BACKGROUND: The aim of our study was to evaluate the prognostic value of glomerular and tubular proteinuria and tubular enzymuria as early indicators of therapeutic response to induction therapy with i.v. pulse cyclophosphamide (CyC) and methylprednisolone (MP) in patients with antineutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis. METHODS AND FINDINGS: An observational single-center study was conducted in 30 patients with ANCA-associated glomerulonephritis. Patients were divided into subgroups with good or poor response to CyC therapy according to clinical and laboratory parameters. The diagnosis of ANCA-associated glomerulonephritis was based on the Chapel-Hill disease definitions. Good response to induction therapy was significantly associated with higher absolute values of urine N-acetyl-beta-D-glucosaminidase (NAG) to creatinine ratio (above 14.83 microcat/mol) and urine immunoglobulin G (IgG) to albumin ratio (above 0.09) at the time of diagnosis, while albuminuria or proteinuria did not have any early predictive value. The remission of renal disease was anticipated as early as 3 months after introduction of induction therapy in patients with reduction of urine NAG to creatinine ratio below the baseline value and in patients with at least 24% rise in eGFR. CONCLUSIONS: Urine IgG to albumin and urine NAG to creatinine ratio are better early predictors of treatment response in patients with ANCA-associated glomerulonephritis than proteinuria or albuminuria.
COBISS.SI-ID: 10328660
BACKGROUND AND AIMS: Exercise-induced iron deficiency is a common finding in endurance athletes. It has been suggested recently that hepcidin may be an important mediator in this process. OBJECTIVE: To determine hepcidin levels and markers of iron status during long-term exercise training in female runners with depleted and normal iron stores. METHODS: Fourteen runners were divided into two groups according to iron status. Blood samples were taken during a period of eight weeks at baseline, after training and after ten days' recovery phase. RESULTS: Of 14 runners, 7 were iron deficient at baseline and 10 after training. Hepcidin was lower at recovery compared with baseline (p(0.05). The mean cell haemoglobin content, haemoglobin content per reticulocyte and total iron binding capacity all decreased, whereas soluble transferrin receptor and hypochromic red cells increased after training and recovery (p(0.05 for all). CONCLUSION: The prevalence of depleted iron stores was 71% at the end of the training phase. Hepcidin and iron stores decreased during long-term running training and did not recover after ten days, regardless of baseline iron status.
COBISS.SI-ID: 4339889
Vascular access dysfunction is one of the main causes of morbidity and hospitalization in hemodialysis patients. This major clinical problem points out the need for prediction of hemodynamic changes induced by vascular access surgery. Here we reviewed the potential of a patient-specific computational vascular network model that includes vessel wall remodeling to predict blood flow change within 6 weeks after surgery for different arteriovenous fistula configurations. For model validation, we performed a multicenter, prospective clinical study to collect longitudinal data on arm vasculature before and after surgery. Sixty-three patients with newly created arteriovenous fistula were included in the validation data set and divided into four groups based onfistula configuration. Predicted brachial artery blood flow volumes 40 days after surgery had a significantly high correlation with measured values. Deviation of predicted from measured brachial artery blood flow averaged 3% with a root mean squared error of 19.5%, showing that the computational tool reliably predicted patient-specific blood flow increase resulting from vascular access surgery and subsequent vascular adaptation. This innovative approach may help the surgeon to plan the most appropriate fistula configuration to optimize access blood flow for hemodialysis, potentially reducing the incidence of vascular access dysfunctions and the need of patienthospitalization.
COBISS.SI-ID: 840620
The authors have presented comprehensive review on neglected issue of periodontal diseases and systemic inflammation in patients with kidney diseases.
COBISS.SI-ID: 720812
Purpose: To evaluate platelet-related hemostasis during hemodialysis performed with five different anticoagulation methods. Methods: 31 chronic hemodialysis patients, 71% men, aged 57.5 17.4 years, participated in our prospective study. Platelet function analyzer PFA -100 closure time (collagen/epinephrine -CEPI, collagen/adenosine diphosphate -CADP) was measured before and after hemodialysis, which was performed consecutively with five different anticoagulation methods: full-dose unfractionated heparin (UFH) and low-molecular weight heparin (LMWH): 31 patients, regional citrate anticoagulation (RCA): 28 patients, low-dose heparin: 25 patients and heparin-free dialysis: 9 patients. The degree of clotting in the dialysis system was graded on a 5 point scale. Results: CEPI (mean SD, reference range 80-160 sec) before vs. after hemodialysis: UFH: 171.7 62.1 vs. 170.8 67.3; LMWH: 167.4 56.9 vs. 159.4 56.4; low-dose heparin: 175.3 69.0 vs. 183.1 60.5; RCA: 172.6 57.4 vs. 161.6 57.0; heparin-free: 181.7 56.8 vs. 209.0 66.5; all differences nonsignificant. CADP (mean SD, reference range: 68-121 sec) before vs. after hemodialysis: UFH: 132.0 56.6 vs.146.3 68.4; LMWH: 132.4 57,0 vs. 123.1 50.8; low-dose heparin: 137.2 64.2 vs. 143.8 55.5; RCA: 140.7 48.2 vs. 132.9 48.1; heparin-free: 137.1 68.0 vs.139.2 29.7; all differences nonsignificant. Before hemodialysis procedure CEPI was increased in 51.2% and CADP in 48.4% of the patients. The best dialysis system clotting score was found with UFH, LMWH and RCA.Conclusions: Platelet dysfunction was demonstrated in approximately half of the chronic hemodialysis patients and was not improved after hemodialysis, regardless of the anticoagulation regimen used.
COBISS.SI-ID: 1056428