1
|
Ostrowski P, Kargul M, Gurazda K, Skoryk A, Ostrowski M, Myślak M, Różański J, Skwirczyńska E. Immunosuppressant Adherence Factors Differentiating Compliant and Non-Compliant Kidney Transplant Recipients. J Clin Med 2023; 12:4081. [PMID: 37373774 DOI: 10.3390/jcm12124081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The purpose of this study is to find out the psychological factor characteristic of non-adherence patients. The study population comprised kidney transplant recipients aged between 18 and 82 years at least 3 months post-transplant who voluntarily agreed to answer a couple of fully anonymous questionnaires that questions pertaining to basic data, type of immunosuppressive drugs taken, and standardized questionnaires. Participants were recruited using direct routine, free-of-charge visits to specialist doctors in transplant clinics. There was no significant difference in the percentage of men and women in both adherence and non-adherence groups. Non-adherence patients were significantly younger compared to adherence patients. There was also a significant difference in the patient's level of education. Adherence patients were better educated. No significant differences in criteria such as place of residence, having children or a partner, or way of living were observed. However, the emotion scale correlated negatively with the level of life orientation in both groups, but the level of the emotions scale and distractions subscale was negatively correlated with the level of self-esteem only for the adherence group. In future research, it would be worthwhile to focus on lifestyle and health-promoting behaviors in juxtaposition with the propensity for adherence.
Collapse
Affiliation(s)
- Piotr Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Michał Kargul
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Klaudia Gurazda
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Anastasiia Skoryk
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Marek Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Marek Myślak
- Department of Nephrology and Kidney Transplantation, Provincial Integrated Hospital, Arkońska 4, 71-455 Szczecin, Poland
| | - Jacek Różański
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Edyta Skwirczyńska
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| |
Collapse
|
2
|
Kudliński B, Trosiak M, Wojciech M, Zaborniak G, Kania J, Buczek A, Fedorowicz O, Myślak M. “A Comparative Analysis of the Number of Organ Retrievals in Relation to Potential Donation Qualifications in Populations of Patients From a Single Anesthesiology and Intensive Care Unit in 2017-2018”. Front Med (Lausanne) 2022; 9:930290. [PMID: 36059819 PMCID: PMC9429814 DOI: 10.3389/fmed.2022.930290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022] Open
Abstract
The population of patients declared as brain dead and qualified for organ donation is relatively low in Poland. The main causes of brain death include cerebral vascular diseases and brain trauma (54 and 34%, respectively, according to Poltransplant registry data). The number of organ procurements in Poland is constantly recorded on average at 14 donations per 1 million citizens (14/mln) in 2017 and 12 donations per one million in 2018. It is difficult to precisely define the number of patients who meet the criteria for brain death certification. The authors have retrospectively analyzed the medical data of 229 patients from 2017 and 2018 records with the aim of identifying potential organ donors among patients of the Intensive Care Unit (ICU) in the University Hospital in Western Poland. Brain death was suspected in 53 patients (23.14%). Brain imaging to confirm no cerebral flow (which is consistent with brain death) was performed in 17 patients (7.45%) and this, as a result, led to organ donation in 9 cases (3.93%). The factors identified as having a positive influence on organ donation included: daily thorough physical examination, (Glasgow Coma Scale) GCS assessment, depth and duration of sedation, ICU length of stay and early performance of a CT-angiogram.
Collapse
Affiliation(s)
- Bartosz Kudliński
- Department of Emergency Medicine, Anesthesiology and Intensive Care in University Hospital Named After K. Marcinkowski, Collegium Medicum University of Zielona Gora, Zielona Góra, Poland
- *Correspondence: Bartosz Kudliński
| | - Marta Trosiak
- Department of Anesthesiology and Intensive Care, University Hospital Named After K. Marcinkowski, Zielona Góra, Poland
| | - Magdalena Wojciech
- Department of Statisical Mathematics and Econometry, Faculty of Mathematics, Informatics and Econometry in University of Zielona Gora, Zielona Góra, Poland
| | - Gabriel Zaborniak
- Faculty of Mathematics, Informatics and Econometry in University of Zielona Gora, Zielona Góra, Poland
| | - Jagoda Kania
- Faculty of Medicine and Health Science, Collegium Medicum University of Zielona Gora, Zielona Góra, Poland
| | - Aleksandra Buczek
- Faculty of Medicine and Health Science, Collegium Medicum University of Zielona Gora, Zielona Góra, Poland
| | - Olga Fedorowicz
- Faculty of Medicine and Health Science, Collegium Medicum University of Zielona Gora, Zielona Góra, Poland
| | - Marek Myślak
- Department of Nephrology, Transplantology and Internal Medicine Clinic, Pomerian Medical University, Szczecin, Poland
| |
Collapse
|
3
|
Madill-Thomsen KS, Abouljoud M, Bhati C, Ciszek M, Durlik M, Feng S, Foroncewicz B, Francis I, Grąt M, Jurczyk K, Klintmalm G, Krasnodębski M, McCaughan G, Miquel R, Montano-Loza A, Moonka D, Mucha K, Myślak M, Pączek L, Perkowska-Ptasińska A, Piecha G, Reichman T, Sanchez-Fueyo A, Tronina O, Wawrzynowicz-Syczewska M, Więcek A, Zieniewicz K, Halloran PF. The molecular phenotypes of injury, steatohepatitis, and fibrosis in liver transplant biopsies in the INTERLIVER study. Am J Transplant 2022; 22:909-926. [PMID: 34780106 DOI: 10.1111/ajt.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 01/25/2023]
Abstract
To extend previous molecular analyses of rejection in liver transplant biopsies in the INTERLIVER study (ClinicalTrials.gov #NCT03193151), the present study aimed to define the gene expression selective for parenchymal injury, fibrosis, and steatohepatitis. We analyzed genome-wide microarray measurements from 337 liver transplant biopsies from 13 centers. We examined expression of genes previously annotated as increased in injury and fibrosis using principal component analysis (PCA). PC1 reflected parenchymal injury and related inflammation in the early posttransplant period, slowly regressing over many months. PC2 separated early injury from late fibrosis. Positive PC3 identified a distinct mildly inflamed state correlating with histologic steatohepatitis. Injury PCs correlated with liver function and histologic abnormalities. A classifier trained on histologic steatohepatitis predicted histologic steatohepatitis with cross-validated AUC = 0.83, and was associated with pathways reflecting metabolic abnormalities distinct from fibrosis. PC2 predicted histologic fibrosis (AUC = 0.80), as did a molecular fibrosis classifier (AUC = 0.74). The fibrosis classifier correlated with matrix remodeling pathways with minimal overlap with those selective for steatohepatitis, although some biopsies had both. Genome-wide assessment of liver transplant biopsies can not only detect molecular changes induced by rejection but also those correlating with parenchymal injury, steatohepatitis, and fibrosis, offering potential insights into disease mechanisms for primary diseases.
Collapse
Affiliation(s)
| | | | - Chandra Bhati
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michał Ciszek
- Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplant Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Sandy Feng
- University of California San Francisco, San Francisco, California, USA
| | - Bartosz Foroncewicz
- Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Jurczyk
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | | | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Geoff McCaughan
- Centenary Research Institute, Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | - Krzysztof Mucha
- Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.,Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Marek Myślak
- Department of Clinical Interventions, Department of Nephrology and Kidney Transplantation SPWSZ Hospital, Pomeranian Medical University, Szczecin, Poland
| | - Leszek Pączek
- Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Grzegorz Piecha
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | | | | | - Olga Tronina
- Department of Transplant Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Marta Wawrzynowicz-Syczewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | |
Collapse
|
4
|
Kusztal M, Myślak M. Therapeutic dilemmas in dialysis patients hospitalized for COVID-19: balancing between nihilism, off-label treatment and side effects. Clin Kidney J 2021; 14:1039-1041. [PMID: 33841852 PMCID: PMC7929032 DOI: 10.1093/ckj/sfaa274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/22/2020] [Indexed: 11/12/2022] Open
Abstract
Avoiding the use of drugs in patients with a glomerular filtration rate (GFR) <30 mL/min/1.73 m2 is due to the exclusion of this group of patients from many clinical trials. However, in view of the widespread COVID-19 pandemic and the need to treat all patients, including those with renal failure, the World Health Organization points out in the Solidarity trial the need for the inclusion some patients with kidney failure and recognizes the urgent need for trials/studies in patients with coronavirus disease 2019 (COVID-19) with lower GFR. It is well known that the therapeutic goal to treat patients with renal failure, acute kidney injury or on maintenance dialysis is complicated by pharmacokinetics, drug interactions and extracorporeal therapies. In patients with COVID-19 and impaired kidney function, the role of nephrologists is crucial in order to draw a balance between nihilism and benefits or potentially harmful effects of current available treatments. The potential use of European Medicines Agency recommended remdesivir and dexamethasone for COVID-19 among dialysis patients are discussed.
Collapse
Affiliation(s)
- Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Marek Myślak
- Center of Nephrology and Kidney Transplantation, Regional Hospital, Szczecin, Poland
| |
Collapse
|
5
|
Sikora P, Zaniew M, Grenda R, Jobs K, Rubik J, Zawadzki J, Myślak M, Durlik M, Erger F, Bieniaś B, Hoppe B, Beck BB. Still diagnosed too late and under-recognized? The first comprehensive report on primary hyperoxaluria in Poland. Pol Arch Intern Med 2020; 130:1053-1063. [PMID: 33274618 DOI: 10.20452/pamw.15698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Primary hyperoxalurias (PHs) are rare disorders leading to overproduction and increased urinary excretion of oxalate. Three monogenic forms (PH1-PH3) were classified. PHs lead to urolithiasis and chronic kidney disease. There are only sparse data on patients with PH from Eastern European countries including Poland. OBJECTIVES The aim of the study was to evaluate the prevalence, genetic background, and clinical course of PH in the Polish population. PATIENTS AND METHODS This was a retrospective multicenter study including data of all identified and genetically confirmed Polish patients with PH. RESULTS Between 1998 and 2019, 21 patients with PH were identified, including 13 patients with PH1 (62%), 2 with PH2 (9%), and 6 with PH3 (29%). In those with PH1, the most common mutation was c.508G>A in AGXT and in PH3, c.700+5G>T in HOGA1. Nine patients (69%) developed end‑stage renal disease at a median age of 13 years and 2 died. In 6 (46%) PH1 cases, the diagnosis was made only after patients had progressed to end‑stage renal disease and received isolated kidney transplantation, followed by graft failure. Combined liver‑kidney transplantation was performed in 6 patients with PH1. Two siblings with PH2 showed a milder course with slightly decreased renal function in one, at age of 11 years. Despite infantile onset of urolithiasis, all patients with PH3 at a median age of 10 years maintained normal renal function. CONCLUSIONS The prevalence of PH1 and PH2 in Poland seems to be much lower than in Western countries with PH3 constituting about 30% of all cases. The molecular findings and clinical course are typical, but the underdiagnosis is of concern.
Collapse
Affiliation(s)
- Przemysław Sikora
- Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland.
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, Zielona Góra, Poland
| | - Ryszard Grenda
- Department of Nephrology, Kidney Transplantation and Hypertension, Children’s Memorial Health Institute, Warsaw, Poland
| | - Katarzyna Jobs
- Department of Pediatrics, Nephrology and Allergology of the Military Institute of Medicine, Warsaw, Poland
| | - Jacek Rubik
- Department of Nephrology, Kidney Transplantation and Hypertension, Children’s Memorial Health Institute, Warsaw, Poland
| | - Jan Zawadzki
- Department of Nephrology, Kidney Transplantation and Hypertension, Children’s Memorial Health Institute, Warsaw, Poland
| | - Marek Myślak
- Department of Clinical Interventions and Disaster Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Magdalena Durlik
- Department of Transplant Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Florian Erger
- Institute of Human Genetics and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Beata Bieniaś
- Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland
| | | | - Bodo B Beck
- Institute of Human Genetics and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
6
|
Madill-Thomsen K, Abouljoud M, Bhati C, Ciszek M, Durlik M, Feng S, Foroncewicz B, Francis I, Grąt M, Jurczyk K, Klintmalm G, Krasnodębski M, McCaughan G, Miquel R, Montano-Loza A, Moonka D, Mucha K, Myślak M, Pączek L, Perkowska-Ptasińska A, Piecha G, Reichman T, Sanchez-Fueyo A, Tronina O, Wawrzynowicz-Syczewska M, Więcek A, Zieniewicz K, Halloran PF. The molecular diagnosis of rejection in liver transplant biopsies: First results of the INTERLIVER study. Am J Transplant 2020; 20:2156-2172. [PMID: 32090446 DOI: 10.1111/ajt.15828] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 01/25/2023]
Abstract
Molecular diagnosis of rejection is emerging in kidney, heart, and lung transplant biopsies and could offer insights for liver transplant biopsies. We measured gene expression by microarrays in 235 liver transplant biopsies from 10 centers. Unsupervised archetypal analysis based on expression of previously annotated rejection-related transcripts identified 4 groups: normal "R1normal " (N = 129), T cell-mediated rejection (TCMR) "R2TCMR " (N = 37), early injury "R3injury " (N = 61), and fibrosis "R4late " (N = 8). Groups differed in median time posttransplant, for example, R3injury 99 days vs R4late 3117 days. R2TCMR biopsies expressed typical TCMR-related transcripts, for example, intense IFNG-induced effects. R3injury displayed increased expression of parenchymal injury transcripts (eg, hypoxia-inducible factor EGLN1). R4late biopsies showed immunoglobulin transcripts and injury-related transcripts. R2TCMR correlated with histologic rejection although with many discrepancies, and R4late with fibrosis. R2TCMR , R3injury , and R4late correlated with liver function abnormalities. Supervised classifiers trained on histologic rejection showed less agreement with histology than unsupervised R2TCMR scores. No confirmed cases of clinical antibody-mediated rejection (ABMR) were present in the population, and strategies that previously revealed ABMR in kidney and heart transplants failed to reveal a liver ABMR phenotype. In conclusion, molecular analysis of liver transplant biopsies detects rejection, has the potential to resolve ambiguities, and could assist with immunosuppressive management.
Collapse
Affiliation(s)
| | | | - Chandra Bhati
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michał Ciszek
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplant Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Sandy Feng
- University of California San Francisco, San Francisco, California, USA
| | - Bartosz Foroncewicz
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | | | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Jurczyk
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | | | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Geoff McCaughan
- Centenary Research Institute, Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, The University of Sydney, Sydney, NSW, Australia
| | | | | | | | - Krzysztof Mucha
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Marek Myślak
- Department of Clinical Interventions, Department of Nephrology and Kidney, Transplantation, SPWSZ Hospital, Pomeranian Medical University, Szczecin, Poland
| | - Leszek Pączek
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | | | - Grzegorz Piecha
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | | | | | - Olga Tronina
- Department of Transplant Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Marta Wawrzynowicz-Syczewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Philip F Halloran
- Alberta Transplant Applied Genomics Centre, Edmonton, Alberta, Canada.,University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
7
|
Bączkowska T, Bissler JJ, Błasińska‑Przerwa K, Borawski J, Chudek J, Ciechanowski K, Czarkowska‑Pączek B, Dębska-Ślizień A, Domański M, Durlik M, Gellert R, Gozdowska J, Goździk M, Imko‑Walczuk B, Janiszewski J, Januszko‑Giergielewicz B, Jeśkiewicz M, Jóźwiak S, Kadylak D, Klinger M, Kosieradzki M, Kotulska K, Kozak Ł, Król E, Krzanowska K, Kurnatowska I, Labij‑Reduta B, Lichodziejewska‑Niemierko M, Lizakowski S, Małyszko J, Matuszewski M, Mazurkiewicz J, Mełeń‑Mucha G, Myślak M, Naumnik B, Nowicki M, Oko A, Pączek L, Perkowska-Ptasińska A, Piątak M, Piecha G, Radzikowska E, Renke M, Rutkowska B, Sawosz M, Skutecki R, Słowińska M, Sosińska‑Mielcarek K, Szafran‑Dobrowolska J, Szołkowska M, Szczepulska‑Wójcik E, Szurowska E, Tarasewicz A, Wągrowska‑Danilewicz M, Wołowiec D, Woźniak J, Zawiasa‑Bryszewska A. Problems of nephrooncology. Proceedings from the 1st Scientific and Training Conference Nephrooncology 5-6 October 2018, Gdańsk, Poland. Pol Arch Intern Med 2019; 129:1-74. [PMID: 31046026 DOI: 10.20452/pamw.14821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
8
|
Nowosiad-Magda M, Roszkowska P, Myślak M, Wojciechowska-Koszko I, Domański L, Rożański J, Marchelek-Myśliwiec M, Ciechanowski K, Dołęgowska B. Serum uromodulin as a marker of kidney graft function*. POSTEP HIG MED DOSW 2019. [DOI: 10.5604/01.3001.0013.6394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Serum uromodulin (sURO) was recently found as a sensitive tubular marker in early chronic kidney disease stages. Thus far, mainly early uromodulin urinary excretion was tested in kidney recipients. The aim of our study was to conduct a long-lastinlong-term assessment of sURO in kidney graft function monitoring. Forty-one stable kidney recipients (aged 47 (13.7)) were studied around the 3<sup>rd</sup> month (3m) and the 2<sup>nd</sup> year (2y) after kidney transplantation. Sera were tested for sURO, creatinine and tacrolimus levels. Kidney biopsy was scored according to revised Banff 97 classification. sURO level (mean 66.06ng/ml at 3m; 77.81 at 2y) increased borderline significantly (P = 0.051) in time and significantly correlated with eGFR (3m RS = 0.46; 2y RS = 0.58), creatinine levels (RS respectively –0.55 and –0.56) and donor age (3m Rs = –0.33; 2y RS = –0.41). We observed borderline correlations between sURO and Banff biopsy scoring: 3m-sURO with arteriolar hyalinosis-ah (RS = –0.3, P = 0.06) and 2y-sURO with peritubular capillaritis-ptc (RS = 0.45, P = 0.07). Correlations of sURO with 3m tacrolimus levels (Rs = 0.3, P = 0.08) were borderline, however patients with CNI toxicity lesions in biopsy had sURO significantly lower (mean 3m-sURO 52.7 vs 83.1 ng/ml; 2y-sURO 61.9 vs 98.1 ng/ml). sURO can reflect kidney graft quality and function. sURO correlated with ptc, which is considered to be an early marker of a chronic antibody-mediated graft injury. Tacrolimus doesn’t influence sURO levels directly, but sURO is lower in patients with toxic kidney injury in biopsy.
Collapse
Affiliation(s)
- Monika Nowosiad-Magda
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Paulina Roszkowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Marek Myślak
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Wojciechowska-Koszko
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Leszek Domański
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Rożański
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | | | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
9
|
Wójcik G, Kornacewicz-Jach Z, Lewandowski M, Surowicz D, Bobak N, Zdziarski K, Myślak M. Analiza standardowej farmakoterapii (tzw. schemat MONA) przez zespoły ratownictwa medycznego w zawale serca z uniesieniem odcinka ST. Folia Cardiologica 2018. [DOI: 10.5603/fc.2018.0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
10
|
Dziewanowski K, Myślak M, Drozd R, Krzystolik E, Krzystolik A, Ostrowski M, Droździk M, Tejchman K, Kozdroń K, Sieńko J. Factors Influencing Long-Term Survival of Kidney Grafts Transplanted From Deceased Donors-Analysis Based on a Single-Center Experience. Transplant Proc 2018; 50:1281-1284. [PMID: 29880347 DOI: 10.1016/j.transproceed.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/19/2017] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Kidney transplantation is a routine procedure in the treatment of patients with kidney failure and requires collaboration of experts from different disciplines. Improvements in the procedure result from numerous factors. METHODS The analyzed group consisted of 150 patients divided into 2 equal subgroups: long-term (>15 years) and short-term (<6 years) graft survival. The following factors were taken into consideration: graft survival time, HLA mismatches, recipient sex, sex compatibility, panel reactive antibodies (PRA), cold ischemia time (CIT), and cause of kidney insufficiency. Factors were analyzed in groups with the use of Student t and chi-square tests, Kruskal-Wallis analysis of variance (ANOVA), and multifactorial ANOVA. RESULTS Basic statistical analysis revealed no significance between long-term and short-term survival groups in HLA mismatches, recipient sex, or sex compatibility. There was a very significant difference in CIT. ANOVA revealed no statistical difference between groups in recipient sex, sex compatibility, or recipient disease. There were more patients in the group with long-term survival with lower PRA. There were more women in the group with long-term survival who received kidneys from men. Multifactorial analysis revealed no interactions or independent influence of the selected factors. CONCLUSIONS CIT was a strong independent factor influencing graft survival. Recipient sex and cause of kidney insufficiency seemed to have no impact. Lower PRA was positively correlated with long-term survival. Women who received kidneys from men lived longer with functioning grafts.
Collapse
Affiliation(s)
- K Dziewanowski
- Center of Nephrology and Kidney Transplantation, Regional Hospital, Szczecin, Poland
| | - M Myślak
- Center of Nephrology and Kidney Transplantation, Regional Hospital, Szczecin, Poland
| | - R Drozd
- Center of Nephrology and Kidney Transplantation, Regional Hospital, Szczecin, Poland
| | - E Krzystolik
- Center of Nephrology and Kidney Transplantation, Regional Hospital, Szczecin, Poland
| | - A Krzystolik
- Department of Cardiology, Regional Hospital, Szczecin, Poland
| | - M Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Droździk
- Department of Clinical and Experimental Pharmacology, Pomeranian Medical University, Szczecin, Poland
| | - K Tejchman
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland.
| | - K Kozdroń
- Department of Cardiology, Regional Hospital, Szczecin, Poland
| | - J Sieńko
- Department of Cardiology, Regional Hospital, Szczecin, Poland
| |
Collapse
|
11
|
Pabisiak K, Ostrowski M, Kram A, Safranow K, Myślak M, Sieńko J, Sulikowski T, Ciechanowski K. Prostate-Specific Antigen. Transplant Proc 2016; 48:1374-7. [DOI: 10.1016/j.transproceed.2016.01.092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 01/21/2016] [Indexed: 11/26/2022]
|
12
|
Wojciuk B, Myślak M, Pabisiak K, Ciechanowski K, Giedrys-Kalemba S. Epidemiology of infections in kidney transplant recipients - data miner's approach. Transpl Int 2015; 28:729-37. [DOI: 10.1111/tri.12536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 04/25/2014] [Accepted: 01/30/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Bartosz Wojciuk
- Department of Microbiology and Immunological Diagnostics; previously Department of Microbiology and Immunology; Pomeranian Medical University; Szczecin Poland
| | - Marek Myślak
- Clinic of Nephrology, Transplantation and Internal Medicine; Pomeranian Medical University; Szczecin Poland
| | - Krzysztof Pabisiak
- Clinic of Nephrology, Transplantation and Internal Medicine; Pomeranian Medical University; Szczecin Poland
| | - Kazimierz Ciechanowski
- Clinic of Nephrology, Transplantation and Internal Medicine; Pomeranian Medical University; Szczecin Poland
| | - Stefania Giedrys-Kalemba
- Department of Microbiology and Immunological Diagnostics; previously Department of Microbiology and Immunology; Pomeranian Medical University; Szczecin Poland
| |
Collapse
|
13
|
Nowosiad-Magda M, Myślak M, Roszkowska P, Borowiec-Chłopek Z, Urasińska E, Różański J, Domański L, Ciechanowski K, Giedrys-Kalemba S. Analysis of specificity of anti-human leukocyte antigen antibodies in kidney recipients in reference to clinical outcome. Transplant Proc 2014; 46:2606-12. [PMID: 25380877 DOI: 10.1016/j.transproceed.2014.09.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Anti-human leukocyte antigens antibodies (HLA) are not always the main cause of graft injury but can be a marker of immune response to the graft. The aim of this study was to analyze anti-HLA specificities with the use of the most sensitive detection method (Luminex) in reference to clinical condition. METHODS Sera of 65 kidney recipients (n = 443) were screened with the use of the mixed LABScreen kit, and, for 47 recipients, sera with maximal normalized background ratio (NBG) were subjected to specificity testing. NBG, numbers of specificities, donor-specific antibodies (DSA), and normalized mean fluorescence index (nMFI) of DSA and maximal anti-HLA were analyzed in reference to clinical (acute rejection [AR] diagnosis, immunosuppression), histopathological (C4d staining, chronic allograft nephropathy, AR type), and laboratory parameters (creatinine). RESULTS We observed 1 to 51 specificities, class I DSA in 26.7%, class II in 10%, and estimated DQ-DSA in 63.3% of tested patients. Patients with AR and humoral AR had significantly higher NBG, number of anti-HLA class I, DQ and DQ-DSA types, and more frequently had anti-HLA and class II DSA-positive sera (P < .052). C4d staining was associated with higher anti-HLA class I (P = .053) and class I DSA (P = .002) type numbers, and maximal anti-HLA nMFI (P = .036) and was more frequent in AR (P = .048) and class II DSA positive patients (P = .046). Patients with chronic allograft nephropathy showed higher DQ-DSA-nMFI (P = .036). DQ-DSA-nMFI and maximal anti-HLA-nMFI correlated with creatinine increase (Spearman range [SR] = 0.64, SR = 0.41). Together with NBG, maximal class I and class II anti-HLA-nMFI correlated with the number of transplantation and maximal panel-reactive antibodies ratio (SR = 0.19-0.40). CONCLUSIONS Anti-HLA detection allows for humoral AR diagnosis but also for identification of patients with risk of any rejection. However, clear rules of anti-HLA interpretation and studies on their clinical impact are needed.
Collapse
Affiliation(s)
- M Nowosiad-Magda
- Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland.
| | - M Myślak
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - P Roszkowska
- Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Z Borowiec-Chłopek
- Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | - E Urasińska
- Departament of Pathology, Pomeranian Medical University, Szczecin, Poland
| | - J Różański
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - L Domański
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - K Ciechanowski
- Department of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - S Giedrys-Kalemba
- Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
14
|
Pabisiak K, Serdyńska M, Kaliszczak R, Falkowski A, Myślak M. Pseudo-allergic symptoms as a rare manifestation of an ascending aortic aneurysm. Kardiol Pol 2014; 72:845. [DOI: 10.5603/kp.2014.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/22/2014] [Accepted: 05/06/2014] [Indexed: 11/25/2022]
|
15
|
Stępniewska J, Dołęgowska B, Popińska M, Sałata D, Budkowska M, Gołembiewska E, Myślak M, Domański M, Marchelek-Myśliwiec M, Ciechanowski K. Prooxidative-antioxidative balance of cells in different types of renal replacement therapy. Blood Purif 2014; 37:4-11. [PMID: 24481175 DOI: 10.1159/000356806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients suffering from chronic kidney disease (CKD) are exposed to increased oxidative stress and disturbances manifesting in the enzymatic and non-enzymatic antioxidative defence system. The object of the research was to assess the differences between conservative treatment, peritoneal dialysis and haemodialysis in moderating cellular antioxidative agents. METHODS The group examined comprised 145 patients. The activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase were obtained using kinetic methods. The spectrophotometric method established the concentrations of reduced glutathione, albumin, uric acid, glucose, total protein and lipids. RESULTS The type of treatment determined significant changes in antioxidative enzyme activities and concentrations of non-enzymatic antioxidative compounds. CONCLUSIONS Peritoneal dialysis provides better antioxidant protection than other types of therapy in CKD and should be considered as first-choice treatment despite more metabolic disorders.
Collapse
Affiliation(s)
- Joanna Stępniewska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Golembiewska E, Safranow K, Kabat-Koperska J, Myślak M, Ciechanowski K. Serum soluble Klotho protein level is associated with residual diuresis in incident peritoneal dialysis patients. Acta Biochim Pol 2013. [DOI: 10.18388/abp.2013_1970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Active vitamin D (1,25-dihydroxyvitamin D₃), PTH, fibroblast growth factor-23 (FGF-23) and Klotho protein are key regulators of phosphate metabolism. Hyperphosphatemia and increased FGF-23 level in patients with end-stage renal disease are associated with increased morbidity and mortality. The relationships among key regulators of phosphate metabolism are still being investigated. FGF-23, the humoral factor involved in phosphate metabolism, is strongly associated with serum phosphorus level. Klotho, a transmembrane protein expressed primarily in renal tubules, functions as an obligatory co-receptor for FGF-23. The soluble form of Klotho, produced by the shedding of the transmembrane protein, is detectable in body fluids. The purpose of the study was to assess if serum soluble alpha-Klotho level was related to phosphate metabolism parameters and residual renal function (RRF) in incident peritoneal dialysis (PD) patients.
Thirty-five clinically stable patients 4 to 6 weeks after the onset of PD were included in the study. For each patient, clinical and laboratory data were reviewed. Serum phosphorus concentration, urinary and peritoneal phosphate clearance, serum FGF-23 and soluble Klotho protein concentrations were determined.
Serum soluble alpha-Klotho was strongly negatively correlated with 24-hour diuresis (Rs = -0.55, p = 0.004) and renal phosphate clearance (Rs = -0.40, p = 0.049), but not with RRF.
Serum soluble Klotho protein concentration is inversely related to residual diuresis and renal phosphate clearance in incident PD patients.
Collapse
|
17
|
Golembiewska E, Safranow K, Kabat-Koperska J, Myślak M, Ciechanowski K. Serum soluble Klotho protein level is associated with residual diuresis in incident peritoneal dialysis patients. Acta Biochim Pol 2013; 60:191-194. [PMID: 23748218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 04/03/2013] [Accepted: 05/23/2013] [Indexed: 06/02/2023]
Abstract
AIM Active vitamin D (1,25-dihydroxyvitamin D₃), PTH, fibroblast growth factor-23 (FGF-23) and Klotho protein are key regulators of phosphate metabolism. Hyperphosphatemia and increased FGF-23 level in patients with end-stage renal disease are associated with increased morbidity and mortality. The relationships among key regulators of phosphate metabolism are still being investigated. FGF-23, the humoral factor involved in phosphate metabolism, is strongly associated with serum phosphorus level. Klotho, a transmembrane protein expressed primarily in renal tubules, functions as an obligatory co-receptor for FGF-23. The soluble form of Klotho, produced by the shedding of the transmembrane protein, is detectable in body fluids. The purpose of the study was to assess if serum soluble alpha-Klotho level was related to phosphate metabolism parameters and residual renal function (RRF) in incident peritoneal dialysis (PD) patients. METHODS Thirty-five clinically stable patients 4 to 6 weeks after the onset of PD were included in the study. For each patient, clinical and laboratory data were reviewed. Serum phosphorus concentration, urinary and peritoneal phosphate clearance, serum FGF-23 and soluble Klotho protein concentrations were determined. RESULTS Serum soluble alpha-Klotho was strongly negatively correlated with 24-hour diuresis (Rs = -0.55, p = 0.004) and renal phosphate clearance (Rs = -0.40, p = 0.049), but not with RRF. CONCLUSIONS Serum soluble Klotho protein concentration is inversely related to residual diuresis and renal phosphate clearance in incident PD patients.
Collapse
Affiliation(s)
- Edyta Golembiewska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
| | | | | | | | | |
Collapse
|
18
|
Słojewski M, Myślak M, Domański L, Pabisiak K, Jasiczek A, Sulikowski T, Sieńko J, Ciechanowski K, Ostrowski M, Sikorski A. Program of laparoscopic living-donor nephrectomy with retroperitoneoscopic access - a Polish single-center experience - success or disappointment? Ann Transplant 2013; 18:82-7. [PMID: 23792506 DOI: 10.12659/aot.883839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Laparoscopic living-donor nephrectomy (LLDN) is an attractive alternative to open approach and is a widely accepted method of kidney retrieval for transplantation. Here, we present the first Polish series of LLDN performed at a single center. MATERIAL AND METHODS Between April 2008 and May 2012, we performed 8 LLDN with an immediate renal transplantation using classical surgical approach and technique. Four men and 4 women were operated on. In all cases of LLDN, left kidneys were retrieved and retroperitoneal approach with 3 trocars was used according to the technique we described previously. RESULTS No intra- or postoperative complications were observed. The average "skin-to-skin" time of surgery was 138 minutes (min. 80; max. 210). The blood loss ranged from 0 to 280 ml (average, 80). Warm ischemia time did not exceed 3 minutes in any case. All organs were immediately implanted in the second operating room. Postoperative course was uneventful in all donors and recipients. CONCLUSIONS Similar to many authors, at the beginning of our program we hoped that introduction of LLDN would increase the donor pool in Poland. Unfortunately, so far, these expectations have not been realized. However, we consider our program as a success regarding multidisciplinary cooperation and feasibility of LLDN in our country.
Collapse
Affiliation(s)
- Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Domański L, Pawlik A, Safranow K, Rozański J, Myślak M, Sulikowski T, Romanowski M, Ostrowski M, Wiśniewska M, Domański M, Kabat-Koperska J, Ciechanowski K. Changes in cytokine concentrations in graft renal vein during reperfusion in patients with and without delayed graft function. Ann Acad Med Stetin 2008; 54:49-52. [PMID: 19127809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The impairment of organ function derived from ischemia-reperfusion injury is still an important problem in solid organ transplantation. Cell alterations induced by ischemia prime the tissue for the subsequent damage that occurs during the reperfusion phase. Despite recent advances in immunosuppressive therapy, delayed graft function (DGF) remains an important problem after kidney transplantation. Different studies have related various clinical factors to DGF, such as donor age, recipient age, cold ischemia time, initial immunosuppressive regimens. The aim of present study was to examine the changes in cytokine concentrations in graft renal vein during the reperfusion in relation to the development of delayed graft function. MATERIAL AND METHODS The study included 17 recipients of cadaveric renal grafts (10 males, 7 females, mean age 49 +/- 7 years, cold ischemia time 25 +/- 3 h)--8 with DGF and 9 without DGF. Levels of IL-lbeta, IL-2, IL-4, IL-6, IL-8, IL-10, IFN-gamma, TNF-beta and TNF-alpha in renal graft vein plasma during 5 first min. of reperfusion were quantified by flow-cytometry. RESULTS The increased concentrations ofIL-6, TNF-alpha and IL-1beta were observed during reperfusion. However there were no statistically significant differences between patients with and without DGF.
Collapse
Affiliation(s)
- Leszek Domański
- Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72, 70-111 Szczecin
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Domański L, Gryczman M, Pawlik A, Sulikowski M, Romanowski M, Ostrowski M, Myślak M, Rózański J, Safranow K, Dutkiewicz G, Ciechanowski K. Circulating adhesion molecules during kidney allograft reperfusion. Transpl Immunol 2006; 16:172-5. [PMID: 17138050 DOI: 10.1016/j.trim.2006.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 07/08/2006] [Accepted: 08/03/2006] [Indexed: 11/23/2022]
Abstract
Adhesion molecule expression is an important event during early transplant failure. The aim of the present study was to examine the release of adhesion molecules during the first minutes of kidney allograft reperfusion in relation to delayed graft function and acute graft rejection. We enrolled 49 renal transplant recipients, including 13 cases of delayed graft function (DGF) and 11 cases of acute graft rejection (AR). Plasma concentrations of E-selectin, VCAM-1 and ICAM-1 after 3 min of reperfusion were significantly higher than in the iliac vein before reperfusion. There was no statistically significant difference between patients with and without DGF as regards E-selectin, VCAM-1 and ICAM-1 concentrations in the iliac vein before and in the renal vein after 3 min of reperfusion. Concentrations of adhesion molecules in the iliac vein before reperfusion and in the renal vein after 3 min of reperfusion did not differ significantly between patients with and without AR except for ICAM-1 iliac vein concentration which was significantly increased in AR patients. Plasma levels of E-selectin, ICAM-1 and VCAM-1 were increased after kidney allograft reperfusion. Moreover, elevated serum levels of ICAM-1 before transplantation correlated with subsequent acute kidney allograft rejection. The results suggest that elevated ICAM-1 levels may be implicated in acute graft rejection.
Collapse
Affiliation(s)
- L Domański
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70111 Szczecin, al. Powstańców Wlkp 72, Poland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Domański L, Dołgowska B, Safranow K, Myślak M, Rózański J, Romanowski M, Ostrowski M, Domański M, Pawlik A, Ciechanowski K. Early phase of reperfusion of human kidney allograft does not affect an erythrocyte anti-oxidative system. Nephrology (Carlton) 2006; 11:467-70. [PMID: 17014563 DOI: 10.1111/j.1440-1797.2006.00672.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Generation of reactive oxygen specimens is the basic mechanism leading to ischaemia/reperfusion injury of the kidney graft. Oxygen burst is a trigger for sophisticated biochemical changes leading to generation of oxygenated lipids and changes in microcirculation, which recruit recipient's neutrophils and contribute to delayed graft function. It has been shown that the free radicals generation correlates with the activity of anti-oxidative system. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione (GSH) are involved in protection against free radicals. AIM To examine the activity of erythrocyte anti-oxidative system during reperfusion of the transplanted kidney allograft. METHODS The study included 40 renal transplant recipients. Blood was taken from the iliac vein before transplantation and from the graft's renal vein immediately, as well as 2 and 4 min after total reperfusion. The authors assessed the process of reperfusion using ThermaCAM SC500 termovision camera. Spectrophotometric methods were used to measure superoxide dismutase, glutathione peroxidase and catalase activity as well as glutathione concentrations in erythrocytes. RESULTS There were no statistically significant differences in the activities of superoxide dismutase, catalase and glutathione peroxidase as well as glutathione concentrations during the first 4 min after total graft reperfusion. Nevertheless, there was a positive correlation between the activity of superoxide dismutase and glutathione peroxidase. CONCLUSION The results suggest that the erythrocyte anti-oxidative system is stable during the early phase after reperfusion. An association between some anti-oxidative enzymes was noted.
Collapse
Affiliation(s)
- Leszek Domański
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczeci, Poland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Domański L, Safranow K, Dołegowska B, Rózański J, Myślak M, Ciechanowski K, Jakubowska K, Dziedziejko V, Romanowski M, Sulikowski T, Sieńko J, Kamiński M, Ostrowski M, Domański M, Pawlik A, Rać ME, Chlubek D. Hypoxanthine as a graft ischemia marker stimulates catalase activity in the renal vein during reperfusion in humans. Transplant Proc 2006; 38:35-8. [PMID: 16504657 DOI: 10.1016/j.transproceed.2005.11.083] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The impairment of organ function derived from ischemia-reperfusion injury is still an important problem in solid organ transplantation. Cell alterations induced by ischemia prime the tissue for subsequent damage occurring during the reperfusion phase. Purine nucleotides and oxypurines are products of adenine nucleotide degradation. Reperfusion and reoxygenation are characterized by great production of reactive oxygen species and free radicals. On the contrary, superoxide dismutase, catalase, glutathione, and glutathione peroxidase are involved in protecting against free radicals. The aim of the study was to examine the correlation between concentrations of ischemia markers (hypoxanthine or inosine) and the activity of erythrocyte superoxide dismutase, catalase, or glutathione peroxidase. PATIENTS AND METHODS The study included 40 renal transplant recipients. Before anastomosis of the kidney vessels with the recipient's iliac vessels, a "0" blood sample was taken from the iliac vein. Then, after anastomosis, the renal vein of the graft was cannulated and blood samples I, II, and III were obtained. The reperfusion of the transplanted kidney was measured with a thermovision camera ThermaCAM SC500. RESULTS The plasma concentrations of hypoxanthine and inosine increased in statistically significant fashion immediately after total tissue reperfusion (P < .0001). Catalase activity at 4 minutes after total tissue reperfusion correlated positively with hypoxanthine concentrations immediately after total tissue reperfusion (Rs = +0.49), 2 minutes after total tissue reperfusion (Rs = +0.47), and 4 minutes after total tissue reperfusion (Rs = +0.46). There were no statistically significant correlations between hypoxanthine or inosine concentrations or superoxide dismutase or glutathione peroxidase activities. CONCLUSIONS The results of the present study suggest that catalase activity may correlate with the concentration of hypoxanthine in the graft renal vein and other mediators of oxidative stress.
Collapse
Affiliation(s)
- L Domański
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, ul. Powst. Wielkopolskich 72, 70-111 Szczecin, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Chudyk A, Masiuk M, Myślak M, Domański L, Sieńko J, Sulikowski T, Machaliński B, Giedrys-Kalemba S. Soluble HLA class I molecules exert differentiated influence on renal graft condition. Transplant Proc 2006; 38:90-3. [PMID: 16504672 DOI: 10.1016/j.transproceed.2005.11.090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The function of soluble HLA (sHLA) antigens in the process of immunoregulation and especially in graft tolerance versus rejection has not yet been established. It has been suggested that donor-derived sHLA may exert an immunotolerant influence on the graft. We sought to determine the role of sHLA class I in kidney graft survival by evaluating the influence of these molecules on allotypic lymphocytotoxic antibodies and the concentration of gamma interferon (INF-gamma). Analysis of sHLA was performed indirectly utilizing their ability to inhibit lymphocytotoxic reaction dependent on complement activation. To demonstrate the inhibitory properties of sHLA, we modified the NIH microcytotoxic test. Furthermore, we determined the concentration of INF-gamma in all sera samples for comparison with the intensity of the cytotoxic test. The comparison of the intensity of cytotoxic test inhibition with the concentration of INF-gamma revealed that high concentrations of this cytokine were associated with stronger inhibition of the cytotoxic test, thus with higher concentrations of sHLA class I molecules in recipient sera. We observed that high concentrations of sHLA class I molecules in recipient sera significantly inhibited cytotoxic reactions, which could contribute to a protective influence of sHLA on renal grafts. On the other hand, the observed increase of INF-gamma concentration might be caused by sHLA themselves, which would produce a detrimental influence on a transplanted organ. Therefore we concluded that the role of sHLA class I molecules in renal graft condition remains ambiguous.
Collapse
Affiliation(s)
- A Chudyk
- Department of Microbiology and Immunology, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Sulikowski T, Kamiński M, Rózański J, Zietek Z, Domański L, Majewski W, Sieńko J, Romanowski M, Mizerski A, Myślak M, Tejchman K, Pabisiak K, Nowacki M, Ostrowski M, Ciechanowski K. Laparoscopic Removal of Renal Cysts in Patients With ADPKD as an Alternative Method of Treatment and Patient Preparation for Kidney Transplantation: Preliminary Results. Transplant Proc 2006; 38:23-7. [PMID: 16504654 DOI: 10.1016/j.transproceed.2005.11.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The most frequent genetic disease of the kidneys occurring in 1 of 1000 inhabitants is autosomal-dominant polycystic kidney disease (ADPKD). Growing renal cysts compress the kidney resulting in damage to parenchyma and functional disorders. Around 10% of these patients are dialyzed due to terminal renal insufficiency. With the advent of laparoscopic techniques, the idea of laparoscopic excision of cysts seemed a tempting alternative to nephrectomy. We assessed the preliminary results of laparoscopic treatment of polycystic kidneys compared with open nephrectomy for patients with ADPKD. MATERIALS AND METHODS Thirty ADPKD patients were treated between 2000 and 2004. Eleven procedures in five men and six women of mean age 51 years included laparoscopic cyst excisions. In the remaining 19 patients (six men and 13 women) of mean age 54 years, nephrectomy was done. Indications for surgery included pain due to compression by large cysts and cyst contamination. Patients after nephrectomy were prepared for renal transplantation when necessary. RESULTS Laparoscopic polycyst removal produced better effects than nephrectomy. Mean operative time was significantly shorter (86 minutes for cyst removal vs 108 minutes for nephrectomy; P < .05). Postoperative pain measured with the VAS scale was reduced in patients after laparoscopy. Hospital stay was shorter (5 vs 9 days), as well as time to recovery. Other benefits of laparoscopic cyst removal included maintained urination in the patient and no need for erythropoietin substitution, as well as reduced risk of cyst contamination. When eligible for renal transplantation, patients after laparoscopic polycyst removal have smaller kidneys that do not interfere with the graft and the risk of infection during immunosuppression seems lower. CONCLUSION Although larger series of patients are required in patients with ADPKD, laparoscopic polycyst removal seemed superior to early nephrectomy.
Collapse
Affiliation(s)
- T Sulikowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Domański L, Dołegowska B, Safranow K, Rózański J, Myślak M, Romanowski M, Sieńko J, Sulikowski T, Ostrowski M, Kedzierska K, Domański M, Chlubek D, Pawlik A, Ciechanowski K. Activity of CuZn-superoxide dismutase, catalase and glutathione peroxidase in erythrocytes in kidney allografts during reperfusion in patients with and without delayed graft function. Clin Transplant 2006; 20:67-71. [PMID: 16556156 DOI: 10.1111/j.1399-0012.2005.00442.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Generation of reactive oxygen species (ROS) is the main mechanism involved in the ischemic/reperfusion damage of the transplanted organ. Oxygen burst is a trigger for complex biochemical events leading to generation of oxygenated lipids and changes in microcirculation. Many markers have been researched to prove the presence of ROS in the transplanted tissue. Some of them, like superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) are considered to play a major role in graft protection against oxygen stress during reperfusion. METHODS The aim of this study was to examine the changes of SOD1, CAT and GPx activity in erythrocytes during the first minutes after total graft reperfusion. Forty patients undergoing kidney transplantation at our center were assigned to two groups: with or without delayed graft function (DGF). Before anastomosing kidney vessels with recipient's iliac vessels, the '0' blood sample was taken from the iliac vein. Next blood samples I, II and III were taken from the graft's renal vein. The reperfusion of the transplanted kidney was evaluated precisely with the thermovision camera. Erythrocyte SOD1, CAT and GPx activity was measured with a spectrophotometric method. RESULTS We did not observe statistically significant changes in SOD1, CAT and GPx activity in erythrocytes during the early phase of reperfusion in patients with and without DGF. CONCLUSIONS Erythrocyte-antioxidative system in graft's vein remain stable during the early phase of reperfusion. The results of the study suggest that further studies on extracellular enzymes are required for the assessment of antioxidant system in the conditions of ischemia/reperfusion.
Collapse
Affiliation(s)
- L Domański
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Kedzierska K, Ciechanowski K, Gołembiewska E, Safranow K, Ciechanowicz A, Domański L, Myślak M, Róźański J. Plasma Prekallikrein as a Risk Factor for Diabetic Retinopathy. Arch Med Res 2005; 36:539-43. [PMID: 16099335 DOI: 10.1016/j.arcmed.2005.03.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Accepted: 03/30/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of the study was to verify the hypothesis that in diabetes there is an increased activation of coagulation system leading in consequence to diabetic retinopathy. METHODS Thirty three healthy subjects (controls, 16 males and 17 females) and 35 patients with diabetes type 1 (15 males and 20 females) were examined. We monitored plasma prekallikrein (PPK), glycemia, fructosamine, glycosylated hemoglobin, activated partial thromboplastin time (PTT), INR, fibrinolysis in euglobulins time (FET), level of antithrombin III (AT III), fibrinogen (Fb) and fibrinogen degradation products (FDP). RESULTS In diabetic patients without retinopathy, PKK concentration was 16% higher (p <0.005), in patients with background retinopathy 33% higher (p <0.001), and in patients with proliferative retinopathy PKK concentration was 50% higher (p <0.001) than in controls. In the subgroup of patients with proliferative retinopathy PTT was significantly shorter (p <0.001), and FET was significantly longer (p <0.001) than in control. In patients with diabetes higher FDP concentrations were found than in controls (p <0.05). Significant correlations were found between PPK and fructosamine levels in all diabetic patients (R(S)=+0.57 p <0.001), in diabetic patients without retinopathy (R(S)=+0.61, p <0.05), and in diabetic patients with retinopathy (R(S)=+0.62, p <0.005). We found negative correlation between PPK concentration and PTT (R(S)=-0.43, p <0.001) and positive correlation between PPK concentration and FET (R(S)=+0.59, p <0.00001) in the entire study group. CONCLUSIONS The occurrence of diabetic retinopathy is connected with higher levels of plasma prekallikrein.
Collapse
Affiliation(s)
- Karolina Kedzierska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Ciechanowski K, Kedzierska K, Gołembiewska E, Safranow K, Bober J, Domański L, Rózański J, Myślak M. Impaired Synthesis Is Not the Reason for Decreased Activity of Extracellular Superoxide Dismutase in Patients with Diabetes. Arch Med Res 2005; 36:148-53. [PMID: 15847948 DOI: 10.1016/j.arcmed.2004.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Accepted: 10/20/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of the study was to find the cause of decreased activity of extracellular superoxide dismutase (EC SOD) in patients with diabetes-is it the decreased synthesis or increased glycation? METHODS Total EC SOD activity, the activity of its fractions (A, B, and C) and its glycated form were determined in basal state and 30 min after intravenous (i.v.) administration of 50 mg of heparin. Patients were given i.v. heparin at a dose of 10,000 IU (100 mg) each 6 h for at least 3 days, and the activity of EC SOD was determined before the first heparin administration, just before each subsequent administration, and 30 min after heparin administration. RESULTS Pre- and postheparinic activities of EC SOD and its fraction C in the group of patients with diabetes were significantly lower (p <0.001) than in control group. Preheparinic activities of EC SOD did not differ between the examined groups of patients. The postheparinic activities were different during the first 18 h of treatment. They were significantly lower in the group of patients with diabetes. During the following hours, after subsequently administered doses, there were no differences in the activity of EC SOD between the examined groups. Decline of EC SOD activity was observed after administration of repeated doses of heparin both in the examined and in the control groups. CONCLUSIONS The decrease of extracellular superoxide dismutase activity in diabetes develops due to excessive glycation but not due to impaired synthesis. Therefore, appropriate glycemic control can lead to normalization of EC SOD activity.
Collapse
Affiliation(s)
- Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Ostrowski M, Bohatyrewicz R, Ciechanowski K, Pabisiak K, Sieńko J, Myślak M, Kamiński M, Sulikowski T. Organ procurements in West Pomerania in years 2000-2001. Ann Transplant 2004; 7:55-7. [PMID: 12854350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Year by year the actual number of transplanted organs has been growing in Poland. In the event of the Województwo Zachodniopomorskie (Western Pomeranian Province) the primary activities were focused on informing medical personnel at hospital departments about approaching donors through trainings for such medical personnel. Such activities resulted in both acceptance and support, especially by medical personnel of medium as well as lower ranks. Since 1983 two transplant units have been functioning in the Province: SPSK-2 and S. P. W. S. Z. in Szczecin, and since 2000 two co-ordination offices, too. Main result of our activities can be seen in the number of organs procured for transplantation. In 2000 we had 27.7 procurements per million (ppm), in 2001 there were 39.9 ppm.
Collapse
Affiliation(s)
- M Ostrowski
- Department of General Surgery and Transplantation Pomeranian Medical Academy, Szczecin, Poland.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Kabat-Koperska J, Herdzik E, Safranow K, Myślak M, Domański L, Rózański J, Ciechanowski K. Oral iron absorption test: should it be performed before starting treatment with ferrous preparations? Biol Trace Elem Res 2003; 94:87-94. [PMID: 12907831 DOI: 10.1385/bter:94:1:87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2002] [Accepted: 10/30/2002] [Indexed: 11/11/2022]
Abstract
The oral iron absorption test is sometimes used in the assessment of ferrous preparation efficacy before therapeutic use in the treatment of patients with anemia. Overdoses of Fe can cause the production of free radicals that are dangerous because of chemical modifications and damage of proteins, lipids, carbohydrates, and nucleotides. We suggest that this test should not be performed with the recommended dose of iron because of the potential threat to the patients. We assessed the serum concentration of iron and total iron-binding capacity during the test. Before and after the test, the concentration of malonyldialdehyde, an end product of lipid peroxidation, was determined in serum. In most patients, we found an increase in malonyldialdehyde concentration, suggesting the enhanced production of free radicals. This increase was particularly marked in patients with an overabsorption of iron. The administration of iron in the dose recommended for the oral iron absorption test causes increase in serum malonyldialdehyde concentration, proving an overproduction of free radicals. This test should not be performed because of the evidence proving detrimental effects of free-radical overproduction on the human body.
Collapse
Affiliation(s)
- Joanna Kabat-Koperska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Academy of Medicine, Szczecin, Poland
| | | | | | | | | | | | | |
Collapse
|
30
|
Ciechanowski K, Kedzierska K, Herdzik E, Bober J, Domański L, Borowiak K, Rózański J, Myślak M. Long-term hyperglycaemia decreases vascular fraction of extracellular superoxide dismutase. Diabetologia 2003; 46:1026-7. [PMID: 12830380 DOI: 10.1007/s00125-003-1140-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2003] [Revised: 04/07/2003] [Indexed: 11/26/2022]
|
31
|
Kedzierska K, Myślak M, Kwiatkowska E, Bober J, Rózański J, Domański L, Ciechanowski K. [Acute renal failure after paracetamol (Acetaminophen) poisoning--report of two cases]. Wiad Lek 2003; 56:587-90. [PMID: 15058171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Two cases of paracetamol (acetaminophen) poisoning resulting in acute oliguric renal failure requiring dialysis in one case are described. There were signs of hepatotoxicity with no marked hepatic failure in either of cases. Neither was treated with N-acetylocystein due to late referral to a dialysis center. It is concluded that acute renal failure during paracetamol poisoning may not necessarily be followed by an evident hepatic failure.
Collapse
Affiliation(s)
- Karolina Kedzierska
- Kliniki Nefrologii, Transplantologii i Chorób Wewnetrznych, Pomorskiej Akademii Medycznej w Szczecinie.
| | | | | | | | | | | | | |
Collapse
|
32
|
Bober J, Kedzierska K, Kwiatkowska E, Ciechanowski K, Widecka K, Stachowska E, Safranow K, Myślak M, Dutkiewicz G. [The erythrocyte sodium-proton exchanger activity in patient with primary hypertension]. Pol Arch Med Wewn 2002; 108:619-24. [PMID: 12412405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A sodium-proton exchanger (NHE) is a membrane transport system taking part in intracellular sodium homeostasis. An increased NHE activity was observed in erythrocytes of primary hypertension (NTP) patients. Study group consisted of 25 NTP patients and 24 control (K). NTP patients were significantly heavier (p < 0.01) than control group (BMI 26.0 +/- 2.9 vs. 23.1 +/- 2.7, respectively). They also had significantly higher systolic, diastolic and mean arterial pressure than K (SBP 167 +/- 24.6 vs. 120 +/- 10.5; DBP 98 +/- 16.7 vs. 76 +/- 6.4; MAP 118.6 +/- 17.9 vs. 89 +/- 6.4, respectively). There was positive correlation between MAP and BMI (p < 0.02) in NTP patients. Mean NHE activity was significantly higher in NTP than in K group (9.6 +/- 3.6 vs. 8.2 +/- 2.6 mmol/L RBC/h) p = 0.05. A bimodal distribution of NHE activity in NTP group was observed. There was no correlation between NHE activity and BMI, MAP, SBP, DBP, age or positive family history of hypertension in NTP or K groups.
Collapse
Affiliation(s)
- Joanna Bober
- Zakład Biochemii i Chemii Pomorskiej AM w Szczecinie
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Rózański J, Myślak M, Domański L, Ciechanowski K, Szmatłoch E. [Clinical view of autosomal dominant polycystic kidney disease]. Pol Arch Med Wewn 2000; 104:525-31. [PMID: 11303321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- J Rózański
- Klinika Chorób Wewnetrznych Pomorskiej Akademii Medycznej w Szczecinie
| | | | | | | | | |
Collapse
|
34
|
Rózański J, Domański L, Myślak M, Ciechanowski K, Szmatłoch E. [Pathophysiology of autosomal dominant polycystic kidney disease]. Pol Arch Med Wewn 2000; 104:519-23. [PMID: 11303320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- J Rózański
- Klinika Chorób Wewnetrznych Pomorskiej Akademii Medycznej w Szczecinie
| | | | | | | | | |
Collapse
|
35
|
Kośmider K, Niezgoda A, Dadej R, Myślak M. [ANalysis of upper extremity injuries in the Szczecin shipyard S.A. in the years 1989-1993]. Med Pr 1998; 49:35-43. [PMID: 9587909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The study covered 534 cases of work-related injuries of upper extremities among workers of the Szczecin Shipyard, registered during the years 1989-93. Some factors influencing the rate and structure of accidents (age, kind of work, section of the plant, occupational exposure and work experience) were analysed. The study showed that hand injuries were the most common effect of work-related accidents involving upper extremities among males employed in the shipyard.
Collapse
Affiliation(s)
- K Kośmider
- Oddziału Klinicznego Chorób Zawodowych, Szczecinie
| | | | | | | |
Collapse
|
36
|
Kośmider K, Niezgoda A, Dadej R, Myślak M. [Analysis of accidents in selected occupations in the Szczecin shipyard S.A. in the years 1989-93]. Med Pr 1998; 48:631-7. [PMID: 9558631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In a five-year follow-up study (1989-93), 1317 work-related accidents and their relation to occupational exposure among male workers employed at the Szczecin Shipyard were analysed. The highest rates of accidents were found among welders, fitters, electrical mechanics and platers. The role of the age, duration of employment, type of the job performed and its contribution to the rate and pattern of accidents, were also investigated.
Collapse
Affiliation(s)
- K Kośmider
- Oddziału Klinicznego Chorób Zawodowych, Pomorskiej Akademii Medycznej w Szczecinie
| | | | | | | |
Collapse
|
37
|
Myślak M, Kośmider K. [Frequency of sister chromatid exchanges (SCE)in peripheral blood lymphocytes from stainless steel welders]. Med Pr 1998; 48:399-406. [PMID: 9471487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In order to detect the genotoxic effects of nickel (Ni) and chromium (Cr) contained in welding fumes on humans, sister chromatid exchanges (SCEs) frequency in lymphocytes was determined in the blood samples derived from 39 stainless steel welders and compared with the data obtained from 22 sex and age matched unexposed controls. The frequency of SCEs was higher in the welders than in the controls. Smoking proved to be a significant, positive predictor for SCE frequency in the controls but not in the welders. Significant correlation between SCE and chromium concentrations in urine of smoking welders was found. A possible synergism between chromium exposure and smoking is discussed. Neither age and urine nickel concentrations nor duration of exposure was a significant predictor for SCE frequency.
Collapse
Affiliation(s)
- M Myślak
- Oddziału Klinicznego Chorób Zawodowych, Pomorskiej Akademii Medycznej w Szczecinie
| | | |
Collapse
|
38
|
Myślak M, Kośmider K. [Kinetics of cell division in peripheral blood lymphocytes of stainless steel welders]. Med Pr 1997; 48:261-4. [PMID: 9312651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Stainless steel welders are not potential occupational risk of geno- and cytotoxic exposure to chemical mutagens and carcinogens contained in welding fumes. The studies of biological activity of welding fumes evidence their cytotoxicity which depends on chromium and nickel content. In 20 stainless steel welders exposed to chromium and nickel contained in welding fumes, kinetics of cell division was assessed in the culture of peripheral blood lymphocytes. No significant differences were found in the cell division rates between the group of exposed welders and the controls. In welders who smoke, the number of cells present after 70 hrs in the third mitotic division, was reduced in comparison to smokers in the control group what may be considered as a symptom of cytotoxic effect of a combined exposure to welding fumes and tobacco smoke.
Collapse
Affiliation(s)
- M Myślak
- Oddziału Klinicznego Chorób Zawodowych, Pomorskiej Akademii Medycznej w Szczecinie
| | | |
Collapse
|