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EN
Due to its fluorescent and phototoxic properties, rose bengal (RB) is used in photodynamic therapy. To improve the delivery of RB to its site of action, the application of nanocarrier systems has been proposed. The most promising approach includes the use of pH-responsive nanoparticles. To evaluate the pattern of drug release in different buffers, equilibrium dialysis is commonly used. Here, we used water and two buffers to determine the impact of solvent composition on the aggregation and dialysis rate of RB through a cellulose membrane. The results show that buffer composition does not influence the fluorescent properties of RB. However, the presence of additional ions causes a change in diffusion rate that is most probably linked to the size of RB aggregates.
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Content available remote Vitamin K status in peritoneally dialyzed patients with chronic kidney disease
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EN
Abnormal vitamin K status was documented in patients with chronic kidney diseases (CKD), especially those undergoing hemodialysis. The data related to patients undergoing peritoneal dialysis (PD) are contradictory. Therefore, in the present study we aimed to evaluate vitamin K status in patients with CKD who are treated with continuous ambulatory PD. Twenty-eight patients entered into the study. Dialysis vintage ranged from 3 to 89 months. Vitamin K status was assessed in all subjects using undercarboxylated prothrombin measurement (PIVKA-II). In addition, total protein and albumin levels, total cholesterol, LDL cholesterol, triglyceride, calcium, urea and creatinine concentrations were determined. PIVKA-II concentrations were abnormal in 13 (46.4 %) subjects. BMI values, both total and LDL cholesterol concentrations were significantly higher in patients with than those without vitamin K deficiency. Moreover, PIVKA II levels correlated with BMI values (r = 0.441, p < 0.019), LDL cholesterol (r = 0.434, p < 0.021) and creatinine (r = 0.406, p < 0.032) concentrations. However, through the use of logistic regression analysis and multiple regression analysis, no clinical factor was documented to be the independent risk factor of vitamin K deficiency. In conclusion, vitamin K deficiency is a frequent condition in peritoneally dialyzed patients. Assessment of vitamin K status should become a standard procedure in this group of patients.
EN
Optimization of dialysis needs methods for quantitative assessment of fluid and solutes transport in body compartments and solute and fluid exchange between body and dialysate. A mathematical model describing the dynamics of these quantities during dialysis is presented. This model is first and foremost based on the existing models, but also includes some new solutions. All parts were combined and extended by the detailed descriptions of selected aspects. The "virtual patient" model was applied to simulate and test different methods of treatment and their influence on the condition of the patient. The purpose of this model is to serve as a decision support system for selection of "optimal" treatment options for particular patient.
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EN
Native arteriovenous fistula is considered the best type of access for dialysis. Its function is affected by multiple factors.The aim of the study was to identify risk factors of the loss of fistula patency.Material and methods. Between 1990-2004, 218 patients underwent 276 surgical procedures involving vascular access creation. In 245 (89%) of cases, a fistula was created using only patient's own blood vessels; in 31 (11%) of cases a vascular graft was implanted. 158 (64%) radio-cephalic fistulae were created, 15 (6%) radiobasilic fistulae, 33 (14%) brachiocephalic and 39 (16%) brachiobasilic fistulae. Duration of primary patency was identified for 217 native fistulae. Age, gender, diabetes mellitus, type, mode of creation and fistula location, vein translocation, type of anastomosis and time of initial cannulation were analyzed as potential factors affecting the fistula patency. Cox proportional hazards model was used in the analysis.Results. Probability of fistula patency loss in patients above 46 years of age was 2.12-fold higher than in younger patients and 1.62-fold higher for end-to-side anastomosis versus end-to-end anastomosis. Risk of loss of patency in fistulae cannulated for the first time within the first 14 days, 15-21 days and 22-35 days from their creation was 31-, 19- and 7-fold higher than when they were cannulated after the first 35 days.Conclusions. Type of vascular anastomosis, age above 46 years and time of the first cannulation are independent risk factors of the loss of patency of vascular access. First cannulation should not take place earlier than 7 weeks after its creation.
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Content available The Struggle with Time in Chronic Illness
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EN
It is worth looking at chronic illness with its pain, suffering and increasing limitations from the perspective of time. By time we mean subjective time relating to the perception and dynamics of the malady in the patient’s impressions and the role which time plays in the structuring of the patient’s life and experience. The main focus of this article is the experience of progressive kidney failure (uraemia), a condition which requires regular dialysis or kidney transplantation. Due to its specific crises, hopes and periods of waiting, painstaking medical procedures lasting many hours and turning points in the disease’s trajectory, time and its passage are a particularly adequate instrument with which to analyse the experiences of patients with uraemia. These experiences are discussed against the backdrop of selected elements of health care and attitudes towards transplantation which provide the social context for patients’ struggle with illness.
EN
Possibilities of the application of dialysate optical absorption at certain wavelenghts for the estimation of dialysis progress are presented. It was also discussed when in the monitoring of waste removal process enzymic solutions should be used.
PL
W pracy przedstawiono możliwości wykorzystania pomiaru absorpcji optycznej płynu dializacyjnego na wybranych długościach fal w celu monitorowania procesu oczyszczania krwi z głównych produktów przemiany materii podczas hemodializy. Wskazano również w jakich przypadkach monitorowanie omawianą techniką wymaga użycia enzymów.
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Content available remote Application of UV spectrophotometry for monitoring of dialysis progress
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EN
Certain possibilities of on-line monitoring of dialysis efficiency with spectrophotometric method are connected not with the detection of urea, which is the most common marker of removed wastes, but with some other substances, also diffusing from blood to dialysate. Spectrophotometric detection of acetic acid and creatynine seems to be better choice for these substances exhibit significant absorption which can be recognized in the dialysate spectrum.
PL
Możliwości monitorowania skuteczności dializy metodą fotometryczną związane są nie z wykrywaniem mocznika, który jest powszechnie używanym markerem procesu, ale z innymi substancjami, które też dyfundują z krwi do dializatu. Spektrofotometryczna detekcja kwasu moczowego i kreatyniny wydaje się być lepszym wyborem ponieważ substancje te wykazują absorpcję, która wyraźnie zaznacza się na widmie dializatu.
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Content available Co kardiolog powinien wiedzieć o nefrologii?
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PL
Nefrologia jest dziedziną bardzo hermetyczną dla "nienefrologów". W Polsce dializuje się kilkanaście tysięcy pacjentów, wśród których około 90% stanowią chorzy leczeni hemodializą, a 10% - dializą otrzewnową [1]. Z tej populacji około 10-20% stale przebywa w oddziałach szpitalnych z powodu powikłań. Pacjenci z chorobami nerek są specyficzną, niejednorodną grupą chorych, charakteryzującą się odmienną epidemiologią, wysokim odsetkiem powikłań [2], mającą odmienne rokowania po takich samych procedurach terapeutycznych, jak "populacja nienefrologiczna", wymagającą specjalnego traktowania, innego interpretowania badań biochemicznych, odmienności leczenia [3].
EN
Background. Dietary supplements (DS) are available over the counter, but patients with impaired renal function are specifically at risk for toxicity when consuming certain DS. The aim of this study was to evaluate the prevalence and characteristics of DS use in patients with chronic kidney disease (CKD). Material and methods. A cross-sectional, controlled DS use survey (22 questions) was conducted among 180 CKD patients (stage 1-5, dialysis, kidney transplant), with 60 patients without CKD serving as controls. Results. DS use did not differ significantly between subjects with and without CKD, unless the CKD patients were on dialysis. In the CKD group, 20% admitted to use DS regularly and 22% did not take the mat all. In the controls, DS consumption was 17% and 13%, respectively (NS). The DS use was higher among women ascompared to men (89% vs. 70%; p < 0.005), and people living in cities versus those living in the country side (81% vs. 63%; p < 0.05). DS most commonly used were: vitamins, minerals, and herbs. Major indications for DS use included: musculoskeletal issues, general health improvement and prevention of urinary tract infections. Subgroup analyses revealed that dialysis patients were characterized by a significantly higher DS use in comparison to CKD stage 1-5 subjects and renal transplant recipients. The decision to introduce DS was made by the physician in 54% of cases; by a pharmacist in 9% of cases, and by the patients themselves in 37%. Only 21% of patients with CKD, and 27% of subjects without CKD, declared knowledge of any possible side-effects associated with DS (NS). Conclusions. The use of DS among patients with CKD is similar to patients without CKD, with the exception of those on dialysis. Vitamins and minerals were the most commonly reported DS consumed. The knowledge on potential side-effectof DS was limited to approximately one-fourth of those surveyed.
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