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Biomedical subjects

J Małyszko

Publications and source records attributed to J Małyszko.

At least 19 recordsLinked to original sources
PubMed2005

Thrombin activatable fibrinolysis inhibitor (TAFI) in stable angina pectoris patients undergoing coronary artery bypass grafting (CABG).

PURPOSE: Thrombin activatable fibrinolysis inhibitor (TAFI) seems to be a potential haemostatic risk factor of coronary artery disease (CAD). Taking into account interactions between TAFI and haemostasis, especially during cardiopulmonary bypass, we decided to determine concentration of TAFI and activated TAFI (TAFIa) and other haemostasis markers in CABG patients. MATERIAL AND METHODS: 45 CAD patients (11 women, 34 men) undergoing elective CABG were included in the study. Blood samples were taken before the operation, on the 3rd, 7th day and 3 months after CABG. A value of p<0.05 was considered statistically significant. RESULTS: We found a significant decrease in TAFIa concentration on 3rd postoperative day: 6 microg/ml (0.3-43.2) vs 8.9 microg/ml (0.5-37) before CABG (p<0.05), a significant increase in TAFI concentration on the 7th postoperative day: 127.7% +/- 36.8 vs 112.18% +/- 30.34 of standard plasma concentration before CABG (p<0.05), significant increase in plasmin-antyplasmin (PAP) complexes concentration on 3rd and 7th day, respectively: 645 microg/l (323-1237) vs 406 microg/l (197-1840) before CABG (p<0.001); and 1030 microg/l (640-2149) vs 406 microg/l (197-1840) before CABG (p<0.0001). Before operation we found a significant negative correlation between PAP complexes concentration before CABG and EuroSCORE risk scale value (p<0.01). CONCLUSIONS: In CABG patients, there is a significant increase in fibrinolytic activity due to decrease in TAFIa concentration, with simultaneous increase in PAP complexes. A significant negative correlation between PAP complexes concentration before CABG and EuroSCORE risk scale value stressed a potentially higher operation risk in patients with lower fibrinolytic activity.

Adult↗
PubMed2004

Protein Z and vitamin K in kidney disease.

PURPOSE: Disturbances in hemostasis are common complications of kidney diseases. Both bleeding diathesis and thromboembolism may complicate the course of chronic uremia. As far as we know, there is a limited data about protein Z in kidney disease. MATERIAL AND METHODS: The aim of our work was to examine plasma protein Z and vitamin K concentrations in nephrotic syndrome (n = 34), glomerulonephritis (n = 48), kidney transplant recipients (n = 80), peritoneally dialyzed patients (n = 42) and in the healthy volunteers (n = 27). RESULTS: Vitamin K was significantly lower in nephrotic syndrome when compared to non-nephrotic patients, CAPD and healthy volunteers (p < 0.05). Protein Z was the highest in CAPD and kidney transplant recipients when compared to any other group. In nephrotic syndrome protein Z was significantly lower when compared to the healthy volunteers, but it did not differ significantly between two groups of patients with chronic renal failure (with and without nephrotic syndrome). Protein Z correlated only with fibrinogen in CAPD, glomerulonephritis and nephrotic patients. Vitamin K correlated with age and albumin in patients with glomerulonephritis, nephrotic syndrome as well as with albumin in CAPD. CONCLUSIONS: Alterations in protein Z might contribute to the enhanced risk of thromboembolic complications in nephrotic syndrome, CAPD and Tx via different and unknown mechanisms. This phenomenon seems to be unrelated to vitamin K status in these patients.

Adult↗
PubMed2003

Correlations of new markers of bone formation and resorption in kidney transplant recipients.

Renal osteodystrophy is a common complication of chronic renal failure and renal replacement therapy. Successful kidney transplantation reverses many of these abnormalities, but the improvement is often incomplete. The evaluation of renal osteodystrophy in everyday practice is based on noninvasive measurements. Taking this into consideration the aim of the present study was to assess new markers of bone metabolism: serum CrossLaps degradation products of C-terminal telopeptides of type I collagen tartrate-resistant acid phosphatase (TRAP) and bone-specific alkaline phosphatase (bALP), as well as their correlations with bone mineral disease (BMD) in kidney transplant recipients. Twenty-six patients (aged 26 to 54 years) receiving a triple immunosuppressive regimen with stable graft function were enrolled in the study. Serum parathormone (PTH) osteocalcin type collagen C-terminal peptides (ICTP), and procollagen type I carboxyterminal extension peptide (PICP) concentrations were measured by radioimmunoassay (RIA), Serum CrossLaps, bALP, beta2-microglobulin, TRAP 5b by enzyme-linked immunoassay (ELISA), and deoxypyridinoline (DPD) in urine immunochemiluminescence. BMD, as measured by dual-energy X-ray absorptiometry (DEXA), correlated negatively with markers of bone formation (bALP, osteoclacin, and PICP) and resorption (TRAP, ICTP, and beta2-microglobulin). The only positive correlation was between urine DPD and BMD at the femoral neck. Interestingly, BMD correlated negatively with CsA concentration. TRAP 5b correlated positively with serum creatinine, ALP, bALP, osteocalcin, iPTH, ICTP, and serum beta2-microglobulin, and negatively with CsA concentration, and azathioprine and prednisone dose. DPD did not correlate with any parameters. Serum CrossLaps correlated with markers of both bone formation and resorption. Because TRAP and serum CrossLaps correlated with markers of both bone formation and or resorption, additional studies are needed to establish the value of these markers of bone resorption to assess renal osteodystrophy.

Adult↗
PubMed2003

Is there any relation between thyroid gland function and kidney transplant function?

INTRODUCTION: Patients with chronic renal failure exhibit abnormalities of thyroid function. Reports regarding thyroid function in kidney transplant recipients (TX) are rare, particularly those individuals on long-term immunosuppression. The aim of this study was to investigate correlations between FT3, FT4, TSH concentrations, thyroid volume, and graft function. MATERIAL AND METHODS: The study enrolled 46 kidney allograft recipients (aged 27-67 years,) engrafted between years 1994 and 2000 and clinically stable. The mean time after TX was 45.3 +/- 37.4 months. Transplanted patients received prednisone, cyclosporine, and azathioprine. The control group included 22 patients with normal renal function. In addition to serum creatinine, TSH, FT3, and FT4 concentrations, thyroid examinations were performed with a 7.5-MHz linear probe to calculated the thyroid volume. RESULTS: Thyroid volume in TX patients was 25.3 +/- 13.3 mL. A positive correlation existed between thyroid volume and serum creatinine (P <.05), and a negative one between thyroid volume and TSH (P <.05). No correlation was observed between TSH, FT4, and serum creatinine. The time after TX was negatively related to TSH (P <.05). A negative correlation existed also between FT3 and creatinine in TX patients (P <.05). In the control group the concentrations of TSH and FT3 were within normal ranges. CONCLUSION: The FT3 concentration correlates with function of the renal graft. In TX patients the supplementary thyroid hormone therapy should be considered.

Adult↗
PubMed2001

Patients on peritoneal dialysis but not on hemodialysis have elevated concentration and activity of thrombin-activatable fibrinolysis inhibitor.

Cardiovascular disease (CVD) is a leading cause of death in patients on dialysis. Increased concentration of fibrinogen, dyslipidemia and impaired fibrinolysis are regarded as important risk factors for CVD. Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently discovered inhibitor of the fibrinolytic system. The aim of this study was to investigate whether peritoneal dialysis (PD) and hemodialysis (HD) patients differ with regard to TAFI concentration and/or its activity. We also measured albumin, cholesterol, triglycerides and fibrinogen. The study was performed on 35 chronically dialyzed patients (14 on PD and 21 on HD) and 18 healthy volunteers. TAFI antigen and its activity were measured with commercially available kits. Albumin, cholesterol, triglycerides and fibrinogen were measured using standard laboratory methods. Only PD patients had significantly elevated level of TAFI antigen and its activity compared to control subjects. Differences in TAFI concentration and its activity between PD and HD were at the level of statistical significance (P=.09 and P=.07, respectively). PD patients had significantly higher concentration of cholesterol and triglycerides than HD group. Fibrinogen was elevated significantly in PD patients compared to HD and controls. There was no difference in albumin concentration between PD and HD. Significant positive correlations were found between fibrinogen or triglycerides and TAFI activity only in PD patients. We conclude that the above phenomenon may predispose PD patients to suppression of fibrinolysis.

Adult↗
PubMed2001

Correlation between carotid intima-media thickness and hematocrit and hemoglobin values in renal transplant recipients.

BACKGROUND: Cardiovascular diseases are the main causes of morbidity and mortality in kidney transplant recipients. Blood viscosity plays an important role in the development of arteriosclerosis in the general population. Since hematocrit (Ht) and hemoglobin (Hb) values are determinants of blood viscosity, we decided to perform a study to check the possible relevance between these hemorheological factors and carotid intima-media thickness (IMT) in renal transplant recipients. PATIENTS AND METHODS: The study was performed on 33 clinically stable renal transplant recipients and 19 healthy persons. All subjects underwent ultrasonographic measurements of IMT. Analyzed clinical parameters included: age, sex, body mass index (BMI), mean arterial blood pressure (MAP), pulse pressure (PP) time from renal transplantation, and time on dialysis. The following biochemical parameters were assessed: Hb, Ht, fibrinogen (Fbg), and homocysteine (tHcy) concentrations (estimated by enzyme immunoassay). RESULTS: The two analyzed groups did not differ in respect to age and BMI. Mean concentrations of Hb and Ht values were lower in the patients group. Mean carotid IMT, Fbg, tHcy, MAP, and PP were significantly higher in the renal transplant recipients group when compared to the control group. IMT was positively correlated with age (r=0.55; p=0.001), Hb (r=0.36; p=0.04), Ht (r=0.34; p<0.05), PP (r=0.35; p<0.05), Fbg (r=0.4; p=0.02), and time on dialysis prior to transplantation (r=0.50; p=0.003) in the patients group. Multiple regression analysis in renal transplant recipients showed that the IMT was independently related to age, Hb or Ht values, and Fbg. CONCLUSIONS: The results for the first time show positive association between IMT and Ht and Hb values in renal transplant recipients. The results may implicate the role of these rheological factors in progression and acceleration of arterial remodeling in renal transplant recipients.

Adult↗
PubMed2001

[Homocysteine--new risk factor for progression of atherosclerosis and its complications].

The main cause of mortality and morbidity in Europe and United States are cardiovascular diseases. Besides well known atherogenic risk factors there has recently been a lot of attention paid to homocysteine. It is a sulfur aminoacid which is the demethylation product of methionine. Many facts support the role of this agent in development of arteriosclerosis and its sequelle. The relation of hyperhomocysteinemia with vascular complications, therapeutic options and potential atherogenic mechanisms are discussed in this paper. Special attention was paid to chronic renal failure patients.

Arteriosclerosis↗
PubMed2001

[TAFI--thrombin activated fibrinolysis inhibitor ].

This is a review of literature data concerning Thrombin Activatable Fibrinolysis Inhibitor (TAFI) and its role in haemostatic system in vitro and in vivo. This is the glycoprotein, which was identified recently by three independent groups of researchers. TAFI is converted to its active form by thrombin-thrombomodulin complex. TAFIa removes lysine residues from fibrin net, making impossible formation of plasminogen, t-PA and fibrin complex. It causes impairment of plasmin generation, and by this way suppression of fibrinolysis.

Animals↗
PubMed2001

[Platelet aggregation and P-selectin concentration in patients on peritoneal dialysis treated with erythropoietin].

In chronic renal failure disturbances of hemostasis are predominantly due to the defective platelet function and platelet/vessel wall interactions. Erythropoietin, used for treatment of renal anemia, affect hemostasis in dialyzed patients. The aim of the work was to assess platelet aggregation and P-selectin concentration in patients on continuous ambulatory peritoneal dialysis (CAPD) during erythropoietin therapy. The studied were performed on 12 CAPD patients, administered with subcutaneous erythropoietin in a dose of 2000 U three times a week for 3 months. Hemoglobin, hematocrit and erythrocyte count increased significantly after 1 month of the treatment. Platelet aggregation in platelet-rich plasma induced by collagen, ristocetin and serotonin increased significantly after 3 months of erythropoietin therapy when compared to the baseline values. Whole blood platelet aggregation and P-selectin concentration did not change significantly during 3 months of erythropoietin therapy. Erythropoietin treatment in CAPD patients did not affect significantly platelet aggregation and activation.

Adult↗
PubMed2000

Importance of serotonergic mechanisms in the thrombotic complications in hemodialyzed patients treated with erythropoietin.

So far it is not clear how erythropoietin affects the anticoagulant properties of vascular endothelium in uremia. Since serotonin is also thought to play a role in the pathogenesis of thrombosis, the aim of the study was to evaluate major components of extrinsic coagulation pathway, markers of endothelial cell injury, lipoprotein (a) and peripheral serotonergic mechanisms during rHuEPO therapy in hemodialyzed patients. The study was performed on chronically hemodialyzed patients divided into two groups: with rHuEPO treatment and without rHuEPO therapy in relation to the control group. In uremic patients, thrombomodulin and von Willebrand factor, activity of factor VII, tissue factor pathway inhibitor (TFPI) activity, TFPI and tissue factor (TF) concentrations, lipoprotein (a) level were significantly higher when compared to healthy volunteers. Treatment with rHuEPO resulted in a further significant rise in markers of endothelial cell injury: thrombomodulin and von Willebrand factor and TFPI concentration. Extrinsic coagulation factors: activities of factor VII and X, TFPI activity and TF activity and concentration, lipoprotein (a) and vitronectin remained unchanged during rHuEPO therapy. Platelet serotonin content and whole blood serotonin were significantly lower in uremic patients relative to healthy volunteers and during rHuEPO treatment they increased significantly. Whole blood serotonin reached normal values. Plasma serotonin, significantly elevated in uremia, did not change during rHuEPO therapy. Serotonin uptake by uremic platelets was significantly impaired and remained unaltered during rHuEPO administration. Serotonin release by uremic platelets was also significantly depressed but a significant improvement was observed in rHuEPO-treated patients. Our data suggest that endothelial injury, TF pathway components and peripheral serotonergic system disturbances may predispose to thromboembolic complications and play a role in the pathogenesis of atherosclerosis in uremic patients, particularly treated with rHuEPO. Increase in TFPI may compensate the increase in TF in these patients.

Adult↗
PubMed2000

[Tissue factor and tissue factor pathway inhibitor in peritonitis treated with dialysis].

TFPI-tissue factor pathway inhibitor appears to play a primary role in regulating TF-induced coagulation. During CAPD procoagulant and anticoagulant activities of the mesothelium are balanced under normal conditions. The aim of the work was to assess TF and TFPI concentrations during peritonitis in CAPD patients. The study was performed in 9 CAPD subjects with peritonitis and 14 clinically stable CAPD patients. TF, total, free and truncated TFPI, thrombomodulin concentrations were measured in plasma and dialysate; C-reactive protein and tumor necrosis factor-TNF alpha were assayed in serum. In 8 patients with S. aureus peritonitis TF and TFPI were not found in dialysate, but were detectable in a case with E. coli peritonitis. C-reactive protein and TNF alpha significantly elevated at the beginning of peritonitis, fell sharply after the therapy. Further studies are needed to establish whether the kind of bacterial peritonitis (Gram-positive or negative) may affect TF and TFPI in plasma and dialysate in CAPD patients.

Adult↗
PubMed2000

[Selected parameters of bone metabolism in hemodialyzed and peritoneally dialyzed patients].

Renal osteodystrophy is a metabolic bone disease occurring in patients with end-stage renal failure. The aim of the study was to compare serum concentrations of some bone markers in hemodialysed (HD) patients and in patients undergoing continuous ambulatory peritoneal dialysis (CADO). We studied two groups of patients with end-stage renal failure: 52 hemodialysed individuals aged 24-74 years and 19 peritoneally dialysed patients aged 20-70 years. Serum calcium and phosphate concentration, cholesterol, triglycerides, total protein, albumin, alkaline phosphatase, urea before and after HD, urea in CADO patients were determined by standard laboratory methods. Serum PTH, osteocalcin, 1,25(OH)2D3 and insulin-like growth factor (IGF-1) concentrations were measured by commercially available radioimmunoassay. Serum tumor necrosis factor (TNF-alpha) and interleukin-1 (IL-1) concentrations were measured by ELISA. There were no differences between serum concentrations of the studied bone markers in hemodialysed patients and CAPD patients. All dialysed patients presented high concentrations of serum PTH, osteocalcin, alkaline phosphatase activity, lower serum IGF-1 concentration and normal serum calcitriol concentration. High serum PTH and osteocalcin concentrations may indicate intensification of bone synthesis, what is typical for osteitis fibrosa.

Adult↗