Comparison of different methods to assess tacrolimus concentration intra-patient variability as potential marker of medication non-adherence.

Non-adherence to tacrolimus commonly manifests as low drug concentrations and/or high intra-patient variability (IPV) of concentrations across multiple measurements. We aimed to compare several methods of tacrolimus IPV calculation and evaluate how well each reflects blood concentration variation due to medication non-adherence in kidney transplant recipients. This Czech single-center retrospective longitudinal study was conducted in 2019.

[Bone disesase in end-stage kidney disease - renal and non-renal components].

Metabolic bone disease in chronic kidney disease and end-stage renal failure represents one of the most severe clinical complication in kidney patients, namely those on maintenance dialysis. Traditionally, bone changes are induced by secondary hyperparathyroidism. The CKD-MBD concept reflects the link between bone and cardiovascular disease in these patients.

Molecular patterns of diffuse and nodular parathyroid hyperplasia in long-term hemodialysis.

Secondary hyperparathyroidism is a well-known complication of end-stage renal disease (ESRD). Both nodular and diffuse parathyroid hyperplasia occur in ESRD patients. However, their distinct molecular mechanisms remain poorly understood.

Changes of serum calcium, magnesium and parathyroid hormone induced by hemodialysis with citrate-enriched dialysis solution.

Background/aims: In recent years, one of technical attempts to improve biocompatibility and tolerability of the hemodialysis procedure is the substitution of acetate in dialysis solution with citrate. The aim of our study was to compare two dialysis solutions: traditional bicarbonate dialysis solution containing acetate (3 mmol/L) (solution A); and (solution C) commercially produced citrate-enriched bicarbonate dialysis solution (0.8 mmol/L citrate).

Skin wounds associated with calciphylaxis in end-stage renal disease patients on dialysis.

Calciphylaxis is a rare complication of chronic renal failure mostly with poor prognosis. Painful lesions on various skin surface areas are the most prominent feature of this serious disease. Subsequent infection of necrotic skin tissue is associated with the risk of sepsis.

Increase of nocturnal melatonin levels in hemodialyzed patients after parathyroidectomy: a pilot study.

In hemodialyzed patients hormonal disturbances are known to occur. However, melatonin levels have not been completely studied. The aim of the study was to find whether changes in calcaemia affect melatonin secretion.

Resting energy expenditure and thermal balance during isothermic and thermoneutral haemodialysis--heat production does not explain increased body temperature during haemodialysis.

Background: During routine haemodialysis (HD) body temperature increases, which contributes to haemodynamic instability. The relative roles of increased heat production and/or incomplete heat transfer are not fully elucidated. Concomitant measurement of heat production and heat transfer may help to assess the factors determining thermal balance during HD.

Continuous blood volume monitoring and "dry weight" assessment.

There are two distinct facets of adequate fluid balance control in haemodialysis patients--estimation of dry weight (DW) as the target and adequate ultrafiltration (UF) strategy, i.e. the way to reach the target in a possibly symptom-free way.

Comparison of different techniques of hemodialysis vascular access flow evaluation.

Measurement of vascular access flow (QVA) has been suggested as a method of choice for vascular access quality (VAQ) monitoring. Besides traditional duplex Doppler, a number of bedside methods based mostly on the Krivitski principle of QVA evaluation from recirculation at reversed needles (RX), have been developed. This work compares ultrasonic dilution (UD), taken as a reference, HD01, Transonic Systems; duplex Doppler (DD); thermodilution (TD), BTM, Fresenius; optodilutional RX measurement (ORX), Critline III, R-mode, HemaMetrics; direct optodilutional QVA evaluation from jumpwise changes in ultrafiltration rate at both normal and reversed needles connection (OABF), Critline III, ABF-mode; and direct transcutaneous optodilutional QVA evaluation (TQA), Critline III TQA.

[Resting energy expenditure during hemodialysis].

Very few studies have so far reported about resting energy expenditure (REE) in chronic renal failure and there is no information available on REE during hemodialysis (HD). Hypothetically, we can expect an increase in REE during HD procedure (due to the inflammatory response to extracorporeal blood circuit). However, such increase in REE could be modified by thermal balance of the procedure.

[Viral hepatitis of patients in a regular haemodialysis programme].

After cardiovascular diseases and bacterial infections viral hepatitis is the most frequent disease which complicates haemodialyzation treatment of patients with chronic renal failure. Substitution of renal function is for these patients a life saving procedure. It is, however, complicated treatment associated with various risks of acute and chronic complications.

Plasma ghrelin levels in patients with end-stage renal disease.

Ghrelin is an acylated peptide stimulating secretion of the growth hormone (GH). It was originally isolated from the rat stomach as an endogenous ligand for the growth hormone secretagogue receptor. Although being predominantly produced by endocrine cells of the gastric fundus, its secretion has been found in various tissues including the kidney.

[Junctions of hepatology and nephrology].

The liver and the kidney jointly or in a complementary manner play an important role in maintaining homeostasis of the internal environment, mainly regarding detoxification, excretion and regulation. Hepatorenal syndrome can develop under pathological circumstances due to severe hepatic impairment, when the metabolism of both organs is affected by various xenobiotics, when they are damaged by genetic defects as in renal polycystosis, glycogenoses, alpha-1 antitrypsin deficiency or in hereditary amyloidosis. In primary hyperoxaluria or familiar thrombotic microangiopathy renal impairment develops due to the metabolic defect in the liver.

[An importance of vitamin D metabolites assessment in patients with impaired renal function].

The goal of this prospective multicentric study was to assess concentrations of vitamin D metabolites in patients with renal insufficiency and to monitor response of calcium phosphate metabolism parameters to a focused individualised therapy. The sample consisted of 184 patients, 66 of them were undergoing regular dialysis (Ccreat 0.11 +/- 0.

Increased levels of pregnancy-associated plasma protein A are associated with mortality in hemodialysis patients: preliminary results.

Pregnancy-associated plasma protein A (PAPP-A) is a new prognostic indicator of acute coronary syndrome. This protein is elevated in hemodialysis (HD) patients and is closely related to inflammation and oxidative stress. The aim of our pilot study was to find out whether PAPP-A is related to mortality in HD patients.

Relationship of pregnancy-associated plasma protein-a to renal function and dialysis modalities.

Background: The aim of the study was to determine pregnancy-associated plasma protein-A (PAPP-A), which was recently described as a new marker of cardiovascular events, in patients with chronic renal insufficiency/failure and to find out its relationship to renal function and to prominent markers of oxidative stress (advanced oxidation protein products--AOPP) and inflammation (C-reactive protein--CRP).

Methods: The studied group consisted of 36 chronic hemodialysis patients (HD), 10 patients treated with continuous ambulatory peritoneal dialysis (CAPD) and 38 patients with chronic renal insufficiency (CHRI) not yet dialyzed. PAPP-A was measured by Time Resolved Amplified Cryptate Emission technology.

Comparison of different techniques of hemodialysis vascular access flow evaluation.

Measurement of vascular access flow (QVA) has been suggested as a method of choice for vascular access quality (VAQ) monitoring. Besides traditional duplex Doppler, a number of bedside methods based mostly on the Krivitski principle of QVA evaluation from recirculation at reversed needles (RX), have been developed. This work compares ultrasonic dilution (UD), taken as a reference, HD01, Transonic Systems; duplex Doppler (DD); thermodilution (TD), BTM, Fresenius; optodilutional RX measurement (ORX), Critline III, R-mode, HemaMetrics; direct optodilutional QVA evaluation from jumpwise changes in ultrafiltration rate at both normal and reversed needles connection (OABF), Critline III, ABF-mode; and direct transcutaneous optodilutional QVA evaluation (TQA), Critline III TQA.

Physiology in daily hemodialysis in terms of the time average concentration/time average deviation concept.

Quotidian or "daily" hemodialysis (DHD) is practiced in widely differing schedules. Yet all those schedules are reported to significantly ameliorate clinical outcome of patients. It is, however, not clear what is the actual cause of this amelioration.

Advanced glycation end products in clinical nephrology.

As a result of oxidative and carbonyl stress, advanced glycation end products (AGEs) are involved in the pathogenesis of severe and frequent diseases and their fatal vascular/cardiovascular complications, i.e. diabetes mellitus and its complications (nephropathy, angiopathy, neuropathy and retinopathy, renal failure and uremic and dialysis-associated complications), atherosclerosis and dialysis-related amyloidosis, neurodegenerative diseases, and rheumatoid arthritis.

Glycoxidation and inflammation in chronic haemodialysis patients.

Background: Uraemia and haemodialysis treatment are associated with microinflammation and oxidative as well as carbonyl stress, which result in enhanced formation of glycoxidation products. Although both glycoxidation and inflammation can contribute to severe vascular and cardiovascular complications, the role that these pathogenic mechanisms play in the complex response of the whole organism remains to be elucidated.

Methods: We performed a cross-sectional study in 34 clinically stable chronic haemodialysis patients and in 14 healthy controls while determining serum concentrations of pentosidine, fluorescent advanced glycation end-products (AGEs), advanced oxidation protein products (AOPPs) and acute phase reactants.

[Tuberculosis in patients with chronic kidney failure].

Background: In a retrospective study we analysed the incidence of tuberculosis (tb) in end-stage renal disease patients undergoing dialysis treatment at the Department of Medicine Strahov, General University Hospital, 1st Medical Faculty, Charles University, Prague. Study included patients who died and were autopsied from 1991 till 2000.

Methods And Results: Active tb was found in 11 cases (4 men and 7 women, age 56 to 84 years) from the total of 275 patients, i.