Effect of sodium bicarbonate in an experimental model of radiocontrast nephropathy

Aim: The aim of this study is to investigate the efficacy and mechanism of action of intravenous (IV) bicarbonate in preventing radiocontrast nephropathy (RCN). Materials and methods: Twenty-eight Wistar rats were randomized into four groups including control (group 1), radiocontrast (group 2), bicarbonate (group 3), and radiocontrast plus bicarbonate (group 4). Once blood chemistry and arterial blood gases were examined and 24 h urine samples were collected, all rats were administered furosemide (2 mg/kg subcutaneous) and deprived of water for 24 h. Iothalamate sodium (6 mL/kg) was administered to group 2 and group 4. IV bicarbonate (8.4%) was administered to group 3 and group 4 (3 h before the administration of iothalamate). On the fourth day, 24 h urine was collected, and at the end of the day rats were sacrificed and blood chemistry and arterial blood gases were reexamined. Myeloperoxidase (MPO), nitric oxide (NO), total glutathione, and malondialdehyde were quantified on the renal tissue. H&E slides were examined. Results: Basal creatinine and creatinine clearance were similar between groups. There was no significant difference between creatinine and creatinine clearance by the end of the experiment. Glutathione level in group 2 was lower than in group 4. Histopathologically, there was no injury in the control group (group 1) whereas there was an intermediate-severe injury (71.4%) in the radiocontrast group (group 2). The percentage of intermediate-severe injury was significantly lower (71.4% vs. 28.6%, p = 0.02) in the radiocontrast plus bicarbonate group (group 4). Conclusions: Sodium bicarbonate attenuates the development of radiocontrast-induced tubular necrosis

Efficacy and safety of sildenafil for treating erectile dysfunction in patients on dialysis

Objective To assess the efficacy of sildenafil for erectile dysfunction (ED) in patients on haemodialysis (HD) or peritoneal dialysis (PD), as men with end-stage renal disease (ESRD) often have sexual dysfunction (up to 82% among those on chronic dialysis)

Coexistence of Familial Mediterranean fever with sacroiliitis and Behcet's disease: A rare occurrence

Familial Mediterranean fever (FMF) and Behcet's disease are relatively rare but may still coexist in the same patient. Sacroiliitis is another feature whose significance is controversial in either of the diseases. We report a case of longstanding FMF with sacroiliitis who later developed typical characteristics of Behcet's disease. Although occurrence by chance cannot be ruled out, this unusual patient may enhance the claims that FMF and Behcet's disease have common aetiopathogenetic mechanisms. It would be appropriate to include this coexistence in the list of differential diagnoses of the two diseases

The effects of intravenous iron treatment on oxidant stress and erythrocyte deformability in hemodialysis patients

Background: It is well known that free iron causes oxidant stress to increase. However data concerning whether intravenously (IN) administered iron in maintenance doses (10-20 mg) gives rise to increased oxidant stress and disturbed erythrocyte deformability (EDEF) in hemodialysis (HD) patients is lacking. In the present study, we aimed to evaluate and compare the effects of IN iron on oxidant stress and EDEF

Effects of N-acetylcysteine on radiocontrast nephropathy in rats

Objective. N-acetylcysteine (NAC) has yielded some promising results recently in the prevention of radiocontrast nephropathy (RCN). In this study, the structural and functional effects of NAC on RCN were analyzed. Material and methods. Twenty-eight Wistar rats were randomized into four groups, as follows: Group 1, controls; Group 2, contrast; Group 3, contrast + NAC; and Group 4, NAC. All rats were deprived of water for 24 h and then contrast medium (ioxoglate; 10 ml/kg) was administered to Groups 2 and 3. NAC ( 50 mg/kg) was introduced enterally to Groups 3 and 4 at a dose of 50 mg/kg in 0.5 ml of distilled water, in four sequential doses 12 h apart, starting after 12 h of water deprivation. After 4 days, rats were sacrificed. Creatinine clearance was calculated. The malondialdehyde (MDA) level was quantified in tissue samples. Slides stained with hematoxylin - eosin and periodic acid - Schiff were examined by means of light microscopy. Each tubular cross-section from all images was scored as either mild ( preserved brush border, no necrosis), moderate ( loss of brush border, no necrosis) or severe ( loss of brush border accompanied by necrosis) and the frequencies of these lesion severities were compared. Results. Mean baseline serum creatinine levels and creatinine clearances were similar in all groups. Mean serum creatinine level increased significantly only in Group 2 (0.6 +/- 0.1 vs 0.7 +/- 0.2 mg/dl; p< 0.05). Tissue MDA levels were similar in all groups. Moderate ( 13.8% +/- 1.5% vs 42% +/- 1.4%; p< 0.05) and severe (0% vs 40% +/- 2.1%; p< 0.05) lesions were significantly more frequent in Group 2 compared to Group 1. The frequency of severe lesions in Group 3 was found to be halved compared to that in Group 1 ( 40% +/- 2.1% vs 20.2% +/- 0.86%; p< 0.05). Conclusion. NAC protects the kidneys following exposure to contrast medium as it decreased the severity of tubular lesions in rats

Outcome of renal transplantation: 7-year experience

We present an algorithm to rearrange the colour chains of dipole showers inthe shower process according to the colour amplitudes of a simple matrixelement. We implement the procedure in the dipole shower of Herwig and showcomparisons to data

Effects of haemodialysis on pulmonary clearance of Tc-99m diethylene triamine pentaacetate (DTPA)

Objectives: Hypoxaemia occurring during haemodialysis has long been known. Several mechanisms in the pathogenesis have been proposed. The present study was conducted to test whether changes in pulmonary alveolar permeability were among the operating mechanisms. Materials and methods Twenty haemodialysis patients (12 male, 8 female) were included in the study. The mean age was 49 years (age range: 18-85 years). Patients with known pulmonary disease, current smokers and those gaining more than I kg weight during the interdialytic period were excluded. Complete blood count, arterial blood gas analysis, pulmonary function tests and Tc-99m diethylene triamine pentaacetate (DTPA) inhalation scintiscan were carried out before and after haemodialysis. A bronchial provocation test was carried out after each session. A postero-anterior chest radiogram was taken for each patient. Results: When the results before and after haemodialysis were compared, it was observed that the pH and serum bicarbonate levels, haemoglobin and haematocrit values were significantly higher after haemodialysis. However, the platelet count was found to be decreased significantly. Bronchial hyperreactivity, tested by metacholine, was positive in 5 of 19 patients (26%). No correlation between bronchial hyperreactivity and other factors could be identified. No significant difference was observed in pulmonary Tc-99m DTPA clearance after haemodialysis. All chest radiograms were interpreted to be within normal limits. Conclusions: Since we observed no hypoxaemia following haemodialysis, we cannot comment as to whether the changes in pulmonary clearance play a role in the pathogenesis of haemodialysis-associated hypoxaemia. In order to reach reliable conclusions, additional studies are needed

Once-Monthly Continuous Erythropoietin Receptor Activator (Cera) For Haemoglobin Maintenance In Haemodialysis Patients With Chronic Renal Anaemia

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