PubMed Health⌕ Search

Biomedical subjects

W Sułowicz

Publications and source records attributed to W Sułowicz.

At least 55 records · Page 3Linked to original sources

[Etiology and pathogenesis of urolithiasis].

For ages nephrolithiasis has been a widespread disease and clinical statistics prove that its morbidity index is still increasing, thus it becomes a social problem. Peak morbidity usually occurs at the age between 30 and 40, that is why many patients professionally active and creative have to leave their jobs for a long period. In contrast to earlier years, frequency of the disease occurrence in females is systematically increasing and nowadays it is only slightly lower from that in males. Etiology and pathogenesis of the disease is also not entirely explained. It is generally accepted that urinary stone formation is determined by multiple factors which affect first of all chemical composition and physical features of urine. Individual properties of the kidneys and urinary tract and infections especially with urease producing pathogens as well as environmental factors are also taken into account. The most favourable circumstances for nephrolithiasis occurrence is co-existence of all these factors.

Adult↗

[Diagnosis, prophylaxis and treatment of urolithiasis].

Urolithiasis is a disease with complex and not fully explained etiology and pathogenesis. In its development there play role multiple factors, such as individual features of the kidneys and urinary tract, co-existing infections with urease-producing pathogens and environmental factors. Advance in the field of organ imaging has enabled development of new harmless diagnostic procedures that allowed for fast diagnosis, and current methods of treatment (USR, PCNL and ESWL) have significantly limited the number of surgical procedures performed because of urolithiasis. Introduction of these treatment methods markedly disturbed used for a long time scheme of management and in many cases it limited invasiveness of the treatment and shortened hospitalisation time. Unfortunately, not all urology departments in Poland have access to the newest methods of treatment, thus a percentage of patients treated with traditional methods is still high. Used nowadays methods of diagnosis and treatment have not fully solved a problem of urolithiasis metaphylaxis, and urolithiasis still remains a serious disease that requests close cooperation of the patients, nephrologist and urologist.

Humans↗

[Activity of cathepsin B and collagenase in urine and excretion of fibronectin and TGF-beta 1 in urine of patients with membranous glomerulonephritis].

In 30% cases nephrotic syndrome is due to membranous glomerulonephritis (MG). Fifty percent of patients reveal end stage renal disease in 15 years follow-up. The another 50% gain persistent remission. The pathogenesis of disease is not known. Protein accumulation in glomeruli leads to progressive loss of kidney structure and function in MG. Also the role of tissue proteolytic systems and growth factors in this process is not known. We aimed to estimate urine cathepsin B, collagenase activity and urine excretion of TGF-beta 1 and fibronectin in MG. MG patients revealed increased urine cathepsin B activity (10.58 +/- 8.73 pmol AMC/mg creatinine/min. vs. control 7.11 +/- 2.05 pmol AMC/mg creatinine/min. [p < 0.05]), urine collagenase activity (8.59 +/- 4.26 pmol AMC/mg creatinine/min. vs. control 3.84 +/- 2.09 pmol AMC/mg creatinine/min. [p > 0.02]) and increased urine excretion of fibronectin (214 +/- 335 ng/mg creatinine vs. control 12.7 +/- 6.7 ng/mg creatinine [p < 0.05]) and increased urine excretion of TGF-beta 1 (283.55 +/- 248.13 pg/ml vs. control 36.11 +/- 48.01 pg/ml [p < 0.05]). The results indicates on glomerular overproduction of TGF-beta 1 and urinary leak of proteolytic enzymes which may exacerbate glomerular proteolytic activity in MG. This may lead to glomerular protein accumulation and progressive loss of kidney function and structure in MG. Increased urine fibronectin excretion in MG patients seems to confirm the hypothesis.

Adult↗

[Selected renal complications during the course of multiple myeloma].

Multiple myeloma is the most frequent dysproteinemia leading to nephropathy. The aim of the study was to analyse this complication in patients treated in nephrological departments. The study was performed in 83 patients (45 M, 38 F) aged 47-82 years in whom a diagnosis of multiple myeloma was based on clinical manifestation (weakness, subfebrile states, bone aches, loss of body weight, recurrent infections of urinary and respiratory tracts), increased number of plasmocytes in bone-marrow, presence of monoclonal protein in serum and/or urine and lesions in bone system. In a significant number of the studied patients the disease was revealed while diagnosing proteinuria as well as searching for a reason of elevated erythrocyte sedimentation rate or proteinogram abnormalities. The obtained results indicate that signs of nephropathy in the course of multiple myeloma may be the first visible symptoms of the disease. Proteinuria was observed in 79.5% of the studied patients. Bence-Jones protein was found in 41% of individuals and features of renal failure in different stages of development in 67%. Dialysis therapy was started in 3 patients with acute and 7 patients with chronic renal failure.

Aged↗

[Surgical treatment of secondary hyperparathyroidism in patients treated with renal replacement].

Between January 1990 and July 1997, in 15 maintenance dialyzed patients and in 3 patients after renal transplantation manifesting hyperparathyroidisms surgical treatment was performed. The diagnosis was based both on the estimation of serum PTH level, total and ionised calcium, phosphates, alkaline phosphatase and imaging procedures: ultrasonography and 99-mTc subtraction scintigraphy. Indications to surgical treatment included ailments like generalized prurigo, bone and joint pains and muscular weakness with no response to pharmacological treatment. The commonly used procedure was subtotal parathyroidectomy (94%), its extent, however, was in each case determined during surgery, depending on the quantity and size of parathyroid glands found. In all cases the immediate intraoperative histopathological examination of the resected tissues was performed. In 10 patients resection of the thyroid gland tissues was carried out because of goiter (56%), among them in 1 case occult papillar carcinoma was found in histopathological examination. In the postoperative period 4 patients (22%) manifested transient hypocalcemia with good response to pharmacological treatment. Good results of surgical treatment reflected by both ailment relief and normalization of serum PTH and phosphates were obtained in 16 patients (89%). In 2 patients (11%) the ailments subsided but did not completely disappear. Surgical treatment of secondary hyperparathyroidism by subtotal parathyroidectomy is efficacious and entails a low risk of complications.

Adolescent↗

Ethylene glycol acute poisoning treatment results in Kraków in the years 1990-1994.

An analysis of ethylene glycol acute intoxication treatment results was performed in a group of 36 patients hospitalized within a five year period. Mean serum and urine glycol concentrations in the analyzed population ranged from 0-851 mg/dl (mean = 130 mg/dl) and from 12.4 to 930.0 mg/dl (mean 333 mg/dl), respectively. At the time of admission to the clinic 15 of 36 patients were deeply unconscious and mean acid-base balance values were as follows: pH 6.99, pCO2 16.7 mmHg, pO2 140.1 mmHg, HCO3 6.36 mmol/l, BE -29.6 mmol/l. Because of respiratory failure 21/36 patients (58.3%) required controlled ventilation and 24/36 (66.7%) underwent dialysis. Sixteen patients (44.4%) developed acute renal failure. Mean hospitalization period was 16 days (1-53). Eighteen patients (50%) died. The direct death mechanism in 15 patients (83.3%) was asystolia and in the remaining individuals other circulatory disturbances. The main reasons of high mortality rate were multiple organ damages secondary to severe metabolic acidosis.

Acid-Base Imbalance↗

[Selected aspects of organ transplantation].

Problems of replacement therapy with special attention (regards) to renal transplantation and selected aspects of other organ transplantation were presented. Introduced during the lecture information was updated based on enclosed literature.

Humans↗

[Use of urea kinetic modeling for evaluating the efficacy of reusing capillary dialyzers].

The aim of the study was to evaluate the influence of follow fiber dialyzers reprocessing procedure on urea kinetic modeling parameters, dialysis effectiveness for small molecules and effective clearance/predicted clearance ratio. Fifty patients (27 F, 23 M) aged 18-61 years (mean 47) being on maintenance hemodialysis due to end stage renal failure for 4-136 months were included into the study. Patients were treated 3 times a week with blood flow 160-290 ml/min and dialysate flow 500 ml/min. The dialysis time was calculated individually based on urea kinetic modeling parameters. Reprocessing of dialyzers was performed using Renatron RS 8300 and Renalin as sterilized agent. Dialysers with ppr below 80% were excluded from the use. Mean values of dialysis index Kt/V, TAC and dialysis effectiveness (Ct/C0) for urea, creatinine, uric acid and kalium as well as values of effective/predicted clearance ratio for consecutive reprocessing procedures were compared with the results obtained for the new dialyzers. There was no significant influence of reprocessing procedure on Kt/V, TAC and Ct/C0 for tested substances and studied clearances. The obtained results indicates that dialysers reprocessing procedure performed according to the described protocol was safe and didn't decrease dialysis effectiveness.

Adolescent↗

Effect of having a functioning cadaveric renal transplant on cardiovascular mortality risk in patients on renal replacement therapy.

Our aim was to estimate the effect of having a functioning cadaveric renal transplant on the risk of cardiovascular and total mortality in patients on renal replacement therapy (RRT). We retrospectively studied (by the Cox proportional hazards regression model) 195 subjects who began RRT with maintenance dialysis in our centre from 1 January 1978 to 31 December 1991. Out of this number, 76 patients received a cadaveric kidney transplant. Cardiovascular abnormalities at the onset of RRT were the principal independent determinant of both total and cardiovascular mortality risk. As compared to patients on dialysis with the same duration of RRT, patients with a functioning renal transplant for more than 1 year had a significantly lower total mortality risk (mean relative risk (RR): 0.48 (0.25-0.91) (95% confidence limits in parentheses), P = 0.03), an effect whose significance disappeared after adjustment for pretreatment conditions (RR = 0.62 (0.30-1.30), P > 0.3). However, the beneficial effect of a functioning renal transplant for more than 1 year on cardiovascular mortality risk was significant, both before (RR = 0.21 (0.06-0.74), P = 0.02) and after the adjustment for pretreatment conditions (RR = 0.32 (0.11-0.90), P = 0.035). During the first year after a successful transplantation the beneficial effect of having a functioning transplant on cardiovascular mortality risk was only weakly attenuated. During RRT a functioning cadaveric renal transplant decreases cardiovascular mortality risk partially independently of the better pretreatment status of the patients selected for transplantation.

Adult↗

[Resistance to rHuEPO].

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

[Preliminary results of treating patients with chronic renal failure with the help of CAPD].

This study is the preliminary review of the above 2 year period of treatment of patients with chronic renal failure being on CAPD in our center. The study was performed in 14 patients during the cumulative period of 192 patient-months. The analysis of infectious and non-infectious complications was conducted, and patients were also monitored in terms of quantitive measurements of dialysis adequacy and nutritional status using such parameters like total Kt/V (urea), total Weekly Creatinine Clearance (tWCC), normalized protein catabolic rate (npcr) and serum albumin level. We also analysed the influence of residual renal function (RRF) on these parameters and relationships between them. During the study period we observed 7 episodes of peritonitis with the medium rate of 1 episode per 24.7 patient-months. Six of them were treated succesfully conservatively, but in one case catheter removal was necessary because of uneffective farmacological therapy. We also observed two episodes of exist site infection (ESI), one treated finally by catheter replacement. Two technical problems also occurred: leakage into abdominal wall and through the catheter tunnel. During the observation period all patients remained alive, although one was transfered to HD after 14 months of CAPD (earlier 4 months on manual IPD) because of lack of adequacy and severe peritonitis. Obtained results of nutritional status indicate, that 50% of patients were malnourished in terms of npcr and 35.7% in terms of serum albumin level. Seven of 14 patients were adequately dialysed acording to Kt/V, 9 according to tWCC.

Adult↗

[Use of urea kinetic modeling in patients on maintenance hemodialysis].

The effect of urea kinetic modeling (u.k.m.) application on dialysis efficiency and metabolic status was evaluated in 50 maintenance dialyzed patients. U.k.m. sessions were performed once a month based on the self-developed computer program to control dialysis. The dialysis index (Kt/V), the time averaged concentration (TAC), protein catabolic rate (pcr) and dialysis effectiveness (Ct/Co) were evaluated and the results obtained at the beginning and after 2, 4, and 8 months of the study were compared. Kt/V had risen significantly in the modeled patients from 1.04 to 1.24 and was accompanied by 12% Ct/Co increase of urea removal after 8 months. The tendency of the moderate (non significant) decrease of TAC from 54.57 to 52.48 mg% BUN was observed during the study. According to the NCDS criteria the percentage of adequately dialyzed patients increased from 42% at the beginning to 64% after 80 months; underdialyzed patients decreased from 16% to 6% and malnourished also from 16% to 6%, respectively, after u.k.m. application. Dialysis effectiveness for creatinine and uric acid described by Ct/Co for the above after 4 and 8 months was significantly increased when compared with the results obtained at the beginning of the study. These results indicate that u.k.m. application allowed to take control over uremic toxemia and improved dialysis adequacy in patients on maintenance dialysis. Protein catabolic rate in studied patients increased from 1.18 to 1.24 g/kg/per day during the study and it was accompanied by a total blood protein and serum albumin increase. This could indicate improvement of the nutritional status of dialyzed subjects.

Adolescent↗

Influence of prostacyclin infusion on haemodialysis efficiency and blood cells.

Dialysis efficiency, platelet and leukocyte counts, as well as malonyldialdehyde (MDA) level and lactate dehydrogenase (LDH) activity in serum were assessed in 10 patients (8 males, 2 females, aged 28-58 years) treated with repeated haemodialysis due to terminal renal failure. Patients were examined twice: during a 4-hour haemodialysis in the presence of heparin as the anticoagulant, and a week later in the course of another haemodialysis combined with infusion of heparin and prostacyclin. Statistically significant lower level of urea at the end of dialysis and significantly higher urea clearance were found during haemodialysis with prostacyclin-heparin infusion in comparison with infusion of heparin alone. As compared with the initial values obtained prior to dialysis, neutropenia and thrombocytopenia were observed during haemodialysis with heparin alone but the counts remained generally unaltered when both prostacyclin and heparin were administered. During and after haemodialysis with heparin and prostacyclin both MDA level and LDH activity were lower than in case of haemodialysis with heparin alone.

Adult↗

[Occurrence of antibodies against hepatitis C virus (anti-HCV) in patients on long-term hemodialysis].

The prevalence of anti-HCV antibodies, HBs antigenemia and transaminase level were examined in the 136 patients with chronic renal failure on maintenance hemodialysis, treated in dialytic centers of South Poland. In this group anti-HBs and anti-HBc antibodies were also investigated in 60 and 42 patients respectively. Anti-HCV antibodies were present in 16.7-60.0% (mean = 44.1%) of patients depending on the center. These values considerably exceed the percentage of antigen HBs positive patients but they are lower that the percentage of anti-HBs and anti-HBc positive patients.

Adolescent↗

[Results of the treatment of acute renal failure in 3 selected dialysis units in southern Poland 1981-1990].

The results of the treatment of patients with acute renal failure (ARF) in dialysis units of Kraków, Nowy Sacz and Tarnów were estimated on the basis of prepared questionnaire. The increased number of patients treated because of ARF was demonstrated in the successive years of the study. The mortality rate in the tested group of patients remained about 27%. It depended on the cause of ARF and equalled to 26.7% in medical, 36.7% in surgical, 8% in obstetrical and 6.7 in urological patients, respectively.

Acute Kidney Injury↗