[[GUIDELINES FOR THE PREVENTION, MONITORING AND THERAPY OF CHRONIC KIDNEY DISEASE-METABOLIC BONE DISEASE IN PATIENTS WITH CHRONIC KIDNEY DISEASE].].

Chronic kidney disease (CKD) is a systemic disease with numerous complications associated with increased morbidity and mortality. Chronic kidney disease-metabolic bone disease (CKD-MBD) starts at early stages of CKD with phosphorus accumulation and consequent initiation of numerous events that result with the development of secondary hyperparathyroidism with changes on bones and extraskeletal tissues. The most important and clinically most relevant consequences of CKD-MBD are vascular calcifications which contribute to cardiovascular mortality.

What is the impact of immunosuppressive treatment on the post-transplant renal osteopathy?

Although glucocorticoid therapy is considered to be the main pathogenic factor, a consistent body of evidence suggests that other immunosuppressants might also play an important role in the development of the post-transplant renal osteopathy (PRO) through their pleiotropic pharmacological effects. Glucocorticoids seem to induce osteoclasts' activity suppressing the osteoblasts while data regarding other immunosuppressive drugs are still controversial. Mycophenolate mofetil and azathioprine appear to be neutral regarding the bone metabolism.

Impaired regulation of calcium excretion in kidney transplant recipients.

Disorders of mineral metabolism and hypercalcemia are frequent in kidney transplant recipients. Calcium to creatinine (Ca/Cr) clearance ratio was used as a criterion to distinguish between different calcium metabolism disorders. The study comprised 91 (53 men, 38 women) kidney recipients aged 23-70 years, with creatinine clearance (CrCl) >60 ml/min.

[Importance of biochemical indicators of bone turnover in patients on chronic dialysis and after kidney transplantation].

Bone remodeling is a continuous process of removal of microscopic amounts of bone tissue due to synchronized actions of osteoclasts and osteoblasts with the purpose of renewal and repair of bone tissue. During the formation of bone matrix osteoblasts synthesize proteins. Measurement some of these proteins in blood has clinical significance as indicators of bone formation: osteocalcin, procollagen type I propeptide, and bone alkaline phosphatase.

Interleukin-6, transforming growth factor-beta 1, and bone markers after kidney transplantation.

The aim of this study was to investigate the relationship between interleukin 6 (IL-6), transforming growth factor (TGF)-beta 1, IL-6 soluble receptors, and biochemical parameters of bone turnover after kidney transplantation. Of 64 patients enrolled in the study, 19 received the kidney transplant 2 to 12 months before the study, and 45 within the previous 15 to 175 months. We measured IL-6, TGF-beta 1, intact parathyroid hormone (PTH) bone alkaline phosphatase (BALP), osteocalcin (OC), and procollagen type I propeptide (P1CP) concentrations in the serum, and deoxypyridinoline crosslinks (DPD) in the urine of the patients.

[Primary cytomegalovirus infection after combined cadaveric transplantation of the liver and kidney].

Seronegative transplant recipients are at a high risk of developing primary cytomegalovirus (CMV) infection. The D+/R--constellation produces a 60%-80% probability of CMV disease. In such cases CMV prophylaxis is justified.

Parathyroid hormone and bone mass after kidney transplantation.

Metabolic bone disorder develops during chronic renal failure and chronic dialysis treatment, continues after successful kidney transplantation, and is further aggravated by corticosteroids and immunosuppressants. The recognized risk factors for bone loss, i.e.

Determinants of reduced bone mineral density and increased bone turnover after kidney transplantation: cross-sectional study.

Aim: To analyze bone metabolism and the risk factors of bone loss in kidney transplant recipients.

Methods: The bone mineral density (BMD) of the lumbar spine, femoral neck, and radius was determined by dual-energy X-ray absorptiometry in 52 patients 8 days to 228 months after kidney transplantation. Total and bone alkaline phosphatase (BAP), osteocalcin, procollagen, type I collagen telopeptide, collagen cross links, calcium, intact parathyroid hormone (iPTH), and creatinine were measured in all patients.

Circulating hematopoietic progenitors are not altered in patients with post-transplant erythrocytosis.

Granulocyte/macrophage (GM), mixed colony and erythroid burst forming unit assays were performed in 9 post-transplant erythrocytosis (PTE) patients, 18 non-PTE kidney transplant recipients and 12 healthy volunteers. The number of GM precursors was lower in PTE patients than in normal subjects. This indicates that hematopoietic stem cell potential is not altered in PTE.

Biochemical parameters of bone turnover in kidney transplant recipients.

Impairment of bone remodelling due to chronic renal failure persists even after successful kidney transplantation. Bone turnover was assessed in 22 kidney transplant recipients by measurement of serum bone markers: total (tALP) and bone alkaline phosphatase (bALP), osteocalcin (OC), procollagen I C-terminal propeptide (PICP), collagen I C-terminal telopeptide (ICTP), and iPTH. The patients were on dialysis 56.

[The nail-patella syndrome].

The nail-patella syndrome (synonym of onychoosteodysplasia) is considered to be an autosomal dominant hereditary disease affecting numerous tissues of ectodermal and mesodermal origin. The changes are mostly found on nails, patellae, eyes and joints. The symptoms of nephropathy are present in 30% to 40% of patients, and renal insufficiency with typical signs of the syndrome in 25% of patients.