Hepatic and renal insufficiency

In the study of N.А. Gorchakova et al. (2005) Enterogel has been used for treatment of fulminant hepatitis in rats caused by administration of tetrachloromethan. It has been noted that enterosorption hampered lipid peroxidation in liver tissue of experimental animals, elevates activity of enzymes of antioxidant pool, and decreases activity of serum transaminases, what in turn evidences on better preservation of hepatocyte membranes. О.R. Greketal. (2000) who have used multiple administrations of CCl₄ in combination with drinking of 5% ethanol for  modeling  of chronic hepatitis in rats, have demonstrated stable positive effect of Enterosgel administration toward activity of serum transaminases and alkaline phosphatase, as well as the speed of hepatic metabolim of probiotics.

A number of authors (Zh.I. Vozianova et al., 1990; L.А. Garnitskaya, 1994; S.О. Nikityuk, 1997; E.А. Olkhovnikova et al., 1999; V.G. Myasnikov, 2002; V.V. Gebesh and I.G. Semenchenko, 2000; L.V. Moroz et al., 2006) have reported about positive influence of Enterosgel on the course of acute viral hepatitis А and В in children and adults. Patients that received enterosorbents have shown quickier release of cholemic syndrome and hyperfermentemia, attenuation of skin itch, and improvement of performance status compared to the patients from control group. М.А. Andreichinetal. (2009) indicated Enterosgel to the patients with chronic hepatitis C that received as a basic therapy interferon inducers. It has been shown that along with positive subjective effects, enterosorption favors to decrease of activity of serum AlAT and decrease of concentration of serum thrombomodulin that serves as indicator of the degree of endothelial malfunction occurring as a consequence of viral dependent injury of vessel endothelium.

V.V. Gebesh and I.G. Semenchenko have compared the results of surgical treatment of patients with mechanical jaundice in groups that received or did not receive Enterosgel, and have made a conclusion about significant improvement of quality of preparation of patients for surgery and course of postsurgery period in patients undergoing enterosorption. Such improvement is related not only to indexes of cholemia and fermentemia, but also to nitrogen-excreting renal function, electrolytic balance, serum concentration of albumin, RES and leucocytaric formula. Reduction of the terms of patients stay in hospital composes at average 3.5 days, and mortality in the group treated with Enterosgel decreased from 25 to 15%.

In the work of I.М. Skalich and N.I. Zhigarenko (1998), fine result of Enterosgel use for combined therapy of liver of alcohol etiology was described, while О.I. Osadchaya et al. (2008) have shown that in patients of this category, transport function of albumin due to Enterosgel administration elevates from 35±7 to 57±7 mg of stain per 1 g of protein versus 36±4 and 39±5 mg/g in control group and 90±10 mg/g in healthy donors.

The question about use of Enterosgel for treatment of renal pathologies is of exceptional interest.

Table 6. Functional indexes in rats with glycerol model of renal insufficiency.

* - significant difference from untreated control

As it follows from Table 6, 2-weeks administration of Enterosgel has positive influence on the indexes of kidney function and survival of rats with glycerol model of renal insufficiency (L.S. Fira et al, 2009).

The question about use of different enterosorbents, including Enterosgel, for treatment of chronic renal insufficiency of stages II-III has been carefully studied in Ph.D. work of  N.А. Kolesnik (1995) who had shown that an optimized dose of Enterosgel (90 g/day) administered for 3 months, was able to decrease nitrogenemia level in  35% of patients, and to prevent its elevation in 25-30% of patients, what is responding to classic results on the use of carbon enterosorbents (G.D. Shostka et al., 1984; V.G. Nikolaev et al., 1985). М.F. Valentis (1999) offers to administer Enterosgel to patients with chronic renal insufficiency for half of year and more, and notes an improvement of their state already after 4-5 days after initiation of enterosorption with the decrease of nitrogenemia grade and metabolic acidosis, and possibility  of elevation of daily quote of protein. These experimental and clinical results are especially interesting, because Enterosgel possesses only insignificant adsorptive capacity toward such uremic metabolites as urea, creatinine, and uremic acid, and is also uncapable to disconnect the complex of protein-bound uremic toxins being sharply different  from early soviet synthetic SCN enterosorbents and from modern version AST-120, used for treatment of predialysis patients with CRI (T. Sanaka et al., 1989; N. Nakagava et al., 2006).