Renal sonography in bipolar patients on long-term lithium treatment.

Purpose: The aim of the study was to analyze sonographic (US) renal findings in lithium-treated bipolar patients and to correlate them with renal function.

Methods: Renal US and renal function tests were performed on 120 patients with bipolar disorder. Ninety patients (30 males, 60 females), aged 36-82 years, had received lithium therapy for an average of 16 years, whereas 30 patients (10 males, 20 females), aged 35-85 years, who had never been exposed to lithium, served as controls.

Novel markers of kidney injury in bipolar patients on long-term lithium treatment.

Objectives: We assessed kidney function in long-term lithium-treated bipolar patients compared with age-matched patients not taking lithium, including novel markers of kidney injury such as plasma neutrophil gelatinase-associated lipocalin (NGAL) and urinary beta-2 microglobulin (β2-MG) METHODS: The study comprised 120 patients with bipolar disorder of which 90 (30 males and 60 females) have been receiving lithium for 5-38 (mean 16) years, and 30 (10 males and 20 females) have never been exposed to lithium.

Results: Lithium-treated patients, both men and women, showed significantly higher plasma NGAL and urinary β2-MG and lower urine specific gravity and estimated glomerular filtration rate (eGFR), compared with patients not taking lithium. In these patients, serum NGAL did not correlate with any clinical feature or other parameter of kidney function.

The association of glycogen synthase kinase-3beta (GSK-3β) gene polymorphism with kidney function in long-term lithium-treated bipolar patients.

Background: Most bipolar patients experience a reduction in urinary concentrating ability within a few weeks of starting lithium treatment. This phenomenon may be connected with the effect of lithium on the glycogen synthase kinase-3beta (GSK-3β) present in the renal tubules. The GSK-3β gene is located on chromosome 3q13 and possesses a functional -50 C/T polymorphism.

[The effect of long-term lithium treatment on kidney function].

In 1963 it was first demonstrated that long-term lithium administration exerts a "mood-stabilising" effect, preventing recurrences of mania and depression in bipolar affective disorder. Despite the introduction of many other drugs having mood-stabilising effect, lithium still remains the first choice drug for the prophylaxis of affective episodes in mood disorder. Lithium is eliminated nearly exclusively by the kidneys: lithium clearance is proportional to creatinine clearance and is influenced by natriuretic and antinatriuretic factors.

Pregnancy in diabetic woman with coexisting hypothyroidism, coronary artery disease and with early onset nephrotic syndrome--a case report.

We present a case of pregnancy in 28-years old nulliparous woman with an over 20-years long history of diabetes, hypothyroidism, diabetic nephropathy with nephrotic syndrome, retinopathy and coronary artery disease treated with PCA prior the pregnancy (class H diabetes, according to White classification).

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.

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.

Elevated urinary fibronectin excretion predicts poor outcome in patients with primary chronic glomerulonephritis.

Background/aims: Fibronectin (FN) is one of the major matrix proteins in the kidney. The accumulation of FN fragments in inflamed glomeruli could contribute to the progression of renal injury. In the present study, the urinary FN excretion (UFN) was measured for evaluation of its possible role as a prognostic marker in patients with newly diagnosed chronic glomerulonephritis (GN).

Therapeutic equivalence of epoetin zeta and alfa, administered subcutaneously, for maintenance treatment of renal anemia.

Introduction: The primary objective of the trial was to prove the therapeutic equivalence of epoetin zeta to epoetin alfa when administered subcutaneously for maintaining target hemoglobin (Hb) in patients with renal anemia on chronic hemodialysis. Additional information was provided on the safety and tolerability of epoetin zeta with particular focus on the formation of anti-erythropoietin antibodies.

Methods: A total of 462 patients were randomized to either epoetin zeta or alfa for 28 weeks after an open period of dose adjustment of 12-16 weeks with only epoetin zeta.

[Nephrological care in Wielkopolska-region of Poland in 2009--realization of the united idea].

The establishment of net of the dialysis centers within the distance of 50 km each other, created the basis for realization of united idea for organization of nephrological care in the Wielkopolska-region of Poland. Nephrological care consists of both an integrated methods of the renal replacement therapy: hemodialysis, peritoneal dialysis and kidney transplantation and the screening for chronic kidney disease, its early diagnosis and effective treatment which slow-down the progression of the disease. The nephrological ambulatory, associated with dialysis centers and the nephrological departments with dialysis center and ambulatory play an important role in the integrated nephrological care.

Effects of bicarbonate/lactate dialysis solution on the inflammatory response of spontaneous peritonitis in rats undergoing chronic peritoneal dialysis.

Background: We evaluated the incidence of spontaneous peritonitis as well as the local inflammatory response and macroscopic changes in the peritoneum during the use of a bicarbonate/lactate-buffered (P) solution in comparison to conventional (D) solutions in rats on chronic peritoneal dialysis.

Methods: Sixty-three male Wistar rats were implanted with peritoneal catheters. After 7 days, the animals were randomly divided into 2 experimental groups (32 rats in D, 31 rats in P) and infused twice daily over the following 4 weeks.

Effect of intradialytic intravenous administration of omega-3 fatty acids on nutritional status and inflammatory response in hemodialysis patients: a pilot study.

Objective: Because omega-3 polyunsaturated fatty acids (PUFAs) may have anti-inflammatory properties, we tested the hypothesis that intradialytic, intravenous omega-3 PUFA treatment, combined with dietary supplementation, can modify the inflammatory response to dialysis, and influence the nutritional status of hemodialysis (HD) patients.

Methods: Twenty HD patients with serum albumin at <39g/L received 100mL of 10% omega-3 PUFA emulsion during 11 consecutive HD sessions. Body mass index (BMI), serum albumin, transferrin, and lipids were measured before and after treatment.

The Comparison of the Podocyte Expression of Synaptopodin, CR1 and Neprilysin in Human Glomerulonephritis: Could the Expression of CR1 be Clinically Relevant?

Podocytes are considered as the most important cells that determine loss of structure and function of the glomerular filter. We compared the expression of three podocyte markers, i.e.

CD52 gene polymorphism and its potential effect on the response to alemtuzumab in renal transplant recipients.

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.

Effect of membrane permeability on survival of hemodialysis patients.

The effect of high-flux hemodialysis membranes on patient survival has not been unequivocally determined. In this prospective, randomized clinical trial, we enrolled 738 incident hemodialysis patients, stratified them by serum albumin < or = 4 and >4 g/dl, and assigned them to either low-flux or high-flux membranes. We followed patients for 3 to 7.

Early detection of chronic kidney disease: results of the PolNef study.

Background: Continuous increase in the number of patients with end-stage renal disease demands early detection of chronic kidney disease (CKD). The aim of the present study was to diagnose CKD in its earliest stages in a randomly selected population using a diagnostic algorithm developed by the working group.

Methods: An algorithm for the diagnostic procedure was created to identify patients with CKD requiring further nephrological care.

Vascular endothelial growth factor in dialysate in relation to intensity of peritoneal inflammation.

Background: Peritoneal inflammation may induce changes in peritoneal microvessels, including neoangiogenesis/vasculogenesis, leading to increased peritoneal solute transport rate (PSTR) and loss of ultrafiltration capacity. We hypothesized that an inflammatory reaction in the peritoneal cavity during peritonitis induces increased synthesis of vascular endothelial growth factor (VEGF). We therefore studied the relationship between peritoneal inflammation markers, VEGF, and transport of fluid and solutes in rats during acute peritoneal inflammation induced by lipopolysaccharide (LPS) added to standard glucose-based dialysis solution.

Comparison of the therapeutic effects of epoetin zeta and epoetin alpha in the correction of renal anaemia.

Objective: To assess the therapeutic equivalence of epoetin zeta and epoetin alpha for correction of haemoglobin (Hb) concentration in patients with anaemia and chronic kidney disease (CKD) stage 5 maintained on haemodialysis.

Study Design: In total, 609 patients with CKD and anaemia (Hb < 9 g/dL) were randomly assigned to receive either epoetin zeta or epoetin alpha intravenously, one to three times per week for 24 weeks. Dosing was titrated individually to achieve a stable, target Hb concentration of 11-12 g/dL.

[Nephrotic syndrome in the elderly. Treatment of the nephrotic syndrome in the elderly (part II)].

Nephrotic syndrome (NS) in elderly may increase mortality. The severity of NS determines its management. In the milder forms, with serum albumin concentrations greater than 2.

[Nephrotic syndrome in the elderly. The most frequent causes of the nephrotic syndrome in the elderly (part I)].

Nephrotic syndrome (NS) is an essential clinical problem in the elderly. It may be difficult to recognize NS in the elderly because its symptoms are frequently missed with congestive heart failure or venous insufficiency. Glomerular diseases are not most common in elderly population but they play important role in renal pathology in this group of patients.

"Treasure your exceptions": recent advances in molecular genetics of glomerular disease.

The glomerular filtration barrier consists of endothelial cells, the glomerular basement membrane, and podocytes. The membrane is a highly crosslinked macromolecular meshwork composed of specific extracellular matrix proteins. The adjacent foot processes of podocytes are bridged along their basolateral surfaces by a slit diaphragm (a porous filter structure of nephrin molecules).

The MPO Study: just a European HEMO Study or something very different?

Although results from observational and epidemiological studies suggested a survival benefit associated with high-flux hemodialysis, conclusive evidence from prospective randomized clinical trials has been lacking. Both the HEMO Study in the USA and the Membrane Permeability Outcome Study (MPO Study) in Europe are randomized studies investigating the effect of high- and low-flux hemodialysis on patient outcomes, even though there were some significant differences in the design of the two studies. An earlier randomized clinical trial could not show differences on patient survival between patient groups being treated with membranes of different material and permeability, but this trial was not designed specifically to examine this particular endpoint.

Effect of preload reduction on sonographic myocardial integrated backscatter.

Purpose: Sonographic myocardial tissue characterization with integrated backscatter (IBS) is affected by both structural and functional properties of the myocardium. The aim of the present study was to investigate the effect of preload reduction by hemodialysis (HD) on IBS measurements.

Methods: Fifty-two patients on maintenance HD underwent echocardiography before and after a routine HD session.

[Hypotonia in renal failure patients undergoing dialysis therapy].

In this paper we present the current reviews on the causes, symptoms, prevalence and clinical importance of hypotonia in chronic renal failure patients undergoing dialysis therapy. The results of clinical studies indicate that persistent hypotonia in dialysis patients is associated with increased mortality.