Characterization of two polymorphic sites in the human kinin B1 receptor gene: altered frequency of an allele in patients with a history of end-stage renal failure.

On the basis of the genomic structure of the human B1 receptor (B1R) for kinins, the presence of possible allelic polymorphisms of this gene was investigated using restriction fragment-length polymorphism and single-strand conformation polymorphism. The frequencies of the found alleles were determined in healthy volunteers and in patients with a history of end-stage renal failure, because there is evidence for a nephroprotective action of the kallikrein-kinin system. An A1098-->G polymorphism has been identified in exon 3 in a minority of volunteer blood donors, and is located 35 nucleotides downstream from the stop codon and 14 nucleotides upstream from the polyadenylation signal. The frequency of the G allele is 4.4% in the control sample and not significantly altered in patients with a history of end-stage renal failure. A second and more frequent polymorphism (18.1% of the alleles in the control group, prevalence of 33.3%) consists of a single base substitution (G-699-->C) in the putative promoter region. This polymorphism is significantly less frequent in the population of renal failure patients (prevalence of 20.6%) and determines an increased activity of the promoter function in constructions involving a reporter gene. The altered prevalence of this allele was also found in some etiologic subgroups of uremic patients. This study confirms the mapping of the B1R gene to 14q32. Other investigators have mapped the bradykinin B2 receptor (B2R) gene to a close site on human chromosome 14. A previously described B2R polymorphism (exon 2, C181-->T) had an allele frequency of 9.7% in the control sample and appears to be clinically neutral. The polymorphism of the B1R promoter may be a marker of prognostic significance for the preservation of renal function in diseased individuals.

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Comparison of Hemostatic Disturbances between Patients on Capd and Patients on Hemodialysis

Peritoneal Dialysis International ◽

10.1177/089686080102100209 ◽

2001 ◽

Vol 21 (2) ◽

pp. 158-167 ◽

Cited By ~ 38

Author(s):

Jolanta Malyszko ◽

Jacek S. Malyszko ◽

Michal Mysliwiec

Keyword(s):

Renal Failure ◽

Platelet Aggregation ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Factor Vii ◽

Control Group ◽

End Stage Renal Failure ◽

Lipoprotein A ◽

Uremic Patients ◽

End Stage

Objective Disturbances in hemostasis are common findings in uremic patients. Both bleeding diathesis and thrombosis are observed. The purpose of this study was to assess whether renal replacement therapy in the form of hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) affects coagulation and fibrinolysis in patients with end-stage renal failure. Design Comparison of hemostatic measures in patients on CAPD, HD, and matched healthy controls. Setting Department of Nephrology and Internal Medicine, Bialystok University School of Medicine. Patients and Methods Twenty-four HD patients and 23 CAPD patients were evaluated with respect to platelet aggregation, hemostatic parameters, serum lipids, lipoprotein(a), and cytokines [tumor necrosis factor alpha (TNFα) and interleukin-1 (IL-1)]. Interventions Four exchanges of CAPD per day, using 2.0 L dialysate over a period of 25 ± 31 months; or 4 – 5 hours of HD 3 times per week for a period of 31 ± 22 months. Results Platelet aggregation in whole blood and platelet-rich plasma was significantly impaired in both groups of dialyzed patients compared to healthy volunteers. Markers of endothelial cell injury (thrombomodulin and von Willebrand factor) were significantly higher in HD and CAPD patients compared to the control group. A similar pattern of changes was observed for lipoprotein(a), fibrinogen, tissue factor pathway activity, and factor VII activity. Activity of factor X was significantly enhanced in CAPD compared to HD patients and controls. Euglobulin clot lysis time was significantly prolonged in HD and CAPD patients over controls, being more prolonged in CAPD patients. Markers of ongoing coagulation (thrombin–antithrombin complexes and prothrombin fragments 1+2) were higher in uremic patients, significantly higher in CAPD than in HD. A marker of ongoing fibrinolysis (plasmin–antiplasmin complexes) was higher in uremic patients but was lower in CAPD than in HD patients. Concentrations of TNFα and IL-1 were higher in HD than in CAPD patients. Conclusion Patients on CAPD showed evidence of a higher degree of hypercoagulation than HD patients. Thus, hemostatic abnormalities in end-stage renal failure may be affected to some extent by the choice of renal replacement therapy.

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Influence of end-stage renal failure on concentrations of free apolipoprotein A-1 in serum.

Clinical Chemistry ◽

10.1093/clinchem/35.6.963 ◽

1989 ◽

Vol 35 (6) ◽

pp. 963-966 ◽

Cited By ~ 16

Author(s):

F Duval ◽

K Frommherz ◽

V Atger ◽

T Drüeke ◽

B Lacour

Keyword(s):

Renal Failure ◽

High Density Lipoprotein ◽

Density Lipoprotein ◽

Relative Increase ◽

Total Serum ◽

Control Group ◽

End Stage Renal Failure ◽

Apolipoprotein A ◽

Uremic Patients ◽

End Stage

Abstract We determined, immunoturbidimetrically, the concentrations of apolipoprotein A-I (apo A-I) (a) in total serum, (b) in total lipoproteins, and (c) in the fraction of d greater than 1.21 kg/L (free apo A-I) in 31 uremic patients (16 on hemodialysis, HD, and 15 with end-stage renal failure, ESRF) and 14 control subjects. The concentration of free apo A-I in serum was significantly increased in both groups of uremic patients (0.27 +/- 0.07 g/L for HD and 0.22 +/- 0.08 g/L for ESRF, mean +/- SD), in comparison with the control group (0.14 +/- 0.04 g/L). The ratio of total apo A-I to high-density-lipoprotein cholesterol was significantly increased in sera from both uremic groups, whereas the apo A-I/HDL-chol ratio of total lipoproteins was similar in all three groups. No apo A-I could be detected in five ultrafiltrates of plasma, even after 100-fold concentration. Analysis of apo A-I isoforms by isoelectrofocusing revealed a significant relative increase in apo A-I3 and a decrease in apo A-I5 isoform in ESRF patients, but not in HD patients. Finally, we found no relationship between serum TG and free apo A-I concentration.

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Association of Alexithymia with Low Utilization and Perception on a Measure of Social Support in Patients on Peritoneal Dialysis

Psychological Reports ◽

10.2466/pr0.1997.80.1.127 ◽

1997 ◽

Vol 80 (1) ◽

pp. 127-130 ◽

Cited By ~ 10

Author(s):

Isao Fukunishi ◽

Kunimi Maeda ◽

Minoru Kubota ◽

Yasuhiko Tomino

Keyword(s):

Social Support ◽

Renal Failure ◽

Peritoneal Dialysis ◽

Patient Group ◽

Stress And Coping ◽

Control Group ◽

End Stage Renal Failure ◽

Significant Difference ◽

End Stage ◽

And Coping

This study examined the association of social support and alexithymia in 63 patients with end-stage renal failure on peritoneal dialysis. Scores on the Toronto Alexithymia Scale were significantly higher for the patient group than the control group. Social support was measured with the Stress and Coping Inventory. For scores on the Existence of social support there was no significant difference between the two groups; however, scores on the Utilization and Perception of social support were significantly lower for the patients than for the control group. The alexithymia scores were significantly and negatively correlated with the scores on the Utilization and Perception of social support Our findings suggest that patients with peritoneal dialysis score higher on a measure of alexithymia associated with low utilization and perception of social support.

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Renal replacement

Southern African Journal of Anaesthesia and Analgesia ◽

10.36303/sajaa.2020.26.6.s3.2530 ◽

2020 ◽

pp. S17-S20

Author(s):

L Brannigan

Keyword(s):

Renal Failure ◽

Renal Replacement Therapy ◽

Short History ◽

End Stage Renal Failure ◽

Solute Exchange ◽

Threatening Condition ◽

Life Threatening ◽

History Of ◽

Comprehensive Text ◽

End Stage

There are few, if any, technological advancements in the field of medicine that have been able to transform a life-threatening condition, in this case, end-stage renal failure, from a certain and horrible death, just some 100 years ago, to a condition manageable within the confines of one’s home. This refresher course, by no means a comprehensive text on peritoneal or haemodialysis, aims to provide the reader (a pre-part one FCA candidate) with the following brief overview: * A short history of dialysis * The basic physiology of fluid and solute exchange employed in renal replacement therapy (RRT) * The physical principals of RRT * Modality

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Cardiac Troponin T and I in End-Stage Renal Failure

Clinical Chemistry ◽

10.1093/clinchem/46.9.1345 ◽

2000 ◽

Vol 46 (9) ◽

pp. 1345-1350 ◽

Cited By ~ 102

Author(s):

Diana Wayand ◽

Hannsjörg Baum ◽

Gabriele Schätzle ◽

Julia Schärf ◽

Dieter Neumeier

Keyword(s):

Renal Failure ◽

Cardiac Troponin ◽

Troponin T ◽

Cardiac Complications ◽

Cardiac Troponin T ◽

End Stage Renal Failure ◽

History Of ◽

Group 2 ◽

End Stage ◽

Group 1

Abstract Background: In patients suffering from end-stage renal failure, cardiac troponin T (cTnT) and I (cTnI) may be increased in serum without other signs of acute myocardial damage. Whether these increases are specific to myocardial injury or nonspecific is not completely clear. Methods: We investigated time courses of cTnT and cTnI over 1 year and the clinical outcome over 2 years in 59 patients with end-stage renal failure undergoing chronic hemodialysis. At the start of the study, we divided the patients into two groups, group 1, without history of cardiac failure, and group 2, with history of cardiac failure, and looked for differences between the groups in later adverse outcome. cTnT was measured using the Enzymun® troponin T assay on an ES 700 analyzer (Roche). cTnI was measured on a Stratus® II analyzer (Dade Behring). Creatinine and blood urea nitrogen were measured on a Vitros® 950 IRC (Ortho). Results: Dialysis acutely increased cTnT (P <0.01) and decreased cTnI (P <0.001) regardless of the dialysis membrane used. Although statistically not significant, cTnT but not cTnI was increased more frequently in group 2 than in group 1, in some cases over the whole study period. Five patients (8.5%) died of cardiac complications within 2 years; all of them had mostly increased cTnT and, in one or more samples, increased cTnI. Conclusions: Dialysis alters measured cTnT and cTnI concentrations in serum. In patients suffering from end-stage renal failure, sporadic or persistently increased cTnT and cTnI appear to predict cardiac complications. Because of the effects of the dialysis procedure on troponin values, we recommend that blood be collected before dialysis.

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Reversible Uremic Deafness: Is it Correlated with the Degree of Anemia?

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600506 ◽

1997 ◽

Vol 106 (5) ◽

pp. 391-393 ◽

Cited By ~ 10

Author(s):

Faissal A. M. Shaheen ◽

Noor A. Mansuri ◽

Iftikhar A. Sheikh ◽

Abdullah A. Al-Khader ◽

Abdul Munaim Al-Shaikh ◽

...

Keyword(s):

Renal Failure ◽

Pure Tone Audiometry ◽

Common Finding ◽

Control Group ◽

Sensitivity Index ◽

End Stage Renal Failure ◽

Pathogenic Factors ◽

Number Of Patients ◽

End Stage

Hearing loss is a common finding in patients with end-stage renal failure. Uremic toxins, ototoxins, and axonal uremic neuropathy appear to be likely pathogenic factors. We analyzed whether an improvement in hearing capacity can be achieved with an improvement of anemia by erythropoietin (EPO) administration. Fifty patients on long-term hemodialysis in a single center were examined audiologically by otoscopy, tympanometry, pure tone audiometry, and the short increment sensitivity index. Twenty-five patients were treated with EPO in a dose of 120 U/kg per week over a period of 5 to 8 months, and the remaining 25 patients were not treated with EPO (controls). Both groups were reexamined audiologically after the study period, and the results were compared. In the group treated with EPO, the hemoglobin level increased from 7 ± 0.9 to 11 ± 0.8 g/dL, as against the control group, whose hemoglobin increased from 7.1 ± 0.9 to 8 ± 0.8 g/dL. The audiologic tests were repeated at the end of the study period, and a significant improvement of hearing was found in the patients treated with EPO as compared with the control group (p < .001). Our study suggests that improvement of anemia in patients on long-term hemodialysis by administration of EPO is associated with an improvement in hearing capacity in a significant number of patients. Thus, anemia seems to be an important factor responsible for hearing disorders in patients with end-stage renal failure. Studies with larger numbers of patients are required to confirm this observation.

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