Novel glucokinase mutations in patients with monogenic diabetes - clinical outline of GCK-MD and potential for founder effect in Slavic population.

Glucokinase (GCK) gene mutations are the causative factor of GCK-MD (monogenic diabetes) characterized by a mild clinical phenotype and potential for insulin withdrawal. This study presents the results of a nationwide genetic screening for GCK-MD performed in Poland. A group of 194 patients with clinical suspicion of GCK-MD and 17 patients with neonatal diabetes were subjected to GCK sequencing.

Lack of effect of the CD14 promoter gene C-159T polymorphism on nutritional status parameters in hemodialysis patients.

Background: CD14 is a membrane glycoprotein that acts as a co-receptor for the detection of bacterial lipopolysaccharide (LPS). Mutual interaction between CD14 and LPS plays an important role in the innate immune system. Increased serum soluble CD14 levels have been described in hemodialysis (HD) patients, and linked to increased mortality risk, inflammation and protein-energy wasting.

Impact of diabetes mellitus on survival in patients with end-stage renal disease: a three-year follow-up.

Background/aims: To assess the impact of diabetes mellitus (DM) on clinical outcome in patients with end-stage renal disease (ESRD) on a 3-year follow-up.

Methods: 58 ESRD patients were divided into 2 groups according to the presence of DM. We analyzed following end points: death, cardiac arrest, myocardial infarction, stroke, hospitalizations due to cardiovascular causes, revascularization, and combined end point.

Blood pressure control in orthotopic heart transplant and kidney allograft recipients is far from satisfactory.

Hypertension is widely accepted as a risk factor for coronary artery disease, heart failure, stroke, or chronic kidney disease. According to ESH/ESC and JNC guidelines, the target blood pressure should be low 140/90 mm Hg in the general population, and 130/80 mm Hg among patients with chronic kidney disease or diabetes. The aim of this study was to assess the prevalence of achieved target blood pressure among 164 prevalent heart transplant recipients as well as 172 prevalent, kidney transplant, 100 hemodialyzed, and 50 peritoneally dialyzed patients on renal replacement therapy.

Copeptin in relation to New York Heart Association class in heart transplant recipients and kidney transplant recipients.

Copeptin is cosynthesized with vasopressin, also known as antidiuretic hormone. It is more stable than vasopressin. Recently copeptin has been studied as a diagnostic and prognostic marker for various diseases.

Anemia in heart and kidney allograft recipients: is there a role for hepcidin?

The production by hepatocytes of hepcidin, a small defensin-like peptide, is modulated in response to anemia, hypoxia, or inflammation. We studied hepcidin as a marker of iron status (serum iron, ferritin, and soluble receptor of transferrin [sTfR], and as a marker of inflammation among 170 prevalent kidney transplantation (KT) patients and 168 prevalent orthotopic heart transplant (OHT) patients. In addition, we assessed the prevalence of anemia and its relation to measurements of hepcidin, sTfR, and high-sensitivity C-reactive protein, using commercially available enzyme-linked immunosorbent assay (ELISA) kits.

Prevalence of chronic kidney disease in orthotopic heart transplant recipients and kidney allograft recipients using the new Chronic Kidney Disease Epidemiology Collaboration formula.

Chronic kidney disease (CKD) is an important long-term complication of all forms of nonrenal organ transplantation. The aim of this study was to assess the prevalence of kidney dysfunction among heart (n = 163) and kidney allograft recipients (n = 169) using the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, which includes age, gender, and comorbidities. The mean serum creatinine values in these populations were 1.

Kidney injury molecule-1 correlates with kidney function in renal allograft recipients.

Introduction: KIM-1 (kidney injury molecule-1) is responsible for the clearance of debris from damaged renal tubules. KIM-1 can be expressed and excreted in urine within 12 hours after the initial ischemic insult and before regeneration of the epithelium, persisting over time thereafter. Urinary KIM-1 has been reported to be a noninvasive, rapid, sensitive, and reproducible biomarker of experimental nephrotoxic and ischemic acute kidney injury.

Rapid increase in the incidence of type 1 diabetes in Polish children from 1989 to 2004, and predictions for 2010 to 2025.

Aims/hypothesis: We analysed the temporal changes in the incidence of childhood type 1 diabetes and its demographic determinants in Poland from 1989 to 2004, validating the model with data from 1970 to 1989. We also estimated a predictive model of the trends in childhood diabetes incidence for the near future.

Methods: Children under 15 years with newly diagnosed type 1 diabetes mellitus and drawn from seven regional registries in Poland were ascertained prospectively using the Epidemiology and Prevention of Diabetes study (EURODIAB) criteria.

Perfusion defects on real-time myocardial contrast echocardiography predict higher mortality in patients with end-stage renal disease - a 3-year follow-up.

Aim: The aim of this study was to assess the prognostic significance of myocardial contrast echocardiography (MCE) in patients with end-stage renal disease (ESRD) on a 3-year follow-up and to compare the value of MCE with demographic, clinical, and laboratory parameters.

Methods: Fifty-eight ESRD patients on regular dialysis were prospectively screened for coronary artery disease (CAD) using perfusion assessment on real-time MCE. We analyzed the following end points during the 3-year follow-up: death, cardiovascular complications, and combined end point, which consisted of adverse cardiac events mentioned above.

Impact of residual renal function and HCV seropositivity on plasma CD40/CD40L system and oxidative status in haemodialysis patients.

Objectives: We evaluated the impact of residual renal function (RRF) on oxidative stress (SOX) and CD40/CD40L system in haemodialysis (HD) patients.

Design And Methods: We determined sCD40, sCD40L and SOX marker-Cu/Zn superoxide dismutase (Cu/Zn SOD) levels in HD patients with RRF, with anuria (A) and in healthy controls.

Results: sCD40 and Cu/Zn SOD plasma levels were higher in both groups of dialyzed patients compared to controls (all p<0.

Hepatitis C virus seropositivity and TNF superfamily receptors: sCD40, sFas--the new putative determinants of endothelial dysfunction in haemodialysis patients.

Introduction: Hepatitis C virus (HCV) infection occurs frequently among haemodialysis (HD) patients and increases the risk of atherosclerosis. CD40 and Fas belong to tumor necrosis factor receptor (TNFR) superfamily, which play a role in hepatocyte apoptosis during HCV infection. The aim of the present study was to determine whether anti-HCV-seropositivity constitutes an additional risk factor for endothelial dysfunction in HD patients, and whether sCD40 and sFas could be associated with endothelial dysfunction.

The cardio-renal-anaemia syndrome predicts survival in peritoneally dialyzed patients.

Introduction: Anaemia is one of the arms of the cardio-renal-anaemia syndrome (CRA) in chronic kidney disease (CKD) patients. The correction of anaemia was effective in the amelioration of both cardiac and renal failure. We studied the relationship between the severity of CRA syndrome in peritoneally dialyzed patients and their survival probability.

Increased spontaneous production of VEGF by CD4+ T cells in type 1 diabetes.

In the present study we report that CD4(+) T cells from patients with type 1 diabetes produce significantly higher amounts of VEGF than respective cells from the healthy individuals. Among CD4(+) T cells memory subsets were the main source of VEGF. In addition, memory CD4(+) T subsets were the most numerous in patients with diabetic retinopathy (DR).

Different effects of enoxaparin, nadroparin, and dalteparin on plasma TFPI during hemodialysis: a prospective crossover randomized study.

Background: Low-molecular-weight heparins (LMWHs) are an alternative to unfractionated heparin (UFH) for anticoagulation during hemodialysis (HD). We performed a prospective randomized crossover study of the effect of enoxaparin, nadroparin, and dalteparin on some hemostatic factors, including tissue factor pathway inhibitor (TFPI), in patients with maintenance HD.

Methods: Plasma levels (immunoassays) of total TFPI, platelet-derived growth factor-AB (PDGF-AB), and prothrombin fragment 1 + 2 (PF 1 + 2) were evaluated pre-HD, after 10 (T10) and 180 (T180) minutes of HD in 21 patients, who completed a 3-period (for 2 months each) crossover study in 6 groups (Latin-square design).

Renal consequences of obesity.

The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically within the past 2 decades. Our objective is to review the mechanisms that link obesity with altered kidney function. Current evidence suggests that excess weight gain may be responsible for 65-75% of the risk for arterial hypertension.

3-hydroxyanthranilic acid is independently associated with monocyte chemoattractant protein-1 (CCL2) and macrophage inflammatory protein-1beta (CCL4) in patients with chronic kidney disease.

Objectives: CC-chemokines and kynurenine pathway (KP) metabolites are associated with accelerated atherosclerosis in chronic kidney disease (CKD) patients.

Design And Methods: We evaluate the plasma levels of anthranilic acid (AA), 3-hydroxyanthranilic acid (3-HAA) and their possible relationship with CC-chemokines, Cu/Zn superoxide dismutase (Cu/Zn SOD) as the marker of oxidative status and high sensitivity C-reactive protein (hsCRP) as an index of inflammation in the population of 48 CKD patients.

Results: Compared with controls, CKD patients showed a significant increase in plasma concentrations of CCL2, CCL4, AA, 3-HAA, Cu/Zn SOD and hsCRP.

[Regulatory T lymphocytes expressing L-selectin in children and adolescents with type 1 diabetes mellitus].

Introduction: Quantitative and/or qualitative dysfunctions in a subset of naturally arising regulatory T lymphocytes may have impact on autoimmune disease development, including diabetes type 1. CD62L is a homing receptor that directs T lymphocytes to lymph nodes. Studies conducted on NOD mice showed that depletion of Tregs expressing CD62L results in diabetes and only CD62Lhigh Tregs are able to protect against the disease.

[Higher percentages of T regulatory cells in children at risk for developing type 1 diabetes mellitus].

Introduction: The natural history of type 1 diabetes is concerned with the appearance of autoantibodies against antigens of pancreatic beta cells. The last decade revealed some evidence of the participation of T regulatory lymphocytes - cells which suppress immune response - in the pathogenesis of type 1 diabetes and prediabetes.

Aim Of The Study: was the assessment of T regulatory cells in the blood of children at risk for developing type 1 the diabetes mellitus.

Visfatin and endothelial function in dialyzed patients.

Aim: Visfatin is an adipocytokine that has recently generated much interest. The aim of the study was to assess visfatin in correlation with markers of endothelial damage and inflammation in haemodialyzed and peritoneally dialyzed patients.

Methods: Visfatin, leptin, apelin and adiponectin, markers of coagulation (thrombin-antithrombin complexes (TAT), prothrombin fragments 1+2 (F1+2)), fibrinolysis (tissue plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1)), endothelial function/injury (Von Willebrand factor (vWF), thrombomodulin, intracellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), CD146) and inflammation (high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6) were assessed.

Kynurenine pathway - a new link between endothelial dysfunction and carotid atherosclerosis in chronic kidney disease patients.

Purpose: The endothelium dysfunction is an important component of atherosclertic cardiovascular disease. It has been also suggested that kynurenine pathway activation may be involved in the pathogenesis of this disease.

Material/methods: This is a cross-sectional study in chronic kidney disease (CKD) patients (n=106; 60 Males).

Possible relationship between neutrophil gelatinase-associated lipocalin, hepcidin, and inflammation in haemodialysed patients.

Background: Neutrophil gelatinase-associated lipocalin (NGAL) binds small, iron-carrying molecules - siderophores. On the other hand, hepcidin is a small defensin-like peptide produced by hepatocytes, modulated in response to anaemia, hypoxia, or inflammation. We tested the hypothesis that NGAL may be related to hepcidin, not only to iron metabolism, in 182 prevalent haemodialysed patients.