Przemyslaw Szyber

Publications (2)4.49 Total impact

• Article: Superficialization of the radial artery - an alternative secondary vascular access.

  Waclaw Weyde, Mariusz Kusztal, Tomasz Golebiowski, Krzysztof Letachowicz, Waldemar Letachowicz, Ewa Watorek, Katarzyna Madziarska, Magdalena Krajewska, Przemyslaw Szyber, Dariusz Janczak, Marian Klinger
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  ABSTRACT: Purpose: The standard approach in patients with a clotted arteriovenous fistula (AVF) on the forearm is the creation of another vascular access on the arm using the patient’s own vessels or a prosthetic graft. Here we propose another option as secondary angioaccess for chronic hemodialysis (HD): superficialization of the radial artery. Methods: Indications for the procedure were 1) long-standing forearm AVF that has irreversibly clotted and/or central vein stenosis resistant to angioplasty; 2) patients who have no other prospect for forearm or even brachial AVF. The procedure was undertaken in 7 chronic HD patients dialyzed by forearm AVF for 27±26 months. Results: In one case the superficialization was abandoned intra-operatively due to small diameter of the artery (<4 mm). Five of 6 elevated arteries were patent and the follow-up period ranges from 11 to 15 (median 12) months. In 1 male patient with prothrombin G20210A mutation the artery clotted after 13 months of usage. Conclusions: Superficialized radial artery was successfully used for hemodialysis over one year. The only prerequisite for safe repeated puncture is a patent and enlarged radial artery. Due to avoidance of arteriovenous shunt this access type may be particularly suitable for patients with cardiac failure.
  The journal of vascular access 05/2012; · 1.09 Impact Factor
• Article: The increased risk of post-transplant diabetes mellitus in peritoneal dialysis-treated kidney allograft recipients.

  Katarzyna Madziarska, Waclaw Weyde, Magdalena Krajewska, Dariusz Patrzalek, Dariusz Janczak, Mariusz Kusztal, Hanna Augustyniak-Bartosik, Przemyslaw Szyber, Cyprian Kozyra, Marian Klinger
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  ABSTRACT: Post-transplant diabetes mellitus (PTDM) is a common metabolic complication in kidney allograft recipients, significantly contributing to the elevated cardiovascular morbidity after renal transplantation and increased risk of chronic transplant dysfunction. The aim of the present investigation was to evaluate the factors influencing PTDM development. Under particular consideration were the elements, existing before the transplantation, especially the modality of dialysis treatment significance, i.e. haemodialysis (HD) versus peritoneal dialysis (PD). Three hundred and seventy-seven consecutive outpatients who underwent renal transplantation (RTx) in our institution between January 2003 and December 2005 were analysed. PTDM was diagnosed according to the current American Diabetic Association/World Health Organization criteria. Statistical inference was conducted by means of univariate methods (one factor versus PTDM) and multivariate methods in frames of generalized linear model. In the study group, 72 patients (23.4%) developed PTDM after RTx (55 HD and 17 PD patients). PTDM incidence at 3, 6 and 12 months was 15.9%, 22.1% and 23.4%, respectively. The mean interval from transplantation to the onset of PTDM was 3.08 ± 2.73 months. In univariate analysis, the factors associated with the elevated risk of PTDM appearance were older recipient age, positive family history of diabetes, hypertensive nephropathy as end-stage renal disease cause, higher body mass index at transplantation, treatment by PD, and the graft from an older donor. In multivariate verification, statistical significance remained: older recipient age (P < 0.001), positive family history of diabetes (P = 0.002), and treatment by PD (P = 0.007). Treatment by PD appears to be a possible novel factor, not yet reported, which may increase the risk of PTDM development.
  Nephrology Dialysis Transplantation 04/2011; 26(4):1396-401. · 3.40 Impact Factor