Cristina Capusa

Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients

Background/Aims: Since peritoneal membrane is more compatible and residual renal function better preserved during peritoneal dialysis, we questioned whether the oxidative burden in chronic kidney disease (CKD) is influenced by dialysis modality. Methods: 49 stable CKD patients, 17 on continuous ambulatory peritoneal dialysis (CAPD), 16 on hemodialysis (HD), and 16 non-dialyzed, and 13 healthy subjects were enrolled. Plasma thiobarbituric acid-reactive substances (TBARS; nmol/g protein), serum total antioxidant activity (TAA), total plasma-free thiols (Pt-SH; µmol/g protein), albumin and uric acid were measured by spectrophotometry. Serum residual antioxidant activity (RAA) was calculated. Results: TBARS were higher in HD (78.3 ± 20.3) versus both non-dialyzed (53.1 ± 27.9, p = 0.007) and CAPD groups (58.3 ± 19.8, p = 0.008). Pt-SH was reduced in CKD patients, but showed comparable values between dialysis groups. TAA and RAA were similarly increased in HD and CAPD patients than in the other two groups. Conclusion: Oxidative stress occurs in all CKD patients and worsens as renal function declines. Lipid peroxidation seems more augmented during chronic HD as compared to CAPD, but the plasma antioxidant status did not differ between the investigated dialysis methods. Therefore, dialysis modality appears to influence lipid peroxidation without changing the extracellular antioxidant defense of CKD patients.

International evaluation of unrecognizably uglifying human faces in late and severe secondary hyperparathyroidism in chronic kidney disease. Sagliker syndrome. A unique catastrophic entity, cytogenetic studies for chromosomal abnormalities, calcium-sensing receptor gene and GNAS1 mutations. Striking and promising missense mutations on the GNAS1 gene exons 1, 4, 10, 4.

Hypotheses explaining pathogenesis of secondary hyperparathyroidism (SH) in late and severe CKD as a unique entity called Sagliker syndrome (SS) are still unclear. This international study contains 60 patients from Turkey, India, Malaysia, China, Romania, Egypt, Tunisia, Taiwan, Mexico, Algeria, Poland, Russia, and Iran. We examined patients and first degree relatives for cytogenetic chromosomal abnormalities, calcium sensing receptor (Ca SR) genes in exons 2 and 3 abnormalities and GNAS1 genes mutations in exons 1, 4, 5, 7, 10, 13. Our syndrome could be a new syndrome in between SH, CKD, and hereditary bone dystrophies. We could not find chromosomal abnormalities in cytogenetics and on Ca SR gene exons 2 and 3. Interestingly, we did find promising missense mutations on the GNAS1 gene exons 1, 4, 10, 4. We finally thought that those catastrophic bone diseases were severe SH and its late treatments due to monetary deficiencies and iatrogenic mistreatments not started as early as possible. This was a sine qua non humanity task. Those brand new striking GNAS1 genes missense mutations have to be considered from now on for the genesis of SS.

Nephropathology: A Cornerstone for Understanding and Estimation of Recent Advances in Glomerular Diseases

Abstract The developments in the field of kidney pathology are major objectives for nephrology worldwide, since the histopathologic diagnosis is a cornerstone for all glomerulopathies (either primary or secondary related to systemic diseases-for tubulointerstitial and vascular lesions as well as renal allograft nephropathy). Moreover, the correct interpretation of kidney tissue samples is a challenge for pathologists too. Consequently, a new subspecialty - nephropathology, was accepted by many medical schools in various universities, while dedicated scientific meetings, journals and websites were also created. In the following few pages, a short overview on the history, classic and novel meanings of the renal pathology for the understanding of glomerular pathophysiology will be discussed.

Haemodialysis treatment influence on carbonyl stress parameters

Chronic renal failure is associated with increased oxidative and carbonyl stress. Even if haemodialysis eliminates toxic metabolic products, the procedure per se is associated with further increased oxidative and carbonyl stress in patients with renal disease. The aim of our work was to evaluate the influence of long term haemodialysis treatment on oxidative and carbonyl stress parameters in patients with chronic renal failure. Methods A total of 58 subjects participated in this study: 16 patients with chronic renal insufficiency (CRF) randomly selected from Carol Davila Hospital patients, 20 patients with end stage renal disease undergoing haemodialysis treatment 3 times weekly (HD) and 22 subjects apparently healthy (C) as controls. On blood samples collected after overnight fasting we have determined the concentrations of Amadori Products (AP), total dicarbonilic compounds (DC), malondialdehyde (MDA) and total thiols (SH). Results AP, MDA and DC were significantly increased in patients with chronic renal failure (CRF) while total thiols levels were significantly decreased compared with the controls. Interestingly, for patients undertaking haemodialysis treatment (HD) the AP levels were not significantly increased compared with controls while SH levels were increased. MDA and DC levels were also significantly increased in HD patients compared with the controls. We have not found any significant correlation between AP levels and DC levels in our subjects. Conclusion Haemodialysis treatment is lowering Amadori Products levels in end stage renal disease patients while having no beneficial effect on total dicarbonilic compounds levels. Increased total thiols levels found in HD patients may constitute an activated antioxidant answer to increased oxidative stress