[Conditions and consequences of cardiac alterations in patients with end-stage renal disease on maintenance hemodialysis]. / Uwarunkowania i nastepstwa zmian w sercu u chorych ze schylkowa niewydolnoscia nerek przewlekle dializowanych.

The arterial hypertension, hyperlipidemia, fluid overload, electrolytic disorders, the presence of arteriovenous fistula and secondary hyperparathyroidism are the most essential causative factors in cardiac pathology of uremic patients. Apart from that, hemodialysis itself is not an indifferent factor. The cardiac consequences consist in prevalence of hypertrophy or dilatation of the heart including valvular annuli or sheer myocardial calcifications and even the acquired heart diseases. Their coexistence with ischaemic heart disease, systolic and especially diastolic dysfunction of the left ventricle may jeopardize life.

[Evolution of morphological and clinical changes in mesangial proliferative glomerulonephritis]. / Ewolucja zmian morfologicznych i klinicznych w klebkowych rozplemowych mezangialnych zapaleniach nerek.

The clinical and morphological analysis is reported of the changes evolving in 12 cases of mesangial proliferative glomerulonephritis based on repeated biopsies carried out at intervals from 1 to 7 years. Clinical findings at the time of the first biopsy included in 2 cases nephrotic syndrome, and in the remaining cases proteinuria ranging from 0.3 to 2/1000. In all cases erythrocytes in urine were present ranging from 4-6 to 50-100 erythrocytes per field of vision. Hypertension was found in 4 cases, and increased serum creatinine level in 1 patient. At the time of repeated biopsy in 11 cases clinical evidence of improvement was noted with decreased proteinuria anderythrocytes in urine. In 1 case worsening was found and several months later signs of renal failure developed which led to death. The morphological examinations demonstrated in the first biopsies mesangial proliferative glomerulonephritis. In second biopsies these findings were confirmed. In 1 case with unfavourable outcome the changes became more pronounced, and in the remaining ones no significant differences were noted in relation to the first biopsy which evidenced lack of a close correlation between the clinical condition and the morphological state of the kidneys.