Systemic and Renal Dynamics of Free Sulfhydryl Groups during Living Donor Kidney Transplantation.

During ischemia−reperfusion injury (IRI), reactive oxygen species are produced that can be scavenged by free sulfhydryl groups (R-SH, free thiols). In this study, we hypothesized that R-SH levels decrease as a consequence of renal IRI and that R-SH levels reflect post-transplant graft function. Systemic venous, arterial, renal venous, and urinary samples were collected in donors and recipients before, during, and after transplantation.

Promoter Variant, Water Transport, and Outcomes in Peritoneal Dialysis.

Background: Variability in ultrafiltration influences prescriptions and outcomes in patients with kidney failure who are treated with peritoneal dialysis. Variants in , the gene that encodes the archetypal water channel aquaporin-1, may contribute to that variability.

Methods: We gathered clinical and genetic data from 1851 patients treated with peritoneal dialysis in seven cohorts to determine whether variants were associated with peritoneal ultrafiltration and with a risk of the composite of death or technique failure (i.

Comparison of Longitudinal Membrane Function in Peritoneal Dialysis Patients According to Dialysis Fluid Biocompatibility.

Introduction: Preservation of peritoneal function is essential in long-term peritoneal dialysis. Biocompatible dialysis solutions might prevent or postpone the membrane alteration resulting in ultrafiltration failure and consecutive morbidity and mortality.

Methods: We conducted an observational cohort study in which we made a longitudinal comparison between the course of peritoneal solute and fluid transport during treatment with conventional and biocompatible solutions.

Hydrogen sulphide-induced hypometabolism in human-sized porcine kidneys.

Background: Since the start of organ transplantation, hypothermia-forced hypometabolism has been the cornerstone in organ preservation. Cold preservation showed to protect against ischemia, although post-transplant injury still occurs and further improvement in preservation techniques is needed. We hypothesize that hydrogen sulphide can be used as such a new preservation method, by inducing a reversible hypometabolic state in human sized kidneys during normothermic machine perfusion.

Peritoneal vasculopathy in the pathophysiology of long-term ultrafiltration failure: A hypothesis based on clinical observations .

Ultrafiltration failure in long-term peritoneal dialysis patients is a well-known and important, but poorly-explained complication of the treatment. Transcapillary ultrafiltration consists mainly of small-pore fluid transport and partly of free-water transport. The former is to a large extent dependent on the hydrostatic pressure gradient and on the number of perfused peritoneal microvessels.

Localization of parathyroid adenomas using C-methionine pet after prior inconclusive imaging.

Purpose: Minimally invasive parathyroidectomy (MIP) is the recommended treatment in primary hyperparathyroidism (pHPT) for which accurate preoperative localization is essential. The current imaging standard consists of cervical ultrasonography (cUS) and MIBI-SPECT/CT. C-MET PET/CT has a higher resolution than MIBI-SPECT/CT.

The value of osmotic conductance and free water transport in the prediction of encapsulating peritoneal sclerosis.

Qualitative assessments in long-term patients and in those with encapsulating peritoneal sclerosis (EPS) have shown that impaired osmotic conductance is likely a factor contributing to the presence of ultrafiltration failure in those individuals. In the present study, we investigated the value of osmotic conductance, its components LpA and the reflection coefficient sigma, and free water transport (FWT) in 12 patients with EPS, in 21 patients with long-term ultrafiltration failure, and in 26 time-restricted control subjects with normal ultrafiltration. A decrease in all parameters was observed during a period of 4 years in patients with EPS and ultrafiltration failure, with FWT showing the largest difference between all three groups; however, the receiver operating curves showed that only FWT appeared to be a significant predictor of EPS.

Longitudinal analysis of peritoneal fluid transport and its determinants in a cohort of incident peritoneal dialysis patients.

Background And Objectives: There is a paucity of large longitudinal studies on the time course of peritoneal fluid transport. The aim of the present study was to longitudinally analyze changes in fluid transport and relevant solute transport parameters in patients treated with a conventional peritoneal dialysis (PD) fluid and, to mimic clinical reality, not selected for the presence or absence of ultrafiltration (UF) failure.

Methods: This prospective single-center cohort study followed 138 consecutive incident PD patients from July 1994 until censoring in August 2004.

Can effluent matrix metalloproteinase 2 and plasminogen activator inhibitor 1 be used as biomarkers of peritoneal membrane alterations in peritoneal dialysis patients?

Background: Peritoneal effluent contains clinically relevant substances derived from intraperitoneal production or transperitoneal transport, or both. The glycoproteinase matrix metalloproteinase 2 (MMP-2) cleaves denatured collagen and complements other collagenases in the degradation of fibrillar collagens. Elevated intraperitoneal levels of plasminogen activator inhibitor 1 (PAI-1) have been demonstrated to be present in patients with intra-abdominal adhesions.

The -174G/C variant of IL6 as risk factor for mortality and technique failure in a large cohort of peritoneal dialysis patients.

Background: Functional variants in the IL6 gene, in particular the -174G/C polymorphism (rs1800795), affect the mortality risk in dialysis patients. Peritoneal dialysis (PD) patients harbouring the C allele of the -174G/C polymorphism of IL6 showed faster peritoneal transport. The aim of this study was to investigate this IL6 variant as risk factor for mortality and technique failure in a large cohort of Caucasian PD patients.

Free water transport in children on peritoneal dialysis is higher with more biocompatible dialysis solutions, higher with older age and declines with time.

Background: Water transport in peritoneal dialysis occurs through small pores and aquaporins. Free water transport (FWT) occurs through aquaporins only and gives a reflection of peritoneal aquaporin function. In this study, FWT in children was calculated for the first time in different settings.

Variability of effluent cancer antigen 125 and interleukin-6 determination in peritoneal dialysis patients.

Background: Cancer antigen (CA) 125 is a glycoprotein that provides data on the state of the peritoneal membrane in peritoneal dialysis (PD). Interleukin-6 (IL-6) acts as a mediator in acute-phase responses. The study evaluated the usefulness of CA125 and IL-6 in random effluent samples, by assessing their variability in individual patients during clinical practice at the outpatient department.

Lack of correlation between baseline peritoneal membrane status and pre-dialytic characteristics.

The determinants of peritoneal transport status in incident peritoneal dialysis (PD) patients are not well defined. Comorbidity, inflammation status, race, age, and mesothelial cell mass are some factors correlated with the baseline dialysate-to-plasma ratio of creatinine. Our aim was to define factors in the pre-dialysis period that possibly correlate with baseline peritoneal transport characteristics.

Addition of a nitric oxide inhibitor to a more biocompatible peritoneal dialysis solution in a rat model of chronic renal failure.

Biocompatible dialysis solutions have been developed to preserve peritoneal membrane morphology and function. Compared with a conventional solution, a combination of glycerol, amino acids, and dextrose in a bicarbonate/lactate buffer (GLAD) led to less peritoneal fibrosis and fewer vessels in a chronic peritoneal exposure model in the rat. However, no concomitant reduction in small-solute transport was observed.

The time course of peritoneal transport parameters in peritoneal dialysis patients who develop encapsulating peritoneal sclerosis.

Background: Encapsulating peritoneal sclerosis (EPS) is a severe complication of peritoneal dialysis (PD). The first aim was to analyse the risk of EPS in patients who had developed ultrafiltration failure (UFF). The second aim was to identify specific peritoneal transport alterations that distinguish patients with UFF from patients who will develop EPS.

Induction of chronic kidney failure in a long-term peritoneal exposure model in the rat: effects on functional and structural peritoneal alterations.

Background: A long-term peritoneal exposure model has been developed in Wistar rats. Chronic daily exposure to 3.86% glucose based, lactate buffered, conventional dialysis solutions is possible for up to 20 weeks and induces morphological abnormalities similar to those in long-term peritoneal dialysis (PD) patients.

Intensive insulin therapy in severe traumatic brain injury: a randomized trial.

Background: Intensive insulin therapy (IIT) has been shown to reduce morbidity and mortality in critically ill patients. Little investigation has been done to find out whether it improves the prognosis of patients with severe traumatic brain injury (STBI).

Methods: We conducted a prospective controlled study where adult patients with blunt STBI, with Glasgow Coma Scale View Article and Find Full Text PDF

Dry body weight and ultrafiltration targets in peritoneal dialysis.

A review is given on methods that can be used for the assessment of dry body weight in peritoneal dialysis patients. Besides clinical examination, the use of natriuretic hormone concentrations in plasma, and the value of multifrequency bio-impedance analysis is discussed. Ultrafiltration targets as formulated in various guidelines are reviewed.

Biological markers in the peritoneal dialysate effluent: are they useful.

A review is given on biomarkers in peritoneal effluent. It comprises methods to distinguish between diffusion and local production. This is followed by examples of various biomarkers.

Fluid transport with time on peritoneal dialysis: the contribution of free water transport and solute coupled water transport.

Ultrafiltration in peritoneal dialysis occurs through endothelial water channels (free water transport) and together with solutes across small pores: solute coupled water transport. A review is given of cross-sectional studies and on the results of longitudinal follow-up.

Peritoneal function in clinical practice: the importance of follow-up and its measurement in patients. Recommendations for patient information and measurement of peritoneal function.

A review is given on peritoneal function, especially ultrafiltration and ultrafiltration failure followed by recommendations on how to translate pathophysiology into clinical practice. The subsequent consequences for management of peritoneal membrane function and for patient information are also included.

Karl d. Nolph state of the art lecture: feasible and future options for salvation of the peritoneal membrane.

A review is given of the various available strategies that can be used to protect the peritoneal membrane. A discussion of experimental studies on approaches that are still experimental, but that might be applied in patients in the future, follows. The currently available approaches include dietary sodium restriction, use of high-dose loop diuretics and of inhibitors of the renin-angiotensin system.

The relationship between effluent potassium due to cellular release, free water transport and CA125 in peritoneal dialysis patients.

Background. Recently, we found evidence of effluent potassium (K(+)) additional to diffusion and convection, suggesting cellular release (CR). Its relationship with free water transport (FWT) in stable peritoneal dialysis (PD) patients suggested an effect of hypertonicity of the dialysis solution leading to cell shrinkage.