[The effect of pathogenetic therapy on the expression of endogenous intoxication in patients with chronic glomerulonephritis].

The content of medium-sized molecules (MSM) in the blood serum was measured in 52 patients with exacerbation of chronic glomerulonephritis (CGN) given pathogenetic therapy. All the patients manifested an initial rise of the content of MSM. Administration of cytostatics and (or) glucocorticoids led to the regression of the nephrotic syndrome in 32 patients. In 20 patients, it was ineffective. All the patients in whom the treatment appeared effective demonstrated the lowering of the content of MSM 2 weeks after the treatment initiation, which outstripped the dynamics of the other parameters characteristic of CGN exacerbation. At the same time the urinary clearance of MSM remained unchanged. The patients in whom the pathogenetic therapy turned out ineffective manifested an increase of the blood content of MSM and of the urinary clearance of these substances. It is suggested that the test with the detection of the urinary clearance and the content of MSM in the blood serum may be used before the treatment and 2 weeks after its initiation to early estimate the treatment efficacy. The prognostic value of the positive test is 82%, that of the negative 80%. It is assumed that the mechanism that triggers the increase of the rate of MSM generation may lie in lipid peroxidation activation.