[Pathogenesis of polyglobulia after kidney transplantation].
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Alleles↗
Biomedical subjects
F Kokot
Publications and source records attributed to F Kokot.
[Nephrologic analysis of 94 women with diagnosed "primary" gestosis].
Among 94 women with diagnosed "primary" gestosis during pregnancy, 67 patients demonstrated (3-6 months after delivery) chronic glomerulonephritis (25 women) or chronic pyelonephritis (28 women) or hypertension caused by others than nephrologic reasons. "Primary" gestosis was diagnosed correctly only in 29% cases. The most often reason of "secondary" gestosis was undiagnosed chronic nephropathy before and during pregnancy. Obtained results confirm other data informing that "primary" gestosis is a rare phenomenon.
Adult↗
-Efficacy and safety of using amlodipine in treatment of mild and moderate essential hypertension-.
UNLABELLED: The present study aimed to assess the efficacy and tolerance of amlodipine (Norvasc-Pfizer) in the treatment of 152 patients with mild and moderate essential hypertension. This study was a multicenter and open trial and lasted 24 weeks. During 7 visits arterial blood pressure, heart rate, body weight and side effects of amlodipine were registered. The dosage of amlodipine was 5 to 10 mg/day. 59 patients received also other antihypertensive drugs in doses used before starting amlodipine treatment. 57 patients needed changes in amlodipine dosing from 5 to 10 mg/day. During the study no significant changes in body weight or heart rate were noticed. Mean arterial blood pressure dropped significantly from 123.9 +/- 0.6 at the beginning of the study to 102.3 +/- 0.8 mm Hg at the end of this study. During this study a total of 26 dropouts were noticed. The reasons of these dropouts were the following: side effects--6 patients, noncompliance--7 patients, insufficient hypotensive effect--7 patients, unknown reason--5 patients, hypertensive crisis--1 patient. The following side effects were observed ocdemata of the legs in 10.5%, headaches in 2% of patients. One patient complained of increased susceptibility to weather changes, 1 patient had nausea and dizziness and 1 had headaches, pains in the legs and chest and nausea. All these side effects were mild and transient. CONCLUSION: Results obtained in this trial suggest, that amlodipine is an efficient and well tolerated antihypertensive drug in patients with mild and moderate essential
Adult↗
[In memory of our deceased editor-in-chief Prof. dr habil. med Zygmunt Hanicki].
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History, 20th Century↗
[Improvement of sexual function in hemodialyzed male patients with chronic renal failure treated with erythropoietin (rHuEPO)].
The present study aimed to assess the influence of long-term recombinant human erythropoietin therapy on selected parameters of sexual function in haemodialyzed males with chronic renal failure and severe nephrogenic anaemia. All patients were randomized into two groups. The first one consisted of 11 patients treated for 12 months with rHuEPO in order to achieve and maintain a target Hct value of 30-35% (EPO group). The other 9 male patients were only carefully monitored clinically and biochemically for 12 months similarly as patients of the EPO group but were not treated with rHuEPO (No-EPO group). After 12 months of monitoringan an anonimous questionnaire was completed by the patients describing selected parameters of quality of life and sexual function. Haemodialyzed males treated with rHuEPO showed a significantly higher score of improvement of well-being, exercise tolerance, erection quality and libido as compared with patients not treated with rHuEPO. Results obtained in this study suggest, that EPO therapy shows a beneficial effect on sexual function in haemodialyzed patients with chronic renal failure.
Adult↗
[Influence of long-term human recombinant erythropoietin treatment on secretion of pancreatic polypeptide and gastrin in hemodialysed patients with chronic renal failure].
The study aimed to assess the influence of long-term rhu-EPO treatment on secretion of pancreatic polypeptide (PP) and gastrin. A total of 27 haemodialysed patients and nine healthy subjects were examined. Nine patients with uraemic anaemia were treated with rhu-EPO for 12 months (EPO group), while another nine patients did not receive rhu-EPO (non-EPO group), but were monitored biochemically and clinically as patients of the EPO group. The third group (HD) comparised nine haemodialysed patients with a haematocrit value > or = 30% without rhu-EPO therapy. In all subjects plasma levels of PP and gastrin were estimated before and after administration of a test meal. Patients of the EPO and non-EPO group were examined before and after 6 and 12 months of rhu-EPO therapy (EPO group) or clinical monitoring (non-EPO group) respectively, while only one test was performed in patients of the HD group and healthy subjects. Six months rhu-EPO therapy was followed by an decrease of basal plasma level of PP and increased response of gastrin to the test meal. After 12 months of rhu-EPO therapy basal plasma level of PP was still lower, the response of PP secretion to a test meal was higher, while that of gastrin secretion lower that the pretreatment ones. Our results suggest, that rhu-EPO treatment exerts effect on secretion of PP and gastrin. These alterations seem not to be related to improvement of the haematological status.
Adult↗
[The concentration of ferritin in blood serum of patients with neoplasms of the larynx and the maxillary-ethmoidal complex].
The increased level of ferritin is known as a nonspecific marker of inflammatory processes and neoplasms. A purpose of the article was to indicate concentration of ferritin in blood serum before treatment of 33 patients with cancer of larynx and 16 patients with malignant neoplasms of maxillo-ethmoid complex. The patients with cancer of larynx were characterized by significantly high level of ferritin in comparison to patients with malignant neoplasms of maxillo-ethmoid complex (p < 0.05) and to healthy people (p < 0.05) (respectively 241.9 +/- 154.9; 106.9 +/- 45.4 and 125.0 +/- 30.4 ng/ml). Contrary to patients with cancer of larynx patients with malignant neoplasms of maxillo-ethmoid complex did not differ in significant level of ferritin from healthy people. The concentration of hemoglobin in blood in both groups of patients was similar and was characteristically lower than values obtained in healthy people. The results achieved suggest that indicating of ferritin can be helpful while making a differentiation between cancer of larynx and malignant neoplasms of maxillo-ethmoid complex.
Aged↗
[Erythropoietin secretion in patients with chronic obstructive lung diseases during normobaric oxygen inhalation].
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are characterized by compensatory polycythaemia probably induced by increased erythropoietin (EPO) secretion in the kidneys. METHODS AND RESULTS: As the regulatory mechanisms of erythropoietin secretion in chronic obstructive pulmonary disease are scarcely known we studied plasma EPO levels in 14 patients with COPD (pO2 = 61.9 +/- 1.4 mm Hg, Hct = 47.8 +/- 1.1%) under basal conditions, after two hours of isobaric oxygen breathing and two and four hours after discontinued oxygen breathing. The control group consisted of 12 healthy subjects (pO2 = 87.5 +/- 2.2 mm Hg, Hct = 43.7 +/- 1.6%). Under basal conditions patients with COPD showed significantly higher plasma erythropoietin levels as compared with healthy controls. Oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with COPD as in the control group. This decline was significantly more marked and of longer duration in COPD patients than in healthy controls. CONCLUSIONS: 1. Patients with chronic obstructive pulmonary disease are characterized by significantly higher plasma EPO levels as compared with healthy subjects. 2. The renal oxygen sensor function involved in the regulation of EPO secretion seems to be altered in COPD patients.
Erythropoietin↗
Renal clearance of endogenous erythropoietin in patients with proteinuria.
Recent data indicated the importance of urinary losses of erythropoietin (Epo) in the pathogenesis of anaemia in patients with nephrotic syndrome. In the present study we aimed to investigate plasma and urinary Epo levels and their renal handling in relation to beta 2-microglobulin (beta 2m), sodium metabolism and the renin-angiotensin-aldosterone system (RAAS), respectively, in patients with sub-nephrotic range proteinuria (SNP), microalbuminuric diabetics and hypertensives, and in healthy subjects studied on a standardized diet containing 120 mmol sodium and 70 g protein per day. We found that patients with SNP were characterized by lower plasma levels of Epo than healthy subjects but no differences were found in urinary excretion of Epo, endogenous Epo clearance and its fractional excretion (FEEpo). There were no differences between groups in FE beta 2m and FENa and plasma aldosterone levels but plasma renin activity was higher in patients with SNP than in the controls. No relationships were found between Epo levels and activity of the RAAS and sodium metabolism, respectively. Our data suggest that lower levels of plasma Epo in patients with SNP and normal renal excretory function are not due to urinary losses of Epo but rather to the decreased production/degradation ratio.
Adult↗
Safety and efficiency of recombinant human erythropoietin treatment in anemic pregnant women with a kidney transplant.
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Adult↗
Erythropoietin concentration in cyst fluid in patients with simple renal cysts.
High erythropoietin (EPO) levels in cyst fluid and blood plasma in patients with autosomal dominant polycystic kidney disease (ADPKD) have been reported. In the present study we assessed EPO levels and the biochemical composition of cyst fluid obtained from 50 simple renal cysts. Basing on cyst fluid/plasma sodium ratio 38 cysts were classified as cysts of proximal origin, and 12 as cysts of undetermined origin. EPO concentrations in cyst fluid obtained from proximal cysts were significantly higher than in fluid from cysts of undetermined origin (472.9 +/- 116.2 vs. 112.1 +/- 33.3 mU/ml, p < 0.05). Patients with proximal cysts had significantly higher plasma EPO levels (31.8 +/- 3.5 mU/ml) than healthy subjects (17.3 +/- 1.96 mU/ml, p < 0.005). We conclude that: (1) simple renal cysts of distal origin seem to be rare; (2) the presence of high EPO level in cyst fluid suggests its proximal origin; (3) estimation of cyst fluid EPO levels seems to be of similar pathogenetic value as the assessment of the cyst fluid/plasma sodium ratio.
Adult↗
Erythropoietin secretion in patients with chronic renal failure after pure oxygen breathing.
The present study aimed to assess the relationship between erythropoietin (EPO) secretion and hyperoxemia in uremic patients. In 19 patients with chronic renal failure (10 were hemodialyzed and 9 were not dialyzed) and in 13 healthy subjects plasma erythropoietin levels were assessed during 6 h of air breathing and a second time during 2 h of pure oxygen breathing and during 4 h after discontinued oxygen breathing. Under basal conditions, uremic patients showed higher plasma erythropoietin levels (39.85 +/- 5.86 mU/ml in hemodialyzed and 29.05 +/- 4.94 mU/ml in nondialyzed patients) as compared with healthy controls (21.04 +/- 1.77 mU/ml). Pure oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with chronic renal failure and in the control group. However, this decline was significantly less marked and of longer duration in chronic renal failure patients than in healthy controls.
Administration, Inhalation↗
Effect of isobaric hyperoxemia on erythropoietin secretion in hypertensive patients.
We assessed the influence of hyperoxemia on erythropoietin secretion in patients with various etiological forms of arterial hypertension (essential, n = 15; renoparenchymal, n = 16; renovascular, n = 15) and in 15 healthy subjects. On the first day of the study, blood was withdrawn at 1-hour intervals for the estimation of erythropoietin during a total of 6 hours and at 2-hour intervals for the assessment of PO2. Three days later the same parameters were assessed again at identical time intervals, but the subjects were breathing pure oxygen during the first 2 hours. Breathing with pure oxygen resulted in a significant increase of blood PO2 (184.85 +/- 4.47 versus 85.92 +/- 2.28 in essential, 185.21 +/- 5.52 versus 84.55 +/- 3.04 in renoparenchymal, and 181.7 +/- 3.14 versus 87.49 +/- 2.25 in renovascular hypertension groups and 189.84 +/- 5.2 versus 85.89 +/- 1.73 mm Hg in healthy subjects; P < .001 in all groups). Baseline plasma erythropoietin was not different among the groups (29.33 +/- 4.14 in essential, 24.56 +/- 3.09 in renoparenchymal, and 27.77 +/- 3.29 in renovascular hypertension groups and 24.23 +/- 2.70 mU/mL in the control group). The pattern of erythropoietin decline was different in the groups of hypertensive patients. In patients with essential hypertension, unlike in healthy subjects and patients with other etiological forms of arterial hypertension, only a very short-term suppression of erythropoietin levels was observed during hyperoxemia. No significant changes in blood pressure during breathing with pure oxygen were found in any of the studied groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Renovascular hypertension--a persistently difficult diagnostic problem].
Renal ischaemia, both unilateral or bilateral, is the cause of renin dependent hypertension but only at the beginning of kidney hypoperfusion. Long lasting renovascular hypertension is progressively becoming more and more independent from the renal renin-angiotensin (RA) system and finally mostly dependent from extrarenal hypertensinogenic factors. This is the reason, why assessment of the individual components of the renal RA system and anatomical or physiological methods of kidney imaging are becoming progressively less sensitive and less specific in the diagnosis of renovascular hypertension of long-term duration.
Humans↗
[Concentrations of B2-microglobulin and Tamm-Horsfall protein in cyst fluid and urinary excretion of these proteins in patients with simple renal cysts].
The existing classifications of simple renal cysts are based on cyst fluid sodium concentration or cyst fluid/plasma sodium ratio. The present study aimed to assess: 1) the usefulness of cyst fluid concentrations of beta-2-microglobulin (beta-2-MG) as a marker of proximal tubules function and Tamm-Horsfall protein (THP) as a marker of distal tubules function to define the origin of renal cysts (proximal or distal); and 2) the function of proximal and distal tubules in patients with simple renal cysts. 31 patients with simple renal cysts and 10 healthy subjects were examined. Basing on the cyst fluid/plasma sodium ratio, 25 cysts were classified as of proximal origin and 6 as of undetermined origin. In all patients cyst fluid and plasma concentrations of beta-2-MG, erythropoietin, sodium, potassium and total protein were assessed. Urinary excretion of beta-2-MG and THP was also estimated and fractional excretion of beta-2-MG was calculated. The concentration of beta-2-MG in fluid obtained from cysts of proximal origin were significantly higher than in fluid from cysts of undetermined origin (2.26 +/- 0.36 vs. 0.65 +/- 0.13 mg/l, p = 0.0004). Concentrations of THP (6.85 +/- 1.21 vs. 3.14 +/- 1.06 micrograms/ml, p < 0.05), erythropoietin (500.6 +/- 176.8 vs. 42.0 +/- 17.7 mU/ml, p < 0.05) and potassium (4.39 +/- 0.07 vs. 3.13 +/- 0.44 mmol/l, p < 0.05) were also higher in fluid from proximal cysts than in fluid from cysts of undetermined origin.(ABSTRACT TRUNCATED AT 250 WORDS)
Adjuvants, Immunologic↗
[Does long-term human recombinant erythropoietin (rHuEPO) influence secretion of hormones regulating volume and pressure of arterial blood?].
This study aimed to assess the effect of anaemia on volume related hormones in dialyzed patients with chronic uraemia. Three groups of subjects were examined. The first one comprised 34 hemodialyzed patients with severe anaemia (haematocrit value < 28%). 17 patients were treated with EPO for 1 year (EPO group) while the other 17 patients did not receive rHuEPO (no-EPO group) but were intensively monitored biochemically and clinically as patients of the EPO group. The second group (HD) consisted of 12 hemodialyzed uraemic patients with a Hct > 30% without rHuEPO treatment, while the third one comprised 15 healthy subjects. In patients of the EPO and no-EPO group plasma renin activity (PRA), plasma concentration of aldosterone (Ald) atrial natriuretic peptide (ANP and vasopressin (AVP) were assessed before (0) and after 3, 6, 9 and 12 months of clinical monitoring, while in patients of the HD group and in normals the above mentioned parameters were estimated only once. EPO treatment improved significantly the Hct value already after three months of therapy. No significant changes in PRA and plasma concentrations of Ald, ANP and AVP in the noEPO group were noticed during 12 months of monitoring. In contrast EPO treatment induced a significant, although transitory decrease of PRA, Ald and AVP, but an increase of plasma ANP. No influence of rHuEPO therapy on blood pressure was noticed.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Effect of elevated blood pressure and proteinuria on progression of mesangioproliferative glomerulonephritis].
UNLABELLED: Mesangioproliferative glomerulonephritis (GNpm) is one of the most frequent histopathological forms in patients with proteinuria and erythrocyturia. The aim of this study was to assess the rate of deterioration of renal function in 39 patients with mesangioproliferative glomerulonephritis. All patients (25 M and 14 F, age from 19 do 55 year) were diagnosed in the Department of Nephrology Silesian University School of Medicine in Katowice two times: before and at least 12 month after renal biopsy respectively. 21 patients with mesangioproliferative glomerulonephritis was oligosymptomatic. In 6 patients the leading sign of GNpm was moderate arterial hypertension while in the other 22 nephrotic syndrome. 17 patients with mesangioproliferative glomerulonephritis received immunosuppressive medication while in the other 22 patients these drugs were not used. Deterioration of renal function was assessed using a progression index (PI) which is calculated by dividing delta of serum creatinine (mumol/l) by the observation period (months). Deterioration of renal function was faster in nephrotic patients (PI = 0.27 +/- 0.11 mumol creat./month) and in patients with the hypertensive form of mesangioproliferative glomerulonephritis (PI = 0.69 +/- 0.29 umol creat./month) than in patients with oligosymptomatic mesangioproliferative glomerulonephritis (PI = 0.06 +/- 0.04 mumol creat./month). Significantly slower deterioration of renal function was noticed in patients treated with immunosuppressive drugs than medicated only symptomatically (PI = 0.05 +/- 0.007 mumol creat./month vs 0.70 +/- 0.06 mumol creat./month). CONCLUSIONS: 1) Presence of hypertension and of a nephrotic syndrome does influence adversely the progression of mesangioproliferative glomerulonephritis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Excretion of beta-2-microglobulin and Tamm-Horsfall protein in patients undergoing a conditioning regimen before bone marrow transplantation].
UNLABELLED: This study aimed assess function of renal tubules in patients undergoing conditioning regimen before bone marrow transplantation. The examined group comprised 19 patients. 13 of them underwent autologuous bone marrow transplantation (ABMT), or autologuous peripheral blood stem cells transplantation (APBSCT). These patients were treated with Cyclophosphamide (Cy) (120 mg/kg), Etoposide (1.6-1.8 g/m2) and Carmustine (400-450 mg/m2). The remaining 6 patients underwent allogenic bone marrow transplantation (BMT). They were treated with Cy 200 mg/kg or with Cy 120 mg/kg and Busulfan 16 mg/kg (doses given are the total amount or respective drugs were administered during the whole conditioning regimen). Urinary excretion of beta-2MB and THP was assessed a) before the conditioning regimen was started, b) one day before completion of it, and c) one day before bone marrow transplantation. In ABMT/APBSCT patients urinary excretion of beta-2-MG was significantly higher before and during conditioning regimen as compared with baseline value (3309 +/- 1123.7 vs 3919 +/- 1417.8 vs 246.7 +/- 50.3 mg/24h, respectively, p < 0.05). Urinary excretion of THP in these patients was significantly higher only during the conditioning regimen (90.6 +/- 14.3 vs. 30.4 +/- 6.24 mg/24h, p < 0.0002). In BMT patients conditioning regimen was followed by similar but less marked changes of urinary excretion of beta-2-MG and THP as compared with ABMT/APBSCT patients. CONCLUSIONS: 1. Conditioning regimen do influence significantly function of proximal and distal renal tubules. 2. The extent of disturbed function of renal tubules seems to depend on kind of medication that is given during the conditioning regimen.
Adjuvants, Immunologic↗