Histomorphological and clinical study of primary and secondary glomerulopathies in Southeast Serbia (20-year period of analysis).

Background/aim: Epidemiological studies of renal biopsies have been performed to follow up the incidence of glomerular diseases on a specified territory and to compare the obtained results with results from other regions. The aim of this study was to analyze the frequency of certain histopathophysiological types of glomerular diseases on the territory of Southeast Serbia.

Methods: In a 20-year period (1986-2006), 316 kidney biopsies were performed in patients with clinical signs of impaired renal function, in Southeast Serbia.

Diagnostic value of the aminopeptidase N, N-acetyl-beta-D-glucosaminidase and dipeptidylpeptidase IV in evaluating tubular dysfunction in patients with glomerulopathies.

Aim: The aim of the present study was to investigate the value of the urine cell glycoprotein 1 (PC-1), aminopeptidase N (APN), N-acetyl-beta-D-glucosaminidase (NAGA), and dipeptidylpeptidase IV (DPP IV) in the evaluation of tubular damage in patients with primary glomerulonephritis, diabetic nephropathy, and lupus nephritis.

Subjects And Methods: PC-1, APN, NAGA, and DPP IV activities were determined in serum, urine, and lymphocytes of 178 subjects, including 10 patients with membranous nephropathy, 38 with IgA nephropathy, 29 with lupus nephritis, 51 with diabetic nephropathy, and 50 control subjects.

Results: Urinary PC-1 excretion in IgA nephropathy group was significantly higher (p < 0.

The impact of malnutrition on mortality in patients on maintenance hemodialysis in Serbia.

Numerous studies suggest a strong association between nutrition and clinical outcome in chronic hemodialysis (HD) patients. While determination of malnutrition is often based on objective measurements, such as biochemical parameters and anthropometric data, there is no single measurement that can reliably predict the risk for malnutrition or poor outcome. The aim of the present investigation was to determine the prevalence and severity of malnutrition among HD patients in a large university-affiliated HD center in Serbia, and to examine the relationship between various nutritional and nonnutritional factors, and the clinical outcome in the period of 20 months follow-up.

Diagnostic criteria for Balkan endemic nephropathy: proposal by an international panel.

Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression to terminal renal failure. Diagnostic criteria for BEN have been described more than 40 years ago. Research groups on BEN use one of at least three described lists of criteria.

Dietary curcumin does not protect kidney in glycerol-induced acute renal failure.

Generation of reactive oxygen species significantly contribute to the pathogenesis of renal injury induced by myoglobin release. The present study was performed to investigate the effects of dietary curcumin, a natural antioxidant isolated from plant Curcuma longa, in an experimental model of myoglobinuric acute renal failure. Rats received curcumin at an oral dose of 100mg/kg/day for 30 days.

Ethanol inhibitory effect on rat kidney brush border aminopeptidases.

Background/aim: Confusing data have been reported about the effect of ethanol or its metabolic products on blood pressure. The pressor agent, angiotensin II (Ang II), is found to be susceptible to degradation by different enzymes known as angiotensinases. We have studied the effects of ethanol and L-NAME, an inhibitor of nitric oxide synthase, consumption on rat serum and kidney ectoenzymes: aminopeptidase N (APN) and aminopeptidase A (APA).

Assessment of health-related quality of life in patients treated with hemodialysis in Serbia: influence of comorbidity, age, and income.

The importance of measuring health-related quality of life (HRQoL) in patients on maintenance hemodialysis (HD) is being increasingly recognized, but few studies, especially from the Balkan region, have addressed this issue. The aims of this study were (i) to evaluate HRQoL in an outpatient university-affiliated dialysis facility in South Serbia; (ii) to determine the effects of age, presence of comorbidity, primary kidney disease, dose of HD, and family income; and (iii) to make comparisons of the HRQoL in Serbian patients on chronic HD with that reported by others previously. The study enrolled 192 patients on HD for more than 3 months.

Influence of co-morbidity on health-related quality of life in patients treated with hemodialysis.

Unlabelled: Studies on the outcome of hemodialysis (HD) patients over time have mainly focused on morbidity and mortality, but currently, the importance of measuring the patient's health-related quality of life (HRQoL) is being increasingly recognized. On the other hand, comorbidity is the single most important determinant of outcome in patients on HD. The aims of this study were to evaluate HRQoL in patients at the initiation of HD therapy (incident cohort), and in patients on long-term HD treatment (prevalent cohort), and to establish the relationship between the presence of comorbidity and patient's HRQoL.

Lymphocyte ecto-5'-nucleotidase in obese type 2 diabetic patients treated with gliclazide.

Objective: Lymphocyte 5'-nucleotidase is sensitive to superoxide anion, and is an indicator of oxidative stress in humans. The aim of this study was to assess the effect of the sulfonylurea drugs gliclazide and glibenclamide on lymphocyte ecto-5'-nucleotidase of type 2 diabetic patients.

Methods: Thirty obese type 2 diabetic patients were treated for three months after randomisation either with gliclazide or glibenclamide.

Etiology of Balkan endemic nephropathy and associated urothelial cancer.

Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression to terminal renal failure. Evidence has accumulated that BEN is an environmentally induced disease. There are three actual theories attempting to explain the environmental cause of this disease: (1) the aristolochic acid hypothesis, which considers that the disease is produced by chronic intoxication with Aristolochia, (2) the mycotoxin hypothesis, which considers that BEN is produced by ochratoxin A, and (3) the Pliocene lignite hypothesis, which proposes that the disease is caused by long-term exposure to polycyclic aromatic hydrocarbons and other toxic organic compounds leaching into the well drinking water from low-rank coals in the vicinity to the endemic settlements.

Progression of kidney damage in Balkan endemic nephropathy: a 15-year follow-up of patients with kidney biopsy examination.

Progression of kidney damage was studied in 18 patients with Balkan endemic nephropathy (BEN), with a mean 15-year follow-up after renal biopsy. According to kidney function, estimated by 99mTc-DTPA clearance, patients were divided into three groups: with apparently normal kidney function (clearance 103.5+/-21.

Lymphocyte 5'-nucleotidase and aminopeptidase N activity in patients on maintenance hemodialysis treated with human recombinant erythropoietin and 1-alpha-D3.

Background: Patients with end-stage renal disease (ESKD) present an immunodeficiency state paradoxically exacerbated by hemodialysis (HD) and associated with signs of T-cell activation. B cells are also activated in uremia, and this activation could be altered by erythropoietin therapy in HD patients. In this study, the effects of human recombinant erythropoietin (rHu-EPO) and 1-alpha-D3 treatments on lymphocyte immunomodulatory enzymes, aminopeptidase N (APN), and 5'-nucleotidase activity in patients on HD were investigated in hemodialysis patients before and after two-month treatment with s.

Effects of physical exercise in patients with end stage renal failure, on dialysis and renal transplantation: current status and recommendations.

There is increasing evidence about the benefits of regular physical activity in the chronically ill. Patients with chronic renal failure prior to and after renal transplant are one of the target groups in which increased controlled physical activity is highly recommended. Significant atrophy and increased non-contractile tissue are present in the muscle of predialytic and patients on hemodialysis, which is associated with poor physical performance and poor outcome of renal disease.

Treatment of dyslipidemia in chronic kidney disease.

Dyslipidemia is a common feature of various renal diseases. This perturbed lipid metabolism results in accelerated atherosclerosis and increased cardiovascular morbidity and mortality. Treatment of dyslipidemia, in addition to normalization of blood pressure and reduction of proteinuria, could provide additional means to retard the progression of chronic renal insufficiency.

Plasma cell membrane glycoprotein 1 (PC-1): a marker of insulin resistance in obesity, uremia and diabetes mellitus.

Insulin resistance is a characteristic feature of obesity and type 2 diabetes mellitus, but it is also present in up to 25% of healthy nonobese individuals. The molecular mechanisms causing insulin resistance are not yet fully understood. Recently, overexpression of several potential inhibitors of the insulin receptor tyrosine-kinase activity, a key step in insulin signaling, has been described in insulin-resistant subjects .

Increased urinary protein excretion in children from families with balkan endemic nephropathy.

Background: Balkan endemic nephropathy (BEN) has not been described in children, however some previous studies of children from families with BEN have revealed abnormalities of the urinary tract including an increased urinary protein excretion.

Methods: In the present study, urinary excretion of total protein was studied in 703 healthy children, aged 9-13, from endemic and non-endemic settlements around the South Morava River. Since BEN is an environmentally induced disease, with possible seasonal variation of toxin(s), children were studied three times a year: in spring, autumn and winter, during a 3-year period.

Urinary PC-1 activity in patients with type 1 diabetes mellitus.

Background: Insulin resistance characterizes type 1 diabetes mellitus with nephropathy. The molecular mechanisms of insulin resistance are not completely understood. Recently some advances have been made in identification of transmembrane glycoprotein PC-1 as a potential factor of insulin resistance.

Urinary PC-1 and N-acetyl-beta-D-glucosaminidase activity in patients with type 2 diabetes treated with metformin, gliclazide or glibenclamide.

Background: Insulin resistance is a key feature of type 2 diabetes mellitus. Plasma cell differentiation antigen (PC-1) is an inhibitor of insulin receptor tyrosine kinase, and has been implicated in the pathogenesis of insulin resistance.

Methods: Urinary excretion of PC-1 was determined in 45 newly detected, obese diabetic patients treated with metformin (16 patients), gliclazide (14 patients) or glibenclamide (15 patients).

Treatment of insulin resistance in uremia.

Insulin resistance is a characteristic feature of uremia. As long as the hyperinsulinemia adequate to overcome the insulin resistance, glucose tolerance remains normal. In patients destined to develop type 2 diabetes, the beta cell compensatory response declines, and relative, or absolute, insulin deficiency develops.

Nephroprotective effects of pentoxifylline in experimental myoglobinuric acute renal failure.

The nephroprotective effects of pentoxifylline, a methylxantine, were studied in glycerol-induced acute renal failure. Glycerol treated rats exhibited collecting duct and medullary ascending limb dilation and casts, with focal tubular damage, confined mainly to the superficial cortex. In the interstitium focal mononuclear infiltration was observed.

Increased urinary albumin excretion in children from families with Balkan nephropathy.

Balkan nephropathy (BN) has not been described in children. However, some previous studies have revealed abnormalities of the urinary tract in children from families with BN. In the present study, urinary excretion of albumin was studied in 703 healthy children, age 9-13 years, from endemic and non-endemic settlements around the South Morava River.

Increased expression of glomerular mesangial cell 5'-nucleotidase in membranous nephropathy.

It has been demonstrated in anti-Thy1 glomerulonephritis that extracellular adenine nucleotides have a significant pro-inflammatory activity, however, glomerular ATP/ADPase, which in concert with 5'-nucleotidase converts ATP/ADP, and AMP to anti-inflammatory adenosine had an anti-inflammatory role. We have studied distribution of 5'-nucleotidase and divalent cation-activated ATPase in kidney biopsies of 15 patients with glomerulonephritis. The major finding was an overexpression of 5'-nucleotidase in the mesangium of kidney from patients with membranous nephropathy.

Effect of polyamines on mesangial cell ecto-5'-nucleotidase and ecto-ATPase activity.

Polyamines were found to modulate the activity of several membrane-bound enzymes, participating in cell growth and differentiation. We have studied the effect of polyamines (spermidine, spermine and putrescine) on rat mesangial cell ectoenzymes: 5'-nucleotidase, Mg(2+)-ATPase and Ca(2+)-ATPase. Ecto-5'-nucleotidase activity was significantly increased after 48 h treatment with spermine and spermidine.

Balkan endemic nephropathy: a decreasing incidence of the disease.

Balkan endemic nephropathy (BEN) is a chronic tubulointerstitial kidney disease prevalent in Serbia, Bosnia, Croatia, Bulgaria and Romania. This study investigates the incidence of BEN patients on dialysis with end-stage kidney disease (ESKD), and BEN-associated mortality in endemic areas around the South Morava River in Serbia from 1978 to 1997. In the last 10 years a marked decrease in the incidence of ESRD and BEN-induced mortality has been documented in the region.