Yersinia enterocolitica Infection in Patients Undergoing Intermittent Hemodialysis

End-stage renal disease is the last stage of chronic kidney disease and affects more than 2 million patients worldwide. The infection-related hospitalization is an important cause of excess morbidity and mortality in this group of patients. Yersinia enterocolitica (YE) is one of the bacteria that hemodialysis (HD) patients can occasionally be infected with. The most common symptoms are fever and mild diarrhea, which is self-limited. However, in HD patients, especially in iron-overloaded cases, severe watery or bloody diarrhea can occur. The consumption of undercooked food by patients should sensitize the physician to the possibility of YE infection. Clinically, YE is difficult to diagnose due to nonspecific symptoms and the relatively low prevalence of yersiniosis, compared to other causative pathogens in dialysis patients. There is little information about yersiniosis in HD patients. For this reason, this review aims to summarize the current knowledge on YE infection in HD patients, with the main objective of expounding the problems in identifying, diagnosing, and treating yersiniosis in HD patients

Autonomous parathyroid nodule in peritoneal dialysis patient treated with cinacalcet — a case report

Wtórna nadczynność przytarczyc jest najczęstsząpostacią kliniczną zaburzeń mineralno-kostnychtowarzyszących przewlekłej chorobie nerek. Żadnaze stosowanych metod leczenia tego zaburzenianie jest w pełni skuteczna. Jednym z nowszychsposobów hamowania nadmiernego wydzielaniaparathormonu jest stosowanie cynakalcetu. Ważnymproblemem w leczeniu tym kalcymimetykiemjest prawidłowa kontrola gospodarki wapniowo-fosforanoweji osoczowego stężenia parathormonu.Pojawienie się gruczolaka przytarczyc w okresie ichwtórnej nadczynności sprawia, że leczenie cynakalcetemjest nieskuteczne. Poniżej opisano przypadekpojawienia się autonomicznego guzka przytarczycu chorej dializowanej otrzewnowo z wtórną nadczynnościąprzytarczyc, u której po 3 latach leczeniacynakalcetem wystąpiła hiperkalcemia i wzroststężenia parathormonu.Secondary hyperparathyroidism is the most commonclinical manifestation of chronic kidneydisease-mineral and bone disorder. None of thetreatment methods of this disorder is fully effective.One of the new methods of inhibition ofparathyroid hormone secretion is the use of cina -calcet. The main problem in the treatment withcalcimimetics is correct control of calcium-phosphatebalance and serum parathyroid hormonelevel. The presence of parathyroid adenoma insecondary hyperparathyroidism makes treatmentwith cinacalcet ineffective. In this case report wedescribe the presence of parathyroid adenoma inperitoneal dialysis patient with secondary hyperparathyroidism,which was diagnosed after 3 yearsof treatment with cinacalcet

Self-Reported Physical Activity, Quality of Life, and Psychological Status in Relation to Plasma 25-Hydroxyvitamin D Concentration in Patients Treated with Hemodialysis

Background/Aims: Vitamin D status is announced among factors that may influence physical performance and mental health. Our aim was to evaluate self-reported physical activity, quality of life, psychiatric functioning, and affects with respect to plasma 25-hydroxyvitamin D [25(OH)D] concentrations in HD patients. Methods: The study was carried out in HD patients not receiving vitamin D supplements (n = 112). IPAQ-L, QLI-D, GHQ-28, and PANAS were used in psychological evaluations. Plasma 25(OH)D concentration was determined by a chemiluminescent microparticle immunoassay. Results: Plasma 25(OH)D level was suboptimal in all patients (14.6 ± 4.1 ng/ml). Adjusted correlates of 25(OH)D concentration included the GG genotype of GC rs7041 (β±SE: 1.77± 0.70, P=0.014), female sex (β±SE: -2.19±0.75, P=0.004), and treatment with high flux HD (β±SE: 2.59±0.69, P=0.0003). In adjusted analyses, circulating 25(OH)D showed the independent association with total activity related to domestic and gardening domain (β±SE: 53.2±23.8, P=0.028), and with moderate-intensity activities (β±SE: 54.9±27.4, P=0.048), but not with any of quality of life, psychiatric functioning, or affects measures. Conclusions: Vitamin D status is independently positively associated with physical activity in HD patients. Quality of life and mental health do not seem to be associated with circulating 25(OH)D under condition of its suboptimal levels

SERPINA3: Stimulator or Inhibitor of Pathological Changes

SERPINA3, also called α-1-antichymotrypsin (AACT, ACT), is one of the inhibitors of serine proteases, one of which is cathepsin G. As an acute-phase protein secreted into the plasma by liver cells, it plays an important role in the anti-inflammatory response and antiviral response. Elevated levels of SERPINA3 have been observed in heart failure and neurological diseases such as Alzheimer’s disease or Creutzfeldt–Jakob disease. Many studies have shown increased expression levels of the SERPINA3 gene in various types of cancer, such as glioblastoma, colorectal cancer, endometrial cancer, breast cancer, or melanoma. In this case, the SERPINA3 protein is associated with an antiapoptotic function implemented by adjusting the PI3K/AKT or MAPK/ERK 1/2 signal pathways. However, the functions of the SERPINA3 protein are still only partially understood, mainly in the context of cancerogenesis, so it seems necessary to summarize the available information and describe its mechanism of action. In particular, we sought to amass the existing body of research focusing on the description of the underlying mechanisms of various diseases not related to cancer. Our goal was to present an overview of the correct function of SERPINA3 as part of the defense system, which unfortunately easily becomes the “Fifth Column” and begins to support processes of destruction

ENHO, RXRA, and LXRA polymorphisms and dyslipidaemia, related comorbidities and survival in haemodialysis patients

Abstract Background The energy homeostasis-associated gene (ENHO), retinoid X receptor alpha gene (RXRA), and liver X receptor alpha gene (LXRA) are involved in adipogenic/lipogenic regulation. We investigated whether single-nucleotide polymorphisms in these genes (ENHO rs2281997, rs72735260; RXRA rs749759, rs10776909, rs10881578; LXRA rs2279238, rs7120118, rs11039155) are associated with dyslipidaemia, related comorbidities and survival of haemodialysis (HD) patients also tested for T-helper (Th) cell interleukin genes (IL). Methods The study was carried out in 873 HD patients. Dyslipidaemia was diagnosed by the recommendations of the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines (2003); atherogenic dyslipidaemia was referred to if the TG/HDL cholesterol ratio was equal to or higher than 3.8. Genotyping of ENHO SNPs, LXRA SNPs, and IL12A rs568408 was carried out using HRM analysis. RXRA SNPs, IL12B rs3212227, and IL18 rs360719 were genotyped using PCR-RFLP analysis. The circulating adropin concentration was determined in 126 patients by enzyme-linked immunosorbent assay. Survival probability was analysed using the Kaplan-Meier method in 440 patients followed through 7.5 years. Results Dyslipidaemia by K/DOQI was diagnosed in 459 patients (91% revealed hyper-LDL- cholesterolaemia), atherogenic dyslipidaemia was diagnosed in 454 patients, and 231 patients were free of dyslipidaemia by both criteria. The variant allele (T) of ENHO rs2281997 was associated with the hyper-LDL cholesterolaemic pattern of dyslipidaemia by K/DOQI. The frequency of atherogenic dyslipidaemia was lower in T-allele bearers than in CC-genotype patients. The rs2281997 T allele was associated with lower cardiovascular mortality in HD patients showing atherogenic dyslipidaemia. ENHO, RXRA, and LXRA showed epistatic interactions in dyslipidaemia. Circulating adropin was lower in atherogenic dyslipidaemia than in non-atherogenic conditions. RXRA rs10776909 was associated with myocardial infarction. Bearers of LXRA rs2279238, rs7120118 or rs11039155 minor alleles showed higher mortality. ENHO SNP positions fell within the same DNase 1 hypersensitivity site expressed in the Th1 cell line. Epistatic interactions occurred between rs2281997 and Th1 IL SNPs (rs360719, rs568408). Conclusions Atherogenic dyslipidaemia occurs in HD patients in whom ENHO encodes less adropin. ENHO, RXRA, and LXRA SNPs, separately or jointly, are associated with dyslipidaemia, myocardial infarction, and survival in HD patients. Differences in the availability of transcription binding sites may contribute to these associations

The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review

Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous side effects such as oxidative stress, systemic and local-intestinal inflammation, dysbiosis, carcinogenic processes and gastrointestinal adverse events. Therefore, this review aimed to provide insight into the physiological mechanisms of iron management and investigate the state of knowledge of the relationship between iron supplementation, inflammatory status and changes in gut microbiota milieu in diseases typically complicated with IDA and considered as having an inflammatory background such as in inflammatory bowel disease, colorectal cancer or obesity. Understanding the precise mechanisms critical to iron metabolism and the awareness of serious adverse effects associated with iron supplementation may lead to the provision of better IDA treatment. Well-planned research, specific to each patient category and disease, is needed to find measures and methods to optimise iron treatment and reduce adverse effects

Diagnostic Problems in C3 Glomerulopathy

Background: C3 glomerulopathies (C3GN) are a group of rare kidney diseases associated with impaired complement regulation. The effects of this disease include the accumulation of complement C3 in the kidneys. Based on the clinical data, as well as light, fluorescence, and electron microscopy results, the diagnoses were verified. The study group consisted of biopsy specimens, which were obtained from 332 patients who were diagnosed with C3 glomerulopathy. In all cases, histopathological examinations were performed; deposits of complement C3 and C1q components, as well as the immunoglobulins IgA, IgG, and IgM, were identified using immunofluorescence. Furthermore, electron microscopy was also performed. Results: The histopathological examination results presented cases of C3GN (n = 111) and dense deposit disease (DDD; n = 17). The non-classified (NC) group was the most numerous (n = 204). The lack of classification was due to the poor severity of the lesions, even on the electron microscopic examination or in the presence of intense sclerotic lesions. Conclusions: In cases of suspected C3 glomerulopathies, we believe an electron microscopy examination is necessary. This examination is beneficial in mild-to-extremely-severe cases of this glomerulopathy, where the lesions are barely discernible when using immunofluorescence microscopy