Comparison of Widely Used Biochemical Analytes in the Serum and Saliva Samples of Dialysis Patients.

BACKGROUND: The aim of this study is to determine whether the saliva analysis is an alternative to routine biochemical and immunoassay analyses in patients undergoing perito - neal dialysis (PD) or hemodialysis (HD). METHODS: Study group consisted of 40 healthy control, 44 PD and 44 HD patients. Routine biochemical analytes, thyroid stimulating hormone (TSH), free T3, free T4, vitamin B12, ferritin and folic acid were measured. RESULTS: Compared to pre-HD, urea, creatinine, uric acid, potassium levels were lower in post-HD, and calcium, magnesium, vitamin B12 levels were higher in post-HD both in saliva and serum. Positive correlations between saliva and serum were found for TSH and ferritin in control; urea, LDH, K in PD; urea, creatinine, alkaline phosphatase in pre-HD, and gamma-glutamyl transferase, iron, TSH in post-HD. There was a negative correlation only for creatine kinase and Mg in pre-HD and calcium in post-HD. In all groups, a positive correlation was found for urea, creatinine and a negative correlation was found for magnesium. CONCLUSIONS: Our study showed higher salivary urea and creatinine levels in patient groups, consistent with serum levels. Based on these results, salivary urea and creatinine levels may be useful in the evaluation of azotemia in dialysis patients.

Oral high-dose ankaferd administration effects on gastrointestinal system.

BACKGROUND AND AIMS: Ankaferd Blood Stopper (ABS) is a herbal extract obtained from five different plants. It has a therapeutic potential for the management of external hemorrhage and controlling gastrointestinal bleeding. However, ABS's effects are not unknown on gastrointestinal systems. The aim of this study was to assess the effect of short- and long-term systemic exposure and gastrointestinal safety following the oral administration of high-dose ABS in rats. METHODS: Eighteen healthy adult male rats were included into the study. The rats were divided into 4 groups: group A was fed with high dose ABS (2ml/Kg) for one week, group B for one month, group C for three months and group D's diet did not contain any ABS. On termination of the ABS treatment, the gastrointestinal system from the esophagus to the anus and the liver were surgically removed and histological investigated. RESULTS: During the study period, there was no mortality; signs of intoxication in any of the studied groups. No gastrointestinal tissue fibrosis, dysplasia, or metaplasia was detectable in any of the groups. The stomach had a normal morphology in all groups. However, the other gastrointestinal tract sections showed mucosal inflammation, goblet cell decrements, and intra-epithelial lymphocyte infiltration. The most common changes were mucosal inflammation in all rats in group B and C. Frequency of inflammation was greater in groups B and C in comparison to group A (P= 0.001). Loss of goblet cell and intra-epithelial lymphocyte infiltration were not significantly different between groups A and B (P=0.308 and P=0.189, respectively). However, there was significantly higher intra-epithelial lymphocyte infiltration in group C than in group A (P=0.04). Histopathological examination of the liver showed no inflammation, fibrosis, bile duct destruction or proliferation in any of the groups. However, each groups revealed vascular dilatation and erythrocyte accumulation at the sinusoidal structures of the liver. CONCLUSIONS: ABS seems to be a safe agent and it can be used for hemorrhage originated from gastric lesions. Further work needs to be done to establish whether ABS leads to be used to stop gastrointestinal bleeding.

Percutaneous ankaferd injection to in vivo liver tissue in comparison to ethanol in an experimental rat model.

AIM: Percutaneous ethanol injection is an established management of nonresectable hepatocellular carcinoma (HCC) because of its high effectiveness and minimal invasiveness. However, ethanol has many disadvantages like less anti-tumoral necrotic effectivity, unequal permeation and local diffusion. The aim of this study is to compare hepatic tissue effects of percutaneous Ankaferd Blood Stopper (ABS) injection in comparison to ethanol in rat liver tissue. MATERIALS AND METHODS: Twenty-one healthy rats were randomly divided into three groups, each containing seven animals. Group I received 0.1cm(3) percutaneous injection of isotonic saline, group II received 0.1cm(3) ethanol, and group III received 0.1cm(3) ABS. At the 5th day, the livers were dissected. Macroscopic and histopathological features of the liver lesions were documented. RESULTS: All the rats in the group I and II lived during study period; one rat died in the ABS group. Macroscopic pale yellow coloration was observed within 2 minutes in both ethanol and ABS groups. Necrosis was observed in both Group II and III. The necrosis volumes of the ABS group (volume: 1475.00 ± 697.16 cm(3)) were significantly higher than the ethanol group (volume: 60.714 ± 26.277 cm(3)) (P=0.002). In the histopathological analyses of the liver tissues, aggregated erythrocytes in sinusoidal spaces and bile duct proliferation have been detected in ABS group. CONCLUSION: ABS may be considered as a possible percutaneous treatment in HCC instead of or as an alternative to ethanol. With its unique hemostatic actions and the safety profile, ABS can be considered as a useful novel agent for the percutaneous therapy of HCC instead of ethanol in the future.

Macroprolactin does not contribute to elevated levels of prolactin in patients on renal replacement therapy.

OBJECTIVE: Three molecular forms of PRL with molecular weights of 23, 50-60 and > 100 kDa have been defined. The high-molecular-weight forms are called macroprolactin. Different immunoassays produce varyingly elevated results with macroprolactin-containing sera. The kidneys are reported to clear 25% of PRL from the circulation. Hyperprolactinaemia is seen in 20-75% of patients with chronic renal failure (CRF). PRL clearance rate has been reported to be reduced in CRF and the resulting hyperprolactinaemia is due to reduced renal function. PATIENTS: To determine the contribution of macroprolactinaemia to elevated PRL levels in CRF, 91 patients receiving haemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and renal transplantation (RT) therapies and 72 control subjects were included in the study. MEASUREMENTS: Serum PRL levels were measured by a sandwich immunoassay with electrochemical detection. Following polyethylene glycol (PEG) precipitation, recovery ratios were calculated and samples with a recovery of < 50% were identified as having macroprolactin isoforms. RESULTS: The serum and supernatant PRL levels of CRF patients were significantly higher than those of the control group (P < 0.001). The serum PRL levels of HD and CAPD patients were significantly higher than those of the RT patients (P < 0.001). The serum PRL levels of the RT patients and the control group did not differ significantly (P > 0.05). A moderate correlation was found between PRL and creatinine levels (r = 0.609, P < 0.001). CONCLUSIONS: The hyperprolactinaemia seen in renal replacement therapy is not associated with the presence of macroprolactin isoforms but with the decline in renal function.