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- Hoppe, K, et al.
(författare)
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Cardiac Troponin T and Hydration Status as Prognostic Markers in Hemodialysis Patients
- 2015
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Ingår i: Blood purification. - : S. Karger AG. - 1421-9735 .- 0253-5068. ; 40:2, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to assess cardiac troponin T (cTnT) and hydration state as cardiovascular (CV) risk markers in hemodialysis (HD) patients. Two hundred and forty one patients were divided according to HD vintage into two groups: SV (HD ≤24 months) and LV. Water balance was assessed with overhydration (OH%; bioimpedance analysis) and daily diuresis (DD); CV dysfunction with cTnT and heart ultrasound; nutrition with subjective global assessment (SGA), cholesterol (TC) and albumin. SV had lower OH% (2.8 vs. 3.5, p < 0.05) and higher DD (1,161 vs. 637 ml, p < 0.001), while LV had higher cTnT (0.1 ± 0.04 vs. 0.1 ± 0.07 ng/ml, p < 0.05) and lower interventricular septum thickness (IVS; 13.4 vs. 14.5 mm, p < 0.05). Nutritional state as reflected by lower TC was worse in LV (184.7 vs. 169.5 mg/dl, p < 0.05). Mortality was higher in patients in the LV group (15 vs. 27 deaths, p < 0.05). OH% correlated inversely with albumin (r = -0.36, p < 0.001), TC (r = -0.31, p < 0.001) and cTnT (r = -0.4, p < 0.001). cTnT correlated positively with IVS (r = 0.39, p < 0.001), SGA (r = 0.23, p = 0.001) and mortality rate (r = 0.21, p < 0.01), and negatively with DD (r = -0.34, p < 0.001) and albumin (r = -0.25, p < 0.001). Longer dialysis vintage associates with CV dysfunction, overhydration and increased mortality, which may be predicted with OH% and cTnT. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=376603.
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- Pawlaczyk, K, et al.
(författare)
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Animal Models of Peritoneal Dialysis: Thirty Years of Our Own Experience
- 2015
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Ingår i: BioMed research international. - : Hindawi Limited. - 2314-6141 .- 2314-6133. ; 2015, s. 261813-
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Tidskriftsartikel (refereegranskat)abstract
- Experimental animal models improve our understanding of technical problems in peritoneal dialysis PD, and such studies contribute to solving crucial clinical problems. We established an acute and chronic PD model in nonuremic and uremic rats. We observed that kinetics of PD in rats change as the animals are aging, and this effect is due not only to an increasing peritoneal surface area, but also to changes in the permeability of the peritoneum. Changes of the peritoneal permeability seen during chronic PD in rats are comparable to results obtained in humans treated with PD. Effluent dialysate can be drained repeatedly to measure concentration of various bioactive molecules and to correlate the results with the peritoneal permeability. Additionally we can study inin vitroconditions properties of the effluent dialysate on cultured peritoneal mesothelial cells or fibroblasts. We can evaluate acute and chronic effect of various additives to the dialysis fluid on function and permeability of the peritoneum. Results from such study are even more relevant to the clinical scenario when experiments are performed in uremic rats. Our experimental animal PD model not only helps to understand the pathophysiology of PD but also can be used for testing biocompatibility of new PD fluids.
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- Pawlaczyk, K, et al.
(författare)
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Effects of bicarbonate/lactate dialysis solution on the inflammatory response of spontaneous peritonitis in rats undergoing chronic peritoneal dialysis
- 2009
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Ingår i: Blood purification. - : S. Karger AG. - 1421-9735 .- 0253-5068. ; 28:3, s. 200-208
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> We evaluated the incidence of spontaneous peritonitis as well as the local inflammatory response and macroscopic changes in the peritoneum during the use of a bicarbonate/lactate-buffered (P) solution in comparison to conventional (D) solutions in rats on chronic peritoneal dialysis. <i>Methods:</i> Sixty-three male Wistar rats were implanted with peritoneal catheters. After 7 days, the animals were randomly divided into 2 experimental groups (32 rats in D, 31 rats in P) and infused twice daily over the following 4 weeks. <i>Results:</i> After 14 and 23 days, rats dialyzed with D had a higher peritonitis rate than those dialyzed with P. The median number of days until peritonitis occurred was 22 days for the rats in the D group and 29 days for the rats in the P group. Spontaneously infected rats dialyzed with the D solution had higher scores for adhesion formation. <i>Conclusions:</i> In this animal model, dialysis with P delayed the time to the 1st infection, reduced the overall peritonitis rate and reduced peritonitis-associated peritoneal adhesion formation during chronic peritoneal dialysis.
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- Pawlaczyk, K, et al.
(författare)
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Vascular endothelial growth factor in dialysate in relation to intensity of peritoneal inflammation
- 2008
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Ingår i: The International journal of artificial organs. - : SAGE Publications. - 0391-3988 .- 1724-6040. ; 31:6, s. 535-544
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Tidskriftsartikel (refereegranskat)abstract
- Peritoneal inflammation may induce changes in peritoneal microvessels, including neoangiogenesis/vasculogenesis, leading to increased peritoneal solute transport rate (PSTR) and loss of ultrafiltration capacity. We hypothesized that an inflammatory reaction in the peritoneal cavity during peritonitis induces increased synthesis of vascular endothelial growth factor (VEGF). We therefore studied the relationship between peritoneal inflammation markers, VEGF, and transport of fluid and solutes in rats during acute peritoneal inflammation induced by lipopolysaccharide (LPS) added to standard glucose-based dialysis solution. Methods Under ether anesthesia, male Wistar rats were injected intraperitoneally with 30 mL Dianeal 3.86% without (Control; n=6) or with LPS (μg/mL): 0.001 (LPS 0.001; n=6), 0.01 (LPS 0.01; n=7), 0.1 (LPS 0.1; n=7), 1.0 (LPS 1.0; n=8). After 8 hours, dialysate volume (IPV), peritoneal solute transport rate (PSTR) and dialysate cell count (DCC) were measured and effluent samples were collected. Results LPS i.p. resulted in increased PSTR and decreased IPV (p<0.005). DCC (cells/μL) and the neutrophil/macrophage ratio were higher for all LPS concentrations compared to the control group. After 8 hours, LPS-exposed rats had significantly higher dialysate levels of all investigated cytokines (TNF-α, MCP-1 and IL-10) than the control group. Addition of LPS resulted in increased dialysate VEGF concentrations (pg/mL) (LPS 0.001, 28.2±5.9; LPS 0.01, 38.9±11.6; LPS 0.1, 43.0±5.9; LPS 1.0, 46.6±11.3; Control, 14.5±9.8; p<0.0005 for all LPS vs. Control). Conclusions The infusion of Dianeal 3.86% with different doses of LPS induced a strong acute intraperitoneal inflammatory reaction with increased DCC and cytokine levels, resulting in increased peritoneal solute transport and decreased IPV LPS induced a dose-dependent parallel increase of the intraperitoneal concentrations of MCP-1, IL-10 and TNF-α, as well as of VEGF. These results suggest that intraperitoneal VEGF synthesis is induced in response to inflammation, and that this may be an important component in the process leading to peritoneal transport alterations.
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- Yao, Q, et al.
(författare)
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Peroxisome proliferator-activated receptor-gamma agonists diminish peritoneal functional and morphological changes induced by bioincompatible peritoneal dialysis solution
- 2006
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Ingår i: Blood purification. - : S. Karger AG. - 0253-5068 .- 1421-9735. ; 24:5-6, s. 575-582
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> To evaluate if peroxisome proliferator-activated receptor-γ (PPAR-γ) agonists have a potential protective effect on the peritoneum changes induced by bioincompatible peritoneal dialysis (PD) solution in vivo. <i>Methods:</i> Male Wistar rats were dialyzed three times daily for 28 days with 1.36% Dianeal® (two groups: with (D+R) or without (D) rosiglitazone) or 1.36% Physioneal® (two groups: with (P+R) or without (P) rosiglitazone). Peritoneal transport of fluid and small solutes was assessed. Nine rats that did not receive dialysis served as controls. <i>Results:</i> Significant morphological changes were found in the D group compared with controls. Additional use of rosiglitazone in the D+R group resulted in less morphological changes and expression of collagen I as well as an increased drainage volume. The expression of VEGF was inhibited by rosiglitazone while no apparent effect was found regarding TGF/Smad pathway. <i>Conclusions:</i> The addition of rosiglitazone to standard dialysis fluids can maintain the peritoneal morphology and increase ultrafiltration in a PD rat model.
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- Yao, Q, et al.
(författare)
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The role of the TGF/Smad signaling pathway in peritoneal fibrosis induced by peritoneal dialysis solutions
- 2008
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Ingår i: Nephron. Experimental nephrology. - : S. Karger AG. - 1660-2129. ; 109:2, s. E71-E78
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Peritoneal dialysis (PD) solutions contribute to peritoneal membrane damage. We investigated how conventional and biocompatible PD solutions with different glucose concentrations affect morphological and functional signs of peritoneal fibrosis as well as the TGF-β1/Smad signaling pathway in a chronic PD rat model. <i>Methods:</i> Non-uremic male Wistar rats (n = 28) were dialyzed thrice daily for 28 days with 20 ml of a conventional solution (Dianeal® 1.36%, D1, or 3.86%, D3) or a biocompatible solution (Physioneal® 1.36%, P1, or 3.86%, P3). A peritoneal equilibration test was performed. Six rats without dialysis served as controls. <i>Results:</i> The use of conventional solutions, particularly D3, resulted in expansion of the submesothelial compact zone, loss of mesothelial cell layer integrity, hypercellularity, accumulation of collagen I, increased vessel numbers and increased TGF-β1/Smad expression, but this did not significantly change fluid and solute peritoneal transport characteristics. In comparison with D1 and D3, the use of P1 and P3 was associated with less TGF-β1/Smad expression and less expansion of the submesothelial cell layer. <i>Conclusions:</i> Our findings indicate that biocompatible solutions with less glucose may decrease the rate of peritoneal fibrosis. The TGF-β1/Smad pathway is stimulated by PD solutions, representing a plausible pathophysiological mechanism.
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