Effect of oral fructose load on serum uric acid and lipids in kidney transplant recipients treated with cyclosporine or tacrolimus.

Hyperuricemia, frequently observed following kidney transplantation, may adversely affect graft survival. Although hyperuricemia is a well-known adverse effect of cyclosporine (CsA), a similar effect of tacrolimus (Tac) remains debatable. Hyperuricemia is also seen after oral fructose intake in beverages and processed foods. This sugar is blamed for the epidemic of obesity and metabolic syndrome. The aim of our study was to compare the effects of CsA and Tac on an acute oral fructose load in terms of plasma uric acid, serum lipids, and blood pressure in kidney transplant patients. Thirty-two kidney transplant recipients treated with CsA- or Tac-based triple (calcineurin inhibitor + mycophenolate mofetil + prednisone) immunosuppressive therapy displaying stable allograft function (mean glomerular filtration rate = 53 mL/min/1.73m(2)) received an oral challenge with 70 g of fructose. Serum uric acid, lipids, and blood pressure were measured before as well as 60, 120, 180, and 240 minutes after fructose administration. A significant increase in serum uric acid was observed in both groups after oral fructose administration (P < .001). A peak increase in serum uric acid was recorded at 120 minutes after fructose intake. Serum total, LDL, and HDL cholesterol also significantly decreased and serum triglycerides increased to a similar extent in both CsA and Tac groups. No significant changes in blood pressure were observed after fructose consumption. Oral fructose intake induced an acute rise in serum uric acid and triglycerides and decrease in serum cholesterol among kidney transplant recipients. Those changes were similar among patients treated with CsA or Tac.

[Autoantibodies against neutrophil cytoplasm and their significance in the classification of systemic vasculitis]. / Autoprzeciwciala przeciw cytoplazmie granulocytów obojetnochlonnych i ich znaczenie w klasyfikacji ukladowych zapalen naczyn.

In this article new informations about systemic vasculitis were reviewed. Evaluation of ANCA and their antigen specificity is of a great help in classification of systemic vasculitis. Among idiopathic systemic vasculitis anti-serine proteinase antibodies are found in Wegener granuloma, anti-MPO antibodies in Churg-Strauss syndrome and in polyarteritis nodosa. Antibodies against other components of PMNL granules still remain unknown. The main purpose of this review was to underline incidence of systemic vasculitis and the meaning of ANCA in the diagnosis and classification of these diseases.

[Antibodies against neutrophil cytoplasm and their role in pathology and diagnosis of systemic vasculitis]. / Przeciwciala przeciw cytoplazmie granulocytów obojetnochlonnych i ich rola w patologii i diagnostyce ukladowych zapalen naczyn.

Experimental data and clinical observations suggesting the role of antibodies against neutrophil cytoplasm in pathology and diagnosis of systemic vasculitides have been presented. There are no data indicating that ANCA specificity allow to distinguish diverse forms of necrotizing vasculitis. However, detection of ANCA has a diagnostic interest since it is a key to the diagnosis of vasculitis in complex clinical settings where diagnosis is not obvious. ANCA may be useful in monitoring the course of the disease and effects of treatment.