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Rafał Ficek

Publications and source records attributed to Rafał Ficek.

5 recordsLinked to original sources

Plasma concentrations of tumor necrosis factor alpha may predict the outcome of patients with acute renal failure.

BACKGROUND/AIMS: Elevated plasma tumor necrosis factor-alpha (TNFalpha) concentration is frequently found in patients with chronic renal failure on hemodialysis (HD) and correlates with their mortality. The present study aimed to analyze the relationship between plasma TNFalpha concentrations and survival of patients with nonseptic acute renal failure (ARF). METHODS: Twenty-seven patients with ARF and 27 HD patients were examined. In ARF the patients' plasma TNFalpha concentrations were assessed 3 times: before the first HD session (phase I), 5 days later at the anuric/oliguric phase (phase II), and at the polyuric phase at discharge of the patients from the hospital (phase III). In 17 ARF patients kidney function recovered and 10 patients died in phase I. RESULTS: In ARF patients plasma TNFalpha concentration was markedly higher [70 pg/ml (37-275)] than reference values (<5 pg/ml) but significantly lower than in HD patients [216 pg/ml (18-350)]. Moreover, also plasma TNFalpha levels at the polyuric phase remained elevated. An initial plasma TNFalpha concentration in ARF patients lower than 70 pg/ml predicted the beneficial outcome with a sensitivity of 64.7% and a specificity of 70.0%. CONCLUSIONS: (1) Plasma TNFalpha concentration may predict the outcome in patients with ARF. (2) Plasma TNFalpha concentration remained elevated at the polyuric phase in ARF despite a marked improvement of excretory kidney function.

Acute Kidney Injury↗

Influence of parathyroidectomy on blood pressure and function of the transplanted kidney in patients with tertiary hyperparathyroidism.

BACKGROUND: Tertiary hyperparathyroidism is one of the causes of bone demineralisation, nephrolithiasis and a potential risk factor influencing blood pressure and excretory graft function in patients after kidney transplantation (Tx). The aim of the study is to analyse the influence of parathyroidectomy (PTx) on graft function and blood pressure control in these patients. METHODS: 392 subsequent patients after kidney Tx were included into this analysis. Records of 84 patients (21.4%) with elevated plasma calcium concentration (> 2.6 mmol/l) during observation were reviewed. In 39 patients (9.9%) calcaemia remained elevated for over 1 year after kidney Tx. Eleven patients (2.81%) were referred for PTx. In 2 cases PTx were performed within the first 6 months, while the 9 others undergone surgery between 16 and 36 months after Tx. We have evaluated the influence of PTx on renal allograft excretory function, blood pressure and the number of antihypertensive drugs in kidney transplant patients. RESULTS: In 7 out of 11 patients the indication for PTx was renal osteodystrophy, while in other cases the indication was the asymptomatic hypercalcaemia. Shortly after surgery normalisation of calcaemia was observed in all cases. However the creatinine clearance did not changed shortly after PTx (64 +/- 12 vs. 63 +/- 16 ml/min), and a slight deterioration of transplanted kidney excretory function was observed in 2 patients. 12 months after PTx deterioration of GFR (5320 ml/min) of borderline significance was found. All patients before PTx suffered from arterial hypertension, ten of them were receiving antihypertensive drugs (average 1.6 medicine per patient). Two weeks after PTx a transient decline of both systolic and diastolic blood pressures (-13 +/- 14 mmHg; p = 0.02 and -46 mmHg; p = 0.06, respectively) was observed. However there was a negative correlation between initial plasma calcium concentration and decline of diastolic blood pressure (R = -0.884; p = 0.0003). Six and twelve months after PTx blood pressure values were at the same magnitude as before PTx. CONCLUSIONS: (1) Parathyroidectomy and normalisation of calcaemia did not influence significantly the excretory allograft kidney function. (2) Patients benefit from PTx only with the transient improvement of their blood pressure control.

Adult↗

[Influence of recombinant human erythropoietin (rHuEPO) on plasma levels of selected hormones in females with rheumatoid arthritis].

During recent years, it was shown, that treatment with recombinant human erythropoietin (rHuEPO) stimulates erythropoiesis in patients both with renal and nonrenal anaemia. Additionally in patients with chronic renal failure treated with rHuEPO a significant, however only transient, influence on function of endocrine glands was also found. The present study aimed to asses for the first time the influence of rHuEPO on function of endocrine organs in anaemic patients with rheumatoid arthritis and normal renal function. Twenty two woman with rheumatoid arthritis and concomitant anaemia (Ht < or = 30%) were enrolled into the study. In 13 of them rHuEPO was used during 4 months (5000 IU 2 times per week s.c.). The rest 9 woman with similar degree of anaemia did not receive rHuEPO therapy. In woman of both groups intensive clinical and biochemical monitoring during 4 months period was performed. Blood samples were withdrawn before and after 4 months of rHuEPO therapy or clinical observation only. In these blood samples plasma concentrations of somatotropin (HGH), insulin (IRI), aldosterone (ALD), atrial natriuretic peptide (ANP), 25-hydroxycholecalciferol (25OHD3), intact parathyroid hormone (iPTH) and plasma renin activity (PRA) were estimated. After 4 months of rHuEPO therapy significant increase of plasma IRI, ANP concentrations and significant decrease of PRA and plasma ALD, HGH concentrations were found. Therapy with rHuEPO does not influence significantly plasma iPTH and 25OHD3 concentration. During 4 months of clinical observation in patients not treated with rHuEPO, plasma concentrations of HGH, IRI, ALD, ANP, 25OHD3, iPTH and plasma renin activity (PRA) did not change significantly. Results obtained in this study suggest, that rHuEPO therapy does influence the function of endocrine organs also in patients with rheumatoid arthritis with normal renal function.

Adult↗