Xanthine oxidoreductase activity in platelet-poor and rich plasma as a oxidative stress indicator in patients required renal replacement therapy.

BACKGROUND: Xanthine oxidoreductase (XOR) is a hydroxylase enzyme involved in the metabolism of purines. XOR activity can vary: the homodimer protein can be converted into two different isoforms XD (antioxidant) and XO (prooxidant). Oxidative stress and inflammation that accompanying chronic kidney disease (CKD), dialysis, and kidney transplantation, resulted in platelet activation. Present study aimed to determine the influence of applied renal replacement therapy on xanthine oxidoreductase and its isoforms activity. MATERIALS AND METHODS: The study group consisted of 117 patients, divided into 4 groups: hemodialysis - 30 patients, peritoneal dialysis - 30 patients, kidney transplant patients - 27 and conservative treatment - 30 patients. The control group consisted of 30 healthy volunteers. RESULTS: Significant differences were found in XOR activity in platelet-poor plasma (PPP) within the groups studied (p = 0.001). There was a relationship between the type of renal replacement therapy of all oxidoreductase isoforms in PPP (p < 0.001 all isoforms) and XD (p = 0.008), XO (p < 0.001) in platelet rich-plasma (PRP). A relationship was observed between the activity of all oxidoreductase isoforms in PPP and PRP, and the type of renal replacement therapy and the duration of dialysis and the age of patients. The cause of chronic kidney disease was also reflected differences in XD and XO activity in PPP. CONCLUSIONS: The type of renal replacement therapy used in CKD patients, age of patients, duration of dialysis, CKD causes, and stage of progression significantly affect the activity of XOR and its isoforms.

Assessment of the Relationship between Selected Factors and Stress-Coping Strategies in Handcyclists-A Preliminary Study.

Background and Objectives: Playing competitive sports is associated with stress, especially during the starting season. Disabled athletes are additionally burdened with physical and/or emotional factors, resulting from the trauma they have experienced. The aim of the work was to assess the relationship between strategies of coping with stress and the level of education, category of disability and its duration of handcyclists before the competition. Materials and Methods: 44 handcyclists with a mean age of 41.8 ± 11.6, from European countries, were divided according to the severity of mobility impairments, education and duration of the disability. The participants were asked to fill in the Mini-COPE Inventory for Measuring Coping with Stress, which provided answers in writing to some sociodemographic questions regarding age, sex, education, type of mobility impairment and duration of the disability. Results: The subjects who had suffered spinal injury at the cervical section obtained the lowest scores regarding their subjective assessment of their active stress management in difficult situations (p = 0.007). They scored the lowest, 1.5 points, when asked about acceptance in difficult circumstances compared to those with university education (p = 0.02). A statistically significant correlation was found to exist between education levels and positive revaluation, acceptance and seeking instrumental support. A negative correlation was observed between education and sustained use of psychoactive substances and denial. Conclusions: Highly educated cyclists with short-lasting disability, damage to the lower spine section or amputations tend to cope better with stress than other study participants.

Assessment of Sclerostin and Interleukin 6 Levels and Selected Anthropometric Parameters in Patients Receiving Hemodialysis Replacement Therapy-Pilot Study.

Background and Objectives: Chronic kidney disease (CKD) is an important public health problem associated with, e.g., progressive renal insufficiency, bone mineral disorders, and increased inflammatory marker levels. The objective of this study was to compare selected biochemical parameters and to evaluate potential correlations between selected anthropometric parameters and levels of sclerostin and interleukin 6 (IL-6) in blood plasma. Materials and Methods: The study group consisted of 34 patients aged 59.8 ± 9.8 years, receiving hemodialysis therapy. The control group consisted of 31 individuals aged 55.4 ± 9.37 years, presenting with GFR (glomerular filtration rate) of more than 60 mL/min/1.73 m2. Selected anthropometric and biochemical parameters were assessed at baseline, as well as 3 and 6 months into the study. Statistical analyses were performed using the Statistica 2014 software package (StatSoft, Inc.Tulsa, OK, USA). Analyses included descriptive statistics, intergroup comparisons using the Mann-Whitney U-test or the Kruskal-Wallis test, and Spearman's correlation analysis. The significance level was set at p ≤ 0.005. Results: At all measurement time points, i.e., at baseline, at month 3, and at month 6, the IL-6 levels in the study group were significantly higher than those in the control group. No correlations were observed in the study group between SCL or IL-6 levels and anthropometric parameters such as body weight, body mass index (BMI), or waist circumference. Conclusions: Patients receiving hemodialysis replacement therapy present with significantly higher levels of IL-6 in their blood. Anthropometric parameters (body weight, BMI, and waist circumference) have no impact on sclerostin and IL-6 levels in patients undergoing hemodialysis therapy. The results obtained are satisfactory, and the research will be continued.

SLC22A5 polymorphism associated with risk of extra-articular manifestations in rheumatoid arthritis patients.

OBJECTIVES: Rheumatoid arthritis (RA), the most common autoimmune disease, is thought to be a complex disease in which a combination of risk alleles from different susceptibility genes predisposes to development of the disease, following exposure to as yet unknown environmental factors. An important component of the carnitine system is the plasma membrane carnitine transporters, also called organic cation transporters, i.e. OCTN1 and OCTN2 encoded by the SLC22A4 and SLC22A5 genes, respectively. The aim of this study was to investigate the association between SLC22A5 polymorphism and RA. MATERIAL AND METHODS: The study was carried out on 404 patients diagnosed with RA according to the criteria of the American College of Rheumatology and 560 healthy subjects. The single nucleotide polymorphism (SNP) within the SLC22A5 gene - 207C>G (rs 2631367) was genotyped using pre-validated TaqMan genotyping assays. RESULTS: The distribution of SLC22A5 genotypes and alleles in RA patients did not differ significantly from that in healthy controls. Moreover, there were no significant associations between SLC22A5 genotypes and age at time of disease diagnosis, rheumatoid factor, erosive disease and response to treatment with methotrexate. Extra-articular manifestations were diagnosed in 16.7% of SLC22A5 GG homozygous patients, in 9.4% with the GC genotype and in 7.2% of homozygous CC patients. The frequency of extra-articular manifestations was two-fold greater in homozygous GG patients as compared with carriers of the C allele (GG vs. GC + CC), OR = 2.06 (95% CI: 1.11-3.85, p = 0.022). CONCLUSIONS: The results of the present study suggest that the SLC22A5 polymorphism may be associated with the development of extra-articular manifestations of RA but the distribution of SLC22A5 genotypes and alleles in studied RA patients did not significantly differ from healthy subjects.

The association of the Klotho polymorphism rs9536314 with parameters of calcium-phosphate metabolism in patients on long-term hemodialysis.

BACKGROUND: Patients on long-term hemodialysis frequently suffer from complications, such as secondary hyperparathyroidism, bone fractures, and arteriosclerosis. The process of regulating Ca/P metabolism depends on factors, such as FGF23 and Klotho. This study aimed to answer the question of whether the Klotho polymorphism rs9536314 is associated with FGF23 plasma concentration. METHODS: In 118 patients undergoing hemodialysis, blood was collected before and after hemodialysis. The following parameters were measured in plasma: FGF23, serum: Ca, P, PTH, HGB, and iron concentrations. The KL gene polymorphism rs9536314 was identified by PCR-RFLP. RESULTS: The KL polymorphism rs9536314 was not associated with Ca, P, PTH, or FGF23. There was a negative correlation between FGF23 and blood HGB levels and positive correlation between FGF23 and ESA dose. CONCLUSIONS: The results obtained may indicate that there is no association between the KL polymorphism and FGF23 concentration in patients undergoing long-term.

Ascending aorta aneurysm as a cause of superior vena cava syndrome.

Superior vena cava syndrome (SVCS) is mostly presented in advanced stage of lung cancer. Similar symptoms may misdirect correct diagnosis, especially in nonmalignant cases of SVCS. In the fifties of the 20th century, mediastinitis caused by tuberculosis and syphilis were dominant causes of non-malignant SVCS. Currently, non-cancer causes of SVCS are responsible for 5% to 22% of all SVCS cases. In most cases inner obliteration of the vessel is a result of thrombosis at the site of endothelial injury caused by either intravascular devices (catheters, electrodes). Clinical signs are nonspecific particularly in acute course of syndrome. We present a case of a men with edema of the lower part of the head and neck, as a pseudo allergic acute reaction, where eventually diagnosis of acute superior vena cava syndrome due to ascending aorta aneurysm was established. Based on the case, review of nonmalignant causes of SVCS and treatment options are discussed.

Impact of Effectiveness of Physical Activity in a Virtual Environment on the Regulation of Sclerostin and Interleukin 6 Levels in Haemodialysis Patients.

Background: Chronic kidney disease is a significant public health issue associated with reduced physical activity. This can lead to mineral and bone disorders and increased levels of inflammatory markers. One innovative solution that can significantly contribute to increasing patient motivation is the combination of physical training with virtual reality technology during haemodialysis sessions. The aim of this study is to comprehensively assess the impact of regular virtual reality-based physical activity on plasma sclerostin and interleukin 6 levels, as well as on physical performance and the level of physical activity in patients undergoing renal replacement therapy through haemodialysis. Methods: This study is a prospective cohort study. Patients included in the study were randomly assigned to two groups: the study group and the control group. The study group consisted of patients who were entrusted with the task of conducting training using the prototype of the NefroVR system. The duration of the study period for both the study and control groups was 3 months. Results: One hundred and two (102) patients with stage 5 chronic kidney disease who underwent haemodialysis as a renal replacement therapy participated in the study. Patients from the study group were characterized by higher physical activity compared to the control group. There was a significant difference in the level of IL-6 and SOST between the study and control groups in the second measurement. Conclusions: Regular physical activity, especially using approaches such as virtual reality, contributes to improving physical fitness and overall activity levels in patients undergoing haemodialysis. The study demonstrated that regular exercise may be associated with a reduction in inflammatory parameters and positive effects on bone metabolism in patients undergoing haemodialysis.

Does Exercising with the Use of Virtual Reality during Haemodialysis Have an Impact on Plasma Levels of Interleukin 1ß, Interleukin 6, and Interleukin 8?

Cytokines are a group of fine proteins which play a key role in the regulation of various biological processes, including inflammatory reactions. Proinflammatory cytokines, such as interleukin 1ß (IL-1ß), interleukin 6 (IL-6), and interleukin 8 (IL-8), are produced in response to various stimuli, including infections, tissue damage, and oxidative stress. Virtual reality (VR) use during intradialytic exercises improves physical activity. The purpose of the study was to evaluate the relationship between exercising regularly with the use of virtual reality during haemodialysis and the levels of selected cytokines (Il-1, Il-6, Il-8). The study and the control groups consisted of end-stage renal disease patients who underwent haemodialysis as a renal replacement treatment. The study group comprised patients subject to haemodialysis as a renal replacement therapy who were to work out with the use of a prototype of the NefroVR system for 20 min when undergoing haemodialysis (HD). Statistical analyses utilised Statistica 13. The conducted research demonstrated that regular exercises with the use of virtual reality might be related to a decrease in inflammation in patients included in the chronic haemodialysis programme. It is key to encourage patients with end-stage renal disease treated with haemodialysis to exercise regularly because of the possibility of their proinflammatory parameters becoming reduced.

Autosomal dominant polycystic kidney disease and hypertension are associated with left ventricular mass in a gender-dependent manner.

BACKGROUND: The aim of this study was to compare echocardiographic parameters in patients with autosomal dominant polycystic kidney disease (ADPKD) and in controls with normal kidney function taking into account gender and the presence of hypertension. METHODS: 47 patients with ADPKD (age 36.3 ± 11.0 years) and 49 healthy controls (36.8 ± 9.2 years) were enrolled. M-mode echocardiography was performed in all subjects. Left ventricular hypertrophy (LVH) was diagnosed when the left ventricular mass index (LVMI) was greater than or equal to 125 g/m2 in males and 110 g/m2 in females. RESULTS: The prevalence of LVH was greater in ADPKD patients than in controls (13% vs. 2%; p=0.05). Among females, ADPKD patients demonstrated greater LVMI (87.9 ± 18.5 vs. 68.8 ± 15 g/m2, p=0.00009) than controls. There was a positive correlation between LVMI and blood pressure in ADPKD females (Rs=0.54, p=0.027 for systole blood pressure-SBP and Rs=0.50, p=0.0053 for diastole blood pressure-DBP) but not in males. CONCLUSION: Left ventricular mass is increased in ADPKD females with normal renal function. A positive correlation between SBP and DBP and LVMI was found in ADPKD females but not in ADPKD males.

The association between eNOS intron 4 VNTR polymorphism and delayed graft function of kidney allografts.

Nitric oxide (NO) is a multifunctional agent which serves as a key signaling molecule in physiological processes such as host defense, neuronal communication, and the regulation of vascular tone. Different polymorphic variations have been identified in the human NOS3 (eNOS) gene.The aim of the present study was to examine the association between polymorphisms of the NOS3 gene (G894T substitution within exon 7 and intron 4 VNTR polymorphism) and the development of delayed graft function as well as acute and chronic rejection.One hundred eighty-seven recipients of first renal transplants were included in the study. There were no significant associations between these polymorphisms and acute and chronic kidney allograft rejection. The intron 4 polymorphism was associated with delayed graft function after transplantation. The results of this study suggest that patients with the a allele of the eNOS intron 4 VNTR polymorphism may be predisposed to delayed graft function.

The association of -262C/T polymorphism in the catalase gene and delayed graft function of kidney allografts.

BACKGROUND: Catalase is an intracellular antioxidant enzyme that is mainly located in cellular peroxisomes and in the cytosol. This enzyme plays a significant role in the development of tolerance to oxidative stress in the adaptive response of cells and tissues. The aim of the present study was to examine the association between the -262C/T polymorphism in the catalase gene and delayed graft function (DGF), acute rejection and chronic allograft nephropathy of kidney allografts. METHODS: One hundred eighty-seven recipients of first renal transplants were included in the study. The histories of the patients were analysed regarding DGF, acute rejection and chronic allograft nephropathy. The polymorphism -262C/T in the catalase gene was analysed using the polymerase chain reaction--restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: The risk of DGF was significantly lower in T allele carriers compared with CC homozygotes: odds ratio = 0.34, 95% confidence interval = 0.17-0.67, P = 0.001. There were no statistically significant associations between the studied polymorphism and acute rejection or chronic allograft nephropathy. CONCLUSION: The results of this study suggest that -262C/T polymorphism in the catalase gene is associated with DGF in kidney allograft recipients.

Physical Activity versus Sclerostin and Interleukin 6 Concentration in Patients Receiving Renal Replacement Therapy by Hemodialysis.

INTRODUCTION: Chronic kidney disease and renal replacement therapy are associated with reduced motor activity, which may result in the presence of mineral bone disorders and an increase in inflammation markers. The aim of the study was to assess the relationship between the performance of daily physical activity, expressed in the number of steps performed by patients undergoing hemodialysis and the concentration of selected biochemical parameters (SCL, IL-6). PATIENTS AND METHODS: The study group (B) involved 33 patients aged 59.8 ± 9.8 years from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. In group B, interventions considering an increase in physical activity expressed in the number of steps were introduced. Group C consisted of 30 people aged 54.9 (9.37), with GFR over 60 mL/min/1.73m. Physical activity was measured with pedometers. Anthropometric and biochemical parameters were assessed at baseline, after the third and sixth month of the study. Descriptive statistics, intergroup comparisons using Mann-Whitney U test and Spearman correlation analysis were performed. The level of significance was set at p≤0.005. RESULTS: A relationship between IL-6 concentration and the number of steps in group B after three months of intervention was demonstrated. In group C, the concentration of SCL and IL-6 decreased with the increase in the number of steps taken. Only in group C the waist circumference decreased with the increase of the number of steps performed. CONCLUSION: Patients receiving renal replacement therapy by hemodialysis showed significantly lower physical activity compared to people without kidney disease. Performing bigger number of steps can lower interleukin 6 levels in hemodialysis patients.

The association between cytokine gene polymorphisms and kidney allograft survival.

BACKGROUND: Cytokines regulate cellular and humoral immune responses. One determinant of the variable cytokine production observed among individuals is genetic polymorphism in cytokine genes. These polymorphisms represent normal allelic variations in the cytokine genes; usually single base changes. Homozygous genotypes for high producer alleles are generally associated with high cytokine production, heterozygotes with intermediate production, and homozygotes for the low producer alleles with low cytokine production. Cytokines have been implicated in the regulation of acute and chronic rejection of allografts. The aim of the study was to evaluate the promoter polymorphism of TNF-alpha gene (-308 promoter polymorphism), IL-2 gene (-330 promoter polymorphism), IL-4 gene (-590 promoter polymorphism), and IL-6 gene (-174 promoter polymorphism) in renal transplant recipients with allograft duration under and over 10 years to establish whether aforementioned polymorphism are involved in kidney allograft survival. MATERIAL/METHODS: The study included 197 renal transplant recipients with well-functioning grafts for 2 to 18 years. The patients were divided into two subgroups: recipients with allograft duration under 10 years and recipients with allograft duration over 10 years. RESULTS: Among renal transplant recipients with allograft duration over 10 years we observed the prevalence of subjects with the T1T1 genotype of TNF alpha (low expression of TNF alpha) and GG of IL-6 (high expression of IL-6). There was no difference in relation to IL-2 and IL-4 promoter polymorphism. CONCLUSIONS: The results of present study suggest that the TNF-alpha -308 and the IL-6 -174 promoter polymorphisms may be the genetic factors influencing the renal allograft survival.

Oxypurine and purine nucleoside concentrations in renal vein of allograft are potential markers of energy status of renal tissue.

BACKGROUND: Impairment of organ function derived from ischemia-reperfusion injury is an important problem in solid organ transplantation. Cell alterations induced by ischemia prime the tissue for subsequent damage that occurs during the reperfusion phase. Purine nucleosides and oxypurines are products of adenine nucleotides degradation. Reperfusion and reoxygenation are accompanied by production of reactive oxygen species and free radicals, which lead to damage of graft tissue. The aim of this study was to measure concentrations of adenine nucleotides and their metabolites in renal allograft vein as well as in recipient's peripheral veins during the reperfusion period and to evaluate their usefulness as markers of tissue metabolism in kidney allografts. METHODS: The study enrolled 20 renal transplant recipients. The first blood sample was taken from the recipient's ulnar vein before anastomosing of the kidney graft's vessels with recipient's iliac vessels. Samples were then taken from the renal allograft and ulnar veins 5 min after total graft reperfusion measured with an infrared camera. High-performance liquid chromatography (HPLC) was performed to measure whole blood and plasma concentrations of adenosine triphosphate (ATP), adenosine monophosphate (AMP), guanosine (Guo), inosine (Ino), hypoxanthine (Hyp), xanthine (Xan), uric acid (UA), and uridine (Urd). RESULTS: Hyp and Xan concentrations were significantly increased in renal allograft vein after reperfusion as compared with peripheral vein during the pre- and post-reperfusion periods. CONCLUSIONS: The results of the present study suggest that differences in Hyp and Xan concentrations between renal and peripheral veins reflect metabolic alterations in renal tissue during reperfusion and may be useful for graft function monitoring during reperfusion.

Autosomal dominant polycystic kidney disease reduces the risk of diabetes mellitus.

BACKGROUND: Patients with autosomal dominant polycystic kidney disease (ADPKD) are at greater risk of new-onset diabetes after transplantation as compared with other renal graft recipients. METHODS: We mailed questionnaires to 459 ADPKD patients retrieved from the Polish Registry of ADPKD. We analyzed data from 291 respondents and 271 siblings with a known status of ADPKD and diabetes. RESULTS: The prevalence of transplant-unrelated diabetes was significantly higher in siblings without ADPKD (8.2%) than in respondents (1.7%; p = 0.0028) and their ADPKD siblings (2.0%; p = 0.023). Univariate logistic regression demonstrated that the prevalence odds ratio (POR) for transplant-unrelated diabetes in the pooled ADPKD group vs. siblings without ADPKD was 0.21 (95% CI: 0.08-0.54, p = 0.0013). Multivariate regression accounting for age and gender disclosed an even smaller POR for diabetes (0.18) in ADPKD patients (95% CI: 0.07-0.47, p = 0.00049). Age was a significant risk factor for diabetes (POR 1.05, 95% CI: 1.01-1.09 per year of life; p = 0.025) and gender was without effect. The prevalence of diabetes in females and males with vs. without ADPKD was similar (1.6% vs. 8.3%, p = 0.0091 for females; 2.2% vs. 8.0%, p = 0.069 for males). Age and gender were not inter-related. In the group of siblings without ADPKD diabetes was associated with higher age (62.2 +/- 15.6 vs. 47.0 +/- 16.3 years, p = 0.0053). CONCLUSIONS: Our findings demonstrate lower prevalence of transplant-unrelated diabetes among ADPKD patients. We hypothesize that metabolic disturbances in polycystic kidneys suppress the synthesis of endogenous glucose and reduce renal breakdown of insulin.

The influence of gender, weight, height and BMI on pentosidine concentrations in plasma of hemodialyzed patients.

BACKGROUND/AIMS: Advanced glycation end-products (AGEs) such as pentosidine play an important role in complications associated with chronic renal failure (CRF) and hemodialysis (HD). This study was undertaken to determine the influence of anthropometric parameters and inflammation on plasma pentosidine concentrations. METHODS: We measured total and free pentosidine in the plasma of 49 patients on chronic HD. Acid hydrolysis of plasma and protein precipitation with trichloroacetic acid was done in the case of total and free pentosidine, respectively. Pentosidine was measured by high performance liquid chromatography (HPLC). C-reactive protein (CRP) was measured by the nephelometric method. RESULTS: A strong negative correlation between dry weight and mean concentration of total pentosidine before and after HD was found (R = -0.47, p < 0.001). This correlation was stronger in males (R = -0.47, p = 0.017) than females (R = -0.34, p = 0.10). Even stronger correlations were noted between body mass index (BMI) and total (R = -0.55, p < 0.001), as well as free (R = -0.39, p = 0.01) pentosidine. Multivariate analysis demonstrated that BMI and time on HD were two independent factors influencing total pentosidine concentrations. CRP did not correlate with pentosidine or BMI. CONCLUSIONS: Lower BMI values are associated with significantly higher plasma pentosidine concentrations in patients on HD. Presumably this relationship is mediated by hypercatabolism observed in these patients. Catabolism produces weight loss and reduces BMI concurrently with the induction of oxidative and carbonyl stresses that stimulate the generation of pentosidine and other harmful AGEs in dialyzed patients.

Nonaccidental Out-of-Hospital Cardiac Arrest in an Urban Area as a Potential Source of Uncontrolled Organ Donors.

BACKGROUND Donation after cardiac death offers the possibility of increasing the pool of organs for transplantation by up to 30%. Maastricht category type 3 (M3) dominates in most countries with active DCD programs. During preparations to introduce a permanent program for uncontrolled donation after circulatory death in Szczecin, Poland, the donor pool has been estimated. In Poland, Maastricht category type 2 (M2) is considered a basic source for organ recovery. MATERIAL AND METHODS This was a retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to local Emergency Medical Services (EMS) between 1 December 2014 and 30 November 2015. The following inclusion criteria were used in the analysis: demographic (age 18-60 years, known identity), clinical (no chest or abdominal injury, no cachexia as an equivalent of wasting diseases), and organizational (weekdays from 8:00 am to 3:00 pm). RESULTS During 12-month period, 118 EMS interventions were recorded in response to sudden cardiac arrest. The stratification process mentioned above used criteria to establish potential, eligible, qualified, and actual donor pools (27 (30.3%), 24 (26.4%), 7 (7.3%), and 6 (6.7%), respectively). To establish a "virtual" actual number of uDCD, the nationwide average level of lack of authorization for donation was 12%. CONCLUSIONS Activation of a permanent program of organ recovery from uDCD would increase the donor pool by 6 cases. Compared to the number of brain-dead donors referred from regional hospitals, this increase would be equivalent to the formation of a new reporting center. The number of transplantable organs could increase by 22% per year.

Copper modifies the activity of sodium-transporting systems in erythrocyte membrane in patients with essential hypertension.

The aim of the study was to verify the hypothesis if copper could influence the activity of sodium-transporting systems in erythrocyte membrane that could be related to essential hypertension. The examined group of patients consisted of 15 men with hypertension. The control group was 11 healthy male volunteers. The Na+/H+ exchanger (NHE) activity in erythrocytes was determined according to Orlov et al. The activity of transporting systems (ATP-Na+/K+; co-Na+/K+/Cl-; ex-Na+/Li+; free Na+ and K+ outflow [Na+, K+-outflow]) was determined according to Garay's method. The concentration of copper in plasma was assessed using atomic absorption spectrometry. The activity of ATP-Na+/K+ (micromol/L red blood cells [RBCs]/h) in hypertensive patients was 2231.5 +/- 657.6 vs 1750.5 +/- 291 in the control (p < 0.05), the activity of co-Na+/K+/Cl- (micromol/L RBCs/h) in hypertensives was 171.3 +/- 77.9 vs 150.7 +/- 53.9 in the control (NS). Na+-outflow (micromol/L RBCs/h) in hypertensives was 118.3 +/- 51.6 vs 113.3 +/- 24.4 in the control (NS). The K+-outflow (micromol/L RBCs/h) in hypertensives was 1361.7 +/- 545.4 vs 1035.6 +/- 188.3 in the control (NS). The activity of ex-Na+/Li+ (micromol/L RBCs/h) in hypertensive patients was 266.1 +/- 76.1 vs 204.1 +/- 71.6 in the control (p < 0.05). NHE activity (mmol/L RBCs/h) in hypertensives was 9.7 +/- 2.96 vs 7.7 +/- 1.33 in the control (p < 0.05). In hypertensive patients, negative correlation was found between the activity of Na+/K+/Cl- co-transport and plasma copper concentration (Rs = -0.579, p < 0.05) and between the activity of ex-Na+/Li+ and plasma copper concentration (Rs = -0.508, p < 0.05). Plasma copper concentration significantly influences the activity of sodium transporting systems in erythrocyte membrane. Copper supplementation could be expected to provide therapeutic benefits for hypertensive patients.

[Tuberous sclerosis--symptoms, diagnosis and treatment]. / Stwardnienie guzowate--klinika, diagnostyka, leczenie.

Tuberous sclerosis (Bourneville-Pringle disease) is an inherited disease with a prevalence rate ranging from 1:10,000 to 1:23,000. It is inherited as an autosomal dominant with a variable gene penetrance. However about 60% of cases represent new mutations. This disease is characterized by a defect in cell migration, proliferation and differentiation in organs like skin, brain, kidneys, heart, lungs and eyes. The mechanism involves formation of hamartoma tumours responsible for the functional impairment of these organs.

Three clinical cases of nonrespiratory acidosis in kidney transplant recipients receiving anti-CMV therapy.

BACKGROUND: To preserve kidney graft function it is necessary to use ganciclovir or valganciclovir as a therapy for fresh CMV infection or prophylaxis in high-risk kidney transplant recipients. Ganciclovir-induced lactic acidosis has thus far not been reported. CASE REPORT: Three cases of nonrespiratory acidosis in kidney transplant recipients receiving ganciclovir or valganciclovir as anti-CMV therapy or prophylaxis are presented. Lactic acidosis developed in 2 patients, and the other patient had nonrespiratory acidosis of unknown origin. The possible mechanism of the development of lactic acidosis in presented cases is explored. CONCLUSIONS: The analysis of the described cases cannot eliminate the potential negative influence of anti-CMV therapy on acid-base equilibrium, especially with coexisting active viral infection.