1
|
Kamińska D, Hożejowski R, Chamienia A, Dębska-Ślizień A, Idasiak-Piechocka I, Oko A, Baranowicz-Gąszczyk I, Załuska W, Mazanowska O, Krajewska M. Conversion From Immediate-Release to Prolonged-Release Tacrolimus in Kidney Transplant Patients With Tremor: A Case Series Study. Transplant Proc 2024:S0041-1345(24)00080-0. [PMID: 38453593 DOI: 10.1016/j.transproceed.2024.01.060] [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: 12/09/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND/AIM Tremor is common with tacrolimus treatment and is linked with peak blood drug concentrations. We investigated the effect of switching from immediate-release tacrolimus (IR-TAC) to MeltDose prolonged-release tacrolimus (LCPT) on tremor in kidney transplant recipients experiencing tremor at therapeutic levels of IR-TAC. METHODS The Activities of Daily Living Subscale (ADL, range 0-48, lower = better) of the Essential Tremor Rating Scale was used to assess the effect of therapy change on speech, occupational impairment and social activities over a 12-month follow-up period. RESULTS The study included 18 patients (mean age = 45.6 y, range 26-73; median (IQR) time from transplant = 1.1 y (0.6-1.5), with baseline IR-TAC trough concentrations (C0) ranging from 4.2 to 9.4 ng/mL (mean C0 = 6.7 ± 1.3 ng/mL). After the switch to LCPT, the mean ADL score improved from baseline 11.2 to 8.4 after 7 to 14 days (an 18% improvement, P < .001). This improvement was sustained after 3 months (ADL score = 5.0, 46% improvement vs baseline), 6 months (ADL score = 4.4, 48% improvement vs baseline), and 12 months (ADL score = 3.6, 63% improvement vs baseline); all P < .001. Despite a 40% reduction in LCPT daily doses (mean -1.9 mg/day compared to IR-TAC), the achieved C0 was constant during the course of the 12-month observation (P = .755). The renal function remained stable after conversion (eGFR 12 months vs baseline = +1.1 mL/min/1.73 m2, 95% CI: -5.6 to +7.9). CONCLUSION Conversion to LCPT may alleviate symptom burden and improve daily activities in kidney transplant recipients experiencing tremor within therapeutic IR-TAC concentrations.
Collapse
Affiliation(s)
- Dorota Kamińska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
| | | | - Andrzej Chamienia
- Department of Nephrology, Transplantology and Internal Diseases, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Wojciech Załuska
- Department of Nephrology, Medical University of Lublin, Lublin, Poland
| | - Oktawia Mazanowska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
2
|
Miedziaszczyk M, Oko A, Wolc A, Woźniak A, Idasiak-Piechocka I. Assessment of serum concentration and urinary excretion of tumor necrosis factor receptor 1 and 2 and their potential as markers of immunoglobulin A nephropathy activity. ADV CLIN EXP MED 2023; 33:0-0. [PMID: 37962255 DOI: 10.17219/acem/171000] [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: 08/23/2022] [Revised: 05/21/2023] [Accepted: 08/13/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Tumor necrosis factor receptor 1 (TNFR1) and 2 (TNFR2) can be cleaved from the cell surface and circulate alone or in combination with tumor necrosis factor alpha (TNF-α). These soluble receptors may play a key role in regulating the inflammatory response. OBJECTIVES The study aimed to evaluate the role of TNFRs in regulating the inflammatory response in immunoglobulin A nephropathy (IgAN). MATERIAL AND METHODS The study included 26 patients with newly diagnosed and biopsy-confirmed IgAN and 20 healthy controls. Study material included blood and fresh urine collected the morning before kidney biopsy and therapy. The serum concentrations of TNFR1 (STNFR1) and TNFR2 (STNFR2) and urinary excretion of TNFR1 (UTNFR1) and TNFR2 (UTNFR2) were determined with immunoassay. Subsequently, the data were evaluated statistically. RESULTS The STNFR1 and STNFR2 levels were higher in IgAN patients than in healthy subjects (4747.87 pg/mL and 2817.62 pg/mL compared to 2755.68 pg/mL (95% CI: from -2948.41 to -1035.97; p = 0.001) and 1437.83 pg/mL (95% CI: from -1958.50 to -419.60; p = 0.001). The power of the test was 98.5% for STNFR1 and 96% for STNFR2. Urinary concentrations only increased for TNFR1 (3551.29 compared to 2338.95 pg/mg of creatinine (Cr) (95% CI: from -2247.03 to -177.66; p = 0.023). The STNFR1 marker was characterized by a sensitivity of 73.08% and a specificity of 90.00% (p < 0.001). CONCLUSIONS Our results suggest that TNFR1 and TNFR2 are good markers of TNF-α pathway activation in IgAN patients.
Collapse
Affiliation(s)
- Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Anna Wolc
- Department of Animal Science, Iowa State University, Ames, USA
- Hy-Line International, Dallas Center, USA
| | - Aldona Woźniak
- Department of Clinical Pathology, Poznan University of Medical Sciences, Poland
| | - Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| |
Collapse
|
3
|
Idasiak-Piechocka I, Miedziaszczyk M, Woźniak A, Pawliczak E, Kaczmarek E, Oko A. Interleukin-6 and epidermal growth factor as noninvasive biomarkers of progression in chronic glomerulonephritis. Am J Physiol Cell Physiol 2023; 325:C1267-C1275. [PMID: 37721004 DOI: 10.1152/ajpcell.00058.2023] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
Several cytokines and chemokines are involved in the pathogenesis and progressive injury of renal tissues in patients with primary chronic glomerulonephritis (CGN). The objective of this study was to determine whether the urinary excretion of interleukin-6 (IL-6), transforming growth factor β1 (TGFβ1), monocytes chemoattractant protein (MCP-1), soluble tumor necrosis factor receptor 1 (sTNFR1), and epidermal growth factor (EGF) in patients with newly recognized CGN can serve as prognostic biomarkers in patients with newly recognized CGN and whether they can be effective in predicting a progressive reduction of renal function in prospective observation. The study included 150 Caucasian patients. UIL-6, UTGFβ1, UMCP-1, UsTNFR1, and UEGF were measured using enzyme-linked immunosorbent assay (ELISA) methods (Quantikine R&D System). UIL-6, UTGFβ1, UMCP-1, and UsTNFR1 were significantly higher, yet UEGF excretion was significantly lower in nephrotic patients, in patients with estimated glomerular filtration rate (eGFR) < 60/min/1.73 m2 at presentation, as well as in the progressor (PG) subgroup. In a multivariate regression analysis basal eGFR correlated with UsTNFR1, UIL-6, and UEGF excretion, although in the follow-up, ΔeGFR (delta estimated glomerular filtration rate) significantly correlated only with UEGF excretion. A logistic regression analysis showed that the most significant independent risk factors for the deterioration of renal function with time are initial high (>11.8 pg/mgCr) UIL-6 excretion, initial low (<15.5 ng/mgCr) urinary UEGF excretion, and male gender. In patients with newly diagnosed CGN, UIL-6, and UEGF can serve as prognostic biomarkers for the progression of the disease.NEW & NOTEWORTHY Baseline high urinary interleukin-6 (IL-6) excretion and low urinary epidermal growth factor (EGF) excretion and particularly high IL-6/EGF ratio were stronger predictive factors of the progression of the deterioration of the kidney function than initial estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria. In patients with newly diagnosed chronic glomerulonephritis, UIL-6 and UEGF can serve as prognostic biomarkers for the progression of the disease.
Collapse
Affiliation(s)
- Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Aldona Woźniak
- Department of Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Pawliczak
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Kaczmarek
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
4
|
Cholerzyńska H, Zasada W, Michalak H, Miedziaszczyk M, Oko A, Idasiak-Piechocka I. Urgent Implantation of Peritoneal Dialysis Catheter in Chronic Kidney Disease and Acute Kidney Injury-A Review. J Clin Med 2023; 12:5079. [PMID: 37568481 PMCID: PMC10419992 DOI: 10.3390/jcm12155079] [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: 06/08/2023] [Revised: 07/13/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Acute kidney injury (AKI) and sudden exacerbation of chronic kidney disease (CKD) frequently necessitate urgent kidney replacement therapy (UKRT). Peritoneal dialysis (PD) is recognized as a viable modality for managing such patients. Urgent-start peritoneal dialysis (USPD) may be associated with an increased number of complications and is rarely utilized. This review examines recent literature investigating the clinical outcomes of USPD in CKD and AKI. Relevant research was identified through searches of the MEDLINE (PubMed), Scopus, Web of Science, and Google Scholar databases using MeSH terms and relevant keywords. Included studies focused on the emergency use of peritoneal dialysis in CKD or AKI and reported treatment outcomes. While no official recommendations exist for catheter implantation in USPD, the impact of the technique itself on outcomes was found to be less significant compared with the post-implantation factors. USPD represents a safe and effective treatment modality for AKI, although complications such as catheter malfunctions, leakage, and peritonitis were observed. Furthermore, USPD demonstrated efficacy in managing CKD, although it was associated with a higher incidence of complications compared to conventional-start peritoneal dialysis. Despite its cost-effectiveness, PD requires greater technical expertise from medical professionals. Close supervision and pre-planning for catheter insertion are essential for CKD patients. Whenever feasible, an urgent start should be avoided. Nevertheless, in emergency scenarios, USPD does remain a safe and efficient approach.
Collapse
Affiliation(s)
| | | | | | - Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (H.C.); (W.Z.); (H.M.); (A.O.); (I.I.-P.)
| | | | | |
Collapse
|
5
|
Miedziaszczyk M, Oko A, Idasiak-Piechocka I. Corrigendum to "WCN23-0458 Assessment of Omeprazole and Famotidine Effect on the Pharmacokinetics of Tacrolimus in Patients After Kidney Transplant"Kidney International Reports, Volume 8, Issue 3, Supplement, March 2023, Page S392. Kidney Int Rep 2023; 8:1276. [PMID: 37645633 PMCID: PMC10461072 DOI: 10.1016/j.ekir.2023.03.021] [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: 08/31/2023] Open
Abstract
[This corrects the article DOI: 10.1016/j.ekir.2023.02.881.].
Collapse
Affiliation(s)
- Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences
| | - Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences
| |
Collapse
|
6
|
Jazienicka-Kiełb A, Babicki M, Krajewska M, Oko A, Kłoda K, Mastalerz-Migas A. Assessment of primary care physicians' knowledge of chronic kidney disease in Poland. Front Public Health 2022; 10:1032240. [PMID: 36339213 PMCID: PMC9631929 DOI: 10.3389/fpubh.2022.1032240] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/05/2022] [Indexed: 01/29/2023] Open
Abstract
Chronic kidney disease (CKD) affects 10-15% of the adult population worldwide and is a major societal problem. A latent course of the disease and little alarming, gradually increasing symptoms usually do not cause concern in patients and diagnostic vigilance in physicians. CKD is most often diagnosed in its end-stage when treatment options are extremely limited. This study aims to assess the knowledge of CKD among primary care physicians (PCPs) in Poland. A CAWI survey was conducted based on an authors' own questionnaire that consisted of two parts. The first part concerned patients' socioeconomic data while the second part consisted of nine single- and multiple-choice questions assessing knowledge of the criterion for diagnosis, risk factors, diagnostic evaluation, and course of CKD. A total of 610 physicians took part in the survey, including 502 (82.3%) who fully completed the questionnaire. Women accounted for 83.1% of the study group. The mean age of the study group was 37.4 ± 10.1 years. Specialists or resident physicians in family medicine accounted for 79.9% of respondents and 93.8% of physicians are those who mainly work in primary care settings. In the knowledge test, the mean score obtained by physicians was 6.5 ± 1.3 out of possible 9, with only 2.4% of respondents answering all questions correctly. According to the survey, 78.4% of respondents correctly indicated the criterion for the diagnosis of CKD, while only 68.9% identified a test for increased urinary albumin loss as the one of the greatest diagnostic values in the early stages of CKD. More than half, 63.1%, of physicians selected the correct set of answers in the multiple-choice question regarding CKD risk factors. Despite a fairly high level of knowledge among family medicine physicians regarding the causes, risk factors and course of CKD, there is a need for further education and an increase in the factual information held by this professional group, especially that the vast majority of PCPs declare a desire to expand their knowledge and believe that this will help them in their daily clinical practice.
Collapse
Affiliation(s)
| | - Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, Wrocław, Poland,*Correspondence: Mateusz Babicki
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | | | | |
Collapse
|
7
|
Hoppe K, Schwermer K, Dopierała M, Kałużna M, Hoppe A, Chou JTT, Oko A, Pawlaczyk K. Can Overnutrition Lead to Wasting?-The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis. Nutrients 2022; 14:nu14020247. [PMID: 35057428 PMCID: PMC8779228 DOI: 10.3390/nu14020247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The population of end-stage renal disease (ESRD) patients with diabetes mellitus (DM) may be at increased risk of protein energy wasting (PEW). The aim of the study was to investigate the impact of DM on selected indicators of PEW in the ESRD population that was undergoing maintenance hemodialysis (MHD). Methods: A total of 515 MHD patients were divided into two subgroups with and without DM. The evaluation of diet composition, Charlson Comorbidity Index (CCI), SGA, and laboratory and BIS analyses were performed. All-cause and cardiovascular mortality was recorded. Results: DM patients had lower albumin (3.93 (3.61–4.20) vs. 4.10 (3.80–4.30) g/dL, p < 0.01), total cholesterol (158 (133–196) vs. 180 (148–206) mg/dL, p < 0.01), and creatinine (6.34 (5.08–7.33) vs. 7.12 (5.70–8.51) mg/dL, p < 0.05). SGA score (12.0 (10.0–15.0) vs. 11.0 (9.0–13.0) points, p < 0.001), BMI (27.9 (24.4–31.8) vs. 25.6 (22.9–28.8) kg/m2, p < 0.001), fat tissue index (15.0 (11.4–19.6) vs. 12.8 (9.6–16.0) %, p < 0.001), and overhydration (2.1 (1.2–4.1) vs. 1.8 (0.7, 2.7) L, p < 0.001) were higher in the DM group. Increased morbidity, reflected in the CCI and mortality—both all-cause and cardiovascular—were observed in DM patients. Conclusions: Hemodialysis recipients with DM experience overnutrition with a paradoxically higher predisposition to PEW, expressed by a higher SGA score and lower serum markers of nutrition. This population is also more comorbid and is at higher risk of death, including from cardiovascular causes.
Collapse
Affiliation(s)
- Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
- Correspondence: (K.H.); (K.P.); Tel.: +48-618-691-610 (K.P.)
| | - Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
| | - Mikołaj Dopierała
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
| | - Małgorzata Kałużna
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland;
| | - Anna Hoppe
- Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznań, Poland;
| | - Jadzia Tin-Tsen Chou
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (M.D.); (J.T.-T.C.); (A.O.)
- Correspondence: (K.H.); (K.P.); Tel.: +48-618-691-610 (K.P.)
| |
Collapse
|
8
|
Schwermer K, Hoppe K, Kałużna M, Dopierała M, Olszewska M, Nealis J, Łukawiecka A, Oko A, Pawlaczyk K. Overhydration as a modifiable cardio-vascular risk factor in patients undergoing hemodialysis. Pol Arch Intern Med 2021; 131:819-829. [PMID: 34351089 DOI: 10.20452/pamw.16071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Cardio-vascular mortality in end-stage renal disease patients remains high despite advancement in dialysis techniques. This can be attributed to a number of traditional and non-traditional risk factors. Overhydration seems to be one of the promising non-traditional cardio-vascular risk factors to target in order to improve the survival. Objectives The aim of this study was to assess the influence of chronic overhydration and its dynamic changes on cardio-vascular and all-cause morbidity and mortality in the group of hemodialyzed patients. Patients and methods The study has been conducted on a total number of 511 patients. Hydration was assessed with whole-body bioimpedance spectroscopy. The entire cohort has been divided into 4 subgroups according to initial hydration value. Additionally, patients with at least 2 observation visits (n = 277) have been assigned to 4 subgroups created with respect to hydration change-over-time. Results Statistical analysis showed that male gender (P <0.001), diabetes (P <0.001), heart insufficiency (P < 0.001), smoking (P = 0.049) and cerebrovascular incidents (P = 0.007) were significant risk factors for overhydration. Cardiovascular toxicity of overhydration was reflected with elevated levels of NT-proBNP (P <0.001) and cTnT (P <0.001). Albumin and total cholesterol values were the lowest in highly overhydrated subgroups (P <0.001) showing the prevalence of malnutrition. Mortality rate was significantly lower in groups of normal hydration and mild overhydration (P <0.001), as well as of patients with stable low or descending overhydration levels (P = 0.002). Conclusion We can state that the degree of overhydration of hemodialyzed patients is significantly associated with the incidence of cardiovascular complications and affects the prognosis in end-stage renal disease.
Collapse
Affiliation(s)
- Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Małgorzata Kałużna
- Department of Endocrinology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
| | - Mikołaj Dopierała
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Marta Olszewska
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Justin Nealis
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Andżelika Łukawiecka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| |
Collapse
|
9
|
Kałużna M, Pawlaczyk K, Schwermer K, Hoppe K, Yusuf Ibrahim A, Czlapka-Matyasik M, Wrotkowska E, Ziemnicka K, Oko A, Ruchała M. Is Preptin a New Bone Metabolism Parameter in Hemodialysis Patients? Life (Basel) 2021; 11:341. [PMID: 33921361 PMCID: PMC8069327 DOI: 10.3390/life11040341] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Preptin is a bone-anabolic pancreatic peptide hormone. Its role in bone metabolism has been studied in rats and in patients with diabetes, but its levels and significance in bone metabolism in hemodialyzed (HD) patients is unknown. METHODS The relationships between preptin and anthropometric and biochemical parameters related to bone metabolism were studied in 73 patients on chronic hemodialysis (48 males, 25 females; mean age of 57 years; HD vintage of 69.7 months). Of these subjects, 36 patients had diabetes or impaired glucose tolerance (DM/IGT), and 37 patients had normal glucose tolerance (NGT). Dual-energy X-ray absorptiometry of the femoral neck and lumbar spine were also performed. RESULTS No differences were observed in preptin levels between DM/IGT and NGT HD patients. Preptin was positively correlated with HD vintage (r = 0.312, p = 0.007). Negative correlations between preptin and bone mineral density (BMD), T-score, and Z-score in the lumbar spine (L2-L4) were observed (r = -0.319, p = 0.009; r = -0.341, p = 0.005; r = -0.375, p = 0.002). Preptin was positively correlated with parathormone (PTH) levels (r = 0.379, p < 0.001) and osteocalcin levels (r = 0.262, p = 0.027). CONCLUSIONS The results indicate that preptin may reflect on bone and mineral metabolism disturbances seen in HD patients. The significant correlation of preptin with PTH and osteocalcin suggests that preptin may be important in indirect measurement of bone turnover in HD patients.
Collapse
Affiliation(s)
- Małgorzata Kałużna
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (M.K.); (E.W.); (K.Z.); (M.R.)
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (K.H.); (A.Y.I.); (A.O.)
| | - Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (K.H.); (A.Y.I.); (A.O.)
| | - Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (K.H.); (A.Y.I.); (A.O.)
| | - Aisha Yusuf Ibrahim
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (K.H.); (A.Y.I.); (A.O.)
| | | | - Elżbieta Wrotkowska
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (M.K.); (E.W.); (K.Z.); (M.R.)
| | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (M.K.); (E.W.); (K.Z.); (M.R.)
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (K.S.); (K.H.); (A.Y.I.); (A.O.)
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland; (M.K.); (E.W.); (K.Z.); (M.R.)
| |
Collapse
|
10
|
Kusztal M, Kłopotowski M, Bazan-Socha S, Błażejewska-Hyżorek B, Pawlaczyk K, Oko A, Krajewska M, Nowicki M. Is home-based therapy in Fabry disease the answer to compelling patients' needs during the COVID-19 pandemic? Survey results from the Polish FD Collaborative Group. ADV CLIN EXP MED 2021; 30:449-454. [PMID: 33908195 DOI: 10.17219/acem/132038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Fabry disease (FD) is an X-linked disorder related to a deficiency of the lysosomal enzyme alpha-galactosidase A. In Poland, enzyme replacement therapy (ERT) for FD is offered by the National Health Fund only at selected hospital infusion centers. Patients with FB are considered at a high risk of developing complications from COVID-19. Some patients omitted infusions due to fear of infection or outbreaks in hospitals. Lack of alternative infusion sites hampered the situation. OBJECTIVES To analyze the impact of the SARS-CoV-2 pandemic on FD patients, especially their fears and expectations, the Polish FD Collaborative Group collaborated on a survey project. MATERIAL AND METHODS Between September and November 2020, we distributed a customized survey exploring expectations and fears among FD subjects. RESULTS Fifty-five individuals (35 receiving ongoing ERT) from different FD centers completed the study. The median age was 40 years [IQR 25; 50], and gender distribution was almost equal (27 F; 28 M). One-fourth of FD patients reported severe disability limiting transportation for infusions that, in the opinion of the other 25% of responders, consumed >4 h. Forty-four (80%) of all would prefer home infusions performed by a nurse (n = 37, 67.3%) or by a trained non-medical person (n = 7, 12.7%), while 8 (14.5%) patients would choose a local hospital. As expected, transportation time (in one direction) was longer in those preferring home infusions (89.4 ±63 vs 36.2 ±67 min; p = 0.02). Also, those with more severe FD manifestation would prefer home infusions to treatment in FD centers (p = 0.03). The vast majority of respondents (n = 46; 83%) would not change their preferences after pandemic termination. CONCLUSIONS To maintain ERT, FD patients prefer home infusions or those given in the nearest hospital, especially during a pandemic.
Collapse
Affiliation(s)
- Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland
| | - Mariusz Kłopotowski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warszawa, Poland
| | - Stanisława Bazan-Socha
- Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology, and Internal Diseases, Poznan University of Medical Sciences, Poland
- Department of Nephrology, University Hospital of Karol Marcinkowski, Zielona Góra, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology, and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland
| | - Michał Nowicki
- Department of Nephrology, Hypertension, and Kidney Transplantation, Medical University of Lodz, Poland
| |
Collapse
|
11
|
Sikorska D, Pawlaczyk K, Baum E, Wanic-Kossowska M, Czepulis N, Łuczak J, Samborski W, Oko A. The association of serum soluble Klotho levels and residual diuresis and overhydration in peritoneal dialysis patients. ADV CLIN EXP MED 2019; 28:1345-1349. [PMID: 30868770 DOI: 10.17219/acem/104552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Klotho, originally identified as an anti-aging factor, is a transmembrane protein expressed in the kidney. It has been reported that Klotho deficiency could be associated with a loss of residual renal function and cardiovascular complications in peritoneal dialysis (PD) patients. OBJECTIVES The main aim of the study was to evaluate whether serum levels of Klotho correlate with residual diuresis and hydration status in PD patients. MATERIAL AND METHODS The cross-sectional study involved 57 PD patients ≥18 years of age who had been on PD ≥ 3 months. Serum Klotho was measured using high-sensitivity enzyme-linked immunosorbent assay (ELISA). Hydration status was assessed with bioimpedance analysis (BIA). RESULTS Serum levels of soluble Klotho ranged from 100 pg/mL to 700 pg/mL. The patients were divided into 2 subgroups, with Klotho levels below and above the median (260 pg/mL). The data revealed a tendency for lower residual diuresis (1.3 ±1.0 L vs 1.8 ±0.8 L; p = 0.055) in patients with lower levels of Klotho in serum. Serum Klotho correlated negatively with overhydration according to BIA (r = -0.27; p = 0.044) and positively with residual diuresis (r = 0.26; p = 0.045). CONCLUSIONS Soluble Klotho correlates inversely with hydration status in BIA. Residual urine output, but not dialysis parameters, could be associated with the levels of serum soluble Klotho in PD patients.
Collapse
Affiliation(s)
- Dorota Sikorska
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Ewa Baum
- Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poland
| | - Maria Wanic-Kossowska
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Joanna Łuczak
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| |
Collapse
|
12
|
Abstract
BACKGROUND High mortality in peritoneal dialysis (PD) patients is associated with the presence of nontraditional cardiovascular risk factors, such as malnutrition. However, hypoalbuminemia in patients undergoing PD may have gender-dependent consequences. OBJECTIVES The aim of the study was to evaluate the relationship between hypoalbuminemia, overhydration (OH), inflammation, and cardiovascular risk, depending on gender. MATERIAL AND METHODS The group studied consisted of 54 PD patients: 26 male (mean age: 59 ±19 years) and 28 female (mean age: 52 ±15 years). Serum albumin levels were measured routinely by the hospital central laboratory. The degree of OH was assessed by bioelectrical impedance analysis (BIA). Serum concentrations of C-reactive protein (CRP) and interleukin (IL)-6 were measured as inflammatory markers. Levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and troponin T (TnT) were used to assess cardiovascular risk. RESULTS Median serum albumin concentration was 3.9 g/dL (3.6-4.2 g/dL). Both genders were comparable regarding most parameters except body weight (79 ±16 kg vs 67 ±16 kg; p = 0.009), but no differences were observed in body mass index (BMI) (26.3 ±5.0 kg/m2 vs 26.2 ±5.9 kg/m2; non significant (NS)). There was also no difference in the prevalence of hypoalbuminemia between female and male PD patients (23% vs 21%; NS). In females, low serum albumin concentrations were associated with OH, inflammation and cardiovascular risk, while in males serum albumin levels correlated with the parameters of dialysis and cardiovascular risk. CONCLUSIONS The impact of hypoalbuminemia may be gender-dependent. It seems that hypoalbuminemia is more important for female patients. It is also possible that different mechanisms regulate serum albumin concentration in female and male PD patients.
Collapse
Affiliation(s)
- Dorota Sikorska
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
| | - Anna Olewicz-Gawlik
- Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies, Poznan University of Medical Sciences, Poland
| | - Ewa Baum
- Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| |
Collapse
|
13
|
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]
|
14
|
Kałużna M, Pawlaczyk K, Schwermer K, Hoppe K, Człapka-Matyasik M, Ibrahim AY, Sawicka-Gutaj N, Minczykowski A, Ziemnicka K, Oko A, Ruchała M. Adropin and irisin: New biomarkers of cardiac status in patients with end-stage renal disease? A preliminary study. ADV CLIN EXP MED 2019; 28:347-353. [PMID: 30525316 DOI: 10.17219/acem/81538] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The new polypeptide hormones adropin and irisin have a broad impact on human metabolism and energy homeostasis. They could be potential biomarkers of cardiac injury. In end-stage renal disease (ESRD), the clinical importance of adropin and irisin is yet to be investigated. OBJECTIVES The aim of this study was to determine the relationship between these peptides and cardiac status in ESRD patients. MATERIAL AND METHODS Seventy-nine ESRD patients on hemodialysis (HD), peritoneal dialysis (PD) or after renal transplantation (Tx), and 40 healthy, ageand sex-matched controls (CON) were included in this study. Serum concentrations of adropin and irisin were measured with enzyme-linked immunosorbent assay (ELISA). Cardiac status was estimated by transthoracic echocardiography and the plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT). RESULTS The levels of irisin were significantly lower in HD patients as compared to CON. During HD sessions, the concentrations of adropin did not change significantly, whereas the concentrations of irisin increased with borderline significance. Positive correlations were evident between adropin concentration and cTnT as well as NT-proBNP. Adropin was also correlated with left ventricular systolic internal diameter (LVIDs) (r = 0.375, p = 0.045) and relative wall thickness (RWT) (r = -0.382, p = 0.034). Irisin was correlated with right ventricular diameter (RVd) (r = -0.363, p = 0.045). No correlations were found between irisin and adropin, and blood pressure (BP) measurements. CONCLUSIONS Adropin could be a new candidate marker of cardiac dysfunction in HD patients. The cause of low levels of irisin found in HD patients is still unclear. These 2 myokines should be further investigated as potential prognostic markers of cardiac status in HD patients.
Collapse
Affiliation(s)
- Małgorzata Kałużna
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | | | - Aisha Yusuf Ibrahim
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Nadia Sawicka-Gutaj
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Andrzej Minczykowski
- Department of Cardiology - Intensive Therapy, Poznan University of Medical Sciences, Poland
| | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poland
| |
Collapse
|
15
|
Hoppe K, Schwermer K, Kawka A, Klysz P, Baum E, Kaluzna M, Sikorska D, Scigacz A, Lindholm B, Pawlaczyk K, Oko A. Dialysis vintage stratified comparison of body composition, hydration and nutritional state in peritoneal dialysis and hemodialysis patients. Arch Med Sci 2018; 14:807-817. [PMID: 30002698 PMCID: PMC6040140 DOI: 10.5114/aoms.2016.61902] [Citation(s) in RCA: 6] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/17/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Body mass decomposition and hydration state imbalances affect patients on maintenance dialysis. We compared body composition, hydration and nutritional state of patients on peritoneal dialysis (PD) and hemodialysis (HD) based on dialysis vintage (DV). MATERIAL AND METHODS Three hundred and fifty-nine prevalent patients on HD (n = 301) and PD (n = 58) were divided into 3 subgroups depending on DV: < 2 years HD (n = 41) and PD (n = 28), 2-4 years HD (n = 111) and PD (n = 17), > 4 years HD (n = 149) and PD (n = 13). Bioimpedance analysis delivered data including overhydration (OH), Lean (LTM) and adipose lipids mass (FAT). Other measurements included daily diuresis (DD), subjective global assessment (SGA) and serum albumin (alb), C-reactive protein (CRP) and total cholesterol (TChol), and hemoglobin (Hb). RESULTS Dialysis vintage < 2 years. Hemodialysis patients were older (65.5 ±18.5 vs. 50.9 ±17.1; p < 0.01) with a higher mortality (28 vs. 1; p < 0.01) and OH (8.0 ±4.3 vs. 1.6 ±3.1; p < 0.001). Hemoglobin (10.6 ±1.5 vs. 11.8 ±1.7; p < 0.05), TChol (180.2 ±47.0 vs. 211.7 ±46.3; p < 0.05), DD (871 ±729 vs. 1695 ±960; p < 0.001) and LTM (46.5 ±12.9 vs. 53.8 ±14.4; p < 0.05) were lower on HD. Dialysis vintage 2-4 years: when compared to PD, HD patients had higher OH (11.7 ±5.9 vs. 2.1 ±3.2; p < 0.001) and lower Hb (10.8 ±1.5 vs. 11.9 ±1.4; p < 0.01). Dialysis vintage > 4 years: compared to PD, HD patients had higher LTM (44.3 ±11.7 vs. 38.6 ±7.9; p < 0.05) and lower FAT (34.4 ±11.1 vs. 42.8 ±6.4; p < 0.01). CONCLUSIONS Dialysis patients' body composition depends on dialysis modality and DV. Dialysis vintage < 2 years is associated with better hydration, nutritional state, and survival in PD patients, but longer DV reduces these benefits. Dialysis vintage > 4 years associated with similar hydration and mortality in both PD and HD while body composition was better on HD.
Collapse
Affiliation(s)
- Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Kawka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Patrycja Klysz
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Baum
- Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Kaluzna
- Department of Endocrinology, Metabolic Disorders and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Sikorska
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Scigacz
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Bengt Lindholm
- Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
16
|
Perkowska-Ptasinska A, Bartczak A, Wagrowska-Danilewicz M, Halon A, Okon K, Wozniak A, Danilewicz M, Karkoszka H, Marszalek A, Kowalewska J, Mroz A, Korolczuk A, Oko A, Debska-Slizien A, Naumnik B, Hruby Z, Klinger M, Ciechanowski K, Myslak M, Sulowicz W, Rydzewski A, Wiecek A, Manitius J, Gregorczyk T, Niemczyk S, Nowicki M, Gellert R, Stompor T, Wieliczko M, Marczewski K, Paczek L, Rostkowska O, Deborska-Materkowska D, Bogdanowicz G, Milkowski A, Durlik M. Clinicopathologic correlations of renal pathology in the adult population of Poland. Nephrol Dial Transplant 2017; 32:ii209-ii218. [PMID: 28339709 DOI: 10.1093/ndt/gfw365] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 05/31/2016] [Accepted: 09/13/2016] [Indexed: 01/28/2023] Open
Abstract
Background This is the first report on the epidemiology of biopsy-proven kidney diseases in Poland. Methods The Polish Registry of Renal Biopsies has collected information on all (n = 9394) native renal biopsies performed in Poland from 2009 to 2014. Patients' clinical data collected at the time of biopsy, and histopathological diagnoses were used for epidemiological and clinicopathologic analysis. Results There was a gradual increase in the number of native renal biopsies performed per million people (PMP) per year in Poland in 2009-14, starting from 36 PMP in 2009 to 44 PMP in 2014. A considerable variability between provinces in the mean number of biopsies performed in the period covered was found, ranging from 5 to 77 PMP/year. The most common renal biopsy diagnoses in adults were immunoglobulin A nephropathy (IgAN) (20%), focal segmental glomerulosclerosis (FSGS) (15%) and membranous glomerulonephritis (MGN) (11%), whereas in children, minimal change disease (22%), IgAN (20%) and FSGS (10%) were dominant. Due to insufficient data on the paediatric population, the clinicopathologic analysis was limited to patients ≥18 years of age. At the time of renal biopsy, the majority of adult patients presented nephrotic-range proteinuria (45.2%), followed by urinary abnormalities (38.3%), nephritic syndrome (13.8%) and isolated haematuria (1.7%). Among nephrotic patients, primary glomerulopathies dominated (67.6% in those 18-64 years of age and 62.4% in elderly patients) with leading diagnoses being MGN (17.1%), FSGS (16.2%) and IgAN (13.0%) in the younger cohort and MGN (23.5%), amyloidosis (18.8%) and FSGS (16.8%) in the elderly cohort. Among nephritic patients 18-64 years of age, the majority (55.9%) suffered from primary glomerulopathies, with a predominance of IgAN (31.3%), FSGS (12.7%) and crescentic GN (CGN) (11.1%). Among elderly nephritic patients, primary and secondary glomerulopathies were equally common (41.9% each) and pauci-immune GN (24.7%), CGN (20.4%) and IgAN (14.0%) were predominant. In both adult cohorts, urinary abnormalities were mostly related to primary glomerulopathies (66.8% in younger and 50% in elderly patients) and the leading diagnoses were IgAN (31.4%), FSGS (15.9%), lupus nephritis (10.7%) and FSGS (19.2%), MGN (15.1%) and pauci-immune GN (12.3%), respectively. There were significant differences in clinical characteristics and renal biopsy findings between male and female adult patients. Conclusions The registry data focused new light on the epidemiology of kidney diseases in Poland. These data should be used in future follow-up and prospective studies.
Collapse
Affiliation(s)
| | - Artur Bartczak
- Department of Pathology, Medical Center of Postgraduate Education, Warsaw, Poland
| | | | - Agnieszka Halon
- Department of Pathomorphology, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Okon
- Department of Clinical and Experimental Pathology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Aldona Wozniak
- Biopsy Diagnostics Laboratory, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Henryk Karkoszka
- Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Katowice, Poland
| | - Andrzej Marszalek
- Department of Pathomorphology, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Jolanta Kowalewska
- Department of Pathology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Andrzej Mroz
- Department of Pathology, Medical Center of Postgraduate Education, Warsaw, Poland
| | | | - Andrzej Oko
- Department of Nephrology, Transplantology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Alicja Debska-Slizien
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Beata Naumnik
- Department of Nephrology and Transplantology with Dialysis Unit, Medical University Bialystok, Bialystok, Poland
| | - Zbigniew Hruby
- Department of Nephrology, with subdivision of Diabetology and Transplantology, District Specialist Hospital in Wroclaw, Wroclaw, Poland
| | - Marian Klinger
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Kazimierz Ciechanowski
- Clinic of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
| | - Marek Myslak
- Department of Nephrology and Kidney Transplantation, District Hospital in Szczecin, Szczecin, Poland
| | | | - Andrzej Rydzewski
- Department of Internal Diseases, Nephrology and Transplantology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
| | - Andrzej Wiecek
- Department of Nephrology, Silesian School of Medicine, Katowice, Poland
| | - Jacek Manitius
- Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum UMK, Bydgoszcz, Poland
| | | | - Stanislaw Niemczyk
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| | - Michal Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland.,Nephrology and Dialysis, Polish Mother's Memorial Hospital, Lodz, Poland
| | - Ryszard Gellert
- Department of Nephrology, Medical Center for Postgraduate Education, Warsaw, Poland
| | - Tomasz Stompor
- PD Unit, Chair and Department of Nephrology, Jagiellonian University, Cracow, Poland
| | - Monika Wieliczko
- Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Marczewski
- Zaklad Etyki i Filozofii Czlowieka, Uniwersytet Medyczny w Lublinie, Lublinie, Poland
| | - Leszek Paczek
- Department of Immunology, Transplant Medicine, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Olga Rostkowska
- Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | | | | | - Magdalena Durlik
- Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | | |
Collapse
|
17
|
Hoppe K, Szalek A, Schwermer K, Kryszan K, Kawka A, Olszewska M, Baum E, Pawlaczyk K, Oko A. SP507IS SOLUBLE ALPHA-KLOTHO A NOVEL SENSITIVE MARKER OF PROGNOSIS FOR PATIENTS ON MAINTENANCE PERITONEAL DIALYSIS? Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx151.sp507] [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] [Indexed: 11/12/2022] Open
|
18
|
Sikorska D, Pawlaczyk K, Olewicz-Gawlik A, Roszak M, Samborski W, Baum E, Kałużna M, Wanic-Kossowska M, Lindholm B, Oko A. Factors associated with overhydration in peritoneal dialysis patients. JMS 2017. [DOI: 10.20883/jms.2017.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Aim. Overhydration is a prevalent problem in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the effect of several factors on the development of overhydration in PD patients. Material and Methods. The study was performed on 74 PD patients, who were divided into two groups according to bioimpedance analysis hydration status (OHBIA): Group A OHBIA < 1.1 L (n = 40) and Group B OHBIA ? 1.1 L (n = 34). The assessments of the adequacy of the dialysis dosage were based on the Kt/V ratio as well as weekly creatinine clearance. To evaluate the permeability of the peritoneal membrane a standard peritoneal equilibration test was used.Results. A statistically significant difference between the groups was found in: the average age of patients (53 ± 18 vs. 62 ± 14 years; p < 0.03), the prevalence of diabetes (27.5% vs. 55.9%; p < 0.02) and residual diuresis (1.7 ± 0.8 vs 1.2 ± 0.9 L; p < 0.05). There was no statistically significant difference in gender distribution, although attention is paid to the greater participation of male in overhydrated group. The study found no statistically significant differences between PD vintage, type of PD, assessment of adequacy of PD and other parameters describing the PD method. Logistic regression model selected diabetes (p < 0.03) as a significant risk factor for the occurrence of hypervolemia.Conclusions. Diabetes and older age are potential predisposing factors for the development of overhydration in PD patients. Overhydrated PD patients may have relatively high parameters regarding adequacy of dialysis therapy. Probably the most important protective factor in PD patients is residual diuresis
Collapse
|
19
|
Hoppe K, Schwermer K, Olewicz-Gawlik A, Klysz P, Kawka A, Baum E, Sikorska D, Ścigacz K, Roszak M, Lindholm B, Pawlaczyk K, Oko A. Dialysis vintage and cardiovascular injury as factors influencing long-term survival in peritoneal dialysis and hemodialysis. ADV CLIN EXP MED 2017; 26:251-258. [PMID: 28791842 DOI: 10.17219/acem/64936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiovascular (CV) incidents are the major cause of mortality in maintenance dialysis (MD) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD). CV injury indicators may be useful to investigate the dialysis modality influence on survival. OBJECTIVES The aim of this study was to compare selected laboratory and echocardiographic (ECHO) markers of CV injury in terms of dialysis vintage (DV), CV-related mortality and all-cause mortality. MATERIAL AND METHODS The study involved 301 patients on HD (n = 301) and PD (n = 58), who were divided into subgroups according to DV. The subjects' medical histories included diabetes mellitus (DM), myocardial infarction (MI), stroke, CV deaths and deaths from non-CV causes. Their CV parameters were measured with ECHO for the left ventricle ejection fraction (EF), posterior wall (LVW) and interventricular septum (IVS). Serum analyses of cardiac troponin T (TnT) and N-terminal pro-brain natriuretic peptide (BNP) were also carried out. RESULTS In the subgroup with a DV of 4 years, the PD and HD patients were of a similar age, and had similar mortality and morbidity rates and CV markers, except for thicker IVS in the HD patients. CONCLUSIONS Focusing on the data analysis based on mortality, and both laboratory and echocardiographic markers of cardiovascular injury, PD seems to be a more favorable method of dialysis. The advantage of PD was noted in subjects with a DV < 2 years. HD showed no outcome benefit over PD in longer DV.
Collapse
Affiliation(s)
- Krzysztof Hoppe
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Krzysztof Schwermer
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Anna Olewicz-Gawlik
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Patrycja Klysz
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Anna Kawka
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Ewa Baum
- Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poland
| | - Dorota Sikorska
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Katarzyna Ścigacz
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Magdalena Roszak
- Department of Biostatistics, Poznan University of Medical Sciences, Poland
| | - Bengt Lindholm
- Karolinska Institutet, Clinical Science, Intervention and Technology, Stockholm, Sweden
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
- Karolinska Institutet, Clinical Science, Intervention and Technology, Stockholm, Sweden
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
| |
Collapse
|
20
|
Sikorska D, Pawlaczyk K, Olewicz-Gawlik A, Czepulis N, Posnik B, Baum E, Wanic-Kossowska M, Lindholm B, Oko A. The importance of residual renal function in peritoneal dialysis. Int Urol Nephrol 2016; 48:2101-2108. [PMID: 27734218 DOI: 10.1007/s11255-016-1428-3] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/21/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients. METHODS Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray. RESULTS With increasing residual diuresis in group A, B and C, fewer patients had signs of overhydration defined as OHBIA > 1.1 L (75.0, 42.9 and 33.3 %) or peripheral edema (25.0, 21.4 and 0 %) and NT-proBNP (15199 ± 16150 vs. 5930 ± 9256 vs. 2600 ± 3907 pg/mL; p < 0.05) and TnT (0.15 ± 0.17 vs. 0.07 ± 0.09 vs. 0.04 ± 0.03 ng/mL; p < 0.05) were significantly lower. Significant differences were found also in ejection fraction, SGA, and total cholesterol, albumin and hemoglobin levels whereas blood pressures and serum CRP did not differ significantly. CONCLUSION Signs of OH and cardiac strain are common in PD patients, even in those with diuresis of 1000-2000 mL/day and with no clinical signs or symptoms, suggesting that even moderate decrease in residual renal function in PD patients associate with OH and other complications.
Collapse
Affiliation(s)
- Dorota Sikorska
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland.,Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.,Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland. .,Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
| | - Anna Olewicz-Gawlik
- Department of Rheumatology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Posnik
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland
| | - Ewa Baum
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Wanic-Kossowska
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland
| |
Collapse
|
21
|
Sikorska D, Pawlaczyk K, Roszak M, Czepulis N, Oko A, Karczewski M, Breborowicz A, Witowski J. Preliminary observations on the association between serum IL-6 and hydration status and cardiovascular risk in patients treated with peritoneal dialysis. Cytokine 2016; 85:171-6. [PMID: 27371776 DOI: 10.1016/j.cyto.2016.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 02/21/2016] [Revised: 04/12/2016] [Accepted: 06/05/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Systemic inflammation, as defined by elevated blood IL-6, is a strong independent predictor of peritoneal dialysis (PD) patient survival. The present study has aimed to determine whether there exists a particular "phenotype" associated with high systemic IL-6 that characterizes PD patients in terms of their fluid status and cardiac parameters. METHODS Fifty-seven prevalent PD patients were classified according to serum concentrations of IL-6. The degree of overhydration was assessed by bioimpedance analysis (BIA). Echocardiography and serum concentrations of NT-proBNP and troponin T were used to assess cardiovascular risk. RESULTS Patients with high serum IL-6 were older, more often diabetic, treated with PD for longer, and significantly more overhydrated. There was a significant correlation between serum IL-6, hydration status (r=0.38; p=0.002) and serum albumin (r=-0.35; p=0.009). Multivariate regression analysis confirmed a strong association of overhydration, hypoalbuminemia, and systemic IL-6 concentration. Patients with high IL-6 had significantly increased levels of both NT-proBNP (r=0.36; p=0.006) and TnT (r=0.50; p<0.001) in the absence of abnormalities in echocardiography. CONCLUSIONS High systemic IL-6 identifies PD patients with increased cardiovascular risk that is significantly related to overhydration. Thus, the measurement of serum IL-6 may contribute to the more accurate assessment of cardiovascular status in patients undergoing PD.
Collapse
Affiliation(s)
- Dorota Sikorska
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland; Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Magdalena Roszak
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland
| | - Marek Karczewski
- Department of Transplantology, General, Vascular and Plastic Surgery, Poznan University of Medical Sciences, Poland
| | - Andrzej Breborowicz
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poland.
| |
Collapse
|
22
|
Hoppe K, Schwermer K, Kawka A, Klysz P, Baum E, Radziszewska D, Lindholm B, Pawlaczyk K, Oko A. MP655PERITONEAL (PD) OR HEMODIALYSIS (HD) - DIALYSIS VINTAGE DEPENDENT COMPARISON OF BODY COMPOSITION, HYDRATION AND NUTRITION. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw199.02] [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] [Indexed: 11/14/2022] Open
|
23
|
Hoppe K, Schwermer K, Klysz P, Radziszewska D, Sawatiuk P, Baum E, Kaczmarek J, Roszak M, Kaluzna M, Lindholm B, Pawlaczyk K, Oko A. Cardiac Troponin T and Hydration Status as Prognostic Markers in Hemodialysis Patients. Blood Purif 2015; 40:139-45. [DOI: 10.1159/000376603] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 01/30/2015] [Indexed: 11/19/2022]
Abstract
This study aimed to assess cardiac troponin T (cTnT) and hydration state as cardiovascular (CV) risk markers in hemodialysis (HD) patients. Two hundred and forty one patients were divided according to HD vintage into two groups: SV (HD ≤24 months) and LV. Water balance was assessed with overhydration (OH%; bioimpedance analysis) and daily diuresis (DD); CV dysfunction with cTnT and heart ultrasound; nutrition with subjective global assessment (SGA), cholesterol (TC) and albumin. SV had lower OH% (2.8 vs. 3.5, p < 0.05) and higher DD (1,161 vs. 637 ml, p < 0.001), while LV had higher cTnT (0.1 ± 0.04 vs. 0.1 ± 0.07 ng/ml, p < 0.05) and lower interventricular septum thickness (IVS; 13.4 vs. 14.5 mm, p < 0.05). Nutritional state as reflected by lower TC was worse in LV (184.7 vs. 169.5 mg/dl, p < 0.05). Mortality was higher in patients in the LV group (15 vs. 27 deaths, p < 0.05). OH% correlated inversely with albumin (r = -0.36, p < 0.001), TC (r = -0.31, p < 0.001) and cTnT (r = -0.4, p < 0.001). cTnT correlated positively with IVS (r = 0.39, p < 0.001), SGA (r = 0.23, p = 0.001) and mortality rate (r = 0.21, p < 0.01), and negatively with DD (r = -0.34, p < 0.001) and albumin (r = -0.25, p < 0.001). Longer dialysis vintage associates with CV dysfunction, overhydration and increased mortality, which may be predicted with OH% and cTnT. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=376603.
Collapse
|
24
|
Schwermer K, Hoppe K, Radziszewska D, Kłysz P, Sawatiuk P, Nealis J, Kałużna M, Kaczmarek J, Baum E, Lindholm B, Pawlaczyk K, Oko A. N‑terminal pro‑B-type natriuretic peptide as a marker of hypervolemia and predictor of increased mortality in patients on hemodialysis. ACTA ACUST UNITED AC 2015; 125:560-9. [PMID: 26140435 DOI: 10.20452/pamw.2969] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) is an established biomarker of heart failure in the general population. However, its diagnostic value is unclear in hemodialysis (HD) patients owing to renal insufficiency. OBJECTIVES The aim of the study was to establish the usefulness of NT‑proBNP for hydration assessment and the relation of NT‑proBNP to the nutritional state and prognosis of survival. PATIENTS AND METHODS In 321 HD patients (206 men; mean age, 65.1 ±21.4 years), we assessed NT‑proBNP levels, overhydration (OHBIA), and the indices of the nutritional state (using a bioimpedance analysis [BIA]) in relation to cardiac troponin T (cTnT), hemoglobin, albumin, total cholesterol (TC), and C‑reactive protein (CRP) levels. The efficacy of HD was assessed using Kt/V, weekly HD dose, and HD session ultrafiltration. The cohort was divided into NT‑proBNP quartiles. Patients with 2 NT‑proBNP measurements were categorized also into change‑over‑time subgroups. A follow‑up lasted for a median period of 23.8 ±26.3 months. RESULTS Relative OHBIA increased across the NT‑proBNP quartiles (Q1/Q2/Q3/Q4, 1.31% ±2.56%/2.06% ±2.35%/2.92% ±2.97%/4.62% ±4.22%; P <0.0001). NT‑proBNP was also closely associated with other OH parameters. In addition, there was a significant correlation between NT‑proBNP and cTnT (r = 0.55; P <0.0001). Body mass index (BMI) and fat tissue index (FTI) decreased across the quartiles (BMI, 28.5 ±7.7/26.0 ±6.6/25.8 ±5.4/23.7 ±5.5 kg/m2; FTI, 14.4 ±9.0/14.1 ±7.3/12.3 ±6.8/11.6 ±6.1; P <0.001). The highest albumin level was present in Q1 (4.10 ±0.63/3.99 ±0.51/3.90 ±0.62/3.97 ±0.78 g/dl; P = 0.006). The TC level was the lowest in Q4 (190 ±60/169 ±56/173 ±51/153 ±56 mg/dl; P = 0.002). The hemoglobin level decreased across the quartiles (11.44 ±1.25/11.15 ±2.50/10.79 ±1.51/10.45 ±1.67 g/dl; P = 0.0006). The differences in CRP levels and HD‑related parameters were nonsignificant. During the follow‑up, 97 deaths were recorded (11/26/21/39, P <0.0001). CONCLUSIONS NT‑proBNP seems to be a useful biomarker of hypervolemia in HD patients. Nevertheless, it has to be interpreted with regard to the patient's individual residual renal function and cardiovascular status.
Collapse
|
25
|
Hoppe K, Schwermer K, Klysz P, Baum E, Polcyn-Adamczak M, Fidera M, Kunysz D, Pawlaczyk K, Lindholm B, Oko A. FP490DO HYDRATION STATE FLUCTUACTIONS AFFECT HEMODIALYZED PATIENTS’ RISK OF COMPLICATIONS AND MORTALITY RATE? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv179.19] [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] [Indexed: 11/12/2022] Open
|
26
|
Schwermer K, Hoppe K, Kunysz D, Fidera M, Klysz P, Kaluzna M, Pawlaczyk K, Oko A. FP618HIGH RESIDUAL DIURESIS DECREASES MORTALITY IN HEMODIALYZED PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv181.11] [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] [Indexed: 11/14/2022] Open
|
27
|
Lemoine S, Fournier T, Kocevar G, Belloi A, Ibarrola D, Sappey-Marinier D, Juillard L, Kaysen G, Usvyat L, Grassmann A, Marcelli D, Pecoits-Filho R, Marelli C, Kooman J, Van Der Sande F, Haviv Y, Power A, Kotanko P, Migliori M, Cantaluppi V, Medica D, Paoletti S, Panichi V, Kuragano T, Yahiro M, Kida A, Nagasawa Y, Hasuike Y, Nanami M, Nakanishi T, Garneata L, Slusanschi O, Dragomir DR, Corbu-Stancu A, Barbulescu C, Mircescu G, Minutolo R, Borrelli S, De Nicola L, Conte G, Basic-Jukic N, Katalinic L, Ivandic E, Kes P, Jelakovic B, Beberashvili I, Sinuani I, Azar A, Shapiro G, Feldman L, Stav K, Sandbank J, Averbukh Z, Bruschetta E, Righetti M, Colombo F, Palmieri N, Prencipe M, Bracchi O, Stefani F, Amar K, Scalia A, Conte F, Rosenberger J, Majernikova M, Kissova V, Straussova Z, Boldizsar J, Cobo G, Di Gioia C, Camacho R, Garcia Lacalle C, Ortega O, Rodriguez I, Mon C, Ortiz M, Herrero J, Oliet A, Vigil A, Gallar P, Kyriazis J, Markaki A, Kourtesi K, Kalymniou M, Vougazianos S, Kyriazis P, Stylianou K, Tanaka H, Tsuneyoshi S, Sawa M, Fujisaki K, Daijo Y, Hristea D, Paris A, Lefrancois G, Volteau C, Savoiu C, Ozenne S, Testa A, Coupel S, Bertho I, Legall MC, Magnard J, Deschamps T, Capusa C, Stoian I, Barbulescu C, Santimbrean C, Dumitru D, Mircescu G, Kato S, Lindholm B, Yuzawa Y, Shiels PG, Hwang JC, Jiang MY, Lu YH, Wang CT, Chiou TTY, Lee YT, Ng HY, Lee CT, Kaminska D, Koscielska-Kasprzak K, Chudoba P, Mazanowska O, Zabinska M, Banasik M, Boratynska M, Lepiesza A, Korta K, Klinger M, Struijk-Wielinga T, Neelemaat F, Slieker T, Koolen M, Ter Wee PM, Weijs PJ\, Tsuchida K, Hirose D, Minakuchi J, Kawashima S, Tomo T, Lee JE, Yun GY, Choi HY, Lee S, Kim W, Jo IY, Ha SK, Kim HJ, Park HC, Migliori M, Scatena A, Cantaluppi V, Rosati A, Pizzarelli F, Panichi V, Shin BC, Kim HL, Chung JH, Malgorzewicz S, Chmmielewski M, Debska-Slizien A, Rutkowski B, Kolesnyk M, Stepanova N, Korol L, Kulizkyi M, Ablogina O, Migal L, Takahashi T, Kitajima Y, Hirano S, Naka A, Ogawa H, Aono M, Sato Y, Hoppe K, Schwermer K, K Ysz P, Kaczmarek J, Baum E, Sikorska D, Radziszewska D, Szkudlarek M, Olejniczak P, Pawlaczyk K, Lindholm B, Oko A, Severova Andreevska G, Trajceska L, Gelev S, Dzekova P, Selim G, Sikole A, Trajceska L, Severova Andreevska G, Rambabova Busletik I, Gelev S, Pavleska Kuzmanovska S, Dzekova Vidimiski P, Selim G, Sikole A, Borrelli S, De Simone E, Laurino S, De Simone W, Ahbap E, Kara E, Basturk T, Sakaci T, Koc Y, Sahutoglu T, Akgol C, Sevinc M, Atan Ucar Z, Unsal A, Girndt M, Fiedler R, Martus P, Pawlak M, Storr M, Boehler T, Templin M, Trojanowicz B, Ulrich C, Glomb M, Liehr K, Werner K, Zickler D, Schindler R, Vishnevskii KA, Gerasimchuk RP, Zemchenkov AY, Moura A, Madureira J, Alija P, Fernandes JC, Oliveira JG, Lopez M, Filgueiras M, Amado L, Sameiro-Faria M, Miranda V, Vieira M, Santos-Silva A, Costa E, Zaluska W, Kotlinska-Hasiec EKH, Zaluska A, Rzecki Z, Zadora P, Dabrowski W, Sikole A, Trajceska L, Amitov V, Busletik IR, Dzekova P, Selim G, Severova Andreevska G, Gelev S, Aicardi Spalloni V, La Milia V, Longhi S, Volo L, Del Vecchio L, Pontoriero G, Locatelli F, Martino F, Scalzotto E, Corradi V, Nalesso F, Zanella M, Brandolan A, Perez De Jose A, Abad S, Vega A, Reque J, Quiroga B, Lopez-Gomez JM, Esteve Simo V, Duarte Gallego V, Moreno Guzman F, Fulquet Nicolas M, Pou Potau M, Saurina Sole A, Carneiro Oliveira J, Ramirez De Arellano Serna M, Ahbap E, Kara E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Sevinc M, Atan Ucar Z, Unsal A, Van Diepen AT, Hoekstra T, De Mutsert R, Rotmans JI, De Boer M, Suttorp MM, Struijk DG, Boeschoten EW, Krediet RT, Dekker FW, Trigka K, Chouchoulis K, Musso CG, Kaza M, Mpimpi A, Pipili C, Kyritsis I, Douzdampanis P, Streja E, Rezakhani S, Rhee CM, Kalantar-Zadeh K, Streja E, Doshi M, Rhee C, Kovesdy C, Moradi H, Kalantar-Zadeh K, Dantas MA, Resende LL, Silva LF, Matos CM, Lopes GB, Lopes AA, Knap B, Arnol M, Buturovic J, Ponikvar R, Bren A, Codognotto M, Piasentin P, Conte F, Righetti M, Limido A, Tsuchida K, Michiwaki H, Minakuchi J, Kawashima S, Tomo T, Mutsaers HA, Jansen J, Van Den Broek PH, Verweij VG, Van Den Heuvel LP, Hoenderop JG, Masereeuw R, Clari R, Mongilardi E, Vigotti FN, Scognamiglio S, Consiglio V, Nazha M, Avagnina P, Piccoli G, Costelloe SJ, Freeman J, Keane DF, Lindley EJ, Thompson D, Kang GW, Lee IH, Ahn KS. DIALYSIS. PROTEIN-ENERGY WASTING, INFLAMMATION AND OXIDATIVE STRESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu159] [Citation(s) in RCA: 3] [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] [Indexed: 11/13/2022] Open
|
28
|
Rothuizen TC, Ocak G, Verschuren JJ, Dekker FW, Rabelink TJ, Jukema JW, Rotmans JI, Silva V, Raimann JG, Grassmann A, Marcelli D, Usvyat L, Canaud B, Kotanko P, Pecoits-Filho R, Consortium M, Strippoli GF, Sue YM, Tang CH, Chen TH, Hong CY, Ochi A, Ishimura E, Masuda M, Tsujimoto Y, Okuno S, Tabata T, Nishizawa Y, Inaba M, Moon Ki H, Do Hyoung K, Min Jee H, Hyun K, Wang Soo L, Su-Hyun K, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Gelev S, Amitov V, Petronievic Z, Sikole A, Kee YK, Kim YL, Han JH, Oh HJ, Park JT, Han SH, Yoo TH, Kang SW, Okute Y, Shoji T, Sonoda M, Kuwamura Y, Tsujimoto Y, Tabata T, Shioi A, Tahara H, Emoto M, Inaba M, El Amrani M, Asserraji M, Benyahia M, Galloway PA, Yiu V, Hiemstra TF, Nilssen C, Zannad F, Jardine A, Schmieder R, Fellstrom B, Holdaas H, Mjoen G, Eftimovska - Otovic N, Babalj - Banskolieva E, Bogdanoska - Kostadinoska S, Grozdanovski R, Silva BC, Freitas GR, Silva VB, Abensur H, Luders C, Pereira BJ, Castro MC, Oliveira RB, Moyses RM, Elias RM, Perez De Jose A, Abad S, Vega A, Reque J, Quiroga B, Lopez-Gomez JM, Sasaki K, Yamguchi K, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Kidir V, Ersoy I, Altuntas A, Inal S, Do an A, Sezer MT, Azar H, Chacra D, Dabar G, Chelala D, Zhao L, Huang S, Liang T, Tang H, Turkmen K, Demirtas L, Akbas EM, Buyuklu M, Bakirci E, Kocyigit I, Ozcelik O, Guney I, Mumajesi S, Velaj A, Idrizi A, Pasko N, Cadri V, Barbullushi M, Bolleku E, Strakosh A, Cenaj A, Kacori V, Zekollari E, Rista E, Dusha D, Belba A, Thereska N, Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Naess H, Fellstrom B, Jardine AG, Schmieder RE, Zannad F, Holdaas H, Mjoen G, Sasaki K, Yamguchi S, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Bilevich O, Bunova S, Semchenko S, Schwermer K, Hoppe K, Klysz P, Baum E, Sikorska D, Radziszewska D, Sawatiuk P, Olejniczak P, Pawlaczyk K, Lindholm B, Oko A, El Amrani M, Asserraji M, Rbaibi A, El Kharass A, Benyahia M, Rroji ( Molla) M, Seferi S, Cafka M, Spahia N, Likaj E, Thereska N, Barbullushi M, Pelletier CC, Jolivot A, Kalbacher E, Panaye M, Bureau Du Colombier P, Juillard L, Burmeister JE, Mosmann CB, Bastos JP, Burmeister BO, Munaro G, Pereira JD, Youssef DW, Rosito GA. DIALYSIS CARDIOVASCULAR COMPLICATIONS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu175] [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] [Indexed: 11/13/2022] Open
|
29
|
Vlahu CA, De Graaff M, Struijk DG, Krediet RT, Shin HS, Ryu ES, Choi HS, Ryu DR, Choi KB, Kang DH, Sanchez-Alvarez E, Rodriguez-Suarez C, Galvan-.Hernandez JA, Kim YL, Kee YK, Lee MJ, Oh HJ, Park JT, Han SH, Yoo TH, Kang SW, Zhu F, Abbas SR, Bologa R, Lanto B, Kotanko P, Parikova A, Smit W, Struijk DG, Krediet RT, Rroji ( Molla) M, Seferi S, Cafka M, Thereska N, Huang CC, Wang IK, Shiao YT, Teixeira L, Sousa I, Rodrigues A, Mendonca D, Ueda A, Iwase M, Usui T, Hirayama A, Nagai K, Saito C, Yamagata K, La Milia V, Pontoriero G, Locatelli F, Kim SM, Kim TY, Lee JE, Teta D, Guillodo MP, Kolko-Labadens A, Lasseur C, Levannier M, Panaye M, Fouque D, HAMADA C, Hara K, Kang SH, Cho KH, Park JW, Yoon KW, Do JY, Dogan I, Biro Dr B, Zakar Dr G, Foldine Z, Staudt S, Martins AR, Vizinho R, Branco PQ, Gaspar MA, Barata JD, Sikorska D, Klysz P, Posnik B, Baum E, Hoppe K, Schwermer K, Wanic-Kossowska M, Frankiewicz D, Pawlaczyk K, Lindholm B, Oko A, Busuioc M, Trolliet P, Guerraoui A, Caillette-Beaudoin A, Hallonet P, Yang JO, Gursu M, Topcuoglu D, Koc LK, Yucel L, Sumnu A, Cebeci E, Doner B, Ozkan O, Behlul A, Koc L, Ozturk S, Kazancioglu R, Casas Parra AII, Gonzalez MTT, Sandoval DA, Carlota GC, Grinyo JMM, Tseng CH, Chao CT, Yen CJ, Chiang CK, Hung KY, Huang JW, Al Wakeel JS, Al Ghonaim M, Al Suwaida A, Al Harbi A, Makoshi Z, Abdullah S, Matsushita Y, Basic-Jukic N, Coen-Herak D, Martinovic Z, Radi -Antoli M, Kes P, Wu TJ, Chen JS, Lin SH, Shiang JC, Wu CC, Munteanu D, Gemene M, Mircescu G, Opatrna S, Popperlova A, Tesar V, Rychlik I, Viklicky O, Jin K, Park BS, Jeong HJ, Kim YW, Hogas S, Voroneanu L, Onofriescu M, Nistor I, Apetrii M, Siriopol D, Cujba M, Hogas M, Covic A. PERITONEAL DIALYSIS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu174] [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] [Indexed: 11/12/2022] Open
|
30
|
Pawlik M, Mostowska A, Lianeri M, Oko A, Jagodziński PP. Association of aldosterone synthase (CYP11B2) gene -344T/C polymorphism with the risk of primary chronic glomerulonephritis in the Polish population. J Renin Angiotensin Aldosterone Syst 2013; 15:553-8. [PMID: 23681285 DOI: 10.1177/1470320313489588] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION We evaluate whether angiotensinogen AGT M235T (rs699), angiotensin-converting enzyme ACE (I/D) (rs4646994) and aldosterone synthase CYP11B2 -344C/T (rs1799998) polymorphisms can be genetic risk factors of chronic glomerulonephritis (GN) in the Polish population. MATERIALS AND METHODS The study was conducted in 140 patients with primary chronic GN: mesangial proliferative GN (MesPGN) (n = 49), IgA nephropathy (IgAN) (n = 31), membranous nephropathy (MN) (n = 27), focal segmental glomerulosclerosis (FSGS) (n = 25), membranoproliferative GN (MPGN) (n = 4), and minimal change disease (MCD) (n = 4), and controls (n = 187). Genotypes were determined by HRM curve analysis for AGT M235T, by PCR and agarose gel separation for ACE (I/D), and by PCR-RFLP for CYP11B2 -344C/T. RESULTS We found a significant association of the CYP11B2 -344C/T polymorphism in the recessive model with all subtypes of GN (OR = 1.925 (95% CI = 1.152-3.219, p = 0.0118, p(corr) = 0.0354)). We also observed that the CYP11B2 -344C/T polymorphism in the recessive model may also be an independent significant risk factor of IgAN (OR = 2.743 (95% CI = 1.219-6.172, p = 0.0122, p(corr) = 0.0366)), FSGS (OR = 2.895 (95% CI = 1.200-6.985, p = 0.0145, p(corr) = 0.0435)), and all proliferative GNs (MesPGN, IgAN, MPGN) (OR = 2.171 (95% CI = 1.211-3.894, p = 0.0084, p(corr) = 0.0252)). CONCLUSION Our results suggest that the CYP11B2 -344C/T polymorphism might be an independent risk factor of IgAN, FSGS and all proliferative chronic GNs.
Collapse
Affiliation(s)
| | - Adrianna Mostowska
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, Poland
| | - Margarita Lianeri
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, Poland
| | - Andrzej Oko
- Department of Nephrology, Transplantology and Internal Medicine
| | - Paweł P Jagodziński
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, Poland
| |
Collapse
|
31
|
Yayar O, Buyukbakkal M, Eser B, Yildirim T, Ercan Z, Erdogan B, Kali A, Merhametsiz O, Haspulat A, Akdag I, Ayli MD, Quach T, Tregaskis P, Menahem S, Koukounaras J, Mott N, Walker R, Zeiler M, Santarelli S, Degano G, Monteburini T, Agostinelli RM, Marinelli R, Ceraudo E, Grzelak T, Kramkowska M, Walczak M, Czyzewska K, Guney I, Turkmen K, Yazici R, Arslan S, Altintepe L, Yeksan M, Vaduva C, Popa S, Mota M, Mota E, Wan Md Adnan WAH, Zaharan NL, Moreiras-Plaza M, Blanco-Garcia R, Beato-Coo L, Cossio-Aranibar C, Martin-Baez I, Santos MT, Fonseca I, Santos O, Aguiar P, Rocha MJ, Carvalho MJ, Cabrita A, Rodrigues A, Guo Z, Lai X, Theodoridis M, Panagoutsos S, Thodis E, Karanikas M, Mitrakas A, Kriki P, Kantartzi K, Passadakis P, Vargemezis V, Vakilzadeh N, Pruijm M, Burnier M, Halabi G, Azevedo P, Santos O, Carvalho M, Cabrita A, Rodrigues A, Laplante S, Rutherford P, Shutov E, Isachkina A, Gorelova E, Troya MI, Teixido J, Pedreira G, Del Rio M, Romero R, Bonet J, Zhang X, Ma J, Kim Y, Kim JK, Song YR, Kim SG, Kim HJ, Eloot S, Vanholder R, Van Biesen W, Heaf J, Pedersen C, Elgborn A, Arabaci T, Emrem G, Keles M, Kizildag A, Martino F, Amici G, Rodighiero MP, Crepaldi C, Ronco C, Tanaka H, Tsuneyoshi S, Yamasaki K, Daijo Y, Tatsumoto N, Al-Hilali N, Hussain N, Fathy V, Negm H, Alhilali M, Grzegorzewska A, Cieszynski K, Kaczmarek A, Sowinska A, Soleymanian T, Najafi I, Ganji MR, Ahmadi F, Saddadi F, Hakemi M, Amini M, Tong LNMN, Yongcheng HNMN, Qijun WNMN, Shaodong LNMN, Velioglu A, Albaz M, Arikan H, Tuglular S, Ozener C, Bakirdogen S, Eren N, Mehtap O, Bek SG, Cekmen MB, Yilmaz A, Cabana Carcasi MLL, Fernandez Ferreiro A, Fidalgo Diaz M, Becerra Mosquera V, Alonso Valente R, Buttigieg J, Borg Cauchi A, Rogers M, Buhagiar L, Farrugia Agius J, Vella MP, Farrugia E, Han JH, Kim HR, Ko KI, Kim CH, Koo HM, Doh FM, Lee MJ, Oh HJ, Han SH, Yoo TH, Kang SW, Choi KH, Sikorska D, Frankiewicz D, Klysz P, Schwermer K, Hoppe K, Nealis J, Kaczmarek J, Baum E, Wanic-Kossowska M, Pawlaczyk K, Oko A, Hiss M, Gerstein F, Haller H, Gueler F, Fukasawa M, Manabe T, Wan Q, He Y, Zhu D, Li J, Xu H, Yayar O, Eser B, Buyukbakkal M, Ercan Z, Erdogan B, Merhametsiz O, Yildirim T, Kali A, Haspulat A, Oztemel A, Akdag I, Ayli MD, Pilcevic D, Kovacevic Z, Maksic D, Paunic Z, Tadic-Pilcevic J, Mijuskovic M, Petrovic M, Obrencevic K, Rabrenovic V, Ignjatovic L, Terzic B, Jovanovic D, Chang CH, Chang YS, Busuioc M, Guerraoui A, Caillette-Beaudoin A, Bahte SK, Hiss M, Kielstein JT, Polinder-Bos H, Emmelot-Vonk M, Gaillard C. Peritoneal dialysis II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft145] [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] [Indexed: 11/15/2022] Open
|
32
|
Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Ulu SM, Yilmaz F, Ahsen A, Akci A, Yuksel S, Mihaescu A, Olariu N, Avram C, Schiller O, Schiller A, Xiao DM, Niu JY, Gu Y, Drechsler C, van den Broek H, Vervloet M, Hoekstra T, Dekker F, Ketteler M, Brandenburg V, Turkvatan A, Kirkpantur A, Mandiroglu S, Afsar B, Seloglu B, Alkis M, Erkula S, GURBUZ H, Serin M, CALIK Y, Mandiroglu F, Balci M, Choi BS, Choi SR, Park HS, Hong YA, Chung BH, Kim YS, Yang CW, Kim YS, Park CW, Jung JY, Sung JY, Kim AJ, Kim HS, Lee C, Ro H, Chang JH, Lee HH, Chung W, Sezer S, Bal Z, Tutal E, Bal U, Erkmen Uyar M, Ozdemir Acar N, Karakas Y, Sahin G, Urfali F, Bal C, Akcar Degirmenci N, Sirmagul B, Janda K, Krzanowski M, Dumnicka P, Kusnierz-Cabala B, Sulowicz W, Balci M, Kirkpantur A, Mandiroglu S, Afsar B, Seloglu B, Alkis M, Serin M, CALIK Y, Erkula S, GURBUZ H, Mandiroglu F, Turkvatan A, Valtuille RA, Gonzalez MS, Casos ME, Yoshida T, Yamashita M, Hayashi M, Raikou VD, Tentolouris N, Makropoulos I, Kaisidis P, Boletis JN, Abdalla AA, Roche D, Forbes JF, Hannigan A, Hegarty A, Cronin CJ, Casserly LF, Stack AG, Guinsburg A, Raimann JG, Usvyat L, Kooman J, Marelli C, Etter M, Marcelli D, Levin NW, Kotanko P, Kim CS, Choi JS, Bae EH, Ma SK, Kim SW, Ryu JH, Lee S, Ryu DR, Kim SJ, Kang DH, Choi KB, Shoji T, Tsuchikura S, Shimomura N, Kakiya R, Tsujimoto Y, Tabata T, Emoto M, Nishizawa Y, Inaba M, Selim G, Stojceva-Taneva O, Tozija L, Georgievska-Ismail L, Gelev S, Dzekova-Vidimliski P, Trajceska L, Petronievic Z, Sikole A, Wu CJ, Pan CF, Chen HH, Lin CJ, Kim Y, Kim JK, Song YR, Kim SG, Kim HJ, Kuwahara M, Bannai K, Kikuchi K, Yamato H, Segawa H, Miyamoto KI, De Mauri A, Chiarinotti D, Ruva CE, David P, Capurro F, De Leo M, Han JH, Kim HR, Ko KI, Kim CH, Koo HM, Doh FM, Lee MJ, Oh HJ, Han SH, Yoo TH, Choi KH, Kang SW, Shibata K, Sohara H, Kuji T, Kawata S, Kogudhi N, Nishihara M, Satta H, Jung JY, Ro H, Lee C, Kim SM, Kim AJ, Kim HS, Chang JH, Lee HH, Chung W, Kramann R, Erpenbeck J, Becker M, Brandenburg V, Kruger T, Marx N, Floege J, Schlieper G, Power A, Fogarty D, Wheeler D, Kerschbaum J, Schwarz CP, Mayer G, Prajitno CW, Matsuzawa R, Matsunaga A, Ishii A, Abe Y, Yoneki K, Harada M, Takagi Y, Yoshida A, Takahira N, Sirch J, Pfeiffer S, Fischlein T, El-Nahid MS, Issac MS, Bal Z, Tutal E, Bal U, Erkmen Uyar M, Guliyev O, Sayin B, Sezer S, Bajari T, Hermann M, Gmeiner B, Regele H, Aumayr K, Gensberger ET, Scharrer S, Sengoge G, Novo A, Tania S, Anes E, Domingues A, Mendes E, Batista G, Viana J, Rroji M, Cafka M, Seferi S, Seiti J, Petrela E, Likaj E, Thereska N, Selim G, Stojceva-Taneva O, Tozija L, Georgievska-Ismail L, Gelev S, Dzekova-Vidimliski P, Trajceska L, Petronievic Z, Sikole A, Turkmen K, Ozcicek F, Erdur F, Turk S, Yeksan M, Tonbul H, Castellano S, Palomares I, Merello JI, Mandiroglu S, Torkvatan A, Balci M, Seloglu B, Alkis M, Serin M, Erkula S, Gurbuz H, Calik Y, Afsar B, Mandiroglu F, Kirkpantur A, Ulusal Okyay G, Okyay K, Polattas Solak E, Sahinaslan A, Pasaoglu O, Ayerden Ebinc F, Boztepe Derici U, Sindel S, Arinsoy T, Lee YK, Son SY, Choi MJ, Lee SM, Yoon JW, Koo JR, Noh JW, Vaziri ND, Matias P, Amaral T, Ferreira AC, Mendes M, Azevedo A, Jorge C, Aires I, Gil C, Ferreira A, Carretero Dios D, Merello Godino JI, Moran Risco JE, Castellano Gasch S, Schwermer K, Hoppe K, Klysz P, Radziszewska D, Sikorska D, Nealis J, Polcyn-Adamczak M, Zaremba-Drobnik D, Pawlaczyk K, Oko A, Mentese A, Yavuz A, Karahan C, Sumer A, Ozkan G, Ulusoy S, Yildiz G, Duman A, Aydin H, Yilmaz A, Hur E, Magden K, Cetin G, Candan F, Franczyk-Skora B, Gluba A, Kowalczyk M, Banach M, Rysz J, Novo A, Domingues A, Preto L, Sousa T, Mendes E, Batista G, Vaz J, Oue M, Kuragano T, Hamahata S, Fukao W, Toyoda K, Nakanishi T, Otsubo S, Tsuchiya K, Akiba T, Nitta K, Afsar B, Saglam M, Yuceturk C, Agca E, Tosic J, Djuric Z, Popovic J, Buzadzic I, Djuric P, Jankovic A, Dimkovic N, Simone S, Dell'Oglio MP, Ciccone M, Castellano G, Corciulo R, Balestra C, Giangrande M, Gigante M, Grandaliano G, Gesualdo L, Pertosa GP, Mohamed EA, Marouane B, Mohamed Reda EF, Aziz R, Hicham B, Youssef B, Abdennasser EK, Salaheddine T, Mohammed A, Hwang JC, Jiang MY, Lu YH, Wang CT, Grzegorzewska A, Cieszynski K, Niepolski L, Sowinska A, Abdallah E, Al-Helal B, Waked E, Abdel-Khalik A, Nabil M, El-Shanawany F, Tekce H, Kursat S, Bahadir Colak H, Aktas G, Ozcicek A, Turkmen K, Ozcicek F, Akbas E, Demirtas L, Ozbicer A, Cetinkay R, Capoglu I, Valocikova I, Valocik G, Vachalcova M, Kolesarova E, Nowak A, Friedrich B, Artunc F, Serra A, Breidthardt T, Twerenbold R, Peter M, Potocki M, Muller C. Cardiovascular complications in CKD 5D. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft147] [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] [Indexed: 11/13/2022] Open
|
33
|
Sanandaji N, Oko A, Haviland D, Tholén E, Hedenqvist M, Gedde U. Inkjet printing as a possible route to study confined crystal structures. Eur Polym J 2013. [DOI: 10.1016/j.eurpolymj.2012.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
34
|
Inazu T, Kawahara T, Endou H, Anzai N, Sebesta I, Stiburkova B, Ichida K, Hosoyamada M, Testa A, Testa A, Leonardis D, Catalano F, Pisano A, Mafrica A, Spoto B, Sanguedolce MC, Parlongo RM, Tripepi G, Postorino M, Enia G, Zoccali C, Mallamaci F, Working Group* M, Luque de Pablos A, Garcia-Nieto V, Lopez-Menchero JC, Ramos-Trujillo E, Gonzalez-Acosta H, Claverie-Martin F, Arsali M, Demosthenous P, Papazachariou L, Athanasiou Y, Voskarides K, Deltas C, Pierides A, Lee S, Jeong KH, Ihm C, Lee TW, Lee SH, Moon JY, Wi JG, Lee HJ, Kim EY, Rogacev K, Friedrich A, Hummel B, Berg J, Zawada A, Fliser D, Geisel J, Heine GH, Brabcova I, Brabcova I, Dusilova-Sulkova S, Dusilova-Sulkova S, Krejcik Z, Stranecky V, Lipar K, Marada T, Stepankova J, Viklicky O, Buraczynska M, Zukowski P, Zaluska W, Kuczmaszewska A, Ksiazek A, Gaggl M, Weidner S, Hofer M, Kleinert J, Fauler G, Wallner M, Kotanko P, Sunder-Plassmann G, Paschke E, Heguilen R, Heguilen R, Albarracin L, Politei J, Liste AA, Bernasconi A, Kusano E, Russo R, Pisani A, Messalli G, Imbriaco M, Prikhodina L, Ryzhkova O, Polyakov V, Lipkowska K, Ostalska-Nowicka D, Smiech M, Jaroniec M, Zaorska K, Szaflarski W, Nowicki M, Zachwieja J, Spoto B, Spoto B, Testa A, Sanguedolce MC, D'arrigo G, Parlongo RM, Pisano A, Tripepi G, Zoccali C, Mallamaci F, Moskowitz J, Piret S, Tashman A, Velez E, Lhotta K, Thakker R, Kotanko P, Cox J, Kingswood J, Mbundi J, Attard G, Patel U, Saggar A, Elmslie F, Doyle T, Jansen A, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin M, Korf B, Flamini R, Kohrman M, Sparagana S, Wu J, Ford J, Shah G, Franz D, Zonnenberg B, Cheung W, Urva S, Wang J, Frost M, Kingswood C, Budde K, Kofman T, Narjoz C, Raimbourg Q, Roland M, Loriot MA, Karras A, Hill GS, Jacquot C, Nochy D, Thervet E, Jagodzinski P, Mostowska M, Oko A, Nicolaou N, Kevelam S, Lilien M, Oosterveld M, Goldschmeding R, Van Eerde A, Pfundt R, Sonnenberg A, Ter Hal P, Knoers N, Renkema K, Storm T, Nielsen R, Christensen E, Frykholm C, Tranebjaerg L, Birn H, Verroust P, Neveus T, Sundelin B, Hertz JM, Holmstrom G, Ericson K, Fabris A, Cremasco D, Zambon A, Muraro E, Alessi M, D'angelo A, Anglani F, Del Prete D, Alkmim Teixeira A, Quinto BM, Jose Rodrigues C, Beltrame Ribeiro A, Batista M, Kerti A, Kerti A, Csohany R, Szabo A, Arkossy O, Sallai P, Moriniere V, Vega-Warner V, Lakatos O, Szabo T, Reusz G, Tory K, Addis M, Anglani F, Tosetto E, Meloni C, Ceol M, Cristofaro R, Melis MA, Vercelloni P, D'angelo A, Marra G, Kaniuka S, Nagel M, Wolyniec W, Obolonczyk L, Swiatkowska-Stodulska R, Sworczak K, Rutkowski B, Chen C, Jiang L, Chen L, Fang L, Mozes M. M, Boosi M, Rosivall L, Kokeny G, Diana R, Gross O, Johanna T, Rainer G, Ayse C, Henrik H, Gerhard-Anton M, Nabil M, Intissar E, Belge H, Belge H, Bloch J, Dahan K, Pirson Y, Vanhille P, Demoulin N. Genetic diseases. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
35
|
|
36
|
Idasiak-Piechocka I, Oko A, Pawliczak E, Kaczmarek E, Czekalski S. Urinary excretion of soluble tumour necrosis factor receptor 1 as a marker of increased risk of progressive kidney function deterioration in patients with primary chronic glomerulonephritis. Nephrol Dial Transplant 2010; 25:3948-56. [PMID: 20525973 DOI: 10.1093/ndt/gfq310] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The effects of tumor necrosis factor α (TNF α), a potent proinflammatory cytokine, in the kidneys are mediated by two membrane receptors (TNFR), TNFR1 and TNFR2. The expression of both TNF and TNFRs increases in several kidney diseases and is associated with the shedding of the receptors out of the cell membranes. In an experimental model of glomerulonephritis (GN), elevated concentrations of TNFRs in serum and TNFRs excretion in urine were demonstrated. The aim of this study was evaluation of urinary excretion of TNFR1 and its relationship with the clinical markers of kidney injury in patients with GN. The value of basal urinary TNFR1 excretion as a prognostic indicator of the progression of kidney function impairment was also assessed. MATERIAL AND METHODS Fifty-five patients with newly diagnosed, biopsy-proven primary GN were included in the study. In all patients, and in 20 healthy subjects, UTNFR1 was measured using an ELISA . In the patients, risk factors of the progression of impairment of kidney function (reduced eCcr, nephrotic syndrome, hypertension and intensity of morphological lesions in the kidneys) were evaluated. The appropriate treatment was then introduced and the patients were in follow-up for 4 years. The progression of kidney function impairment was defined as a reduction of eCcr > 5 mL/min/1.73 m2 /year during follow-up. The association of basal TNFR1 excretion with the progression was evaluated. RESULTS Urinary excretion of TNFR1 in the patients with GN (4039.2 ± 3801.5 pg/mgCr) was greater than in the healthy subjects (1358.9 ± 927.8 pg/mgCr, P < 0,00002). A significant negative correlation between TNFR1 excretion and eCcr (Sr=0.464, P < 0.01) and a positive correlation between TNFR1 excretion and proteinuria (Sr = 0,463, P < 0.01) were found. In 13 patients, a marked reduction of eCcr was observed during follow-up. Logistic regression analysis revealed that TNFR1 excretion > 3863.3 pg/mgCr predicts progression of renal function impairment along with advanced interstitial fibrosis in the kidney biopsy specimens at presentation. CONCLUSION Markedly elevated urinary TNFR1 excretion may be considered as a good marker of an activated TNFα-pathway in patients with newly diagnosed GN and as a potentially modifiable risk factor of progressive kidney function impairment.
Collapse
Affiliation(s)
- Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.
| | | | | | | | | |
Collapse
|
37
|
Idasiak-Piechocka I, Oko A, Pawliczak E, Kaczmarek E, Czekalski S. Elevated Urinary Fibronectin Excretion Predicts Poor Outcome in Patients with Primary Chronic Glomerulonephritis. ACTA ACUST UNITED AC 2010; 116:c47-52. [DOI: 10.1159/000314550] [Citation(s) in RCA: 4] [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: 09/06/2009] [Accepted: 11/20/2009] [Indexed: 11/19/2022]
|
38
|
Ondzotto G, Fouemina T, Oko A, Akolbout D, Itiere F. [Childhood laterocervical abscess fistulized in the pharynx: a case study]. Arch Pediatr 2009; 16:1562-4. [PMID: 19880296 DOI: 10.1016/j.arcped.2009.09.013] [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: 11/28/2008] [Revised: 02/20/2009] [Accepted: 09/07/2009] [Indexed: 10/20/2022]
Abstract
Cervical adenophlegmon is frequently encountered in children. We report on a case of an exceptional direct communication between a retropharyngeal abscess and a cervical adenophlegmon, observed in a 25-month-old child. Treatment comprised double antibiotic therapy and retropharyngeal drainage, which led to the subsidence of the laterocervical abscess. The progression was uncomplicated.
Collapse
Affiliation(s)
- G Ondzotto
- Service ORL et CCF, CHU de Brazzaville, BP 13356, Brazzaville, Congo.
| | | | | | | | | |
Collapse
|
39
|
Idasiak-Piechocka I, Oko A, Łochyńska-Bielecka K, Skrobańska B. Efficacy and safety of low-dose chlorambucil in nephrotic patients with idiopathic membranous nephropathy. Kidney Blood Press Res 2009; 32:263-7. [PMID: 19776643 DOI: 10.1159/000239539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 08/03/2009] [Indexed: 11/19/2022] Open
Abstract
AIM This observational study aimed to evaluate the results of treatment with low-dose chlorambucil in combination with corticosteroids in patients with idiopathic membranous nephropathy (iMGN) and nephrotic syndrome. METHODS Thirty-two patients with nephrotic syndrome and biopsy-proven iMGN were included in the study. At presentation, 9 patients were found to be in stage 1, 13 patients in stage 2 and 10 patients in stage 3 chronic kidney disease. In all patients, i.v. methylprednisolone pulses (500 mg/day for 3 days) were administered, followed by oral prednisone at an initial dose of 1 mg/kg per day, tapered gradually after 8 weeks to the maintenance dose of 5 mg/day after 6 months, and chlorambucil 2 mg twice daily for 6 months. RESULTS Complete remission of nephrotic syndrome was obtained in 14 patients (47.3%) and partial remission in 16 patients (50%). Two patients relapsed after 1 year of treatment. We did not record any severe side effects in treated patients, except glucose intolerance in 4 subjects on high corticosteroid doses. CONCLUSION Immunosuppressive treatment with corticosteroids and low-dose chlorambucil seems to be effective and well tolerated in nephrotic patients with iMGN.
Collapse
Affiliation(s)
- Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, University of Medical Sciences, Poznań, Poland.
| | | | | | | |
Collapse
|
40
|
Oko A, Wyrwicz LS, Glyda M, Idasiak-Piechocka I, Bińczak-Kuleta A, Kaczmarczyk M, Drozd A, Ciechanowicz A, Czekalski S. CD52 gene polymorphism and its potential effect on the response to alemtuzumab in renal transplant recipients. Ann Acad Med Stetin 2009; 55:22-26. [PMID: 20349607] [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: 05/29/2023]
Abstract
CD52 is a small glycopeptide leukocyte antigen present on selected subpopulations of human cells. From the clinical point of view this protein is an important target for therapeutic interventions aimed at leukocyte depletion in hematological malignancies and post-transplant immunosuppression. Recently, two variants of CD52--rs1071849 (A119G; Asn40Ser) and rs17645 (A123G; I1e41Met)--were discovered. We now report on the distribution of these variants in kidney graft recipients and controls. Our bioinformatics findings suggest that CD52 polymorphism may affect the efficiency of GPI anchor formation and thus may indirectly alter the response to anti-CD52 agents.
Collapse
Affiliation(s)
- Andrzej Oko
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych, Uniwersytetu Medycznego im. Karola Marcinkowskiego ul. Przybyszewskiego 49, 60-355 Poznań
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Chrzanowska M, Kurzawski M, Droździk M, Mazik M, Oko A, Czekalski S. Thiopurine S-methyltransferase phenotype-genotype correlation in hemodialyzed patients. Pharmacol Rep 2006; 58:973-8. [PMID: 17220558] [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: 05/08/2006] [Revised: 10/18/2006] [Indexed: 05/13/2023]
Abstract
Thiopurine S-methyltransferase (TPMT) is a cytosolic enzyme, catalyzing S-methylation of thiopurine drugs. TPMT exhibits autosomal codominant polymorphism. Patients carrying a variant genotype have low TPMT activity, and produce elevated levels of 6-thioguanine nucleotides (6-TGN) in their red blood cells (RBC). 6-TGN accumulation may result in azathioprine (AZA)-induced bone marrow myelosuppression in the course of treatment with the drug in a standard dosage regimen in patients following renal transplantation. In the current study, TPMT activity (phenotype) and genotype were determined in dialyzed patients, qualified for renal transplantation. TPMT activity was measured in RBC after dialysis by HPLC method. Patients were genotyped for TPMT *2, *3A and *3C variant alleles using PCR-RFLP and allele-specific PCR methods. TPMT activity ranged between 12.2 and 45.5 nmol 6-mMP/g Hb/h (median value 30.6). A significant correlation between TPMTphenotype and genotype was noted: the heterozygous patients (11.5%) demonstrated significantly lower mean TPMT activity as compared to the wild homozygotes (17 +/- 3.6 vs. 32.4 +/- 4.8 nmol 6-mMP/g Hb/h, p < 0.0003). No overlap in TPMT activity values between the group of heterozygous (range 12.2-20.6) and wild-type homozygous patients (range 22.7-45.5) was noted. TPMT activity, established after hemodialysis and TPMT genotyping results seem to be convergent in dialyzed patients, so both methods can be used for the identification of patients with lower TPMT activity. Such tests could be helpful in AZA dose individualization, and thus in reducing the risk of myelosuppression during AZA therapy following renal transplantation.
Collapse
Affiliation(s)
- Maria Chrzanowska
- Department of Physical Pharmacy and Pharmacokinetics, University of Medical Sciences, Swiecickiego 6, PL 60-781 Poznań, Poland
| | | | | | | | | | | |
Collapse
|
42
|
Czekalski S, Oko A, Pawlaczyk K. [Inherited reduced number of nephrons versus primary arterial hypertension]. Pol Merkur Lekarski 2006; 21:120-2; discussion 123-4. [PMID: 17144093] [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: 05/12/2023]
Abstract
The reduced number of nephrons, which was determined during fetal development may play a role as an important factor influencing blood pressure level in adult life. The results of a study which confirmed the involvement of the reduced nephron number in the etiopathogenesis of primary arterial hypertension were published recently. It was demonstrated, that the number of nephrons in the kidneys of hypertensive persons (without kidney disease) was significantly lower than in matched normotensive persons. The mean glomerular volume in hypertensive persons was markedly greater than in normotensives. The inherited reduced nephron numbers may depend not only on environmental influences acting during fetal development (like malnutrition) but also on the genetic factors. The hypothesis was presented that adaptative hypertrophy of less numerous nephrons is associated with the trait of sodium sensitivity of blood pressure. The results of the described studies may be of significant importance for clarification of the pathogenesis of primary arterial hypertension.
Collapse
Affiliation(s)
- Stanisław Czekalski
- Akademia Medyczna w Poznaniu, Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych.
| | | | | |
Collapse
|
43
|
Wanic-Kossowska M, Kobelski M, Oko A, Czekałski S. Arterial Hypertension due to Perirenal and Subcapsular Hematoma Induced by Renal Percutaneous Biopsy. Int Urol Nephrol 2005; 37:141-3. [PMID: 16132777 DOI: 10.1007/s11255-004-2355-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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
In this study we report three patients, in whom arterial hypertension was induced by compression of the kidney parenchyma due to perirenal or subcapsular hematoma following percutaneous blind renal biopsy with use of Vim-Silverman type needle.
Collapse
Affiliation(s)
- Maria Wanic-Kossowska
- Department of Nephrology, Transplantology and Internal Diseases, University of Medical Sciences, Poznan, Poland.
| | | | | | | |
Collapse
|
44
|
Oko A, Pawlaczyk K, Czekalski S. [Uraemic toxins and cardiovascular diseases]. Przegl Lek 2005; 62 Suppl 2:7-10. [PMID: 16623109] [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: 05/08/2023]
Abstract
The uremic syndrome is the result of the retention of solutes, which under normal conditions are excreted by the healthy kidneys into the urine. The most practical classification of uremic toxins is based on their physicochemical characteristics that influence their dialytic removal, in (a) small water soluble compounds, (b) the larger "middle molecules," and (c) the protein bound compounds. Most small water soluble compounds are not very toxic and the toxic ones often show a kinetic behavior that is different from that of urea. The incidence of vascular disease and the morbidity and mortality related to it are extremely high in the population of uremic patients. A large proportion of uremic patients suffer from inflammation. Most often, the uremic solutes that play a role in inflammation and cardio-vascular complications are middle molecules and/or protein bound. Protein bound toxins inhibit several biochemical functions. High concentrations of cytokines with an immune activating potential are present in the plasma of uremic patients.
Collapse
Affiliation(s)
- Andrzej Oko
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych Akademii Medycznej w Poznaniu.
| | | | | |
Collapse
|
45
|
Kurzawska-Firlej D, Suchanek-Krawiec A, Piernik T, Oko A. [Outcome of immunosuppressive treatment of a patient with renal failure due to retroperitoneal fibrosis]. Pol Arch Med Wewn 2004; 112:845-8. [PMID: 15526846] [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: 05/01/2023]
Abstract
Retroperitoneal fibrosis (RPF) is an uncommon disease of unclear aetiology. The review of the literature over the past 20 years revealed 160 published cases. Till now, no accepted diagnostic or therapeutic strategy exist. Most of patients diseases progress to end-stage renal failure without pharmacological treatment. In the paper we report a case of a 58-year old man admitted to the department of urology due to body mass loss, lower-back pain, vomiting, development of oliguria and anuria and intermittent claudication. On physical examination arterial hypertension (180/100 mm Hg), peripheral oedema, tenderness of the enlarged kidneys and lower limbs ischemia were found. Creatinine serum level (Pcr) was 232 micromol/l (2.69 mg/dl). On ultrasonography, symmetrical hydronephrosis and the existence of a hypoechogenic mass along of the aorta and below of renal arteries was found. The diagnosis of RPF was confirmed with MRI. Ureteral catheters were inserted with subsequent decompression of both kidneys and the patient was discharged from the hospital. Seven months later he still presented symptoms of lower limbs ischemia, arterial pressure was high and Per decreased to 138 micromol/l (1.55 mg/dl). The patient was admitted to the department of internal diseases. The treatment with prednisone at the dose of 40 mg/d during 6 weeks was introduced, and the dose was decreased gradually to 10 mg/d within 6 months. Simultaneously, the patient received intravenous therapy with cyclophosphamide 600 mg/infusion once monthly during 6 months. Two month after starting immunosuppressive treatment the intermittent claudication disappeared and after six months MRI examination demonstrated the regression of RPF. The ureteral catheters were removed. After 18 months of follow up, no recurrence of RPF is observed and the kidney function is normal.
Collapse
|
46
|
Czekalski S, Oko A, Pawlaczyk K, Idasiak-Piechocka I. [Chronic renal insufficiency (part I)--diagnosis]. Pol Arch Med Wewn 2004; 111:91-6. [PMID: 15088428] [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: 04/29/2023]
Affiliation(s)
- Stanisław Czekalski
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM w Poznaniu
| | | | | | | |
Collapse
|
47
|
Czekalski S, Oko A, Pawlaczyk K, Idasiak-Piechocka I. [Chronic renal insufficiency (part II)--current methods of slowing down disease progression]. Pol Arch Med Wewn 2004; 111:97-103. [PMID: 15088429] [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: 04/29/2023]
Affiliation(s)
- Stanisław Czekalski
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM w Poznaniu
| | | | | | | |
Collapse
|
48
|
Czekalski S, Oko A, Pawlaczyk K. [Advances in the diagnosis and treatment of diabetic nephropathy]. Pol Arch Med Wewn 2003; 110:1133-7. [PMID: 14699671] [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: 04/27/2023]
Affiliation(s)
- Stanisław Czekalski
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM w Poznaniu
| | | | | |
Collapse
|
49
|
Pawlaczyk K, Oko A, Lindholm B, Czekalski S. [Malnutrition -- inflammation -- atherosclerosis (MIA syndrome) in patients with renal failure]. Pol Merkur Lekarski 2003; 15:334-41; discussion 341-3. [PMID: 14974361] [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
Cardiovascular disease (CVD) is the major cause of death in end-stage renal disease (ESRD). Malnutrition may worsen patient outcome by aggravating existing inflammation and heart failure, accelerating atherosclerosis and increasing susceptibility to infection. Available data demonstrate that chronic inflammation, a non-traditional risk factor which is observed commonly in uremic patients, play a key role in the genesis of both malnutrition and CVD in ESRD. Moreover, inflammation is associated with congestive heart failure. Pro-inflammatory cytokines are pivotal to the inflammation. There is evidence that a chronic inflammation with activation of C-reactive protein, interleukin-6, tumour necrosis factor alpha and other cytokines is associated with increased oxidative stress and endothelial dysfunction in ESRD patients. Strong relations between malnutrition, inflammation and atherosclerosis in ESRD patients suggest the presence of a MIA (malnutrition, inflammation, and atherosclerosis) syndrome, which is associated with high mortality rate. Thus, it could be speculated that suppression of the vicious cycle of malnutrition, inflammation and atherosclerosis (MIA) would improve survival in ESRD patients. Therefore, the early stage of chronic renal failure is the ideal time to start therapeutic interventions.
Collapse
Affiliation(s)
- Krzysztof Pawlaczyk
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM w Poznaniu
| | | | | | | |
Collapse
|
50
|
Oko A, Łochyńska K, Idasiak-Piechocka I, Czekalski S. [Arterial hypertension in glomerulonephritis]. Pol Merkur Lekarski 2003; 15:344-6. [PMID: 14974362] [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
Numerous factors causing the disturbances of pressure natriuresis mechanism may be involved in the development of arterial hypertension in kidney diseases. In particular patients with parenchymatous kidney disease, the relative effect of the impaired renal sodium excretion causing extracellular fluid volume expansion and the disequilibrium of vasoconstricting and vasorelaxating factors may differ, and in addition, these effects are influenced by the type of kidney disease, the degree of the kidney function impairment and sodium intake. In our studies on the hypertension in kidney disease we have choosen the evaluation of incidence of hypertension in the early stage of primary glomerulonephritis (GN) and the comparison of distribution of genotypes and alleles depending on insertion/deletion polymorphism of angiotensin converting enzyme (ACE) gene in patients with early stage of GN and healthy subjects. Arterial hypertension was diagnosed according to actual criteria in 46% out of 74 patients with early stage of GN. It was also found that hypertension was more common in patients with nephrotic syndrome (63%) than in patients with lower proteinuria (36% of patients). Among 50 patients with early stage of GN the distribution of genotypes and alleles depending on the polymorphism ACE gene was significantly different from 100 healthy controls. These results indicate that hypertension is often present in early stage of GN, particularly in patients with nephrotic syndrome and depends on the morphological type of glomerular disease. Further studies are needed for verification of the role of ACE gene polymorphism in the predisposition to development of GN and associated arterial hypertension.
Collapse
Affiliation(s)
- Andrzej Oko
- Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM w Poznaniu
| | | | | | | |
Collapse
|