[Prognostic value of dobutamine stress echocardiography in patients with terminal renal insufficiency undergoing hemodialysis--a 5-year follow up].

Introduction: Patients with end-stage renal failure have high morbidity and mortality rates due to cardiovascular complications. Screening for coronary heart disease in these patients is of utmost importance. The aim of this study was to investigate the prognostic value of the dobutamine test in patients on hemodyalisis during a 5-year follow-up period.

Simple "closed-circuit" group-specific immunoadsorption system for ABO-incompatible kidney transplants.

There is a need for improvement of the detection and treatment of the antibody-mediated graft rejection for ABO-incompatible kidney transplant recipients. With the development of novel pre-conditioning protocols, which employ anti-CD20 antibody, therapeutic plasma exchange plus extracorporeal immunoadsorption and standard immunosuppression application, together with the use of more sensitive and objective assays for immunological monitoring, patients that were not candidates for kidney transplant in the past, are now being transplanted. We have designed a pre-conditioning protocol for ABO-incompatible kidney transplants based on TPE plus our own simple "closed-circuit" immunoadsorption technique - combined by anti-CD20, standard immunosuppressive treatment, and without splenectomy.

Conversion of azathioprine to mycophenolate mofetil and chronic graft failure progression.

The purpose of the study was to evaluate the impact of conversion from azathioprine (AZA) to mycophenolate mofetil (MMF) on graft function in 35 renal transplant recipients with chronic allograft nephropathy (CAN). The immunosuppressive regimen originally consisted of AZA, cyclosporine (CsA), and prednisone (Pr). At the onset of the study (mean period = 39 posttransplant months), a graft biopsy was performed on all patients who were randomly divided into group 1 (n = 17) in whom MMF was introduced instead of AZA.

Co-morbidity and kidney graft failure-two main causes of malnutrition in kidney transplant patients.

Background: Malnutrition is very frequent in chronic renal failure but, after successful kidney transplantation, body weight gain is common and is widely investigated, while malnutrition after transplantation is underestimated. In the present study, the prevalence of malnutrition in kidney transplant patients and the factors which might contribute to its development are analysed.

Method: In a population of 452 kidney transplant patients followed-up regularly at our department, body mass index (BMI) was determined.

[Lupus nephritis: retrospective analysis of the course of the disease].

Introduction: Systemic lupus erythematosus is a multisystemic autoimmune disease characterized by various clinical manifestations, as well as unpredictable course and therapy response. Lupus nephritis is a severe manifestation of the disease, significantly influencing its prognosis. Since the pathogenesis of lupus nephritis has not been elucidated, optimal therapeutic approach is still subject of numerous studies.

[Evaluation of the rate of progression of chronic renal transplant rejection using the proliferating cell nuclear antigen ].

Unlabelled: Since the introduction of kidney transplantation, the short-term patient and graft survival have been progressively improving, but the long-term graft survival and half-life of transplants have not. Beyond doubt, chronic rejection (CR) remains the major cause of chronic graft failure and is responsible for the loss over 10 years of 50% of grafts. (1-4).

Glucocorticoid receptors in lymphocytes and stability of kidney graft function.

The glucocorticoid receptors in lymphocytes of patients treated with glucocorticoids after kidney transplantation have been studied in order to determine whether abnormalities in corticosteroid binding and trans-activation of steroid-receptor complexes, i.e., their translocation into nuclei, may contribute to the resistance of patients to glucocorticoid therapy.

Does tuberculosis after kidney transplantation follow the trend of tuberculosis in general population?

Despite improvement in graft survival, infection continues to be an important cause of morbidity and mortality after kidney transplantation. We analyzed the clinical courses and outcomes of 16 transplanted patients with positive cultures for mycobacterium tuberculosis. In the course of a 20 year period, there were 13 cases of tuberculosis registered that developed in 456 patients who underwent kidney transplantation in our department, and in three refugees transplanted in other centers (a prevalence of 3.

Markers of oxidative stress after renal transplantation.

An increased degree of oxidative stress (OS) in chronic renal failure (CRF) and a possible role of free radicals in CRF have already been described. However, data on OS after renal transplantation are scarce. The aim of the present study was to estimate the degree of OS in renal transplant patients.

[Kidney transplantation in Bombay].

The paper presents results of renal transplantation from a living unrelated donor in Bombay. Within the past three years 15 patients reported themselves at our Clinic immediately upon renal transplantation from a living unrelated donor, 7 of whom were women and 8 men, 17 to 52 years of age. There were no data on previous pretransplantation processing for the majority of patients, and treatment by repeated hemodialyses in 46.

[Kidney transplantation in children].

During the last 14 years, since the opening of the Center for Childrens' Hemodialysis the University Children's Hospital of Belgrade, 174 children with terminal renal failure were treated by chronic hemodialysis. Of these, only 35 patients (20.1%), 14 girls and 21 boys, mean age 12.

[Progression of chronic renal insufficiency in chronic rejection: the role of chronic transplantation glomerulopathy].

Unlabelled: Chronic rejection of kidney transplant is a chronic and progressive decline of kidney transplant function related to certain morphologic changes, such as obliterate vasculopathy, interstitial fibrosis, tubular atrophy, and transplant glomerulopathy [1]. The purpose of this study was to investigate the involvement of chronic transplant glomerulopathy in the progression of chronic renal failure.

Method, Patients: Of 16 transplant patients with histologic diagnosis of chronic kidney transplant rejection in biopsy specimens, 8 patients had chronic transplant glomerulopathy (ChR-1), and in the other 8 patients glomeruli were relatively preserved (ChR-2).

[Lupus nephritis--clinical and morfological correlation].

During the last five years at our Department renal biopsy was carried out in 41 patients with systemic lupus erythematosus. On the basis of the pathologic findings glomerular changes were classified as follows: minimal in 5 patients; mesangial proliferative glomerulonephritis in 11; focal and segmental proliferative glomerulonephritis in 5; diffuse proliferative glomerulonephritis in 15; membranous glomerulonephritis in 3, and diffuse sclerosing glomerulo-nephritis in 2 cases. Morphological changes of renal biopsy did not correlate with the degree of deterioration of glomerular function.

[Acute renal failure after kidney transplantation].

The aim of the study was to establish causes of acute renal failure after renal transplantation and to investigate its influence on subsequent kidney function. Hundred sixty seven renal transplantations were performed at the Institute of Urology and Nephrology, Belgrade, from January 1988 to November 1991. Acute renal failure occurred in 29 patients.

[Kidney transplantation in high-risk patients].

Immunosuppression with Cyclosporine A in kidney transplantation, triple therapy (CyA + Imuran + corticosteroids) and plasmapheresis before and after kidney transplantation in high risk recipients (positive cytotoxic antibody, MLC at the level of non related persons), also in high risk patients (juvenile diabetes, patients over 50 years old). In 1988 we had done in our Centre, kidney transplantation in 52.8% (28: 53) in high and increased risk patients.