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Oxidative stress is at play in the progression of chronic renal failure (CRF) and in the genesis of atherosclerosis. The aim of the present study was to evaluate the factors that might influence the oxidative-antioxidative balance in patients on hemodialysis. The study group consisted of 71 hemodialysis patients due to CRF. Sixteen healthy subjects constituted a control group. The levels of 8-hydroxy-2’-deoxyguanosine (8-OHdG), C-reactive protein (CRP), and the blood lipid profile were measured in both groups. The results showed significantly higher mean levels of both 8-OHdG and CRP in the hemodialysis patients compared with that in the control subjects. The highest level of 8-OHdG was found in the subgroups of the patients with CRF primarily caused by diabetes (16.4 ng/ml) and with hypertensive nephropathy (15.8 ng/ml). More than a 2.5-fold higher level of 8-OHdG in the hemodialysis patients compared with the control subjects points to the presence of intensive oxidative stress in the patients.
Background: Numerous authors have shown that selenium (Se) concentration and glutathione peroxidase (GSH-Px) activity in plasma of chronic kidney disease (CKD) patients are lower than in healthy subjects, but there are only few publications on the level of GSH-Px protein in those patients and no reports on the effect of Se supplementation to HD patients on the level of this enzyme. Subjects and Methods: Se concentration and GSH-Px protein level in plasma were measured in a group of 30 CKD patients on hemodialysis (HD) supplemented with 200 μg Se/day for 3 months, and 28 patients on HD administered with placebo. Se concentration was measured by graphite furnace atomic absorption spectrometry and plasma GSH-Px protein level by the sandwich ELISA method using polyclonal antibody specific for human plasma GSH-Px. Results: Se concentration in patients on placebo did not change throughout the 3-month study period, but increased significantly in Se supplemented group. Se supplementation to CKD patients on HD had no effect on the level of GSH-Px protein. Conclusions: The lack of GSH-Px protein in CKD patients on HD is not linked to Se deficiency since the level of this element increased after Se supplementation while enzyme protein level did not change. The damaged kidney of HD patients is unable to synthesize GSH-Px, even after induction with selenium.
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The majority of hemodialyzed patients suffer from sleep disturbances. In the present study the prelevence of sleep apnea syndrome in hemodialyzed patients with end-stage renal disease (ESRD-patients) was investigated by the survey, Epworth Sleepiness Scale (ESS), and polysomnography (PSG). Sixty-one patients: 24 women and 37 men were involved in the study. All subjects participated in the first part of the study consisting of the survey and ESS. The second and third parts consisted of nighttime PSG, performed the night after hemodialysis (17 patients) and between hemodialyses (11 patients). Eleven out of the 61 patients had the symptoms of sleep apnea and heavy daily sleepiness. Eleven subjects were involved in the double PSG study: after and between hemodialyses. Obstrucive sleep apnea was found in 7 of those patients during both nights analyzed. Our results confirm the occurrence of sleep disorders in ESRD-patients. Hemodialysis does not change the prevalence of obstructive sleep apnea in chronic renal disease.
Protein-energy malnutrition with muscle wasting occurs in a large proportion of patients with chronic renal failure and is, in addition to atherosclerosis, a strong risk factor for cardiovascular mortality in dialysis patients. There is evidence that a chronic inflammation with activation of C-reactive protein and proinfalammatory cytokines is associated with increased oxidative stress and endothelial dysfunction. Strong relations between malnutrition, inflammation and atherosclerosis in dialysis patients suggest the presence of a MIA (malnutrition, inflammation and atherosclerosis) syndrome, which is associated with high mortality rate. Thus, it could be speculated that suppression of the vicious cycle of malnutrition, inflammation and atherosclerosis would improve survival in dialysis patients.
The properties of red blood cell membranes in patients with chronic renal failure were investigated using electron paramagnetic resonance spectroscopy. Using spin traps, 5,5-dimethylpirroline-l-oxide and N-tert-butyl-a-phenylni- trone, we found generation of hydroxyl radicals in the blood of patients with chronic renal failure after 20 min of regular hemodialysis. The physical state of membrane proteins and membrane osmotic fragility and reductive properties of red blood cells were studied. The increase in the relative correlation time of 4-(2-iodoacetamido)-2,2,6,6-tetramethylpiperidine-l-oxyl in­dicates the immobilization of membrane protein molecules in erythrocytes of chronic renal failure patients. The decrease in membrane protein mobility was observed in whole blood incubated with tert-butylhydroperoxide, regardless of the presence of iron. We found that the addition of ferrous ions did not aggravate profound changes in membrane proteins induced with tert-butylhy­droperoxide. We also demonstrated higher osmotic fragility of erythrocytes in the patients with renal failure as compared to normal subjects.
Celem pracy jest wykazanie obecności bakterii w materiale pobranym z cewników dializowanych owiec w formie badań wstępnych. Pięć permanentnych kateterów zostało założonych pięciu owcom w żyłę szyjną zewnętrzną. Materiał do badań w postaci heparyny o stężeniu 1250 j.m./ml pobierano ze światła cewnika co 10 dni na przestrzeni czasu, w którym odbywały się dializy. Przeprowadzono 30 analiz mikrobiologicznych w celu określenia ogólnej liczby bakterii, bakterii Echerichia coli oraz bakterii z grupy coli. W 50% prób wykazano obecność drobnoustrojów, z czego tylko w jednej stwierdzono obecność bakterii z grupy coli. Implantacja permanentnych cewników hemodializacyjnych wiąże się z ryzykiem wystąpienia infekcji wtórnych. Wyniki badań wskazują na możliwość wystąpienia zakażeń odcewnikowych i rozwinięcie ewentualnej bakteriemii u hemodializowanych zwierząt.
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