ABSTRACT: Insulin resistance was an independent predictor of cardiovascular mortality in uremic patients without diabetes. Rosiglitazone (ROS) improves insulin sensitivity in the liver, muscle, and adipose tissue. We prospectively investigated the effects of ROS on cardiac functions by standard (SDE) and tissue Doppler echocardiography (TDI) in continuous ambulatory peritoneal dialysis (CAPD) patients.
A total of 24 CAPD patients (13 males, 11 females; mean age 42.2 +/- 14.8 years) were included. Routine blood samples were examined. Left and right ventricular functions were assessed, and myocardial performance index (MPI) was calculated by SDE and TDI at baseline and after 12-month ROS therapy. Left and right atrial volumes were measured and indexed to body surface area.
When compared with baseline, after 12 months of ROS treatment, it was shown that early (E) and late (A) diastolic velocities of atrioventricular valves, E/A ratio, mitral E-wave deceleration time (DT), isovolumetric relaxation time (IVRT), and MPI were similar (p > 0.05). Also, no significant changes were detected in LV dimensions, LV mass index, LVEF, LA volume index, or RA volume index measured by SDE before and after ROS therapy (p > 0.05). Left and right ventricular function parameters measured by TDI including Sm, Em, Am, Em/Am ratio, E/Em ratio, and MPI were similar.
It was found that there was no negative effect of long-term ROS therapy on cardiac functions measured by SDE and TDI in CAPD patients.
Renal Failure 01/2009; 31(6):464-9. · 0.82 Impact Factor
ABSTRACT: Thrombotic thrombocytopenic purpura–hemolytic uremic syndrome (TTP/HUS) is a multisystem disorder characterized by consumptive
thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, renal function abnormalities, and fever. Coexistence
of TTP/HUS and adult onset Still’s disease (ASD) is extremely rare. We report the case of a 46-year-old woman who presented
with fever, arthritis, myalgias, petechia on skin and confusion fiveyears after the onset of ASD. Thrombocytopenia, renal
failure, marked elevation lactate dehydrogenase, and red cell fragmentation on peripheral blood smear were observed. We made
a diagnosis of TTP/HUS associated with ASD, according to physical examination and characteristic laboratory data. She recovered
from the TTP/HUS following daily sessions of therapeutic plasma exchange with fresh frozen plasma replacement and glucocorticoid
therapy. Awareness of the possible development of TTP/HUS in ASD is important for early diagnosis and treatment.
Modern Rheumatology 07/2008; 18(4):403-406. · 1.58 Impact Factor
Annals of Pharmacotherapy 08/2007; 41(7):1319-20. · 2.13 Impact Factor
Renal Failure 02/2007; 29(6):777-8. · 0.82 Impact Factor