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Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences 12/2008; 29(2):9-11.
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ABSTRACT: Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression to terminal renal failure. Diagnostic criteria for BEN have been described more than 40 years ago. Research groups on BEN use one of at least three described lists of criteria. Comparison of studies using such criteria is difficult, and a recent meeting of investigators (Zagreb, October 2006) has suggested that unified criteria have to be elaborated. In this paper, an International Panel of BEN Investigators agreed on criteria appropriate to epidemiologic studies and clinical investigations of BEN. A screening procedure of BEN in endemic settlements is proposed.
Renal Failure 02/2007; 29(7):867-80. · 0.82 Impact Factor
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Aleksandar Sikole,
Pavlina Dzekova,
Nexhmi Selja,
Magdalena Gaseva,
Igor G Nikolov,
Mustafa Zabzun,
Sheriat Muharemi,
Arben Asani,
Vili Amitov,
Sami Mena,
Violeta Grunevska,
Ljubomir Ivanovski, Momir Polenakovic
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ABSTRACT: The high prevalence of hepatitis C virus (HCV) infection in hemodialysis patients is of great concern because they have a higher rate of mortality than HCV-negative hemodialysis patients. The aim of the study was to evaluate the efficacy and safety of pegylated interferon alpha-2a monotherapy in hemodialysis patients with chronic HCV infection.
Fourteen dialysis patients with chronic HCV infection were scheduled to receive 135 mug pegylated interferon alpha-2a subcutaneously, once a week, after dialysis session for a period of 48 weeks. Efficacy and safety were assessed by end of treatment viral response, sustained viral response, biochemical response, and adverse events. Serum HCV RNA levels were assessed using reverse transcriptase polymerase chain reaction (RT-PCR), while HCV genotype was analyzed by RT-PCR followed by hybridization of amplified products.
Of the 14 patients enrolled in the study, 9 completed treatment. Eight patients (57%) had undetectable levels of HCV RNA at the end of treatment, while one patient remained positive. Two (14.3%) patients were discontinued because of insufficient therapeutic response. Three patients (21.34%) did not finish treatment because serious adverse events occurred: one patient with bronchopneumonia and one with pericarditis were discontinued from treatment, while one patient died due to cerebral hemorrhage. Sustained viral response was present in 36% of the patients (5/8 patients) at the end of the follow up period. Biochemical response with normalization of serum ALT levels during treatment was observed in all treated patients (83 +/- 20.1 U/L at baseline vs. 23.4 +/- 4.6 U/L at week 48). The most common adverse events were flu-like syndrome, myalgia, arthralgia, and pancytopenia. Most of the adverse events were manageable. The serious adverse events were believed to be unrelated to the therapy, but rather to the co-morbidities of the hemodialysis patients.
Pegylated interferon alpha-2a treatment was effective in a considerable proportion of the treated hemodialysis patients with hepatitis C, and it was reasonably safe to use.
Renal Failure 02/2007; 29(8):961-6. · 0.82 Impact Factor
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ABSTRACT: The appearance of soft tissue calcifications in patients with chronic renal failure has been recognised as one of the serious complications of uremia. An elevated serum calcium-phosphate product has almost invariably been detected, although the exact mechanisms of precipitation are still not fully understood. Among the factors responsible for triggering the precipitation process are: hyperphosphatemia, secondary hyperparathyroidism, hypercalcemia, treatment with vitamin D3, etc. Phosphate binders have been used to prevent, among other things, soft tissue calcifications, and parathyroidectomy has most frequently been applied as the therapy of choice, once precipitation of calcium salts has occurred. We present a case of soft tissue calcifications in the gluteal regions of a chronic haemodialysis female patient. The therapy we chose was a combination of biphosphonate and deferoxamine. The patient was treated for two months. The regression of the soft tissue calcifications was very significant, as registered both clinically and radiologically. The exact mechanism by which this reversal was achieved needs further investigation.
Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences 08/2006; 27(1):145-50.
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ABSTRACT: Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression to terminal renal failure. Evidence has accumulated that BEN is an environmentally induced disease. There are three actual theories attempting to explain the environmental cause of this disease: (1) the aristolochic acid hypothesis, which considers that the disease is produced by chronic intoxication with Aristolochia, (2) the mycotoxin hypothesis, which considers that BEN is produced by ochratoxin A, and (3) the Pliocene lignite hypothesis, which proposes that the disease is caused by long-term exposure to polycyclic aromatic hydrocarbons and other toxic organic compounds leaching into the well drinking water from low-rank coals in the vicinity to the endemic settlements. Moreover, it was suggested that BEN risk is influenced by inherited susceptibility. Therefore, it has been expected that molecular biological investigations will discover genetic markers of BEN and associated urothelial cancer, permitting early identification of susceptible individuals who may be at risk of exposure to the environmental agents. Since kidney pathophysiology is complex, gene expression analysis and highly throughput proteomic technology can identify candidate genes, proteins and molecule networks that eventually could play a role in BEN development. Investigation of gene-gene and gene-environment interactions could be the content of further studies determining the precise risk for BEN.
American Journal of Nephrology 02/2006; 26(1):1-11. · 2.54 Impact Factor
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Nephrology Dialysis Transplantation 01/2004; 18(12):2684-5. · 3.40 Impact Factor
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Nephrology Dialysis Transplantation 07/2003; 18(6):1233-4. · 3.40 Impact Factor
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ABSTRACT: A 5-year-old boy was investigated after an episode of gross hematuria of non-glomerular origin and was found to have idiopathic hypercalciuria. Despite normalization of calciuria he had recurrent attacks of gross hematuria. Since SDS-PAGE analysis of urinary proteins indicated a glomerular origin of hematuria, a renal biopsy was performed and revealed IgA nephropathy. We believe that association of hypercalciuria and IgA nephropathy is by chance, since both are frequently found in children with hematuria. Also, we recommend all children with well-controlled hypercalciuria who experience further attacks of gross hematuria be evaluated for glomerular disease.
Pediatric Nephrology 05/2003; 18(4):394-6. · 2.52 Impact Factor
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ABSTRACT: The high cardiac output state is considered a major factor for occurrence of left ventricular hypertrophy (LVH). Increased left ventricular mass is a powerful predictor of morbidity and mortality. We analyzed morphologic changes of the heart in dialysis patients during treatment with erythropoietin (EPO) and after cessation of therapy. Fourteen hemodialysis patients were treated with EPO for 1 year. They were above age 18, dialyzed 3 times per week, and with a hematocrit below 28 vol%. EPO was given subcutaneously, at a dose of 20 U/kg body weight 3 times per week, before each hemodialysis session. Anemia was corrected and hematocrit maintained between 30 and 35 vol%. When this part of the study was completed, EPO was stopped in all 14 patients. Echocardiography was performed three times: at baseline, at 12 months of therapy, and 1 year after EPO cessation. Mean hematocrit of the group at these 3 time intervals was 23.78 +/- 2.11 vol%; 33.14 +/- 1.95 vol%; and 25.93 +/- 5.23 vol%, respectively (mean +/- SD). The following echocardiographic changes occurred. End-diastolic volume decreased from 134.8 +/- 25.4 to 113.2 +/- 26.4 ml and increased back to 136.2 +/- 46.2 ml. Left ventricular mass decreased from 296.6 +/- 62.4 to 225.2 +/- 52.7 g and increased again to 311.7 +/- 106 g. Cardiac output decreased from 7,295.8 +/- 2,166.9 to 5,816.4 +/- 1,216.2 ml/min and increased to 6,803.2 +/- 1,646.5 ml/min. Total peripheral resistance increased from 1,360.8 +/- 428 to 1,691.3 +/- 326 and decreased again to 1,242.8 +/- 303.3 dyne x s/cm5. All these changes were significant. Mean arterial pressure increased from 114.7 +/- 13.9 to 119.3 +/- 13.8 mm Hg and decreased to 100.5 +/- 9.3 mm Hg. LVH could be affected severely by the degree of anemia in uremics and was reversible.
Artificial Organs 03/2002; 26(2):98-102. · 2.00 Impact Factor
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ABSTRACT: Mesangial glomerulonephritis is uncommon histopathological pattern as a part of primary glomerular diseases. 64 (6.6%) patients of 968 non-transplant renal biopsies done at our department presented pure mesangial glomerulonephritis, without evidence of IgA nephropathy or systemic disorders. 22/64 (34.7%) of the patients presented with nephrotic syndrome, 12 were male, 10 female, aged 33.32 +/- 3.14. All of them were treated with steroids, 3/22 revealed complete remission, 4/22 partial remission and 6/22 did not respond to steroids, and later combined therapy with cyclophosphamide and cyclosporine. They developed end-stage renal failure within 4-8 years. 42/64 (65.3%) patients, 26 male, 16 female, aged 32.29 +/- 1.74 presented with erythruria and non-nephrotic proteinuria. Because of the absence of nephrotic syndrome only anti-hypertensive treatment was performed in this group of patients if necessary. One patient died because of hypertension complication (intracranial hemorrhage), two developed end-stage renal failure follow-up of 12 and 6 years.
Renal Failure 02/2002; 24(1):59-68. · 0.82 Impact Factor
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ABSTRACT: A four-year old boy was admitted to the hospital due to acute thrombocytopenic purpura. Three days later he developed edema, hematuria and hypertension. The diagnosis of acute poststreptococcal glomerulonephritis was based upon the evidence of previous sore throat, hypocomplementemia and increased antistreptolysin O titer. Renal biopsy was contraindicated due to throbocytopenia. An extensive work-up was done to exclude mebranoproliferative glomerulonephritis and systemic diseases such as hemolytic uremic syndrome or systemic lupus erythematosus. The clinical outcome of the nephritis and thrombocytopenia was excellent in respect to both conditions. To the best of our knowledge concurrent occurrence of acute thrombocytopenic purpura and poststreptococcal glomerulonephritis is very rare; there are only four similar cases reported in the literature. A careful work-up and follow-up are mandatory to exclude systemic disease.
The Turkish journal of pediatrics 45(2):148-51. · 0.44 Impact Factor
