ÍÄ×ÒÏËÏÂÉÀ - DNT Union
ÍÄ×ÒÏËÏÂÉÀ - DNT Union ÍÄ×ÒÏËÏÂÉÀ - DNT Union
12 Terapiuli RonisZiebebis algoriTmi pirveladi mpgn-is dros pirveladi idiopaTiuri membranul-proliferaciuli glomerulonefriti meoradi mpgn-is gamoricxva proteinuria > 3 g/dReSi da/an gfs-is daqveiTeba ki ara bavSvi mozrdili prednizoloni 40 mg/m 2 yovel meore dRes 6-12 Tve dakvirveba dinamikaSi aspirini 325 mg dReSi + dipiridamoli 225 mg dReSi 6-12 Tve proteinuriis Semcireba gfs-is stabilizacia ki ara Terapiis gagrZeleba kargi amtanobis SemTxvevaSi dakvirveba dinamikaSi simptomuri Terapia simptomuri Terapia
membranul-proliferaciuli glomerulonefritis recidivi Tirkmlis transplantatSi arsebobs garkveuli histologiuri msgavseba transplantatis qronikul glomerulopaTiasa da membranul-proliferaciul glomerulonefrits Soris. diferenciuli diagnozisaTvis mniSvnelovania imunofluorescenciuli kvleva, romelic mpgn-is recidivis SemTxvevaSi C3-is ufro intensiur CarTvas uCvenebs IgM-Tan SedarebiT (transplantatis glomerulopaTiisagan gansxvavebiT). eleqtronuli mikroskopiiT I tipis mpgn-is SemTxvevaSi Cans subendoTeluri mkvrivi CanarTebi. mpgn-is transplantatSi recidivis mTavari klinikuri gamovlenaa proteinuria, romelmac SeiZleba nefrozul xarisxs miaRwios. proteinuriis garda, gvxvdeba hematuria, arteriuli hipertenzia da Tirkmlis funqciis progresuli daqveiTeba transplantatis terminaluri ukmarisobis ganviTarebamde. Tirkmlis transplantatSi mpgn-is recidivis sixSiris Sesaxeb gansxavavebuli monacemebi arsebobs. iTvleba, rom daavadebis histologiuri niSnebi transplantatSi TiTqmis 100%-Si gvxvdeba (gansakuTrebiT II tipis mpgn-is SemTxvevaSi), Tumca klinikuri gamovlena SesaZlebelia mniSvnelovnad gansxvavdebodes - dawyebuli asimptomuri mimdinareobidan damTavrebuli nefrozuli sindromiT an terminaluri ukmarisobis swrafi ganviTarebiT. transplantatSi mpgn-is recidivis specifiuri mkurnaloba ar arsebobs. mniSvnelovania hipertenziis, mZime proteinuriisa da hiperlipidemiis kontroli, Trombozuli garTulebebis prevencia. meoradi mpgn-is SemTxvevaSi SesaZloa efeqturi iyos ZiriTadi daavadebis mkurnaloba - magaliTad, lamivudinis gamoyeneba B hepatitis virusis persistuli antigenemiis SemTxvevaSi. arsebobs calkeuli monacemebi transplantatSi pirveladi mpgnis recidivis SemTxvevaSi ciklofosfamidis an plamzaferezis gamoyenebis Sesaxeb, Tumca am saxis Terapiis efeqturoba dadasturebuli ar aris. gamoyenebuli literatura: 1. Ulrich Kuhlmann, Dieter Walb: Nephrologie Pathophysiologie-Klinik-Nierenersatzverfahren, Georg Thieme Verlag 2003 2. Alex M. Davison et al.: Oxford Textbook of Clinical Nephrology, 2005 3. Schrier, Robert W.: Diseases of the Kidney & Urinary Tract, 8th Edition, Lippincott Williams & Wilkins, 2007 4. Franko Ferrario, Maria Pia Rastalndi. Membranoproliferative Glomerulonephritis. Renal Pathology Learning. 5. European Best Practice Guidelines for Renal Transplantation. 13
- Page 1 and 2: ÓÀØÀÒÈÅÄËÏÓ ÃÉÀËÉÆ
- Page 3 and 4: membranul-proliferaciuli glomerulon
- Page 5 and 6: cxr.2 C3 nefrituli faqtoris maxasia
- Page 7 and 8: imunofluorescencia: mkveTrad dadebi
- Page 9 and 10: imunofluorescencia: xasiaTdeba C3-i
- Page 11: klinikuri mimdinareoba da laborator
- Page 15 and 16: amiloiduri depozitebis warmoqmna Se
- Page 17 and 18: preglomeruluri sisxlZarRvebi Tirkml
- Page 19 and 20: amiloidozis Tanamedrove mkurnaloba
- Page 21 and 22: amiloidis daSla rogorc zemoT iyo aR
- Page 23 and 24: diagnostika Tirkmlebis qronikuli da
- Page 25 and 26: mkurnalobis ZiriTad meTods hemotran
- Page 27 and 28: mogvyavs eriTropoetin-rezistentuli
- Page 29 and 30: eriTropoetinis sawinaaRmdego antisx
- Page 31: hemotransfuzia renuli anemiis mqone
membranul-proliferaciuli glomerulonefritis recidivi<br />
Tirkmlis transplantatSi<br />
arsebobs garkveuli histologiuri msgavseba transplantatis qronikul<br />
glomerulopaTiasa da membranul-proliferaciul glomerulonefrits Soris.<br />
diferenciuli diagnozisaTvis mniSvnelovania imunofluorescenciuli kvleva,<br />
romelic mpgn-is recidivis SemTxvevaSi C3-is ufro intensiur CarTvas uCvenebs<br />
IgM-Tan SedarebiT (transplantatis glomerulopaTiisagan gansxvavebiT).<br />
eleqtronuli mikroskopiiT I tipis mpgn-is SemTxvevaSi Cans subendoTeluri<br />
mkvrivi CanarTebi.<br />
mpgn-is transplantatSi recidivis mTavari klinikuri gamovlenaa proteinuria,<br />
romelmac SeiZleba nefrozul xarisxs miaRwios. proteinuriis garda, gvxvdeba<br />
hematuria, arteriuli hipertenzia da Tirkmlis funqciis progresuli<br />
daqveiTeba transplantatis terminaluri ukmarisobis ganviTarebamde.<br />
Tirkmlis transplantatSi mpgn-is recidivis sixSiris Sesaxeb<br />
gansxavavebuli monacemebi arsebobs. iTvleba, rom daavadebis histologiuri<br />
niSnebi transplantatSi TiTqmis 100%-Si gvxvdeba (gansakuTrebiT II tipis<br />
mpgn-is SemTxvevaSi), Tumca klinikuri gamovlena SesaZlebelia mniSvnelovnad<br />
gansxvavdebodes - dawyebuli asimptomuri mimdinareobidan damTavrebuli<br />
nefrozuli sindromiT an terminaluri ukmarisobis swrafi ganviTarebiT.<br />
transplantatSi mpgn-is recidivis specifiuri mkurnaloba ar arsebobs.<br />
mniSvnelovania hipertenziis, mZime proteinuriisa da hiperlipidemiis<br />
kontroli, Trombozuli garTulebebis prevencia. meoradi mpgn-is SemTxvevaSi<br />
SesaZloa efeqturi iyos ZiriTadi daavadebis mkurnaloba - magaliTad,<br />
lamivudinis gamoyeneba B hepatitis virusis persistuli antigenemiis<br />
SemTxvevaSi. arsebobs calkeuli monacemebi transplantatSi pirveladi mpgnis<br />
recidivis SemTxvevaSi ciklofosfamidis an plamzaferezis gamoyenebis<br />
Sesaxeb, Tumca am saxis Terapiis efeqturoba dadasturebuli ar aris.<br />
gamoyenebuli literatura:<br />
1. Ulrich Kuhlmann, Dieter Walb: Nephrologie Pathophysiologie-Klinik-Nierenersatzverfahren, Georg Thieme Verlag 2003<br />
2. Alex M. Davison et al.: Oxford Textbook of Clinical Nephrology, 2005<br />
3. Schrier, Robert W.: Diseases of the Kidney & Urinary Tract, 8th Edition, Lippincott Williams & Wilkins, 2007<br />
4. Franko Ferrario, Maria Pia Rastalndi. Membranoproliferative Glomerulonephritis. Renal Pathology Learning.<br />
5. European Best Practice Guidelines for Renal Transplantation.<br />
13
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