The influence of unfractionated and low-molecular weight heparins on the properties of human umbilical vein endothelial cells (HUVEC).

Heparins, as anticoagulants widely used in the prophylaxis and treatment of many conditions connected with hypercoagulability, have a potent effect on the vascular endothelium. Unfractionated Heparin (UFH) is characterized by relatively low biological accessibility, short activity time, binding of numerous proteins, as well as unfavorable influence on endothelium and blood platelets. Low-Molecular Weight Heparins (LMWHs), formed by chemical and enzymatic UFH depolymerizations, show a significantly more favorable impact on endothelium, which was confirmed on the HUVEC cultures study models. The studies on the heparins' modulation of angiogenesis process proved the superiority of LMWHs over UFH. It was connected with a better deactivation of growth factors' receptors (e.g. for VEGF165, FGF-2). Comparing the effects of LMWHs and UFH on haemostatic and antiangiogenic properties of HUVEC, significant differences were found as well. A new effect, engaging these compounds in the pathomechanism of an excessive osteoclastogenesis via osteoprotegerin /RANKL/RANK pathway has been discovered recently

OPG/RANK/RANKL signaling system and its significance in nephrology.

Recent years brought the discovery of new members of TNF receptor superfamily - osteoprotegerin/receptor activator of nuclear factor-kappaB and its ligand (OPG/RANK/RANKL) system as regulator of bone remodeling. Further studies showed its involvement in control of vascular and immune system. Animal studies' results confirm the OPG/RANK/RANKL role in pathogenesis of vascular calcifications and osteoporosis. Human studies, especially in patients with chronic kidney disease (CKD), have brought many conflicting data. Understanding of exact contribution of each molecule creating this axis may be crucial for diagnosis and treatment of CKD complications involving renal osteodystrophy and vascular calcification. In this review we try to summarize recent knowledge and OPG/RANK/RANKL role in patient with chronic kidney diseases

Sleep disturbances in chronically dialyzed patients

Zaburzenia snu są bardzo częste u chorych przewlekle dializowanych. Wiążą się one ze zmęczeniem, upośledzeniem zdolności poznawczych, gorszą jakością życia, otyłością, cukrzycą, chorobą sercowo- -naczyniową oraz zwiększoną śmiertelnością. Wiele czynników uczestniczy w patogenezie zaburzeń snu u chorych dializowanych, między innymi terapia nerkozastępcza, choroby współistniejące czy leczenie farmakologiczne. Pomimo powszechności problemu pozostaje on w dużej mierze niezdiagnozowany oraz nieleczony. Praca ta ma na celu przybliżenie najczęstszych postaci zaburzeń snu, metod diagnostycznych i sposobów leczenia u chorych przewlekle dializowanych.Sleep disturbances are common in chronically dialyzed patients. Poor sleep is associated with fatigue, cognitive impairment, decreased quality of life, obesity, diabetes, cardiovascular diseases and increased mortality. Many factors contribute to pathogenesis of sleep disturbances in dialyzed patients e.g. renal replacement therapy, comorbidities and medications. Although the problem is common, it remains largely under-recognized and undertreated. The review describes the most common sleep disturbances, diagnostic approach and the methods of treatment in maintenance dialyzed patients

Chorzy trudni nietypowiOstra niewydolność nerek jako nietypowe powikłanie migotania przedsionków

We present a case of a 76-year-old woman with persistent atrial fibrillation, recent diagnosis of ischemic stroke and embolic occlusion of the iliac artery, who was admitted to our department with symptoms of acute renal failure. Using the data from medical history, physical examination, ECG, laboratory tests (urinalysis, LDH in serum and urine) and radiologic studies (color Doppler ultrasound, angio-CT) we diagnosed renal artery embolus and infarct of solitary functioning kidney. We presumed that this complication was related to the inadequate anticoagulation in the course of atrial fibrillation. Patient received intravenous heparin followed by oral warfarin and started renal replacement therapy

OPG/RANK/RANKL signaling system and its significance in nephrology.

Recent years brought the discovery of new members of TNF receptor superfamily - osteoprotegerin/receptor activator of nuclear factor-kappaB and its ligand (OPG/RANK/RANKL) system as regulator of bone remodeling. Further studies showed its involvement in control of vascular and immune system. Animal studies' results confirm the OPG/RANK/RANKL role in pathogenesis of vascular calcifications and osteoporosis. Human studies, especially in patients with chronic kidney disease (CKD), have brought many conflicting data. Understanding of exact contribution of each molecule creating this axis may be crucial for diagnosis and treatment of CKD complications involving renal osteodystrophy and vascular calcification. In this review we try to summarize recent knowledge and OPG/RANK/RANKL role in patient with chronic kidney diseases