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W Sułowicz

Publications and source records attributed to W Sułowicz.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Long-term good results of surgical treatment for spontaneous epi- and subdural hematoma in a female patient on maintenance hemodialysis].

Spontaneous intracranial hematoma is not rare, but with bad prognosis, complication in patients on maintenance hemodialysis (HD). Diagnostic difficulties result from a fact that symptoms of acute hematoma such as headaches,, nausea, vomitis, apathy, sleepiness, parestesia and seizures may also suggest dysequilibrium syndrome, dialytic dementia as well as hypertensive encephalopathy. We describe a case of female patient with 20-year interview data of hypertension on HD since 1981 because of end-stage renal failure in a course of chronic glomerulonephritis, who developed spontaneous epi- and subdural hematoma four year ago in 47 age of life. Performed CT examination confirmed diagnosis and on the same day the patient underwent right frontoparietotemporal craniotomy and the hematoma was removed. During postoperative period, HD sessions were performed without heparin. After surgery the patient developed transcient hypertonia, epileptic sizures and left-sided paresis. Currently, 48 months after craniotomy the patient is fully rehabilitated, with normal blood pressure, without epileptic sizures or palsy. Gradually we discontinued anticonvulsans and antihypertensives.

Craniotomy↗
PubMed1999

Effect of a hemodialysis session on plasma levels of endothelin-1 in hypertensive and normotensive subjects with end-stage renal failure.

BACKGROUND: Elevated plasma endothelin-1 (ET-1) was found in end-stage renal failure (ESRF). However, there are discordant reports on the influence of hypertension on plasma ET-1 in ESRF and on the effect of hemodialysis on ET-1 concentrations. AIM: To compare the time course of plasma ET-1 during hemodialysis in hypertensive (HT) and normotensive (NT) ESRF patients. METHODS: Plasma ET-1 and mean blood pressure (MP) were measured in 12 HT patients and 11 matched NT patients on maintenance hemodialysis at baseline (B), after a 2.5-3.5 h hemodialysis with ultrafiltration (P1) and after a subsequent 1 h isovolumic dialysis (P2). RESULTS: In HT patients, plasma ET-1 increased at P1 with no further change after P2 (B vs. P1 and P2, p < 0.05). In NT patients, ET-1 levels were similar at B, P1 and P2. In HT, but not in NT subjects, volume loss correlated with change of ET-1 at P1. In HT patients, MP fell during P1 and tended to return towards baseline at P2. In NT patients, MP dropped after P1 and remained lower also at P2. CONCLUSION: Hypertensive ESRF subjects exhibit potentiated ET-1 release on hemodialysis, possibly stimulated by volume depletion with sympathetic activation, which may attenuate hypotensive hemodialysis effects thus contributing to hypertension in ESRF.

Adult↗
PubMed1999

[Nonsteroidal anti-inflammatory drugs--nephrotoxic mechanism of action].

Non-steroid anti-inflammatory drugs are easily available and commonly used. Mechanism of their action is based on inhibiting prostaglandin synthesis. Prostaglandins are arachidonic acid derivatives that are responsible, among others, for regulation of renal blood flow. In some kidney disorders as well as in hemodynamic disturbances, their increased release aims at balancing substances causing kidney ischemia. Blocking prostaglandin synthesis in such conditions may result in development of nephrotoxic effect, manifesting in water-electrolyte imbalance, acute tubulo-interstitial nephropathy, nephrotic syndrome, acute and chronic renal papillary necrosis as well as acute or chronic renal failure. Analgesic nephropathy with papillary necrosis is a particular form of the nephrotoxic effect of non-steroid anti-inflammatory drugs. Development of this complication has been described in patients abusing phenacetin or other analgesic drugs and especially their combination.

Analgesics, Non-Narcotic↗
PubMed1999

[Lipid abnormalities in kidney diseases--significance of radical hypolipemic therapy (LDL-apheresis)].

In several renal diseases such as nephrotic syndrome or terminal renal insufficiency changes in lipids metabolism may lead to increase of cholesterol level or changes in its fractions proportions. There are many clinical and experimental observations demonstrating direct toxic effect of lipids on endothelium leading to impairment of endothelial function what can increase damage of glomeruli. It is associated with passive filtration of lipoprotein to mesangium and active fagocytosis by mesangial cells and infiltrating macrophages, which release cytokines and growth factors increasing mesangial proliferation. There are first publications suggesting possibility of application LDL-apheresis-radical cholesterol removing procedure in renal disease. Periodical cholesterol lowering in the blood reduces proteinuria in patients with resistant for pharmacotherapy nephrotic syndrome, especially with focal glomerulonephritis.

Cholesterol, LDL↗
PubMed1999

[Hyperhomocysteinemia in chronic renal failure].

Cardiovascular disease constitute the main cause of death in chronic renal failure patients on maintenance dialysis. During the last years one of the suspected cause promoting atherosclerotic lesions in this group of patients has been increased plasma homocystein level. The following article presents selected causes of hyperhomocysteinemia in chronic renal failure patients, mechanism of their toxic effect on cardiovascular system and methods of treatment of these disturbances.

Cardiovascular Diseases↗
PubMed1999

[Usefulness of bioelectric impedance as a method for evaluating body composition of patients on peritoneal dialysis].

The aim of a study was to evaluate the usefulness of bioelectric impedance as a method of body composition analysis in patients treated with CAPD, with the special attention paid on hydration status and lean body mass. The values of parameters obtained by bioelectric impedance and other methods were compared. The impact of peritoneal dialysis fluid in peritoneal cavity on bioimpedance measurement results were also analyzed. The study was performed in 33 patients dialyzed with CAPD for mean period of 12.3 months, aged between 23 and 72 years (mean 50.9 years). Bioimpedance measurements were also performed in 10 healthy volunteers. The significant impact of 2-liters dialysate volume on measurement results was found. The percentage water contain as well as LBM are under this condition higher (59.2% vs. 58.3%; p < 0.005 and 80.73 vs. 79.6; p < 0.01, respectively), and body fat--lower (19.07 vs. 20.39%; p < 0.005) as compared to empty peritoneal cavity. We also found, that the values of body water obtained from BEI measurements are higher as compared to those calculated from Watson formulas and lean body mass values obtained from BEI analysis are higher as compared to those derived from creatinine kinetics (39.4 vs. 36.96 I.; p < 0.05 and 53.7 vs. 51.1 kg; p < 0.01, respectively). Total and lean body mass did not differ from the values predicted in the treatment group, however the percentage contain of body water was significantly higher (58.34 vs. 51.39%; p < 0.0001). No significant differences were found between body composition of CAPD patients and control individuals.

Adult↗
PubMed1999

Is CAPD a renal replacement therapy method of choice for women?

The aim of this study was to evaluate if there were any differences in clinical outcome as well as in values of quantitative adequacy/nutritional parameters in ESRD patients treated with continuous ambulatory peritoneal dialysis, depending on their sex. Nutritional and adequacy parameters: NPCR, Kt/V, weekly creatinine clearance (wClCr), dialysis index (DI), serum albumin concentration, as well as clinical parameters such as hospitalization rate, admission rate, peritonitis rate, exit-site infection rate and co-morbidity score were evaluated in 31 CAPD patients (12 F and 19 M). Lower comorbidity score (0.583 vs. 1.58 points; p < 0.05) and higher Kt/V total and residual (2.25 vs. 1.57; p < 0.01 and 1.7 vs. 1.42; p < 0.01, respectively) were found in women as compared to men. The value of the quantitative nutritional parameter--NPCR--was also higher in women (0.842 vs. 0.73 g/kg b.w./24 hours; p < 0.05). Despite these differences, only a small difference was found in the clinical outcome and survival between men and women. The obtained data may suggest that women can achieve better treatment results with the CAPD method as compared to men.

Adult↗
PubMed1998

Urine activity of cathepsin B, collagenase and urine excretion of TGF-beta 1 and fibronectin in membranous glomerulonephritis.

In 30% of cases nephrotic syndrome is caused by membranous glomerulonephritis (MG). Protein accumulation in glomeruli leads to progressive loss of kidney function and damage of structure in MG. The role of tissue proteolytic systems and growth factors in this process is not known. The purpose of the study was to estimate urine cathepsin B, collagenase activity and urine excretion of TGF-beta 1 and fibronectin in MG. Cathepsin B activity was greater in the urine of MG patients than in the control group (10.58 +/- 8.73 pmol AMC/mg creatinine per min-1 vs control 7.11 +/- 2.05 pmol AMC/mg creatinine per min-1; P < 0.05). Urine collagenase activity was higher in the group of patients than in the control group (8.59 +/- 4.26 pmol AMC/mg creatinine per min-1 vs control 3.84 +/- 2.09 pmol AMC/mg creatinine per min-1 P < 0.02). Urine excretion of fibronectin (45.60 ng/mg creatinine vs control 10.30 ng/mg creatinine; P < 0.04) and TGF-beta 1 levels in the urine were higher than in controls (283.55 +/- 248.13 pg/ml vs 36.11 +/- 48.01 pg/ml; P < 0.01). Results suggest glomerular overproduction of TGF-beta 1 and urinary leak of proteolytic enzymes (PE). This may result in decreased glomerular PE activity in MG and, with time, may lead to protein accumulation in renal glomeruli and to progressive loss of kidney function and damage of structures as the course of MG progresses. PE urine composition as well as ECM protein and cytokine urine excretion may allow noninvasive glomerulopathy course monitoring in humans in the future.

Adult↗
PubMed1998

Cytomegalovirus infection in kidney transplant patients: clinical manifestations and diagnosis.

Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality after solid organ transplantation. CMV infection after kidney transplantation was confirmed in 19 (54.3%) out of 35 patients. 16 of these (84.2%) developed CMV disease. CMV infection was diagnosed based on a fourfold or greater increase of anti-CMV IgG antibody titre, detection of CMV-IgM antibodies and/or virus isolation. Primary infection was observed in 3 patients, reactivation in 9 and an undefined type of infection in 7. In most patients (63%), infection was diagnosed in the first 2 months, and in 3 patients, after 3, 5 and 9 years following kidney transplantation. The most frequent symptoms of CMV disease were fever (58%), pneumonitis (26.3%) and enterocolitis (15.8%). In 53% of the patients, CMV infection co-occurred with other pathogens such as Candida albicans. Cryptococcus neoformans, bacteria or viruses (HBV, HCV, HSV). Treatment with polyvalent globulin (Sandoglobin) or hyperimmune globulin (Cytotect), in combination with ganciclovir in 7 patients, resulted in a regression of CMV disease.

Adolescent↗
PubMed1998

[Current opinions on the etiology and pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). II. Factors other than genetic factors which have an influence on disease course and selected clinical problems].

In the first part of this paper achievements in the genetic investigations of ADPKD and pathomechanism of cyst formation have been presented. Majority of authors acknowledge that first type of the disease (ADPKD1) in comparison with the second (ADPKD2) has more severe clinical course. On the basis of clinical analysis of selected affected families the larger and larger emphasis has been put on the influence of such factors like: presence of arterial hypertension, especially role of RAA system, sex, diet, hyperlipoproteinemia, environmental factors, toxic and infectious agents. It seems that genetic analysis of the RAA system and ADPKD will partially explain differences in the clinical course of the disease in different families. Persons with DD genotype in RAA system have statistically significant, more severe clinical course in comparison with their relatives with DI or II genotype. Decidedly worse course of the disease is observed in patients with positive family history of arterial hypertension and in persons with increased blood pressure. Patients sex play a major role. Men have more severe renal manifestations, when in women symptoms and complications associated with liver cysts are more frequent than in men. Frequency of intracranial aneurysms (ICA) in the population of patients with ADPKD have been presented. CT, MRA and classical angiography are in order screening tests for detection of ICA, especially in persons with family history of their prevalence. Prevalence of liver cysts and selected clinical symptoms and complications associated with extrarenal manifestations have been discussed. Problems associated with infections of the urinary tract and cysts, their etiology, pathomechanisms and treatment have been presented. Ultrasonography seems to be the best diagnostic tool because of it's accessibility, high sensitivity and low cost. It is accepted, that presence of 3 cysts in both kidneys in ADPKD kindreds in significant for diagnosis. Modified Ravine's criteria for diagnosis of ADPKD have also been presented. Employment of modern diagnostic methods in combination with genetic analysis (especially linkage analysis) enable early diagnosis in persons who are at risk of ADPKD.

Comorbidity↗
PubMed1998

[Metastasis of kidney clear cell carcinoma to the thyroid cell in patients on renal replacement therapy].

The paper presents 2 cases of metastases of clear cell carcinoma of kidney into thyroid gland in patients on renal replacement therapy. In one patient after bilateral nephrectomy due to renal clear cell carcinoma (in 15 years time interval) and in second patient after left-side nephrectomy performed 16 years earlier and terminal right kidney insufficiency due to nephropathy with nephrotic syndrome for a year. In diagnosis essentials were: physical signs--palpable single node within the thyroid gland, earlier neoplastic anamnesis, cold node in scintigraphy, hypoechogenic node in ultrasonography of the thyroid gland, particularly with a rich vascular net within the node in power-doppler examination and, at last cytology of material from ultrasound-guided fine needle biopsy of the node. The diagnosis had been confirmed in intraoperative histopathological examination before the total thyroidectomy was performed.

Adenocarcinoma, Clear Cell↗
PubMed1998

[Current opinions about the etiology and pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). I. Selected genetic aspects and mechanisms of cyst formation].

The aim of this study is to present in the chronological order evolution of opinions about the etiopathogenesis of Autosomal Dominant Polycystic Kidney Disease (ADPKD), with the special regard to the newest genetic investigations. Prevalence of this disease is estimated at 1:1000, and patients with ADPKD compose up to 10% patients, who need renal replacement therapy. Since 1957, when inheritance was defined by Daalgard as autosomal dominant, a rapid progression in investigations of genetic aspects of this disease has been done. Actually three genes responsible for the development of the disease are known: PKD1 gene located on the short arm of the chromosome 16 (isolated and described in 1994-1995), PKD2 gene, which is located on the long arm of the chromosome 4 (isolated in 1996) and exceptionally occurs PKD3 gene which is not mapped by linkage analysis neither on the PKD1 nor the PKD2. Loci for PKD3 gene is unknown up to now. Investigations, which have been done indicate dependence between genetic type of ADPKD and clinical picture of the disease. Majority of authors consider ADPKD1 as the severe form of the disease, although it is not a rule. The biggest emphasis has been also lay on the influence of other factors. Pathomechanisms of cyst formation in kidneys, the presence of which is pathognomonic for this disease has been better and better understood. Employment of modern diagnostic methods with combinations of the genetic analysis (especially linkage analysis) afford possibilities for early diagnosis of the disease among persons, who are kindreds of ADPKD family members and are at risk of the disease.

Chromosomes, Human, Pair 16↗
PubMed1998

[Rhabdomyolysis: clinical features, causes, complications and treatment].

Rhabdomyolysis is a condition affecting body homeostasis that results from impaired supply of muscles with energy, nutritional factors and blood. Complex pathophysiological mechanism causes that extended myolysis may complicate different clinical conditions, such as: crush syndrome, excessive physical effort (work, seizures), toxic effect of drugs and toxins, water-electrolyte disturbances, congenital enzymatic deficiencies etc. It seems that on the cellular level, essential role is played by excessively high intracytoplasmatic calcium level, which affects metabolic processes. So high calcium level is a consequence of muscular cell injury irrespective to its reason. It manifests clinically as muscular weakness, pal and oedema and laboratory tests reveal elevated CK, GOT, GPT, aldolase and LDH levels as well as dark brown urine colour. Demonstration of elevated serum myoglobin level or its presence in urine directly confirms development of rhabdomyolysis. In unfavorable conditions, rhabdomyolysis may result in acute renal failure. Appropriately early and adequate water supply and alkalization plays an essential role in prevention of impairment in renal function. In advanced phase of renal failure, hemodialysis is a standard treatment.

Calcium↗
PubMed1998

[Can we prevent late complications of urinary tract infections?].

Urinary tract infections are one of the most common renal diseases sometimes leading to renal injury and in consequence to chronic renal failure. The most frequent causative pathogen responsible for this infection is Escherichia coli. There are several factors which increase the risk of infection including vesicoureteral reflux, cystic renal disease, urinary calculi, obstruction and other anatomical and functional abnormalities of urinary tract as well as neurological bladder dysfunction, long term indwelling catheters, mechanical vaginal diaphragms and intensive sexual intercourse. This paper will highlight general view on the treatment of different manifestations of urinary tract infections including asymptomatic bacteriuria, urethritis, cystitis, prostatitis as well as acute and chronic pyelonephritis. The details of those problems will be elucidated in another paper.

Adolescent↗
PubMed1998

[The usefulness of normalized protein catabolic rate (NPCR) and serum albumin concentration measurement for evaluation of clinical status in patients treated with continuous ambulatory peritoneal dialysis].

Malnutrition is a serious and common problem among patients dialyzed with peritoneal dialysis. Simple and reproducible methods of nutritional status assessment are needed for early problem identification to prevent and treat this complication. The aim of the present study was to evaluate the usefulness of albumin serum concentration and normalized protein catabolic rate (NPCR) derived from urea kinetic modeling session to assess the clinical status of ESRD patients treated with Continuous Ambulatory Peritoneal Dialysis (CAPD). Statistically significant, negative correlations between NPCR and hospitalization rate (r = -0.307; p < 0.05) and co-morbidity score (r = -0.429; p < 0.001) as well as statistically higher NPCR in the group of patients who survived the whole study period (0.82 vs. 0.74 in Non-Survivors; p < 0.01) support the value of this marker as an indicator of clinical status of peritoneal dialysis patients. Significant, negative correlations between serum albumin level and co-morbidity score (r = -0.379; p < 0.05), peritonitis rate (r = -0.359; p < 0.05) and hospitalization rate (r = -0.601; p < 0.005) were also found. Low absolute values of NPCR for the whole population as well as significant, positive correlations of this marker with dialysis adequacy parameters with concomitant lack of such correlations for albumin indicate, that NPCR as a nutritional marker should be interpreted with caution, and always regarded to the calculation method.

Adult↗
PubMed1997

[Results of treatment with continuous ambulatory peritoneal dialysis. One year observation].

Results of one-year dialysis adequacy monitoring in 20 patients treated with continuous ambulatory peritoneal dialysis with Baxter dialysis systems were presented. Relatively low mortality rate (10%), stable, within accepted range, peritonitis rate (1 episode per 16.4 patient-months), and high percentage of patients dialysed adequately (75%), let us to conclude, that CAPD may be a safe renal replacement therapy modality, which may be, in selected cases, an alternative method to hemodialysis.

Adult↗