimes longer).
Table 1. Location of kidney stones
Location of stones
Number
Stones in the renal pelvis
24
Stones in upper calyx
8
Stones in middle calyx
7
Stones in lower calyx
10
Stones in renal parenchyma
6
Total
55
%
43.6
14.5
12.7
18.2
10.9
100
Experimental study
The research was conducted at the bacteriological laboratory Republic HygienicEpidemiological Station. For the tests, 2 sterile 100 ml glass beakers were filled with testing culture
diluted with sterile physiological solution (1 ml Escherichia coli 5.6×107 CFU/ml and Staphylococcus
aureus 6×108 CFU/ml). The study was conducted through the method of serial cultivation on nutrient
media with the expression analyser "Baktrakt 430014".
Added to the second beaker with the testing culture was 1.5 tablespoons (22g) of Enterosgel
for 3 hours. Enterosgel was not added to the first beaker, it being considered the control. During the
experiment the number of microorganisms in both beakers was compared. 30 observations were
performed.
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Upon contact of the sorbent solution with the test culture in it, the number of microbes
grew. Due to adsorption the number of microorganisms in 1.0 g of sorbent totalled 5.6x107 for E. coli
and 6x108 CFU/ml for S. aureus.
For illustration we include one of the reports of the lab experiment in Table 2.
As can be seen from Table 2, the sorbent adsorbed all the microbes in the initial dilution,
which is evidenced by the number of E. coli - 5.6×105 CFU/ml in 1.0 g of filter in the middle of the
experiment. The sorbent however did not only adsorb the diluted culture that was in the beaker at
the start of the experiment. At the end of the experiment the content of E. coli was 5.6×107 in 1.0 g of
filter and in addition, if there were also leukocytes and erythrocytes in the solution at the start of the
experiment, at the end their number had been reduced to 10 – 20 in the visual field.
Analogous results were also obtained for the microbial culture of S. aureus (Table 3).
No changes took place in the first beaker.
In this experiment the results exceeded our expectations. The sorbent completely eliminated
S. aureus from the initial solution. This is evidenced by the number of bacteria contained in 1.0 g of
Enterosgel, both in the middle and at the end of the observation. At the end of observation the
number of erythrocytes and leukocytes in the suspension had sharply dropped. In vitro observation
also shows that the sorbent "works" very actively and adsorbs elements from the blood and
microbes contained in pus. The amount of suspension the sorbent captures was 40 ml less than the
initial amount (100 ml), which attests to the fact that the sorbent adsorbed part of the liquid with the
microbial suspension.
Such a difference in the quantitative content of bacteria at the beginning and end of
observation can only be explained by the differing amount of sorbent. The amount of microbial
suspension in the second beaker was 40 ml less than in the first, which means that the sorbent
extracted 40 ml of testing culture (each 1 g of sorbent 2.0 g of testing culture suspension).
The activity of the sorbent is explained by the fact that the specially processed granules of
the sorbent have a number of micropores that suck up fluid from the microbial suspension and
coagulate this suspension.
Glucose level dynamics in the experiment
An objective of the experiment was to investigate the dynamic of glucose levels in patients
with secondary acute pyelonephritis in combination with diabetes. At the outset it is necessary to
investigate the dynamic of glucose reduction in the group of patients treated using gastrointestinal
dialysis and then in the group of patients treated using traditional methods. It was decided to first
conduct the experiment in vitro (experiment conducted at the Republic Urologic Centre laboratory by
lab technician A. M. Idrisova).
Table 2. Report on laboratory study on E. coli
Sample marking
Start of observation – initial dilution of culture of E. coli
Middle of observation – bacterial suspension with Enterosgel
End of observation – bacterial suspension with Enterosgel
CFU/ml
Initial dilution 5.6×107 CFU/ml E. coli
In 1.0 g of Enterosgel 5.6×105 CFU/ml E. coli
In 1.0 ml is 5.1×107 CFU/ml of E. coli
Table 3. Report on laboratory study on S. aureus
Sample marking
CFU/ml
Start of observation – initial dilution of culture of S. aureus
Middle of observation – bacterial suspension + Enterosgel
End of observation – bacterial suspension after Enterosgel
Initial dilution of S. aureus culture 6×108
CFU/ml
In 1.0 g of Enterosgel S. aureus 6×108 CFU/ml
In 1.0 ml is 6×108 CFU/ml of S. aureus
A 5% sugar solution was poured into the first and second 100 ml beakers. In order to
determine whether Enterosgel adsorbs sugar or not, 1.5 tablespoons (22.0 g) of Enterosgel was
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added to the second beaker. Nothing was added to the first beaker. We waited 3 hours for the
results and then the amount of sugar in 1 ml was established. The results of the experiment are
provided in Fig. 1.
In the first beaker, no changes in the amount of glucose (0.05 g) were recorded in 3 hours in
any of the 30 observations.
In the second beaker, the amount of sugar at the start of the experiment was 0.05 mmol/ml,
in the middle 0.03 mmol and at the end 0.02 mmol/ml.
In these (30) experiments the results exceeded our expectations. Enterosgel adsorbed more
than half the glucose in the initial solution in 3 hours. This means that every gram of Enterosgel
adsorbed 0.36 of glucose as a result of the fact that the molecules of the enterosorbent have highly
cumulative properties that promote adsorption of sugar.
The results of the experiment are provided in Table 4 and Fig. 3.
Below we provided the same indicators of glucose level dynamics in the form of curves – Fig.
2 and 3.
Of certain interest is the dynamic of glucose levels for patients with acute pyelonephritis
accompanied by diabetes (26 patients) from Groups 1 and 2. Against the background of diabetes
treatment, high glucose levels were found in them – on average 10.3 ± 0.14 mmol/l. For patients
from the treatment group, after 2 days of Enterosgel treatment the level of sugar had dropped to
5.7± 0.22 mmol/l (p<0.05; Fig 4). Such a dynamic of blood glucose levels did not take place in the
patients with pyelonephritis from the control group (13 patients) that suffer from diabetes – 10.7 ±
0.12 m/mol/l. For the patients with pyelonephritis (14 patients) from the control group who do not
suffer from diabetes, the glucose levels before the start of treatment were 5.8 ± 0.8 m/mol/l (Fig. 3).
After the end of treatment their sugar levels were 5.7 ± 0.8 m/mol/l (p<0.05).
We have thus determined that Enterosgel has properties such as reducing the glucose levels
in the blood of patients with diabetes. Glucose, which circulates in the gastrointestinal tract of
patients with diabetes, is evidently adsorbed by Enterosgel and discharged out of the body through
the intestines. This fact is also confirmed by the experiment data wherein Enterosgel reduces the
sugar level in vitro by half or more – from 0.05 to 0.02 mmol/ml. For patients suffering from acute
pyelonephritis with a standard course without diabetes, no reduction of glucose levels in the blood
serum takes place. Evidently then, these patients who do not suffer from diabetes do not have
glucose present in the gastrointestinal tract and Enterosgel molecules do not have anything to
adsorb.
Figure 1. Sugar level without sorbent
vertical:
M/mol/ml
start
middle
end
of observation
Beaker 1
Figure 3. Graphic depiction of sugar dynamic
A
Treatment group
Control group
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Figure 2. Sugar level with Enterosgel introduced
to beaker
vertical: M/mol/ml
start
middle
end
of observation
Beaker 2
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1.5 hours
B
3 hours
Treatment group
Control group
Day 1
Day 2
A – in experiment, B – in blood serum in patients with pyelonephritis accompanied by diabetes.
Laboratory
indicators
Glucose in
blood,
mmol/ml
Treatment group (n = 30)
at start of
after 1.5
after 3 hrs
experiment
hrs
0.05
0.03
0.02
p<0.05
p<0.05
Figure 4
Dynamic of MWP indicators
Before
treatment
Day 4
Treatment group
Control group
Day 8
Table 4. Glucose dynamic in experiment
Control group (n = 30)
at start of
after 1.5
after 3 hrs
experiment
hrs
0.05
0.05
0.05
p<0.05
p<0.05
Figure 5
Dynamic of LII indicators
Before
treatment
Day 4
Treatment group
Control group
Day 8
Figure 6
Dynamic of blood serum
protein level indicators
Before Day 3-4
treatment
Day 7-8
Treatment group
Control group
For illustration we include the following observation. Medical record 27/6905 of a patient
with acute secondary pyelonephritis who suffers from Type 2 diabetes. On admission to the hospital
the glucose level was 10.6 mmol/l on an empty stomach at 19:00. Treatment was begun including
Enterosgel 22.0 g 3 times a day, 2 hours before a meal. The second day in the morning, the sugar
level was 6.6 mmol/l on an empty stomach. The Enterosgel molecules had thus adsorbed the sugar
circulating in the gastrointestinal tract and the blood glucose levels had been lowered to nearly
normal values.
When a blood glucose concentration of 10 mmol/l is reached, the renal barrier is breached
(the ability of the renal tubules to reabsorb glucose is impaired and it begins to appear in the saliva,
urine, and gastrointestinal tract). Naturally, with a glucose level of under 10 mmol/l, glucose is not
present in the gastrointestinal tract, not in healthy persons or in diabetes patients with normal blood
glucose levels.
We have set as the clinical research objective the investigation of symptoms of endotoxicosis
and blood sugar dynamic in patients with acute pyelonephritis before and after comprehensive
treatment by Enterosgel.
Sorption therapy was performed every day, with the Enterosgel dosage ranging from 6 to
22 g. The sorbent was indicated in the same doses 3 times a day, 2 hours before eating. The length of
enterosorption was 10 – 14 days depending on the condition of the patient.
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All patients were evaluated for clinical symptomology, weakness, tachycardia, nausea, etc.
Biological material was collected in order to conduct a clinical blood test and bacteriological
examination of the urine. The blood analysis was conducted on the content of medium-weight
molecular peptides (MWP), cytokines and the leukocyte intoxication index (LII) of the blood serum. A
full clinical and biochemical examination was performed.
A bacteriological examination of the urine was conducted upon admission of the patient, i.e.
1 day prior to the start of treatment, and 8 days after the start of treatment. An indicator of 10 5 CFU
and higher was considered diagnostic.
An examination of the cytokine levels was conducted before treatment – initial value, and on
the 7th-8th day after the start of treatment.
An evaluation of the state of microcirculation in the kidneys was conducted through the
method of colour Doppler ultrasonography (CFM - Colour Flow Mapping), which was performed
before the start of treatment and after 10 days. In order to establish the normal indicators of
microcirculation, a CFM was performed on healthy persons of age 50-59 (10 persons).
Statistical processing of the materials was performed using Excel on a Pentium 4/5 PC. In
analysing the quantitative indicators, both parametric and nonparametric methods were used
according to the criteria of Fischer and Wilcoxon. The mean indicator values (M), standard error (m),
standard deviation (s) and the median (Me) and interquartile range (between the 25th and 75th
percentile) were calculated. The normality of distribution was evaluated according to the criteria of
asymmetry and excess (V. I. Yunkerov and S. G. Grigoryev, 2002). Over the course of the treatment,
before and after treatment, the results were evaluated using dispersion analysis of repeated changes
and the Friedman criteria. The credibility of the differences between indicators of the compared
magnitudes was evaluated according to the Student criteria; differences at the value of p<0.05.
Results and evaluation
The initial clinical-laboratory data for both groups of patients was the same, but during the
study the results showed differences. The property of Enterosgel is its large flat surface of sorbent
micropores, which have a great adsorption ability.
In evaluating the clinical picture before treatment, pain in the lumbar region and
hypothermia were recorded for all patients in both groups, as were symptoms of intoxication:
weakness – in 87% of patients in Group 1, 86% in Group 2; chills – 79% and 70% respectively;
tachycardia – 60% and 57%; nausea – 34% and 42%; perspiration – 25% and 24%; headaches – 24%
and 26%.
Following treatment (Day 13 and 14), all symptoms had completely disappeared for the
patients of Group 2, who had undergone treatment combined with Enterosgel, while for the patients
in Group 1 the symptoms of intoxication persisted: weakness in 20%, tachycardia in 7%, perspiration
in 5%, headaches in 10% and in connection with this their stationary treatment lasted 16 – 20 days.
As a result of the long-lasting inflammatory process of the renal parenchyma, an increasing
intoxication of the body occurs, as microbial cells and toxins get into the blood and from there to the
gastrointestinal tract, which naturally suppresses the patient's immune status. The clinical
effectiveness of sorption therapy has been confirmed by the results of studies focusing on
establishing the levels of cytokines, MWP, serum proteins (SP) and LII, which characterises the
severity of the inflammatory process and endotoxicosis.
LII and MWP determine the degree of endotoxicosis. These indicators for the patients in the
monitored groups are given in the following illustrations, which reflect the therapeutic evaluation of
effectiveness over the course of treatment (Table 5). For illustration Figures 4 and 5 are included.
As can be seen from Table 5 and Figures 4 and 5, the levels of MWP and LII in both groups
were roughly the same before treatment. After performing enterosorption, LII indicator for the
patients in the treatment group had fallen to 0.31±0.2 units by Day 8 of treatment and was 0.05±0.15
units in the control group, which is 1.5 times more.
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The results of our studies show that the most dynamic changes to the MWP took place in the
treatment group patients on the 4th day after the start of treatment. The MWP level began to drop,
while for patients in the control group no changes to the MWP levels were recorded. On Day 8 after
the start of treatment the MWP level in the control group had fallen by only 1.5 unit, compared to
2.24 units in the treatment group (p<0.005).
SP indicators also have a certain significance for investigating the dynamic of endotoxicosis,
reversely proportional to the LII and MWP indicators. MWP with ME1 0.94±0.3 units had, on Day 8,
reduced to ME 0.31±0.62, LII with ME 5.74±0.39 had reduced on Day 8 to ME 3,5±0,34 and the SP
count with ME 65.2±0.09 units had increased to 72 ±0.7 units (p<0.005). In this manner it was proven
that the levels of MWP and LII drop, but he number of SP grows. The mean indicators for SP content
in the blood for all monitored patients in the groups are displayed in Figure 6, from which it can be
seen that the positive dynamic of SP in the blood was more pronounced in the treatment group
patients. For the patients in this group the rise in the SP indicator was 18.6 % (M: 63.4-69, 7-75.2
units), but in the control group 13.9 % (M: 63.8-68.8-72.2 units).
The differences in the initial values between groups were compared according to the
criterion of the Mann-Whitney test (p=0.747), in dynamic according to Student (p=0.019 and p=0.08).
The results achieved attest to the positive and effective influence of Enterosgel on the body of a
patient with acute pyelonephritis. Aside from the data acquired on the monitored parameters, the
cytokine level indicators (Table 6) also provide a significant evaluation of the effectiveness of
including enterosorbent in the complex of comprehensive treatment during acute pyelonephritis or
the deterioration thereof.
As can be seen from Table 6, for patients with acute pyelonephritis, a low level of proinflammatory cytokines was observed before the start of treatment on the basis of urolithiasis, which
attests to a weakened immune response. In an acute inflammatory process, comprehensive
treatment with unconditional execution of enterosorption leads to an increase in pro-inflammatory
cytokine activity in the treatment group and anti-inflammatory interleukine-10 (IL-10) in both groups,
which is characteristic for regression of the acute infectious inflammatory process.
The positive dynamic of levels of IL-10 and protein fractions in the blood was more
pronounced in the patients of the treatment group. The increase in IL-10 levels in the treatment
group was 32.1±1.8 pg/ml, SP – 18.6%, but the reduction of MWP levels – 38.7 %; for the control
group the IL-10 increase was – 46.1 %, SP – 12.7% and MWP reduction – 13.3%.
When evaluating the clinical picture before treatment, pain in the lumbar region,
hyperthermia and symptoms of intoxication were recorded in all patients of both groups: weakness
in 87% of patients in Group 1 and 86% in Group 2; chills in 79% and 70% respectively; tachycardia in
60% and 57%; nausea in 34% and 42%; perspiration in 25% and 24%; headaches in 24% and 26%.
Laboratory indicators in monitored groups
Treatment
Control
Table 5. MWP and LII dynamic in patients with acute pyelonephritis over course of treatment
MWP indicators during treatment
LII indicators during treatment
before
Day 4
Day 8
before
Day 4
Day 8
treatment
treatment
0.94
0.72
0.31
5.74
5.4
3.5
0.92
0.79
0.5
5.8
5.7
4.3
Table 6. Dynamic of cytokine levels in patients with secondary pyelonephritis over course of treatment
Laboratory
indicators
Interleukin-1
Interleukin-10,
Treatment group
initial indicator
Day 8
22.2±1.1
17.6±4.2
15.3±1.6
32±1.8
Control group
initial indicator
Day 8
22.6±2.3
18.7±4.2
17.2±2.1
46±0.46
1
Translator's note: The abbreviation ME was transcribed from the original Russian – the meaning was not
found. In the current dictionary of Russian abbreviations it has many meanings. It could mean, for example,
unit of mass or international unit, etc.
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pg/ml
Table 7. Microbial spectrum for patients with nephritis, complicated secondary pyelonephritis
Cause
E. coli, n (%)
Proteus, n (%)
Pseudomonas aeruginosae, n (%)
Enterobacter, n (%)
Staphylococcus epidermidis, n (%)
Klebsiella, n (%)
Association of microorganisms, n (%)
Urinalysis, sterile, n (%)
Total, n (%)
Number of patients - n (%)
Group 1
Group 2
Sparflo therapy (n=28)
Sparflo + Enterosgel (n=27)
before
4(14.3)
10(35.8)
9(32.1)
1(3.6)
1(3.6)
1(3.6)
2(7.1)
0
28(100)
after
2(7.1)
7(25.6)
6(21.4)
0
0
0
0
13(46.4)
28(100)
before
5(18.5)
8(29.6)
6(22.2)
2(7.4)
3(11.1)
2(7.4)
1(3.7)
0
27(100)
after
2(7.4)
5(18.5)
0
0
0
0
0
20(74)
27(100)
Following treatment (Day 13 – 15), all symptoms had completely disappeared for the patients
of Group 2, who had undergone treatment combined with Enterosgel, while for the patients in Group
1 the symptoms of intoxication persisted: weakness in 20%, tachycardia in 7%, perspiration in 5%,
headaches in 10% and in connection with this their stationary treatment lasted 16 – 20 days.
According to the data from the urinalysis before treatment was began, some microorganism
or another was found in the urine of the patients in both groups. Analysis the microbe content after
treatment showed that the positive dynamic differed for the two groups. The analysis returned a
sterile result in 74% of patients from Group 2, while in Group 1 this was 46% of cases, which confirms
the effectiveness of comprehensive treatment (Table 7).
During the research it was pointed out that the patients with acute pyelonephritis who also
suffered from diabetes (26 patients) and were using Diabeton had high blood sugar levels – a mean
(M) of 10.3±0.14. After using Enterosgel, within 2 – 3 days the glucose levels in the 13 patients from
the treatment group had been reduced to 5.7±0.1 mmol/l; such a dynamic was not recorded in the
patients with pyelonephritis and diabetes in the control group.
We thus discovered a property of Enterosgel, which is the reduction of glucose levels in
patients with diabetes. Enterosgel apparently adsorbs glucose circulating in the gastrointestinal tract
and removes it from the body. This confirms the data from the experiment in which Enterosgel in
vitro reduced the sugar levels by half.
In examining the microcirculation of kidneys in patients with acute pyelonephritis, a
reduction of VS and increase of RI (resistance index); the action of the acute inflammatory process
thus leads to weakening of the renal hemodynamic. The average VS and RI values improved in
patients from both groups, but more marked changes were recorded in those patients from the
treatment group (Table 8). The data listed in Table 8 reflect a more dynamic change over the course
of treatment for the VS and RI parameters, which attests to an improvement of blood perfusion in
the renal arteries of the treatment group patients.
After treatment was completed, a certain improvement in blood perfusion and
microcirculation in the kidney was recorded in patients form the control group, while for patients
from the treatment group the mean values of the monitored parameters had improved markedly.
Our study thus proves that during acute pyelonephritis, the blood microcirculation in the
inflamed kidney is impaired, i.e. circulation hypoxia of the organ occurs. A number of domestic
authors support this opinion [12, 13]. Under the same clinical and laboratory studies it is stated that
for patients in the treatment group who received Enterosgel, the typical signs of effective treatment
predominate and are of a more pronounced nature.
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Conclusions
1. During calculous pyelonephritis caused by calculi of small dimensions that do not disrupt the
urodynamic, we consider the use of antibacterial treatment along with therapy to support passing of
calculi possible.
2. The results of research show that the levels of cytokines, LII, MWP and SP are important indicators
that make it possible to check the performed pathogenic therapy during acute inflammatory kidney
illnesses.
3. The use of Enterosgel in comprehensive treatment of acute pyelonephritis shows clear
detoxification, bactericidal activity on the originators of pyelonephritis, improves microcirculation,
reduces bacteriuria and, if the illness is accompanied by diabetes, reduces blood sugar levels.
VS, cm/s
RI
Table 8. Indicators of kidney microcirculation according to CMF data in group patients
Name of parameter
Treatment group
Control group
initial
Day 8 - 9
initial
Day 8 – 9
indicator
indicator
Right renal artery
31±8.6
42±12.8
29±8.2
38±12.3
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Left renal artery
30±7.9
40±12.1
28±7.8
37±11.6
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Segmental artery
16±4.2
19±5.4
17±4.7
18±5.1
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Right renal artery
0.9±0.04
0.58±0.2
0.8±0.03
0.66±0.2
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Left renal artery
0.8±0.03 0.59±0.02 0.75±0.03 0.61±0.3
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Segmental artery
0.16±0.07 0.55±0.55 0.74±0.07 0.69±0.07
PL = 0.05 PL = 0.05 PL = 0.05
PL = 0.05
Enterosgel
enterosorbent no. 1*
for poisoning,
hangover, allergies
*based on data from retail audit by DSM Group, 2013
MICROBES TOXINS ALLERGENS
HARMFUL SUBSTANCES HANGOVER
ENTEROSGEL
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CLINICAL STUDIES
_____________________________
Paste for internal use 225 g
LITERATURE
1.
2.
3.
4.
5.
6.
7.
8.
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Information on the authors:
K. M. Arbuliyev – Doctor of Medical Science, Urology Department at the Dagestan State Medical Academy, Makhachkala
M. G. Arbuliyev – Doctor of Medical Science, Urology Department at the Dagestan State Medical Academy, Makhachkala
M. G. Magomedov – Candidate of Medical Science, Urology Department at the Dagestan State Medical Academy,
Makhachkala
F.M. Abdurakhmanova - Urology Department at the Dagestan State Medical Academy, Makhachkala
M. O. Azizov - Urology Department at the Dagestan State Medical Academy, Makhachkala
FARMATEKA No. 3 - 2015