Vnitřní lékařství, 2004 (vol. 50), issue 7
[C-reactive protein in diagnosis of complications in renal insufficiency and failure].
J Erben, V Panácek, J Procházka, H Stambergová
Vnitr Lek 2004, 50(7):497-502
C-reactive protein (CRP) is one of the positive proteins in an acute phase. It is produced in hepatocytes in response to cytokines activity, especially to IL-6. Its increase is the second biggest after significant bacterial and cardiovascular insults. It reaches its peak between 24 and 48 hours. CRP monitoring makes possible monitoring of the intensity of the pathologic process and to control efficiency of treatment measures according to fluctuation of its level. According to its serum values it can reflect a place of inflammation, e.g. in upper or lower airways, urinary tract etc. It helps to distinguish between bacterial and viral inflammations and...
[Continuous ambulatory peritoneal dialysis and respiratory pulmonary functions].
M Mydlík, J Stubna, S Tóth, K Derzsiová, A Molcányiová
Vnitr Lek 2004, 50(7):503-506
Acidobasic balance and respiratory pulmonary functions were examined in 15 patients with chronic renal insufficiency during continuous ambulatory peritoneal dialysis (CAPD) using a dialysis solution containing 1.5% or 2.5% of glucose. Patients did not suffer from any pulmonary disease nor ischemic heart disease. Biochemical indicators of acidobasic balance were in reference range or on its lower margin. Respiratory pulmonary functions were in tolerance except maximum expiratory flow volume at 50% and 25% of vital capacity (MEF50 and MEF25) and except diffusion lung capacity (DLCO) which were decreased. Decrease of maximum expiratory flow could be caused...
[A new method to estimate glomerular filtration rate based on serum concentration of creatinine, urea and albumin (MDRD, Modification of Diet in Renal Disease)].
O Schück, J Smrcková, V Teplan, P Stávek, J Skibová, M Stollová
Vnitr Lek 2004, 50(7):507-509
The equation developed from the MDRD (Modification of Diet in Renal Disease) study provides more accurate estimate of GFR than other commonly used equations. The aim of this study was to compare prediction of GFR based on MDRD and Cockcrof-Gault (CG) method. The study was performed in 111 patients (mean age 42 +/- 5 years) with chronic renal impairment (Scr = 281 +/- 83 micromol/l). The mean of MDRD was 0.480 +/- 0.345 ml/s/1.73 m2 and that of CG 0.608 +/- 0.336 ml/s/1.73 m2. The difference is highly significant (p < 0.0001). The mean of CG/MDRD ratio was 1.24 +/- 0.17. This ratio was significantly higher (p < 0.01) in obese patients (1.59 +/-...
[An importance of vitamin D metabolites assessment in patients with impaired renal function].
S Sulková, M Fortová, J Uhrová, T Zima
Vnitr Lek 2004, 50(7):510-518
The goal of this prospective multicentric study was to assess concentrations of vitamin D metabolites in patients with renal insufficiency and to monitor response of calcium phosphate metabolism parameters to a focused individualised therapy. The sample consisted of 184 patients, 66 of them were undergoing regular dialysis (Ccreat 0.11 +/- 0.05 ml/sec., age 57.6 +/- 16.6) and 118 patients were dispensed for renal insufficiency (Ccreat 0.42 +/- 0.23 ml/sec., age 60.8 +/- 11.0). After an assessment of basic parameters of bone metabolism (Ca, Pi, ALP) and parameters of acidobasic balance, calcidiol, calcitriol, and parathormon were assessed by radiation...
[Hemolytic-uremic syndrome].
K Bláhová
Vnitr Lek 2004, 50(7):519-525
Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in children below 3 years of age. It is defined by a triad of symptoms which associates hemolytic anemia with fragmented erythrocytes, thrombocytopenia and acute renal failure. Three types of HUS can be distinguished: typical HUS, also called diarrhoea-associated (D+HUS), very rare atypical HUS (D-HUS) and secondary HUS (drug induced, C+HUS, in patients receiving marrow transplantation, etc.). The common event among these entities appears to be vascular endothelial cell injury, which induces mechanical destruction of erythrocytes, activation of platelet aggregation and...
[Analysis and adjustment of acid-base disturbances according to the Stewart-Fencl principle].
K Matousovic, V Martínek
Vnitr Lek 2004, 50(7):526-530
In 1983, P. J. Stewart proposed a new approach for evaluation of acid-base balance of body fluids. He defined three independent variables responsible for hydrogen ion concentration in body fluids: 1. the partial pressure of carbon dioxide (pCO2); 2. strong ion difference, SID, i.e. the difference between the sums of all the strong (fully dissociated, chemically nonreacting) cations and sums of the strong anions; 3. the total concentration of all the non-volatile weak acids (mainly albumin) designated as [Atot]. On the basis of this theory, V. Fencl invented a new classification of clinical acid-base disturbances. Respiratory acidosis and alkalosis...
[Renoprotective effects of antihypertensives].
V Monhart
Vnitr Lek 2004, 50(7):531-536
A characteristic feature of a majority of chronic renal diseases is their progressive course. The speed of deterioration of renal function depends besides an aetiology of a primary disease on the level of systemic (and glomerular) blood pressure and a degree of proteinuria. Angiotensin II plays an important role in the use of hemodynamic and nonhemodynamic factors of progression. Inhibitors of angiotensin converting enzyme or angiotensin antagonists comparable with other hypertensives used in blood pressure control have more substantial renoprotective effects both in diabetic and nondiabetic kidney diseases. A prerequisite of an effective renal protection...
[Vitamin D: synthesis, metabolism, regulation, and an assessment of its deficiency in patients with chronic renal disease].
V Spustová, R Dzúrik
Vnitr Lek 2004, 50(7):537-543
The main source of vitamin D in a man is its synthesis in human skin. 7-Dehydrocholesterol converts into cholecalciferol--vitamin D3--as a result of UV radiation. Cholecalciferol hydroxylates in liver into 25-hydroxyvitamin D3 [25(OH)D, calcidiol], which concentration in blood is a relevant indicator of the total of vitamin D in a human body. 25(OH)D hydroxylates in kidneys into 1,25-dihydroxyvitamin D3 [1,25(OH)2D, calcitriol], which is considered an active metabolite of vitamin D. Epidemiological studies showed high prevalence of low concentrations of 25(OH)D especially in older population and people with chronic diseases. 25(OH)D concentrations...
[Overweight and obesity--risk factors in the development and progression of renal disease].
K Sebeková, A Klassen, U Bahner, A Heidland
Vnitr Lek 2004, 50(7):544-549
Overweight/obesity represent an underestimated risk factor of renal disease. The incidence of obesity-related glomerulopathy (ORG) tremendously increased within the last decade. The first sign of renal damage in overweight conditions is microalbuminuria or proteinuria, indicating the potential risk of its progression to renal insufficiency and the development of premature cardiovascular events. In the early stage of obesity renal hemodynamics are characterized by a renal hypercirculation and glomerular hyperfiltration, particularly in the presence of hypertension. The hyperfiltration is especially harmful in patients with pre-existing inflammatory...
[Present opinions on use of ketoanalog essential aminoacids in a conservative treatment of chronic renal insufficiency].
V Teplan, O Schück, M Stollová
Vnitr Lek 2004, 50(7):550-555
Conservative treatment implies procedures which involve normalization or improvement of metabolic disorders in chronic renal insufficiency and failure by medicamentous and dietary means. Keto amino acids administration can remarkable influence protein synthesis, metabolic acidosis, Ca-P and PTH levels, carbohydrate and lipid disorders, but has no effect on hyperfiltration. Long-term co-administration of rHuEPO and keto amino acids in CRF patients on LPD has accelerated metabolic effect associated with a delay in progression of renal failure and reduction of proteinuria. Also, concomitant administration of ACE inhibitors and angiotensin II AT1 receptor...
[Results of proteomic-based study of the kidney, urine, plasma, and uremic ultrafiltrate. Potential applications of the results in nephrology].
K Opatrný
Vnitr Lek 2004, 50(7):556-563
Proteomics, a new branch of science studying proteins, only emerged in the postgenomic period. What makes so it important is that fact even the exciting recent insights into the genome have not furnished sufficient information about proteins, which are the main agents behind cellular, subcellular, and supracellular functions. The center of attention of proteomics is identification of proteins in complex protein mixtures with an emphasis on the identification of a large number of proteins at a time, search for interrelations between identified proteins, their more exact characterization, determination of quantity, and better understanding of their function....