Search results for: kidney
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 48

Search results for: kidney

18 Some Biological and Molecular Characterization of Bean Common Mosaic Necrosis Virus Isolated from Soybean in Tehran Province, Iran

Authors: F. S. Abtahi, M. Koohi Hbibi, M. Khodaei Motlagh

Abstract:

Bean common mosaic necrosis virus (BCMNV) is a potyvirus with a worldwide distribution. This virus causes serious economic losses in Iran in many leguminoses. During 20008, samples were collected from soybeans fields in Tehran Province. Four isolates (S1, S2 and S3) were inoculated on 15 species of Cucurbitaceae, Chenopodiaceae, Solanacae and Leguminosae. Chenopodium quinoa and C. amaranticolor. Did not developed any symptoms.all isolates caused mosaic symptoms on Phaseolus vulgaris cv. Red Kidney and P. vulgaris cv. Bountiful. The molecular weights of coat protein using SDS-PAGE and western blotting were estimated at 33 kDa. Reverse transcription polymerase chain reaction (RT-PCR) was performed using one primer pairs designed by L. XU et al. An approximately 920 bp fragment was amplified with a specific primer.

Keywords: ELISA, RT-PCR, SDS-PAGE, BCMNV.

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17 The System Architecture of the Open European Nephrology Science Centre

Authors: G. Lindemann, D. Schmidt, T. Schrader, M. Beil, T. Schaaf, H.-D. Burkhard

Abstract:

The amount and heterogeneity of data in biomedical research, notably in interdisciplinary research, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charite Medical School in Berlin has established together with the German Research Foundation (DFG) a new information service center for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). The system is based on a service-oriented architecture (SOA) with main and auxiliary modules arranged in four layers. To improve the reuse and efficient arrangement of the services the functionalities are described as business processes using the standardised Business Process Execution Language (BPEL).

Keywords: Software development management, Business dataprocessing, Knowledge based systems in medicine

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16 Oxidantantioxidant Status in Calves Supplemented with Green Tea Extract

Authors: Ibrahim I. Elshahawy

Abstract:

The objective of the present study was to investigate the effect of green tea extract on serum oxidant and antioxidant profile, liver and kidney function. 40 Friesian calves are included in this study and allocated into two groups: Group I (n=20) clinically healthy calves showing no clinical abnormalities, not receiving any treatment and served as control; group II (n=20) received green tea extract (GTE) for 30 days. Non-significant changes in blood urea nitrogen (BUN) were detected between groups, on contrary, serum creatinine and activities of liver enzymes aspartate transaminase (AST) and alanine transaminase (ALT) were significantly different between two groups. There were significant increases in the mean values of serum antioxidative parameters (total antioxidant capacity, catalase, superoxide dismutase, reduced glutathione and glutathione peroxidase) in group II. Whereas, the activity of lipid peroxidase significantly decreased in GTE treated calves when compared to control.

Keywords: Green tea extract, antioxidants, oxidants, calves.

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15 A Neural Network Approach in Predicting the Blood Glucose Level for Diabetic Patients

Authors: Zarita Zainuddin, Ong Pauline, C. Ardil

Abstract:

Diabetes Mellitus is a chronic metabolic disorder, where the improper management of the blood glucose level in the diabetic patients will lead to the risk of heart attack, kidney disease and renal failure. This paper attempts to enhance the diagnostic accuracy of the advancing blood glucose levels of the diabetic patients, by combining principal component analysis and wavelet neural network. The proposed system makes separate blood glucose prediction in the morning, afternoon, evening and night intervals, using dataset from one patient covering a period of 77 days. Comparisons of the diagnostic accuracy with other neural network models, which use the same dataset are made. The comparison results showed overall improved accuracy, which indicates the effectiveness of this proposed system.

Keywords: Diabetes Mellitus, principal component analysis, time-series, wavelet neural network.

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14 Efficacy and Stability of Ceramic Powder to Inactivate Avian Influenza Virus

Authors: Chanathip Thammakarn, Misato Tsujimura, Keisuke Satoh, Tomomi Hasegawa, Miho Tamura, Akinobu Kawamura, Yuki Ishida, Atsushi Suguro, Hakimullah Hakim, Sakchai Ruenphet, , Kazuaki Takehara

Abstract:

This experiment aims to demonstrate the efficacy of ceramic powder derived from various sources to inactivate avian influenza virus and its possibility to use in the environment. The ceramics used in the present experiment were derived from chicken feces (CF), scallop shell (SS), polyvinyl chloride (PVC) and soybean (SB). All ceramics were mixed with low pathogenic AIV (LPAIV) H7N1, and then kept at room temperature. The recovered virus was titrated onto Madin-Darby canine kidney (MDCK) cells. All ceramics were assessed the inactivation stability in the environment by keeping under sunlight and under wet-dry condition until reached 7 week or 7 resuspension times respectively. The results indicate that all ceramics have excellent efficacy to inactivate LPAIV. This efficacy can be maintained under the simulated condition. The ceramics are expected to be the good materials for application in the biosecurity system at farms.

Keywords: Avian Influenza, Ceramics, Efficacy, Stability.

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13 Gold Nanoparticle: Synthesis, Characterization, Clinico-Pathological, Pathological, and Bio-Distribution Studies in Rabbits

Authors: M. M. Bashandy, A. R. Ahmed, M. El-Gaffary, Sahar S. Abd El-Rahman

Abstract:

This study evaluated the acute toxicity and tissue distribution of intravenously administered gold nanoparticles (AuNPs) in male rabbits. Rabbits were exposed to single dose of AuNPs (300 μg/ kg). Toxic effects were assessed via general behavior, hematological parameters, serum biochemical parameters, and histopathological examination of various rabbits’ organs. Inductively coupled plasma–mass spectrometry (ICP-MS) was used to determine gold concentrations in tissue samples collected at predetermined time intervals. After one week, AuNPs exerted no obvious acute toxicity in rabbits. However, inflammatory reactions were observed in liver, lungs and kidneys accompanied with mild absolute neutrophilia and significant monocytosis. The highest gold levels were found in the spleen and liver followed by lungs, and kidneys. These results indicated that AuNPs could be distributed extensively to various tissues in the body, but primarily in the spleen and liver.

Keywords: Gold nanoparticles, toxicity, pathology, hematology, liver function, kidney function.

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12 The Resource Description Framework (RDF) as a Modern Structure for Medical Data

Authors: Gabriela Lindemann, Danilo Schmidt, Thomas Schrader, Dietmar Keune

Abstract:

The amount and heterogeneity of data in biomedical research, notably in interdisciplinary fields, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charité - University Hospital Berlin has established together with the German Research Foundation (DFG) a new information service centre for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). Beside a collaborative aspect to create new research groups every single partner or institution of this science information centre making his own data available is allowed to search the whole data pool of the various involved centres. A core task is the implementation of a non-restricting open data structure for the various different data sources. We decided to use a modern RDF model and in a first phase transformed original data coming from the web-based Electronic Patient Record database TBase©.

Keywords: Medical databases, Resource Description Framework (RDF), metadata repository.

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11 A Semi-Automatic Mechanism Used in the Peritoneal Dialysis Connection

Authors: I-En Lin, Feng-Jung Yang

Abstract:

In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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10 Ameliorative Effect of Calocybe indica, a Tropical Indian Edible Mushroom on Hyperglycemia Induced Oxidative Stress

Authors: Shanmugasundaram Krishnakumari, Paramasivam Rajeswari, Subramanian Kathiravan

Abstract:

Mushrooms are a group of fleshy macroscopic fungi. They have been valued throughout the world as both edible and medicine. They are highly nutritious with good amount of quality proteins, vitamins and minerals. An edible mushroom, Calocybe indica was selected to validate its nutritional and medicinal properties. Since tissue damage in hyperglycemia has been related to oxidative stress, we evaluated the enzymatic and non-enzymatic antioxidant status in the serum, liver and kidney since they are the target organs in diabetic complications. From the results, increased oxidative stress and decreased antioxidants might be related to the causation of diabetes mellitus. The treatment in the diabetic rats with the Calocybe indica showed an increase in the antioxidant system and decrease in the production of free radicals. The mushrooms which contain antioxidant phytochemicals has potential free radical scavenging capacity and hence can induce the antioxidant system in the body significantly reduces the generated free radicals thereby maintaining the normal levels of the antioxidants

Keywords: Antioxidants, Calocybe indica, diabetes mellitus, edible mushroom, oxidative stress.

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9 Antioxidative Potential of Aqueous Extract of Ocimum americanum L. Leaves: An in vitro and in vivo Evaluation

Authors: B. T. Aluko, O. I. Oloyede

Abstract:

Ocimum americanum L (Lamiaceae) is an annual herb that is native to tropical Africa. The in vitro and in vivo antioxidant activity of its aqueous extract was carefully investigated by assessing the DPPH radical scavenging activity, ABTS radical scavenging activity and hydrogen peroxide radical scavenging activity. The reducing power, total phenol, total flavonoids and flavonols content of the extract were also evaluated. The data obtained revealed that the extract is rich in polyphenolic compounds and scavenged the radicals in a concentration dependent manner. This was done in comparison with the standard antioxidants such as BHT and Vitamin C. Also, the induction of oxidative damage with paracetamol (2000 mg/kg) resulted in the elevation of lipid peroxides and significant (P < 0.05) decrease in activities of superoxide dismutase, glutathione peroxidase, glutathione reductase and catalase in the liver and kidney of rats. However, the pretreatment of rats with aqueous extract of O. americanum leaves (200 and 400 mg/kg) and silymarin (100 mg/kg) caused a significant (P < 0.05) reduction in the values of lipid peroxides and restored the levels of antioxidant parameters in these organs. These findings suggest that the leaves of O. americanum have potent antioxidant properties which may be responsible for its acclaimed folkloric uses.

Keywords: Antioxidants, free radicals, Ocimum americanum, scavenging activity.

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8 Effects of Boron Compounds in Rabbits Fed High Protein and Energy Diet: A Metabolomic and Transcriptomic Approach

Authors: N. Baspinar, A. Basoglu, O. Ozdemir, C. Ozel, F. Terzi, O. Yaman

Abstract:

Current research is targeting new molecular mechanisms that underlie non-alcoholic fatty liver disease (NAFLD) and associated metabolic disorders like non-alcoholic steatohepatitis (NASH). Forty New Zealand White rabbits have been used and fed a high protein (HP) and energy diet based on grains and containing 11.76 MJ/kg. Boron added to 3 experimental groups’ drinking waters (30 mg boron/L) as boron compounds. Biochemical analysis including boron levels, and nuclear magnetic resonance (NMR) based metabolomics evaluation, and mRNA expression of peroxisome proliferator-activated receptor (PPAR) family was performed. LDLcholesterol concentrations alone were decreased in all the experimental groups. Boron levels in serum and feces were increased. Content of acetate was in about 2x higher for anhydrous borax group, at least 3x higher for boric acid group. PPARα mRNA expression was significantly decreased in boric acid group. Anhydrous borax attenuated mRNA levels of PPARγ, which was further suppressed by boric acid. Boron supplementation decreased the degenerative alterations in hepatocytes. Except borax group other boron groups did not have a pronounced change in tubular epithels of kidney. In conclusion, high protein and energy diet leads hepatocytes’ degenerative changes which can be prevented by boron supplementation. Boric acid seems to be more effective in this situation.

Keywords: High protein and energy diet, boron, metabolomic, transcriptomic.

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7 Effect of Oxytocin on Cytosolic Calcium Concentration of Alpha and Beta Cells in Pancreas

Authors: Rauza Sukma Rita, Katsuya Dezaki, Yuko Maejima, Toshihiko Yada

Abstract:

Oxytocin is a nine-amino acid peptide synthesized in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) of the hypothalamus. Oxytocin promotes contraction of the uterus during birth and milk ejection during breast feeding. Although oxytocin receptors are found predominantly in the breasts and uterus of females, many tissues and organs express oxytocin receptors, including the pituitary, heart, kidney, thymus, vascular endothelium, adipocytes, osteoblasts, adrenal gland, pancreatic islets, and many cell lines. On the other hand, in pancreatic islets, oxytocin receptors are expressed in both α-cells and β-cells with stronger expression in α- cells. However, to our knowledge there are no reports yet about the effect of oxytocin on cytosolic calcium reaction on α and β-cell. This study aims to investigate the effect of oxytocin on α-cells and β-cells and its oscillation pattern. Islet of Langerhans from wild type mice were isolated by collagenase digestion. Isolated and dissociated single cells either α-cells or β-cells on coverslips were mounted in an open chamber and superfused in HKRB. Cytosolic concentration ([Ca2+]i) in single cells were measured by fura-2 microfluorimetry. After measurement of [Ca2+]i, α-cells were identified by subsequent immunocytochemical staining using an anti-glucagon antiserum. In β-cells, the [Ca2+]i increase in response to oxytocin was observed only under 8.3 mM glucose condition, whereas in α-cells, [Ca2+]i an increase induced by oxytocin was observed in both 2.8 mM and 8.3 mM glucose. The oscillation incidence was induced more frequently in β-cells compared to α-cells. In conclusion, the present study demonstrated that oxytocin directly interacts with both α-cells and β-cells and induces increase of [Ca2+]i and its specific patterns.

Keywords: α-cells, β-cells, cytosolic calcium concentration, oscillation, oxytocin.

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6 Microalbuminuria in Essential Hypertension

Authors: Sharan Badiger, Prema T. Akkasaligar, Sandeep HM, Biradar MS

Abstract:

Essential hypertension (HTN) usually clusters with other cardiovascular risk factors such as age, overweight, diabetes, insulin resistance and dyslipidemia. The target organ damage (TOD) such as left ventricular hypertrophy, microalbuminuria (MA), acute coronary syndrome (ACS), stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension is high in India, the relationship between microalbuminuria and target organ damage in hypertension is not well studied. This study aim at detecting MA in essential hypertension and its relation to severity of HTN, duration of HTN, body mass index (BMI), age and TOD such as HTN retinopathy and acute coronary syndrome The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.University-s Sri B.M.Patil Medical College, Bijapur, from October 2008 to April 2011. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. The prevalence of MA in this study was found to be 63 %. In that 42% were male & 21% were female. In this study a significant association between MA and the duration of hypertension (p = 0.036) & (OR =0.438). Longer the duration of hypertension, more possibility of microalbumin in urine. Also there was a significant association between severity of hypertension and MA (p=0.045) and (OR=0.093). MA was positive in 50 (79.4%) patients out of 63, whose blood pressure was >160/100 mm Hg. In this study a significant association between MA and the grades of hypertensive retinopathy (p =0.011) and acute coronary syndrome (p = 0.041) (OR =2.805). Gender and BMI did not pose high risk for MA in this study.The prevalence of MA in essential hypertension is high in this part of the community and MA will increase the risk of developing target organ damage.Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.

Keywords: Acute coronary syndrome, Essential hypertension, Microalbuminuria, Target organ damage

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5 Transcriptional Evidence for the Involvement of MyD88 in Flagellin Recognition: Genomic Identification of Rock Bream MyD88 and Comparative Analysis

Authors: N. Umasuthan, S. D. N. K. Bathige, W. S. Thulasitha, I. Whang, J. Lee

Abstract:

The MyD88 is an evolutionarily conserved host-expressed adaptor protein that is essential for proper TLR/ IL1R immune-response signaling. A previously identified complete cDNA (1626 bp) of OfMyD88 comprised an ORF of 867 bp encoding a protein of 288 amino acids (32.9 kDa). The gDNA (3761 bp) of OfMyD88 revealed a quinquepartite genome organization composed of 5 exons (with the sizes of 310, 132, 178, 92 and 155 bp) separated by 4 introns. All the introns displayed splice signals consistent with the consensus GT/AG rule. A bipartite domain structure with two domains namely death domain (24-103) coded by 1st exon, and TIR domain (151-288) coded by last 3 exons were identified through in silico analysis. Moreover, homology modeling of these two domains revealed a similar quaternary folding nature between human and rock bream homologs. A comprehensive comparison of vertebrate MyD88 genes showed that they possess a 5-exonic structure.In this structure, the last three exons were strongly conserved, and this suggests that a rigid structure has been maintained during vertebrate evolution.A cluster of TATA box-like sequences were found 0.25 kb upstream of cDNA starting position. In addition, putative 5'-flanking region of OfMyD88 was predicted to have TFBS implicated with TLR signaling, including copies of NFkB1, APRF/ STAT3, Sp1, IRF1 and 2 and Stat1/2. Using qPCR technique, a ubiquitous mRNA expression was detected in liver and blood. Furthermore, a significantly up-regulated transcriptional expression of OfMyD88 was detected in head kidney (12-24 h; >2-fold), spleen (6 h; 1.5-fold), liver (3 h; 1.9-fold) and intestine (24 h; ~2-fold) post-Fla challenge. These data suggest a crucial role for MyD88 in antibacterial immunity of teleosts.

Keywords: MyD88, Innate immunity, Flagellin, Genomic analysis.

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4 Snails and Fish as Pollution Biomarkers in Lake Manzala and Laboratory C: Laboratory Exposed Snails to Chemical Mixtures

Authors: Hanaa M. M. El-Khayat, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hanan S. Gaber, Hoda, M. A. Abu Taleb, Hassan E. Flefel

Abstract:

Snails are considered as suitable diagnostic organisms for heavy metal–contaminated sites. Biomphalaria alexandrina snails are used in this work as pollution bioindicators after exposure to chemical mixtures consisted of heavy metals (HM); zinc (Zn), copper (Cu) and lead (Pb); and persistent organic pollutants; Decabromodiphenyl ether 98% (D) and Aroclor 1254 (A). The impacts of these tested chemicals, individual and mixtures, on liver and kidney functions, antioxidant enzymes, complete blood picture, and tissue histology were studied. Results showed that Cu was proved to be the highly toxic against snails than Zn and Pb where LC50 values were 1.362, 213.198 and 277.396 ppm, respectively. Also, B. alexandrina snails exposed to the mixture of HM (¼ LC5 Cu, Pb and Zn) showed the highest bioaccumulation of Cu and Zn in their whole tissue, the most significant increase in AST, ALT & ALP activities and the highest significant levels of total protein, albumin and globulin. Results showed significant alterations in CAT activity in snail tissue extracts while snail samples exposed to most experimental tests showed significant increase in GST activity. Snail samples that exposed to HM mixtures showed a significant decrease in total hemocytes count while snail samples that exposed to mixtures containing A & D showed a significant increase in total hemocytes and Hyalinocytes. Histopathological alterations in snail samples exposed to individual HM and their mixtures for 4 weeks showed degeneration, edema, hyper trophy and vaculation in head-foot muscle, degeneration and necrotic changes in the digestive gland and accumulation in most tested organs. Also, the hermaphrodite gland showed mature ova with irregular shape and reduction in sperm number. In conclusion, the resulted damage and alterations in B. alexandrina studied parameters can be used as bioindicators to the presence of pollutants in its habitats.

Keywords: Biomphalaria, Zn, Cu, Pb, AST, ALT, ALP, total protein albumin, globulin, CAT and Histopathology.

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3 Evaluation of Systemic Immune-Inflammation Index in Obese Children

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.

Keywords: Children, c- reactive protein, systemic immune-inflammation index, obesity.

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2 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

Abstract:

The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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1 Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy

Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

Abstract:

Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: Cardiovascular risk, malondialdehyde, metabolic balance, minerals, type 2 diabetes.

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