Protective effect of vitamin B5 (dexpanthenol) on cardiovascular damage induced by streptozocin in rats.

OBJECTIVES: This study investigated whether Dexpanthenol (DEX) improves diabetic cardiovascular function and cardiac performance by regulating total oxidant and antioxidant status. METHODS: Diabetes was induced by a single intraperitoneal injection of Streptozocin (50 mg/kg in 1 ml of saline) and treatment groups received DEX (300 mg/kg/day) for 6 weeks. Endothelium (in)dependent relaxation responses were assessed in thoracic aortic rings and coronary vasculature together with alpha receptor and voltage dependant contractile responses of aorta. Myocardial contractility has been recorded by an intra ventricular latex balloon. Total oxidant and antioxidant status were measured from the serum samples. RESULTS: Induction of diabetes resulted in an apparent body weight loss, high blood glucose, endothelial dysfunction and increased serum oxidant status. DEX supplementation restored the endothelial dysfunction, antioxidant status and body weight whereas decreasing blood glucose level. CONCLUSION: Along with the standard therapy of diabetes, DEX can be used as a safe and economical way of adjuvant therapy to diminish the burden of the disease (Tab. 3, Fig. 3, Ref. 30).

The influence of functional pinealectomy and exogenous melatonin application on healing of a burr hole in adult rat calvaria: a histological and immunohistochemical study.

BACKGROUND: Even today, repair of the cranial defects still represents a significant challenge in neurosurgery and various options have been used for their reconstruction to date. However, there are very few studies investigating the effects of exogenous administration of melatonin (MEL) as an agent that promotes bone regeneration. The goal of this study was to investigate the effects of functional pinealectomy (Px) and exogenous MEL administration on the bone repair properties and surrounding connective tissue alterations in a rat calvaria model. MATERIALS AND METHODS: The total of 30 adult female Wistar-Albino rats was randomly divided into three groups (n = 10): control group (CO; 12 h light/12 h dark exposure), functional Px group (24 h light exposure, light-induced functional Px), and Px+MEL group (light-induced Px + MEL, 20 mg/kg/day for 12 weeks). Critical-sized burr-hole defects (diameter: 3.0 mm) were surgically created by a single operator in the calvarium of all rats, using an electric drill. Animals in Px+MEL group received MEL 20 mg/kg/day for 12 weeks. At the end of the study, bone healing and connective tissue alterations surrounding drilled defect area in the rat calvaria were determined in haematoxylin-eosin-stained and Mallory Azan slices applied in anti-bone sialoprotein. Image Pro Express 4.5 programme was used for histomorphometric calculation of areas of new bone and fibrotic tissue. Normality control was performed by Shapiro-Wilk test. Variance homogeneities were examined by Shapiro-Wilk and Levene tests; Tukey HSD test was used as a post hoc method since there was no homogeneity problem. All hypothesis tests were performed at the 0.05 significance level. RESULTS: Histological analysis showed that the bone repair process in the Px+MEL group was similar to that of the CO group, whereas the functional Px group showed a delay. Histomorphometrically, it was found that the Px group had the largest hole diameter and the most fibrotic scar area, although no binary statistical significance was found between the CO and Px+MEL groups (p = 0.910). In terms of vascularisation, it was observed that the most vascular structure was found in the Px+MEL group among the scar tissue and ossification areas, while the vascularisation was the least in the Px group (p < 0.001). CONCLUSIONS: Our findings revealed that bone repair process was impaired in functional Px group, but exogenous MEL replacement was able to restore this response. Thus, it is concluded that utilisation of MEL may improve the bone repair in calvarial defects.

Antimicrobial activity of the essential oil of Centaurea aladagensis.

Composition of the water-distilled oil of the aerial parts of Centaurea aladagensis, endemic in Turkey, was analysed by GC-MS. Hexadecanoic acid (39.3%), caryophyllene oxide (6.6%) and hexahydrofarnesyl acetone (4.3%) were found as main constituents in the oil. The oil was tested against 7 human pathogenic microorganisms.

The composition, geographical variation and antimicrobial activity of Lippia javanica (Verbenaceae) leaf essential oils.

Lippia javanica is widely distributed throughout South Africa where it is used extensively in traditional herbal preparations. An infusion of the leaves is commonly used as a decongestant for colds and coughs. A preliminary study indicated that the essential oil chemistry varies dramatically both within and between natural plant populations. As the antimicrobial activity may be directly related to the specific composition of the oil, the activity may also fluctuate. The aerial parts of Lippia javanica were collected from various localities in southern Africa to study the essential oil composition and the antimicrobial activity thereof. The hydrodistilled essential oils were analysed by GC/MS and a cluster analysis was performed on the essential oil dataset. From 16 samples (representing five natural populations), 5 chemotypes were identified; a myrcenone rich-type (36-62%), a carvone rich-type (61-73%), a piperitenone rich-type (32-48%), an ipsenone rich-type (42-61%) and a linalool rich-type (>65%). The myrcenone and linalool chemotypes have been mentioned in the literature but the carvone, ipsenone and piperitenone chemotypes have not previously been reported for Lippia javanica. Time kill studies were performed on three microbial respiratory isolates to document the scientific rationale of using Lippia to treat respiratory complaints in traditional herbal medicine. Klebsiella pneumoniae, Cryptococcus neoformans and Bacillus cereus showed reduction in microbial populations with the strongest bacteriostatic effect observed for Klebsiella pneumoniae.

The in vitro pharmacological activities and a chemical investigation of three South African Salvia species.

Salvia species (sage) are well known in folk medicine throughout the world. In South Africa sage is used against fever and digestive disorders. Three closely related South African species (Salvia stenophylla, Salvia repens and Salvia runcinata) were investigated for their anti-oxidant (DPPH assay); anti-inflammatory (5-lipoxygenase and cyclo-oxygenase assays); antimalarial (tritiated hypoxanthine incorporation assay); antimicrobial (disc diffusion and micro-dilution assays) properties and toxicity profile (tetrazolium-based assay). The solvent extracts exhibited anti-oxidant, antimalarial and antibacterial and poor anti-inflammatory properties. The essential oils exhibited anti-inflammatory and antimalarial properties, but displayed poor anti-oxidant and antimicrobial activity. The extract of Salviastenophylla and the essential oil of Salvia runcinata displayed the highest toxicity profile. Overall, Salvia runcinata displayed the most favorable activity of all three taxa tested with an IC(50) value of 6.09 (anti-oxidant); 29.05 (antimalarial) and 22.82 microg/ml (anti-inflammatory). Analytical procedures (GC-MS and HPLC-UV) were employed to generate chromatographic profiles for the essential oils and solvent extracts respectively. The HPLC analysis revealed the presence of rosmarinic acid in all three taxa while carnosic acid was only present in Salvia repens and Salvia stenophylla. The GC-MS analysis showed that oils were qualitatively and quantitatively variable. beta-Caryophyllene was present in large amounts in all three taxa. Other components present include camphor, alpha-pinene and alpha-bisabolol. The results of the in vitro pharmacological activities provide a scientific basis to validate the use of these Salvia species in traditional medicine in South Africa.

Post-transplant C-reactive protein predicts arterial stiffness and graft function in renal transplant recipients.

BACKGROUND: The aim of this study was to evaluate the renal and cardiovascular outcomes of post-transplant c-reactive protein (CRP) levels. METHODS: One hundred fifty renal transplant recipients (113 men; median age, 38.9 ± 10.8 years) were cross-sectionally analyzed. Mean pre-transplant and post-transplant CRP levels were analyzed by the 1(st), 3(rd), 6(th), 12(th), and 24(th) months of transplantation. Patients were divided into 3 groups according to mean post-transplantation CRP levels: group 1 (CRP >20 mg/L and fluctuating levels; n = 34), group 2 (CRP, 6-20 mg/L; n = 40), and group 3 (CRP <6 mg/L; n = 76). Arterial stiffness was measured by means of carotid femoral pulse-wave velocity (PWv) by use of the SphygmoCor system. RESULTS: Patients in group 1 had significantly lower estimated glomerular filtration rate (eGFR) (P = .000) and left ventricular systolic function and higher duration of dialysis before transplantation, pulse-wave velocity (PWv), proteinuria, and left ventricular mass index when compared with the other two groups. In regression analysis, eGFR and PWv were detected as the predictors of post-transplantation CRP levels. CONCLUSIONS: Fluctuating and high stable (>20 mg/L) post-transplant CRP levels predict eGFR, proteinuria, left ventricular mass index, and PWv after transplantation. Thus, CRP levels may be a useful marker to anticipate graft survival and cardiovascular morbidity in renal transplant recipients.

High-grade proteinuria as a cardiovascular risk factor in renal transplant recipients.

BACKGROUND: Proteinuria is a marker of graft damage and is closely associated with a higher risk of morbidity, mortality, and cardiovascular disease in kidney transplant recipients (KTRs). Arterial stiffness is a well-known predictor of vascular calcification and systemic arteriosclerosis. In our study, we aimed to investigate the association between proteinuria and graft/patient survival and to determine whether proteinuria may be a predictor for cardiovascular disease in our KTR population. METHODS: Ninety KTRs (31 women; age, 38.7 ± 11 years, with 45.9 ± 9.6 months post-transplantation period) with normal graft functions in the 3 to 5 years of the post-transplantation period were enrolled. All patients were evaluated for their standard clinical (age, sex, and duration of hemodialysis) parameters. High-grade proteinuria was defined as proteinuria >500 mg/day in the 24-hour urine collection. All patients were evaluated by means of pulse-wave velocity (PWV) measurement at the initiation of the study. RESULTS: Patients were divided into 2 groups: group 1 (high-grade proteinuria) patients with ≥500 mg/24 hours (n = 30) and group 2 (low-grade proteinuria) patients with <500 mg/24 hours (n = 60). High-grade proteinuria was correlated with higher PWV measurements and lower estimated glomerular filtration levels. Proteinuria appears to precede the elevation of serum creatinine and thus may be a useful marker of renal injury and may also be a contributing factor on deterioration of the graft. CONCLUSIONS: High-grade (>500 mg/day) proteinuria in KTRs is strongly associated with poor graft survival and increased risk of cardiovascular events. In our study, we proved the significant difference between high-grade and low-grade proteinuric patients, and we suggest 500 mg/day as the threshold of proteinuria in KTR population.

Post-transplantation Anemia Predicts Cardiovascular Morbidity and Poor Graft Function in Kidney Transplant Recipients.

OBJECTIVE: We aimed to investigate whether low post-transplantation-period hemoglobin levels are predictive of cardiovascular morbidity in terms of left ventricular (LV) hypertrophy and vascular stiffness and to determine the contributing factors of post-transplantation anemia in kidney transplant (KT) recipients. METHODS: One hundred fifty (mean age, 38.9 ± 10.8 y; 113 male) KT recipients with functioning grafts were enrolled in the study. All subjects underwent clinical and laboratory evaluations (24-hour urinary protein loss, complete blood count) and transthoracic echocardiography to assess LV systolic function. Arterial stiffness was measured by means of carotid-femoral pulse-wave velocity (PWV). Mean hemoglobin levels were analyzed at the 1st, 6th, 12th, and 24th months after transplantation. Patients were divided into 2 groups according to presence of anemia: patients with anemia (group 1; n = 120) and normal (group 2; n = 30). RESULTS: PWV values (6.8 ± 1.9 m/s vs 6.4 ± 1.1 m/s in groups 1 and 2, respectively; P = .002) and LV mass index (LVMI; 252.1 ± 93.7 g/m(2) vs 161.2 ± 38.5 g/m(2) groups 1 and 2, respectively; P = .001) were significantly higher in group 1. Estimated glomerular filtration rate and (64 ± 28.5 m/min vs 77.8 ± 30 m/min in groups 1 and 2, respectively; P = .001) LV systolic function (57.2 ± 5.8% vs 77.8 ± 30% in groups 1 and 2, respectively; P < .005) were significantly lower in group 1. In regression analysis, LV systolic function and LVMI were predictors of post-transplantation hemoglobin levels. CONCLUSIONS: Post-transplantation anemia contributes to cardiovascular morbidity by deteriorating LV function and increasing PWV and is therefore associated with poor prognosis for graft survival. Early correction of post-transplantation anemia, especially with the use of erythropoietin, may be beneficial for both graft and recipient survivals.

Graft function and arterial stiffness: can bioimpedance analysis be useful in renal transplant recipients?

OBJECTIVE: We aimed to determine the total body water (TBW) by means of bioimpedance analysis (BIA) and to analyze the association of TBW, graft function, and arterial stiffness by means of pulse-wave velocity (PWV) and echocardiographic measurements in renal transplant (RT) recipients. METHODS: Eighty-two RT recipients (mean age, 38.7 ± 11.5 y; 58 male) who were using ≥1 antihypertensive treatment were enrolled in the study. Biochemical parameters, 24-hour urinary protein loss, estimated glomerular filtration rate (eGFR), transthoracic echocardiography, bioimpedance analysis according to systolic blood pressure, TBW, lean tissue index (LTI), extracellular water (ECW), intracellular water (ICW), lean tissue mass (LTM), phase angle (Phi50) levels, and renal resistive index (RRI) were evaluated. RESULTS: TBW and ECW were significantly correlated with systolic blood pressure. Urinary protein loss, pulmonary artery pressure, frequency of overhydration, systolic blood pressure, TBW, LTI, ECW, ICW, LTM, and Phi50 values were significantly higher in patients with estimated glomerular filtration rate (eGFR) 15-49 mL/min but similar in patients with eGFR 50-70 mL/min. CONCLUSIONS: Hypertensive RT recipients have increased TBW, LTI, ICW, FTI, LTM, and Phi50 values. Graft function is positively correlated with systolic blood pressure and BIA parameters. Therefore, hypertensive RT recipients should be closely followed with the use of BIA for an early diagnosis of loss of graft function.

Follicular viability and morphology of sheep ovaries after exposure to cryoprotectant and cryopreservation with different freezing protocols.

OBJECTIVE: To test the toxicity of cryoprotectant in sheep ovarian tissue and to determine optimal conditions for freezing hemiovary cortex. DESIGN: Small follicles (<60 microm in diameter) were isolated enzymatically for viability testing. Dead and live follicles were identified by using trypan blue staining, and follicle morphology was examined histologically. SETTING: Centre hospitalo-universitaire de Biologie de la Reproduction, Hôpital Edouard Herriot, Lyon, France. ANIMAL(S): Lambs 5 to 6 months of age. INTERVENTION(S): Two-millimeter slices of hemiovarian cortex were prepared for cryoprotectant toxicity tests and freezing procedures. MAIN OUTCOME MEASURE(S): Follicular mortality and histologic structure. RESULT(S): For freezing procedures, the concentration of cryoprotectant was increased to 2 M on the basis of results of cryoprotectant toxicity tests in fresh tissues. Follicular mortality rates were 4.6% with of 2 M dimethyl sulfoxide (DMSO) and 3.8% with 2 M of propylene glycol (PROH). After freezing with semiautomatic seeding, follicular mortality rates were 8.4% (2 M of DMSO) and 12.4% (2 M of PROH). Tissue morphology was well preserved with 1.5 M of DMSO or PROH. With 1.5 M DMSO, results of the slow cooling protocol (2 degrees C/min) without seeding and the standard very slow cooling protocol (0.3 degrees C/min) were similar. CONCLUSION(S): Optimal survival of primordial follicles in the sheep was obtained by using a slow cooling protocol with semiautomatic seeding at 2 M of DMSO.

Restoration of ovarian steroid secretion and histologic assessment after freezing, thawing, and autograft of a hemi-ovary in sheep.

OBJECTIVE: To evaluate the effects of freezing, thawing, and autograft of a hemi-ovary on steroid secretion, endometrial maturation, and ovarian histology in ewes. DESIGN: Experimental animal study. SETTING: Laboratoire de Zootechnie, Ecole Nationale Vétérinaire, Marcy l'Etoile, France. ANIMAL(S): Six lambs aged 6 months to 1 year old. INTERVENTION(S): Hemi-ovaries were prepared and frozen from the right ovary of six lambs and autografted 4 weeks later to the contralateral ovarian hilus. The autografts and the uterus were recovered 1 year later. Blood tests were performed each week to measure P concentration. MAIN OUTCOME MEASURE(S): Number of primordial follicles; levels of plasma P. RESULT(S): Histologic examination of ovarian slices after freezing showed no destruction of primordial, primary, secondary, or cavitary follicles. The frozen ovarian autograft showed good recovery of the macroscopic and microscopic ovarian structure. After autografting, histologic examination revealed primordial to cavitary follicles. Secretion of P started to rise 4 weeks after the autograft. Histologic analysis of the endometrium showed numerous glands, vessels, and mucous secretion. CONCLUSION(S): Frozen ovarian autografts achieved P secretion and endometrial maturity.

Composition and antimicrobial activity of the essential oils of Micromeria cristata subsp. phrygia and the enantiomeric distribution of borneol.

Water-distilled essential oils from herbal parts of Micromeria cristata (Hampe) Griseb. subsp. phrygia P. H. Davis (Endemic) (Lamiaceae) collected from three different localities were analyzed by GC-MS. The major component characterized in the three oils was borneol (27-39%). Other main components were determined as camphor (9-15%), caryophyllene oxide (4-6%), and trans-verbenol (4-6%) in the oils. Enantiomeric distributions of borneol and camphor in the oils were determined on a fused silica Lipodex-E capillary column using a multidimensional GC-MS system. The three essential oils and both enantiomers of borneol have been evaluated for their antimicrobial activity. They showed inhibitory effects on Gr (-) and Gr (+) pathogenic microorganisms.

Screening of biotransformation products of carvone enantiomers by headspace-SPME/GC-MS.

In the course of our continuing work on transformation of monoterpenes by microorganisms, the biotransformation of (+)- and (-)-carvone was carried out. The metabolites formed during microbial transformations were screened using a simple, rapid and efficient technique: Headspace-solid phase microextraction (SPME)/GC-MS. The results as well as the application of this technique are described.

Antimicrobial activities of Ferulago essential oils.

Essential oils from Ferulago asparagifolia Boiss., F. galbanifera (Miller) W. Koch, F. humilis Boiss. (Endemic), F. trachycarpa Boiss. growing in Turkey were evaluated against 15 microorganisms for their antifungal and antibacterial activity using an agar tube dilution and microdilution broth susceptibility assay, respectively. The essential oil compositions were investigated by GC/MS. Inhibitory effects against Escherichia coli, Enterobacter aerogenes, Candida albicans, Gaeumannomyces graminis var. tritici, Sclerotium rolfsii and Fusarium moniliforme were remarkable. Results are discussed in comparison with the chemical composition of the essential oils.

HPLC profiling and quantification of active principles in leaves of Hedera helix L.

Ivy (Hedera helix L., Araliaceae), is an evergreen medicinal and ornamental plant. Depending on leaf polymorphism different shaped ivy leaves were extracted and subsequently analyzed by reversed-phase high performance liquid chromatography (RP-HPLC). Quantitative determination of its most prominent saponins hederacoside C (1) and alpha-hederin (2) from different ivy leaf extracts were detected, validated and optimized for quick profiling. The linearity of response, repeatability and reproducibility of the applied RP-HPLC method are reported.

The effects of dexpanthenol in streptozotocin-induced diabetic rats: histological, histochemical and immunological evidences.

This study was designed to investigate the effects of Dexpanthenol (Dxp) on liver and pancreas histology and cytokine levels in streptozotocine (STZ)-induced diabetic rats. Twenty-four Wistar albino male rats were divided into four groups: control, Dxp, STZ-induced diabetic (STZ) and diabetic treatment with Dexpanthenol (STZ-Dxp) groups. Experimental diabetes was induced by single dose STZ (50 mg/kg) intraperitoneally (i.p.). After administration of STZ, the STZ-Dxp group began to receive a 300 mg/kg/day i.p. dose of Dxp for 6 weeks. Liver and pancreas tissues of the control group were in normal morphology. Liver tissue of STZ group showed vacuolisation of hepatocytes in the liver parenchyma with enlargement of sinusoidal spaces and increasing amounts of connective tissue in the portal area. Pancreatic section of STZ group displayed ß-cells with of cytoplasmic mass, reduction of islet size, and atrophy. The STZ-Dxp group that received Dxp treatment exhibit partially normal hepatic parenchyma. Histochemical examinations revealed that the diabetes-induced glycogen depletion markedly improved with the Dxp treatment (p⟨0.001). The severity of degenerative alteration was lessened by Dxp supplementation in the STZ-Dxp group. Induction of STZ presented a significant increase both in interleukin-1α (IL-1α) (p=0.033) and monocyte chemotactic protein-1 (MCP-1) (p=0.011) levels, when compared with the control rats. DXP-treated diabetic rats' IL-1α and MCP-1 levels were similar to control value. This evidence suggests that Dxp is effective in reducing STZ-induced, diabetic-related complications and may be beneficial for the treatment of diabetic patients.

The essential oil composition of aerial parts of Anthemis tricolor Boiss. from Cyprus.

The water-distilled essential oil from the aerial parts of Anthemis tricolor Boiss. (Asteraceae), an endemic taxon from Cyprus, was analysed by GC and GC-MS. The analysis revealed 40 compounds accounting for 84.5% of the oil. Muurola-4,11-diene (20.2%), ß-caryophyllene (9.1%) and germacrene-D (5.5%) were the main compounds of A. tricolor. To the best of our knowledge, this is the first detailed study of the essential oil composition of A. tricolor collected from Cyprus.

Reliability of bioelectrical impedance analysis in the evaluation of the nutritional status of hemodialysis patients - a comparison with Mini Nutritional Assessment.

INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in patients who have end-stage renal disease (ESRD). Mini Nutritional Assessment (MNA) is an important and confirmed tool to evaluate PEW that has been recommended by many guidelines. Bioelectrical impedance analysis (BIA) is a noninvasive technique for assessing body composition. The aim of the present study was to analyze the reliability of BIA in malnutrition diagnosis by comparing it with standard MNA in a group of 100 ESRD patients. METHODS: One hundred ESRD patients who were medically stable and under dialysis treatment for at least 6 months were enrolled to the study. Monthly assessed serum creatinine, albumin, C-reactive protein (CRP), and lipid profiles from the last 6 months prior to the study were retrospectively collected. A standard Full-MNA and body composition analyses were applied to all patients. Body compositions were analyzed with the BIA technique using the Body Composition Analyzer (Tanita BC-420 MA; Tanita, Tokyo, Japan). Patients were classified into three groups according to MNA scores as PEW (n = 15, score <17), moderate PEW or risk group (n = 49, score 17-23.5), and well-nourished (n = 36, score ≥ 24) patients. RESULTS: Mean duration of maintenance hemodialysis treatment was significantly shorter in the PEW group compared to both of the other groups described (P = .015). Well-nourished and risk groups had lower CRP and higher albumin levels compared to PEW patients; however, these values were statistically similar in these two groups (P = .018, .01, respectively). According to BIA findings, well-nourished patients had the highest fat ratio, fat mass, muscle mass, visceral fat mass, and fat-free mass compared to both moderate the PEW/risk and the PEW groups (P < .05). Risk group patients also had higher muscle mass, visceral fat mass, and fat-free mass values compared to the PEW group (P < .05). A correlation analysis revealed that MNA scores were positively correlated with albumin (P = .005), creatinine (P = .049), fat mass (P = .045), muscle mass (P = .001), visceral fat ratio (P = .007), and BMI (P = .047) and in negative correlation with CRP (r = -0.357, P = .0001) levels. CONCLUSIONS: We recommend BIA as a complementary diagnostic tool to evaluate nutritional status of ESRD along with MNA, anthropometric measures, and classical biochemical markers.

Evaluation of nutritional status in renal transplant recipients in accordance with changes in graft function.

INTRODUCTION AND AIMS: Renal transplantation (RT) is the ultimate treatment modality for end-stage renal disease (ESRD) patients. Malnutrition is a strong predictor of cardiovascular disease among ESRD patients. Body composition analysis using bioimpedance devices (BIA) is a useful noninvasive tool to detect malnutrition in this population. We investigated the impact of graft function on nutritional status and reliability of BIA to detect malnutrition in RT recipients. METHODS: We evaluated retrospectively 189 RT recipients including 59 females, and of overall mean age of 38.3 ± 10.6 years who had a minimum posttransplant follow-up of 12 months. Body Composition Analyzer (Tanita BC-420MA) determinations were complemented with monthly assessments of biochemical parameters. Patients were divided into 3 groups according to glomerular filtration rate (GFR) levels: normal graft function/high GFR group (group 1, normal creatinine levels, no proteinuria and GFR ≥ 90 mL/min; n = 59); low renal function/low GFR group (normal or high creatinine levels with low GFR levels; group 2; GFR 89-60 mL/min; n = 87) and group 3, (GFR < 60 mL/min; n = 43). RESULTS: Group 3 patients displayed significantly lower as well as hemoglobin albumin and calcium concentrations, with higher phosphorus and parathyroid hormone levels (P = .0001). They also showed significantly lower body weight (P = .0001), body mass index (P = .002), fat (P = .002) and muscle (P = .0001) contents as well as fat-free mass (P = .0001). Group 2 patients had significantly lower values compared with group 1 and higher values than group 3. GFR values positively correlated with albumin, fat, muscle, and fat-free mass (r = 0.337, 0.299, 0.281, 0.278, respectively; P = .0001). GFR values positively correlated with visceral fat ratio (r = 0.170; P = 0.02), body mass index (r = 0.253; P = .0001), and waist-hip ratio (r = 0.218; P = .006). CONCLUSION: Loss of muscle and fat mass is an early sign of malnutrition among RT recipients. It is closely associated with loss of GFR. BIA is a noninvasive and reliable diagnostic tool that should be included in the follow-up of these patients for an early diagnosis of malnutrition-related complications.

Low graft function and ongoing hyperparathyroidism are closely related to post-transplantation osteoporosis.

INTRODUCTION: Renal transplantation (RT) is the gold standard therapy for chronic renal failure. Immunosuppressive drug choice, malnutrition, adynamic bone disease and hyperparathyroidism are important factors impacting the development of posttransplant osteoporosis. Body composition analysis with bioimpedance devices (BIA) is a useful noninvasive tool to detect malnutrition among the RT population. We investigated the effects of graft function, immunosuppressive drug regimens and biochemical characteristics on bone mineral density of RT patients as well as the reliability of BIA measurements to diagnose osteoporosis. METHODS: One hundred three recipients with a minimum of 12 months post-RT follow-up underwent body composition analysis using the Tanita Analyzer. The last 6 months of monthly biochemical parameters and glomerular filtration rates (GFR) as well as drug regimens were collected retrospectively from patient charts. Patients were divided into 2 groups, according to their femoral neck and lumbal T scores, as osteoporosis (n = 42) and control groups (n = 61). RESULTS: The mean GFR of osteoporotic patients was significantly lower (P = .04) and parathyroid hormone (PTH) levels significantly higher (P = .002). According to BIA, osteoporotic patients showed lower bone mass, fat mass, visceral fat ratio, muscle mass, waist-hip ratios, and body mass index values (P < .05). Correlation analysis revealed GFR to negatively correlate with PTH (r = -0.231, P = .010) and positively with femur t scores (r = 0.389, P = .0001) as well as with BIA findings (P = .0001). In contrast, PTH levels in negatively correlated with lumbar and femoral neck t scores (r = -0.22, -0.4 and P = .026, .0001, respectively) but not with BIA findings including bone mass. CONCLUSION: Changes in bone density after RT were affected by graft function. The rapid loss of bone mineral density emphasizes the need for prevention started in the early posttransplant period. BMD measurements provided a guide for treatment and for subsequent evaluation.