The future of Polish and European nephrology belongs to the young: the Young Nephrologists’ Platform

Według danych rejestru Europejskiego Towarzystwa Nefrologicznego (ERA-EDTA) w kwietniu 2013 roku osoby w wieku do 40. roku życia stanowiły około 21% wszystkich jego członków. Ostatnio w ERA-EDTA powstała nowa inicjatywa: The Young Nephrologists’ Platform (YNP) — Platforma Młodych Nefrologów. Ambitnym celem platformy jest stworzenie nowoczesnej sieci współpracy młodych nefrologów, głównie z Europy, poprzez bezpośrednie kontakty przy wykorzystaniu nowoczesnych kanałów komunikacyjnych. Nowymi inicjatywami YNP są między innymi program międzynarodowego mentorstwa, kursy CME zgodne z oczekiwaniami młodych nefrologów, udział członków YNP w grupach roboczych ERA-EDTA. Przyszłość polskiej i europejskiej nefrologii zależy w dużej mierze od aktywności młodego pokolenia a uczestnictwo w YNP może ułatwić rozwój kariery zawodowej i naukowej młodych nefrologów.The prevalence of colleagues aged < 40 years account for the 21% of the European Renal Association (ERA-EDTA) members in 2013. Recently, the ERA-EDTA has launched a new platform, the Young Nephrologists’ Platform (YNP), whose ambitious aim is to become the first modern network of young nephrologists from Europe and beyond. Among new initiatives driven be the YNP we can find mentorship program, young-oriented clinical courses on hot topics and involvement of young nephrologists in working groups and scientific project. The future of Polish and European nephrology belongs to the young and YNP might be the right and fast track for the professional growth of young nephrologists

Podsumowanie wytycznych praktyki klinicznej dotyczących przed- i pooperacyjnej opieki nad naturalnymi przetokami tętniczo-żylnymi i przetokami z użyciem protez naczyniowych (graftów) u dorosłych hemodializowanych pacjentów

Vascular access remains one of the most challenging aspects of renal replacement therapy. New European Renal Best Practice (ERBP) Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis was published in 2019 (https://doi.org/10.1093/ndt/gfz072). During Advisory Board meeting of ERBP,the official guidance providing body of ERA-EDTA, it was decided that ERBP will stimulate the translation of the short version of the guidelines into different languages (www.european-renal-best-practice.org/sites/default/files/u33/ERBP_006-VASCAC_Short-Version.pdf).Dostęp naczyniowy pozwalający na przeprowadzenie hemodializy musi funkcjonować prawidłowo, zapewniać odpowiedni przepływ krwi, pozwalając na usunięcie w czasie zabiegu toksyn mocznicowych, a jednocześnie nieść możliwie niskie ryzyko infekcji ogólnoustrojowej. European Renal Best Practice (ERBP), oficjalny organ ERA-EDTA, postanowiła zaktualizować wcześniejsze wytyczne dotyczące tego zagadnienia i opracowało zestaw zaleceń, które mają być pomocne w podejmowaniu decyzji dotyczących wyboru dostępu naczyniowego do hemodializ, sposobu kierowania chorych na zabieg jego wytworzenia, oceny jego przydatności, a także nadzoru i leczenia powikłań. Niniejsze opracowanie stanowi tłumaczenie skróconej wersji tych wytycznych, opublikowanych w 2019 roku (www.european-renal- best-practice.org/sites/default/files/u33/ERBP_ 006-VASCAC_ShortVersion.pdf). Zalecenia te, dotyczące praktyki klinicznej, obejmują w szczególności około- i pooperacyjne aspekty postępowania z przetokami z naczyń własnych, jak również wytworzonymi z użyciem sztucznych naczyń (graftów)

An unsuspected histopathological finding —concomitant IgA nephropathy in a patient with ANCA-associated vasculitis: a case report and literature review

Although associations of IgA nephropathy (IgAN) and ANCA-associated vasculitis (AAV) have been described, this coexistence scarcely occurs and requires multidisciplinary management. Herein, we discuss a course of treatment introduced in a patient with two exacerbations. Furthermore, alterations in histopathological images between two kidney biopsies are presented. The applicability of traditional inflammatory markers, e.g., CRP, in monitoring disease severity in AAV and IgAN is limited. Based on our patient and current literature, we suggest ANCA testing in patients with rapidly progressing IgAN for therapeutic and prognostic purposes. As regards the therapy of IgAN associated with AAV, aggressive immunosuppressive regimens with methylprednisolone and cyclophosphamide are recommended. Alternatively, methylprednisolone with rituximab, plasma exchange, mycophenolate mofetil, and intravenous immunoglobulin (IVIG) could also be considered

Secular and catastrophic processes reflected in sediments of the Suchedniów water reservoir, Holy Cross Mountains (Poland)

The Suchedniów water reservoir is located in the central section of the River Kamionka in the northern part of the Holy Cross Mountains of central Poland. This area once belonged to the Old Polish Industrial District that, during the Middle Ages, was very intensively developed by iron metallurgy. Many forges and mills along the rivers used water power, which led to the construction of an anthropogenic, small-scale water retention system. At the beginning of the twentieth century many of these reservoirs were drained after the collapse of metallurgical activities. The present-day reservoir was built in 1974 and drained in 2017. Research into the drained basin has documented various forms and sediments, some of which record present-day depositional processes (fire proof clay layer, inland fan delta), while others represent the historical period (lacustrine sediments of older reservoirs). Traces of catastrophic events have been preserved as well; an assemblage of megaripples marks the sudden drainage caused by a dam break in 1974

Fabry disease and sleep disorders: a systematic review

BackgroundFabry disease (FD) is an X-chromosome-linked disorder characterized by a reduced or complete absence of the enzyme α-galactosidase, resulting in the accumulation of lysosomal globotriaosylceramide. Despite the presence of these deposits in multiple organs, the problem of sleep disorders within this population has very rarely been documented.ObjectiveThis study aimed to investigate the types and prevalence of sleep disorders among patients with FD.MethodsScreening of the following medical databases using key terms was performed on 10 February 2023: PubMed, Scopus, and Embase. A total of 136 records were identified. The quality assessment of the studies was conducted by using tools from the National Institutes of Health (NIH) and critical appraisal tools from the Joanna Briggs Institute (JBI).ResultsThe study included nine studies on sleep disorders in patients with FD. The overall quality of the majority of these studies was assessed as either poor or fair. Among 330 patients, there was a slightly higher representation of female patients (56%). Sleep problems manifested 4–5 years after the onset of FD and sometimes even after 10–11 years. Genotypes of disease associated with sleep problems were rarely described. Within the FD population, the most commonly reported conditions were excessive daytime sleepiness (EDS) as well as obstructive and central sleep apnea (OSA, CSA). However, EDS occurred more frequently in FD patients, while the prevalence of OSA and CSA was within the ranges observed in the general population. The studies included indicated a lack of association between organ impairment by primary disease and EDS and OSA. The effectiveness of enzyme replacement therapy (ERT) in treating sleep disorders was not demonstrated.ConclusionThe findings of this report revealed the presence of many sleep-related disorders within the FD population. However, very few studies on this subject are available, and their limited results make it difficult to truly assess the real extent of the prevalence of sleep disturbances among these individuals. There is a need to conduct further studies on this topic, involving a larger group of patients. It is important to note that there are no guidelines available for the treatment of sleep disorders in patients with FD

The Relationship of Epicardial Adipose Tissue and Cardiovascular Disease in Chronic Kidney Disease and Hemodialysis Patients

Cardiovascular diseases remain the most common cause of morbidity and mortality in chronic kidney disease patients undergoing hemodialysis. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Additionally, EAT has been proposed as a novel cardiovascular risk in the general population and in end-stage renal disease patients. It has also been shown that EAT, more than other subcutaneous adipose tissue deposits, acts as a highly active organ producing several bioactive adipokines, and proinflammatory and proatherogenic cytokines. Therefore, increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis, and high morbidity and mortality in hemodialysis patients. In the present review, we aimed to demonstrate the role of EAT in the pathophysiological mechanisms of increased cardiovascular morbidity and mortality in hemodialysis patients

Cognitive Impairment in End Stage Renal Disease Patients Undergoing Hemodialysis: Markers and Risk Factors

(1) Background: Cognitive impairment (CI) is common in chronic kidney disease (CKD) and patients treated with hemodialysis. (2) Methods: The systematic review was prepared following the PRISMA statement (2013). The biomedical electronic databases MEDLINE and SCOPUS were searched. (3) Results: out of 1093 studies, only 30, which met problem and population criteria, were included in this review. The risk factors for CI can be divided into three groups: traditional risk factors (present in the general population), factors related to dialysis sessions, and nontraditional risk factors occurring more frequently in the HD group. (4) Conclusions: the methods of counteracting CI effective in the general population should also be effective in HD patients. However, there is a need to develop unique anti-CI approaches targeting specific HD risk factors, i.e., modified hemodialysis parameters stabilizing cerebral saturation and blood flow

Kidney Transplantation in COVID Pandemic—A Review of Guidelines

The paper describes problems with the transplantation process during the COVID-19 pandemic. Transplantation procedures and programs have been impacted by COVID-19. The number of transplants has fallen noticeably. The first part of the paper points out changes in service organization, in particular donor and recipient pre-transplant and peri-transplant management. If the patients during pre-transplant evaluation need to attend face-to-face appointments, such as blood testing or other investigations, the risk of contracting or spreading COVID-19 should be minimized. “Clear green areas”, which are COVID-19-free pathways, are highly recommended in hospitals during transplant procedures. Diagnostic procedures concerning donors, including CT scans and coronavirus testing (nasopharyngeal swab), are necessary before transplant surgery. COVID-19 symptoms and risks of the transplant population are described. Detailed guidelines from transplant societies concerning changes in immunosuppression in infected recipients are discussed. Management of infected or suspected medical staff is mentioned. The paper ends with guidelines concerning vaccination against COVID-19 in transplant recipients