KIDNEY FUNCTION IN A PATIENT WITH THROMBOTIC THROMBOCYTOPENIC PURPURA

Trombotička trombocitopenična purpura (TTP) je multisistemska bolest koja neliječena ima visoku stopu smrtnosti. Prikazujemo slučaj bolesnice od TTP dijagnosticiranog i liječenog u Kliničkom centru Crne Gore, uz prikaz dijagnostike i metodologije liječenja. Opisano je i praćenje bubrežne funkcije bolesnika nakon završenog liječenja i postizanja remisije TTP.Thrombotic thrombocytopenic purpura is a systemic disorder with high mortality rate if not treated with plasma exchange. We present a case of severe thrombotic thrombocytopenic purpura diagnosed and treated at Montenegro Clinical Center, with special reference to the follow-up of renal function

POVEZANOST IZMEĐU STAVOVA I NAVIKA U ISHRANI I SERUMSKOG FOSFORA U BOLESNIKA NA HEMODIJALIZI

Nutritional problems in hemodialysis (HD) patients are frequently associated with poor control of serum phosphorus what may lead to chronic kidney disease-metabolic bone disease. Hyperphosphatemia is an important risk factor for extraskeletal and vascular calcifications and is associated with cardiovascular morbidity and mortality. Increased ingestion of phosphorus is an important factor in development of hyperphosphatemia. We investigated nutritional habits and attitudes of HD patients and determined their correlation with serum phosphate levels in 57 patients treated in Clinical centre Montenegro. Twenty-two patients were male (38.6%), with average age 57 (range, 30-73 years). Statistically significant correlation was found between red meat or milk ingestion and serum phosphate, as well as between educational level and serum phosphate. In our population, socioeconomic level was directly correlated with serum phosphate. Conclusion: a serum phosphate level is determined by socioeconomic level, ingestion of red meat and milk, and depends on educational level in HD population of the capital of Montenegro.Poremećaj uhranjenosti bolesnika kojima se bubrežna funkcija nadomješta hemodijalizom (HD) često je povezan s lošom kontrolom serumskog fosfora, što može dovesti do poremećaja metabolizma kosti s posljedičnim razvojem sekundarnog hiperparatireoidizma i poremećajem mineralo-koštanog metabolizma. Hiperfosfatemija je značajan čimbenik rizika za razvoj kalcifikacija mekih tkiva, kao i za pobolijevanje i smrtnost od srčano-žilnih bolesti. Povećan unos hrane bogate fosforom značajan je čimbenik koji dovodi do hiperfosfatemije. Istraživanje ima za cilj ispitati prehrambene navike i stavove bolesnika liječenih HD i utvrditi njihovu povezanost s razinama serumskog fosfora. Istraživanje je provedeno u ožujku 2015. u Centru za hemodijalizu, Kliničkog centra Crne Gore. Istraživanje je provedeno na 57 bolesnika koji su na redovitom programu intermitentne hemodijalize. Muškaraca je bilo 22 (38,6 %). Prosječna dob bolesnika bila je 57 godina (raspon 30-73 godine). Pronađena je statistički značajna povezanost između vrste hrane, osobito crvenog mesa ili konzumiranja mlijeka i mliječnih proizvoda i serumske razine fosfora, kao i između razine obrazovanja ispitanika i razine serumskog fosfora. U našoj je populaciji serumska razina fosfora bila direktno povezana sa socioekonomskim statusom bolesnika. Zaključujemo da je: koncentracija fosfata u serumu određena socijalno–ekonomskom razinom društva, kao i običajem da se u prehrani koriste meso i mlijeko. Nadalje, u konkretnom slučaju vezana je uz prosvjećenost bolesnika koji se dijaliziraju u glavnom gradu Crne Gore

POVEZANOST IZMEĐU STAVOVA I NAVIKA U ISHRANI I SERUMSKOG FOSFORA U BOLESNIKA NA HEMODIJALIZI

Nutritional problems in hemodialysis (HD) patients are frequently associated with poor control of serum phosphorus what may lead to chronic kidney disease-metabolic bone disease. Hyperphosphatemia is an important risk factor for extraskeletal and vascular calcifications and is associated with cardiovascular morbidity and mortality. Increased ingestion of phosphorus is an important factor in development of hyperphosphatemia. We investigated nutritional habits and attitudes of HD patients and determined their correlation with serum phosphate levels in 57 patients treated in Clinical centre Montenegro. Twenty-two patients were male (38.6%), with average age 57 (range, 30-73 years). Statistically significant correlation was found between red meat or milk ingestion and serum phosphate, as well as between educational level and serum phosphate. In our population, socioeconomic level was directly correlated with serum phosphate. Conclusion: a serum phosphate level is determined by socioeconomic level, ingestion of red meat and milk, and depends on educational level in HD population of the capital of Montenegro.Poremećaj uhranjenosti bolesnika kojima se bubrežna funkcija nadomješta hemodijalizom (HD) često je povezan s lošom kontrolom serumskog fosfora, što može dovesti do poremećaja metabolizma kosti s posljedičnim razvojem sekundarnog hiperparatireoidizma i poremećajem mineralo-koštanog metabolizma. Hiperfosfatemija je značajan čimbenik rizika za razvoj kalcifikacija mekih tkiva, kao i za pobolijevanje i smrtnost od srčano-žilnih bolesti. Povećan unos hrane bogate fosforom značajan je čimbenik koji dovodi do hiperfosfatemije. Istraživanje ima za cilj ispitati prehrambene navike i stavove bolesnika liječenih HD i utvrditi njihovu povezanost s razinama serumskog fosfora. Istraživanje je provedeno u ožujku 2015. u Centru za hemodijalizu, Kliničkog centra Crne Gore. Istraživanje je provedeno na 57 bolesnika koji su na redovitom programu intermitentne hemodijalize. Muškaraca je bilo 22 (38,6 %). Prosječna dob bolesnika bila je 57 godina (raspon 30-73 godine). Pronađena je statistički značajna povezanost između vrste hrane, osobito crvenog mesa ili konzumiranja mlijeka i mliječnih proizvoda i serumske razine fosfora, kao i između razine obrazovanja ispitanika i razine serumskog fosfora. U našoj je populaciji serumska razina fosfora bila direktno povezana sa socioekonomskim statusom bolesnika. Zaključujemo da je: koncentracija fosfata u serumu određena socijalno–ekonomskom razinom društva, kao i običajem da se u prehrani koriste meso i mlijeko. Nadalje, u konkretnom slučaju vezana je uz prosvjećenost bolesnika koji se dijaliziraju u glavnom gradu Crne Gore

Cutaneous manifestations of tuberous sclerosis

No abstract availabl

DISSEMINATED INTRAVASCULAR COAGULATION AND ACUTE KIDNEY INJURY REQUIRING RENAL REPLACEMENT THERAPY AFTER DIAGNOSTIC AMNIOCENTESIS

Diseminirana intravaskularna koagulacija (DIK) je vrlo rijetka komplikacija amniocenteze. Opisujemo slučaj 33-godišnje bolesnice koja je nakon dijagnostičke amniocenteze razvila DIK s posljedičnom akutnom ozljedom bubrega. Bubrežna funkcija je nadomještana kontinuiranom veno-venskom hemodijafiltracijom tijekom osam dana, a nakon toga intermitentnom hemodijalizom. Stanje je bilo dodatno komplicirano razvojem intracerebralnog hematoma i akutnim respiratornim distres sindromom. Nakon 67 dana hospitalizacije bolesnica je otpuštena na kućnu njegu sa serumskim kreatininom 337 umol/L. Bolesnica se uspješno oporavila i ostvarila uspješnu trudnoću koja je u tijeku.Disseminated intravascular coagulation (DIC) is a very rare complication of amniocentesis. We present a case of a 33-year-old patient who developed DIC with acute respiratory distress syndrome and acute kidney injury after diagnostic amniocentesis. The patient required replacement of renal function for 59 days with continuous venovenous hemodiafiltration and later with hemodialysis. She was treated with heparin, fresh frozen plasma, platelets and cryoprecipitate. Her condition was further complicated with the development of intracranial hematoma. After 67 days of hospitalization, she was discharged from the hospital with serum creatinine 337 μmol/L. Three years later, her serum creatinine was 102 μmol/L, and she is currently in the 7th month of pregnancy

Cutaneous manifestations of tuberous sclerosis

No abstract availabl

DISSEMINATED INTRAVASCULAR COAGULATION AND ACUTE KIDNEY INJURY REQUIRING RENAL REPLACEMENT THERAPY AFTER DIAGNOSTIC AMNIOCENTESIS

Diseminirana intravaskularna koagulacija (DIK) je vrlo rijetka komplikacija amniocenteze. Opisujemo slučaj 33-godišnje bolesnice koja je nakon dijagnostičke amniocenteze razvila DIK s posljedičnom akutnom ozljedom bubrega. Bubrežna funkcija je nadomještana kontinuiranom veno-venskom hemodijafiltracijom tijekom osam dana, a nakon toga intermitentnom hemodijalizom. Stanje je bilo dodatno komplicirano razvojem intracerebralnog hematoma i akutnim respiratornim distres sindromom. Nakon 67 dana hospitalizacije bolesnica je otpuštena na kućnu njegu sa serumskim kreatininom 337 umol/L. Bolesnica se uspješno oporavila i ostvarila uspješnu trudnoću koja je u tijeku.Disseminated intravascular coagulation (DIC) is a very rare complication of amniocentesis. We present a case of a 33-year-old patient who developed DIC with acute respiratory distress syndrome and acute kidney injury after diagnostic amniocentesis. The patient required replacement of renal function for 59 days with continuous venovenous hemodiafiltration and later with hemodialysis. She was treated with heparin, fresh frozen plasma, platelets and cryoprecipitate. Her condition was further complicated with the development of intracranial hematoma. After 67 days of hospitalization, she was discharged from the hospital with serum creatinine 337 μmol/L. Three years later, her serum creatinine was 102 μmol/L, and she is currently in the 7th month of pregnancy

High uric acid and low superoxide dismutase as possible predictors of all-cause and cardiovascular mortality in hemodialysis patients

We investigated the role of serum uric acid (sUA) and superoxide dismutase (SOD) as predictive factors for mortality in hemodialysis (HD) patients. SOD, butyrylcholinesterase, and malondialdehyde were estimated spectrophotometrically and the other parameters by standard procedures. High-sensitive C-reactive protein was assayed by a sandwich ELISA method. sUA among survivors (112.1 +/- A 13.82 mu mol/L) was significantly lower than in deceased (160.8 +/- A 16.81 mu mol/L, p lt 0.001), while SOD was higher in survivors (31.8 +/- A 6.61 kU/L) than among deceased (20.2 +/- A 3.03, p lt 0.05). Kaplan-Meier survival curves showed the greatest mortality risk in the highest tertile of basal sUA concentration (a parts per thousand yen127.11 mu mol/L, p lt 0.001), and for SOD in the lowest tertile (a parts per thousand currency sign23.83 kU/L, p lt 0.05). Our results suggest that high sUA and low SOD may predict all-cause and cardiovascular mortality in HD patients