Mirosław Śnit

Substance P and intensity of pruritus in hemodialysis and peritoneal dialysis patients.

Background Uremic pruritus is a common complication in patients undergoing dialysis. The pathophysiological mechanisms of pruritus in patients with end-stage renal disease remain unknown. Neuropeptides, including substance P, are postulated to play an important role in the pathogenesis of pruritus. The aim of this study was to evaluate the role of substance P in uremic pruritus in patients on hemodialysis and peritoneal dialysis. Material/Methods We included 197 patients with end-stage renal disease: 54 on continuous ambulatory peritoneal dialysis and 143 on hemodialysis. Substance P, calcium, phosphorus, iron, ferritin, CRP, albumin, hemoglobin, Ca × P product, and iPTH level were determined in all participants. The correlation between these parameters and self-reported itching was evaluated in patients on hemodialysis in comparison with peritoneal dialysis patients. Results The incidence of itching was similar in hemodialysis and peritoneal dialysis patients. No differences in substance P level between the 2 groups were found. There was no correlation between substance P level and the incidence or intensity of pruritus in dialyzed patients. Conclusions This study demonstrates that substance P does not play any important role in pruritus in hemodialysed and peritoneal dialyzed patients. However, further studies are necessary to assess the exact role of neuropeptides in uremic pruritus.

Impact of glycemic control on survival of diabetic patients on chronic regular hemodialysis: a 7-year observational study.

In their Diabetes Care article, Oomichi et al. (1) stated that poor glycemic control is an independent predictor of poor prognosis of survival in patients on chronic regular dialysis. In the dialysis center of the Clinic of Internal Medicine, Diabetology and Nephrology in Zabrze, we have undertaken regular dialysis of ∼200 patients. We have recently published our experiences in regards to renal replacement therapy, especially concerning diabetic patients (2,3), but we have never analyzed the relationship between …

Association of rs 3807337 polymorphism of CALD1 gene with diabetic nephropathy occurrence in type 1 diabetes — preliminary results of a family-based study

INTRODUCTION The worldwide growing burden of diabetes and end-stage renal disease due to diabetic nephropathy has become the reason for research looking for a single marker of chronic kidney disease development and progression that can be found in the early stages of the disease, when preventive action delaying the destructive process could be performed. The aim of the study was to investigate the influence of rs3807337 polymorphism of the caldesmon 1 (CALD1) gene located on the long arm of chromosome 7 encoding for protein that is connected with physiological kidney function on development of diabetic nephropathy. MATERIAL AND METHODS There was an association study of rs3807337 polymorphism of the CALD1 gene in parent-offspring trios by PCRRFLP method. Ninety-nine subjects: 33 patients with diabetic nephropathy due to type 1 diabetes and 66 of their biological parents, were examined. The mode of alleles transmission from heterozygous parents to affected offspring was determined using the transmission disequilibrium test. RESULTS The allele G of rs3807337 polymorphism of the CALD1 gene was transmitted to affected offspring significantly more often than expected for no association. CONCLUSIONS The obtained results suggest that the genetic variability of the CALD1 gene may influence the development of diabetic nephropathy in type 1 diabetes, but further studies involving larger studied groups of patients are needed. (Endokrynol Pol 2017; 68 (1): 13-17).

Prevalence of high on-treatment platelet reactivity in patients with chronic kidney disease treated with acetylsalicylic acid for stroke prevention

Introduction Chronic kidney disease (CKD) is one of risk factors for stroke and may be associated with impaired platelet reactivity. Objectives The aim of the study was to evaluate platelet reactivity in patients with CKD treated with acetylsalicylic acid (ASA), using 2 different laboratory methods. Moreover, we searched for factors responsible for the phenomenon of high on-treatment platelet reactivity (HOPR). Patients and methods A total of 108 patients with CKD and 41 controls without CKD using ASA were enrolled in the study. Platelet function was assessed by impedance aggregometry in whole blood, using a multi-channel platelet function analyzer (Multiplate®; ASPItest). Urinary 11-dehydrotromboxane levels were measured by the AspirinWorks® test. Results No significant differences were observed in the prevalence of HOPR between patients with and without CKD. Patients with CKD and HOPR measured by ASPItest had higher creatinine levels (P = 0.05) and were younger (P <0.01) than patients with CKD without HOPR, while patients with CKD and HOPR measured by AspirinWorks® had lower red blood cell count (P = 0.05), hemoglobin (P = 0.05), hematocrit (P = 0.05), and high-density lipoprotein levels (P = 0.05). All patients with HOPR had higher C-reactive protein levels (P <0.05) (AspirinWorks®) and white blood cells (P <0.05) (ASPItest). Conclusions The applied methods allowed to detect HOPR in more than one third of CKD patients taking ASA for stroke prevention. The compatibility of both methods for HOPR assessment was confirmed. The study revealed several potential risk factors for HOPR in CKD, including younger age, higher levels of inflammatory markers, dyslipidemia, and lower hematocrit and hemoglobin levels.

Acyl-CoA type 5 gene polymorphism and inappropriate body mass occurrence related to waist circumference and insulin resistance index among the population living in southern Poland

WSTĘP : Zaburzenia przemian lipidów i związana z nimi otyłość to problem coraz częściej dotykający ludzi w krajach wysoko rozwiniętych. Syntetaza acylo-CoA typu 5 (ACSL5) jest ważnym enzymem metabolizmu lipidów, biorącym udział w aktywacji kwasów tłuszczowych. Prawidłowe funkcjonowanie tego enzymu zapewnia substraty zarówno dla lipogenezy, jak i oksydacji kwasów tłuszczowych, stąd określenie związku między polimorfizmem genu dla ACSL a kształtowaniem otyłości stanowi istotny problem badawczy. CEL P RACY : Celem pracy było wykazanie zależności między nieprawidłową masą ciała oraz wartością wskaźnika HOMA-IR (homeostasis model assessment) a występowaniem polimorfizmu genu syntetazy acylo-CoA izoformy 5. MAT ERIAŁ I M ETODY : Przebadano łącznie 506 pacjentów, u których za pomocą sond specyficznie wiążących się z DNA matrycy oznaczono polimorfizm ACSL5 rs2419621. WYNI KI : Za pomocą testu statystycznego Hardy’ego-Weinberga wykazano, że proporcje genotypów w populacji są zachowane. Wśród pacjentów stanowiących próbę badawczą wyróżniono 177 osób o prawidłowej masie ciała oraz 330 osób z nieprawidłową wartością indeksu BMI. WNIOS KI : Wykazano brak zmiennych różnic statystycznych w rozkładzie genotypów polimorfizmu genu syntetazy acylo-CoA izoformy 5. Wyniki przeprowadzonego badania nie pozwalają wykazać zależności między polimorfizmem genu dla ACSL5 a kształtowaniem otyłości.

Biosimilar insulin as an alternative for the original products

The medical knowledge makes a great progress in methods of treating diseases that makes our life much longer. Diabetes is a typical disease of civilization affecting more and more people all over the world. The cost of insulin therapy constitutes a great part of all expenditures associated with the treatment of patients with diabetes mellitus type 1 and type 2. Nowadays, when the patents covering biological insulins expire, new possibilities of using biosimilar insulins in treating diabetic patients appear. What is more, this group of products seems to be very promising. The authors describe, how the biopharmaceuticals and biosimilar drugs started to be used in the treatment. They present the similarities and differences between the biosimilars, original drugs and also generic products, with taking special interest in immunogenicity and the safety profile. The authors also point out the potential advantages and the risk of possible side effects of using biosimilar insulins in patients suffering from diabetes.