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EN
Introduction: Ischaemia-reperfusion injury (IRI) is a factor leading to the damages of the transplanted kidney, what affects mainly the proximal tubules. Early monitoring of tubule damage can be an efficient tool to predict the allograft dysfunction. Present in proximal tubules, N-acetyl-beta-glucosaminidase (NAG) is a lysosomal enzyme whose excretion rises as a result of IRI or acute rejection. The aim of this study was to monitor the NAG urine activity to evaluate the early proximal tubule damage, and to try to predict the long-term function of the transplanted kidney. Material and methods: The study enrolled 87 Caucasian renal transplant recipients (61.7% males, 38.3% females, mean age 45.56±14.34 years). Urine samples were collected for NAG and creatinine analysis on the 1st day after transplantation, and then in the 3rd and 12th month. Protocol biopsies were performed in the 3rd and 12th month. Results: A significant positive correlation between NAG urine activity in the 3rd month after transplantation and creatinine concentration on the 14th (p=0.004) and 30th day (p=0.05), in the 3rd month (p=0.009) and after the 1st (p=0.005) and 2nd year (p=0.003) was observed. A statistically significantly higher urinary NAG activity in samples collected in the first 3 days and in the 3rd month after transplantation among patients with DGF (p=0.006 and p=0.03 respectively) was found. There was a significant positive correlation between NAG urine activity in the 3rd month and the grade of tubular atrophy in specimens collected in the 3rd (p=0.03) and 12th (p=0.04) month. Conclusions: Monitoring of NAG urine activity is useful in the evaluation of early proximal tubule damage and predicting the long-term function of the transplanted kidneys.
EN
Background. Occupational factors have previously been mentioned as contributing to decreased kidney function and the development of chronic kidney disease of unknown cause. Sea salt workers are one of the occupations facing high outdoor temperatures and a highly, intensive workload. Objective. The purpose of the study was to examine whether the kidney function of sea salt workers at the beginning of the harvest season differs from kidney function at the end of the harvest season and to identify factors that can predict the change of kidney function. Material and methods. Data were collected from salt workers (n=50) who were between 18–60 years of age without hypertension, diabetes, and kidney disease in Samut Sakhon province, Thailand. Urine specific gravity (USG) was used for hydration status and the estimated glomerular filter rate (eGFR) was used to measure kidney function. The mixed model was used to find differences over the harvest season and prediction of factors. Results. On average, the eGFR was estimated to decrease by 15.2 ml/min/1.73 m2 over the harvest season. The decline in eGFR of sea salt workers with moderate and heavy workloads were significantly faster than their light workload counterparts after controlling for other covariates. Similarly, dehydration (USG ≥ 1.030) significantly accelerated the rate of kidney function loss. Conclusions. Our study confirmed exposure to heat over the harvest season leads to decreased eGFR in sea salt workers. The rate of change of eGFR could be predicted by workload and hydration status. Workers with dehydration who performed medium to heavy workloads in farms showed faster kidney function decline than those who performed light workload.
EN
Vitamin D deficiency is associated with muscle weakness. It is unknown, however, how supra-physiological levels of vitamin D affect skeletal muscle. To investigate the effects of increased serum vitamin D (1,25 (OH)2D3 or 1,25D) levels on the contractile properties of the medial gastrocnemius muscle, adult and old female Fischer344 x Brown Norway F1 rats were orally treated with vehicle or the vitamin D analogue alfacalcidol for 1 or 6 weeks. Alfacalcidol treatment resulted in elevated 1,25D serum levels. This was accompanied by hypercalcaemia and a reduction in body mass, the latter largely attributable to a reduced food intake. However, kidney function, as reflected by normal creatinine serum levels, as well as heart mass were unaffected. The 17% reduction in maximal isometric force and power was explicable by a similar loss of muscle mass. The force-frequency relationship of the 6-week-treated old rats was shifted to the left, but neither the shape of the force-velocity relationship nor the fatigability of the muscle were altered. Supra-physiological doses of vitamin D were accompanied by significant reductions in body and muscle mass, but not by an improvement in muscle functioning. Weight loss was largely due to a reduced food intake, while the left shift in the force-frequency relation may be due to increased 1,25D levels.
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