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Biomedical subjects

I Pietrzak

Publications and source records attributed to I Pietrzak.

At least 19 recordsLinked to original sources
PubMed2001

Erythrocyte transketolase activity and guanidino compounds in hemodialysis patients.

BACKGROUND: The toxic effects of guanidino compounds on enzymatic activity in uremic patients are known. Thus, we determined the hemodialysis (HD) impact on this toxicity. METHODS: The erythrocyte transketolase activity (ETKA), total guanidino compounds (TGCs), and guanidinosuccinic acid (GSA) levels in plasma were compared before, after 5 hours of HD, and at 12 and 24 hours from the end of HD. Thirty-seven HD patients (28 to 49 years old) with primary glomerulopathies participated in this study. Thirty healthy volunteers (HVs) served as controls. RESULTS: At the beginning of this study, ETKA was lower in uremics (1.94 +/- 0.45) than in HVs (2.59 +/- 0.26). The TGC and GSA plasma levels were higher (26.07 +/- 5.34 and 4.5 +/- 1.22) than in HVs (10.41 +/- 1.42 and 0.76 +/- 0.09, P < 0.001), respectively. After five hours of HD, the ETKA increased to 2.49 +/- 0.62 (P < 0.001). The plasma levels TGC decreased to 12.56 +/- 2.02 (P < 0.001) and the GSA to 2.12 +/- 0.68 (P < 0.001). After 12 and 24 hours from the end of HD, the ETKA decreased to 2.25 +/- 0.56 and 2.09 +/- 0.49 (P < 0.001), respectively. The plasma levels for TGC and GSA both increased: TGC to 19.39 +/- 3.67 and 25.68 +/- 4.61 (P < 0.001), respectively; GSA to 3.49 +/- 1.11 and 4.53 +/- 1.12 (P < 0.001), respectively. CONCLUSION: There was no significant correlation between ETKA and the plasma levels of the examined toxins. By removing the guanidino compounds, HD temporarily decreases the inhibition of ETKA, diminishing other metabolic disturbances connected with pentose phosphate cycle.

Case-Control Studies↗
PubMed2001

Platelet aggregation and prostaglandin metabolism in uremic patients.

The pathogenesis of depressed platelet activity in uremia is still unknown. The influence of some uremic toxins on platelet aggregation (PLA) and prostaglandin metabolism in 50 uremic patients treated by hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) was studied. Fifty-seven healthy volunteers (HVs) served for reference values. Adenosine diphosphate (ADP) and thrombin (Thr) were used as agonists of PLA. PLA was determined using the Born method. Malonyldialdehyde (MDA) levels in platelets as an indicator of prostaglandin metabolism, after stimulation with arachidonic acid, were measured according to Stuart. The relationship of PLA and prostaglandin metabolism with plasma concentrations of methylguanidine (MG), guanidinosuccinic acid (GSA), and creatinine (Cr) was assessed. PLA-ADP values in regular HD patients (42 +/- 5 mm) were significantly lower than in CAPD patients (65 +/- 8 mm) and HVs (73 +/- 3 mm). PLA-Thr values in HD patients (25 +/- 4 mm) were significantly lower than in CAPD patients (34.9 mm) and HVs (36 +/- 3 mm). MDA levels in HD patients (7 +/- 1 nmol/L/10(9)) were significantly lower than in CAPD patients (12 +/- 2 nmol/L/10(9)) and HVs (15 +/- 1 nmol/L/10(9)). In HD patients, inverse correlations of PLA-ADP with MG levels (r = -0.92), PLA-Thr with Cr levels (r = -89), and MDA levels with GSA levels (r = -0.86) were found. In CAPD patients, no relationship of PLA and MDA with uremic toxins was observed. Depressed activity of platelets and prostaglandin metabolism was strongly expressed in HD patients.

Adenosine Diphosphate↗
PubMed2000

[The effect of cocarboxylase treatment on erythrocyte transketolase and blood thiamine in patients with end stage renal disease undergoing maintenance hemodialysis].

The depressed ETKA in ESRD patients is supposed to be caused and/or aggravated by several factors among which the diminished content of thiamine in blood and/or disturbances of thiamine utilization seem to play the major role. This role stems from the fact that thiamine acts as the cofactor of transketolase. In order to check the therapeutic significance of this relationship we introduced the thiamine pyrophosphoric acid ester chloride (Cocarboxylasum-CC) administration in 25 patients (mHD + CC). Immediately after each HD performance CC was given i.v. during 12 weeks in a doses of 5 mg/kg b.w., 3 times a week. The blood for ETKA value, free and total thiamine in plasma and erythrocytes, as well as, the total protein and albumins/globulins index investigation was drawn before, after 6 and 12 weeks of CC administration, and 3 months after cessation of this therapy. In 10 patients, on maintenance HD nontreated by CC (mHD), the blood was drawn at the same time intervals. Normal values we obtained from 15 healthy volunteers. For ETKA evaluation photocolorimetric method was used, thiamine content in blood was estimated by fluorimetric method. At the beginning of the study the mean value of ETKA, in two examined groups, was found statistically decreased (p < 0.01) when compared with normals. Mean values of thiamine in plasma and erythrocytes were lower but did not differ significantly from those in normals. After 6 weeks of CC administration ETKA value increased, but only after 12 weeks it increased significantly (p < 0.01), reaching normal value. On the other hand, striking increase in plasma thiamine and erythrocyte thiamine levels was observed after 6 weeks of CC administration already (p < 0.01). Three months after cessation of CC administration significant decrease in ETKA value and thiamine level in blood was observed (p < 0.01). ETKA returned to lower value than in normals even in the presence of still high thiamine levels in blood. In mHD patients nontreated by CC the ETKA value and thiamine levels in blood did not change significantly during all periods of study. The nutritional status assessed by total protein and albumins/globulins index did not change in both groups through the study. We conclude, the administration of high doses of CC to ESRD patients on maintenance hemodialysis HD was successful in terms of increasing ETKA value and thiamine levels in blood without any side effects. Thus, supplementation with large doses of CC deserves further study because it promises to be another adjunct in the treatment of potential thiamine deficiency and metabolic disturbances in the course of dialysotherapy.

Adult↗
PubMed1999

Investigations on magnesium and chromium antagonism in the skin of experimental animals.

Investigations were performed over 30 days on 25 male rats Wistar breed divided into five groups. Animals received intraperitoneally (i.p.) potassium dichromate (KDCH) 5 mg/kg (basal doses, b.d.), 2 mg/kg (0.4 b.d.) and 100 mg Mg Cl2/kg body weight (b.w.). In performed investigations the highest concentration of chromium in animal skin 1.17 +/- 0.11 micrograms/g was observed by i.p. administration of KDCH 5 mg/kg b.w. Simultaneous i.p. administration of KDCH 5 mg/kg b.w. and MgCl2 100 mg/kg b.w. resulted in significant lower concentration of chromium (in comparison to the preceding group) in animal skin: 0.8 +/- 0.2 microgram/g (p < 0.001). In i.p. administration of KDCH in the doses of 0.4 b.d. the concentration of Cr in the skin amounted to 0.55 +/- 0.1 microgram/g. Values of Cr in the skin in exposed groups were significantly higher than in the control group, (p < 0.001).

Animals↗
PubMed1999

[The influence of the psycho-biological factors on the level of knowledge and skills concerning the diabetes in children and adolescents with type 1 diabetes mellitus].

The aim of the study was to evaluate the influence of the psycho-biological factors on the level of knowledge and skills concerning the diabetes in children and adolescents with type 1 diabetes mellitus. The study was performed in 100 patients aged 12-18 years with diabetes duration 1-13 years. Diabetes knowledge was assessed by using a 29 item diabetes knowledge test. Then practical abilities concerning self-control were estimated. The analysis of psycho-biological qualities of patients included age, sex, duration of the disease, age at onset of diabetes, education, intellectual abilities level (Raven's Standard Matrix Test) and general condition of the patient (HbA1c, occurrence of severe hypoglycaemia, co-occurrence of other chronic diseases). The best results of written and practical tests were obtained by patients at the age of 15 or more. The lowest evaluation of knowledge and practical ability was obtained by children at the age of 12-13. Practical ability level was statistically significantly higher in patients suffering for 1-2 years than in the remaining of the examined persons. Children who fell ill at the age of 0.5-6 years presented a statistically significantly lower level of knowledge in their self-control than patients who fell ill after 11 years of age. Theoretical and practical training degree in diabetes self-control showed a positive correlation with the education level of the subjects. A positive correlation between the test results and intellectual abilities of the subjects was observed within the examined group. The level of patients' health education positively correlates with their age, formal education and intelligence. Health education of children and adolescents with type 1 diabetes mellitus should be individualised and adapted to their particular qualities.

English Abstract↗
PubMed1998

[Stents for treatment of transluminal percutaneous coronary angioplasty (PTCA) complications].

UNLABELLED: This study describes initial results of stent implantation in bailout situations in 38 patients with obstructive dissection after percutaneous transluminal coronary angioplasty (PTCA). Before stent introduction 1.8% of all patients after PTCA required emergency bypass grafting (CABG) because of postprocedural complications. In 1997 the rate of such emergency operations decreased to only 0.5% (p < 0.05). The success rate of stent deployment in patients included in the study was 95%. Mean final inflation pressure used for stent deployment was 12.0 +/- 2.3 atm. After stent implantation average residual stenosis was -0.81 +/- 5.75%. Of the 38 patients, 15 (40%) were treated before stent implantation with prolonged inflations with perfusion catheter. Bailout stenting was performed in 10 (25%) patients undergoing PTCA for restenotic lesions. The stents were placed in the left anterior descending coronary artery in 26 patients (69%), left circumflex coronary artery in 3 patients (8%), and in the right coronary artery in 9 patients (23%). Before bailout stenting 28 patients (75%) presented with type C and D dissection. One patient (2.5%) developed acute stent thrombosis. No episodes of subacute stent thrombosis were noted. During six-months clinical follow up no death and no Q-MI were observed. Angiographic follow up restenosis rate was 13/30 (43%), predominantly in patients treated with prolonged perfusion balloon inflations before stent implantation. The incidence of repeated PTCA and elective CABG due to restenosis was 12/30 (40%) and 1/30 (3%), respectively. There were no vascular complication at the puncture site. IN CONCLUSION: the introduction of coronary stenting has provided an excellent non-surgical modality for treatment of imminent or acute vascular closure complicating coronary angioplasty.

Adult↗
PubMed1998

[Coronary bypass grafting after failed percutaneous angioplasty (PTCA)].

Between January 1991 and September 1997, in the Cardiovascular Surgery Department of the Institute of Cardiology of Jagiellonian University Medical School, 23 patients underwent emergency CABG due to acute myocardial ischaemia in result of failed PTCA. Over the same period of time invasive cardiologists performed 1883 PTCAs out of which 23 (1.2%) were emergency cardiosurgical procedures, and in 38 patients, stents were implanted in the damaged coronary arteries. The patients' age ranged from 37 to 67 years (median 52.2). In all patients good left ventricular function was preserved, median ejection fraction being 64%. Two patients required IABP to support left ventricular function. 1-4 bypass grafts were implanted (median 1.9 per patient). In one patient, internal mammary artery was collected and then implanted into anterior interventricular branch. The most common complication was myocardial infarction which occurred in 12 patients (52%). In ten patients low output was observed postoperatively. One operated patient (a female died (4.3%). The mean time of hospitalization was 11 days. Emergency myocardial revascularisation procedures performed after failed PTCA, bring higher risk of mortality and dangerous postoperative complications.

Adult↗
PubMed1998

[The role of carnitine in human lipid metabolism].

Carnitine is an important nutrient that is present in diet (particularly in meat and dairy products) and is synthesized from amino acids. Carnitine has two principal functions in the organism. One is to transport long-chain fatty acids into the mitochondrion. The second function of carnitine is to regulate the intramitochondrial ratio of acylocoenzyme A to free coenzyme A. This function is important because it allows to remove excessive (and potentially toxic) short- and medium-chain fatty acids from the mitochondrion, and because it maintains sufficient free coenzyme A within the mitochondrion to support energy metabolism.

Carnitine↗
PubMed1997

Comparison of the thiamine level in blood and erythrocyte transketolase activity in hemodialyzed and nondialyzed patients during recombinant human erythropoietin therapy.

Thiamine and erythrocyte transketolase activity (ETKA) disturbances in end-stage renal disease are caused mainly by uremia and dialysis treatment. We examined whether recombinant human erythropoietin (rhEPO) can correct these abnormalities in uremic patients. Thirteen hemodialysis (HD) and 12 nondialyzed (ND) anemic patients showed decreased free and total thiamine levels in plasma and in erythrocytes and decreased ETKA when compared to 20 healthy subjects. Thiamine blood levels (mumol/l) were determined using a fluorimetric technique, and ETKA (mumol/l per minute) was assessed with a photocolorimetric method. Over 20 weeks of study, rhEPO was given intravenously for 8 weeks at 50 Ul/kg body weight (BW) three times a week, and subcutaneously for 4 weeks at 25 Ul/kg BW, twice a week, and for the last 8 weeks at 25 Ul/kg BW once a week. The correction of anemia was associated with an increase in plasma thiamine and erythrocyte total thiamine as well as ETKA in HD patients and with an increase in erythrocyte total thiamine in ND patients only during the period of intravenous infusions.

Adult↗
PubMed1996

Recombinant human erythropoietin improves enzyme activity in erythrocytes of predialysis uremics.

The influence of r-HuEPO on the activity of erythrocyte transketolase (ETKA), glutathione reductase (GSH) and glutamic-pyruvic transaminase (EGPT) was determined by spectrophotometry. 150 IU/kg BW/week of r-HuEPO was given i.v. during 2 months to 12 predialyzed uremics (PDU). Twenty healthy volunteers (HV) served as controls. GSH and EGPT activity were expressed as a coefficient. ETKA in HV = 2.39 +/- 0.10 and PDU = 1.53 +/- 0.10 mumol/ml/min differed significantly (p < 0.001). GSH in HV = 1.20 +/- 0.09 and PDU = 1.25 +/- 0.07, EGPT in HV = 1.20 +/- 0.10 and PDU = 1.38 +/- 0.11 differed significantly (p < 0.01 and p < 0.001, respectively). After 2 months of r-HuEPO treatment, ETKA, GSH and EGPT rose significantly (p < 0.01). Thus, r-HuEPO increases the activity of enzymes related with the content of vitamins B1, B2 and B6 in uremics.

Alanine Transaminase↗
PubMed1996

[Vitamin disturbances in chronic renal insufficiency. II. Fat soluble vitamins].

Fat soluble vitamins (except vitamin K) are protein bounded with subsequent storage in the body. It is generally accepted that plasma level of vitamin A is increased in majority of patients with chronic renal insufficiency (CRI) including those on continuous ambulatory peritoneal dialysis (CAPD). Thus, there is no need to supplement this vitamin in CRI patients (pts). Plasma level of vitamin E in CRI pts may be elevated, normal or decreased. It seems to be justified to supplement this vitamin, in spite of its normal plasma level, in case platelet aggregation is increased. Both in dialyzed and nondialyzed CRI pts a normal serum level of vitamin K has been observed. Decreased or extremely low serum level of vitamin D following the gradual loss of renal tissue is to be observed in CRI pts. This deficit is regarded as the main factor leading to the decrease in serum level of calcium, the secondary hyperparathyroidism and bone changes. Treatment with 1.25(OH)2D3 (calcitriol) proved to be most successful in alleviation of symptoms resulting from the deficit of vitamin D3 in the body. Intravenous "pulsating" administration of calcitriol results in rapid normalization of serum PTH level. Treatment with 25(OH)D3 (calcidiol) given orally 3 times a week ("pulsating" method) revealed also fairly good results in this respect. During treatment with vitamin D3 hypercalcemia tends to develop, serum alkaline phosphatase normalizes, elevated PTH serum level decreases. Vitamin D metabolites are less active than 1.25(OH)2D3 being less hypercalcemic.

Avitaminosis↗
PubMed1996

[Content of thiamin in plasma and erythrocytes in patients with end stage renal disease].

In 68 patients with end stage renal disease (ESRD), nondialyzed-(ND)-21 treated by hemodialysis (HD)-27 or intermittent peritoneal dialysis (IPD)8 and continuous ambulatory peritoneal dialysis (CAPD)-12, we examined thiamine free (Th F) and thiamine total (Th T) content in plasma (P) and erythrocytes (E). 20 healthy volunteers (HV) served as a control group. Thiamine content in plasma and in hemolysate was assessed by fluorimetric method according to Blum and Merkel. In all patients the mean Th FP, Th TP, and Th FE, Th TE levels were decreased in comparison to HV. Mean level of Th FE in ND and IPD was significantly decreased (p < 0.05) in comparison to Th FE to HV and to patients treated by HD or CAPD. Mean level of Th FP was the lowest in IPD group, but did not differ significantly from Th FP in ND, HD and CAPD). In IPD patients mean level of Th TE was the lowest and differed significantly (p < 0.05) from that in HD and CAPD groups. The lowest mean level of Th TP we found in CAPD patients. There was significant difference with it in ND and HV group (p). Patients treated by HD and CAPD presented almost normal levels of Th FE and Th TE. The highest mean levels of Th FP and Th TP were found in ND patients. We suggest the need of thiamine supplementation in ESRD patients especially in those treated by dialysis. The supplementation of thiamine is needed particularly in patients on peritoneal dialysis.

Adult↗
PubMed1996

[Uremic polyneuropathy in patients treated conservatively (nondialyzed) or treated with dialysis].

Uremic polyneuropathy is a common complication in dialyzed patients (pts). In 37 end stage renal disease (ESRD) pts the electroneurophysiological (ENF) parameters and serum creatinine (Pcr), guanidino compounds (GC) and guanidinosuccinic acid (GSA) levels were studied. There were 21 nondialyzed (ND), 10-hemodialyzed (HD) and 6-intermittently peritoneally dialyzed (IPD) pts. The following ENF parameters on both upper extremities, using method described by Buchtal and Rosenfalck, were performed: sensory nerves (nn.) conduction velocity, amplitude of evoked potential, subjective and objective impulse and motor nerve-conduction velocity. Cr level in serum was measured by enzymatic method, GC-by Rosenberg, Ennor, Morison method, modified by Szczepkowska. GSA isolation was performed by column chromatography. The results indicated disturbances in peripheral nn. function in all studied groups of pts and did not correlate with levels of uremic toxins in serum. However, it does not mean, that sum of the accumulated various toxic metabolites in ESRD pts, does not influence the development of polyneuropathy. The degree of impairment of peripheral nn. conduction in ESRD did not differ significantly between ND and HD or IPD pts. We did not notice, any significant differences in the degree of polyneuropathy in HD or IPD pts.

Adult↗
PubMed1996

[Pulmonary infarction as a complication of thrombotic changes in an arteriovenous fistula of a patient with terminal renal insufficiency treated with long-term hemodialysis and recombinant human erythropoietin].

The case of 48 year old female patient with terminal renal insufficiency treated with hemodialysis and human recombinant erythropoietin was observed because of pulmonary infraction. The symptoms of disease were observed in the right lung and in region of arteriovenous fistula. It was documented that therapy with human recombinant erythropoietin may induce thrombosed complications during hemodialysis with arteriovenous fistula.

Arteries↗
PubMed1996

[Effect of furosemide on transperitoneal transport of guanidine derivatives: in vitro studies].

The transperitoneal transport dynamics (removal) of guanidinoacetic acid (GAA) and guanidinosuccinic acid (GSA) has been determined in vitro in the control conditions and after application of furosemide (10(-4) mmol/l) on the mesothelial side of the membrane. GAA peritoneal transfer values, as a rule, were higher than GSA and equaled at mean, in the control series of experiments 0.132 i 0.068 mg x 10(-4) x cm-2 x s-2, respectively. Furosemide decreased GSA passage in 30 min after it addition by about 30%, but GSA transfer diminished later, in 120 min., by about 37%. Therefore, mean GAA transport values before (30-90 min.) and after application of furosemide (120-210 min.) were not statistically significant differentiated, whereas GSA transport parameters were lowered by about 40%. Heterogeneity of the peritoneal GAA and GSA transport dynamics in the control series of the experiments, as well as in the series with furosemide, may be related to the physico-chemical differences (e.g. molecular mass) of the analysed derivates.

Animals↗
PubMed1995

[Vitamin disturbances in chronic renal insufficiency. I. Water soluble vitamins].

Deficiency and/or altered metabolism of vitamins in CRI is caused by uremic toxins, dietary restrictions, catabolic illness, losses during dialysis and drug interaction. There are no reports of consistent studies on vitamin status of water soluble vitamins in CRI. Vitamin B1 (thiamine) deficiency several authors found most frequently in CAPD patients. The cause of this deficiency depends probably on increased requirement of vitamin B1 due to high glucose intake with peritoneal dialysis solution. In patients with polyneuropathy high doses of thiamine pyrophosphate (Cocarboxylase), given i.v., can be helpful in this respect. There are conflicting reports concerning plasma level of vitamin B2 (riboflavin) in CRI patients. Some authors recommend its supplementation. The majority of patients with CRI exhibit biochemical and clinical signs of vitamin B6 deficiency. There exists an univocal opinion that supplementation of this vitamin effects the cellular immune system and the amino acid metabolism as well. An adequate dose of vitamin B6 is still a matter of dispute. Evidence of vitamin B12 deficiency has been reported rarely, thus, only few authors recommend the supplementation of it, mainly in CAPD patients. According to most authors the losses of folic acid and ascorbic acid during dialysis require oral supplementation. Despite the divergences in opinions concerning the deficiency of water-soluble vitamins in CRI patients, the supplementation of these vitamins is practised in many nephrological centers. The amount and the route of vitamins, administered to CRI patients, should be individualized.

Food, Fortified↗