Different effects of chronic renal failure on erythrocyte nucleotide concentrations in humans and rats.
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Biomedical subjects
Publications and source records attributed to J Manitius.
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This study examined the influence of a calcium channel antagonist, nitrendipine, on blood pressure and kidney function in a rat model of chronic renal failure. Additionally, the effects of low frequency renal nerve stimulation were studied in the presence and absence of nitrendipine. Male Wistar rats were fed a diet high in adenine for 4 weeks and then acutely anaesthetised and prepared for renal functional measurements. Blood pressure was elevated but renal blood flow and glomerular filtration rate were reduced, between 30 to 50%, urine flow and absolute sodium excretion were lower and fractional sodium excretion was two to three times higher than in normal rats. Nitrendipine (0.25 microg/kg/min i.v.) decreased blood pressure at 114+/-7 mm Hg, by 11% (P<0.05), increased left renal blood flow, at 1.3+/-0.2 ml/min(-1) g(-1), by 16% (P<0.01), and urine flow, absolute and fractional sodium excretions, by between 50-83% (all P<0.05). Renal nerves stimulation (0.7-1.3 Hz, 15V, 0.2 ms) decreased (P<0.02) left renal blood flow by 10% but had no effect on excretory variables, irrespective of nitrendipine administration. These results show that in renal failure rats the vascular and tubular responses to nitrendipine are preserved. However, the neural regulation of tubular reabsorption is abolished in this experimental model, irrespective of nitrendipine administration.
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The rate of progression of renal disease depends on many factors including serum lipids and tubulo-interstitial injury. Aim of the study was to see whether fish-oil therapy may affect serum lipids and NAG excretion with urine (a marker of tubular cell damage) in humans with renal disease. The effects of dietary fish-oil fatty acids on the serum lipids, NAG urinary excretion and serum arachidonic acid concentration were examined in thirteen primary glomerulonephritic patients with proteinuria and normal renal function. The regular diet enriched with 1650 mg n-3 polyunsaturated fatty acids (18%: 20:5; n-3 EPA and 12%: 22:5; n-3 DHA) was ingested for three months. At the end of fish-oil enriched diet neither creatinine clearance nor urinary protein excretion changed significantly. But serum concentration of HDL and arachidonic acid increased (48.0 +/- 15 vs. 52.0 +/- 14; p < 0.05), (0.47 +/- 0.13 vs. 0.72 +/- 0.29; p < 0.01), respectively. Simultaneously urine NAG excretion and serum LDL decreased (11.2 +/- 7.1 vs. 10.3 +/- 7.3; p < 0.05), (163.0 +/- 57 vs. 149.0 +/- 51, p < 0.01), respectively. We presume that fish-oil supplementation may have a beneficial effect on renal tubular cells in humans and it could be linked with arachidonic acid metabolism.
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Intraerythrocyte adenine nucleotides concentration reflects energy balance of red cells and plays pivotal role in their function. In hemodialysed patients both ATP and ADP concentration in red cells was higher than in controls, p < 0.001 and p < 0.005 respectively. But AMP and hypoxanthine did not differ from control. No change of ATP, ADP and AMP was observed after hemodialysis, but hypoxanthine fall significantly, p < 0.001. The pattern of nucleotides concentration and its changes during hemodialysis was the same regardless of the mode of the therapy; e.g. acetate or bicarbonate.
The aim of the study was to estimate the HBV infection preventive measures used in the twelve dialysis centres in north Poland. In all of the centres hepatitis B vaccination and segregation of HBV infected patients (dedicated machines or separate rooms), which are the two basic HBV infection control methods, were introduced. Our results point out that in some of the centres certain modification of these methods would be possible, including universal predialysis vaccination programme, changes in hepatitis B vaccination schedules with most effective routes of vaccination only and dedication for HBV infected patients not only separate rooms but separate dialysis staff as well.
Using high-performance liquid chromatography, concentrations of erythrocyte adenine nucleotides and hypoxanthine were evaluated in patients undergoing regular acetate hemodialysis before dialysis, immediately following dialysis, and 24 hr after. It was shown that adenosine triphosphate concentration was maintained consistently high, not only just after hemodialysis but also 24 hr later. There was also no difference in concentration of mono- and diphosphates of adenosine. Hypoxanthine concentration decreased twofold after hemodialysis. However, it was still markedly higher than normal values. The level of hypoxanthine was maintained at the postdialysis level, 24 hr later. This suggests that hypoxanthine production could be stimulated during acetate dialysis.
We have studied the antibody response to hepatitis B vaccine in 42 hemodialysis patients; 8 of them were diagnosed as having HCV infection before vaccination. Hemodialysis patients received four doses of recombinant HB vaccine (Engerix-B, SKB, 40 micrograms per dose). Seroconversion occurred in 71.4% of all hemodialysis patients; in 79.4% of HCV-negative and in 37.5% of HCV-positive patients. Effective immunity (anti-HBs titer higher than 100 m IU/ml) was observed in 12.5% of HCV positive and in 35.3% of HCV-negative patients. We conclude that HCV infection may modify or postpone the response to hepatitis B vaccine.
It is very well known that carbohydrate metabolism disturbances may affect progression of renal disease in patients with moderate renal insufficiency. The aim of this study was to analyse the relationship between glucose, insulin and changes of creatinine clearance and proteinuria in patients with primary glomerulonephritis and normal renal function. Thirteen non-treated patients with primary glomerulonephritis, were given 75 g glucose orally and area under insulin and glucose curves were estimated. Afterwards all patients were followed-up for 17.6 +/- 3.1 months and none of them was subjected to any pharmacological intervention. At the end of the study neither proteinuria nor creatinine clearance changed significantly. But significant linear correlations were found between pre-follow-up glucose and insulin and changes of daily proteinuria (r = 0.632, p < 0.05; r = 0.538, 0.05 < p < 0.1) respectively. No correlations were found between insulin and glucose area and changes of creatinine clearance. Authors analyze the potential role of some factors linking the glucose metabolism and proteinuria.
There are reports concerning profitable influence of unsaturated acids administration on blood pressure, inflammation and proteinuria. The aim of presented study was to estimate the effect of Omega-3 on plasma lipids and renal function in patients with primary glomerulopathies. The tested group consisted of 13 patients (7F and 6M) aged from 22 to 60 years, with primary glomerulopathies and normal renal function. They received Omega-3 (Fishproduct, iceland) 3 x 2 caps for three months. Before, after 2 and 3 months of treatment and 3 months after its discontinuation following parameters were estimated: total cholesterol, HDL and LDL cholesterol (HDL, LDL), triglycerides and an order parameter of erythrocyte lipid bilayer (S). Simultaneously N-acetylglutamate (NAG), creatinine clearance and 24-hours proteinuria were measured. For calculation t-Student test was used. In our study we found statistically significant increase of HDL after 2 and 3 months and decrease of LDL after 3 months of Omega-3 administration (p < 0.05). During the 2 and 3 months of treatment statistically significant decrease of NAG was noticed but a month after its discontinuation significant increase of NAG excretion was observed (p < 0.05). The S parameter in tested group of patients was higher than in healthy population but during Omega-3 administration the value of an order parameter of erythrocyte bilayer increased significantly (p < 0.01). On the base of given results we could conclude that unsaturated acids may have profitable influence on plasma lipids, functional status of erythrocyte membrane and probably proximal tubule function in patients with primary glomerulopathies.
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The aim of this study was to investigate the effect of 2-week fructose feeding on plasma lipids renal function and morphology in the rats. Pair-fed rats were kept individually in metabolic cages for two weeks and given diet containing either 25% fructose or 25% starch (weight/weight). After that time under Nembutal anesthesia blood pressure was measured intra-arterially and blood was withdrawn for cholesterol, triglyceride, insulin, glucose and 24hrs urine was collected to estimate creatinine clearance. At the end of experiment kidneys were removed and fixed for microscopic examination. Creatinine clearance was higher by 15% (p < 0,01) in fructose fed rats and microscopic examination revealed moderate mesangial cells proliferation in animals of the same group. No statistical significant difference was observed with regard to lipids or glucose and insulin between two groups. Our study suggest that fructose feeding is associated with hyperfiltration and hyperplasia of mesangial cells in glomeruli.
Development of dialysis methods and progress in kidney and pancreas transplantation allowed to treat an increasing number of patients suffering from diabetic nephropathy (D.N.). This report evaluates availability and results of treatment in these patients. 31.12.93 in Gdansk and Bydgoszcz area there were treated 519 patients, including 43 (8.2%) with D.N. It is impossible to evaluate the demand for renal replacement therapy in patients with D.N., because there is no exact data concerning diabetic patients with progressing renal failure. Up to now 88 patients with D.M. (68 with IDDM, 20 with NIDDM) were treat in this area. Most of them (92%) were treated with hemodialysis is and only a few with CAPD, 13 patients received a kidney graft. The average patient survival on dialysis treatment in NIDDM patients was 15 months and in IDDM patients was 11 months. Deaths were mainly caused by cardiovascular complications. The results of renal replacement therapy in these patients cannot be compared with data from other re ports, because the treatment was introduced at advanced stage of D.N. in patients with systemic complications (serum creatinine in IDDM was 9.7 md% and in NIDDM was 6.2% mg%). Following conclusions can be drawn from our observations: 1. There is a need for close cooperation between diabetologist and nephrologist in repeat of evaluation of the demand for renal replacement therapy and time for its institution in a particular patient. 2. The choice of method of renal replacement therapy depends on clinical findings in a particular patient but also on methods available in a particular center. 3. Improvement of therapy outcome can be achieved primarily by earlier institution of dialysis (serum creatinine below 5 m5%).
The kidney transplantation is one of the renal replacement therapy methods, which prolongs live of the patients with the end stage renal disease for many years. Moreover, this method is well known, safe and not so expensive as dialysotherapy. Our purpose was to present the 15-year activity of the transplantation center in Gdańsk. The first renal transplantation took place on the 31st of March 1980 and there have been 137 renal transplantations in Gdańsk until now. We can divide the time between the 31st of March 1980 and the end of 1994 into two periods: I from 31.03.80 to 31.12.89 and II from 1991 to 1994. During the first were 46, and during the second were 91 renal transplantations performed. It means that since the second half of 1991 the activity of the center in Gdańsk has increased. The graft function was noted in 29 patients (63%) during the first period and in 75 (82%) during the second. The acute graft failure was observed in the most of the cases mentioned above. The 5-year living of the transplanted patients and the dialysed patients is comparable and amounts to 90%. Infections were the main reason of death during the first period, and cardiovascular complications during the second. The 5-year graft's functioning is 60%. Nowadays the results of the kidney transplantation center in Gdańsk are good and comparable with the results of other centers in Poland and Europe. Our center, as similar ones in Poland is prepared to extend the kidney transplantation activity. So it is necessary to intensify an effort to gain more organs for transplantations.