Репозиторий Университета

© Russian Association of Endocrinologists, 2018. Background: As in many other developed nations, the problem of obesity and type 2 diabetes is acute in Russia. In Russia, the only combination of sibutramine and metformine (Reduxin®Met) is authorized to reduce body mass and prevention development of type 2 diabetes mellitus or its complication. The article presents the results of the observational program “AVRORA”. Aim: Evaluation of the effectiveness and safety of Reduxin®Met (sibutramine + microcrystalline cellulose + Metformin) in patients with type 2 diabetes and alimentary obesity in routine clinical practice. Materials & methods: The observational program “AVRORA” was conducted from September 2016 to October 2017 under the auspices of the Endocrinological Scientific Center and the Russian Association of Endocrinologists. The “AVRORA” program was a multicenter, non-interventional study of patients to whom the attending physicians prescribed Reduxin®Met, a set (tablets + capsules), in accordance with the instruction for medical use as part of routine clinical practice. The treated group included patients of both sexes, aged 18–65 years, with an established diagnosis of obesity in combination with type 2 diabetes. The duration of the drug usage was determined by the attending physician and was up to 6 months. Reduxine®Met was prescribed in addition to the existing glucose-lowering therapy, the dose of metformin was adjusted to the patient's needs. Results: The “AVRORA” study was attended by 259 doctors and 5,812 patients in 240 medical institutions from 12 cities of the Russian Federation. The average age of patients was 46.6 ± 10.5 years, the ratio of male / female -24% / 76%. The decreasing of BMI during 6 months of the therapy amounted to 5.4 ± 2.3 kg / m2 (on average, 15.1 ± 6.4 kg). After 3 months of the therapy 81.6% of patients achieved clinically significant weight loss of 10.6% or more. The average decrease in waist circumference during 6 months of therapy was 13.8 ± 7.4 cm. A decrease of indicators of glycemic control and lipid metabolism right up to the target values was observed. Conclusions: In “AVRORA” study it was shown that addition of Reduxine®Met (sibutramine+ microcrystalline cellulose+met-formine) to the complex therapy of the diabetes in combination with obesity according to approved indications is safe and effective for long-term treatment in regards to weight loss, regulation of lipemic index, glucose profile and quality of life.

© 2018 National Academy of Pediatric Science and Innovation. All rights reserved. Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per year is 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.

2019 © Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All Rights Reserved. The goal of study was the epidemiological substantiation of optimization measures of a vaccinal prevention of whooping cough in the Russian Federation. Materials and methods. The retrospective descriptive epidemiological research has been conducted by analysis of the official statistical data on the whooping cough case rate (form No. 2) in 2005-2017 in the Russian Federation, as well as the data about preventive whooping cough inoculations (forms No. 5, No. 6) in 2005-2017 and about epidemic outbreakes in 2017 (form No. 23-17). The assessment of an economic damage from whooping cough in 2005-2017 has been carried out. Results. The following adverse characteristics of a modern epidemiological situation on whooping cough in Russia are shown: long-term recurrence of epidemic process, tendency of rising of a case rate of children of 0-2 years; high percentage of children of preschool and school age among whooping cough cases; prevalence among the patients with whooping cough of the children who have been vaccinated against this infection previously, epidemic outbreakes in children's collectives, the stability of a case rate of teenagers and adults with prevalence of the mild and the erased clinical forms of this infection. The risks due to weaknesses of the whooping cough vaccinal prevention are noted: the insufficient immunization coverage owing to falce contraindications and refusals of parents of vaccinations of children, noncompliance with terms and intervals between inoculations, lack of domestic vaccine for revaccination of children at the age of 5 years and older. Conclusion. It is necessary to introduce in the national vaccination schedule a preschool booster dose for children at the age of 6 and adolescents at 14 years with the combined reduced antigen content tetanus-diphtheria and acellular pertussis vaccines as well as the inoculations of this vaccine according to epidemiological indications to health workers, employees of educational institutions. A revaccination against whooping cough is recommended as “cocoon” for the persons contacting to not vaccinated child under 1 year of age.

© 2018 ABC-press Publishing House. All rights reserved. The objective is to perform comparative analysis of intra- and postoperative complications of retroperitoneoscopic radical nephrectomy (RRN) and laparoscopic radical nephrectomy (LRN) for large tumors. Materials and methods. The study includes examination and treatment data for 108 patients with stage T1–3a renal cell carcinoma. Results and conclusion. A number of advantages of RRN compared to LRN were demonstrated associated with shorter surgery duration with fast processing of the renal pedicle, lower blood loss, lower use of analgesics in the postoperative period, shorter duration of hospitalization, and quick recovery after the surgery. The rate of intra- and postoperative complications for RRN was 19.2 and 17.3 %, for LRN – 33.9 and 37.5 %, respectively. Complications associated with abdominal organs were absent for RRN. After LRN, the rate of serious complications was significantly higher than after RRN.

Copyright: © 2018 Sapelnikov et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 License. Mitral valve disease, including dysfunction of the mitral valve, is often accompanied by atrial fibrillation. Among the patients with prosthetic mitral valves, atrial fibrillation occurs in 30-50% cases. Development of atrial arrhythmias and incisional tachycardia in the early and late postoperative periods can significantly influence patients' rehabilitation and prognosis. Our clinical case describes a patient with a mechanical mitral valve and incisional tachycardia, which led to progression of heart failure and reduced left ventricular systolic function. The patient underwent catheter ablation with non-invasive myocardium mapping. The case reveals the potentials of treatment of incisional tachycardia and atrial fibrillation, which do not respond to drug therapy. Modern methods of visualization enable the cardiac surgeons to reduce possible intraoperative risks and development of complications in this group of patients.

© 2018 Pirogov Russian National Research Medical University. All Rights Reserved.  Rivaroxaban is a safer and more effective alternative to warfarin. However, there are reports of some cases of major hemorrhagic complications associated with rivaroxaban that significantly impair the patients' quality of life and can lead to a fatality. Personalized therapy, including pharmacogenetic testing, may help prevent such adverse events. This study aimed to investigate how ABCB1 3435C>T (rs1045642) and CYP3A5 6986A>G (rs776746) gene polymorphisms, when carried by a patient taking rivaroxaban to prevent thrombosis after total hip or knee replacement surgery, affect prothrombin time (PT). Sixty-five patients participated in the study. Their genotypes were identified by PCR in real time. To learn PT peculiar to each patient, we collected venous blood on the 5 th day of their anticoagulation therapy, 1 hour before they took rivaroxaban and 3 hours after. Having calculated %∆PT, we divided the patients into 2 groups: 1) %∆PT ≤ 0 (n = 7; 10.8%); 2) %∆PT > 0 (n = 58; 89.2%). Regarding the distribution of rs1045642 polymorphism, we determined the difference between the groups to be statistically significant (χ 2 = 6.64; p = 0.027). As for rs776746 polymorphism, the difference was insignificant (χ 2 = 0.101; p = 1.0). We discovered that rs1045642 polymorphism has a significant effect on PT variance in patients taking rivaroxaban to prevent thrombosis after total hip or knee replacement surgery.

© 2018 Paediatrician Publishers, LLC. All Rights Reserved. Background. Improving the quality of medical care is based on a coordinated policy at the federal, regional and municipal levels in the field of health. The implementation of this goal is based on a regular assessment of the current state of the healthcare system in the Russian Federation. Objective. Our aim was to analyse of the main indicators characterizing medical care for children with cancer in the South Federal District. Methods. The operative reports for 2017 of the executive authorities in the sphere of health protection of 8 subjects of the Russian Federation that are part of the South Federal District of the Russian Federation have been analyzed. Results. The number of children were 3 216 797 people (aged 0-17 years), the number of children's oncological beds is 272 (0.8 per 10 thousand children aged 0-17 years), the average number of days of berth employment in the year is 289.9 bed days. In 4 (50%) subjects of the department of pediatric oncology are absent, in 1 (12.5%) - there are no children's oncological beds. The number of doctors providing medical care to children with cancer is 50, of them 42 (84%, 0.1 per 10 thousand children aged 0-17 years) have a certificate of a pediatric oncologist. In 2 (25%) subjects, there are no pediatric oncologists. Incidence of malignant tumors was 13.9 (per 100,000 children aged 0-17 years), prevalence was 86.5 (per 100,000 children aged 0-17 years), mortality was 2.5 (per 100,000 children aged 0-17 years), a one-year mortality rate of 4.7%. 8% of patients were actively detected. 104 (23.2%) of primary patients were sent to medical organizations of federal subordination, 4 (0.9%) of primary patients left the territory of the Russian Federation. Conclusion. The analysis revealed a number of defects: incorrect information contained in the reports, low incidence (detectability) of patients, including during planned preventive examinations, staff shortages and non-rational use of bed facilities.

© 2018 by the MediaSphere. A case of thyrotoxic myocarditis in a 60-year-old female patient is oresented. With the diagnosis of «Unstable angina» she was admitted to the intensive care unit for patients with myocardial infarction at the Yudin city clinical hospital in Moscow. Earlier, the patient had been treated with tyrosol for thyrotoxicosis, but she independently abolished the drug. She ecperienced pain in the chest for the first time in her life. Emergency, coronaroangiography was performed. No hemodynamically significant damage to the blood vessels of the heart was detected. Later, according to the outpatient blood test for thyroid hormones, a diagnosis was established — «severe thyrotoxicosis». The next day after hospitalization, treatment with tyrosol was started at a dose of 30 mg per day. Sinus tachycardia persisted. A reliable increase in cardiospecific enzymes was detected. The pain in the chest did not recur. Echocardiography did not reveal impairment of local or global myocardial contractility. On the fifth day of hospital treatment the patient suddenly died of cardiac and respiratory arrest. The autopsy study revealed autoimmune thyroiditis, thyrotoxic serous-lymphocytic myocarditis, which was complicated by a rupture of the myocardium, and pericardial gemotamponade. The difficulties of differential diagnosis of myocarditis and acute coronary syndrome and the features of treatment tactics in elderly patients with thyrotoxicosis are discussed.

© 2018 University of Rijeka, Faculty of Medicine. All Rights Reserved. Background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results is also the basis of the strategy for the development of medical care for this category of patients. Objective. Our aim was to analysie the main indicators characterizing medical care for children with cancer in the North-Caucasian, Volga, Urals, Siberian and Far Eastern Federal Districts. Methods. In ecological study the operative reports for 2017 of the executive authorities in the sphere of health protection of 44/48 (91.6%) subjects of the Russian Federation that are part of the listed above federal districts have been analyzed (Chuvash Republic, Irkutsk Region, Republic of Sakha (Yakutia) and Khabarovsk Territory did not provide data). Results. The number of children's population was 15 555 306 people (0-17 years), the number of children's oncological beds - 1166 (0.7 per 10 thousand 0-17 years), the average number of days of berth employment in the year - 324.6 bed days. In 13 (29.5%) subjects of the department of pediatric oncology are absent, in 6 (13.6%) - there are no children's oncological beds. The number of doctors providing medical care to children with cancer is 213, of which 132 (62%; 0.08 for 10 thousand 0-17 years) have a certificate of a pediatric oncologist. In 6 (13.6%) subjects there are no doctors-children oncologists (6 more (13.6%) subjects did not provide data). The incidence of malignant neoplasms was 13.1 (per 100.000 0-17 years), the prevalence of 93.1 (per 100.000 0-17 years), mortality rate 2.5 (per 100.000 0-17 years), one-year lethality - 6.8%. 10.1% of patients were actively detected. 781 (38.3%) of primary patients were sent to medical organizations for federal subordination, 39 (1.9%) of primary patients left the territory of the Russian Federation. Conclusion. Obvious accounting defects (low incidence rate) and lack of reliable follow-up data (estimation of mortality levels is difficult) are eliminated by introducing electronic accounting systems. For reliable estimation of the level of provision of the population with children's cancer beds and the percentage of patients sent for treatment in medical organizations of federal subordination, audit of patients' illnesses is necessary. The traditional problems - the deficiency of doctors and children's oncologists and a low percentage of patients identified actively - must be addressed through the reform of the training program for medical personnel.

The aim of the study was to prove the anatomical and clinical effectiveness of the modified anesthesia of mental nerve. The effectiveness of conductive anesthesia near the mental foramen was objectively evaluated using the electric pulp test (EPT) in 100 volunteers of both sexes, aged 35-43 years. Wet anterior mandible preparations obtained from 350 cadavers aged 18-74 years were also studied. EPT value after local mental anesthesia conducted according to Malamed C. using 4% articain solution of local anesthetic with vasoconstrictor concentration of 1:200.000 after 2 minutes was 93±0.82 mA, after 4 minutes - 188±1.26 mA. Yield variability indicators of intraosseous mental nerve anesthesia was slightly higher varying from 94.11 mA to 96.61 mA after 2 minutes and from 197.4 to 199.92 mA after 4 minutes survey. The study showed the efficiency and predictability of intraosseous anesthesia of the mental nerve.

The modern model of inpatient surgical care of private and optimized state/govermental medical institutions allows us to change the paradigm of nosological attachment of the hospital bed to one profile of specialists for an adaptive model, when the wards can be reassigned depending on the needs of the hospital. In such multidisciplinary medical centers with mixed hospital beds without a nominal distinction in the nosological departments, a new therapeutic service is being developed - hospitalists, which provide a consistent curation of hospitalized patients, compensation of chronic therapeutic illnesses with patient's preparation for surgical interventions. Our work describes the experience of Fast Track recovery program with the active participation of a hospitalist in a surgical team, which is a new experience in the practice of Russian colorectal surgery.

AIM: To evaluate bile ducts injuries and effect of biliary decompression technique on the outcomes of reconstructive surgery. MATERIAL AND METHODS: There were 21 patients with biliary injury during cholecystectomy, 20 patients with cholelithiasis, and 1 patient after surgery for perforated duodenal ulcer. Their age was 22-81 years (mean 54.3 years). Primary surgery through median laparotomy was followed by biliary injury in 12 patients, laparoscopic cholecystectomy - in 6 patients, open laparoscopy - in 3 patients. Patients were divided into 2 groups. In group 1 (n=11) biliary injury was diagnosed intraoperatively, in group 2 (n=10) - in 2-11 days after primary procedure. According to European Association for Endoscopic Surgery (EAES) 2013 classification biliary injury type 1 was found in 5 patients, type 2 - in 9 cases, high damage involving confluence (type 3) - in 1 patient, type 4 - in 1 patient, and type 6 - in 5 patients. Endoscopic retrograde cholangiopancreatography in 3 patients revealed that biliary drainage output after laparoscopic cholecystectomy was caused by cystic duct clipping failure, endoscopic papillosphincterotomy was successfully used for biliary drainage output (type 6). In 3 patients operated through median laparotomy biliary excretion cessation was observed after 2-3 days that indicated damage of aberrant bile ducts. RESULTS: Bile outflow into gastrointestinal tract was restored in 11 out of 16 patients with iatrogenic biliary injury types 1-4, external biliary drainage was used in 4 patients due to their severe condition and abdominal inflammatory changes. Biliary fistulae occurred in 5 out of 8 patients in both groups after primary reconstructive surgery. Biliary stricture was observed in 3 cases due to external biliary drainage failure followed by peritonitis. 7 patients underwent reconstructive surgery with positive result. Mortality was absent. In 1 patient with biliary fistula outcome is unknown. CONCLUSION: Transumbilical biliary drainage is optimal during reconstructive surgery.

Flavonoids are herbal medicines and widely used for chronic venous diseases and hemorrhoids. Flavonoid diosmin in both micronized and non-micronized form is a part of various drugs. According to literature data, flavonoids are able to reduce venous stasis, suppress local inflammation, improve venous tone and lymphatic outflow. It should be noted that biological models of in vivo trials have certain limitations while available data of different researches are contradictory. However, flavonoids were recommended for hemorrhoids in view of meta-analysis of 14 trials comparing flavonoids (diosmin, micronized purified flavonoid fraction and rutosides) with placebo in 1514 patients with hemorrhoids and Cochrane review of 24 randomized controlled trials (2,334 participants). These drugs should be administered as a part of complex therapy. At the same time, there is no conclusive evidence to prefer only one of these medicines. There are also no data confirming the benefits of daily dosage of 3000 mg per day of micronized fraction of flavonoids compared with 1800 mg of purified diosmin per day for treatment of acute hemorrhoids.

AIM: To analyze proceedings of the I-X Conferences 'Modern problems of somnology'. MATERIAL AND METHODS: The authors have analyzed 888 abstracts from the abstract books of the conferences held from 1998 to 2016 in Moscow and Saint-Petersburg. The territorial, sectoral and scientific indicators of the activity of participants as well as longitudinal research trends were analyzed. Mathematical and statistical data analysis was carried out using the methods of descriptive statistics (95% confidence intervals) and χ2 tests. RESULTS: On average, 300 researchers from 6 countries and 14 regions of Russia participated in each conference, most from higher education (19), research (16) and medical (12) institutions. The highest number of publications were related to clinical somnology and sleep medicine (50% to different neurological conditions), the numeral material was included in 83% and statistical analysis was performed in 32.5%. A trend towards more active participation of research and medical institutions from all the country and involvement of new regions was observed. The interest to the clinical subjects, including treatment choices in sleep disorders as well as organizing aspects of sleep medicine, has been increasing. The number of studies on different aspects of sleep apnea has increased significantly as well. CONCLUSION: The features of scientific and clinical activity in the field of somnology presented in the materials of conferences are stable in terms of the institutional and territorial representation. It complies to international trends of research and clinical development. This allows better planning of the structure and main issues of the further conferences.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Aim. To evaluate cost effectiveness of coronary endovascular treatment in patients with stable IHD during “one-night” hospitalization. Materials and methods. Using the cost-minimization analysis direct medical cost of coronary endovascular treatment in patients with stable IHD during the “one-night” hospitalization was compared with the “classic” hospitalization. Results. The most cost-effective strategy for hospitalization of patients for transcutaneous coronary intervention (TCI) with stenting was the “one-night” hospitalization. Differences in direct medical costs (DMC) were statistically significant (p=0.01) in favor of the patient group hospitalized for one night. Conclusion. The “one-night” hospitalization plan for patients with stable IHD to undergo TCI with stenting increases the cost-effectiveness due to the decreased number of days of stay in the hospital and the associated decrease in cost of in-patient maintenance, which resultes in considerable financial savings (∆ between the hospitalization plans was 21.2% in favor of the “one-might” hospitalization). This ∆ indicates high cost effectiveness of the selected approach.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article discusses various mechanisms of developmentt and progression of arterial hypertension in young and middle aged adults. It emphasizes the predominant role of hypersympathicotonia in the development of the disease in this category of patients. Various mechanisms are considered, by means of which the increase of activity of the sympathetic nervous system leads to elevation of arterial pressure and potentiates early damage of target organs, first of all, damage of the heart. The data of numerous studies demonstrating pronounced cardioprotective effects of a highly selective representative of the class of β-blockers bisoprolol in young and middle aged hypertensive patients are presented.

The article reviews the phenomenology of sleep and wakefulness disorders in Parkinson's disease and Alzheimer's disease. Degeneration of sleep and wakefulness centers, secondary effect of other symptoms of diseases and side-effects of drug therapy lead to a widespread prevalence of sleep and wakefulness disturbances in these patients. Along with the review of actual literature concerning mechanisms of development and clinical features of these disorders, the authors discuss principal methods for their treatment.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Purpose: to assess prevalence of dyslipidemia in patients with ischemic heart disease (IHD) older than 75 years as well as to evaluate possible associations between serum lipids and various cardiovascular and other diseases in these patients. Methods: We enrolled in this cross sectional study 555 hospitalized IHD patients aged 75-98 years (mean age 86.8 years, 74.5% women). Levels of lipids (total cholesterol [TC], triglycerides [TG], low and high-density lipoprotein cholesterol [LDLC, HDLC]) were measured by enzyme method on the biochemistry analyzer Konelab 60i. Results: Elevated TC; hypertriglyceridemia and elevated LDLC were observed in 13.3, 10.4 and 26.3% of patients, respectively. In the majority of patients severity of dyslipidemia was mild. With increasing age serum levels of TC and LDLC decreased. Negative correlation between TC level and patient's age was significant (r= -0.13; p=0.001). Mean TC level was 5.43, 5.0 and 4.7 mmol/l in patients aged <80 (group 1), 80-89 (group 2), and ≥90 (group 3) years, respectively (p=0.001 for differences between groups 1-and 3). Similar results were registered in respect of LDLC: mean LDLC level was 3.7 and 2.7 mmol/l in groups 1 and 3, respectively (p=0.004). Mean concentrations of all lipids in women were higher than in men: TC 5.1 vs 4.5 (p<0.0001), LDLC 3.1 vs 2.5 (p=0.0002), HDLC - 1.26 vs 1.17 mmol/l (p=0.01). Lower lipids levels (especially those of TC) were significantly associated with clinically significant heart failure (p<0.0001) and atrial fibrillation (p<0.0001). Higher TC and TG correlated positively with higher systolic and diastolic blood pressure (p=0.001). Significant positive correlations existed between TG and glucose concentration (p<0.0001) as well as between TG and uric acid level (p=0.001). Higher TG and lower HDLC levels were registered in patients with higher creatinine level (p=0.001 and 0.0003, respectively). Only 11.4% of study patients received statins. Conclusion: The study results evidence for considerable peculiarities of lipid profile in the very elderly patients with IHD. Significant associations between dyslipidemia and a number of diseases were also revealed.

© 2018, Dynasty Publishing House. All rights reserved. The objective. Assessment of the practice of breastfeeding support in a department of neonatal and premature infant pathology of the Tambov Regional Children’s Clinical Hospital (TRCCH) after 3–4 years of becoming a WHO/UNICEF Baby Friendly Hospital. Patients and methods. Mothers were questioned using specially designed questionnaires at their admission to the department and at discharge from hospital. Overall, 356 mothers were questioned at admission and 327 at discharge. The results were processed on the SPSS.19 statistical programme. Frequency distribution, mean values (± standard deviation) and Student’s t-coefficient were determined. Results. The practice of supporting breastfeeding in the department consisted in observance of the 10 steps of successful breastfeeding: mother and infant remaining together (98.2%), breastfeeding on an infant’s demand (91.3%), breastfeeding at night (98.6%), breast milk extraction for infant feeding and lactation stimulation (88.6%), informing mothers about the benefits and technique of breastfeeding (90.5%). The percentage of breastfed infants significantly increased by the time of discharge from the department – to 89.4% (at admission – 71.9%; p < 0.0001), among them exclusively breastfed infants – to 66.5% (at admission – 45.3%; p < 0.0001). Conclusion. The practice of breastfeeding based on current international recommendations is successfully supported in the neonatal department of TRCCH. Nevertheless, breastfeeding parameters might be considerably improved due to attainment of continuity in the work of maternity clinics and TRCCH and optimization of the practices of breast milk extraction, storage and use in the department.

© 2018 Brovko et al. Purpose: Experimental studies suggest that the nephrotic syndrome is associated with “vasopressin escape”, characterized by low aquaporin-2 (AQP2) expression in the collecting duct despite high vasopressin secretion. We investigated this phenomenon in patients with the nephrotic syndrome. Patients and methods: We recruited 47 patients with proteinuric kidney disease who were distributed into the following four groups: 1) nephrotic syndrome with kidney dysfunction (n=10); 2) nephrotic syndrome with normal kidney function (n=16); 3) partial remission of nephrotic syndrome (n=10); and 4) minimal proteinuria (n=11). Nine healthy volunteers comprised a control group. Serum copeptin level (as a marker of vasopressin secretion) and urinary AQP2 were measured using ELISA. Results: Nephrotic syndrome was associated with a significant increase in serum copeptin levels compared with those in the other groups (all P<0.05). In patients with nephrotic syndrome and a partial remission of nephrotic syndrome combined, there was more than a ten-fold decrease in the median urinary AQP2 excretion (0.03 ng/mL) compared with healthy volunteers (0.41 ng/mL; P<0.001) and more than a five-fold decrease compared with patients with minimal proteinuria (0.21 ng/mL; P<0.05). Unlike copeptin levels, the median urinary AQP2 excretion in patients with minimal proteinuria also decreased but less significantly than in those with nephrotic syndrome. There was a negative correlation between the urinary AQP2 excretion and daily proteinuria (R=−0.41; P=0.005). Conclusion: Our clinical study was the first to demonstrate low AQP2 excretion in nephrotic syndrome that may indicate an escape from the vasopressin regulating effect.