Search PubMed⌕ Search

Biomedical subjects

W Zoch-Zwierz

Publications and source records attributed to W Zoch-Zwierz.

At least 19 recordsLinked to original sources

Does a late referral to a nephrologist constitute a problem in children starting renal replacement therapy in Poland?--a nationwide study.

BACKGROUND: It is estimated that 20-50% of adult patients start chronic dialysis therapy without prior contact with a nephrologist. The aim of this nationwide study was to assess clinical and metabolic status of children at the start of chronic dialysis in Poland with regard to the timing of the referral to a nephrologist. METHODS: We studied data of 180 children (mean age 14+/-6 years) undergoing chronic dialysis in 13 (out of 14) dialysis pediatric centres in Poland. Patients were classified as early referrals (ERs) when they entered the dialysis programme at least 1 month after the first referral to a nephrologist or late referrals (LRs) when the dialysis was introduced within 1 month from the first visit. RESULTS: Seventy-nine percent of pediatric patients were referred early (ER) to the dialysis centre and 21% were referred late (LR) and had to start dialysis within a month. When starting dialysis, LR patients had significantly higher levels of urea and phosphate as well as lower calcium and haemoglobin in comparison with ERs. Hypertension, pulmonary oedema, fluid overload, treatment in the intensive care unit (ICU) and body mass index (BMI) below 10th percentile turned out to be more frequent in the LR group. Peritoneal dialysis (PD) was used as the first method of dialysis in 59% of ERs and 46% of LRs. The majority of ER patients was treated in the predialysis period with calcitriol, phosphate binders and low protein diet (84%, 89%, 92% of all children, respectively), and 20% of them received epoetin. In the up to 3 years observation of our initial cohort, we also found that the patients who were referred late were less likely to receive kidney transplant (P = 0.02). CONCLUSION: The results of the study indicate that the LR to a pediatric nephrologist was associated with poorer clinical and metabolic status of children entering chronic dialysis programmes.

Adolescent↗

Assessment of selected adhesion molecules and lymphocyte subpopulations in children with IgA nephropathy.

PURPOSE: The aim of the study was to assess the expression of selected adhesion molecules on mononuclear cells of peripheral blood and lymphocyte subpopulations in children with IgA nephropathy (IgAN). MATERIAL AND METHODS: 14 children with IgAN and 20 healthy controls were included in the study. Flow cytometry was used to determine the expression of such adhesion molecules as L selectin (CD62L), VLA-4 integrin (CD49d), intracellular molecule ICAM-1 (CD54) and cytotoxic lymphocyte molecule CTLA-4 (CD152), as well as the lymphocyte antigens: CD3, CD4, CD8, CD19, CD1656 (NK), CD4 and CD8 RO+ and RA+. RESULTS: The findings revealed that the expression of the adhesion molecules VLA-4 and CTLA-4 did not differ from that of the healthy controls (p > 0.05). However, the expression of CD62L (L-selectin) was increased (p < 0.05). The expression of ICAM-1 was reduced, but not significantly, compared to the control group (p > 0.05). We found a decrease in the expression of NK cells (CD1656) and CD4/CD8 ratio, and an increase in CD8 cells (p < 0.05). In the group of 9/14 children, with proteinuria over 1.0 g/24 hours, a decreased expression of CD4 was additionally found (p < 0.05). CONCLUSIONS: The children with IgAN show: 1. Changes in peripheral lymphocyte subpopulations involving an increase in CD8 cells and a decrease in CD1656(NK) cells, a reduction in the CD4/CD8 ratio, and additionally in cases with proteinuria a reduction in CD4 cell count, 2. Increased expression of L-selectin (CD62L) on peripheral blood mononuclear cells.

Adolescent↗

[The course of post-streptococcal glomerulonephritis depending on methods of treatment for the preceding respiratory tract infection].

UNLABELLED: The aim of our work was to assess the course of post-streptococcal glomerulonephritis (APSGN) in children according to the way of preceding respiratory tract infection treatment. The examinations were carried out in a group of 26 children aged 5-15 years, who were divided into two subgroups: I--12 children, who did not receive antibacterial treatment, and II--14 children who were shortly treated with different antibiotics (3-5 days). All the children had full symptomatic picture of post-streptococcal glomerulonephritis with haematuria, oedemas, hypertension and hypocomplementemia. The etiology was diagnosed retrospectively during observation of ASO titer dynamics and additionally in 18 after finding pathogenic Streptococcus strains in pharyngeal swab. The differences in the course of illness was shown only during first weeks. In children from the group I the course of acute APSGN was a little more serious, because haematuria, proteinuria and hypertension were observed longer. Symptoms of nephrotic syndrome were observed in two children, acute renal insufficiency in two children, and one with hypertensive encephalopathy. After 3 and 12 months no children had pathological signs. Erythrocyturia was observed in 19 of 26 children after 3 months and in 10 of 26 children after 12 months after illness with similar frequency in both groups. In 5 children with proteinuria renal biopsy showed mesangialis proliferative glomerulonephritis--1st degree. CONCLUSION: All observed children with APSGN were not cured properly during the respiratory tract infection preceding the disease, however even short antibacterial treatment caused the moderation of symptoms.

Adolescent↗

[Lymphocyte subpopulations of peripheral blood in children with Schönlein-Henoch purpura and IgA nephropathy].

The main lymphocytes' subpopulations of peripheral blood in 21 children (mean age--9.8 +/- 3.3 y) with permanent proteinuria and haematuria, 11 with IgA nephropathy (IgA) and 10 with nephropathy in course of Schonlein-Henoch purpura (Sch-H) during intensification of symptoms were assessed on flow cytometer f. Coultier, using monoclonal antibodies. The control group consisted of 21 healthy children at the same age. The results showed decreased percentage of CD4 and increased percentage of CD8 with decreased CD4/CD8 ratio in both groups of examined children. In most cases also increased percentage of B lymphocytes (CD19) were noticed and especially in children from N IgA group increased concentration of immunoglobulin A in serum. Only in some patients increased percentage of natural cytotoxic cells NK were noticed. The results were similar either in N IgA or Sch-H groups.

Adolescent↗

[Sacral bone dysgenesis in a child whose mother has diabetes].

We introduced 2.5-year old girl with gait and miction disturbances as a result of sacral bone dysgenesis (only S1 existed) and abnormal position of nerve roots of medulla. The 28-year old mother of the child has been treated for diabetes mellitus type I since she was 15.

Abnormalities, Multiple↗

[Urinary calcium/creatinine excretion in children with isolated hematuria].

The aim of this study was to assess the oxalate excretion (Ox) in 23 children aged 3-17 years with haematuria (I), using the enzymatic method. Control group (II) consisted of 21 healthy children. The results showed out that in children with haematuria both mean oxalate excretion (Ox/ker) and mean calcium excretion (Ca) and calcium/creatinine ratio (Ca/ker) were higher than in control group. However, the differences were not significant important (p > 0.05). Significantly higher oxalate and calcium excretion was diagnosed in 5 children with renal stone disease and 8 children without stones but with paroxysmal abdominal pain and positive family history.

Adolescent↗

[Ultrasound-guided renal biopsy with automatic needle with a leader].

UNLABELLED: The aim of this work was to discuss the results of percutaneous renal biopsy under control of ultrasound, using automated needle. 110 specimen in 55 children aged 3-18 years were obtained. Adequate biopsy was obtained in 53 children. Only in 26% of children the number of glomeruli in each specimen was below 8. The most frequent complication was microscopic haematuria, lasted 1-3 days, which was shown in 70.9% of children. Perirenal haematoma smaller than 2 cm was observed in about 12% of children and pain during the first day after biopsy in 20% of examined children. CONCLUSION: Percutaneous renal biopsy using automated biopsy needle under control of ultrasound is safe and efficient method, which is used for definitive diagnosis.

Adolescent↗

[Immunoglobulin E and eosinophils in urine of children with bronchial asthma].

Excretion IgE and eosinophils was assayed in the urine of 25 children with bronchial asthma during attack (I) after regression of symptoms (II) and in a group of healthy children aged 4-15 years. Three healthy children (12%) excreted trace amounts of IgE and single eosinophils to urine. In the group of sick children during attack (I), 20 children (80%) excreted IgE in urine, 10 children (40%) excreted eosinophils. Thirteen children (52%) had nocturia, dysuria or erythrocyturia of unknown cause. After regression of acute symptoms of asthma (II) IgE in urine was excreted in smaller amounts than in (I) by 60% of the children, while eosinophils by 24% children. In the II investigation, 8 children (32%) still had nocturia. It was found that IgE and eosinophils are present in the urine of children with bronchial asthma, regardless if symptoms from the urinary tract are present or not.

Adolescent↗

[Anomalies of the cervical spine in children].

Two children are presented with congenital anomalies of the cervical spine and associated malformations of the nervous and urinary systems. The attention is paid to the usefulness of the cervical spine assessment in children in cases of recurrent cerebellar manifestations of unclear aetiology or combined malformations of the urinary system.

Abnormalities, Multiple↗

[Evaluation of N-acetyl-beta-D-glucosaminidase (NAG) and its isoenzyme activities in the urine of children with primary and secondary hypertension].

The total activity of N-acetyl-beta-D-glucosaminidase (NAG) and its isoenzymes A and B was determined in the urine of 18 children aged 9-18 years with essential hypertension and 21 with nephrogenic hypertension. The results were compared with those in a control group of 30 healthy children. The obtained results show that in children with stabilized hypertension (above the 95 centile) of essential type the proportion (above the 95 centile) of essential type the proportion of urinary isoenzymes are changes, with higher activity of the B isoenzyme. On the other hand, in children with nephrogenic hypertension the total activity and the activity of the B isoenzyme are increased. After reduction of blood pressure following hypotensive treatment (below the 90th centile) the activity of NAG and its isoenzymes was again normal in essential hypertension and was much reduced in nephrogenic hypertension. The study demonstrated that hypertension leads to transient damage to the proximal tubules which is reversed by effective hypotensive treatment.

Acetylglucosaminidase↗

[Familial occurrence of central diabetes insipidus].

Two cases are presented of familial diabetes insipidus with analysis of pedigree involving four generations. The analysis of diabetes insipidus occurrence in this family indicates the autosomal dominant type of inheritance.

Adult↗

[Clinical results of the treatment of bacterial infections in children with ceftazidime].

Ceftazidime (Fortum-Glaxo) was administrated to 19 children with urinary tract infections and to 21 children with pneumonia. Clinical symptoms of the infections resolved in 17 children (89%) with the urinary tract infections treated with ceftazidime within 4 days. The remaining children (11%) recovered after 7 days of therapy. Clinical symptoms of pneumonia resolved in 19 children (90%) within 7 days of the treatment. A significant improvement was achieved in the remaining 2 children after 10 days of the treatment.

Adolescent↗

[The NBT test in bacterial infections complicating prednisone-treated nephrotic syndrome].

The spontaneous nitroblue tetrazolium reduction test was done in children with nephrotic syndrome treated with prednisone and with secondary bacterial infections and in children with urinary tract infections not treated with prednisone. In healthy children 9.0 +/- 1.3% of polymorphonuclear leucocytes in peripheral blood showed presence of deposits in the NBT test. In children not treated with prednisone the number of NBT (+) leucocytes was increased over fourfold. The value of the NBT test was highest at the beginning of the disease. In children treated with prednisone the value of the NBT test increased slowly. The highest results were obtained in the second week of infection treatment. In relation to controls the proportion of NBT (+) test in peripheral blood was increased threefold.

Bacterial Infections↗