Concentration of Adipokines in Peritoneal Effluent: A New Marker of Acute Peritonitis in Peritoneal Dialysis Patients?

2008 ◽  
Vol 28 (5) ◽  
pp. 527-632 ◽  
Author(s):  
Aureliusz Kolonko ◽  
Jerzy Chudek ◽  
Andrzej Więcek
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Permeability ◽  
Clinical Symptoms ◽  
Plasma Concentrations ◽  
Signs And Symptoms ◽  
Control Group ◽  
Peritoneal Membrane ◽  
Reactive Protein ◽  
Acute Peritonitis ◽  
Important Challenge

Background An early and reliable diagnostic procedure for acute peritonitis in patients on peritoneal dialysis (PD) without typical clinical symptoms remains an important challenge in modern nephrology. During the first days of peritonitis, establishing the diagnosis based on peritoneal effluent pleocytosis and inflammatory markers [C-reactive protein (CRP) or interleukin-6] is not efficient in all cases. Increased peritoneal membrane permeability is a well-known consequence of peritonitis. Therefore, we evaluated the concentrations of selected circulating adipose tissue-derived proteins in the peritoneal effluent of PD patients with episodes of acute peritonitis. Material and Methods Concentrations of adiponectin and leptin, in both plasma and peritoneal effluent, were assessed in 24 adult PD patients with peritonitis episodes confirmed by clinical symptoms and/or microbiological tests, and in 23 PD patients without signs and symptoms of inflammation (control group). Results In peritoneal effluent collected from patients with acute peritonitis (also without pleocytosis or increased CRP), both adiponectin and leptin concentrations were markedly elevated: adiponectin 744.1 (344.2 – 1144.1) ng/mL vs 4.8 (3.1 – 6.5) ng/mL; leptin 16.3 (9.4 – 23.1) ng/mL vs 5.1 (0.5 – 9.6) ng/mL. Receiver operating characteristic analyses revealed that peritoneal effluent adiponectin concentration >180 ng/mL has 100% sensitivity and 100% specificity, while peritoneal effluent leptin concentration >11.0 ng/mL has 58.3% sensitivity and 95.5% specificity for the diagnosis of acute peritonitis. The increases in adiponectin and leptin concentrations in peritoneal effluent were not consequences of changes in their plasma levels. A positive correlation between peritoneal effluent and plasma concentrations of adiponectin and leptin in patients with peritonitis was found. Conclusion Increased concentration of leptin and especially adiponectin in peritoneal effluent seems to be a valuable and new early marker of high peritoneal membrane permeability due to acute peritonitis.

Peritoneal Homocysteine Clearance is Inefficient in Peritoneal Dialysis Patients

2000 ◽  
Vol 20 (6) ◽  
pp. 766-771 ◽  
Author(s):  
David W. Johnson ◽  
Troy D. Kay ◽  
David A. Vesey ◽  
Nicole Isbel ◽  
Scott B. Campbell ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Protein Binding ◽  
Plasma Protein Binding ◽  
Plasma Protein ◽  
Tertiary Care ◽  
Plasma Concentrations ◽  
Elevated Plasma ◽  
C Reactive Protein ◽  
Protein Loss ◽  
Reactive Protein

Objectives To investigate the degree and the determinants of peritoneal homocysteine (Hcy) clearance and to compare measured Hcy clearance with the Hcy clearance predicted based on molecular weight (MW). Design Cross-sectional observational analysis. Setting Tertiary care institutional dialysis center. Patients Sixty-five stable peritoneal dialysis (PD) patients. Outcome Measures Fasting blood and 24-hour pooled dialysate effluents were collected for determination of peritoneal clearances of Hcy (CpHcy), urea (CpUr), and creatinine (CpCr). The dialysate-to-plasma creatinine ratio at 4 hours (D/P Cr 4 h) and levels of red cell folate, B12, ferritin, and C-reactive protein (CRP) were measured concurrently. Observed CpHcy was compared with predicted clearance, based on Hcy plasma protein binding and the relative molecular weights of Hcy, urea, and creatinine. Results Plasma concentrations of Hcy averaged 24.6 ± 1.1 μmol/L and were elevated above the upper limit of normal in 59 (91%) patients. The mean dialysate concentration of Hcy was 2.9 ± 0.3 μmol/L, equating to a daily peritoneal elimination of 34.6 ± 3.6 μmol. Observed CpHcy was closely approximated by predicted CpHcy (8.7 ± 0.6 L/week/1.73 m2 vs 9.0 ± 0.3 L/week/1.73 m2 respectively, p = 0.55). Patients maintained on automated PD ( n = 5) had a CpHcy similar to that of patients treated with continuous ambulatory peritoneal dialysis (8.9 ± 1.0 L/week/1.73 m2 vs 8.7 ± 0.6 L/week/1.73 m2, p = 0.92). The CpHcy was significantly correlated with C-reactive protein (CRP), D/P creatinine, CpUr, CpCr, and peritoneal protein loss, but not with plasma Hcy, albumin, B12, ferritin, age, dialysis duration, peritonitis episodes, or daily dialysate effluent volume. By multivariate analysis, the only variables that remained significant independent predictors of CpHcy were CRP and D/P Cr 4 h. High and high-average transporters had a higher CpHcy than low and low-average transporters (9.7 ± 0.8 L/week/1.73 m2 vs 7.0 ± 0.7 L/week/1.73 m2, p < 0.05), despite comparably elevated plasma Hcy concentrations [25.2 ± 1.5 μmol/L vs 23.4 ± 1.6 μmol/L, p = nonsignificant (NS)]. Conclusions Elevated plasma concentrations of Hcy are not efficiently reduced by PD. The relatively low peritoneal clearance of Hcy is largely accounted for by a high degree of plasma protein binding and is significantly influenced by peritoneal membrane permeability.

ELECTRODIAGNOSTIC CRITERIA FOR DIAGNOSING CARPAL TUNNEL SYNDROME NEED TO BE REVISED IN HYPOTHYROID PATIENTS

2017 ◽  
Vol 20 (03) ◽  
pp. 1750014
Author(s):  
Mahdieh Asadi ◽  
Sharareh Roshanzamir
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Control Group ◽  
Tunnel Syndrome ◽  
Clinical Signs And Symptoms ◽  
Relationship Of ◽  
Hypothyroid Patients

Background: Previous studies do not agree with each other on the association between electrodiagnostic findings and clinical symptoms of Carpal tunnel syndrome (CTS). In most of these studies, many variables such as age, sex, obesity and hypothyroidism have not been taken into account. Material & methods: About 62 patients with hypothyroidism and 62 patients without hypothyroidism with sign and symptoms of CTS were included in this study. Electrodiagnostic tests were done for all patients. And relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters was examined statistically in each group. Results: This study showed that distal motor latency in control group (without hypothyroidism) is significantly more prolonged than hypothyroid patients. Also there was significant correlation between clinical symptoms and electrodiagnostic findings in control group, but there was not such correlation in hypothyroid patients. In 62% of hypothyroid patients with clinical signs and symptoms of CTS, electrodiagnostic findings were normal and only in 38% of cases, electrodiagnostic findings were suggestive of CTS. Conclusion: Relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters is very weak in hypothyroid patients. Many hypothyroid patients with clinical signs and symptoms of CTS have normal electrodiagnostic findings; so we need more studies for revising the para-clinic criteria of labeling patients having CTS in hypothyroid patients.

scholarly journals Influence of decompression sickness on vasocontraction of isolated rat vessels

2016 ◽  
Vol 120 (7) ◽  
pp. 784-791 ◽  
Author(s):  
Aleksandra Mazur ◽  
Kate Lambrechts ◽  
Qiong Wang ◽  
Marc Belhomme ◽  
Michael Theron ◽  
...  
Keyword(s):  
Dose Response ◽  
Clinical Symptoms ◽  
Decompression Sickness ◽  
Vascular Dysfunction ◽  
Plasma Concentrations ◽  
Mesenteric Arteries ◽  
Control Group ◽  
Response Curves ◽  
Endothelin 1 ◽  
Dose Response Curves

Studies conducted in divers indicate that endothelium function is impaired following a dive even without decompression sickness (DCS). Our previous experiment conducted on rat isolated vessels showed no differences in endothelium-dependent vasodilation after a simulated dive even in the presence of DCS, while contractile response to phenylephrine was progressively impaired with increased decompression stress. This study aimed to further investigate the effect of DCS on vascular smooth muscle. Thirty-two male Sprague-Dawley rats were submitted to the same hyperbaric protocol and classified according to the severity of DCS: no-DCS (without clinical symptoms), mild-DCS, or severe-DCS (dead within 1 h). A control group remained at atmospheric pressure. Isometric tension was measured in rings of abdominal aorta and mesenteric arteries. Single dose contraction was assessed with KCl solution. Dose-response curves were obtained with phenylephrine and endothelin-1. Phenylephrine-induced contraction was observed in the presence of antioxidant tempol. Additionally, plasma concentrations of angiotensin II, angiotensin-converting enzyme, and thiobarbituric acid reactive substances (TBARS) were assessed. Response to phenylephrine was impaired only among mild-DCS in both vessels. Dose-response curves to endothelin-1 were impaired after mild-DCS in mesenteric and severe-DCS in aorta. KCl-induced contraction was affected after hyperbaric exposure regardless of DCS status in aorta only. These results confirm postdive vascular dysfunction is dependent on the type of vessel. It further evidenced that vascular dysfunction is triggered by DCS rather than by diving itself and suggest the influence of circulating factor/s. Diving-induced impairment of the L-type voltage-dependent Ca2+ channels and/or influence of renin-angiotensin system is proposed.

scholarly journals A Pilot Study on Controlling Coronavirus Disease 2019 (COVID-19) Inflammation Using Melatonin Supplement

2021 ◽  
Author(s):  
Zahra Alizadeh ◽  
Nastaran Keyhanian ◽  
Sara Ghaderkhani ◽  
Simin Dashti-Khavidaki ◽  
Raheleh Shokouhi Shoormasti ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Intervention Group ◽  
Control Group ◽  
Low Light ◽  
Reactive Protein ◽  
Significant Difference ◽  
Before And After ◽  
And Control ◽  
To Receive ◽  
Chest Ct Scan

No effective antiviral drugs and vaccines are available for the treatment of patients with severe coronavirus 2019 (COVID-19). Therefore, available, safe, and inexpensive drugs and supplements such as melatonin are among the proposed options for controlling inflammation. We did a randomized, single-blind study in Imam Khomeini Hospital between June 30, 2020, and August 5, 2020. Mild to moderate COVID-19 patients aged 25-65 years were eligible to enter the study based on chest CT scan, clinical symptoms, and physician diagnosis. The intervention group was prescribed 6 mg of oral melatonin for 2 weeks, which consumed half an hour before bedtime every night in low light conditions. Clinical symptoms and C-reactive protein (CRP) were measured before and after treatment in the melatonin received and control (regular medications) groups. Among screened patients with COVID-19, 14 patients were assigned to receive melatonin, and 17 patients were considered as controls. A significant difference (p=0.005) between CRP 1 and CRP 2 levels (before and after using melatonin) was found in the melatonin group while this difference (p=0.069) was not significant in the control group. Also, the percentage of recovery (based on symptoms) in patients who took melatonin was higher than that of patients in the control group (85.7% VS 47.1%).  The result of this study confirmed the effectiveness of melatonin in mild to moderate outpatients with COVID-19. More clinical trials on elderly, diabetic, obese patients and severe cases are suggested in future studies.   

MO900ENHANCED EXPRESSION OF THIOREDOXIN-INTERACTING PROTEIN (TXNIP) RESULTS IN REDUCED TRX ACTIVITY AND INCREASED OXIDATIVE DNA-DAMAGE IN PERITONEAL DIALYSIS PATIENTS*

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tina Oberacker ◽  
Severin Schricker ◽  
Moritz Schanz ◽  
Dominik M Alscher ◽  
Markus Ketteler
Keyword(s):  
Dna Damage ◽  
Peritoneal Dialysis ◽  
Protein Expression ◽  
High Glucose ◽  
Oxidative Dna Damage ◽  
Control Group ◽  
Healthy Controls ◽  
Plasma Samples ◽  
Peritoneal Membrane ◽  
Uremic Patients

Abstract Background and Aims Peritoneal dialysis (PD) is an effective method of renal replacement therapy (RRT). The long-term use of PD as a RRT is limited due to adverse effects of high glucose-based PD solutions to the structure and function of the peritoneal membrane. PD patients show excessive oxidative stress compared to healthy controls. However, there are only scare information on pathophysiological mechanisms leading to oxidative DNA-damage in PD patients. Therefore, the aim of this study was to elucidate the mechanism leading to excessive oxidative stress in human samples of the peritoneal membrane. Method Human peritoneal biopsies of healthy controls, PD patients and patients with EPS were collected. Protein expression of TXNIP was analysed by ELISA using plasma samples and by immunohistochemistry of peritoneal biopsies using a Histo-Score. Protein expression of TRX was examined by immunohistochemistry. To measure TRX activity a kit based on the reduction of insulin by reduced TRX was used. The resulting oxidative DNA-damage was investigated by immunohistochemistry using a Histo-Score or by ELISA using plasma samples of patients. Results Biopsies from the peritoneum of 8 healthy controls, 11 uremic patients, 22 patients on PD &lt; 12 months or 29 patients on PD &gt; 12 months and of 13 patients with EPS were collected. The age of the uremic patients was higher (median 65.0 years, IQR: 49.0-75.0) than in the other subgroups (PD &lt; 12 months: median 62.0 years, IQR: 52.25-68.25, PD &gt; 12 months: median 60.0 years, IQR: 39.5-70.5 and EPS: median 51.00 years, IQR: 40.0-57.5). In general, there were more female participants in the control-group (75 %) compared to all other groups (uremic group: 27%, PD &lt; 12 months: 18 %, PD &gt;12 months: 41% and EPS group 33 %). Time on PD was longer in EPS patients (median 72.0 months) than in PD patients (PD &lt;12 months: median 10.0 months and PD &gt; 12 months: 39.0 months). The ELISA study of plasma samples showed that TXNIP is upregulated in all groups compared to healthy controls. Immunohistochemically studies of peritoneal biopsies showed also an upregulation of TXNIP upon exposure to high glucose-based dialysis fluids (PD and EPS group). Interestingly, a glucose-related change in protein expression of its interacting partner and cellular anti-oxidant TRX was only observed in EPS samples. TRX activity in uremic patients was almost unchanged compared to healthy controls except for one patient. However, enhanced TXNIP expression correlated with a reduced activity of TRX in samples of PD as well as EPS patients. Reduced TRX activity resulted in an increase of produced ROS. Therefore, the effect on the generation of oxidative damage was analysed by ELISA of plasma samples and by immunohistochemistry on peritoneal sections. Both analysis showed an increase in the oxidative DNA-damage marker 8-Hydroxydesoxyguanosin (8-OHdG) in all PD samples and samples of EPS patients compared to the control group. Conclusion Here, we show that high glucose-based peritoneal dialysis solutions lead to an upregulation of TXNIP expression in human peritoneal samples. This increase in TXNIP expression reduces the activity of its interacting partner an antioxidant TRX leading to an increase in ROS production and enhanced levels of DNA-damage. In this study, we elucidate for the first time a novel mechanism showing that glucose-dependent upregulation of TXNIP induces a perturbation of the intracellular redox equilibrium leading to alterations of the peritoneal membrane. Therefore, manipulation of TXNIP expression may be a promising therapeutic target to improve peritoneal membrane function.

Plasma Concentrations of C-Reactive Protein and Fibrinogen in Ischaemic Stroke

2002 ◽  
Vol 30 (6) ◽  
pp. 591-596 ◽  
Author(s):  
İ İyigün ◽  
Y Bakirci
Keyword(s):  
Ischaemic Stroke ◽  
Cerebral Artery ◽  
Plasma Concentrations ◽  
Control Group ◽  
C Reactive Protein ◽  
Arterial Lesion ◽  
Reactive Protein ◽  
The Difference ◽  
Unconscious Patients ◽  
The Relationship

This study investigated how fibrinogen and C-reactive protein (CRP) levels change in response to neural damage occurring after ischaemia, and the relationship between the distribution of the arterial lesion, the disease prognosis and the levels of these substances. Fibrinogen and CRP levels were measured in blood samples obtained from 83 patients admitted to hospital within 72 h of a first ischaemic stroke. The patients were evaluated clinically with the Glasgow Outcome Scale (GOS), and results were compared with 43 age-matched controls. The fibrinogen and CRP levels in unconscious patients with hemiparesis or hemiplegia were higher than those in conscious hemiplegic patients. Also, the difference in GOS values between the unconscious patients with hemiparesis or hemiplegia and conscious patients with hemiparesis or hemiplegia was statistically significant. Patients with large infarcts in the median cerebral artery and anterior cerebral artery had higher fibrinogen and CRP concentrations than the control group. In conclusion, fibrinogen and CRP may be important measures for determining the prognosis and outcome in patients following ischaemic stroke.

scholarly journals Multicenter study of lipoprotein(a) and apolipoprotein(a) phenotypes in patients with end-stage renal disease treated by hemodialysis or continuous ambulatory peritoneal dialysis.

1995 ◽  
Vol 6 (1) ◽  
pp. 110-120
Author(s):  
F Kronenberg ◽  
P König ◽  
U Neyer ◽  
M Auinger ◽  
A Pribasnig ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Multicenter Study ◽  
Plasma Concentrations ◽  
Small Sample ◽  
Control Group ◽  
Case Control Studies ◽  
Lipoprotein A ◽  
Treatment Groups ◽  
Apolipoprotein A

Numerous studies have investigated lipoprotein(a) (Lp(a)) plasma concentrations in patients with ESRD, a patient group with an enormous risk for atherosclerosis. The reported differences in Lp(a) between controls and patients vary from a decrease of 49% to an increase of more than 1,000%. However, data are not consistent, mostly because of problems with statistical analysis, and only limited data are available for patients treated by continuous ambulatory peritoneal dialysis (CAPD). To estimate the significance of Lp(a) in ESRD and to demonstrate the statistical pitfalls concerning Lp(a) in case-control studies, a large multicenter study including 702 patients treated by either hemodialysis (HD) (N = 534) or CAPD (N = 168) was conducted, and results were compared with results from 256 healthy controls. Both patient groups showed significantly elevated Lp(a) levels in comparison with controls: 23.4 +/- 25.0 mg/dL (P < 0.005; HD) and 34.6 +/- 38.4 mg/dL (P < 0.0001; CAPD) versus 18.4 +/- 22.8 mg/dL (controls). CAPD patients showed significantly higher Lp(a) values than did patients treated by HD (P < 0.001). The difference between the two treatment groups possibly reflects an overproduction of Lp(a) to compensate for protein losses in CAPD patients. Both treatment groups included significantly more patients with Lp(a) values greater than the 75th percentile (25.6 mg/dL) of the control group (33.9 and 41.7% for HD and CAPD, respectively; P < 0.005). The higher Lp(a) values in patients were not explained by differences in isoform frequencies and the increase in Lp(a) was apolipoprotein(a) type specific: only patients with high-molecular-weight apolipoprotein(a) isoforms showed a significant elevation in Lp(a) levels. The increased plasma concentrations of Lp(a) may contribute to the high risk for atherosclerosis in ESRD, especially in patients treated by CAPD. Finally, it is believed that small sample sizes are responsible for the diverging results in Lp(a) literature.

scholarly journals Assessment of the frequency and biochemical parameters of conjunctivitis in COVID-19 and other viral and bacterial conditions

2020 ◽  
Vol 45 (4) ◽  
pp. 443-449
Author(s):  
Yavuz Oruc ◽  
Suleyman Aydin ◽  
Ramazan Fazil Akkoc ◽  
Suna Aydin ◽  
Fatih Cem Gul ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Anterior Segment ◽  
Antibody Test ◽  
High Specificity ◽  
Control Group ◽  
Bacterial Conjunctivitis ◽  
Laboratory Findings ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Specificity And Sensitivity

AbstractObjectivesWe compared the laboratory and clinical symptoms of coronavirus disease 2019 (COVID-19), other viral (beside COVID-19), and bacterial conjunctivitis patients with the values of controls.MethodsTwenty COVID-19, 15 other viral, 15 bacterial patients, and 15 control group were included in the study. COVID-19 was diagnosed with the real time reverse transcription–polymerase chain reaction while the indirect immunofluorescent antibody test was used in the detection of other viral agents. Bacterial agents were determined with the detection of the agent. The ophthalmologic examination of all cases was carried out by direct penlight, and the anterior segment evaluation was performed. The laboratory findings of all cases included in the study were obtained from the hospital records.ResultsIt was determined that 5% conjunctivitis and 5% diplopia developed in patients diagnosed with COVID-19, 20% conjunctivitis developed in patients due to other viral agents, and 66.6% conjunctivitis developed in patients due to bacterial agents.ConclusionThe incidence of conjunctivitis in COVID-19 patients was lower than in other viral and bacterial groups. Neutrophil/lymphocyte ratio and C-reactive protein come to the forefront as precious parameters with high specificity and sensitivity that might be useful to distinguish these diseases.

Changes in peritoneal membrane permeability and proteinuria in patients on peritoneal dialysis after treatment with paricalcitol – a preliminary study

2012 ◽  
Vol 78 (08) ◽  
pp. 93-99 ◽  
Author(s):  
Francisco Coronel ◽  
Secundino Cigarran ◽  
Antonio Gomis ◽  
Beatriz Rodríguez-Cubillo ◽  
José Antonio Herrero ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Permeability ◽  
Peritoneal Membrane ◽  
Preliminary Study
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