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Biomedical subjects

B Rutkowski

Publications and source records attributed to B Rutkowski.

At least 19 recordsLinked to original sources
PubMed2001

Diurnal rhythm of cholesterol biosynthesis in experimental chronic renal failure.

Changes in lipid metabolism are an important risk factor for vascular complications during chronic renal failure (CRF). In experimental CRF hypercholesterolemia has been found to be the main lipid disorder. It is probably due to enhanced cholesterologenesis. Mechanisms of these changes remain poorly understood. It is well known that activity of cholesterologenesis undergoes a significant diurnal rhythm. However, there was no evidence that this rhythm is still present in the course of experimental CRF. Results of our studies indicate that in contrast to puromycin induced nephrotic syndrome, diurnal rhythm of cholesterologenesis in CRF rats is preserved both in liver and in the intestine tissue. Significant higher incorporation of tritiated water into cholesterol fraction was found in vivo both in liver as well as in intestine of CRF rats, as compared to control animals. Increased (with comparison to the controls) incorporation of 14C-acetate, and 3H-mevalonate into CRF rat liver sterols indicate that mechanism of enhanced cholesterologenesis is more complex than simply due to the elevated level of mevalonate (potential substrate for cholesterologenesis) which has been reported in plasma of CRF animals.

Animals↗
PubMed2001

Lipogenesis in experimental chronic renal failure in rats.

Hyperlipidemia is a common occurance in patients with chronic renal failure (CRF) and has been the subject of many clinical and experimental studies. Despite this, the role of lipogenesis in the development of hyperlipidemia is still obscure. The present study is based on a rat model of CRF involving a two-stage subtotal nephrectomy. In this study, we measured the activity of fatty acid synthase (FAS). This is the rate-limiting enzyme of lipogenesis and is present in liver and white adipose tissue (WAT). Using isotopic methods, we also determined the rate of lipogenesis in vivo in liver and WAT. In both liver and WAT, the results of the analyses were similar. In the uremic rats, there was a tendency for the FAS activity to rise. However, the difference was not statistically significant. Furthermore, there was no increase in the rate of lipogenesis in vivo in either tissue. In summary, the results of our study confirm the thesis that lipogenesis does not play a role in the development of hypertriglyceridemia seen in an experimental CRF in rats.

Adipose Tissue↗
PubMed2001

Low leptin mRNA level in adipose tissue and normoleptinemia in experimental chronic renal failure.

BACKGROUND: Anorexia and weight loss frequently accompany chronic renal failure (CRF). Although multiple metabolic changes occur during CRF, a bulk of evidence indicates that the decrease in caloric intake plays a major role in CRF-induced weight loss. Recently, it has been suggested that elevated plasma leptin concentrations could contribute to anorexia and to downregulation of leptin gene expression in CRF patients. However, in some CRF patients, plasma leptin concentrations have been found to be lower than one could expect. Thus we assumed that inhibition of leptin synthesis plays an important role in the regulation of plasma leptin concentrations in CRF patients. METHODS: To test this assumption, the leptin mRNA level in rat white adipose tissue from ad-libitum-fed control (sham operated), pair-fed control (sham operated) and rats with experimentally induced CRF has been measured by Northern blotting analysis. In addition, serum leptin concentration (by radioimmunoassay) was determined in all three groups of animals. RESULTS: The results of the present study indicate that in experimental CRF the leptin mRNA level is decreased by about 50% as compared to the sham-operated animals (ad-libitum-fed and pair-fed controls). The mean serum leptin concentration in CRF rats was essentially similar to the leptin concentration in sham-operated ones. CONCLUSION: The data obtained suggest that in CRF animals the serum leptin concentration might be affected not only by the decrease in leptin removal in the kidney, but also by the decrease in leptin secretion from adipose tissue. Furthermore, the results of the study suggest that leptin may be only one of many factors involved in the pathogenesis of malnutrition associated with CRF.

Adipose Tissue↗
PubMed2001

Beneficial clinical effects of ozonated autohemotherapy in chronically dialysed patients with atherosclerotic ischemia of the lower limbs--pilot study.

Ozonated autohemotherapy is a controversial but successful method of treatment, used in particular in European countries. There are many fields in which medical ozone could be of value: treating different infections, immunodeficiency syndromes, neoplasms. Encouraging results have also been achieved in the treatment of atherosclerotic ischemia of the lower limbs. In this preliminary study, the influence of blood ozonation on the intensity of symptoms of ischemia of the lower extremities was analysed among dialysed patients with chronic renal failure. We examined 5 hemodialyzed patients and 7 patients treated with peritoneal dialysis immediately before and after 14 sessions of ozonated autohaemotherapy. Eleven patients (91.6%) reported a subjective decrease in perceived intensity of ischemic pains, or observed prolongation of intermittent claudication distance. During march tests performed on a treadmill, we found significant prolongation of intermittent claudication distance in all examined patients - 65.6% (mean value, p (< or =0.01). Patients treated with peritoneal dialysis achieved much greater improvement than did hemodialyzed patients (165% vs. 42%). We concluded that autohemotherapy with ozone, in a concentration of 34.4 mcg/ml of blood, is safe, easily applied and may be useful In the therapy of atherosclerotic ischemia of lower extremities among dialyzed patients. It could also be a complement to current treatment, especially in cases where the latter has failed.

Adult↗
PubMed2001

Interrelationship between cardiac structure and function and incidence of arrhythmia in peritoneal dialysis patients.

Cardiovascular complications in patients with end-stage renal disease requiring dialytic therapy are frequent and account for approximately 40% of all deaths in these patients. The aim of this study was to analyze the occurrence of cardiac arrhythmia in peritoneal dialysis (PD) patients with respect to the changes in left ventricular structure and function. To determine characteristics of arrhythmia in patients on PD for chronic renal failure, 30 patients (18 male and 12 female; aged 54.1+/-13.8 years) underwent twice (interval of 20+/-4.1 months) ambulatory 24 hour Holter ECG monitoring. At the same time all the patients were analyzed by echocardiography and pulsed Doppler echocardiography to estimate cardiac structure and function. Ventricular arrhythmias were seen in 9 patients (30%) during the first examination and in 13 patients (43.3%) on the second. Ventricular arrhythmias were observed only in patients with left ventricular hypertrophy (LVH). Supraventricular arrhythmias were seen in 12 (40%) and 17 (56.7%) patients. The majority of these patients also had LVH, with 11/12 (91.7%) patients at the first examination and 15/17 (88.2%) at the second respectively. We conclude that the incidence of arrhythmia is primarily dependent on the presence of LVH in PD patients. It appears that peritoneal dialysis does not provoke or aggravate arrhythmia.

Age Factors↗
PubMed2001

[Adenine reutilization as a cause of increased ATP concentration in erythrocytes of patients with chronic renal failure].

Abnormalities of adenine nucleotide metabolism are observed in erythrocytes of patients with chronic renal failure (CRF) and the elevated ATP concentration is the most impressive one. In humans, adenine and/or adenosine reutilization is the only source of purine moiety used to erythrocyte adenine nucleotide synthesis. In the present study we have focused on the role of adenine as a substrate for the intraerythrocyte ATP production. 10 patients with CRF and 10 healthy volunteers (control group) were included into the study. Using HPLC, the measurements were performed in plasma and erythrocyte extracts. We observed a few fold higher adenine concentration in both plasma and erythrocytes of patients with CRF when compared with control group. There was also elevated an intraerythrocyte ATP concentration in the studied group of patients. Moreover, we have found a positive correlations between a) plasma creatinine concentration and plasma adenine concentration, b) plasma creatinine concentration and erythrocyte adenine concentration, c) plasma adenine concentration and intraerythrocyte ATP concentration. It appears that increased adenine reutilization could be a principle reason of the increased ATP synthesis in erythrocytes of patients with CRF.

Adenine↗
PubMed2001

[Renal involvement in vasculitis].

Systemic vasculitides are a heterogenous group of diseases, characterized by inflammation of blood-vessel walk. In the course of different types of vasculitis renal involvement is quite often present. Renal dysfunction may manifest as a component of multi-system disease or as the first clinical expression of vasculitis. Presented paper shows the clinical picture of different form of vasculitis and possibilities of their urinary tract manifestations.

Diagnosis, Differential↗
PubMed2000

Accelerated degradation of adenine nucleotide in erythrocytes of patients with chronic renal failure.

Recently, we have shown that erythrocytes obtained from patients with chronic renal failure (CRF) exhibited an increased rate of ATP formation from adenine as a substrate. Thus, we concluded that this process was in part responsible for the increase of adenine nucleotide concentration in uremic erythrocytes. There cannot be excluded however, that a decreased rate of adenylate degradation is an additional mechanism responsible for the elevated ATP concentration. To test this hypothesis, in this paper we compared the rate of adenine nucleotide breakdown in the erythrocytes obtained from patients with CRF and from healthy subjects. Using HPLC technique, we evaluated: (1) hypoxanthine production by uremic RBC incubated in incubation medium: (a) pH 7.4 containing 1.2 mM phosphate (which mimics physiological conditions) and (b) pH 7.1 containing 2.4 mM phosphate (which mimics uremic conditions); (2) adenine nucleotide degradation (IMP, inosine, adenosine, hypoxanthine production) by uremic RBC incubated in the presence of iodoacetate (glycolysis inhibitor) and EHNA (adenosine deaminase inhibitor). The erythrocytes of healthy volunteers served as control. The obtained results indicate that adenine nucleotide catabolism measured as a hypoxanthine formation was much faster in erythrocytes of patients with CRF than in the cells of healthy subjects. This phenomenon was observed both in the erythrocytes incubated at pH 7.4 in the medium containing 1.2 mM inorganic phosphate and in the medium which mimics hyperphosphatemia (2.4 mM) and metabolic acidosis (pH 7.1). The experiments with EHNA indicated that adenine nucleotide degradation proceeded via AMP-IMP-Inosine-Hypoxanthine pathway in erythrocytes of both patients with CRF and healthy subjects. Iodoacetate caused a several fold stimulation of adenylate breakdown. Under these conditions: (a) the rate of AMP catabolites (IMP + inosine + adenosine + hypoxanthine) formation was substantially higher in the erythrocytes from patients with CRF; (b) in erythrocytes of healthy subjects degradation of AMP proceeded via IMP and via adenosine essentially at the same rate; (c) in erythrocytes of patients with CRF the rate of AMP degradation via IMP was about 2 fold greater than via adenosine. The results presented in this paper suggest that adenine nucleotide degradation is markedly accelerated in erythrocytes of patients with CRF.

Adenine Nucleotides↗
PubMed2000

Changing pattern of end-stage renal disease in central and eastern Europe.

BACKGROUND: The epidemiology of end-stage renal disease (ESRD) is changing all over the world. Particularly dramatic changes of the epidemiology of ESRD have occurred in central and eastern Europe (CEE). The aim of the present study was (i) to document the further expansion of renal replacement therapy (RRT) noted in recent years in CEE and (ii) to analyse in some detail treatment modalities and underlying renal conditions. METHODS: Three independent surveys were performed in 1995, 1997 and 1998. Fifteen CEE countries participated. The data were mainly obtained from national registries which are based on centre and patient questionnaires. RESULTS: The data collected from 15 CEE countries document further expansion of RRT in this region. The report includes data on the availability of RRT in Byelorussia, Estonia, and Russia which have become available for the first time. The epidemiology of dialysed patients has changed remarkably. In the majority of countries the number of diabetic patients has increased, most dramatically so in the Czech Republic (31% of all dialysed patients), in the majority of the other countries 10-14%. The number of ESRD patients with the diagnosis of hypertensive nephropathy has also increased and this was accompanied by an increase in proportion of elderly (>65 years) patients, i.e. 46% in the Czech Republic and 12-25% in most other countries. CONCLUSION: Dramatic changes of the availability of RRT treatment have occurred in central and eastern Europe. The proportion of diabetic nephropathy and elderly patients has risen. Large differences in RRT exist between individual CEE countries and this appears mainly dependent on the level of economic development.

Age Distribution↗
PubMed2000

Increased rate of adenine incorporation into adenine nucleotide pool in erythrocytes of patients with chronic renal failure.

BACKGROUND: Elevated purine nucleotide pool (mainly ATP) in erythrocytes of patients with chronic renal failure (CRF) is a known phenomenon, however the mechanism responsible for this abnormality is far from being clear. We hypothesize that the increased rate of adenine incorporation into adenine nucleotide pool is responsible for the elevated level of ATP in uremic erythrocytes. METHODS: In chronically uremic patients we evaluated using HPLC technique: (a) plasma adenine concentration; (b) the rate of adenine incorporation into adenine nucleotide pool in uremic erythrocytes. Additionally, the effect of higher than physiological phosphate concentration (2.4 mM) and lower than physiological pH (7.1) on adenine incorporation into erythrocytes adenine nucleotide pool was investigated. Healthy volunteers with normal renal function served as control. RESULTS: The concentration of adenine in plasma of CRF patients was found to be significantly higher than in plasma of healthy subjects. In contrast, adenosine concentration was similar both in healthy humans and in CRF patients. In isolated erythrocytes of uremic patients (incubated in the medium pH 7.4, containing 1.2 mM inorganic phosphate) adenine was incorporated into adenine nucleotide pool at a rate approximately 2-fold higher than in erythrocytes from healthy subjects. The rate of adenosine incorporation into adenine nucleotide pool was similar in erythrocytes of both studied groups. Incubation of erythrocytes obtained from healthy subjects in the medium pH 7.4, containing 2.4 mM inorganic phosphate, caused the increase of adenine incorporation into adenine nucleotide pool by about 60%. Incubation of the cells in the pH 7.1 buffer containing 2. 4 mM inorganic phosphate increased the rate of adenine incorporation into adenylate approximately 2-fold as compared to erythrocytes incubated in the medium pH 7.4 containing 1.2 mM inorganic phosphate. Erythrocytes obtained from uremic patients and incubated in the pH 7.1 medium containing 2.4 mM phosphate incorporated adenine into adenine nucleotide pool at a rate similar to erythrocytes incubated in the medium pH 7.4 containing 1.2 mM phosphate. Erythrocytes obtained from either healthy subjects or from patients with CRF and incubated in the presence of higher than physiological concentration of inorganic phosphate (2.4 mM) and lower than physiological pH (7. 1) did not exhibit any increase in the rate of adenisine incorporation into adenine nucleotide pool. CONCLUSION: These results suggest that the increased rate of adenine incorporation into adenine nucleotide pool could be partially responsible for the increased concentration of ATP in uremic erythrocytes.

Adenine↗
PubMed2000

Correlation between plasma carnitine, muscle carnitine and glycogen levels in maintenance hemodialysis patients.

Chronic hemodialysis (HD) may lead to losses of carnitine from plasma and muscle. Plasma carnitine does not reflect the body content of carnitine. The purpose of this study was the evaluation of total and free plasma and muscle carnitine concentrations (TPC, FPC, TMC, FMC), muscle glycogen and the relationship between plasma and tissue carnitine content and the basic indices of lipid metabolism in HD patients. The studies were conducted in two groups: the first one consisted of 37 HD patients (19 F, 18 M), the second one served as the control and was composed of 29 (10 F, 19 M) patients with healthy kidneys. Tissue specimens in HD patients were taken during surgery on arterio-venous fistula from brachioradial muscle. Carnitine and glycogen measurements were performed using enzymatic methods according to Cederblad and Huijng respectively. Total cholesterol (CH), HDL-CH, and triglycerides were assayed by enzymatic commercial test system (Boehringer-Mannheim, Germany). To summarise, we found the following phenomena in our HD patients in comparison with the controls: 1) In plasma: similar TPC but decreased FPC levels and FPC/TPC ratio which may suggest free carnitine deficiency. 2) In muscle: significantly lower TMC and FMC levels but normal FMC/ITMC ratio. 3) Negative correlation between TMC and FMC levels and duration of dialysis treatment. 4) No correlation between plasma and muscle camitine concentration. 5) Significantly higher concentration of muscle glycogen which could be explained by the changes in the structure of muscle fibres in HD patients and/or lower physical activity. 6) A positive correlation between FPC/APC or FPC/TPC ratio and HDL-CH in HD patients which may suggest that an appropriate proportion between free and acylcarnitines may influence HDL-CH levels in that population.

Adult↗
PubMed2000

Comparison of the quality of life in hemodialysed (HD) and peritoneally dialysed (CAPD) patients using the EORTC QLQ-C30 questionnaire.

BACKGROUND: The aim of the paper was to assess reliability and validity of the QLQ-C30 questionnaire in studying the quality of life in dialysed patients, and then to compare the life quality in patients on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and healthy controls. The present study included 65 HD patients, 22 CAPD patients and a group of 76 healthy volunteers. METHODS: Quality of Life Questionnaire (QLQ-C30), Hospital Anxiety and Depression Scale (HADS), Cantrill ladder. RESULTS: The EORTC QLQ-C30 questionnaire appeared to be a reliable and valid tool for assessing the quality of life in dialysis patients. HD patients had significantly poorer quality of life in the areas of physical, social, cognitive and emotional functioning in comparisons to the controls. CAPD patients were not significantly different life quality-wise from controls, except for their social and professional life.

Adolescent↗
PubMed2000

[Cyclophosphamide pulse therapy in patients with primary glomerulonephritis].

UNLABELLED: Cyclophosphamide is a cytostatic drug, widely used in therapy of secondary glomerulonephritis. Because pulse therapy bears less side effects than oral one we aimed to follow the cyclophosphamide effect on the course of patients with primary glomerulonephritis. We observed 20 pts (7 women and 13 men), mean age 33 +/- 10.0 yrs, age range 18-50 yrs with primary glomerulonephritis and proteinuria more than 3.5 g. 12 patients also had erythro-cyturia. In all pts kidney biopsy was performed, but in one woman the biopsy was not diagnostic. Renal biopsy revealed: FSG in 2 pts, membranous glomerulonephritis in 2 pts, in 9 pts mesangial proliferative changes and in 6--mesangiocapillary lesions. In 5 pts renal failure was observed. Cyclophosphamide was administered i.v. in the dose 0.75 g/m2 b.s., no more than 1.0 g per dose, in renal failure 0.5 g/m2. During the first six months patients received cyclophosphamide every month and then every three months. Before cyclophosphamide pulse therapy all patients were pretreated with steroids, 3 pulses of 1.0 g Methylprednisolone and then oral prednisone in the dose 20 mg/m2 body surface. RESULTS: In 3 patients we obtained remission of proteinuria, in 11 patients decrease of proteinuria but 6 patients didn't answer to the introduced treatment. In whole group of examined patients we obtained the statistically significant decrease of proteinuria from 12.2 +/- 10.5 to 5.3 +/- 5.2 g (p < 0.05) after the treatment. The creatinine clearance did not change in the time of the treatment and any special complications during the treatment were observed. We suggest that cyclophosphamide pulse therapy could be an effective treatment in pts with primary glomerulonephritis. Our results showed that the answer of proposed treatment was independent of the type to the changes found in kidney biopsy.

Adult↗