Pulmonary hypertension in CKD.

Pulmonary arterial hypertension is a rare disease often associated with positive antinuclear antibody and high mortality. Pulmonary hypertension, which rarely is severe, occurs frequently in patients with chronic kidney disease (CKD). The prevalence of pulmonary hypertension ranges from 9%-39% in individuals with stage 5 CKD, 18.

Exposure of pregnant rats to cigarette-smoke condensate causes glomerular abnormalities in offspring.

Background: Higher blood pressure and albuminuria are found in offspring of mothers who smoke during pregnancy. Whether or not kidney development is affected by maternal smoking is unknown.

Methods: Sprague-Dawley rats were randomly allocated to twice-daily cigarette smoke and nicotine condensate (1 mg/kg) or vehicle at day 10 of pregnancy until delivery.

The lipid story in chronic kidney disease: a long story with a happy end?

Cardiovascular (CV) morbidity and mortality increase with the severity of kidney disease, reaching 30 times higher mortality rates in dialysis patients compared with the general population. Although dyslipidemia is a well-established CV risk factor in the general population, the relationship between lipid disorders and CV risk in patients with chronic kidney disease (CKD) is less clear. Despite the clear evidence that statins reduce the risk of atherosclerotic events and death from cardiac causes in individuals without CKD, the use of statins in patients with kidney disease is significantly less frequent.

The use of echocardiography in observational clinical trials: the EURECA-m registry.

Echocardiography is the most widely used non-invasive imaging technique due to its availability, low cost, transportability and lack of ionizing radiations. However, it suffers from the main limitation of being highly subjective and operator-dependent. Furthermore, specifically, population or disease-dependent issues exist which should be addressed when this technique is applied in multicenter studies.

Epidemiology and optimal management in patients with renal artery stenosis.

Renovascular hypertension (hypertension induced by renal artery stenosis) is a form of secondary hypertension caused by overactivation of the renin-angiotensin system by the ischemic kidney. Prevalence of renal artery stenosis (RAS) is estimated to be between 2% (unselected hypertensives) and 40% (older patients with other atherosclerotic comorbidities). Most cases of RAS are caused by atherosclerosis; other causes, including fibromuscular dysplasia, vasculitis, thromboembolism and aneurysms, are less frequent.

Influence of conversion from cyclosporine A to tacrolimus on insulin sensitivity assessed by euglicaemic hyperinsulinemic clamp technique in patients after kidney transplantation.

Background: Recent studies have shown diabetogenic properties of calcineurin inhibitors, but the mechanism of more pronounced diabetogenic effect of tacrolimus (TAC) has not been completely elucidated. The study was designed to answer 2 questions: Does conversion from CyA to TAC influence tissue insulin sensitivity in patients after kidney transplantation? Are there any additional factors influencing insulin sensitivity in these patients?

Material/methods: Fifteen non-diabetic kidney transplant recipients, receiving CyA-based regimen were recruited to the study. Enrolled patients required conversion to TAC-based treatment due to CyA adverse effects.

[Liddle's syndrome--a case report and genetic diagnostics].

We present a case of a 52-year-old male with Liddle syndrome. The results of genetic studies and treatment in this condition is described.

Serological prevalence of hepatitis B virus and hepatitis C virus infection in the elderly population: Polish nationwide survey--PolSenior.

Background: The hepatitis B virus (HBV) and hepatitis C virus (HCV) infections may seriously affect survival rate. The median length of life in developed countries is increasing and the elderly may be considered as an epidemiologically distinct group due to higher whole-life risk of blood-borne viral infections.

Aim: To determine the seroprevalence of HBV and HCV infections in elderly individuals participating in a Polish nationwide survey - PolSenior.

Is plasma urotensin II concentration an indicator of myocardial damage in patients with acute coronary syndrome?

Introduction: Urotensin II (UII) is a vasoactive peptide secreted by endothelial cells. Increased plasma UII concentration was observed in patients with heart failure, liver cirrhosis, diabetic nephropathy and renal insufficiency. In patients with myocardial infarction both increased and decreased plasma UII concentrations were demonstrated.

Ischemic nephropathy - pathogenesis and treatment.

In this review paper we would like to summarized the current knowledge concerning the  pathogenesis and treatment of ischemic nephropathy. Epidemiological data suggest that the prevalence of ischemic nephropathy increases, especially among older individuals. The pathogenesis of this disease is more complex than just narrowing of the renal artery due to atherosclerosis.

Comparative pharmacokinetic study of two mycophenolate mofetil formulations in stable kidney transplant recipients.

We compared steady-state pharmacokinetics of mycophenolate mofetil (MMF) - Myfenax(®) (Teva) and CellCept(®) (Roche) - in stable kidney transplant recipients (KTRs). This was an international, multi-centre, randomized, open-label, two-treatment, two-sequence crossover study with a 3-month follow-up. We included KTRs at least 12 months post-transplantation with stable renal graft function for at least 3 months.

Monocyte subpopulations and cardiovascular risk in chronic kidney disease.

Chronic microinflammation and its cellular hallmark, monocyte activation, contribute substantially to the tremendous burden of cardiovascular disease (CVD) in patients with chronic kidney diseases (CKD). Monocyte heterogeneity is widely acknowledged. Cell-surface expression of CD14 and CD16 defines three functionally and phenotypically distinct subsets of monocytes: classical (CD14(++)CD16(-)) monocytes, intermediate (CD14(++)CD16(+)) monocytes, and nonclassical (CD14(+)CD16(++)) monocytes.

Telmisartan improves cardiometabolic profile in obese patients with arterial hypertension.

Objective: There are several lines of evidence that telmisartan may improve cardiometabolic profile. The aim of the study was to estimate changes of insulin resistance and plasma concentrations of adipokines after long-term antihypertensive treatment with telmisartan in obese hypertensive patients.

Methods: 34 previously untreated obese adults with arterial hypertension were enrolled.

Changes of bone mineral density in obese perimenopausal women during 5-year follow-up.

Introduction: The beneficial effect of obesity on bone mineral density (BMD) has not been definitely established.

Objectives: The aim of the study was to evaluate changes in BMD in obese perimenopausal women during a 5-year follow-up.

Patients And Methods: The study involved 54 obese women.

Effect of low-dose atorvastatin on plasma concentrations of adipokines in patients with metabolic syndrome.

Objective: It has not been conclusively proven whether or not the beneficial effect of statins on the cardiovascular system is mediated through their influence on adipokine secretion. We designed a prospective open-label study to assess the influence of 6 months' atorvastatin therapy on plasma concentrations of some adipokines in patients with metabolic syndrome.

Subjects: 36 adult patients with metabolic syndrome and serum LDL cholesterol >3.

Plasma leptin and neuropeptide Y concentrations in patients with rheumatoid arthritis treated with infliximab, a TNF-α antagonist.

TNF-α is one of the key proinflammatory cytokines in pathogenesis of rheumatoid arthritis (RA). TNF-α was also found to enhance synthesis of leptin. Leptin is mainly adipocyte-derived hormone controlling appetite and energy expenditure.

Clinical usefulness of novel prognostic biomarkers in patients on hemodialysis.

Prognosis, risk stratification and monitoring the effects of treatment are fundamental elements in the decision-making process when implementing prevention strategies for chronic kidney disease. The use of biomarkers is increasingly proposed as a method to refine risk stratification and guide therapy. In this Review, we present basic concepts regarding the validation of biomarkers and highlight difficulties inherent to the identification of useful new biomarkers in patients on hemodialysis.

[Treatment with recombinant parathyroid hormone of advanced osteoporosis--series of cases].

Osteoporosis is a systemic skeletal disorder characterized by impaired bone strength, leading to an increased risk of fracture. Patients with severe osteoporosis and multiple vertebral fractures are particularly at risk for subsequent osteoporotic fractures independently of antiresorptive therapy. The effective treatment of osteoporosis should prevent fractures through normalization of bone mass and improving bone microarchitecture.

Medical, psychological and socioeconomic aspects of aging in Poland: assumptions and objectives of the PolSenior project.

Both descriptive and longitudinal studies of aging are nowadays a subject of growing interest in different countries worldwide. However, in Poland and other Central-Eastern European countries, such comprehensive, nationally representative, multidimensional studies were never performed in the past in elderly population. The present paper describes the PolSenior project including its objectives, sample selection and structure, methods, fieldwork procedures and study flow.

Intra-abdominal infections after simultaneous pancreas - kidney transplantation.

Background: Intra-abdominal infections (IAI) are among the most common causes of pancreatic graft loss and recipient death in the early period after simultaneous pancreas - kidney transplantation (SPK). The aim of the study was to analyze risk factors and clinical consequences of IAI in SPK patients.

Material/methods: Forty-six consecutive SPK performed from 2004 to 2010 were subjected to analysis.

Apoptosis of tubular epithelial cells in preimplantation biopsies of kidney grafts with immediate, slow and delayed function.

Background: Apoptosis is a form of cell death observed in kidney grafts as a result of ischemia/reperfusion injury. The aim of our prospective study was to analyze the intensity of apoptosis in kidney tubules after cold storage in respect to early and 12-month post-transplant graft function.

Material/methods: The intensity of renal tubular apoptosis was estimated by TUNEL method in proximal and distal tubules in 72 pre-implantation kidney biopsies.

Dose-finding study of peginesatide for anemia correction in chronic kidney disease patients.

Background And Objectives: Peginesatide is a synthetic, PEGylated, investigational, peptide-based erythropoiesis-stimulating agent. We report the first assessment of its efficacy and safety in correcting renal anemia in a population of 139 nondialysis chronic kidney disease patients.

Design, Setting, Participants, & Measurements: Chronic kidney disease patients who were not on dialysis and not receiving treatment with erythropoiesis-stimulating agents in the 12 weeks before study drug administration were sequentially assigned to one of 10 cohorts; cohorts differed in starting peginesatide dose (different body weight-based or absolute doses), route of administration (intravenous or subcutaneous), and frequency of administration (every 4 or 2 weeks).