Immunosuppressive therapy in glomerular diseases: major accomplishment of Tadeusz Orłowski and his school.

Glomerulopathies are the third most common cause of end-stage renal failure. Immunosuppressive treatment of glomerulonephritis in a systematic way was introduced in Poland by Professor Tadeusz Orłowski in the early 1960s. The studies were conducted at the First Department of Medicine and at the Transplantation Institute of the Medical Academy in Warsaw in the years 1962-1988.

[Selected parameters of antioxidant capacity in renal allograft recipients].

Unlabelled: Various oxidant species, oxygen free radicals (OFR) implicated in patients with chronic renal diseases treated with dialysis and after cadaveric renal transplantation. Oxidative stress occurs when free radical generation exceeds antioxidant defence. We therefore examined markers of lipid peroxidation and antioxidant potential in blood (serum, plasma, RBC) of very carefully (clinically and biochemically) selected 102 subjects (56 female and 46 male, mean age 37.

[Late ophthalmoscopic changes in patients after malignant hypertension].

Aim: Comparison of eye fundus changes in patients in whom malignant hypertension was diagnosed.

Material And Methods: 14 patients (6 F, 8 M) aged 24-54 years were examined. In all cases kidney disease was the cause of arterial hypertension.

Long-term results of treatment of chronic hepatitis B, C and D with interferon-alpha in renal allograft recipients.

The aim of this study was to evaluate the efficacy and safety of interferon-alpha (IFN-alpha) therapy of chronic hepatitis B, C and D (HBV, HCV and HDV, respectively) in renal transplant recipients. A group of 42 patients (30 males, 12 females, mean age 38 years) with documented viraemia and chronic active hepatitis (CAH) were studied, of whom 1 had HBV infection alone, 11 had HCV infection alone, 3 had HBV and HDV infection concomitantly, 12 had HBV and HCV infection concomitantly, and 2 had HBV, HCV and HDV infection concomitantly. Patients received 3 MU IFN-alpha three times weekly for 6 months.

Clinical course of concomitant Hbv and Hcv infection in renal allograft recipients.

We evaluated the impact of concomitant infection with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) on the clinical course after renal transplantation (Tx). In 335 patients (pts) transplanted between 1991 and 1993 we found 30 (9%) recipients who were positive for Hepatitis B surface antigen (HBsAg) (ELISA, Organon) and anti-HCV antibodies (immunoblot assay Lia Tek) preTx. Chronic liver disease (CLD) (two-fold or greater increase in serum ALT and AST levels for at least six months) developed in 40.

Treatment of chronic hepatitis B and C with interferon-alpha in renal allograft recipients: preliminary results.

We evaluated the effects of treatment with interferon (IFN) on liver disease and renal allograft function in ten immunosuppressed cadaver kidney recipients. Two females and eight males (mean age 39 years) with biopsy-proven chronic active hepatitis (n = 8) or persistent hepatitis (n = 2) and serum positive for hepatitis B surface antigen (HBsAg) and HBe antigen (n = 5) or serum positive for anti-HCV antibodies (n = 3) or serum positive for HBsAg, anti-HCV and anti-HDV antibodies (n = 2) received 3 million units IFN thrice weekly of 6 months. All patients responded with a reduction in serum aminotransferase activity and in five of them liver function completely normalized.

[Tuberculosis in patients after kidney transplantation].

Infection caused by Mycobacterium tuberculosis is common among population in Poland. We analyzed the effect of tuberculosis (TB) on patients and graft survival in the group of renal allograft recipients (RAR), treated in our center. Among 1669 renal allograft recipients transplanted from 1981 to 1992, tuberculosis developed in 33 (2%) patients (16 M/17F, age: 22-57 years).

[The immunobiological effects of nitrogranulogen. I. Effect of nitrogranulogen on laboratory and clinical parameters in patients with primary glomerulopathies].

The administration of nitrogranulogen in a dose of 0.01 mg/kg in patients with primary glomerulopathies caused a significant reduction in proteinuria in 10 out of 12 cases. In one patient the effects was striking (fall of proteinuria from 10 g/24 hrs to trace amounts).

Interleukin 2 receptor positive T lymphocytes in renal allograft recipients: association with CMV infection.

The number of interleukin 2 receptor positive T cells freshly isolated from peripheral blood as well as stimulated in culture with PHA was determined in renal allograft recipients with stable graft function, rejection and CMV infection. The most typical phenotype was observed during CMV infection. Patients with CMV had very low levels of circulating positive cells which responded normally to mitogen stimulation in vitro.

[Retinal function after malignant hypertension in patients with transplanted kidneys].

Ophthalmological examinations were carried out in 42 patients (aged 16-45 years) after kidney transplantation in whom malignant hypertension was discovered before transplantation. The first funduscopy revealed pathological changes of various type and grade (I-IV), in 17 patients the visual acuity was lowered and in 18 the ERG record was pathological (residual or extinguished). The control examinations performed in 19 patients after 1-5 years showed that the changes typical for malignant hypertension receded in 7; the fundus of the rest of the patients was the same as before.

Immune monitoring after renal transplantation. I. HLA-D expression on T cells from renal allograft recipients.

The expression of class II antigens (HLA-DR, DP and DQ) on resting and PHA-activated T cells from renal allograft recipients was studied. A tendency for increase in DR+/DQ+ T cells was noted in azathioprine and cyclosporine-treated recipients undergoing rejection. Low inducible HLA-D expression (especially DP) was associated with CMV infection.

IgA nephropathy: a long-term progressive study.

Thirty-three cases of idiopathic IgA nephropathy were followed up for an average of 90.8 +/- 8.4 months.

Long-term immunosuppressive therapy of idiopathic membranoproliferative glomerulonephritis.

Fifty cases of idiopathic membranoproliferative glomerulonephritis were followed up for an average of 10 +/- 0.9 (SE) years. Forty of them, who presented a nephrotic syndrome, were treated by immunosuppressive drugs (prednisone, azathioprine, chlorambucil, cyclophosphamide) for 79 +/- 9.