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Kubanek A, Przybylak M, Paul P, Kowalska AS, Błaszczyk M, Macul-Sanewska A, Renke M, Rutkowski P, Bidzan L, Grabowski J. Use of sertraline and agomelatine in hemodialysis patients: A case series report. Acta Biochim Pol 2023; 70:979-983. [PMID: 38043099 DOI: 10.18388/abp.2020_6936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/03/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) is one of the most common psychiatric issues in hemodialysis population. However, the research on proper diagnostic tools and its treatment is still insufficient. The study was performed to investigate the safety and effectiveness of sertraline and agomelatine in a group of hemodialysis patients. PATIENTS AND METHODS 78 adult patients from one dialysis centre in Poland were included into the study. The Beck Depression Inventory II (BDI-II) was used to screen for depressive symptoms and was followed by the clinical interview with the psychiatrist. Nine patients diagnosed with major depressive disorder received antidepressant treatment with sertraline or agomelatine, according to the best clinical practice. The additional treatment with vortioxetine was used if the initial one was not effective. The time of observation was 24 weeks. The psychiatric follow up as well as the laboratory data were obtained during the course of observation. RESULTS All patients receiving sertraline achieved remission of depressive symptoms. In patients receiving agomelatine no remission was observed despite dose augmentation. The side effects of antidepressants were mild and did not result in treatment discontinuation. No abnormalities in liver enzymes levels were observed. In five cases the significant decrease of haemoglobin level was noticed, with no cases of bleeding reported. CONCLUSION In patients receiving sertraline the antidepressant effect was satisfactory. No remission of depressive symptoms was observed in patients taking agomelatine. The side effects of antidepressants were mild and transient. Further research on depression treatment in hemodialysis patients is needed, including newer medications.
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Affiliation(s)
- Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Mateusz Przybylak
- Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Przemysław Paul
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | | | - Michał Błaszczyk
- Adult Psychiatry Scientific Circle, Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Aleksandra Macul-Sanewska
- Adult Psychiatry Scientific Circle, Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Przemysław Rutkowski
- Department of Internal and Paediatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Leszek Bidzan
- Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Jakub Grabowski
- Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
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Sulima M, Sikorska K, Renke M, Kubanek A, Lenkiewicz E, Susmarska A. Acute necrotizing pancreatitis in a patient with severe falciparum malaria and SARS-CoV-2 coinfection. Pol Arch Intern Med 2023; 133:16518. [PMID: 37387598 DOI: 10.20452/pamw.16518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Affiliation(s)
- Małgorzata Sulima
- Division of Tropical and Parasitic Diseases, University Centre of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland.
| | - Katarzyna Sikorska
- Division of Tropical and Parasitic Diseases, University Centre of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
- Division of Tropical Medicine and Epidemiology, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdynia, Poland
| | - Marcin Renke
- Division of Occupational, Metabolic and Internal Diseases, University Centre of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | - Alicja Kubanek
- Division of Occupational, Metabolic and Internal Diseases, University Centre of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | - Ewa Lenkiewicz
- Department of Hyperbaric Medicine and Sea Rescue, University Centre of Maritime and Tropical Medicine, Gdynia, Poland
| | - Anna Susmarska
- Department of Radiology, University Centre of Maritime and Tropical Medicine, Gdynia, Poland
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Paul P, Rucińska A, Páleníček L, Szafran-Dobrowolska J, Renke M. Mass casualty incidents during the ten years of telemedical maritime assistance service in Gdynia, Poland. Med Pr 2023; 74:145-150. [PMID: 37102201 DOI: 10.13075/mp.5893.01344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Mass casualty incident (MCI) is one of the most difficult situation in emergency medicine. Due to the specific conditions, MCIs occurring at sea are usually far more demanding than those happening on land. In this paper the authors would like to describe the MCIs, which have happened during almost 10 years of functioning of the Polish Telemedical Maritime Assistance Service (TMAS). First incident concerned a group of migrants floating on a raft on the Gulf of Mexico. The cause of the second incident was acute organophosphate intoxication among the crew of the merchant ship. The third incident was triggered by the coronavirus disease 2019 (COVID-19). It is important to emphasize, that triage system may help in proper management of MCIs. Cooperation of the medical services, such as TMAS, local emergency medical staff, Search and Rescue (SAR) service and military force seems to be crucial in MCI managements occuring at sea. In case of any doubts, change of a course and heading to the nearest port or immediate evacuation should be taken into consideration. The authors believe that analysis of these incidents may help TMAS personnel all over the world to handle MCIs in the future. Med Pr. 2023;74(2).
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Affiliation(s)
- Przemysław Paul
- Medical University of Gdańsk, Gdańsk, Poland (Department of Occupational, Metabolic and Internal Diseases)
| | - Angelika Rucińska
- Medical University of Gdańsk, Gdańsk, Poland (Department of Occupational, Metabolic and Internal Diseases)
| | - Lukáš Páleníček
- Medical University of Gdańsk, Gdańsk, Poland (Department of Occupational, Metabolic and Internal Diseases)
| | - Joanna Szafran-Dobrowolska
- Medical University of Gdańsk, Gdańsk, Poland (Department of Occupational, Metabolic and Internal Diseases)
| | - Marcin Renke
- Medical University of Gdańsk, Gdańsk, Poland (Department of Occupational, Metabolic and Internal Diseases)
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Szafran-Dobrowolska J, Grubman-Nowak M, Renke M, Jeżewska M. The psychosocial burden and stress coping strategies among seafarers. Int Marit Health 2023; 74:122-128. [PMID: 37417846 DOI: 10.5603/imh.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The seafarers' professional group is one of the most numerous in the world. According to the statistics of the European Maritime Safety Agency (2020), there are approximately 280,000 people employed at sea in the European Union. The specific work environment on the ship (climatic, physical, chemical, psychological factors, etc.) is related to experiencing long-term stress. The World Health Organization considers work-related stressors to be very important determinants of health and disease. One of the basic psychological resources related to adaptation to demanding working conditions are strategies for coping with stress. The aim of the study is to assess the occurrence of harmful psychosocial factors in the work of seafarers and the stress coping strategies and their relationship with somatic diseases. MATERIALS AND METHODS One hundred and fifteen seafarers who received a maritime health certificate participated in the study at the Occupational Medicine Clinic. The study was part of a larger project looking at the prevalence of cardiovascular risk factors among seafarers. The study used the Coping Questionnaire in Stressful Situations (CISS) (Endler and Parker) and a general questionnaire created for the purposes of the study. RESULTS Thirty six per cent respondents were exposed to traumatic event and to having nightmares, 13% had been discriminated at least once in the workplace. A positive correlation was found between discrimination and depression, nightmares and trauma. In addition, people who admitted having experienced trauma slept shorter (also while at home) and experienced nightmares more often. The most common style of coping was task oriented (29; 28.5%), and avoidance oriented (15%). The study also found a positive correlation between depression and the style of emotion-oriented coping and avoidance-oriented coping. CONCLUSIONS The specific working conditions and exposure to traumatic events have a negative impact on the health of seafarers by increasing the risk of depression and cardiovascular diseases. The coping styles with stress depend on the position in the ship hierarchy.
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Affiliation(s)
- Joanna Szafran-Dobrowolska
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Poland
| | - Marta Grubman-Nowak
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Poland.
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Poland
| | - Maria Jeżewska
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Poland
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Błeszyńska-Marunowska E, Jagiełło K, Grodzicki T, Wierucki Ł, Sznitowska M, Kalarus Z, Renke M, Mitręga K, Rewiuk K, Zdrojewski T. Polypharmacy among elderly patients in Poland: prevalence, predisposing factors, and management strategies. Pol Arch Intern Med 2022; 132. [PMID: 36169051 DOI: 10.20452/pamw.16347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION The world's elderly population is growing dramatically. Pharmacotherapy in seniors is particularly challenging due to changes in metabolism, multimorbidity, and a great interest in nonprescription drugs. OBJECTIVES We aimed to provide up‑to‑datedata on pharmacotherapy in the geriatric population of Poland, to determine factors predisposing to polypharmacy and excessive polypharmacy, and to identify seniors who are most likely to require multidisciplinary interventions in the field of pharmacotherapy. PATIENTS AND METHODS We analyzed the use of all prescription and nonprescription drugs taken within 2 weeks preceding the study in a representative national sample of 3014 home‑dwelling seniors aged over 65 years. The variables of age, sex, place of residence, level of education, and multimorbidity were considered. Poststratification was used to balance the sample structure to match the Polish population of 2017. RESULTS Consumption of at least 1 drug was reported by 90.7% of the participants, and the mean number of drugs used was 5.01 (95% CI, 4.87-5.15). At least 1 nonprescription drug was used by 44.2% of the respondents, with a mean number of 0.52 (95% CI, 0.49-0.55). More than 5 drugs were taken by 53.5% of the entire population, while the use of more than 10 drugs was reported by 8.7% of the respondents, with multimorbidity as the most predisposing factor. Single‑pill combinations accounted for 27.2% of medications. CONCLUSIONS The high prevalence of polypharmacy resulting from multimorbidity confirms the need for the implementation of combined medical and pharmaceutical care of the geriatric patients.
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Affiliation(s)
| | - Kacper Jagiełło
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Wierucki
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland
| | - Małgorzata Sznitowska
- Department of Pharmaceutical Technology, Medical University of Gdansk, Gdańsk, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Gdańsk, Poland
| | - Katarzyna Mitręga
- Department of Cardiology, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Krzysztof Rewiuk
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland
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Wołyniec W, Szwarc A, Kasprowicz K, Zorena K, Jaskulak M, Renke M, Naczyk M, Ratkowski W. Impact of hydration with beverages containing free sugars or xylitol on metabolic and acute kidney injury markers after physical exercise. Front Physiol 2022; 13:841056. [PMID: 36338481 PMCID: PMC9632281 DOI: 10.3389/fphys.2022.841056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
The proper fluid and carbohydrates intake is essential before and during physical exercise, and for this reason most athletes drink beverages containing a high amount of free sugars. Sweetened soft drinks are also commonly consumed by those not doing any sport, and this habit seems to be both unhealthy and also the cause of metabolic problems. Recently, several sweeteners have been proposed to replace sugars in popular beverages. To examine the impact of free sugars and the popular sweetener xylitol on metabolic profile and the markers of kidney function and injury after exercise the present study was conducted with semi-professional football players. All participants were healthy, with a mean age of 21.91 years. Their sports skills were on the level of the 4th-5th division of the league. The subjects took part in four football training sessions. During each session they drank a 7% solution of sugar (sucrose, fructose, glucose) or xylitol. The tolerability of these beverages and well-being during exercise was monitored. Before and after each training session, blood and urine were collected. The markers of kidney function and injury, uric acid, electrolytes, complete blood count, CRP, serum albumin, serum glucose and the lipid profile were analyzed. The main finding of this study was that the xylitol beverage is the least tolerated during exercise and 38.89% of participants experienced diarrhea after training and xylitol intake. Xylitol also led to unfavorable metabolic changes and a large increase in uric acid and creatinine levels. A mean increase of 1.8 mg/dl in the uric acid level was observed after xylitol intake. Increases in acute kidney injury markers were observed after all experiments, but changes in urine albumin and cystatin C were highest after xylitol. The other three beverages (containing “free sugars” - glucose, fructose and sucrose) had a similar impact on the variables studied, although the glucose solution seems to have some advantages over other beverages. The conclusion is that sweeteners are not a good alternative to sugars, especially during exercise. Pure water without sweeteners should be drunk by those who need to limit their calorie consumption. Clinical Trial Registration:ClinicalTrials.gov, (NCT04310514)
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Affiliation(s)
- Wojciech Wołyniec
- Division of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
- *Correspondence: Wojciech Wołyniec,
| | - Andrzej Szwarc
- Department of Sport Sciences, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Kasprowicz
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Zorena
- Division of Immunobiology and Environmental Microbiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Jaskulak
- Division of Immunobiology and Environmental Microbiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Renke
- Division of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Naczyk
- Laboratory of Nutritional Biochemistry, Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | - Wojciech Ratkowski
- Department of Athletics, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
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Piotrowska M, Zieliński M, Tylicki L, Biedunkiewicz B, Kubanek A, Ślizień Z, Polewska K, Tylicki P, Muchlado M, Sakowska J, Renke M, Sudoł A, Dąbrowska M, Lichodziejewska-Niemierko M, Smiatacz T, Dębska-Ślizień A, Trzonkowski P. Local and Systemic Immunity Are Impaired in End-Stage-Renal-Disease Patients Treated With Hemodialysis, Peritoneal Dialysis and Kidney Transplant Recipients Immunized With BNT162b2 Pfizer-BioNTech SARS-CoV-2 Vaccine. Front Immunol 2022; 13:832924. [PMID: 35935974 PMCID: PMC9354587 DOI: 10.3389/fimmu.2022.832924] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/21/2022] [Indexed: 01/14/2023] Open
Abstract
Vaccination against COVID-19 in patients with end-stage renal disease (ESRD) on replacement therapy and kidney transplant recipients (KTRs) is particularly important due to the high mortality rate. Here, we tested the local and systemic immunity to the novel Pfizer BioNTech (BNT162b2) messenger RNA (mRNA) in ESRD, KTR patients, and healthy individuals (150 subjects). The ESRD group was divided into: hemodialysis (HD) and peritoneal dialysis (PD). We investigated the local and systemic immunity based on anti-N (nucleoprotein) and anti-S (spike1/2) Immunoglobulin A (IgA) and Immunoglobulin G (IgG) antibodies, respectively. Additionally, we performed an Interferon gamma (IFN-γ) release test Interferon-gamma release assay (IGRA) to monitor the cellular component of vaccine response. The control group had the highest level of anti-S IgG antibodies (153/2,080 binding antibody units (BAU)/ml) among all analyzed patients after the 1st and 2nd dose, respectively. The HD group (48/926 BAU/ml) had a diminished antibody level compared to PD (93/1,607 BAU/ml). Moreover, the seroconversion rate after the 1st dose was lower in HD than PD (56% vs. 86%). KTRs had extremely low seroconversion (33%). IgA-mediated immunity was the most effective in the control group, while other patients had diminished IgA production. We observed a lower percentage of vaccine responders based on the IFN-γ level in all research participants (100% vs. 85% in control, 100% vs. 80% in PD, 97% vs. 64% in HD). 63% of seropositive KTRs had a positive IGRA, while 28% of seronegative patients produced IFN-γ. Collectively, PD patients had the strongest response among ESRD patients. Two doses of the Pfizer vaccine are ineffective, especially in HD and KTRs. A closer investigation of ESRD and KTRs is required to set the COVID-19 vaccine clinical guidance.
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Affiliation(s)
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
| | - Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Zuzanna Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Polewska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marta Muchlado
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Justyna Sakowska
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Adam Sudoł
- Clinical Laboratory, University Clinical Centre, Gdansk, Poland
| | | | - Monika Lichodziejewska-Niemierko
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
- Department of Palliative Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Smiatacz
- Department of Infectious Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
- *Correspondence: Piotr Trzonkowski,
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Rzymski P, Pazgan-Simon M, Kamerys J, Moniuszko-Malinowska A, Sikorska K, Wernik J, Zarębska-Michaluk D, Supronowicz Ł, Sobala-Szczygieł B, Skrzat-Klapaczyńska A, Simon K, Piekarska A, Czupryna P, Pawłowska M, Brzdęk M, Jaroszewicz J, Kowalska J, Renke M, Flisiak R. Severe Breakthrough COVID-19 Cases during Six Months of Delta Variant (B.1.617.2) Domination in Poland. Vaccines (Basel) 2022; 10:557. [PMID: 35455306 PMCID: PMC9025315 DOI: 10.3390/vaccines10040557] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 02/04/2023] Open
Abstract
The emergence of a highly transmissible and a more pathogenic B.1.617.2 (delta) variant of SARS-CoV-2 has brought concern over COVID-19 vaccine efficacy and the increased risk of severe breakthrough infections. The objective of this study was to assess the frequency and the clinical characteristics of severe breakthrough COVID-19 cases recorded in 10 Polish healthcare units between 1 June and 31 December 2021, a period during which a rapid surge in the share of B.1.617.2 infections was seen, while a significant number of populations were already fully vaccinated. Overall, 723 individuals who completed the initial vaccination regime (fully vaccinated group) and an additional 18 who received a booster dose were identified—together, they represented 20.8% of all the COVID-19 patients hospitalized during the same period in the same healthcare institutions (0.5% in the case of a group that received a booster dose). Although laboratory and clinical parameters did not differ between both groups, patients who received a booster tended to have lower CRP, IL-6, PCT, and d-dimer levels and they required oxygen therapy less frequently. The most common early COVID-19 symptoms in the studied group were fatigue, cough, fever (>38 °C), and dyspnea. Individuals with no detectable anti-spike IgG antibodies constituted 13%; the odds of being a humoral non-responder to the vaccine were increased in patients aged >70 years. Fully vaccinated patients hospitalized after more than 180 days from the last vaccine dose were significantly older and they were predominantly represented by individuals over 70 years and with comorbidities, particularly cardiovascular disease. Contrary to mRNA vaccines, most patients vaccinated with adenoviral vector vaccines were infected within six months. A total of 102 fatal cases (14% of all deaths among vaccinated individuals; 0.7% in the case of a group that received a booster dose) were recorded, representing 17.6% of all the COVID-19 fatalities recorded in June−December 2021 in the considered healthcare units. The odds of death were significantly increased in men, individuals aged >70 years, patients with comorbidities, and those identified as humoral non-responders to vaccination; in fully vaccinated patients the odds were also increased when the second vaccine dose was given >180 days before the first COVID-19 symptoms. The mortality rate in immunocompromised subjects was 19%. The results indicate that compared to vaccinated individuals, severe COVID-19 and deaths in the unvaccinated group were significantly more prevalent during the B.1.617.2-dominated wave in Poland; and, it highlight the protective role of a booster dose, particularly for more vulnerable individuals.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland
| | - Monika Pazgan-Simon
- 1st Infectious Diseases Ward, Gromkowski Regional Specialist Hospital, 50-149 Wroclaw, Poland;
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, 51-149 Wrocław, Poland;
| | - Juliusz Kamerys
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, 90-549 Łódź, Poland; (J.K.); (A.P.)
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, 15-089 Białystok, Poland; (A.M.-M.); (P.C.)
| | - Katarzyna Sikorska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Joanna Wernik
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland; (J.W.); (M.P.)
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases, Jan Kochanowski University, 25-369 Kielce, Poland; (D.Z.-M.); (M.B.)
| | - Łukasz Supronowicz
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089 Białystok, Poland; (Ł.S.); (R.F.)
| | - Barbara Sobala-Szczygieł
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-055 Katowice, Poland; (B.S.-S.); (J.J.)
| | - Agata Skrzat-Klapaczyńska
- Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.S.-K.); (J.K.)
| | - Krzysztof Simon
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, 51-149 Wrocław, Poland;
| | - Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, 90-549 Łódź, Poland; (J.K.); (A.P.)
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, 15-089 Białystok, Poland; (A.M.-M.); (P.C.)
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland; (J.W.); (M.P.)
| | - Michał Brzdęk
- Department of Infectious Diseases, Jan Kochanowski University, 25-369 Kielce, Poland; (D.Z.-M.); (M.B.)
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-055 Katowice, Poland; (B.S.-S.); (J.J.)
| | - Justyna Kowalska
- Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.S.-K.); (J.K.)
| | - Marcin Renke
- Division of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, 81-519 Gdynia, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089 Białystok, Poland; (Ł.S.); (R.F.)
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Kuźmiuk-Glembin I, Heleniak Z, Pięta R, Głyda M, Lizakowski S, Renke M, Konopa J, Chamienia A, Biedunkiewicz B, Rutkowski B, Tylicki L, Dębska-Ślizień A. Short-term Effects of Losartan on Cardiovascular Risk and Allograft Injury Biomarkers in Kidney Transplant Recipients. Transplant Proc 2022; 54:981-988. [PMID: 35346485 DOI: 10.1016/j.transproceed.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/03/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is a controversy over the renoprotective and cardioprotective effects of renin-angiotensin-aldosterone system blockade in kidney transplant recipients (KTRs). The aim of the study was to evaluate the short-term effects of losartan on allograft injury, cardiovascular risk biomarkers and safety of the treatment in KTRs. METHODS An interim analysis of a prospective, open, multicenter, controlled clinical trial CELART (Cardiovascular Effects of Losartan After Renal Transplantation) was performed. KTRs were allocated to losartan (L) 50 to 100 mg or standard hypotensive treatment (ST) group to reach target blood pressure (BP) <140/90 mm Hg. The short-term effects of the therapy were evaluated after 6 months: estimated glomerular filtration rate (eGFR), albuminuria, the intrarenal fibrosis biomarkers: urine excretion of transforming growth factor β-1 (TGFβ-1) and procollagen type III amino terminal propeptide (PIIINP), cardiac biomarker: serum concentration of N-terminal-pro-B-type natriuretic peptide (NT-proBNP), 24-hour ambulatory BP measurement, and hemoglobin and potassium concentrations. RESULTS At baseline the groups did not differ with respect to age, primary nephropathy, comorbidity, immunosuppressive therapy, albuminuria, and graft function. A total of 61 (L group) and 73 (ST group) patients reached the target BP and completed protocol at 6 months. After 6 months of therapy there were no significant differences in changes of eGFR, albuminuria, hemoglobin and potassium concentrations, urine excretion of PIIINP, and TGFβ-1 between groups. There was a trend in the L group to decrease the concentration of serum NT-proBNP. CONCLUSIONS Losartan shows minimal adverse effects and no influence on graft function and biomarkers of graft fibrosis. It may have a positive effect on cardiovascular risk in KTRs. Further interim analyses of the CELART study will be conducted.
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Affiliation(s)
- Izabella Kuźmiuk-Glembin
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Renata Pięta
- Department of Transplantology and Surgery, District Public Hospital, Poznań, Poland
| | - Maciej Głyda
- Department of Transplantology and Surgery, District Public Hospital, Poznań, Poland; Collegium Medicum In Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Sławomir Lizakowski
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Renke
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland; Division of Occupational, Metabolic, and Internal Diseases, National Centre for Maritime Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Joanna Konopa
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej Chamienia
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Bolesław Rutkowski
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Leszek Tylicki
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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10
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Biedunkiewicz B, Tylicki L, Ślizień W, Lichodziejewska-Niemierko M, Dąbrowska M, Kubanek A, Rodak S, Polewska K, Tylicki P, Renke M, Dębska-Ślizień A. Waning Humoral Response after COVID-19 mRNA Vaccination in Maintenance Dialysis Patients and Recovery after a Complementary Third Dose. Vaccines (Basel) 2022; 10:vaccines10030433. [PMID: 35335065 PMCID: PMC8950255 DOI: 10.3390/vaccines10030433] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to analyze the waning of anti-spike (S) antibodies after mRNA vaccination against COVID-19 in maintenance dialysis patients, and to assess the safety and effectiveness of the complementary third dose. This was a prospective, longitudinal study in which we analyzed the kinetics of antibodies up to six months after a two-dose vaccination (first protocol) in infection-naïve dialysis patients (IN-Ds), previously infected dialysis patients (PI-Ds) and subjects without chronic kidney disease (the controls), as well as their humoral response to the third dose of the same mRNA vaccine (second protocol). The respective reduction in antibody titer after 3 and 6 months by 82.9% and 93.03% in IN-Ds (n = 109), 73.4% and 93.36% in PI-Ds (n = 32) and 75.5% and 88.8% in the controls (n = 20) was demonstrated. Consequently, a protective antibody titer above 141 BAU/mL was found in only 47.7% and 23.8% of IN-Ds after 3 and 6 months, respectively. After the third vaccine dose, a significant increase in antibody titer was observed in all groups, with increases by a factor of ×51.6 in IN-Ds, ×30.1 in the controls and ×8.4 in PI-Ds. The median antibody titer after the third dose differed significantly between groups, and was the highest in PI-Ds: PI-Ds, 9090 (3300−15,000) BAU/mL; the controls, 6945 (2130−11,800); IN-Ds, 3715 (1470−7325) (p < 0.001). In conclusion, we observed similar degrees of antibody waning in all patients. After 3 months, over half of the infection-naïve dialysis patients had a very low antibody titer, and almost twenty percent of them had no antibodies at all. The humoral response to the third dose was very good, raising their titer of antibodies to a higher level than those in the general population who have received the primary two-dose scheme. The results support the administration of a complementary third dose of the mRNA vaccine for dialysis patients as soon as possible.
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Affiliation(s)
- Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
- Correspondence: ; Tel.: +48-58-5844700
| | | | - Monika Lichodziejewska-Niemierko
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | | | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Sylwia Rodak
- NZOZ Diaverum, 81-519 Gdynia, Poland; (W.Ś.); (S.R.)
| | - Karolina Polewska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Piotr Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (B.B.); (M.L.-N.); (K.P.); (P.T.); (A.D.-Ś.)
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11
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Ślizień Z, Muchlado M, Kubanek A, Biedunkiewicz B, Renke M, Komorowska K, Dębska-Ślizień A, Tylicki L. Safety and tolerability of mRNA COVID-19 vaccines in kidney transplant recipients. Transplant Proc 2022; 54:878-883. [PMID: 35961734 PMCID: PMC8926897 DOI: 10.1016/j.transproceed.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/09/2022] [Indexed: 11/03/2022]
Abstract
Background Materials and Methods Results Conclusion
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12
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Tylicki P, Polewska K, Och A, Susmarska A, Puchalska-Reglińska E, Parczewska A, Biedunkiewicz B, Szabat K, Renke M, Tylicki L, Dębska-Ślizień A. Angiotensin Converting Enzyme Inhibitors May Increase While Active Vitamin D May Decrease the Risk of Severe Pneumonia in SARS-CoV-2 Infected Patients with Chronic Kidney Disease on Maintenance Hemodialysis. Viruses 2022; 14:451. [PMID: 35336859 PMCID: PMC8951398 DOI: 10.3390/v14030451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/01/2023] Open
Abstract
The group most at risk of death due to COVID-19 are patients on maintenance hemodialysis (HD). The study aims to describe the clinical course of the early phase of SARS-CoV-2 infection and find predictors of the development of COVID-19 severe pneumonia in this population. This is a case series of HD nonvaccinated patients with COVID-19 stratified into mild pneumonia and severe pneumonia group according to the chest computed tomography (CT) pneumonia total severity score (TSS) on admission. Epidemiological, demographic, clinical, and laboratory data were obtained from hospital records. 85 HD patients with a mean age of 69.74 (13.19) years and dialysis vintage of 38 (14-84) months were included. On admission, 29.14% of patients had no symptoms, 70.59% reported fatigue followed by fever-44.71%, shortness of breath-40.0%, and cough-30.59%. 20% of the patients had finger oxygen saturation less than 90%. In 28.81% of patients, pulmonary parenchyma was involved in at least 25%. The factors associated with severe pneumonia include fever, low oxygen saturation and arterial partial pressure of oxygen, increased C-reactive protein and ferritin serum levels, low blood count of lymphocytes as well as chronic treatment with angiotensin converting enzyme inhibitors; while the chronic active vitamin D treatment was associated with mild pneumonia. In conclusion, even though nearly one-third of the patients were completely asymptomatic, while the remaining usually reported only single symptoms, a large percentage of them had extensive inflammatory changes at diagnosis with SARS-CoV-2 infection. We identified potential predictors of severe pneumonia, which might help individualize pharmacological treatment and improve clinical outcomes.
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Affiliation(s)
- Piotr Tylicki
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
| | - Karolina Polewska
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
| | - Aleksander Och
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
| | - Anna Susmarska
- Department of Radiology, University Center for Maritime and Tropical Medicine, 81-519 Gdynia, Poland;
| | | | | | - Bogdan Biedunkiewicz
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
| | - Krzysztof Szabat
- 7th Naval Hospital in Gdańsk, 80-305 Gdańsk, Poland; (E.P.-R.); (A.P.); (K.S.)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Faculty of Health Science, Medical University of Gdansk, 81-519 Gdynia, Poland;
| | - Leszek Tylicki
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
| | - Alicja Dębska-Ślizień
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.T.); (K.P.); (A.O.); (B.B.); (A.D.-Ś.)
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13
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Grubman-Nowak M, DĘbska-ŚlizieŃ A, Renke M. Employment after renal transplantation vs. the health locus of control and the quality of life. Int J Occup Med Environ Health 2022; 35:53-62. [PMID: 34533137 PMCID: PMC10464777 DOI: 10.13075/ijomeh.1896.01765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/12/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES The aim of the presented study was to compare the health locus of control (HLC) between employed and unemployed patients after kidney transplantation (KT), and to investigate the relationship between HLC and the quality of life (QoL). MATERIAL AND METHODS The study group consisted of 101 KT patients and the control group of 60 hemodialysis (HD) patients. The applied methods were: the Multidimensional Health Locus of Control Questionnaire (MHLC), the WHO Quality of Life Questionnaire (WHOQoL-BREF), and a survey collecting information on the socio-demographic status and work experience. RESULTS Overall, 57.5% of KT patients were employed and 42.5% were unemployed. In the HD group, 25% were employed and 71% were unemployed, while 4% did not disclose their employment status. The unemployed KT patients, in comparison with the employed ones, presented a higher feeling of the impact of chance on their health (unemployed M±SD 23.68±6.59; employed M±SD 21.02±4.57) and a lower level of QoL on the Somatic Scale (unemployed Me = 14.00, IQR = 3.00; employed Me = 1450, IQR = 3.00) and the Environmental Scale (unemployed M±SD 15.39±2.83; employed M±SD 16.85±3.24). In the employed KT group, the Internal Control Scale (MHLC) correlated with all QoL scales (the Somatic Scale: r = 0.292, p = 0.036; the Psychological Scale: r = 0.455, p = 0.001; the Social Scale: r = 0.304, p = 0.029; and the Environmental Scale: r = 0.307, p = 0.027). In the unemployed KT group, the Internal Control Scale (MHLC) correlated significantly with the Somatic Scale (r = 0.396, p = 0.013) and the Psychological Scale (r = 0.374, p = 0.019). CONCLUSIONS The employed KT patients have a higher level of independence, with results indicating a strong internal type. Additionally, the working patients assess their QoL better, both in terms of their health condition and the organization of satisfying environment. The obtained knowledge about the psychological characteristics of KT patients may be useful for the occupational activation programs and psycho-education for those with weaker predispositions. Int J Occup Med Environ Health. 2022;35(1):53-62.
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Affiliation(s)
- Marta Grubman-Nowak
- Medical University of Gdańsk, Clinic of Occupational, Metabolic and Internal Diseases, Gdańsk, Poland
| | - Alicja DĘbska-ŚlizieŃ
- Medical University of Gdańsk, Department of Nephrology, Transplantology and Internal Diseases, Gdańsk, Poland
| | - Marcin Renke
- Medical University of Gdańsk, Clinic of Occupational, Metabolic and Internal Diseases, Gdańsk, Poland
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Wachnicka-Truty R, Curyłło B, Wojtowicz D, Kulawiak-Gałąska D, Renke M, Sikorska K, Gruchała M, Koziński M. Life-threatening COVID-19 and aspergillosis co-infection in a heart transplant recipient: A cardiologist's nightmare. Cardiol J 2022; 29:351-354. [PMID: 35146731 PMCID: PMC9007474 DOI: 10.5603/cj.a2022.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Renata Wachnicka-Truty
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | - Bartosz Curyłło
- Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Dagmara Wojtowicz
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | | | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | - Katarzyna Sikorska
- Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland
| | - Marcin Gruchała
- Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland.
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15
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Dębska-Ślizień A, Muchlado M, Ślizień Z, Kubanek A, Piotrowska M, Dąbrowska M, Bzoma B, Konopa J, Renke M, Biedunkiewicz B, Tylicki L. Significant humoral response to mRNA COVID-19 vaccine in kidney transplant recipients with prior exposure to SARS-CoV-2. The COViNEPH Project. Pol Arch Intern Med 2021; 132. [PMID: 34809419 DOI: 10.20452/pamw.16142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Marta Muchlado
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Zuzanna Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Faculty of Health Science, Medical University of Gdansk, Gdynia, Poland
| | - Magdalena Piotrowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | | | - Beata Bzoma
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Joanna Konopa
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Faculty of Health Science, Medical University of Gdansk, Gdynia, Poland
| | - Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland.
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16
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Paul P, Kanclerz K, Kubanek A, Bałasz A, Renke M. [Haff disease - are we threatened with another epidemic?]. Med Pr 2021; 72:605-610. [PMID: 34491243 DOI: 10.13075/mp.5893.01138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Haff disease is a group of symptoms caused by rhabdomyolysis following ingestion of some species of fish and crayfish. Pathophysiology remains unknown. Outbreaks of the Haff disease have been reported in many regions of the world. In this article we present the case of a 38-years-old patient, professional fisherman, suspected of suffering from Haff disease. He developed symptoms of diffuse myalgia, headache, chest pressure, brown-colored urine and elevated blood pressure. Predominant laboratory abnormalities were elevated serum creatine kinase and creatinine concentrations. During hospitalization the patient required the renal replacement therapy. As a result of applied procedures, clinical and laboratory improvement was achieved. The patient was discharged home in good general condition. The Haff disease should be included in the differential diagnosis of rhabdomyolysis. Detailed medical interview, especially questions about recently consumed food and occupational exposure, is crucial in making a proper diagnosis. Med Pr. 2021;72(5):605-10.
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Affiliation(s)
- Przemysław Paul
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Katarzyna Kanclerz
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Alicja Kubanek
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Andrzej Bałasz
- Niepubliczny Zakład Opieki Zdrowotnej Centrum Chorób Wewnętrznych "El-Vita" Sp. z o.o. / Non-public Health Care Facility Internal Medicine Center "El-Vita" Ltd., Elbląg, Poland (Oddział Chorób Wewnętrznych z Pododdziałem Nefrologii i Stacją Dializ / Internal Medicine Department with the Nephrology Division and Dialysis Station)
| | - Marcin Renke
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
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Dębska-Ślizień A, Ślizień Z, Muchlado M, Kubanek A, Piotrowska M, Dąbrowska M, Tarasewicz A, Chamienia A, Biedunkiewicz B, Renke M, Tylicki L. Predictors of Humoral Response to mRNA COVID19 Vaccines in Kidney Transplant Recipients: A Longitudinal Study-The COViNEPH Project. Vaccines (Basel) 2021; 9:1165. [PMID: 34696273 PMCID: PMC8540727 DOI: 10.3390/vaccines9101165] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The efficacy of SARS-CoV-2 vaccination among kidney transplant recipients (KTR) is low. The main goal of this study was to analyze factors that may influence the humoral response to vaccination. METHODS We analyzed the titer magnitude of IgG antibodies directed against spike (S)-SARS-CoV-2 antigen after the second dose of the mRNA vaccine in 142 infection naïve KTR (83 men, i.e., 58.4%) with a median age (IQR) of 54 (41-63), and 36 respective controls without chronic kidney disease. mRNA-1273 or BNT162b2 were applied in 26% and 74% of KTR, respectively. RESULTS S-specific immune response (seroconversion) was seen in 73 (51.41%) of KTR, and in all controls 36 (100%). Independent predictors of no response were elder age, shorter transplantation vintage, and a more than two-drug immunosuppressive protocol. In subgroup analyses, the seroconversion rate was highest among KTR without MMF/MPS treatment (70%), treated with no more than two immunosuppressants (69.2%), treated without corticosteroid (66.7%), younger patients aged <54 years (63.2%), and those vaccinated with the mRNA-1273 vaccine (62.16%). The independent predictors of higher S-antibody titer among responders were younger age, treatment with no more than two immunosuppressants, and the mRNA-1273 vaccination. CONCLUSIONS Our study confirmed a low rate of seroconversion after vaccination with the mRNA vaccine in KTR. The major modifiable determinants of humoral response were the composition of the immunosuppressive protocol, as well as the type of vaccine. The latter could be taken into consideration when initial vaccination as well as booster vaccination is considered in KTR.
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Affiliation(s)
- Alicja Dębska-Ślizień
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Zuzanna Ślizień
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Marta Muchlado
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Faculty of Health Science, Medical University of Gdansk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Magdalena Piotrowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Małgorzata Dąbrowska
- Central Clinical Laboratory, The University Clinical Centre, 80-952 Gdańsk, Poland;
| | - Agnieszka Tarasewicz
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Andrzej Chamienia
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Bogdan Biedunkiewicz
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Faculty of Health Science, Medical University of Gdansk, 81-519 Gdynia, Poland; (A.K.); (M.R.)
| | - Leszek Tylicki
- Department of Nephrology Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.D.-Ś.); (Z.Ś.); (M.M.); (A.T.); (A.C.); (B.B.)
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Polewska K, Tylicki P, Biedunkiewicz B, Rucińska A, Szydłowska A, Kubanek A, Rosenberg I, Rodak S, Ślizień W, Renke M, Dębska-Ślizień A, Tylicki L. Safety and Tolerability of the BNT162b2 mRNA COVID-19 Vaccine in Dialyzed Patients. COViNEPH Project. Medicina (Kaunas) 2021; 57:732. [PMID: 34357013 PMCID: PMC8307559 DOI: 10.3390/medicina57070732] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The Pfizer-BioNTech (BNT162b2) COVID-19 mRNA vaccine has demonstrated excellent efficacy and safety in phase 3 trials. However, no dialyzed patients were included, and therefore safety data for this patient group is lacking. The aim of the study was to assess the safety and tolerances of vaccinations with BNT162b2 performed in chronically dialyzed patients. Materials and Methods: We performed a prospective cohort study including a group of 190 dialyzed patients (65% male) at median age 68.0 (55-74) years. 169 (89.0%) patients were treated with hemodialysis and 21 (11.0%) with peritoneal dialysis. The control group consisted of 160 people (61% male) without chronic kidney disease at median age 63 (range 53-77) years. Both groups were vaccinated with BNT162b2 with a 21-day interval between the first and the second dose. Solicited local and systemic reactogenicity, unsolicited adverse events and antipyretic and pain medication use were assessed with a standardized questionnaire. The toxicity grading scales were derived from the FDA Center for Biologics Evaluation and Research guidelines. Results: 59.8% (dose 1), 61.4% (dose 2) and 15.9% (dose 1), 29.4% (dose 2) dialyzed patients reported at least one local and one systemic reaction respectively within seven days after the vaccination. Many local and systemic solicited reactions were observed less frequently in dialyzed patients than in the age and sex matched control group and much less frequently than reported in the pivotal study. They were mostly mild to moderate, short-lived, and more frequently reported in younger individuals and women. No related unsolicited adverse events were observed. Conclusions: We have shown here that BNT162b2, an mRNA vaccine from Pfizer-BioNTech against SARS-COV-2 is safe and well-tolerated by dialyzed patients. The results can be useful for the nephrological community to resolve patients' doubts and reduce their vaccine hesitancy.
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Affiliation(s)
- Karolina Polewska
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (K.P.); (P.T.); (A.D.-Ś.); (L.T.)
| | - Piotr Tylicki
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (K.P.); (P.T.); (A.D.-Ś.); (L.T.)
| | - Bogdan Biedunkiewicz
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (K.P.); (P.T.); (A.D.-Ś.); (L.T.)
| | - Angelika Rucińska
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland; (A.R.); (A.S.); (A.K.); (M.R.)
| | - Aleksandra Szydłowska
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland; (A.R.); (A.S.); (A.K.); (M.R.)
| | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland; (A.R.); (A.S.); (A.K.); (M.R.)
| | - Iwona Rosenberg
- NZOZ Diaverum, 81-519 Gdynia, Poland; (I.R.); (S.R.); (W.Ś.)
| | - Sylwia Rodak
- NZOZ Diaverum, 81-519 Gdynia, Poland; (I.R.); (S.R.); (W.Ś.)
| | | | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland; (A.R.); (A.S.); (A.K.); (M.R.)
| | - Alicja Dębska-Ślizień
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (K.P.); (P.T.); (A.D.-Ś.); (L.T.)
| | - Leszek Tylicki
- Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (K.P.); (P.T.); (A.D.-Ś.); (L.T.)
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Paul P, Kanclerz K, Kubanek A, Renke J, Renke M. [New biochemical markers of ethyl alcohol abuse - new possibilities in clinical practice]. Med Pr 2021; 72:173-184. [PMID: 33783441 DOI: 10.13075/mp.5893.01025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Alcohol ranks as one of the leading behavioral threats to health and life in developed countries. Alcohol abuse triggers serious social and economic effects: it contributes to higher prevalence of work-related and road accidents, as well as absence from work. The diagnosis and treatment of alcoholism still remain very difficult. Hence, the use of objective biochemical markers of alcohol abuse may contribute to earlier detection, more effective therapy and reliable teetotalism control. The aim of this study is to present the sensitive and specific biomarkers of alcohol abuse available in Poland, with particular emphasis on the practical use possibilities. Such tests may be widely used, e.g., in driving license regranting cases involving drivers whose licenses were suspended for driving when intoxicated, for the early detection of persons abusing alcohol in employment-related health controls, for abstinence monitoring during withdrawal treatment, for detecting alcohol consumption in transplant settings, for assessing the prevalence of alcohol drinking in pregnancy, as well as in autopsical examinations. The standardization of biomarkers measurement methods is essential. Moreover, concomitant disorders may pose a significant problem in the proper outcome analysis. Despite these limitations, objective biochemical markers of ethyl alcohol abuse may become helpful tools in medical care. They can play a particular role in occupational medicine diagnostics, contributing to the higher level of safety on public roads and to worker safety. Med Pr. 2021;72(2):173-84.
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Affiliation(s)
- Przemysław Paul
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Katarzyna Kanclerz
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Alicja Kubanek
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Joanna Renke
- Uniwersytet Gdański / University of Gdansk, Gdańsk, Poland (Katedra Biochemii Ogólnej i Medycznej / Department of General and Medical Biochemistry)
| | - Marcin Renke
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
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20
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Wołyniec W, Ratkowski W, Renke J, Renke M. Changes in Novel AKI Biomarkers after Exercise. A Systematic Review. Int J Mol Sci 2020; 21:E5673. [PMID: 32784748 PMCID: PMC7461060 DOI: 10.3390/ijms21165673] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/26/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022] Open
Abstract
More than 100 substances have been identified as biomarkers of acute kidney injury. These markers can help to diagnose acute kidney injury (AKI) in its early phase, when the creatinine level is not increased. The two markers most frequently studied in plasma and serum are cystatin C and neutrophil gelatinase-associated lipocalin (NGAL). The former is a marker of kidney function and the latter is a marker of kidney damage. Some other promising serum markers, such as osteopontin and netrin-1, have also been proposed and studied. The list of promising urinary markers is much longer and includes cystatin C, NGAL, kidney injury molecule-1 (KIM-1), liver-type fatty-acid-binding protein (L-FABP), interleukin 18, insulin-like growth factor binding protein 7 (IGFBP-7), tissue inhibitor of metalloproteinases-2 (TIMP-2) and many others. Although these markers are increased in urine for no longer than a few hours after nephrotoxic agent action, they are not widely used in clinical practice. Only combined IGFBP-7/TIMP-2 measurement was approved in some countries as a marker of AKI. Several studies have shown that the levels of urinary AKI biomarkers are increased after physical exercise. This systematic review focuses on studies concerning changes in new AKI biomarkers in healthy adults after single exercise. Twenty-seven papers were identified and analyzed in this review. The interpretation of results from different studies was difficult because of the variety of study groups, designs and methodology. The most convincing data concern cystatin C. There is evidence that cystatin C is a better indicator of glomerular filtration rate (GFR) in athletes after exercise than creatinine and also at rest in athletes with a lean mass lower or higher than average. Serum and plasma NGAL are increased after prolonged exercise, but the level also depends on inflammation and hypoxia; therefore, it seems that in physical exercise, it is too sensitive for AKI diagnosis. It may, however, help to diagnose subclinical kidney injury, e.g., in rhabdomyolysis. Urinary biomarkers are increased after many types of exercise. Increases in NGAL, KIM-1, cystatin-C, L-FABP and interleukin 18 are common, but the levels of most urinary AKI biomarkers decrease rapidly after exercise. The importance of this short-term increase in AKI biomarkers after exercise is doubtful. It is not clear if it is a sign of mild kidney injury or physiological metabolic adaptation to exercise.
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Affiliation(s)
- Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9b Powstania Styczniowego Street, 81-519 Gdynia, Poland;
| | - Wojciech Ratkowski
- Department of Athletics, Gdańsk University of Physical Education and Sport, 1 Górskiego Street, 80-336 Gdańsk, Poland;
| | - Joanna Renke
- Department of General and Medical Biochemistry, University of Gdansk, 59 Wita Stwosza Street, 80-308 Gdańsk, Poland;
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9b Powstania Styczniowego Street, 81-519 Gdynia, Poland;
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Błeszyńska E, Wierucki Ł, Zdrojewski T, Renke M. Pharmacological Interactions in the Elderly. ACTA ACUST UNITED AC 2020; 56:medicina56070320. [PMID: 32605319 PMCID: PMC7404696 DOI: 10.3390/medicina56070320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023]
Abstract
Pharmacological therapy in the elderly is particularly complicated and challenging. Due to coexistence of three main predisposing factors (advanced age, multiple morbidity and polypharmacotherapy), this group of patients is prone to occurrence of drug interactions and adverse effects of incorrect drug combinations. Since many years patient safety during the treatment process has been one of key elements for proper functioning of healthcare systems around the world, thus different preventive measures have been undertaken in order to counteract factors adversely affecting the therapeutic effect. One of the avoidable medical errors is pharmacological interactions. According to estimates, one in six elderly patients may be at risk of a significant drug interaction. Hence the knowledge about mechanisms and causes of drug interactions in the elderly, as well as consequences of their occurrence are crucial for planning the process of pharmacotherapy. For the purpose of pharmacovigilance, a review of available methods and tools gives an insight into possible ways of preventing drug interactions. Additionally, recognizing the actual scale of this phenomenon in geriatric population around the world emphasizes the importance of a joint effort among medical community to improve quality of pharmacotherapy.
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Affiliation(s)
- Emilia Błeszyńska
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland;
- Correspondence: ; Tel.: +48-60-5881-185
| | - Łukasz Wierucki
- Department of Preventive Medicine & Education, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (L.W.); (T.Z.)
| | - Tomasz Zdrojewski
- Department of Preventive Medicine & Education, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (L.W.); (T.Z.)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland;
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Grubman-Nowak M, Jeżewska M, Szafran-Dobrowolska J, Ślizień AD, Renke M. Occupational Activity After Renal Transplantation vs Quality of Life, Personality Profile, and Stress Coping Styles. Transplant Proc 2020; 52:2423-2429. [PMID: 32576475 DOI: 10.1016/j.transproceed.2020.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Kidney transplantation (KT) increases the quality of life (QoL) of patients with chronic kidney disease. Employment is one the objective indicators of KT success. The aim of the presented study was to assess the psychological predispositions of KT and hemodialysis (HD) patients, such as stress coping styles, chosen personality features, and their relationship with employment and QoL. MATERIAL AND METHODS One hundred and sixty-one persons were examined, 101 after KT, and 60 HD patients. The following methods were applied: NEO-FFI Personality Inventory; Coping Inventory for Stressful Situations (CISS); WHOQoL-BREF; and general survey, measuring sociodemographic data and work experience. RESULTS In the KT group, 58 persons were employed and 43 were unemployed. HD patients were mostly unemployed, with only 15 persons working. Significant differences were identified between the results of the following variables: WHOQoL environmental scale (employed m= 16.8, standard deviation [SD] = 3; unemployed m= 15, SD = 2.8); extraversion (employed m = 6.7, SD = 2; unemployed m = 5.6, SD = 2); somatic WHOQoL scale (HD m = 12.2, SD = 2.7; KT m = 14.2, SD = 3.5). In the KT group, the following correlations were identified: extraversion with contact seeking strategy (r = 0.553), agreeableness (r = 0.245), and conscientiousness (r = 0.384); agreeableness with conscientiousness (r = 0.336). In the HD group, the following correlations were identified: task-oriented style with conscientiousness (r = 0.474); avoidance-oriented style with conscientiousness (r = -0.466); contact seeking with extraversion (r = 0.402) and agreeableness (r = 0.469). CONCLUSIONS The following conclusions were reached: Social competence, such as seeking and maintaining contacts, positively translates to features connected with occupational activity. Social skills strengthen the organization of healthier environment and increase QoL. Employed patients have higher social skills and QoL.
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Affiliation(s)
- Marta Grubman-Nowak
- Clinic of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland.
| | - Maria Jeżewska
- Clinic of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Alicja Dębska Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Renke
- Clinic of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
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23
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Renke J, Wasilewska E, Kędzierska-Mieszkowska S, Zorena K, Barańska S, Wenta T, Liberek A, Siluk D, Żurawa-Janicka D, Szczepankiewicz A, Renke M, Lipińska B. Tumor Suppressors-HTRA Proteases and Interleukin-12-in Pediatric Asthma and Allergic Rhinitis Patients. Medicina (Kaunas) 2020; 56:E298. [PMID: 32560402 PMCID: PMC7353852 DOI: 10.3390/medicina56060298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/30/2022]
Abstract
Background and objective: Allergy belongs to a group of mast cell-related disorders and is one of the most common diseases of childhood. It was shown that asthma and allergic rhinitis diminish the risk of various cancers, including colon cancer and acute lymphoblastic leukemia. On the other hand, asthma augments the risk of lung cancer and an increased risk of breast cancer in patients with allergy has been observed. Thus, the relation between allergy and cancer is not straightforward and furthermore, its biological mechanism is unknown. The HTRA (high temperature requirement A) proteases promote apoptosis, may function as tumor suppressors and HTRA1 is known to be released by mast cells. Interleukin-12 (Il-12) is an important cytokine that induces antitumor immune responses and is produced mainly by dendritic cells that co-localize with mast cells in superficial organs. Material and methods: In the present study we have assessed with ELISA plasma levels of the HTRA proteins, Il-12, and of the anti-HTRA autoantibodies in children with allergy (40) and in age matched controls (39). Children are a special population, since they usually do not have comorbidities and take not many drugs the processes we want to observe are not influenced by many other factors. Results: We have found a significant increase of HTRA1, 2 and 3, and of the Il-12 levels in the children with atopy (asthma and allergic rhinitis) compared to controls. Conclusion: Our results suggest that the HTRA1-3 and Il-12 levels might be useful in analyzing the pro- and antioncogenic potential in young atopic patients.
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Affiliation(s)
- Joanna Renke
- Department of General and Medical Biochemistry, University of Gdańsk, Wita Stwosza 59 80-308 Gdańsk, Poland; (S.K.-M.); (T.W.); (D.Ż.-J.); (B.L.)
| | - Eliza Wasilewska
- Department of Allergology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland;
| | - Sabina Kędzierska-Mieszkowska
- Department of General and Medical Biochemistry, University of Gdańsk, Wita Stwosza 59 80-308 Gdańsk, Poland; (S.K.-M.); (T.W.); (D.Ż.-J.); (B.L.)
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland;
| | - Sylwia Barańska
- Department of Bacterial Molecular Genetics University of Gdańsk Wita Stwosza 59, 80-308 Gdańsk, Poland;
| | - Tomasz Wenta
- Department of General and Medical Biochemistry, University of Gdańsk, Wita Stwosza 59 80-308 Gdańsk, Poland; (S.K.-M.); (T.W.); (D.Ż.-J.); (B.L.)
| | - Anna Liberek
- Faculty of Health Sciences with Subfaculty of Nursing, Medical University of Gdańsk, Tuwima 15, 80-210 Gdańsk, Poland;
| | - Danuta Siluk
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland;
| | - Dorota Żurawa-Janicka
- Department of General and Medical Biochemistry, University of Gdańsk, Wita Stwosza 59 80-308 Gdańsk, Poland; (S.K.-M.); (T.W.); (D.Ż.-J.); (B.L.)
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Pediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, 60-512 Poznan, Poland;
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland;
| | - Barbara Lipińska
- Department of General and Medical Biochemistry, University of Gdańsk, Wita Stwosza 59 80-308 Gdańsk, Poland; (S.K.-M.); (T.W.); (D.Ż.-J.); (B.L.)
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Dębska-Ślizień A, Gałgowska J, Bułło-Piontecka B, Bzoma B, Chamienia A, Król E, Lichodziejewska-Niemierko M, Lizakowski S, Pankrac Z, Preis K, Renke M, Rutkowski P, Śledziński Z, Zdrojewski Z. Pregnancy After Kidney Transplantation With Maternal and Pediatric Outcomes: A Single-Center Experience. Transplant Proc 2020; 52:2430-2435. [PMID: 32444125 DOI: 10.1016/j.transproceed.2020.01.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 01/26/2020] [Indexed: 10/24/2022]
Abstract
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 m2 (range, 27-106 mL/min/1.73 m2). 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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Affiliation(s)
- Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Joanna Gałgowska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland.
| | - Barbara Bułło-Piontecka
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Beata Bzoma
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Andrzej Chamienia
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Ewa Król
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | | | - Sławomir Lizakowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Zofia Pankrac
- Department of Obstetrics, Medical University of Gdańsk, Poland
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational and Internal Medicine, Medical University of Gdańsk, Poland
| | - Przemysław Rutkowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | | | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
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Kanclerz K, Wołyniec W, Rutkowski P, Renke M. [Mesoamerican nephropathy - a new challenge for occupational physicians]. Med Pr 2020; 71:353-361. [PMID: 32313269 DOI: 10.13075/mp.5893.00889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Mesoamerican nephropathy (MeN) is an endemic form of chronic kidney disease (CKD) that is not related to risk factors for CKD, such as diabetes and hypertension. It primarily affects men, rural and agricultural laborers, who work in an extremely hot and dry environment. The greatest increase in the prevalence of CKD, particularly since the late 1990s, has been reported in Central America and Southern Mexico, where the prevalence is almost 9 times higher than in the USA. The highest mortality associated with CKD is reported in El Salvador where a 10-fold increase was recorded in 1984-2005. In histological examination, MeN patients manifest tubulointerstitial lesions and, in some cases, also lesions in the glomeruli. The cause of MeN remains unclear. Repeated episodes of occupational heat stress, and sweating accompanied by water loss, have a significant impact on the disease development. The disease is a significant social and economic problem, and a challenge in the field of diagnostics, therapy and prevention for physicians of many specialties, especially for occupational physicians. Med Pr. 2020;71(3):353-61.
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Affiliation(s)
- Katarzyna Kanclerz
- Gdański Uniwersytet Medyczny / Medical University of Gdańsk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Wojciech Wołyniec
- Gdański Uniwersytet Medyczny / Medical University of Gdańsk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
| | - Przemysław Rutkowski
- Gdański Uniwersytet Medyczny / Medical University of Gdańsk, Gdańsk, Poland (Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych / Department of Nephrology, Transplantology and Internal Medicine)
| | - Marcin Renke
- Gdański Uniwersytet Medyczny / Medical University of Gdańsk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases)
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Kasprowicz K, Ratkowski W, Wołyniec W, Kaczmarczyk M, Witek K, Żmijewski P, Renke M, Jastrzębski Z, Rosemann T, Nikolaidis PT, Knechtle B. The Effect of Vitamin D 3 Supplementation on Hepcidin, Iron, and IL-6 Responses after a 100 km Ultra-Marathon. Int J Environ Res Public Health 2020; 17:ijerph17082962. [PMID: 32344650 PMCID: PMC7215841 DOI: 10.3390/ijerph17082962] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
Deficiencies in iron and vitamin D are frequently observed in athletes. Therefore, we examined whether different baseline vitamin D3 levels have any impact on post-exercise serum hepcidin, IL-6 and iron responses in ultra-marathon runners. In this randomized control trial, the subjects (20 male, amateur runners, mean age 40.75 ± 7.15 years) were divided into two groups: experimental (VD) and control (CON). The VD group received vitamin D3 (10,000 UI/day) and the CON group received a placebo for two weeks before the run. Venous blood samples were collected on three occasions-before the run, after the 100 km ultra-marathon and 12 h after the run-to measure iron metabolism indicators, hepcidin, and IL-6 concentration. After two weeks of supplementation, the intervention group demonstrated a higher level of serum 25(OH)D than the CON group (27.82 ± 5.8 ng/mL vs. 20.41 ± 4.67 ng/mL; p < 0.05). There were no differences between the groups before and after the run in the circulating hepcidin and IL-6 levels. The decrease in iron concentration immediately after the 100-km ultra-marathon was smaller in the VD group than CON (p < 0.05). These data show that various vitamin D3 status can affect the post-exercise metabolism of serum iron.
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Affiliation(s)
- Katarzyna Kasprowicz
- Department of Molecular Biology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
- Correspondence: (K.K.); (B.K.)
| | - Wojciech Ratkowski
- Department of Athletics, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 81-519 Gdynia, Poland; (W.W.); (M.R.)
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-11 Szczecin, Poland;
| | - Konrad Witek
- Department of Biochemistry, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland;
| | - Piotr Żmijewski
- Faculty of Physical Education, Jozef Piłsudski University of Physical Education in Warsaw, 01-813 Warsaw, Poland;
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 81-519 Gdynia, Poland; (W.W.); (M.R.)
| | - Zbigniew Jastrzębski
- Department of Physiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland;
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland;
- Medbase St. Gallen Am Vadianplatz, 9001 St. Gallen, Switzerland
- Correspondence: (K.K.); (B.K.)
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Zadrozny D, Lichodziejewska–Niemierko M, Draczkowski T, Renke M, Liberek T. Laparoscopic Approach for Dysfunctional Tenckhoff Catheters. Perit Dial Int 2020. [DOI: 10.1177/089686089901900217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | - Marcin Renke
- Department of Nephrology Medical University of Gdansk Gdansk, Poland
| | - Tomasz Liberek
- Department of Nephrology Medical University of Gdansk Gdansk, Poland
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Szafran-Dobrowolska J, Renke M, Wołyniec W. Telemedical Maritime Assistance Service at the University Center of Maritime and Tropical Medicine in Gdynia. The analysis of 6 years of activity. Med Pr 2020; 71:121-125. [PMID: 31929519 DOI: 10.13075/mp.5893.00897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In the 1960s, the International Labour Organization passed a convention under which all countries with national shipping were obliged to create a 24-h telemedicine center for ships. In accordance with the convention, Telemedical Assistance Service centers were to provide permanent access to medical advice given by qualified doctors and to create an international platform for the exchange of information and experience. In Poland, the Telemedical Maritime Assistance Service (TMAS) was established in 2012, and its duties in a 24-h system are carried out by doctors from the University Center of Maritime and Tropical Medicine (UCMTM) in Gdynia. The aim of this work was to determine the reasons for medical officers reporting for help from the TMAS doctor on duty and to create a database of the most common diagnoses and actions undertaken, and in particular evacuation. MATERIAL AND METHODS In the presented work, the authors analyzed TMAS telephony and e-mail advice provided by doctors of the UCMTM in Gdynia, in the period from October 2012 to the end of 2018. RESULTS In the 6-year period, UCMTM doctors provided TMAS advice 225 times, recommending evacuation in over 20% of these cases. Infectious diseases were the most common cause of contact in the entire period under analysis - 61 cases were recorded, accounting for as many as 27% of all applications. Injuries were the second most frequent reason for seeking help from TMAS, and 20% of TMAS applications (44 cases) were related to trauma. CONCLUSIONS The obtained data show that TMAS doctors face various medical problems; therefore, providing proper medical assistance to patients requires a close multidisciplinary cooperation between medical officers, TMAS doctors and emergency services. Med Pr. 2020;71(2):121-5.
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Affiliation(s)
- Joanna Szafran-Dobrowolska
- Medical University of Gdańsk, Gdańsk, Poland (Institute of Maritime and Tropical Medicine, Department of Occupational, Metabolic and Internal Diseases)
| | - Marcin Renke
- Medical University of Gdańsk, Gdańsk, Poland (Institute of Maritime and Tropical Medicine, Department of Occupational, Metabolic and Internal Diseases)
| | - Wojciech Wołyniec
- Medical University of Gdańsk, Gdańsk, Poland (Institute of Maritime and Tropical Medicine, Department of Occupational, Metabolic and Internal Diseases)
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Wołyniec W, Kasprowicz K, Giebułtowicz J, Korytowska N, Zorena K, Bartoszewicz M, Rita-Tkachenko P, Renke M, Ratkowski W. Changes in Water Soluble Uremic Toxins and Urinary Acute Kidney Injury Biomarkers After 10- and 100-km Runs. Int J Environ Res Public Health 2019; 16:ijerph16214153. [PMID: 31661892 PMCID: PMC6862582 DOI: 10.3390/ijerph16214153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 12/24/2022]
Abstract
Acute kidney injury (AKI) is described as a relatively common complication of exercise. In clinical practice the diagnosis of AKI is based on serum creatinine, the level of which is dependent not only on glomerular filtration rate but also on muscle mass and injury. Therefore, the diagnosis of AKI is overestimated after physical exercise. The aim of this study was to determine changes in uremic toxins: creatinine, urea, uric acid, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), trimethylamine N-oxide (TMAO) and urinary makers of AKI: albumin, neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule-1 and cystatin-C (uCyst-C) after long runs. Sixteen runners, mean age 36.7 ± 8.2 years, (2 women, 14 men) participating in 10- and 100-km races were studied. Blood and urine were taken before and after the races to assess markers of AKI. A statistically significant increase in creatinine, urea, uric acid, SDMA and all studied urinary AKI markers was observed. TMAO and ADMA levels did not change. The changes in studied markers seem to be a physiological reaction, because they were observed almost in every runner. The diagnosis of kidney failure after exercise is challenging. The most valuable novel markers which can help in post-exercise AKI diagnosis are uCyst-C and uNGAL.
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Affiliation(s)
- Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Katarzyna Kasprowicz
- Department of Biology, Ecology and Sports Medicine, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland.
| | - Joanna Giebułtowicz
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Natalia Korytowska
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Katarzyna Zorena
- Department of Biology Ecology and Sport Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Maria Bartoszewicz
- Department of Biology Ecology and Sport Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | | | - Marcin Renke
- Department of Occupational, Metabolic and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Wojciech Ratkowski
- Department of Athletics, Department of Athletics, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland.
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Szafran-Dobrowolska J, Renke M, Jeżewska M. Is it worth to continue to analyse the factors of cardiovascular risk among the sailors? Review of literature. Int Marit Health 2019; 70:17-21. [PMID: 30931513 DOI: 10.5603/imh.2019.0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/25/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cardiovascular diseases are still the most common cause of death from natural causes among seafarers. The aim of the study was to determine which of the cardiovascular risk factors listed in the current recommendations of the European Society of Cardiology occur among seafarers. MATERIALS AND METHODS The paper is a review of literature from PubMed Database. RESULTS Based on conducted analysis of over 31 papers high prevalence of classic and other cardiovascular risk factors among seafarers was proven. The most common risk factors among off-shore workers are overweight and obesity (over 64%); moreover, these factors occur more often among seafarers than in the general popula- tion. Also hypertension, smoking, type 2 diabetes and unfavourable lipid profile were present more often in this occupational group. In the analysed studies attention was also paid to factors often overlooked in risk assess- ment such as mental and inflammatory illnesses, unfavourable working conditions and psychological burden. CONCLUSIONS Seafarers have a higher cardiovascular risk because, among other things, the prevalence of "old and new" risk factors among them is higher than in general population.
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Affiliation(s)
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Poland
| | - Maria Jeżewska
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Poland
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Wołyniec W, Giebułtowicz J, Kasprowicz K, Rita-Tkachenko P, Renke M, Alicja K, Ratkowski W. FP302THE ASSOCIATION BETWEEN GUT-DERIVED AND WATER-SOLUBLE UREMIC TOXINS AFTER EXTREME PHYSICAL EXERCISE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ratkowski W, Wołyniec W, Kasprowicz K, Rita-Tkachenko P, Alicja K, Joanna SD, Renke M. FP303CHANGES IN BIOCHEMICAL MARKERS OF RENAL HYPOPERFUSION AFTER EXTREME PHYSICAL EXERCISE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bączkowska T, Bissler JJ, Błasińska‑Przerwa K, Borawski J, Chudek J, Ciechanowski K, Czarkowska‑Pączek B, Dębska-Ślizień A, Domański M, Durlik M, Gellert R, Gozdowska J, Goździk M, Imko‑Walczuk B, Janiszewski J, Januszko‑Giergielewicz B, Jeśkiewicz M, Jóźwiak S, Kadylak D, Klinger M, Kosieradzki M, Kotulska K, Kozak Ł, Król E, Krzanowska K, Kurnatowska I, Labij‑Reduta B, Lichodziejewska‑Niemierko M, Lizakowski S, Małyszko J, Matuszewski M, Mazurkiewicz J, Mełeń‑Mucha G, Myślak M, Naumnik B, Nowicki M, Oko A, Pączek L, Perkowska-Ptasińska A, Piątak M, Piecha G, Radzikowska E, Renke M, Rutkowska B, Sawosz M, Skutecki R, Słowińska M, Sosińska‑Mielcarek K, Szafran‑Dobrowolska J, Szołkowska M, Szczepulska‑Wójcik E, Szurowska E, Tarasewicz A, Wągrowska‑Danilewicz M, Wołowiec D, Woźniak J, Zawiasa‑Bryszewska A. Problems of nephrooncology. Proceedings from the 1st Scientific and Training Conference Nephrooncology 5-6 October 2018, Gdańsk, Poland. Pol Arch Intern Med 2019; 129:1-74. [PMID: 31046026 DOI: 10.20452/pamw.14821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wołyniec W, Ratkowski W, Kasprowicz K, Jastrzębski Z, Małgorzewicz S, Witek K, Grzywacz T, Żmijewski P, Renke M. Glomerular Filtration Rate Is Unchanged by Ultramarathon. J Strength Cond Res 2018; 32:3207-3215. [DOI: 10.1519/jsc.0000000000002348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Wołyniec W, Ratkowski W, Kasprowicz K, Małgorzewicz S, Aleksandrowicz E, Witek K, Grzywacz T, Żmijewski P, Renke M. Changes in electrolytes and uric acid excretion during and after a 100 km run. J BIOL REG HOMEOS AG 2018; 32:1205-1210. [PMID: 30334414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Physical activity leads to changes in water and electrolyte homeostasis and to enhanced purine metabolism. The typical abnormalities observed after exercise are hyperkaliemia, hyper- or hyponatremia and hyperuricemia. The possible explanations of hyperuricemia are: increased metabolism and decreased elimination of uric acid. Changes in uric acid excretion are commonly observed in disturbances of sodium and water homeostasis. The aim of this study was to evaluate changes in electrolytes and uric acid excretion during a very long period of exercise. Twenty subjects with a mean age of 40.75±7.15 years took part in a 100 km run. The route of the run was based on the university stadium track. All subjects were experienced amateur runners, with a mean time of regular running of 6.11±7.19 years. Blood was collected before the start, after every 25 km and 12 hours after the run. The levels of electrolytes, creatinine, uric acid, cortisol, aldosterone, creatine kinase, C-reactive protein and interleukin-6 were measured. Creatinine clearance, urinary potassium-to-sodium ratio, fractional excretion of electrolytes and uric acid were calculated. Seventeen runners completed the study. Significant increases in sodium (from 141.65±1.90 to 144.29±3.65mmol/l), potassium (from 4.53±0.34 to 5.03±0.42mmol/l), creatinine (from 0.88±0.11 to 1.10±0.20mg/dl) and uric acid (from 5.15±0.87 to 5.94±1.50 mg/dl) were observed after 100 km (p less than 0.05). Other significant changes during the study were noted in fractional excretions of sodium (from 0.86±0.29 to 0.33±0.13%) and potassium (from 6.66±2.79 to 18.90±10.01%), probably reflecting the decrease in renal blood flow (RBF) and increase in renal tubule reabsorption. The fractional excretion of uric acid slightly increased but without statistical significance from 5.34±1.51 to 6.09±2.34%. The results of our study showed that during very long but not very intensive exercise there is no change in uric acid excretion, although at the same time profound changes in electrolyte excretion are found. Both hyperuricemia and hyperuricosuria may be harmful, therefore it seems logical that the best way to avoid those abnormalities is to maintain fractional uric acid excretion.
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Affiliation(s)
- W Wołyniec
- Department of Occupational and Internal Medicine, Institute of Maritime and Tropical Medicine in Gdynia, Gdansk Medical University, Gdynia, Poland
| | - W Ratkowski
- Department of Athletics, Academy of Physical Education and Sport, Gdańsk, Poland
| | - K Kasprowicz
- Department of Physiology, Academy of Physical Education and Sport, Gdańsk, Poland
| | - S Małgorzewicz
- Department of Clinical Nutrition and Dietetics. Gdansk Medical University, Gdańsk, Poland
| | - E Aleksandrowicz
- Department of Clinical Nutrition and Dietetics. Gdansk Medical University, Gdańsk, Poland
| | - K Witek
- Department of Biochemistry Institute of Sport - National Research Institute, Warsaw, Poland
| | - T Grzywacz
- Department of Physiology, Institute of Sport - National Research Institute, Warsaw, Poland
| | - P Żmijewski
- Department of Physiology, Institute of Sport - National Research Institute, Warsaw, Poland
| | - M Renke
- Department of Occupational and Internal Medicine, Institute of Maritime and Tropical Medicine in Gdynia, Gdansk Medical University, Gdynia, Poland
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Renke J, Kędzierska-Mieszkowska S, Lange M, Nedoszytko B, Liberek A, Plata-Nazar K, Renke M, Wenta T, Żurawa-Janicka D, Skórko-Glonek J, Lipińska B. Immune response against HtrA proteases in children with cutaneous mastocytosis. Acta Biochim Pol 2018; 65:471-478. [PMID: 30148508 DOI: 10.18388/abp.2018_2623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 11/10/2022]
Abstract
Mast cells play an important role in both, the innate and adaptive immunity, however, clonal proliferation of abnormal mast cells in various organs leads to mastocytosis. A skin variant of the disease, cutaneous mastocytosis (CM) is the most frequent form of mastocytosis in children. HtrA proteases are modulators of important cellular processes, including cell signaling and apoptosis, and are related to development of several pathologies. The above and the observation that mast cells constitutively release the HtrA1 protein, prompted us to investigate a possible involvement of the HtrA proteins in pediatric CM. Levels of the serum autoantibodies (IgG) against the recombinant HtrA proteins (HtrA1-4) in children with CM (n=36) and in healthy controls (n=62) were assayed. Anti-HtrA IgGs were detected using enzyme linked immunosorbent assay (ELISA) and Western-blotting. In the CM sera, levels of the anti-HtrA1 and anti-HtrA3 autoantibodies were significantly increased when compared to the control group, while the HtrA protein levels were comparable. No significant differences in the anti-HtrA2 IgG level were found; for the anti-HtrA4 IgGs lower levels in CM group were revealed. In healthy children, the IgG levels against the HtrA1, -3 and -4 increased significantly with the age of children; no significant changes were observed for the anti-HtrA2 IgG. Our results suggest involvement of the HtrA1 and HtrA3 proteins in pediatric CM; involvement of the HtrA4 protein is possible but needs to be investigated further. In healthy children, the autoantibody levels against HtrA1, -3 and -4, but not against HtrA2, increase with age.
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Affiliation(s)
- Joanna Renke
- Department of General and Medical Biochemistry, University of Gdańsk, Gdańsk, Poland
| | | | - Magdalena Lange
- Department of Dermatology, Venerology and Allergology Medical University of Gdańsk, Gdańsk, Poland
| | - Bogusław Nedoszytko
- Department of Dermatology, Venerology and Allergology Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Liberek
- Faculty of Health Sciences with Subfaculty of Nursing, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna Plata-Nazar
- Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdynia, Poland
| | - Tomasz Wenta
- Department of Geriatrics, Qilu Hospital, Shandong University Jinan, Shandong, China
| | | | - Joanna Skórko-Glonek
- Department of Geriatrics, Qilu Hospital, Shandong University Jinan, Shandong, China
| | - Barbara Lipińska
- Department of Geriatrics, Qilu Hospital, Shandong University Jinan, Shandong, China
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Wołyniec W, Sulima M, Renke M, Dębska-Ślizień A. Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients. Medicina (Kaunas) 2018; 54:E27. [PMID: 30344258 PMCID: PMC6037257 DOI: 10.3390/medicina54020027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/21/2018] [Accepted: 04/27/2018] [Indexed: 01/10/2023]
Abstract
Introduction. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. Methods. We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. Results. There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are Giardia duodenalis and Cryptosporidium. Conclusions. Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient's death is challenging.
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Affiliation(s)
- Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80⁻210 Gdansk, Poland.
| | - Małgorzata Sulima
- Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, 81⁻519 Gdynia, Poland.
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80⁻210 Gdansk, Poland.
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, 80⁻210 Gdansk, Poland.
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Renke M, Zegrzda D, Liberek T, Dudziak M, Lichodziejewska-Niemierko M, Kubasik A, Rutkowski B. Interrelationship between Cardiac Structure and Function and Incidence of Arrhythmia in Peritoneal Dialysis Patients. Int J Artif Organs 2018. [DOI: 10.1177/039139880102400607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiovascular complications in patients with end-stage renal disease requiring dialytic therapy are frequent and account for approximately 40% of all deaths in these patients. The aim of this study was to analyze the occurrence of cardiac arrhythmia in peritoneal dialysis (PD) patients with respect to the changes in left ventricular structure and function. To determine characteristics of arrhythmia in patients on PD for chronic renal failure, 30 patients (18 male and 12 female; aged 54.1±13.8 years) underwent twice (interval of 20±4.1 months) ambulatory 24 hour Holter ECG monitoring. At the same time all the patients were analyzed by echocardiography and pulsed Doppler echocardiography to estimate cardiac structure and function. Ventricular arrhythmias were seen in 9 patients (30%) during the first examination and in 13 patients (43.3%) on the second. Ventricular arrhythmias were observed only in patients with left ventricular hypertrophy (LVH). Supraventricular arrhythmias were seen in 12 (40%) and 17 (56.7%) patients. The majority of these patients also had LVH, with 11/12 (91.7%) patients at the first examination and 15/17 (88.2%) at the second respectively. We conclude that the incidence of arrhythmia is primarily dependent on the presence of LVH in PD patients. It appears that peritoneal dialysis does not provoke or aggravate arrhythmia.
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Affiliation(s)
- M. Renke
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdansk, Gdansk - Poland
| | - D. Zegrzda
- Noninvasive Cardiovascular Diagnostic Unit, Medical University of Gdansk, Gdansk - Poland
| | - T. Liberek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdansk, Gdansk - Poland
| | - M. Dudziak
- Noninvasive Cardiovascular Diagnostic Unit, Medical University of Gdansk, Gdansk - Poland
| | | | - A. Kubasik
- Noninvasive Cardiovascular Diagnostic Unit, Medical University of Gdansk, Gdansk - Poland
| | - B. Rutkowski
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdansk, Gdansk - Poland
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Liberek T, Renke M, Lichodziejewska-Niemierko M, Rutkowski B. The Role of Automated Peritoneal Dialysis in Peritoneal Dialysis Programme: One Centre Experience. Int J Artif Organs 2018. [DOI: 10.1177/039139889902201105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The results of the Automated Peritoneal Dialysis (APD) therapy in adult patients in the Department of Nephrology in Gdansk during the years 1995–98 are presented. Seventeen patients (8-M, 9-F) aged 25–86 years (mean age 55.3 years), including 7 diabetics, were treated with different forms of APD. The most common indication for APD therapy was patients' loss of ability to perform Continuous Ambulatory Peritoneal Dialysis due to progressive blindness, leg amputation related to diabetic foot complications or cerebrovascular episodes (8 pts). The cumulative therapy period was 231.5 patient-months. During the observation 4 patients died, 1 received kidney transplant and 12 were still treated with APD at the end of the study. No patient was transferred to long-term hemodialysis. The peritonitis rate in the APD group was 1/57.5 patient-months. Most patients reached adequacy targets, the mean Kt/V value was 1.97 (range 1.17 - 2.36). To achieve this, 12–19 litres of dialysate were used per day (mean 14.6 L/d). There were significant differences between CCPD and NPD groups with respect to dialysis adequacy, body weight and dialysis fluid volume. We conclude that APD may be used with success in patients in whom continuation of CAPD or HD therapy is very difficult due to its complications or comorbid conditions.
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Affiliation(s)
- T. Liberek
- Department of Nephrology, Medical University, Gdansk - Poland
| | - M. Renke
- Department of Nephrology, Medical University, Gdansk - Poland
| | | | - B. Rutkowski
- Department of Nephrology, Medical University, Gdansk - Poland
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Renke M, Parszuto J, Rybacki M, Wołyniec W, Rutkowski P, Rutkowski B, Walusiak-Skorupa J, Dębska-Ślizień A. [Chronic kidney disease - The relevant information for an occupational physician]. Med Pr 2018; 69:67-75. [PMID: 29148546 DOI: 10.13075/mp.5893.00624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
For a number of years chronic kidney disease (CKD) has been listed in the group of lifestyle diseases, such as obesity, diabetes, cardiovascular disease and hypertension. It is estimated that in Poland more than 4 million people may suffer from various stages of CKD. Chronic kidney disease may also be a consequence of all the other civilization diseases. At the same time it is worth noting that nephrological problems are increasingly being taken into account in modern medical certification. The aim of this work is, among other things, to improve safe access to the labor for patients with kidney diseases. In the legislation existing in our country since 2014 it is stated that chronic renal failure is a potential health contraindication to driving. Also in the annex to the Regulation of the Minister of Health dated 9 December 2015 on health conditions required for seafarers to work on a seagoing ship, it is said that ICD-10 codes (International Classification of Diseases) corresponding to acute and chronic renal failure (N17-N19) should be taken into account when qualifying employees to work at sea. Med Pr 2018;69(1):67-75.
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Affiliation(s)
- Marcin Renke
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases).
| | - Jacek Parszuto
- Wojewódzki Ośrodek Medycyny Pracy / Regional Occupational Medicine Center, Gdańsk, Poland.
| | - Marcin Rybacki
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego / Occupational Diseases and Toxicology Clinic).
| | - Wojciech Wołyniec
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases).
| | - Przemysław Rutkowski
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych / Department of Nephrology, Transplantology and Internal Medicine).
| | - Bolesław Rutkowski
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych / Department of Nephrology, Transplantology and Internal Medicine).
| | - Jolanta Walusiak-Skorupa
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego / Occupational Diseases and Toxicology Clinic).
| | - Alicja Dębska-Ślizień
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych / Department of Nephrology, Transplantology and Internal Medicine).
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Wołyniec W, Ratkowski W, Urbański R, Bartoszewicz M, Siluk D, Wołyniec Z, Kasprowicz K, Zorena K, Renke M. Urinary Kidney Injury Molecule-1 but Not Urinary Neutrophil Gelatinase Associated Lipocalin Is Increased after Short Maximal Exercise. Nephron Clin Pract 2017; 138:29-34. [DOI: 10.1159/000481179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/15/2017] [Indexed: 11/19/2022] Open
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Tylicki L, Debska-Slizien AM, Lizakowski S, Przybylska M, Heleniak Z, Renke M, Chamienia AL, Biedunkiewicz B, Rutkowski P, Małgorzewicz S, Rutkowski B. Aliskiren reduces albuminuria after kidney transplantation. Acta Biochim Pol 2017; 64:221-226. [PMID: 28455996 DOI: 10.18388/abp.2016_1297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 11/21/2016] [Accepted: 01/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The renoprotective effects of the direct renin inhibitor, aliskiren, in renal transplant recipients have been supposed, but not finally proven. We performed an exploratory double-blind, losartan controlled, cross-over study to evaluate the influence of aliskiren, direct renin inhibitor, on albuminuria and other surrogate markers of kidney injury in patients after renal transplantation. The safety of this therapy was also evaluated. METHOD 16 of 18 patients (12 M, 4 F), 48.3 ± 9.0 years, 57.7 ± 9.1 months after kidney transplantation, with hypertension and stable serum creatinine 1.4 ± 0.08 mg/dl without proteinuria, completed the protocol. Each patient underwent two 8-week treatment periods (one with 150 mg of aliskiren, and one with 50 mg of losartan) in random order, allowing an 8-week placebo washout between them. RESULTS There were no differences in albuminuria, transforming growth factor β-1 and 15-F2t-isoprostanes urine excretion between aliskiren and losartan. Creatinine serum level, eGFR, 24 h systolic and 24 h diastolic blood pressure were stable through the study. There were no differences in haemoglobin and potassium serum concentration between studied drugs. CONCLUSION Aliskiren decreases albuminuria in renal transplant recipients with clinically minimal side effects. The effect does not differ from that of losartan.
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Affiliation(s)
- Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Alicja M Debska-Slizien
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Slawomir Lizakowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Milena Przybylska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | | | - Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | | | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Boleslaw Rutkowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
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Wołyniec W, Ratkowski W, Kasprowicz K, Urbanski R, Renke M. MP002THE URINARY SODIUM AND POTASSIUM EXCRETION AFTER PHYSICAL EXERCISE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx160.mp002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wołyniec W, Ratkowski W, Kasprowicz K, Jastrzębski Z, Renke M, Małgorzewicz S. SP196KIDNEY FUNCTION DURING AND AFTER A 100 KM RUN. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx143.sp196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wołyniec W, Ratkowski W, Urbański R, Bartoszewicz M, Wolyniec Z, Siluk D, Zorena K, Renke M. SP188URINARY KIM-1 BUT NOT URINARY NGAL IS INCREASED AFTER SHORT MAXIMAL EXERCISE. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw162.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Wolyniec W, Jakubowska SK, Nagel M, Wolyniec Z, Obolonczyk L, Swiatkowska-Stodulska R, Sworczak K, Renke M. A case report of Gitelman syndrome resulting from two novel mutations in SLC12A3 gene. Nefrologia 2016; 36:304-9. [DOI: 10.1016/j.nefro.2015.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/07/2015] [Indexed: 12/18/2022] Open
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Wołyniec W, Renke M, Wójcik-Stasiak M, Renke J. [Selected work-related nephropathies]. Med Pr 2015; 66:583-93. [PMID: 26536975 DOI: 10.13075/mp.5893.00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Infections, high temperature and many of the toxic substances can cause kidney damage. Acute kidney injury is a well known complication of some work-related diseases, e.g., lead intoxication. Chronic kidney disease can also be caused by some occupational factors. Three work-related nephropathies, in which causal connection with work has been proved, are discussed in this article. There are different risk factors of nephrolithiasis, lead nephropathy and silica nephropathy, but each of them can cause chronic kidney disease. Prevention of these nephropaties seems to be relatively simple. The principles of protection from the toxic effects of heavy metals and silica dust are very specific. The most important prevention of kidney stones is correct fluid intake. In addition to providing adequate quantities of drinking water, it is also important to educate exposed workers and assure enough rest breaks at work.
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Affiliation(s)
- Wojciech Wołyniec
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases).
| | - Marcin Renke
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases).
| | - Małgorzata Wójcik-Stasiak
- Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Klinika Chorób Zawodowych, Metabolicznych i Wewnętrznych / Department of Occupational, Metabolic and Internal Diseases).
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Tylicki L, Dębska-Ślizień A, Lizakowski S, Przybylska M, Heleniak Z, Renke M, Chamienia A, Biedunkiewicz B, Rutkowski P, Małgorzewicz S, Rutkowski B. FP866ALISKIREN REDUCES ALBUMINURIA AFTER KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv185.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Kurlapski M, Wójcik-Stasiak M, Klincewicz P, Januszczyk J, Wołyniec W, Renke M, Trzeciakowska-Aziz K. TMAS - Maritime Telemedical Assistance Service at the University Centre of Maritime and Tropical Medicine in Gdynia. The first year activity report. Int Marit Health 2014; 65:174. [PMID: 25471168 DOI: 10.5603/imh.2014.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- Michał Kurlapski
- Department of Occupational and Internal Medicine, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Poland.
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Dębska-Ślizień A, Gałgowska J, Chamienia A, Bułło-Piontecka B, Król E, Lichodziejewska-Niemierko M, Lizakowski S, Renke M, Rutkowski P, Zdrojewski Z, Preis K, Śledziński Z, Rutkowski B. Pregnancy After Kidney Transplantation: A Single-Center Experience and Review of the Literature. Transplant Proc 2014; 46:2668-72. [DOI: 10.1016/j.transproceed.2014.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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