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Biomedical subjects

M Sikut

Publications and source records attributed to M Sikut.

At least 19 recordsLinked to original sources
PubMed1999

[Blood pressure, functional and morphological study of kidneys in children with autosomal dominant polycystic kidney disease].

BACKGROUND: Autosomal dominant polycystic kidney disease is one of the most common inherited disorders with a prevalence of 1:1000 and is responsible for cca 10% of end-stage renal disease in adult patients. Renal insufficiency is a rare symptom of ADPKD in children, however, there are some symptoms, which can occur already in childhood. The aim of this study was to detect early signs of renal damage and to reveal the blood pressure profile in children with ADPKD using ABPM (ambulatory blood pressure monitoring). METHODS AND RESULTS: 32 children (aged 3.4-19.4 years, mean age 12.3)-carriers of PKD-gene with normal GFR, diagnosed on the basis of a positive family history and characteristic ultrasound features, and in 21 cases also indirect DNA analysis revealed positive results. 11/32 children (34%) presented arterial hypertension detected by ABPM (values higher than 95th centile of normal individuals). The mean of ABPM values of all patients was significantly higher than normal children (p < 0.01), 76% patients had values above the 50th centile. Signs of renal damage (proteinuria, microalbuminuria, decreased renal concentrating capacity, pathological excretion of tubular markers) were found in 22-64% of investigated children. Significantly higher renal volume and renal length were found in more than 1/3 of the children, renal volume and length higher than the mean of healthy children in about 90% of patients and a significant correlation between ABPM parameters and renal length and volume (p < 0.05). CONCLUSIONS: The results of this study show, that the signs of renal damage and arterial hypertension occur relatively often in children with ADPKD despite still normal GFR. This justifies the early diagnosis of ADPKD especially as it reveals the most important treatable complication of ADPKD-arterial hypertension. These findings emphasise the importance of early diagnosis in children from families with ADPKD. Probably, early treatment of hypertension could even postpone the otherwise common end-stage renal damage in adult patients with ADPKD. Careful follow up of all children with ADPKD is strongly recommended, above all the blood pressure should be controlled.

Adolescent↗
PubMed1997

Blood pressure and renal function in autosomal dominant polycystic kidney disease.

The purpose of this study was to identify hypertension in children and adolescents in an early stage of autosomal dominant polycystic kidney disease (ADPKD) by the application of ambulatory blood pressure monitoring (ABPM) over 24 h; 32 children and adolescents (mean age 12.3 +/- 4.7 years) were examined. The diagnosis was based on family history and ultrasound examination. In 21 children ADPKD was confirmed by molecular genetic analysis. At the time of the study, 45% patients were asymptomatic and all had glomerular filtration rates (GFRs) > or = 65 ml/min per 1.73 m2. By ABPM, 11 patients (34%) were defined as hypertensive (systolic or diastolic blood pressure > 95th percentile), including 4 with an exclusive nocturnal hypertension. Of 7 patients with daytime hypertension, 4 had normal blood pressure by casual measurements. The nocturnal dip in blood pressure was reduced in 2 patients. Blood pressure correlated with renal size, but not with GFR, concentrating capacity, proteinuria, and plasma renin activity. The study reveals an early trend for increased blood pressure in children with ADPKD, requiring close supervision.

Adolescent↗
PubMed1993

[Severe Amanita phalloides poisoning in a 7-year-old girl].

Authors describe a case of a very severe poisoning, the prothrombin-time was less than 10% of the normal value and the child developed hepatic coma. We suppose, the favourable outcome may have been influenced by the treatment with Silymarin in combination with high doses of G-Penicillin.

Acute Disease↗
PubMed1992

[Immunologic reactivity in children on a chronic dialysis program and after kidney transplantation].

Dialysis and transplantation of the kidney have become in Czechoslovakia part of routine therapy of chronic renal failure (ChRF) in children and adolescents. The authors examined 16 children aged 4-17 years (x = 10.5) treated in a chronic dialyzation programme (ChDP) by haemodyalisis and 20 children after transplantation of a cadaverous kidney, age 4.5-16.5 years (x = 11.5), incl. 14 patients with a stable function of the graft and six patients during the period of acute rejection of the graft. The authors tested the basic parameters of humoral and cellular immunity in all three groups of children. In the group of the CRI a significant drop of the level was found only in serum IgA, the other parameters, incl. examination of sub-populations of lymphocytes CD3+, CD4+ and CD8+, did not differ significantly from normal values. In patients with a stabilized function of the graft treated by Cyclosporin A, prednisone, and in some cases also with azothioprim, the authors found a significantly lower absolute number of lymphocytes of the mentioned sub-populations as compared with controls and patients included in a ChDP. During the period of acute rejection the absolute number of CD3+, CD4+, CD8+ increased significantly, as compared with the period of stabilized function of the graft. Thus patients in CRI do not manifest despite the serious affection of the organism serious changes of immune reactivity within the scope of examinations made by the authors. Monitoring of immunity parameters in patients with transplants can contribute to evaluation of the effect of immunosuppression (it can draw attention to low dosage of drugs) and in the context with other clinical and laboratory examinations it can contribute to the diagnosis of acute rejection.

Adolescent↗
PubMed1992

[Determination of the calcium/creatinine index in urine in healthy neonates, infants and children].

The authors examined a total of 107 healthy subjects--neonates (n = 13), infants (n = 23), toddlers (n = 16), 3-6-year-old children (n = 15) and school children (n = 40). They correlated the urinary Ca excretion mmol/kg/24 h) with the Ca/cr index which was obtained by examination of postprandial urine sample. They revealed a significant correlation of the excretion and index in infants p less than 0.001, in school children p less than 0.01 with a regression coefficient of 0.9 and 0.7 resp. The index was significantly age dependent, the value of the 95th percentile in neonates was 1.38, in infants 1.025, in toddlers 1.26, in three-year-old children 0.835 and in school children 0.56. The urinary Ca/cr values must be thus interpreted in relation to the child's age; the index declines with age. The reason for high indices in young children is the low creatinine concentration in the excreted urine which rises significantly with age. Examination of the Ca/cr index should be part of routine screening in all cases with suspected nephropathy. The accepted upper range of the index, 0.6 (mmol/mmol), applies only to school children, but not to younger children.

Calcium↗
PubMed1991

[The solitary kidney in children and adolescents. Morphologic and functional characteristics].

Reduction of the renal parenchyma in experimental animals can cause glomerulosclerosis in the single kidney and lead sometimes to functional failure. Data on the influence of nephrectomy or agenesis on the later fate of the patient in human medicine are controversial. The authors examined a total of 40 patients with single kidneys. In 23 agenesis was involved (15 boys, 8 girls) aged 6-22 years (mean = 11.9, s = 4.3). In 17 nephrectomy was performed (9 boys, 8 girls); time interval after nephrectomy 1-26 years (mean = 7.8, s = 3.9). Three quarters of all patients excreted increased amounts of albumin (detected as microalbuminuria by immunoturbidometry). The glomerular filtration rate (GFR) was slightly reduced in about one third of the patients but none suffered from renal insufficiency. In one half of the group the authors detected a slightly impaired concentrating capacity with an increased sodium fraction. In one third marginal diastolic hypertension was recorded. In half the group the single kidney was hypertrophic. Regression analysis did not reveal deterioration of the GFR in relation to age but revealed increasing renal hypertrophy in relation to height with accelerated hypertrophy during puberty. There was also a significant drop of the systolic blood pressure in relation to age in patients with agenesis. In none of the other parameters differences were found between the group with agenesis and nephrectomy. Patients with a single kidney deserve prolonged ambulatory follow up. In the investigated group the single kidney influenced in a substantial way also the selection of occupation.

Adolescent↗