Smoking following renal transplantation in Hungary and its possible deleterious effect on renal graft function.

Smoking is a known risk factor for kidney damage and also influences graft function following renal transplantation. Because smoking habits following kidney transplantation are not systematically evaluated, we analyzed them in a single center in Hungary. The survey was conducted among 402 randomly selected kidney graft recipients. We assessed smoking-related questions as well as clinical kidney disease and transplantation data. Posttransplantation renal function was analyzed based on serum creatinine values at 1 month and at 3 years after transplantation. In our study 25% (n = 102) of patients continued to smoke after transplantation. Smokers who received grafts displayed a significantly younger age compared with nonsmokers (40.1 +/- 13.4 vs 47.1 +/- 12.7 years; P < .001) independent of underlying kidney disease. Posttransplantation kidney function in smokers did not differ at 1 month after engraftment, but was significantly impaired at 3 years as assessed based on serum creatinine levels: 138.9 +/- 42.4 versus 128.4 +/- 48.5 micromol/L (P < .05). Decrease of renal function correlated with smoking intensity defined in pack-years (r(2) = 0.102; P < .05). Smoking is common following kidney transplantation in Hungary and might represent a risk factor for kidney damage following renal transplantation. Therefore, effective tobacco-dependence treatment is necessary in this patient population.

Biocompatibility of haemodialysis membranes determined by gene expression of human leucocytes: a crossover study.

BACKGROUND: Biocompatibility of haemodialysis membranes is the most important quality criteria to enable long-term dialysis without major harmful effects. This study sought to evaluate the differences of genomic signatures derived from peripheral blood mononuclear cells (PBMC) in patients undergoing haemodialysis treatment using two different dialyser membranes: one semi-synthetic and one full-synthetic membrane. DESIGN: Microarray experiments were conducted in PBMCs of four stable haemodialysis patients before and after dialysis comparing semi-synthetic (Hemophan GFS Plus 16) and full-synthetic (Hemoflow FX80) dialysis membranes, respectively. Genes differentially expressed when comparing the two different membranes used were analysed in order to elucidate the underlying molecular mechanisms affecting PBMCs in the course of dialysis treatment. RESULTS: One hundred and seventy-two genes were identified as up-regulated after treatment with semi-synthetic membranes when compared to full-synthetic membranes. These genes could be assigned to processes including immunity and defence, signal transduction, and apoptosis. Dialysis with a full-synthetic membrane, on the other hand, led to an activation of 72 genes that were mainly involved in cell cycle and cell cycle control. CONCLUSION: The over-representation of genes belonging to immunity/defence, signal transduction, and apoptosis as found with semi-synthetic membranes suggests that full-synthetic membranes are more biocompatible than semi-synthetic membranes.