Decreased melatonin nocturnal concentrations in hemodialyzed patients.

OBJECTIVES: In spite of broad interest, intensive studies on function of melatonin have not yielded much information about relationships between this hormone and kidneys in health, and particularity, in disease. There are only a few studies dealing with melatonin concentrations in renal diseases, mainly performed in hemodialyzed patients with end-stage renal disease (ESRD). Moreover, the most melatonin assays were performed during the daytime, and the results are conflicting. Therefore, the aim of the present study was to determine the circadian melatonin profiles in patients ESRD before and after hemodialysis. MATERIAL AND METHODS: Thirty patients (19 males and 11 females) with ESRD undergoing dialysis, aged 22 to 64 years (mean+/-SEM: 49.1.0+/-1.9 years) were included in the study. The control group consisted of 20 healthy volunteers (13 males and 7 females) aged 35 to 55 years (mean+/-SEM: 46.2+/-1.4 years) matched according to sex and age. Blood samples were collected on the day preceding hemodialysis and one day following dialysis at 08:00, 12:00, 16:00, 20:00, 24:00, 02:00, 04:00, and 08:00 h. Melatonin concentration was measured by enzyme immunoassay. RESULTS: In patients with renal insufficiency undergoing dialysis mean melatonin nocturnal concentrations were significantly lower then those in healthy volunteers. The presence of the circadian rhythm in melatonin concentrations (although of significantly lower nocturnal amplitude) was detected only in 8 patients with renal failure undergoing hemodialysis, whereas in remaining 22 patients no such rhythm was found. Hemodialysis did not influence melatonin concentrations. CONCLUSIONS: The mechanism of depressed melatonin concentrations in hemodialyzed patients observed in our study remains unclear. However, it seems possible that decline in melatonin levels is due to impairment in adrenergic function that occurs in renal failure. Because the studies on the melatonin secretion in chronic renal failure bring about conflicting results, the relationship between renal diseases and melatonin secretion needs further investigations.

[Assessment of autonomic nervous system by spectral analysis of heart rate and blood pressure in hemodialysed patients]. / Ocena autonomicznego ukladu nerwowego za pomoca analizy zmiennosci rytmu serca i cisnienia tetniczego u chorych hemodializowanych.

The aim of the presented study was to assess autonomic nervous system (ANS) among hemodialysed patients. Twenty-seven pts. were included to the study (15 M, 12 F) and as a control group 22 (12 M, 10 F) healthy persons were taken. To asses cardiovascular part of ANS we used Ewing battery, time and spectral analysis of heart rate variability (HRV) and spectral analysis of blood pressure variability (BPV). QT interval was analyzed from standard 12-lead ECG. The hemodialysed patients showed certain signs of autonomic dysregulation. Forty two percent of pts had abnormalities in Ewing tests most prevalent in parasympathetic part of ANS. Spectral HRV parameters were pathological in 44.4% patients. The low frequency component of BPV was significantly lower in HD patients without changes in the high frequency component. QT interval dispersion and corrected by heart rate QT interval dispersion were significantly higher in hemodialysed patients than in the control group.

[Multifocal fungal infections in patients after renal transplantation undergoing immunosuppression]. / Wieloogniskowe zarazenia grzybami u poddawanych immunosupresji osób po przeszczepach narek.

The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients and the characteristics of 60 species and intraspecies features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosuppression after renal transplantation. Fungal strains were recovered in 66 out of 96 samples (68.2% off all renal transplant recipients). There were in ontocenoses: oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocals mycosis were found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection occurred in 12.5% of all examined renal transplant recipients. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity of 19 hydrolases was investigated using API ZYM. From among 41 strains of fungi the following were found: Candida albicans (31 strains), Candida glabrata (5), Candida guilliermondii (2), Candida krusei (2) and Saccharomyces cerevisiae (1). The enzymograms were described for all strains and the highest activity was noted in case of: leucine arylamidase, acid phosphatase, esterase, naphtol-AS-BI-phosphohydrolase. The presence high mean of activity of this enzymes means high pathogenicity of C. albicans strains.

Circadian serum melatonin profiles in patients suffering from chronic renal failure.

OBJECTIVES: In spite of broad interest, intensive studies on function of melatonin have not yielded much information about relationships between this hormone and kidneys in health, and particularity, in disease. Very little is known about the circadian plasma melatonin concentrations in patients with chronic renal failure (CRF). There are only a few studies dealing with melatonin concentrations in renal diseases, mainly performed in hemodialyzed patients with end-stage renal disease (ESRD). Moreover, the most melatonin assays were performed during the daytime, and the results are conflicting. Therefore, the aim of the present study was to determine the circadian melatonin profiles in patients with different stages of CRF. MATERIAL AND METHODS: Twenty four patients (13 males and 11 females) with CRF aged 35 to 58 years (mean+/-SEM: 47.0+/-1.6 years) were included in the study. Patients were divided into two groups: group 1 -- patients with compensated CRF (serum creatinine: 2.0-5.0 mg/dL), group 2 -- patients with ESRD (serum creatinine: > 8,0 mg/dL). The control group consisted of 20 healthy volunteers (10 males and 10 females) aged 35 to 55 years (mean+/-SEM: 46.0+/-1.5 years) checked not to have renal failure [serum creatinine: 0.8-1.4 mg/dL], and matched according to sex and age. Blood samples were collected at 08:00, 12:00, 16:00, 20:00, 24:00, 02:00, 04:00, and 08:00 h. Melatonin concentration was measured by enzyme immunoassay. RESULTS: In both groups of patients with chronic renal failure, i.e. in patients with compensated disease and in patients with end-stage renal disease melatonin nocturnal concentrations were significantly lower then those in healthy volunteers. Moreover, in patients with compensated renal failure also day-time melatonin concentrations were significantly depressed. Area under curve was significantly lower in both groups of patients in comparison with the control group. CONCLUSIONS: The mechanism of depressed melatonin concentrations in CRF observed in our study remains unclear. However, it seems possible that decline in melatonin levels is due to impairment in adrenergic function that occurs in CRF. Because the studies on the melatonin secretion in CRF bring about conflicting results, the relationship between renal diseases and melatonin secretion needs further investigations.

[Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion after renal transplantation]. / Prewalencja wieloogniskowych zarazen grzybami u chorych z przeszczepami nerek poddawanych stalej immunosupresji.

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion after renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% off all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%) Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2), Saccharomyces cerevisiae (1).

[Characteristics of phenotypic specific and intraspecific features of fungal strains isolated from the organ ontocenoses in patients after renal transplantation]. / Charakterystyka cech fenotypowych gatunkowych i wewnatrzgatunkowych szczepów grzybów wyodrebnionych z wybranych ontocenoz narzadowych osób po przeszczepach nerek.

Characteristics of phenotypic specific and intraspecific features of fungal strains isolated from the organ ontocenoses in patients after renal transplantation. The aim of present study was to describe 60 specific and intraspecific features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosupression after renal transplantation. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity of 19 hydrolases was investigated using API ZYM. Among 41 strains of fungi the following were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2) and Saccharomyces cerevisiae (1). The number of fungal strains isolated from the oral cavity was the highest (21), less numerous from rectum (12) and the least from the genital organs (8). The enzymograms were described for all strains and the highest activity was noted in case of: e6 - leucine arylamidase, e11 - phosphatase acid, e3 - esterase (C4), e12 - naphtol-AS-BI-phosphohydrolase. The activity of these enzymes is connected with higher pathogenicity of C. albicans strains.