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Vascular Calcification and Bone Demineralization in Patiens with Chronic Renal Failure
Mareš, Jan ; Opatrná, Sylvie (advisor) ; Topolčan, Ondřej (referee) ; Spustová, Viera (referee) ; Štěpán, Jan (referee)
Background: Patients treated with chronic dialysis show extreme mortality, particularly due to cardiovascular disease. Renal failure is associated with different risk factors of cardiovascular complications than those defined for non-renal population. One of these factors, currently considered most important, are vascular calcifications. At the same time, patients on dialysis regularly suffer from derrangements of calcium-phosphate metabolism, including skeletal demineralization. As a consequence, both incidence and prevalence of bone fractures are high. Aims: This study therefore investigates vascular calcifications and skeletal demineralization, their clinical implications and associations in patients treated with long-term dialysis. Methods: Two groups of patients were examined in a prospective manner (follow-up > 1 year); 32 patients treated with peritoneal dialysis and 72 treated with regular hemdodialysis. Treatment parameters and biochemical markers of calcium-phosphate metabolism were monitored throughout the study. Bone mineral density of lumbar spine (together with vertebral fractures) as well as coronary artery, valvular and aortic calcifcations were determined repeatedly. All radiological parameters were measured during one computed-tomography scanning session. Results: A significant...
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Biocompatibility of Peritoneal Dialysis Solutions
Procházková Pöpperlová, Anna ; Opatrná, Sylvie (advisor) ; Krejčí, Karel (referee) ; Šebeková, Katarína (referee)
Peritoneal dialysis (PD) is a form of renal replacement therapy using the peritoneum as a dialysis membrane. PD solutions employed to remove nitrogen metabolites and excess plasma fluid, and to restore electrolyte and acid-base balance are being developed to minimize local and systemic inflammatory responses while maintaining peritoneal homeostasis and host defense. The effect of chronic action of PD solutions on the peritoneum results in its remodeling and, possibly, eventual loss of peritoneal ultrafiltration capacity. Factors most responsible for late complications and peritoneal remodeling include high glucose levels in PD solutions, and the presence and formation of glucose degradation products (GDP) and advanced glycation end - products (AGEs) in the peritoneal cavity. The aim of our study described in this dissertation was to test various PD solutions with different glucose content and GDP and, using AGEs receptor ligands, to define their systemic effects and identify PD solutions with highest biocompatibility. This part of the dissertation characterizes conventional glucose - based solutions, low - glucose and GDP load solutions as well as glucose polymer (icodextrin) - based PD solutions while determining the plasma and dialysate levels of soluble receptor for AGEs (s - RAGE) and its...
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Problems of biocompatibility in renal replacement therapy
Polanská, Kamila ; Opatrná, Sylvie (advisor) ; Tesař, Vladimír (referee) ; Mydlík, Miroslav (referee)
.Summary 7.1. The effect of heparin rinse on selected biocompatibility parameters in continuous extracorporeal renal replacement therapy methods In her study assessing the effect of heparin on biocompatibility parameters in continuous renal replacement therapy methods, the author has made the following conclusions: 1) Patients scheduled for CVVHDF show comprehensive hemostasis impairment involving thrombocyte activation, coagulation, and fibrinolysis. 2) These patients show, already prior to CVVHDF initiation, signs of activation of complement with high C5a levels and, also, high leukocyte count compared with a control group of healthy individuals. 3) Preparation of the extracorporeal circuit before CVVHDF using various techniques of rinse (heparin-free saline, saline with 2,000 IU heparin/L and one-hour saline rinse using 10,000 IU heparin/L with recirculation) has no effect on the behavior of thrombogenicity parameters, complement activation and leukocyte count during CVVHDF and will not reduce the consumption of anticoagulants administered. Hence, it can be concluded that heparin rinse of the extracorporeal circuit prior to CVVHDF initiation will confer no benefit in terms of reduced thrombogenicity, need for anticoagulants, and elimination of the adverse effect of the artificial surface on the other...
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Biocompatibility of Peritoneal Dialysis Solutions
Procházková Pöpperlová, Anna ; Opatrná, Sylvie (advisor) ; Krejčí, Karel (referee) ; Šebeková, Katarína (referee)
Peritoneal dialysis (PD) is a form of renal replacement therapy using the peritoneum as a dialysis membrane. PD solutions employed to remove nitrogen metabolites and excess plasma fluid, and to restore electrolyte and acid-base balance are being developed to minimize local and systemic inflammatory responses while maintaining peritoneal homeostasis and host defense. The effect of chronic action of PD solutions on the peritoneum results in its remodeling and, possibly, eventual loss of peritoneal ultrafiltration capacity. Factors most responsible for late complications and peritoneal remodeling include high glucose levels in PD solutions, and the presence and formation of glucose degradation products (GDP) and advanced glycation end - products (AGEs) in the peritoneal cavity. The aim of our study described in this dissertation was to test various PD solutions with different glucose content and GDP and, using AGEs receptor ligands, to define their systemic effects and identify PD solutions with highest biocompatibility. This part of the dissertation characterizes conventional glucose - based solutions, low - glucose and GDP load solutions as well as glucose polymer (icodextrin) - based PD solutions while determining the plasma and dialysate levels of soluble receptor for AGEs (s - RAGE) and its...
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Occupational Diseases in a Selected Country and the CR. Comparative studies.
Opatrná, Sylvie ; Kavka, Aleš (advisor)
This paper deals with comparison of the field of occupational diseases in the Czech Republic and Germany. It is focused on conception of occupational diseases and related terms, legislative measures in this field, proceedings of acknowledgements of occupational diseases as well as compensation in case of acknowledgement; both in the Czech Republic and Germany. Then the paper addresses differences between these two countries. It covers different concepts of occupational diseases, detects differences in the liability insurance of employer during work, process of acknowledgement of occupational diseases and finally compares single points in the list of occupational diseases.
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Vascular Calcification and Bone Demineralization in Patiens with Chronic Renal Failure
Mareš, Jan ; Opatrná, Sylvie (advisor) ; Topolčan, Ondřej (referee) ; Spustová, Viera (referee) ; Štěpán, Jan (referee)
Background: Patients treated with chronic dialysis show extreme mortality, particularly due to cardiovascular disease. Renal failure is associated with different risk factors of cardiovascular complications than those defined for non-renal population. One of these factors, currently considered most important, are vascular calcifications. At the same time, patients on dialysis regularly suffer from derrangements of calcium-phosphate metabolism, including skeletal demineralization. As a consequence, both incidence and prevalence of bone fractures are high. Aims: This study therefore investigates vascular calcifications and skeletal demineralization, their clinical implications and associations in patients treated with long-term dialysis. Methods: Two groups of patients were examined in a prospective manner (follow-up > 1 year); 32 patients treated with peritoneal dialysis and 72 treated with regular hemdodialysis. Treatment parameters and biochemical markers of calcium-phosphate metabolism were monitored throughout the study. Bone mineral density of lumbar spine (together with vertebral fractures) as well as coronary artery, valvular and aortic calcifcations were determined repeatedly. All radiological parameters were measured during one computed-tomography scanning session. Results: A significant...
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Problems of biocompatibility in renal replacement therapy
Polanská, Kamila ; Opatrná, Sylvie (advisor) ; Tesař, Vladimír (referee) ; Mydlík, Miroslav (referee)
.Summary 7.1. The effect of heparin rinse on selected biocompatibility parameters in continuous extracorporeal renal replacement therapy methods In her study assessing the effect of heparin on biocompatibility parameters in continuous renal replacement therapy methods, the author has made the following conclusions: 1) Patients scheduled for CVVHDF show comprehensive hemostasis impairment involving thrombocyte activation, coagulation, and fibrinolysis. 2) These patients show, already prior to CVVHDF initiation, signs of activation of complement with high C5a levels and, also, high leukocyte count compared with a control group of healthy individuals. 3) Preparation of the extracorporeal circuit before CVVHDF using various techniques of rinse (heparin-free saline, saline with 2,000 IU heparin/L and one-hour saline rinse using 10,000 IU heparin/L with recirculation) has no effect on the behavior of thrombogenicity parameters, complement activation and leukocyte count during CVVHDF and will not reduce the consumption of anticoagulants administered. Hence, it can be concluded that heparin rinse of the extracorporeal circuit prior to CVVHDF initiation will confer no benefit in terms of reduced thrombogenicity, need for anticoagulants, and elimination of the adverse effect of the artificial surface on the other...
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