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Biomedical subjects

F Kokot

Publications and source records attributed to F Kokot.

At least 55 records · Page 3Linked to original sources
PubMed1998

Effect of early captopril treatment on blood adrenaline levels in acute myocardial infarction (the substudy of ISIS-4). International Study of Infarct Survival-4.

Of patients with acute myocardial infarction eligible for the International Study of Infarct Survival-4, randomized to captopril (n = 30) or placebo (n = 33), the captopril group had a significant decrease in blood adrenaline on day 3 compared with baseline values. Results suggest that suppression of sympathetic activity contributes to the beneficial effects of treatment with angiotensin-converting enzyme inhibitors in the early phase of acute myocardial infarction.

Aldosterone↗
PubMed1998

Atrial natriuretic peptide and arginine-vasopressin secretion in patients with active renal stone disease.

The pathogenesis of active renal stone disease (ARSD) is still not fully elucidated. In the present study the role of atrial natriuretic peptide (ANP) and arginine-vasopressin (AVP) as potential pathogenetic factors in ARSD were examined. Thirty patients with ARSD and 21 healthy subjects (HS) were examined both under bed rest (BR) and head-out water immersion (WI) conditions. Serum concentrations of electrolytes (Na, Ca, Mg), ANP and AVP were assessed before (0'), and after 60 and 120 minutes of BR or WI, respectively. Urinary excretions of Na, Ca, Mg, and oxalates were also estimated during BR and WI. Patients with ARSD showed higher basal plasma levels of ANP and a greater response of ANP secretion, but a lower suppression of plasma AVP to WI induced hypervolaemia as compared with the controls. In addition, in patients with ARSD the physiological relationship between plasma AVP concentration and urinary excretion of Ca and Mg (positive correlation), between plasma ANP level and urinary excretion of Ca and Mg (negative correlation), and between plasma ANP and AVP concentration (negative correlation), respectively, were absent. In addition, patients with ARSD showed a positive correlation between plasma ANP and urinary oxalate excretion. From the results obtained in this study we conclude that both AVP and ANP may be involved in the pathogenesis of ARSD.

Adult↗
PubMed1998

Urinary excretion of Tamm-Horsfall protein in normotensive and hypertensive elderly patients.

Tamm-Horsfall protein (THP) is a glycoprotein that is exclusively produced by the kidney in the thick ascending limb of Henle's loop (TAHL). Disturbances of TAHL function are associated with decreased urinary THP excretion. It is well known that renal function declines with advancing age. Moreover, it is suggested that THP may play a role in the pathophysiology of hypertension. The aim of this study was to assess urinary excretion of THP (U-THP) in healthy and hypertensive elderly patients. Fifteen young healthy subjects (YHS), 15 young hypertensive patients (YHT), 15 older normotensive (>60 years) subjects (OHS) and 31 older (>60 years) hypertensive patients (OHT) were examined. In all subjects 24-h urinary volume (UV), U-THP and creatinine (U-Cr), specific gravity of urine (U-SG), serum creatinine (S-Cr), and mean arterial pressure (MAP) were assessed. THP urinary excretion was significantly decreased in normotensive elderly patients, but not in hypertensive ones. Higher U-THP in the elderly hypertensive as compared with the elderly normotensive patients seems to be more the consequence than the cause of arterial hypertension.

Adolescent↗
PubMed1998

Tamm-Horsfall protein isolated from urine of pregnant and non-pregnant women has similar oligosaccharides.

BACKGROUND: Differences in the immunosuppressive activity of Tamm-Horsfall protein and uromodulin claimed by many investigators are controversial. They have been ascribed to variations in the carbohydrate moiety. METHODS: We isolated urinary glycoproteins from 18 non-pregnant (THP) and 12 pregnant (UM) women using the same method (adsorption on diatomaceous earth) and performed comparative studies including monocarbohydrate analysis and tests of reactivity with lectins, cytokines and serum proteins. RESULTS: No significant differences in monocarbohydrate content or in the reactivity with specific lectins were found between the native urinary glycoproteins or between their proteolytic products. Also, in Sda+ and Sda- donors monitored throughout pregnancy and after delivery, no time-dependent differences in the sugar moiety were observed. We found that THP/UM from Sda+ donors reacted more strongly with PHA-L than THP/UM from Sda- donors, providing further evidence for carbohydrate variations between Sda+ and Sda- determinants. No differences between THP and UM in terms of their reactivity with recombitant human interleukin (rhIL) 1 alpha, recombinant human tumour necrosis factor (rhTNF) alpha and some serum proteins were found, indicating similar biological activity. CONCLUSION: The results of our carbohydrate analysis together with previous data on amino acid analysis indicate that Tamm-Horsfall protein and uromodulin are identical or very similar glycoproteins.

Adult↗
PubMed1998

The influence of hyperinsulinaemia on calcium-phosphate metabolism in renal failure.

BACKGROUND: Patients with renal failure are characterized by impaired insulin-mediated glucose uptake. Insulin plays a major role in the maintenance of phosphate homeostasis but it remains to be determined whether in uraemia insulin-dependent renal and extrarenal phosphate disposal is also affected. METHODS: The effect of hyperinsulinaemia on serum concentrations of phosphate, ionized calcium and intact PTH as well as renal excretion of calcium and phosphate was studied under euglycaemic conditions (glucose clamp technique) in patients with advanced renal failure and in healthy subjects. Fifteen patients with renal failure (mean serum creatinine 917 micromol/l) and 12 control subjects were included. All subjects underwent a 3-h euglycaemic clamp with constant infusion of insulin (50 mU/m2/min) following a priming bolus. The urine was collected for 3 h before and throughout the clamp. RESULTS: The tissue insulin sensitivity (M/I) was lower in patients with renal failure than in control subjects (5.3+/-2.4 vs 6.7+/-1.8mg/kg/min per mU/ml, P= 0.001) but the phosphate lowering action of insulin was larger in patients with renal failure than in control subjects. Urinary calcium excretion increased (P < 0.05) and phosphate excretion did not change during the clamp in both groups. Despite a decrease of serum ionized calcium in the group of patients with renal failure and no change in the control group, plasma PTH fell significantly in both groups but this effect was still significant after 180 min only in the renal failure group. A significant correlation was observed between changes in serum phosphate and PTH induced by hyperinsulinaemia (r = 0.48, P < 0.01 ) CONCLUSIONS: Phosphate-lowering effect of insulin is well preserved in severe renal failure despite the resistance to insulin-stimulated glucose uptake. The decrease of serum PTH observed during hyperinsulinaemia appears to be independent of serum ionized calcium.

Adult↗
PubMed1998

Influence of long-term recombinant human erythropoietin (rHuEpo) therapy on plasma leptin and neuropeptide Y concentration in haemodialysed uraemic patients.

BACKGROUND: In patients with chronic renal failure, rHuEpo therapy ameliorates anaemia and improves wellbeing, exercise tolerance, and appetite. Both leptin and neuropeptide Y play an important role in regulation of appetite and energy balance in humans. METHODS: The present study aimed to assess the influence of 12 months rHuEpo therapy on plasma leptin and neuropeptide Y concentrations in 15 haemodialysed patients (HDP) (6F, 9M; mean age 40.8+/-2.9 years; mean BMI 23.6+/-1.1 kg/m2; mean duration of HD 3.3+/-0.6 months) (Epo group). A second group (No-Epo group) consisted of 17 HDP (9F, 8M; mean age 44+/-3.2 years; mean BMI 24.3+/-1.0 kg/m2; mean duration of HD 2.5+/-0.4 months) not treated with rHuEpo for 12 months. Basal plasma leptin and neuropeptide Y concentrations were estimated by RIA at the beginning and after 3, 6, 9 and 12 months of rHuEpo therapy (Epo group) or clinical observation (No-Epo group). The control group consisted of 30 healthy subjects (15 females, 15 males, mean age=38.2+/-1.7 years, mean BMI 24.5+/-0.7 kg/m2). RESULTS: Baseline plasma leptin concentrations in HDP were higher, although statistically not significant than leptinaemia in healthy subjects. After 3, 6, and 12 months of rHuEpo therapy plasma leptin concentrations were significantly lower than at the beginning of the study. Baseline plasma neuropeptide Y concentrations in HDP did not differ significantly from controls. After 3 and 6 months of the study period plasma neuropeptide Y concentrations increased significantly in patients of both the Epo and No-Epo group. This increase was, however, significantly higher in rHuEpo-treated than in untreated patients. CONCLUSIONS: (1) rHuEpo treatment in haemodialysed patients with chronic renal failure is followed by a significant decline of leptinaemia and disappearance of the physiological positive BMI/leptinaemia relationship. (2) Suppression of leptinaemia induced by rHuEpo may be of clinical relevance in haemodialysed patients with chronic renal failure.

Adult↗
PubMed1998

Does the vitamin D receptor genotype predict bone mineral loss in haemodialysed patients?

BACKGROUND: It has been suggested that the vitamin D receptor (VDR) gene BsmI-polymorphism is a genetic determinant of bone metabolism. DESIGN: To test this hypothesis, the relationship between VDR genotypes, bone mineral density (baseline and after 18 months) and parameters of calcium metabolism and bone turnover were investigated prospectively in 88 haemodialysed patients not receiving active vitamin D metabolites. METHODS: Whole body, lumbar spine and femoral neck bone mineral density (BMD) were assessed by dual energy X-ray absorptiometry (DEXA). In addition calcium, phosphorus, 25(OH)D3, 1,25(OH)2D3, osteocalcin serum concentrations, alkaline phosphatase activity and intact 1,84 PTH levels were measured. RESULTS: VDR genotype BB, Bb and bb were found in 27, 49 and 24% of patients. Initial BMD (g/cm2) of whole body, lumbar spine and femoral neck did not differ between genotypes (whole body: BB 1.055 +/- 0.120, Bb 1.082 +/- 0.102, bb 1.128 +/- 0.120; lumbar spine: BB 1.075 +/- 0.199, Bb 1.079 +/- 0.185, bb 1.099 +/- 0.170; femoral neck: BB 0.808 +/- 0.160, Bb 0.862 +/- 0.127, bb 0.842 +/- 0.125; mean +/- SD), but the decrease of whole body and femoral neck BMD during 18 months was significantly (P < 0.02) different between the genotype groups (whole body: BB -0.048 +/- 0.028, Bb -0.031 +/- 0.029, bb -0.024 +/- 0.023; femoral neck BB -0.044 +/- 0.069, Bb -0.032 +/- 0.081, bb -0.012 +/- 0.029 g/cm2). CONCLUSION: This preliminary study suggests faster mineral loss in BB genotype of VDR in haemodialysed patients.

Adolescent↗
PubMed1998

Plasma leptin concentration in kidney transplant patients during the early post-transplant period.

BACKGROUND: Leptin, is produced by adipose tissue and is presumed to be involved in the regulation of appetite and energy balance. The kidneys are involved in the inactivation of circulating leptin, and elevated plasma leptin concentrations were reported in uraemic patients. Finally, glucocorticosteroids as used in transplanted patients stimulate leptin secretion. METHODS: The present study aimed to asses the relationship between plasma leptin concentration and kidney graft function in the early post-transplant period. We studied 40 successfully transplanted haemodialysed uraemic patients (27 males, 13 females, mean age 34.3 +/- 1.6 years, mean body mass index 22.5 +/- 0.5 kg/m2). The circadian rhythm of leptinaemia and insulinaemia was assessed twice: 2-4 days after kidney transplantation and 1 day before discharge from the hospital when graft function was good. Plasma leptin concentration was measured at 8 am, 4 pm, and 12 pm. The control group consisted of 21 healthy subjects (13 males, 8 females, mean age 39.4+/-2.5 years, mean body mass index 24.1 +/-0.7 kg/m2). RESULTS: Before kidney transplantation, patients had elevated plasma leptin and insulin levels. A positive correlation was found between BMI and leptinaemia and BMI and insulinaemia, respectively. An inverse relationship was found between leptinaemia and age. Successful kidney transplantation was followed by a significant decline of leptinaemia i.e. from 21.5 +/- 0.1 vs 7.1 +/- 1.3 ng/ml. Kidney transplantation did not influence the circadian rhythm of leptinaemia. CONCLUSION: Leptinaemia was not related to the excretory graft function or immunosuppression. In addition to renal excretory function, other factors must be involved in the post-transplant decline of leptinaemia.

Adult↗
PubMed1998

[Vitamin D receptor gene polymorphism and the rate of bone loss of the femur neck and lumbar spine in hemodialized patients with chronic renal failure].

It has been suggested that the vitamin D receptor (VDR) gene Bsml-polymorphism is a genetic determinant of bone metabolism. To test this hypothesis, the relationship between VDR genotypes, bone mineral density (baseline and after 18 months) and parameters of calcium metabolism and bone turnover were investigated prospectively in 136 haemodialyzed patients. Lumbar spine and femoral neck bone mineral density (BMD) were assessed by dual energy X-ray absorptiometry (DEXA). In addition calcium, phosphorus, 25(OH)D3, 1.25(OH)2D3, osteocalcin serum concentrations, bone alkaline phosphatase activity and intact 1, 84-PTH levels were measured. VDR genotype BB, Bb and bb were found in 24%, 46% and 30% of patients respectively. Initial BMD (g/cm2) of lumbar spine and femoral neck did not differ between genotypes, however the decrease of femoral neck BMD during 18 months of observation differ significantly (p < 0.02) between the particular genotype groups (femoral neck: BB -0.031 +/- 0.029; Bb -0.027 +/- 0.017; bb -0.017 +/- 0.019 g/cm2). Significantly lower serum level of 25OHD3 was found in patients with the BB genotype before and after 18 months of observation in comparison to the respective values obtained in bb genotype patients, (respectively, 21.0 +/- 16.8 ng/ml vs 30.8 +/- 17.9 ng/ml; p < 0.01 and 24.0 +/- 10.8 ng/ml vs 32.4 +/- 16.0 ng/ml; p < 0.02). BB genotype patients were also characterised by significantly lower serum level of 1.25(OH)2D3 both initially and after 18 month of the study (respectively in BB and bb patients 25.9 +/- 9.7 pg/ml vs 30.7 +/- 10.0 pg/ml; p < 0.02 and 18.4 +/- 12.3 pg/ml vs 24.3 +/- 13.0 pg/ml; p < 0.01). No significant differences were found in Ca, P, osteocalcin, iPTH serum concentrations and bone fraction of alkaline phosphatase activity between particular genotypes. Results from this study suggest that faster bone mineral loss and more exaggerated disturbances of vitamin D metabolism are present in haemodialyzed uraemic patients with BB than bb genotype of VDR.

Adult↗
PubMed1998

Partial regression of advanced cyclosporin-induced gingival hyperplasia after treatment with azithromycin. A case report.

Gingival hyperplasia is a well recognised complication of cyclosporin A therapy. Although its pathogenesis is still debated in several recent reports a second generation macrolide antibiotic-azithromycin induced partial or even complete regression of hyperplasia. We present a patient after kidney transplantation treated with cyclosporin who developed very advanced gigival overgrowth (stage 3+). The patient received a 3-day treatment with azithromycin which was repeated after 3 months. The first course of the drug caused a partial regression of gingival hyperplasia during following months but the repeated treatment did not provide a further regression of the changes.

Adult↗
PubMed1998

[Serum erythropoietin concentration in women with uterine or ovarian tumors].

Patients with uterine or ovarian tumors frequently develop anaemia. Causes of anaemia in these patients are still not fully understood. We assessed serum erythropoietin (EPO) concentration in 70 women with benign or malignant uterine or ovarian tumors and in 43 control women. Thirteen women out of 50 with benign and 7 out of 20 with malignant tumors (26% and 35% respectively) were anaemic. In patients with benign tumors serum EPO concentrations did not differ from that in control subjects. In patients with malignant tumors plasma EPO was inappropriately low with respect to the haemoglobin concentration. From results obtained in this study it seems, that uterine or ovarian malignancy exerts a suppressive effect on EPO secretion. Inappropriately low EPO plasma concentration may account for the anaemia frequently occurring in these women.

Adult↗
PubMed1998

[Levels of 1,25-dihydroxyvitamin D3 concentration in renal venous blood serum of patients with renovascular hypertension caused by unilateral renal artery stenosis].

UNLABELLED: Functionally significant, unilateral renal artery stenosis is characterized by reduced renal perfusion and lateralization of both excretory and endocrine function. The present study aimed to assess the influence of unilateral renal artery stenosis on plasma 1,25-dihydroxyvitamin D3 level. In sixteen patients (10 males and 6 females) with unilateral renovascular hypertension blood samples for estimation of plasma renin activity (PRA) and 1,25-dihydroxyvitamin D3 concentration were withdrawn from the renal vein of the ischaemic and normal kidney, from the femoral artery and from the vena cava inferior distally to the orifices of renal veins. Significantly elevated PRA (20.1 +/- 4.52 ng/ml/h vs 6.0 +/- 1.76 ng/ml/h, p < 0.005) but significantly reduced level of 1,25-dihydroxyvitamin D3 (99.25 +/- 4.8 pmol/l vs 115.75 +/- 6.7 pmol/l, p < 0.05) were found in renal vein blood of the ischaemic kidney as compared with the respective values of the normal kidney. No significant correlation was found between PRA and 1.25-dihydroxyvitamin D3 irrespective of the site of blood withdrawal. CONCLUSION: Renal ischaemia seems to exert a suppressive effect on 1,25-dihydroxyvitamin D3 synthesis by the kidney.

Adult↗
PubMed1998

Concentrations of leptin and neuropeptide Y in maternal plasma, umbilical cord blood and in amniotic fluid in pregnant women with EPH-gestosis.

Leptin is presumed to be related to body mass index (BMI) and body fat stores and is involved together with neuropeptid Y (NPY) in the regulation of appetite. As pregnancy is accompanied both by changes of BMI and appetite, performance of studies presented in this paper were fully justified. In 43 healthy pregnant women and in 18 pregnant women with mild or moderate EPH-gestosis, concentrations of leptin and NPY were estimated in maternal venous blood, umbilical cord blood and in amniotic fluid. The control group consisted of 26 healthy nonpregnant women. Healthy nonpregnant women showed a BMI of 23.08+/-0.65 kg/m2 which was significantly lower than in healthy pregnant women (26.9+/-0.4 kg/m2, p < 0.001) and in women with EPH-gestosis (29.7+/-0.9, p < 0.0001). Also in healthy pregnant women the BMI was significantly lower than in EPH-gestosis subjects (p < 0.001). In healthy nonpregnant women plasma leptin levels were significantly lower than in healthy pregnant and EPH-gestosis women (10.9+/-1.68 vs 14.99+/-1.28 vs 21.89+/-2.58 ng/ml, respectively). In umbilical cord blood plasma leptin levels were significantly lower than in maternal blood only in healthy pregnant women (7.37+/-0.69 vs 14.99+/-1.28 ng/ml) but not in EPH-gestosis subjects (18.06+/-3.38 vs 21.89+/-2.58 ng/ml). Leptin levels in amniotic fluid were significantly lower than in umbilical cord blood both in healthy pregnant women (2.25+/-0.20 vs 7.37+/-0.69 ng/ml) and EPH-gestosis women (6.58+/-2.62 vs 18.06+/-3.38 ng/ml). In EPH-gestosis women leptin levels were significantly higher than in healthy pregnant women in maternal blood (21.89+/-2.58 vs 14.99+/-1.28 ng/ml), umbilical cord blood (18.06+/-3.38 vs 7.37+/-0.69 ng/ml) and amniotic fluid (6.58+/-2.62 vs 2.25+/-0.2 ng/ml). In both examined pregnant groups plasma NPY levels were nonsignificantly lower in healthy pregnant and EPH-gestosis women (42.28+/-4.09 and 43.68+/-8.45 pg/ml, respectively) than in nonpregnant women 50.65+/-6.13 pg/ml). In normal pregnancy a significantly higher NPY level was found in umbilical cord blood as compared with respective values in EPH-gestosis women (116.28+/-17.0 vs 49.65+/-7.01 pg/ml). Finally in both examined groups of pregnant women the amniotic fluid NPY level was of similar magnitude (13.85+/-1.52 and 13.89+/-2.46 pg/ml in healthy pregnant and EPH-gestosis women respectively). No significant correlation was found between fetal birth weight and cord-serum leptin and NPY levels respectively.

Adult↗
PubMed1998

[Nephrology in the first decade of the twenty-first century].

Although prophecy in medicine is extremely difficult, I do not expect, that xenotransplantation will become reality in the first decade of the 21th century. However I expect introduction of safer and more effective immunosuppressive agents or even induction of selective immunologic tolerance in kidney transplant patients. I expect a significant decline in the number of uraemic patients with diabetic or hypertensive nephropathies, thanks to better prevention and treatment of these pathological states. I predict intensification of studies of renal fibroblasts responsible for progression and loss of renal parenchyma in nephropathies of different etiology. Gene therapy will become a reality both in inborn and acquired nephropathies although safety of this kind of therapy remains to be established. Finally I expect essential improvement of therapy in clinical settings induced by abnormal homeostatic function of the kidneys mostly thanks to our better understanding of the molecular background of this function.

Forecasting↗
PubMed1997

Markers of bone turnover in patients with nephrolithiasis.

A total of 19 patients with active nephrolithiasis, 14 patients with non-active nephrolithiasis and 17 healthy subjects were examined under standardized intake of calcium, phosphorus, purine and protein. In patients with both active and non-active renal stone disease the following abnormalities were found: elevated plasma levels of PTH and osteocalcin, increased activity of the bone isozyme of alkaline phosphatase, low plasma levels of phosphate and increased urinary excretion of calcium and oxalic acid. These abnormalities were more marked in patients with active than non-active nephrolithiasis. No correlation was found between plasma PTH levels and parameters of bone turnover as well as calciuria and oxaluria. Results presented in this paper suggest that (a) Smith's criteria of active renal stone disease are of minor pathogenetic and therapeutic value and (b) patients with active nephrolithiasis differ from non-active renal stone formers by more elevated oxaluria and markers of bone turnover and more marked abnormalities in calcium-phosphate metabolism related parameters.

Adult↗