Publications by authors named "Ewa Król"

44 Publications

Associations between constipation symptoms and the sleep quality in non-dialysis chronic kidney disease patients: a cross-sectional study.

Pol Arch Intern Med 2021 Apr 27. Epub 2021 Apr 27.

Introduction: Sleep disturbances, similarly to constipation-related symptoms, are common problems in chronic kidney disease (CKD) patients and are associated with worse health-related quality of life.

Objectives: We aimed at detailing the sleep problems in conservatively-treated CKD patients, and at verifying the associations between the sleep quality and constipation in these patients.

Patients And Methods: In this cross-sectional study, 100 conservatively-treated CKD outpatients filled questionnaires that included questions addressing sleep quality (The Medical Outcomes Study 12-item Sleep Scale-Revised (MOS-Sleep-R)) and constipation-related symptoms (PAC-SYM, Rome III criteria).

Results: The T-scores of none of the assessed sleep domains differed significantly across the eGFR terciles (all P > 0.05). PAC-SYM abdominal and stool scales scores significantly correlated with all assessed sleep quality domains. In both univariable and multivariable regression models adjusted for key clinical data, functional constipation, having less than 7 bowel movements a week, abdominal discomfort and pain, as well as too small bowel movements, were independently associated with increased prevalence ratio of decreased sleep quality.

Conclusions: In non-dialysis CKD patients, sleep disorders can possess common etiological factors with constipation-related symptoms.
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http://dx.doi.org/10.20452/pamw.15974DOI Listing
April 2021

New Species from Normal and Galled Flowers of Lamiaceae.

Pathogens 2021 Mar 19;10(3). Epub 2021 Mar 19.

Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy.

A series of isolates of spp. were recovered in the course of a cooperative study on galls formed by midges of the genus (Diptera, Cecidomyidae) on several species of Lamiaceae. The finding of these fungi in both normal and galled flowers was taken as an indication that they do not have a definite relationship with the midges. Moreover, identification based on DNA sequencing showed that these isolates are taxonomically heterogeneous and belong to several species which are classified in two different species complexes. Two new species, and , were characterized within the species complex based on strains from Poland and Italy, respectively. Evidence concerning the possible existence of additional taxa within the collective species and is discussed.
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http://dx.doi.org/10.3390/pathogens10030369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003538PMC
March 2021

Non-HDL-C/TG ratio indicates significant underestimation of calculated low-density lipoprotein cholesterol (LDL-C) better than TG level: a study on the reliability of mathematical formulas used for LDL-C estimation.

Clin Chem Lab Med 2021 Apr 24;59(5):857-867. Epub 2020 Dec 24.

Department of Clinical Chemistry, Medical University of Gdańsk, Gdańsk, Poland.

Objectives: Low-density lipoprotein cholesterol (LDL-C) is the main laboratory parameter used for the management of cardiovascular disease. The aim of this study was to compare measured LDL-C with LDL-C as calculated by the Friedewald, Martin/Hopkins, Vujovic, and Sampson formulas with regard to triglyceride (TG), LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C)/TG ratio.

Methods: The 1,209 calculated LDL-C results were compared with LDL-C measured using ultracentrifugation-precipitation (first study) and direct (second study) methods. The Passing-Bablok regression was applied to compare the methods. The percentage difference between calculated and measured LDL-C (total error) and the number of results exceeding the total error goal of 12% were established.

Results: There was good correlation between the measurement and calculation methods (r 0.962-0.985). The median total error ranged from -2.7%/+1.4% (first/second study) for Vujovic formula to -6.7%/-4.3% for Friedewald formula. The numbers of underestimated results exceeding the total error goal of 12% were 67 (Vujovic), 134 (Martin/Hopkins), 157 (Samspon), and 239 (Friedewald). Less than 7% of those results were obtained for samples with TG >4.5 mmol/L. From 57% (Martin/Hopkins) to 81% (Vujovic) of underestimated results were obtained for samples with a non-HDL-C/TG ratio of <2.4.

Conclusions: The Martin/Hopkins, Vujovic and Sampson formulas appear to be more accurate than the Friedewald formula. To minimize the number of significantly underestimated LDL-C results, we propose the implementation of risk categories according to non-HDL-C/TG ratio and suggest that for samples with a non-HDL-C/TG ratio of <1.2, the LDL-C level should not be calculated but measured independently from TG level.
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http://dx.doi.org/10.1515/cclm-2020-1366DOI Listing
April 2021

Constipation and the Quality of Life in Conservatively Treated Chronic Kidney Disease Patients: A Cross-sectional Study.

Int J Med Sci 2020 18;17(18):2954-2963. Epub 2020 Oct 18.

Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Constipation is a common gastrointestinal disorder that in general population is associated with worse health-related quality of life (HRQoL). The epidemiology of constipation has not been reliably determined in conservatively-treated CKD patients. We aimed to determine the prevalence of constipation and constipation-related symptoms in conservatively-treated CKD patients, to find factors associated with their altered prevalence ratio (PR), and to verify the associations between constipation and HRQoL. In this cross-sectional study, 111 conservatively-treated CKD outpatients fulfilled questionnaires that included questions addressing HRQoL (SF-36v2®), constipation-related symptoms (The Patient Assessment of Constipation-Symptoms questionnaire), the Bristol stool form scale (BSFS), Rome III criteria of functional constipation (FC), and frequency of bowel movement (BM). Depending on the used definition, the prevalence of constipation was 6.6-28.9%. Diuretics and paracetamol were independently associated with increased PR of BSFS-diagnosed constipation (PR 2.86, 95% CI 1.28-6.37, = 0.01) and FC (PR 2.67, 95% CI 1.07-6.64, = 0.035), respectively. The most commonly reported symptoms were bloating (50.9%) and straining to pass a BM (42.7%). Abdominal discomfort (37.3%) was independently associated with worse scores in all analyzed HRQoL domains. In multiple regressions, FC and having <7 BM/week, but not BSFS-diagnosed constipation, were associated with lower scores in several HRQoL domains. Constipation and related symptoms are prevalent in CKD patients. FC and decreased frequency of defecation, but not BSFS-diagnosed constipation, are associated with worse assessment of HRQoL in conservatively-treated CKD patients.
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http://dx.doi.org/10.7150/ijms.49648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646105PMC
October 2020

Gastrointestinal Pathologies in Patients After Successful Renal Transplantation.

Transplant Proc 2020 Oct 23;52(8):2412-2416. Epub 2020 Jul 23.

Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Background: Kidney transplantation (KT) is the most desired and cost-effective modality of renal replacement therapy for patients with chronic kidney failure. KT protects the patient from complications that may develop during chronic dialysis. Unfortunately, evidence also suggests that KT patients are more prone to developing cancer than healthy persons. Many complications after renal transplantation can be prevented if they are detected early. The aim of this study was to evaluate the prevalence of gastrointestinal pathologies in patients after KT.

Methods: Adult patients after KT who are under the care of the Outpatient Department of Nephrology at the Medical University of Gdańsk, Poland, received alarm symptom questionnaires and referral for testing for the presence of fecal occult blood. Then, in 58 selected patients (36 men and 22 women), endoscopic examination was performed. Mean age was 57.34 ± 10.1 (range, 35-83) years.

Results: Out of 940 patients after KT, resting under supervision of the Outpatient Department, 208 patients completed the questionnaire and 118 gave a stool sample for testing: 40 results were positive. After analyzing the questionnaires and stool results, 100 patients qualified for further investigation. The endoscopic examination had been performed so far in 58 patients and revealed gastritis and/or duodenitis in 49 patients, diverticular colon disease in 26, esophagitis in 8, colon polyps in 16, stomach polyps in 4, inflammatory bowel disease in 12, and cancers in 3.

Conclusions: The preliminary results indicate that patients after KT have significant risk of gastrointestinal pathologies and require detailed diagnostic endoscopy.
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http://dx.doi.org/10.1016/j.transproceed.2020.02.121DOI Listing
October 2020

Pregnancy After Kidney Transplantation With Maternal and Pediatric Outcomes: A Single-Center Experience.

Transplant Proc 2020 Oct 19;52(8):2430-2435. Epub 2020 May 19.

Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland.

Outcomes of pregnancies after kidney transplantation were evaluated. Thirty-one pregnancies in 26 women were noted. The mean maternal age at pregnancy was 31 ± 5 years (range, 23-44 years). The interval between transplantation and conception was 54 ± 51 months (range, 7-213 months). The mean serum creatinine concentration before conception was 1.28 ± 0.4 mg/dL (range, 0.8-2.45 mg/dL), and mean estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration) was 62 ± 18 mL/min/1.73 m (range, 27-106 mL/min/1.73 m). There were no maternal deaths. There was 1 case of suspected acute rejection after delivery. There was 1 case of graft loss during pregnancy. Maternal complications included edema (6/26), hypertension (7/26), increase of (2/26) or appearance of proteinuria (5/26), and preeclampsia (4/26). Mean creatinine increase during pregnancy was 0.02 mg/dL. Mean creatinine 1 year after pregnancy was 1.54 mg/dL (±0.8 mg/dL). There were 19 cesarean sections. Fetal outcomes included 25 live births, 4 abortions, and 2 stillbirths. Out of 25 live births, 22 children were considered healthy, 2 children had congenital defects, and there were 2 deaths at neonatal age. Mean pregnancy age was 35 ± 4 weeks (range, 24-40 weeks). The rate of premature deliveries was 15 of 25. Mean neonate birth weight was 2363 ± 1029 grams (range, 490-4100 grams). The rate of babies small for gestational age was 19%. During follow-up (range, 0.5-30 years) 5 of 26 patients lost grafts (between 3 and 15 years after pregnancy); most (20) of the children previously considered healthy had good long-term development. Our results confirm that risk of pregnancy in kidney transplant recipients can be accepted, and children considered healthy at delivery develop well.
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http://dx.doi.org/10.1016/j.transproceed.2020.01.122DOI Listing
October 2020

The necessity of prevention and treatment in the population of adolescents based on a comprehensive health assessment: the SOPKARD-Junior study.

Pol Arch Intern Med 2020 04 6;130(4):358-367. Epub 2020 Apr 6.

Department of Preventive Medicine and Education, Medical University of Gdańsk, Gdańsk, Poland.

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http://dx.doi.org/10.20452/pamw.15280DOI Listing
April 2020

Plasma Levels of Preβ1-HDL Are Significantly Elevated in Non-Dialyzed Patients with Advanced Stages of Chronic Kidney Disease.

Int J Mol Sci 2019 Mar 9;20(5). Epub 2019 Mar 9.

Department of Clinical Chemistry, Medical University of Gdańsk, 80-210 Gdańsk, Poland.

In chronic kidney disease (CKD), the level of high-density lipoprotein (HDL) decreases markedly, but there is no strong inverse relationship between HDL-cholesterol (HDL-C) and cardiovascular diseases. This indicates that not only the HDL-C level, but also the other quantitative changes in the HDL particles can influence the protective functionality of these particles, and can play a key role in the increase of cardiovascular risk in CKD patients. The aim of the present study was the evaluation of the parameters that may give additional information about the HDL particles in the course of progressing CKD. For this purpose, we analyzed the concentrations of HDL containing apolipoprotein A-I without apolipoprotein A-II (LpA-I), preβ1-HDL, and myeloperoxidase (MPO), and the activity of paraoxonase-1 (PON-1) in 68 patients at various stages of CKD. The concentration of HDL cholesterol, MPO, PON-1, and lecithin-cholesterol acyltransferase (LCAT) activity were similar in all of the analyzed stages of CKD. We did not notice significant changes in the LpA-I concentrations in the following stages of CKD (3a CKD stage: 57 ± 19; 3b CKD stage: 54 ± 15; 4 CKD stage: 52 ± 14; = 0.49). We found, however, that the preβ1-HDL concentration and preβ1-HDL/LpA-I ratio increased along with the progress of CKD, and were inversely correlated with the estimated glomerular filtration rate (eGFR), even after adjusting for age, gender, triacylglycerols (TAG), HDL cholesterol, and statin therapy (β = -0.41, < 0.001; β = -0.33, = 0.001, respectively). Our results support the earlier hypothesis that kidney disease leads to the modification of HDL particles, and show that the preβ1-HDL concentration is significantly elevated in non-dialyzed patients with advanced stages of CKD.
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http://dx.doi.org/10.3390/ijms20051202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429079PMC
March 2019

Apolipoprotein E gene polymorphism and renal function are associated with apolipoprotein E concentration in patients with chronic kidney disease.

Lipids Health Dis 2019 Mar 9;18(1):60. Epub 2019 Mar 9.

Clinic & Chair of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.

Background: Chronic kidney disease (CKD) associates with complex lipoprotein disturbances resulting in high cardiovascular risk. Apolipoprotein E (APOE) is a polymorphic protein with three common isoforms (E2; E3; E4) that plays a crucial role in lipoprotein metabolism, including hepatic clearance of chylomicrons and very low-density lipoprotein (VLDL) remnants, and reverse cholesterol transport. It demonstrates anti-atherogenic properties but data concerning the link between polymorphism and level of APOE in CKD patients are inconclusive. The aim of our research was to assess the relationship between APOE gene polymorphism and APOE concentration and its redistribution among lipoproteins along with CKD progression.

Methods: 90 non-dialysed CKD patients were included into the study. Real time PCR was used for APOE genotyping. APOE level was measured in serum and in isolated lipoprotein fractions (VLDL; IDL + HDL; HDL). Kidney function was assessed using eGFR CKD-EPI formula.

Results: The population was divided into three APOE genotype subgroups: E2(ε2ε3), E3(ε3ε3) and E4(ε3ε4). The highest APOE level was observed for the E2 subgroup (p < 0.001). APOE concentration positively correlated with eGFR value in the E2 subgroup (r = 0.7, p < 0.001) but inversely in the E3 subgroup (r = - 0.29, p = 0.02).). A lower concentration of APOE in the E2 subgroup was associated with its diminished contents in HDL and IDL + LDL particles. In the E3 subgroup, the higher concentration of APOE was related to the increased number of non-HDL lipoproteins.

Conclusion: In patients with CKD, APOE genotype as well as renal function are associated with the concentration of APOE and its redistribution among lipoprotein classes.
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http://dx.doi.org/10.1186/s12944-019-1003-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408819PMC
March 2019

Progression of Chronic Kidney Disease Affects HDL Impact on Lipoprotein Lipase (LPL)-Mediated VLDL Lipolysis Efficiency.

Kidney Blood Press Res 2018 15;43(3):970-978. Epub 2018 Jun 15.

Department of Clinical Chemistry, Medical University of Gdańsk, Gdańsk, Poland.

Background/aims: Hypertriglyceridaemia (HTG) and reduction and dysfunction of high density lipoprotein (HDL) are common lipid disturbances in chronic kidney disease (CKD). HTG in CKD is caused mainly by the decreased efficiency of lipoprotein lipase (LPL)-mediated very low density lipoprotein triglyceride (VLDL-TG) lipolysis. It has not been clarified whether HDL dysfunction in CKD contributes directly to HTG development; thus, the aim of this study was to assess the impact of CKD progression on the ability of HDL to enhance LPL-mediated VLDL-TG lipolysis efficiency.

Methods: VLDL was isolated from non-dialysis patients in CKD stages 3 and 4 and from non-CKD patients. The VLDL was incubated with LPL at the constant LPL:VLDL-TG ratio, in the absence or presence of HDL. After incubation, the VLDL was separated and the percentage (%) of hydrolyzed TG was calculated.

Results: HDL presence increased the lipolysis efficiency of VLDL isolated from CKD and non-CKD patients, for the VLDL-TG> 50 mg/dl. Its effect was dependent on the VLDL-TG and HDL-cholesterol concentrations in the reaction mixtures: the higher the concentrations of VLDL-TG and HDL-cholesterol, the greater the effect. The positive impact of HDL on VLDL lipolysis was modified by CKD progression: the percentage of lipolyzed VLDL-TG in the presence of HDL decreased with a reduction in eGFR (r=0.43, p=0.009), and for patients with stage 4 CKD, no positive impact of HDL on lipolysis was observed. The percentage of lipolyzed TG correlated negatively with apoE and apoCs content in VLDL, and positively with HDL-apoCII, as well as with VLDL and HDL apoCII/ apoCIII ratios. The progression of CKD was associated with unfavourable changes in VLDL and HDL composition; apoE and apoCs levels increased in VLDL with a decrease in eGFR whereas the HDL-cholesterol level decreased.

Conclusion: The progression of CKD affects lipoprotein composition and properties, and modulates the positive impact of HDL on VLDL lipolysis efficiency. In CKD patients, HDL deficiency and dysfunction can directly affect hypertriglyceridaemia development.
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http://dx.doi.org/10.1159/000490686DOI Listing
October 2018

Analysis of preoperative blood platelet parameters in terms of diversity of epithelial ovarian cancer.

Medicine (Baltimore) 2018 03;97(12):e0180

Department of Operative Gynaecology and Gynaecological Oncology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.

Smouldering inflammation, thrombocytosis, and platelet hyper-reactivity are linked to malignancy. The relationships between preoperative diagnostic blood morphology parameters and cancer have been the focus of much interest, because some of these parameters are correlated with advanced cancer stages and poor patient survival rates. This study aimed to perform an observational, retrospective analysis of the intradiversity of blood platelet parameters in patients with different International Federation of Gynaecology and Obstetrics (FIGO) stages and different histological types of epithelial ovarian carcinomas (EOC), and also an analysis of the overall survival rate.In all, 94 EOC patients were included in this analysis (23 mucinous, 33 serous, 20 undifferentiated, 14 endometrioid, and 4 clear cell carcinoma cases). Peripheral blood samples were collected and analyzed before drug or surgical treatment.The platelet-to-neutrophil ratio (PNR) was related to the histological type of EOC, particularly mucinous carcinoma. In patients with mucinous cancer, the PNR was significantly lower compared with patients with nonmucinous cancer, and this parameter distinguished between mucinous and nonmucinous groups of patients (area under receiver-operating characteristic [ROC] curve 0.721 ± .056; sensitivity 82.6%; specificity 61%; P < .001; ROC analysis), regardless of the FIGO stage. Moreover, elevated PNR values were correlated with lower survival rate of EOC patients.The reduced PNR, similar to the lower level of cancer antigen 125, is characteristic for mucinous ovarian carcinoma patients. Moreover, elevated PNR index might correlate with poor survival of patients.
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http://dx.doi.org/10.1097/MD.0000000000010180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895358PMC
March 2018

A nonspecific synergistic effect of biogenic silver nanoparticles and biosurfactant towards environmental bacteria and fungi.

Ecotoxicology 2018 Apr 6;27(3):352-359. Epub 2018 Feb 6.

Institute for Ecology of Industrial Areas, Environmental Microbiology Unit, 40-844, Katowice, Kossutha 6, Poland.

The present study focused on the evaluation of a nonspecific synergistic effect of biogenic silver nanoparticles (AgNPs) in combination with biosurfactants against environmental bacteria and fungi. The AgNPs were synthesized in the culture supernatants of the biosurfactant producer Bacillus subtilis grown in brewery effluent, molasses or Luria-Bertani media. Antibacterial activities were tested against Gram-positive and Gram-negative bacteria, while the antifungal activity was tested against phytopathogens. The interactions between biogenic AgNPs and DNA were investigated using a cryo-TEM technique. The presence of biosurfactant significantly increased the stability of biogenic AgNPs and enhanced their antimicrobial activities. The physical properties and antimicrobial activity of biogenic AgNPs were compared with chemically synthesized Ag nanoparticles. Biogenic silver nanoparticles showed a broad spectrum of activity against bacteria and fungi. They were most active against phytopathogenic fungi and Gram-positive bacteria and less active against Gram-negative bacteria. The nonspecific synergistic effect of biogenic AgNPs and biosurfactant on the phytopathogenic fungi was especially observed. In this report, the new roles of biosurfactants as a biogenic AgNPs stabilizer and enhancer of their antimicrobial properties are presented. Our results revealed that the biologically synthesized AgNPs by the biosurfactant-producing bacterium Bacillus subtilis grown on agro-industrial wastes, such as molasses and brewery effluent, could be used as a promising new nanoagent against microbes.
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http://dx.doi.org/10.1007/s10646-018-1899-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859040PMC
April 2018

An assessment of health status and health behaviours in adolescents: main points and methods of the SOPKARD-Junior programme.

Arch Med Sci 2018 Jan 17;14(1):38-51. Epub 2016 Nov 17.

Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland.

Introduction: The study involved preparing and implementation a model of complex screening programme for adolescents and comparison of anthropometric examinations between the population of the SOPKARD-Junior programme and representative sample of Polish children in the same age.

Material And Methods: The screening programme in 14-15 year old pupils ( = 282) included: anthropometric, blood pressure, echocardiographic, electrocardiographic, carotid arteries, kidney and thyroid ultrasound examinations, as well as respiratory, dental and masticatory system, orthopaedic, psychological and psychiatric assessment. Blood and urine tests were also performed. The results of anthropometric examinations from the SOPKARD-Junior and OLAF programmes were used for comparative analysis.

Results: Statistically significant ( < 0.001) differences between young people from Sopot and their peers in the general Polish population were found in height (+3.61 cm for boys), body mass (+5.19 kg for boys and +3.99 kg for girls), body mass index (+0.99 kg/m for boys and +1.33 kg/m for girls), waist circumference (+4.52 cm for boys and +4.52 cm for girls) and hip circumference (+2.51 cm for boys). The highest attendance rate was achieved for examinations performed in school (e.g. anthropometric and blood pressure measurements - = 268; 95%) and the lowest for the echocardiograpy performed in local hospital ( = 133; 47%). The mean score of the programme quality (scale 1-6) assessed by children was 4.63.

Conclusions: The SOPKARD-Junior programme represents an attempt to develop a model of screening assessments for teenagers in Poland. Preliminary results of the SOPKARD-Junior programme indicate small differences in the biological development of Sopot youth in comparison with their peers from Polish population of the OLAF programme. The high attendance rate on research conducted at the school indicate that proposed health examinations in adolescents are acceptable and feasible.
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http://dx.doi.org/10.5114/aoms.2016.63742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778424PMC
January 2018

Morphological and Molecular Characterization of Phoma complanata,a New Causal Agent of Archangelica officinalis Hoffm. in Poland.

Pol J Microbiol 2017 Jul;66(2):281-285

Department of Plant Pathology and Mycology, University of Life Sciences, Lublin, Poland.

The paper concerns the fungus Phoma complanata, isolated for the first time in Poland, from the roots and umbels of angelica (Archangelica officinalis) in 2009. The morphology of fungal isolates was tested on standard culture media. Moreover, the sequence analysis of ITS regions was conducted. Morphological similarity of P. complanata Polish isolates to the reference isolate obtained from CBS culture collection was determined and together with the molecular analysis confirmed the affiliation of the fungus to the species.
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http://dx.doi.org/10.5604/01.3001.0010.7886DOI Listing
July 2017

Metal-dependent SpoIIE oligomerization stabilizes FtsZ during asymmetric division in Bacillus subtilis.

PLoS One 2017 30;12(3):e0174713. Epub 2017 Mar 30.

Department of Molecular Microbiology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, the Netherlands.

SpoIIE is a bifunctional protein involved in asymmetric septum formation and in activation of the forespore compartment-specific transcription factor σF through dephosphorylation of SpoIIAA-P. The phosphatase activity of SpoIIE requires Mn2+ as a metal cofactor. Here, we show that the presence of a metal cofactor also influences SpoIIE oligomerization and asymmetric septum formation. Absence of Mn2+ from sporulation medium results in a delay of the formation of polar FtsZ-rings, similar to a spoIIE null mutant. We purified the entire cytoplasmic part of the SpoIIE protein, and show that the protein copurifies with bound metals. Metal binding both stimulates SpoIIE oligomerization, and results in the formation of larger oligomeric structures. The presence of SpoIIE oligomers reduces FtsZ GTP hydrolysis activity and stabilizes FtsZ polymers in a light scattering assay. Combined, these results indicate that metal binding is not just required for SpoIIE phosphatase activity but also is important for SpoIIE's role in asymmetric septum formation.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174713PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373596PMC
August 2017

Chronic kidney disease in Polish elderly population aged 75+: results of the WOBASZ Senior Survey.

Int Urol Nephrol 2017 Apr 17;49(4):669-676. Epub 2016 Dec 17.

Department of Preventive Medicine and Medical Education, Medical University of Gdansk, Gdańsk, Poland.

Purpose: Kidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population.

Methods: A representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was <60 ml/min/1.73 m. The comorbidities, anthropometric and social factors connected with the onset of CKD were also analyzed.

Results: The prevalence of CKD in the analyzed population was 26.9% (F 32.0%, M 15.8%), which gives an estimated number of 495,590 (95% CI 396,363-594,817) patients in the study subpopulation. The majority of these people were in the G3A category-70.1%, while the remaining fell under the G3B-25.7%, G4-3.1% and G5-1.1% categories. Disease awareness among the participants was found to be at 17%. Arterial hypertension (AH) was more frequent in people with CKD (91.0 vs. 80.3%, P < 0.001), whereas diabetes mellitus (DM) prevalence was comparable in both CKD and non-CKD groups (11.7 vs. 11.4%, ns). In the examined group, DM had no influence on the frequency of CKD. In contrast, the presence of cardiovascular diseases substantially increased the chances of developing CKD (OR 1.87, P < 0.05).

Conclusion: 1. The prevalence of CKD in the Polish elderly population was 26.9%. 2. Awareness of CKD is low. 3. DM, increasing age and AH did not increase the risk of CKD. 4. Coexistence of cardiovascular diseases increased the risk of having CKD.
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http://dx.doi.org/10.1007/s11255-016-1477-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357472PMC
April 2017

FtsZ-Dependent Elongation of a Coccoid Bacterium.

mBio 2016 09 6;7(5). Epub 2016 Sep 6.

Bacterial Cell Biology, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal

Unlabelled: A mechanistic understanding of the determination and maintenance of the simplest bacterial cell shape, a sphere, remains elusive compared with that of more complex shapes. Cocci seem to lack a dedicated elongation machinery, and a spherical shape has been considered an evolutionary dead-end morphology, as a transition from a spherical to a rod-like shape has never been observed in bacteria. Here we show that a Staphylococcus aureus mutant (M5) expressing the ftsZ(G193D) allele exhibits elongated cells. Molecular dynamics simulations and in vitro studies indicate that FtsZ(G193D) filaments are more twisted and shorter than wild-type filaments. In vivo, M5 cell wall deposition is initiated asymmetrically, only on one side of the cell, and progresses into a helical pattern rather than into a constricting ring as in wild-type cells. This helical pattern of wall insertion leads to elongation, as in rod-shaped cells. Thus, structural flexibility of FtsZ filaments can result in an FtsZ-dependent mechanism for generating elongated cells from cocci.

Importance: The mechanisms by which bacteria generate and maintain even the simplest cell shape remain an elusive but fundamental question in microbiology. In the absence of examples of coccus-to-rod transitions, the spherical shape has been suggested to be an evolutionary dead end in morphogenesis. We describe the first observation of the generation of elongated cells from truly spherical cocci, occurring in a Staphylococcus aureus mutant containing a single point mutation in its genome, in the gene encoding the bacterial tubulin homologue FtsZ. We demonstrate that FtsZ-dependent cell elongation is possible, even in the absence of dedicated elongation machinery.
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http://dx.doi.org/10.1128/mBio.00908-16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013293PMC
September 2016

Renal Dysfunction in Post-Stroke Patients.

PLoS One 2016 30;11(8):e0159775. Epub 2016 Aug 30.

Department of Arterial Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.

Background: The presence of chronic kidney disease (CKD) is an indicator of a worse long-term prognosis in patients with ischemic stroke (IS). Unfortunately, not much is known about renal function in the population of post-IS subjects. The aim of our study was to assess the prevalence of renal damage and impaired renal function (IRF) in the population of post-IS subjects.

Methods: This prospective analysis concerned 352 consecutive post-IS survivors hospitalized in Pomeranian stroke centers (Poland) in 2009. In this group estimated glomerular filtration rate (eGFR) according to MDRD (modification of diet in renal diseases) and CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formulas and urine albumin/creatinine ratio (ACR) were determined.

Results: Among survivors decreased eGFR (<60 mL/min./1.73m2 according to MDRD or CKD-EPI) or ACR≥30mg/g were detected in 40.38% (23.07% Men, 55.32% Women; P<0.01). The highest prevalence of IRF was noted in post-IS subjects with atheromatic and lacunar IS. In multivariate analysis the ACR≥30mg/g was predicted by older age, diabetes mellitus (DM) and physical disability (modified Rankin scale 3-5 pts.). The association with reduced eGFR was proved for sex (female), DM and physical disability.

Conclusions: CKD is a frequently occurring problem in the group of post-IS subjects, especially after lacunar and atheromatic IS. Post-IS patients, mainly the elderly women, with physical disability and diabetes mellitus, should be regularly screened for CKD. This could reduce the risk of further cardiovascular events and delay the progression of IRF.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159775PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019346PMC
August 2017

In Search of the Antimicrobial Potential of Benzimidazole Derivatives.

Pol J Microbiol 2016 Aug;65(3):359-364

Department of Molecular Biology, Institute of Biotechnology, The John Paul II Catholic University of Lublin, Lublin, Poland.

A broad series of 4,5,6,7-tetrahalogenated benzimidazoles and 4-(1H-benzimidazol-2-yl)-benzene-1,3-diol derivatives was tested against selected bacteria and fungi. For this study three plant pathogens Colletotrichum sp., Fusarium sp., and Sclerotinia sp., as well as Staphylococcus sp., Enterococcus sp., Escherichia sp., Enterobacter sp., Klebsiella spp. , and Candida spp. as human pathogens were used. MIC values and/or area of growth reduction method were applied in order to compare the activity of the synthesized compounds. From the presented set of 22 compounds, only 8, 16, 18 and 19 showed moderate to good inhibition against bacterial strains. Against Candida strains only compound 19 with three hydroxyl substituted benzene moiety presented high inhibition at nystatin level or lower.
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http://dx.doi.org/10.5604/17331331.1215615DOI Listing
August 2016

Prevalence of chronic kidney disease in a representative sample of the Polish population: results of the NATPOL 2011 survey.

Nephrol Dial Transplant 2016 Mar 10;31(3):433-9. Epub 2015 Nov 10.

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.

Background: Chronic kidney disease (CKD) has been proven to be a major risk factor of cardiovascular disease (CVD). Until now, data on the prevalence of CKD among adults in Poland were limited. The NATPOL 2011 survey is a cross-sectional observational study designed to assess the prevalence and control of CVD risk factors in Poland, and the first study capable of evaluating CKD prevalence in adult Polish citizens.

Methods: Serum creatinine concentration and the urine albumin-to-creatinine ratio (ACR) were measured in 2413 randomly selected participants (ages 18-79 years) from a national survey study. CKD was diagnosed if the estimated glomerular filtration rate (eGFR) was <60 mL/min/1.73 m(2) or ≥60 mL/min/1.73 m(2) with coexisting albuminuria (ACR ≥ 30 mg/g). Additionally, comorbidities and anthropometric and social factors related to the prevalence of CKD were analysed.

Results: The prevalence of CKD was estimated at 5.8% [95% confidence interval (95% CI) 4.6-7.2] using Chronic Kidney Disease Epidemiology Collaboration formula. The general prevalence was higher when the MDRD was applied [6.2% (95% CI 4.0-7.6)]. An eGFR <60 mL/min/1.73 m(2) was found in 1.9% (95% CI 1.5-2.5) of the studied population. This was accompanied by low awareness of this condition (14.9%). The frequency of albuminuria was estimated at 4.5% (95% CI 3.4-5.9). Diabetes mellitus (DM) and arterial hypertension (AH) were more frequent among respondents with diagnosed CKD compared with those without CKD [18.5 versus 4.5% (P < 0.001) and 67.8 versus 29.0% (P < 0.001) respectively]. DM and AH were, apart from increasing age, the two greatest risk factors of CKD.

Conclusion: The estimated prevalence of CKD among adults in Poland is 5.8% (∼1 724 960 patients). Its prevalence was lower than expected. CKD is more frequent in older subjects, smokers and people with comorbidities such as AH and DM.
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http://dx.doi.org/10.1093/ndt/gfv369DOI Listing
March 2016

Antibacterial activity of alkyl gallates is a combination of direct targeting of FtsZ and permeabilization of bacterial membranes.

Front Microbiol 2015 29;6:390. Epub 2015 Apr 29.

Department of Molecular Microbiology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen Groningen, Netherlands.

Alkyl gallates are compounds with reported antibacterial activity. One of the modes of action is binding of the alkyl gallates to the bacterial membrane and interference with membrane integrity. However, alkyl gallates also cause cell elongation and disruption of cell division in the important plant pathogen Xanthomonas citri subsp. citri, suggesting that cell division proteins may be targeted by alkyl gallates. Here, we use Bacillus subtilis and purified B. subtilis FtsZ to demonstrate that FtsZ is a direct target of alkyl gallates. Alkyl gallates disrupt the FtsZ-ring in vivo, and cause cell elongation. In vitro, alkyl gallates bind with high affinity to FtsZ, causing it to cluster and lose its capacity to polymerize. The activities of a homologous series of alkyl gallates with alkyl side chain lengths ranging from five to eight carbons (C5-C8) were compared and heptyl gallate was found to be the most potent FtsZ inhibitor. Next to the direct effect on FtsZ, alkyl gallates also target B. subtilis membrane integrity-however the observed anti-FtsZ activity is not a secondary effect of the disruption of membrane integrity. We propose that both modes of action, membrane disruption and anti-FtsZ activity, contribute to the antibacterial activity of the alkyl gallates. We propose that heptyl gallate is a promising hit for the further development of antibacterials that specifically target FtsZ.
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http://dx.doi.org/10.3389/fmicb.2015.00390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413848PMC
May 2015

FtsZ polymerization assays: simple protocols and considerations.

J Vis Exp 2013 Nov 16(81):e50844. Epub 2013 Nov 16.

Department of Molecular Microbiology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen.

During bacterial cell division, the essential protein FtsZ assembles in the middle of the cell to form the so-called Z-ring. FtsZ polymerizes into long filaments in the presence of GTP in vitro, and polymerization is regulated by several accessory proteins. FtsZ polymerization has been extensively studied in vitro using basic methods including light scattering, sedimentation, GTP hydrolysis assays and electron microscopy. Buffer conditions influence both the polymerization properties of FtsZ, and the ability of FtsZ to interact with regulatory proteins. Here, we describe protocols for FtsZ polymerization studies and validate conditions and controls using Escherichia coli and Bacillus subtilis FtsZ as model proteins. A low speed sedimentation assay is introduced that allows the study of the interaction of FtsZ with proteins that bundle or tubulate FtsZ polymers. An improved GTPase assay protocol is described that allows testing of GTP hydrolysis over time using various conditions in a 96-well plate setup, with standardized incubation times that abolish variation in color development in the phosphate detection reaction. The preparation of samples for light scattering studies and electron microscopy is described. Several buffers are used to establish suitable buffer pH and salt concentration for FtsZ polymerization studies. A high concentration of KCl is the best for most of the experiments. Our methods provide a starting point for the in vitro characterization of FtsZ, not only from E. coli and B. subtilis but from any other bacterium. As such, the methods can be used for studies of the interaction of FtsZ with regulatory proteins or the testing of antibacterial drugs which may affect FtsZ polymerization.
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http://dx.doi.org/10.3791/50844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991336PMC
November 2013

Overweight, obesity, hypertension and albuminuria in Polish adolescents--results of the Sopkard 15 study.

Nephrol Dial Transplant 2013 Nov 24;28 Suppl 4:iv204-11. Epub 2013 Sep 24.

Department of Nephrology, Transplantology and Internal Medicine.

Background: Obesity is a well-known risk factor of many pathologies, including cardiovascular and renal diseases. The prevalence of overweight and obesity has increased markedly in an epidemic way over the past three decades, including a dramatic increase in overweight and obesity among adolescents.

Methods: This study is part of the Sopkard 15 programme-a comprehensive analysis of the overall health of middle school students in the age range between 14 and 15 years with particular emphasis on the risk factors of lifestyle diseases, including metabolic syndrome, chronic kidney disease (CKD) and hypertension. Between 2006 and 2010, we examined 889 students (428 girls, 461 boys) 14 years old, and 26% of them attended classes with an extended sports curriculum. From the three separate blood pressure (BP) measurements a mean value of systolic and diastolic BP from the second and third measurements was taken into analysis. Body mass index (BMI), waist-to-height ratio (WHtR) and body fat mass calculated using bioelectrical impedance analysis (BIA), albuminuria and urine albumin-to-creatinine ratio, estimated glomerular filtration rate (eGFR) estimated on the basis of serum creatinine according to Schwartz and abbreviated Modification of Diet in Renal Disease (MDRD) formula were explored.

Results: In the examined homogeneous population of adolescents, we found 8% of participants to be overweight and a further 8% of participants to be obese. An abnormal BMI was statistically significant and was more often present in girls compared with boys. WHtR values typical for abdominal obesity were reported in 17% of the population, significantly more often in girls 19.8 versus 12.4% in boys, P < 0.02. Albuminuria was detected in 16% of adolescents according to urinary albumin excretion (UAE) compared with 11% by an urine albumin-to-creatinine ratio (UACR) method. A higher number of participants with elevated BP were observed to be statistically significant more often in subpopulations with overweight and obesity compared with adolescents with normal weight. The relationship between obesity and hypertension was also confirmed in participants with an increased WHtR. However, no significant relationship between weight disturbances (BMI), as well as abdominal obesity (WHtR), and albuminuria was identified.

Conclusions: Overweight and obesity are present in a significant proportion of adolescents from a general, healthy population of middle school students in the age of 14 years. This phenomenon is strictly connected to the presence of hypertension.
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http://dx.doi.org/10.1093/ndt/gft328DOI Listing
November 2013

Bacillus subtilis SepF binds to the C-terminus of FtsZ.

PLoS One 2012 13;7(8):e43293. Epub 2012 Aug 13.

Department of Molecular Microbiology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, The Netherlands.

Bacterial cell division is mediated by a multi-protein machine known as the "divisome", which assembles at the site of cell division. Formation of the divisome starts with the polymerization of the tubulin-like protein FtsZ into a ring, the Z-ring. Z-ring formation is under tight control to ensure bacteria divide at the right time and place. Several proteins bind to the Z-ring to mediate its membrane association and persistence throughout the division process. A conserved stretch of amino acids at the C-terminus of FtsZ appears to be involved in many interactions with other proteins. Here, we describe a novel pull-down assay to look for binding partners of the FtsZ C-terminus, using a HaloTag affinity tag fused to the C-terminal 69 amino acids of B. subtilis FtsZ. Using lysates of Escherichia coli overexpressing several B. subtilis cell division proteins as prey we show that the FtsZ C-terminus specifically pulls down SepF, but not EzrA or MinC, and that the interaction depends on a conserved 16 amino acid stretch at the extreme C-terminus. In a reverse pull-down SepF binds to full-length FtsZ but not to a FtsZΔC16 truncate or FtsZ with a mutation of a conserved proline in the C-terminus. We show that the FtsZ C-terminus is required for the formation of tubules from FtsZ polymers by SepF rings. An alanine-scan of the conserved 16 amino acid stretch shows that many mutations affect SepF binding. Combined with the observation that SepF also interacts with the C-terminus of E. coli FtsZ, which is not an in vivo binding partner, we propose that the secondary and tertiary structure of the FtsZ C-terminus, rather than specific amino acids, are recognized by SepF.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0043293PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418248PMC
May 2013

The prevalence of risk factors for atherosclerosis among middle school students in Sopot, Poland: results of the SOPKARD 15 programme.

Kardiol Pol 2011 ;69(6):540-5

Medical University of Gdansk, Poland.

Background: SOPKARD 15 is a comprehensive programme to assess the health status of a population of teenagers. The aspects assessed in the study are: physical development, nutritional status, arterial blood pressure, lipid and carbohydrate metabolism, oral hygiene, and psychological parameters.

Aim: To assess the prevalence of cardiovascular risk factors in the study population.

Methods: We examined 372 children (185 girls) at the age of 14. The cut-off values for normal lipid blood levels were based on the NCEP-Peds guidelines. Body mass index was assessed on the basis of the Polish centile charts. Blood pressure values assessed against the centile charts were the mean values calculated on the basis of the second and third measurements.

Results: Systolic and diastolic blood pressure values were elevated in 15.81% and 10.90% of the subjects, respectively. Abnormal blood glucose was detected in fewer than 6% of the children. Total cholesterol was elevated in 8% and borderline in 24% of the subjects; 8.5% of children were overweight and 7.4% were obese; 5.0% of the subjects took very little physical exercise; 16.4% of boys and 23.4% of girls admitted smoking. Dental examination revealed inflamed gums in 77.6% of the subjects. The diagnosis of a depressive episode was confirmed in 4.2% of the teenagers.

Conclusions: 1. Due to the high prevalence of the risk factors there is a need to launch a comprehensive cardiovascular prevention programme among the teenagers. 2. A considerable proportion of children with lipid abnormalities indicate the need for more frequent lipid profile testing in children.
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October 2011

Aging or comorbid conditions - what is the main cause of kidney damage?

J Nephrol 2010 Jul-Aug;23(4):444-52

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.

Background: Chronic kidney disease (CKD) is widespread in the general population. It is generally accepted that worsening renal function is common with aging. However, the question still remains whether it is caused by the natural process of aging or whether coexisting chronic diseases and comorbid conditions contribute to deteriorating renal function.

Methods: The frequency of albuminuria-the marker of early kidney damage-was evaluated according to different coexisting conditions in younger (18/64 years old, n=2,074) and elderly (=65 years old, n=395) participants of the Polish study PolNef on early detection of CKD. Multivariate logistic regression was performed to identify associations between elevated levels of albuminuria, age and coexisting conditions.

Results: 12% of the younger group demonstrated albuminuria compared to 18% of the elderly. Independent predictors of detecting an elevated level of albuminuria for the whole examined population were male gender (2.48, 1.59-3.88), hypertension ineffectively treated (1.8, 1.34-2.4), diabetes (1.67, 1.11-2.49), and age (1.56, 0.97-2.52) at border levels of significance. Moreover, elevated levels of albuminuria occurred more frequently in the obese elderly group (1.89, 0.98-3.63, p=0.058). The following predictors were found based on gender: for men, hypertension regardless of efficacy of treatment, diabetes, smoking, and age at border level of significance, in contrast to women who had the sole predictor of ineffectively treated hypertension.

Conclusions: The influence of aging alone on kidney damage is not evident. Moreover, it is different in males and females. Hypertension is the only coexisting comorbid condition contributing to kidney damage in both males and females. Advanced age together with comorbid conditions is more harmful to the kidney in males.
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September 2010

Current diagnostic evaluation of autosomal dominant polycystic kidney disease.

Pol Arch Med Wewn 2008 Dec;118(12):767-73

Department of Nephrology, Transplantology and Internal Medicine, Medical University, Gdańsk, Poland.

Despite changing epidemiology of chronic kidney disease, autosomal dominant polycystic kidney disease (ADPKD) is one of the most prevalent causes of end stage renal disease. The first symptoms of the disease occur usually in the 3rd or 4th decade of life, however, it can often be diagnosed much earlier. Advances in the understanding of the disease may lead, in the near future, to slowing the progression of ADPKD in asymptomatic individuals. ADPKD is diagnosed on the basis of family history (autosomal dominant inheritance) and radiological imaging. Ultrasound examination (US) of the kidneys is the most important imaging diagnostic method. US is highly sensitive and specific in patients >30 years of age. In US, Ravine criteria are applied and their modifications with other imaging techniques (computed tomography [CT], magnetic resonance [MR]). In all cases, however, there are multiple cysts in both kidneys and, importantly, concomitant renal enlargement can be observed, which is typical of ADPKD. High expectations for early ADPKD diagnosis are risen by genetics and proteomics. However, these methods are not used routinely. The most sensitive parameter in the evaluation of the disease progression is total renal volume. This parameter is presently used in clinical studies, but its utility in monitoring an individual patient has not been fully proven. Unfortunately, MR and CT are expensive and in case of significantly enlarged kidneys US does not yield accurate assessment of their size and is not sensitive enough for monitoring the disease progression. The rate of glomerular filtration rate (GFR) decline is usually constant. Therefore, it is important to monitor GFR in individuals who have developed renal insufficiency. Other tests, including markers of kidney injury, e.g. albuminuria, or vascular flow parameters, are used mainly in clinical studies. Thus, before more efficient therapeutic approaches have been developed, an early diagnosis and prevention of the disease complications are most essential.
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December 2008

[Program of early diagnosis of chronic renal disease in children--SopKard 15 nephrological project].

Pol Merkur Lekarski 2008 ;24 Suppl 4:108-10

Akademia Medyczna w Gdańsku, Klinika Chorób Nerek i Nadciśnienia Tetniczego Dzieci i Młodziezy.

The Sopot Program of Cardiac Infarct and Stroke Prevention--SopKard 1999-2009 was established for health promotion to decrease cardio-vascular diseases mortality. To serve these purposes a new project SopKard 15 for adolescents was created. The main aim of SopKard 15 is evaluation of health status with particular attention to risk factors of civilization diseases, with chronic kidney disease (CKD) among them. In population of 14-year-old students a complex nephrological examination including medical history, blood pressure measurements, ultrasound examination, and laboratory tests with e.g. albuminuria, urinalysis, and serum creatinine and cystatin C levels was performed. Nephrology part of Program SopKard 15 aspired to early detection of CKD and verifies normal value for this age group.
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October 2008