Short-term Effects of Losartan on Cardiovascular Risk and Allograft Injury Biomarkers in Kidney Transplant Recipients.

BACKGROUND: There is a controversy over the renoprotective and cardioprotective effects of renin-angiotensin-aldosterone system blockade in kidney transplant recipients (KTRs). The aim of the study was to evaluate the short-term effects of losartan on allograft injury, cardiovascular risk biomarkers and safety of the treatment in KTRs. METHODS: An interim analysis of a prospective, open, multicenter, controlled clinical trial CELART (Cardiovascular Effects of Losartan After Renal Transplantation) was performed. KTRs were allocated to losartan (L) 50 to 100 mg or standard hypotensive treatment (ST) group to reach target blood pressure (BP) <140/90 mm Hg. The short-term effects of the therapy were evaluated after 6 months: estimated glomerular filtration rate (eGFR), albuminuria, the intrarenal fibrosis biomarkers: urine excretion of transforming growth factor ß-1 (TGFß-1) and procollagen type III amino terminal propeptide (PIIINP), cardiac biomarker: serum concentration of N-terminal-pro-B-type natriuretic peptide (NT-proBNP), 24-hour ambulatory BP measurement, and hemoglobin and potassium concentrations. RESULTS: At baseline the groups did not differ with respect to age, primary nephropathy, comorbidity, immunosuppressive therapy, albuminuria, and graft function. A total of 61 (L group) and 73 (ST group) patients reached the target BP and completed protocol at 6 months. After 6 months of therapy there were no significant differences in changes of eGFR, albuminuria, hemoglobin and potassium concentrations, urine excretion of PIIINP, and TGFß-1 between groups. There was a trend in the L group to decrease the concentration of serum NT-proBNP. CONCLUSIONS: Losartan shows minimal adverse effects and no influence on graft function and biomarkers of graft fibrosis. It may have a positive effect on cardiovascular risk in KTRs. Further interim analyses of the CELART study will be conducted.

Influence of donor and recipient gender as well as selected factors on the five-year survival of kidney graft.

UNLABELLED: The aim of the study was to determine the impact of the gender of renal allograft donor and recipient on the graft function over a 5-year follow-up period. MATERIAL AND METHODS: The 154 kidney grafts from 77 donors transplanted into recipients of both genders. Two study groups were formed: one group consisted of male donors, while the other consisted of female donors. The recipients in each of the groups consisted of a pair, one male and one female. RESULTS: 71% of grafts survived the five-year period in the group of male and female recipients when the donor was male; in case of female donors, the rate was 62.5%. Depending on the gender of the donor and the recipient, the rates of grafts with five-year survival were as follows: 79.2% for male donors and female recipients (MF); 62.5% for male donors and male recipients (MM). The difference between both groups was not statistically significant. In the case of female donors and male recipients (FM), the five-year survival rate was 58.3%, while in female donors and female recipients, the five-year survival rate was 64.1%. CONCLUSIONS: Grafts from male donors show a trend towards better five-year survival compared to grafts from female donors. The highest five-year survival rate was observed when the donor was male and the recipient was female; the lowest rate was observed for female donors and male recipients.

[Evaluation of the risk of developing lymphoedema of the upper limb in women subjected to motor rehabilitation after radical mastectomy]. / Ocena ryzyka rozwoju obrzeku limfatycznego konczyny górnej u kobiet poddanych rehabilitacji ruchowej po radykalnej mastektomii.

The analysis included 86 women in whom lymphoedema occurred in the upper limn (ULL) after radical mastectomy. The analysis were carried out in this group of patients, as well as in a control group (patients without ULL) 14 somatic parameters were examined. These parameters were evaluated before the intervention. It was established that among the anthropometric traits examined, only the body mass, hip width, hip-shoulder index, Chest flattening index, BMI index, WHR index, Quetelet's index, Rohrer's index, Pignet-Verwaeck's index assume average values in women with ULL in the preoperative period (statistically significantly different from those which occur in women without this complication(. It was shown that the dispensary group of women ill with breast cancer with a statistically significantly high risk of developing ULL was made up of patients with a large mass (>69.2 kg), WHR (>0.94), Quetele's (>448.7), Rohrer's (>1.76) and Pignet-Verwaeck's (107.7). A slim body build and low indexe values appear to be a factor protecting from this occurrence of the complication.