Inversed diurnal rhythm of urinary prostaglandins E2 and F2 alpha excretion in kidney graft recipients.
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Biomedical subjects
Publications and source records attributed to M Mitić.
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Alkaline phosphodiesterase I was demonstrated in human glomerular mesangial cells (HGEC) as an ectoenzyme. Treatment of HGEC by dexamethasone increased surface phosphodiesterase I activity in a dose- and time-dependent manner. Maximal increase of phosphodiesterase I activity, about twice, occurred after treatment with 5 microM dexamethasone for 6 days. Cycloheximide prevented and RU 38486, a glucocorticoid receptor antagonist, suppressed the dexamethasone induced increase in phosphodiesterase I activity. This study shows that HGEC have a surface phosphodiesterase I controlled by glucocorticoids through a receptor-mediated mechanism.
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Increased serum myoglobin levels were previously found in patients with chronic renal failure. In this report we have studied the effects of dialysis on myoglobin elimination in patients on CAPD, IPD, cuprophan and polyacrylonitrile (PAN) membrane hemodialysis. Peritoneal dialysis removed a significant amount of myoglobin, CAPD 480 +/- 65 micrograms/day, IPD 270 +/- 25 micrograms/12 h treatment, while with cuprophan dialysis none, and with PAN dialysis only an insignificant amount of myoglobin. The serum myoglobin levels were 250 +/- 18 and 264 +/- 14 micrograms/l on cuprophan and a 3 month dialysis on PAN membrane, respectively. Markedly increased serum levels were also found in CAPD and IPD patients on peritoneal dialysis, 227 +/- 25 and 286 +/- 32 micrograms/l respectively. This study has shown that there is an increased serum myoglobin concentration in end-stage kidney disease patients on dialysis. Although peritoneal membrane is permeable to myoglobin, a relatively small amount is removed, and the serum level in CAPD and IPD patients was not significantly different from the serum myoglobin concentration in hemodialysis patients. Furthermore myoglobin could not be removed by hemodialysis membrane and an analysis of its important extrarenal catabolism level points were analyzed.
beta 2-microglobulin (beta 2M) is a small molecular mass protein associated with dialysis amyloidosis. We have studied beta 2M elimination in end-stage renal disease (ESRD) patients treated by peritoneal dialysis. In 12 patients on continuous ambulatory peritoneal dialysis (CAPD) and 7 patients on intermittent peritoneal dialysis (IPD) 30.4 +/- 4.2 mg/day and 21.3 +/- 1.8 mg/12 hour of beta 2M, respectively, were removed by dialysis fluid. Approximately the same amount of beta 2M was removed by each of four 2-L exchanges in CAPD; however, the most efficient removal of beta 2M was in the first IPD exchange. Serum beta 2M levels in these patients were 25.7 +/- 4.4 and 31.4 +/- 5.2 mg/L, respectively. In 24 patients on hemodialysis using cuprophan membrane the serum level of beta 2M was 55.1 +/- 4.1 mg/L. After a 3-month dialysis on polyacrylonitrile (PAN) membrane, the serum beta 2M level decreased to 45.0 +/- 2.3 mg/L. A substantial amount of beta 2M was removed by urine, 14.6 +/- 2.3 mg/L, and saliva, 2.3 +/- 0.4 mg/L. This study has shown markedly increased beta 2M levels in patients on conventional hemodialysis treatment, predisposing to beta 2M-related amyloidosis. A significant amount of beta 2M was removed during both CAPD and IPD treatment.
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The circadian rhythms of the serum immunoreactive parathyroid hormone (iPTH) and calcitonin concentration were examined in 6 patients with chronic renal failure (CRF) not treated by haemodialysis. In 3 patients on haemodialysis the influence of haemodialysis with cuprophan and polyacrylonitrile membranes (in a.m. and p.m. periods of day) on serum concentration of these was investigated. The results demonstrate that in patients with CRF in predialysis period the circadian rhythm of serum iPTH concentration is at least partially preserved. However, the effect of dialysis on serum C-terminal iPTH concentration showed a sharp progressive fall of the concentration during haemodialysis on polyacrylonitrile membranes. The study of the circadian rhythm of serum calcitonin concentration in CRF patients with the six hours intervals between blood sampling could not reveal changes which favour the opinion of the existence of circadian rhythmicity. In patients on haemodialysis during haemodialysis with cuprophan membranes a rise of serum calcitonin concentration was observed.
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