Biomedical subjects

R Grozdanovski

Publications and source records attributed to R Grozdanovski.

14 recordsLinked to original sources

PubMed2005

Histomorphometric analysis of fibrosis in the renal interstitial compartment.

The interstitium is the extravascular intertubular space of the renal parenchyma, which provides structural support to the functional renal units and is included at the same time in nearly all renal functions. Alterations to this renal compartment have been found in almost all glomerular diseases. During the last thirty years the studies of a few groups of investigators have shown that the degree of the renal dysfunction is strongly correlated with the changes in the tubulointerstitial compartment. We made a morphometric study of a group of 10 renal biopsies, previously diagnosed as IgA nephropathy or membranoproliferative glomerulonephritis. For morphometric analysis we made colour extraction of the interstitial area on tissue sections stained with trichrom Masson using the LUCIA M-NIKON image analysing system with integrated software for statistical analysis of the data. We measured the surface of the marked fields and the results were expressed as a percentage of the total scanned area. The results were correlated with the serum creatinine at the time of biopsy. We found fibrosis occupying more than 10% of the tubulointerstitial surface in all 10 patients. Six of them had a moderate level of fibrosis, occupying more that 20% of the tubulointerstitial space. The statistical analysis of these results showed a significant correlation between the degree of the interstitial expansion and the serum creatinine. The results showing the correlation between these parameters will enable the quantitative histological analyses to be included in the process of the nephropathological diagnosis in order to evaluate the histological risk factors in glomerular diseases.

Adolescent↗

PubMed2005

Malnutrition inflammation complex syndrome in maintenance haemodialysis patients.

Malnutrition inflammation complex syndrome (MICS) occurs in maintenance haemodialysis (MHD) patients and is a strong predictor of morbidity and mortality in these patients. The aim of our study was to evaluate the influence of inflammation on the biochemical and anthropometrical parameters of the nutritional status in MHD patients. Our study was made on 154 patients (93 men and 61 women, mean age=54.7 yrs. and mean time on dialysis 84 months) over a period of 6 months. The indicator of inflammation, C-reactive protein (CRP), was measured monthly at the central laboratory by nephelometry. The assessment tools used to evaluate the influence of inflammation on the nutritional status in MHD patients were: serum albumin and cholesterol level, midarm circumference (MAC), midarm muscle circumference (MAMC), triceps skin fold thickness (TSF) and body mass index (BMI). Student's t-test was used for group mean comparison between men and women. Person's correlation r was used to determine the significance and the strength of associations. The CRP level was significantly greater in men than in women (12.9 vs. 7.97, p < 0.04). The CRP level showed a strong correlation only with the serum concentration of cholesterol (r=0.49, p < 0.000), and did not correlate with the serum albumin of the MHD patients. There was no correlation between the CRP level and the anthropometrical parameters of the MHD patients in our study. Two separate processes, inflammation and reduced protein intake, each separately contributed to causing a decrease in serum albumin concentration and anthropometrical measurements. The levels of acute phase proteins vary widely as opposed to the serum albumin level; for that reason, changes in the albumin catabolic rate or synthesis require a considerable time to become visible. The average value of the protein catabolic rate of the patients in our study was 1.01 g/kg/d, a value that showed adequate protein intake. These findings would suggest that clinical attention to the maintenance of adequate nutrition could blunt the effects of inflammation on both somatic and visceral protein stores.

C-Reactive Protein↗

PubMed2004

Short-term effect of folic acid supplementation in renal transplant recipients and chronic kidney disease patients with comparable renal function impairment.

Recent evidence suggested that the efficacy of folic acid supplementation in reducing plasma total homocysteine (Hcy) concentration might be similar in renal transplant recipients (RTR) and chronic kidney disease (CKD) patients with a comparable degree of reduction of renal function. However, a direct comparison of the response to high dose folic acid supplementation between renal transplant recipients and CKD patients has never been made. Therefore, the goal of this study was to evaluate the response to folic acid (5 mg/day) supplementation in 15 stable renal transplant recipients with evidence of chronic allograft nephropathy, and in 15 CKD (stage 3) patients matched for age, sex and renal function living in the area of Skopje, Macedonia. After 12 weeks of folic acid supplementation, plasma total Hcy concentrations were significantly reduced in the two groups. Percent reduction of plasma total Hcy levels was nearly identical in the two groups (25.7% vs 24.5%, p = NS). These results confirm previous findings regarding the efficacy of folic acid therapy given separately to either renal transplant recipients or CKD patients, and extend them to a direct confirmation of identical efficacy.

Adult↗

PubMed2001

Lipids, protein intake, and progression of diabetic nephropathy.

Explore the source record for details and available documents.

Diabetes Mellitus, Type 2↗

PubMed2001

Atherosclerosis risk factors related to hemodialysis duration and erythropoietin therapy.

Patients undergoing hemodialysis are at risk for atherosclerosis and its complications. The aim of this study was to examine the effect of erythropoietin therapy and hemodialysis duration on some of the atherosclerotis risk factors. The patients were divided into four groups: I: patients undergoing hemodialysis for less than 10 years (n=22); II: patients undergoing hemodialysis for more than 10 years (n=17); III: patients on no erythropoietin (n=21); IV: patients on erythropoeitin therapy (n=18). A control group of 20 subjects was also examined. Triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein, lipoprotein(a), apolipoprotein-A1, apolipoprotein-B and lipid peroxidation were examined. There was a significant increase in triglycerides, to 2.59+/-1.2 mmol/l (p<0.001) and in lipid peroxidation in hemodialysis patients, to 5.02+/-0.9 micromol/l vs. controls (p<0.001). Significantly elevated triglycerides and lipid peroxidation levels were found in the patients with longer hemodialysis duration. Triglycerides were elevated in group II vs. group I, to 2.90+/-1.0 mmol/l. (p<0.05). Lipid peroxidation in group II, 5.40+/-1.0 micromol/l, showed significant difference compared to group I (p<0.05). Erythropoietin treatment did not affect any of the examined parameters. These results indicate increased risk for atherosclerosis related to hemodialysis duration. Besides the renal disease itself, hemodialysis may also be one of the risk factors for atherosclerosis.

Adult↗

PubMed1997

Long-term diuretic therapy in patients with chronic renal failure.

Ten patients with chronic renal failure from different genesis (serum creatinine levels 150-200 mumol/l), were evaluated from the aspect of the effect of the diuretic therapy. The effects of furosemide (FUR) and polythiazide (POL) were assessed after 3-month application. The mean values of the estimated parameters before treatment, after 3-month administration of FUR as a monotherapy and after the next 3 months simultaneously used (FUR + POL), presented a stable increase of the diuresis, without statistically significant changes of the global renal function, and triglyceride disorders. On the contrary, the improvement of calciuria through combined using of furosemide and polythiazide is statistically and clinically significant.

Diuretics↗

PubMed1997

Acute renal failure with severe tubulointerstitial changes in a patient with minimal change nephrotic syndrome treated with enalapril.

A 35-year-old nephrotic man developed acute renal failure with serum creatinine to 1543 micromol/l after a month of therapy with enalapril. Renal biopsy demonstrated minimal glomerular changes with fusion of podocytes, tubular necrosis with regeneration of tubular epithelial cells, interstitial edema with focal interstitial fibrosis, and interstitial infiltration with neutrophils, eosinophils, plasma cells and mononuclear cells. Three hemodialyses were performed in the patient during the oliguric phase of the disease. Renal function was restored after withdrawal of enalapril and initiation of steroid therapy. Steroids also contributed to the improvement of the nephrotic syndrome and proteinuria decreased from maximal ranges of 27 g/l to 2.2 g/l after six months of the follow-up. Similar cases were previously described associated with captopril treatment, but not with enalapril.

Acute Kidney Injury↗

PubMed1977