bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Knowledge Retention following Predialysis Psychoeducational Intervention
Authors: Devins Gerald M. , Hollomby David J. , Barré Paul E. , Mandin Henry , Taub Kenneth , Paul Leendert C. , Guttmann Ronald , Binik Yitzchak M. 
Published: April 2003

<i>Background/Aims:</i> Early identification and predialysis psychoeducation are gaining acceptance. Although research supports the immediate value of predialysis interventions, long-term benefits remain unknown. We examined long-term knowledge retention following a psychoeducational intervention. <i>Methods:</i> 47 progressive renal failure patients completed the Kidney Disease Questionnaire at baseline and 18, 30, 42, and 54 months after initiating renal replacement therapy (RRT; the ‘longitudinal’ sample). A larger cohort provided data at one or more of these points (n = 132, 117, 101, and 70 at 18, 30, 42, and 54 months, respectively; the ‘cross-sectional’ sample). <i>Results:</i> Initial knowledge gains among psychoeducation recipients were followed by a significant knowledge advantage for three groups throughout follow-up. Patients who received predialysis psychoeducation either before or after starting dialysis demonstrated superior Kidney Disease Questionnaire scores as compared with those identified before the initiation of RRT who received the usual standard of practice. Patients identified after the initiation of RRT and who received standard education, however, demonstrated the same level of knowledge retention as produced by psychoeducation. The results were identical across the longitudinal and cross-sectional samples. <i>Conclusions:</i> Patient education produces important benefits in end-stage renal disease, but the incremental value of early intervention remains to be demonstrated.
Benidipine, a Long-Acting Calcium-Channel Blocker, Prevents the Progression to End-Stage Renal Failure in a Rat Mesangioproliferative Glomerulonephritis
Authors: Nakamura Takamichi , Obata Jun-ei , Onitsuka Makoto , Shimada Yuji , Yoshida Yoji , Kawachi Hiroshi , Shimizu Fujio 
Published: April 2003

<i>Background:</i> Although the renoprotective effect of calcium-channel blockers (CCBs) has been examined in several models of hypertensive nephropathy, it remains unclear. It also remains to be clarified whether CCBs prevent the progression to end-stage renal failure in chronic progressive glomerulonephritis (GN). A new rat model of progressive mesangioproliferative GN was used to study the effect of benidipine hydrochloride, a long-acting dihydropyridine CCB, on the clinical features and morphological lesions. <i>Methods:</i> This animal model of progressive GN was induced by a single intravenous injection of anti-Thy-1 monoclonal antibody (MoAb 1-22-3) two weeks after unilateral nephrectomy. After 10 weeks of treatment with benidipine (1, 3, and 5 mg/kg body weight, p.o.) or hydralazine (5 mg/kg body weight, p.o.), systolic blood pressure (SBP), urinary protein excretion, creatinine clearance, glomerulosclerosis index, tubulointerstitial lesion index, glomerular cross-sectional area, and glomerular expression of transforming growth factor-β (TGF-β) and α-smooth muscle actin (α-SMA) were measured. <i>Results:</i> Untreated rats developed hypertension, massive proteinuria, renal dysfunction, severe glomerular and tubulointerstitial injury, higher glomerular size, and marked glomerular staining for TGF-β and α-SMA, while uninephrectomized control rats did not. Each dose of benidipine and hydralazine equally reduced SBP to uninephrectomized control levels. Three and five mg/kg/day of benidipine increased creatinine clearance, ameliorated glomerular and tubulointerstitial injury, and reduced glomerular staining for TGF-β and α-SMA, but 1 mg/kg/day of benidipine and hydralazine failed. Only a dose of 5 mg/kg/day of benidipine reduced glomerular size, although it did not reduce the size to control levels. <i>Conclusion:</i> These results indicate that in a rat model of progressive mesangioproliferative GN, benidipine prevents the progression to end-stage renal failure in a dose-dependent manner. This renoprotective action is associated with the suppression of glomerular expression of TGF-β and α-SMA.
Cytokine Gene Expression in Adriamycin Nephropathy: Effects of Antioxidant Nuclear Factor κB Inhibitors in Established Disease
Authors: Rangan Gopala K. , Wang Yiping , Tay Yuet-Ching , Harris David C.H. 
Published: April 2003

<i>Background/Aim:</i> Inhibition of nuclear factor ĸB with the antioxidant pyrrolidine dithiocarbamate (PDTC) reduced tubulointerstitial injury in Adriamycin nephropathy (AN), whereas N-acetylcysteine (NAC) was ineffective. Here we hypothesize that PDTC reduces the renal cortical expression of nuclear factor ĸB dependent cytokines in AN. <i>Methods:</i> Male Wistar rats received a single intravenous injection of doxorubicin hydrochloride (7.5 mg/kg). NAC (150 mg/kg twice daily i.p.), PDTC (50 mg/kg twice daily i.p.), or vehicle were commenced on day 14 and continued until day 30. <i>Results:</i> On day 30, mRNAs of selected cytokines were increased in AN (TNF-α 3.4-fold, MCP-1 5.1-fold, IL-10 2.7-fold, TGF-β1 3.5-fold, all p < 0.05) as determined by RT-PCR. PDTC reduced IL-10 and TGF-β1 mRNAs (p < 0.05), whereas the upregulation of MCP-1 and TNF-α mRNAs was not affected. In contrast, NAC increased TNF-α and IL-10 mRNAs (p < 0.05). Nuclear protein levels of activator protein-1 were increased in AN (4.4-fold, p < 0.01) and not significantly altered by PDTC (3.0-fold, p = 0.13) or NAC (5.2-fold, p = 0.18). <i>Conclusions:</i> The protective effects of PDTC in AN are not associated with a local reduction in TNF-α and MCP-1 gene expression. The latter may be due to continued transactivation by activator protein-1. These data also suggest that IL-10 and TGF-β1 mRNA expressions are PDTC dependent and have a role in mediating tubulointerstitial injury.
An Intron 4 Gene Polymorphism in Endothelial Cell Nitric Oxide Synthase Might Modulate Lipid Metabolism in Nondiabetic Patients on Hemodialysis
Authors: Asanuma Katsuhiko , Yokoyama Keitaro , Tsukada Toshihiko , Takemoto Fumi , Hara Shigeko , Yamada Akira , Tomino Yasuhiko 
Published: April 2003

We investigated the relationship between endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphism and lipid metabolism in patients with nondiabetic chronic renal failure on hemodialysis. Serum from 181 nondiabetic patients on hemodialysis were examined. A genomic DNA fragment was amplified by polymerase chain reaction (PCR) for determining the ecNOS genotype. The PCR products were designated as a and b alleles by electrophoresis. In hemodialysis patients, the frequency of the ecNOS4 for b/b, b/a and a/a genotype was 76.6, 22.8 and 0.6%, respectively. There was not significant difference in the levels of total cholesterol (TC), triglyceride (TG) and calculated low-density lipoprotein cholesterol (LDL-c) in sera between patients (aa and ba) with the a allele and patients (bb) without the a allele. On the other hand, the levels of serum high-density lipoprotein cholesterol (HDL-c) in patients with the a allele (51.9 ± 3.33 mg/dl) were significantly higher than those in patients without the a allele (43.05 ± 1.40 mg/dl) (p = 0.005). The frequency of patients with the a allele and low levels of serum HDL-c among patients with a long duration of dialysis (≧10 years) was significantly lower than that in patients with short duration of dialysis (<10 years) (p = 0.05). It appears that an intron 4 gene polymorphism in ecNOS may modulate lipid metabolism in nondiabetic patients on hemodialysis and the a allele of ecNOS gene polymorphism may affect the prognosis of hemodialysis patients with low levels of serum HDL-c.
Onset, Time Course, and Persistence of Increased Haemodialysis-Induced Breath Isoprene Emission
Authors: Trovarelli Gianfranco , Brunori Federica , De Medio Gianna Evelina , Timio Mario , Lippi Giorgio , Pelli Maria Antonietta , Capodicasa Enrico 
Published: April 2003

Recent findings of increased isoprene emission in the exhaled breath of patients undergoing haemodialysis and experimental evidence of the potential toxic and cancerogenic effects of isoprene hydrocarbon led us to assess how long haemodialysis patients are exposed to how much isoprene after a single haemodialysis session. Patients with end-stage renal failure on regular 4-hour (from 08.00 to 12.00 h) maintenance haemodialysis three times weekly were monitored. The breath isoprene content was analyzed by gas chromatography. Intrapatient evaluations were performed by collecting samples before, during, and immediately after the haemodialysis session, during the following hours, and on the following nondialysis day. The breath isoprene content increased in all patients. Isoprene overproduction showing a biphasic pattern was first detected soon after the dialysis session ended. These data show that haemodialyzed patients seem to be consistently exposed to high endogenous isoprene concentrations. The mechanisms and implications of this endogenous isoprene overproduction need to be elucidated with regard to the mevalonic pathway and in the physiopathological setting of the uraemia-dialysis syndrome.
Suppression of Experimental Membranous Glomerulonephritis in Rats by an Anti-MHC Class II Antibody
Authors: Hasegawa Yoshiyuki , Kaneoka Hidetoshi , Tanaka Tomoichiro , Ogahara Satoru , Matsumae Tomoji , Noda Ritsuya , Yoshitake Keisuke , Murata Toshiaki , Naito Setsuya 
Published: April 2003

<i>Background:</i> We previously reported that idiopathic membranous nephropathy (IMN) strongly correlated with HLA-DRB1*1501-DRB5*0101-DQAI*0102-DQB1* 0602, a specific haplotype of human major histocompatibility complex (MHC), in Japanese patients. To investigate the role of MHC in the development of rat Heymann nephritis (HN), an animal model of membranous nephropathy, a monoclonal antibody (mAb) specific to rat MHC class II antigen (RT1B) was administered, and its effectiveness in inhibiting HN was assessed. <i>Methods:</i> Active HN was induced in HN-sensitive Lewis rats by administering brush border proteins of rat proximal uriniferous tubules (FX1A). Rats were divided into four groups: rats treated with 1,000 µg anti-rat MHC class II mAb, rats treated with 100 µg anti-rat MHC class II mAb, rats treated with murine myeloma IgG, and rats that did not receive either FX1A or any other mAb. We examined the differences in 24-hour urinary protein excretion and serum alloantibody titers against FX1A between groups at different time intervals, and the histologic features of kidneys at the end of the study. <i>Results:</i> HN was induced in Lewis rats by inoculation with FX1A antigen. Administration of anti-MHC class II mAb successfully lowered urinary proteins, production of anti-FX1A alloantibodies, and the development of glomerular lesions in a dose-dependent manner. <i>Conclusion:</i> The present results demonstrated that the MHC class II molecule itself is directly involved in the pathogenesis of HN, and suggest that this therapy would be any better (or less toxic) than nonselective immunosuppressants in the treatment of IMN.
mRNA Expression of the IGF System in the Kidney of the Hypersomatotropic Rat
Authors: Hise Michael K. , Salmanullah Muhammad , Tannenbaum Gloria S. , Rohan Richard M. 
Published: April 2003

<i>Aim:</i> To examine the response of the insulinlike growth factor (IGF) system in the kidney during a state of extreme growth. <i>Methods:</i> We studied the mRNA expression of IGF-I, IGF-I receptor, and IGF-binding proteins (BP) using sensitive RNase protection assays following subcutaneous implantation of growth hormone pituitary cells (GH<sub>3</sub>) in rats. <i>Results:</i> Within 5 weeks, the serum GH levels increased from 18.0 ± (SE) 5.0 ng/ml in control animals to 389.8 ± 30.3 ng/ml in GH<sub>3</sub> rats (n = 5, p < 0.001). The circulating IGF-I levels were also elevated. The kidney weights increased from 0.74 ± 0.01 g in controls to 1.06 ± 0.03 g in GH<sub>3</sub> animals (n = 5, p < 0.001). Similar changes were observed at week 10. The renal IGF-I mRNA averaged 1.0 ± (SD) 0.33 relative densitometry units in controls (n = 4) and increased to 2.11 ± 0.13 relative densitometry units in GH<sub>3</sub> rats (n = 5, p < 0.001). On the other hand, mRNA for the type I IGF receptor decreased in hypersomatotropic rats. Messenger RNAs for IGFBP-1 and IGFBP-4, which have been localized to renal tubules, both decreased significantly following growth induction, while IGFBP-3, the mRNA of which has an interstitial localization, was increased at week 10. <i>Conclusion: </i>These data suggest that there is a dynamic relationship between tubular and interstitial compartments with regard to the IGF system in the kidney which may be important in the regulation of the cell mass.
Erythropoietin and Cardiocirculatory Condition in Aged Patients with Chronic Rena l Failure
Authors: Bedani P.L. , Verzola A. , Bergami M. , Stabellini G. , Gilli P. 
Published: April 2003

<i>Background/Aim:</i> The clearest benefit of recombinant human erythropoietin (rHuEPO) in end-stage renal disease is a substantial reduction in transfusion dependency and an improved quality of life. In this report, we describe the efficacy of weekly subcutaneous administration of rHuEPO in 11 elderly patients with anemia secondary to chronic renal failure. <i>Methods:</i> The role of rHuEPO therapy in increasing the patient’s quality of life and in decreasing the hospitalization rates secondary to cardiac morbidity was verified in 11 elderly patients (age range between 66 and 85 years) with anemia due to chronic renal failure. The mean hemoglobin level at the beginning of the study was 8.2 ± (SD) 0.7 g/dl, and the serum creatinine concentration was 4.8 ± 1.36 mg/dl. The patients underwent baseline and annual echocardiography, in addition to an electrocardiogram. <i>Results:</i> Most patients experienced a partial regression of left ventricular hypertrophy, and no congestive heart failure was documented. The mean hemoglobin level during rHuEPO therapy increased to 11.3 ± 1.2 g/dl, while the mean serum creatinine concentration did not change significantly. <i>Conclusions:</i> Our results confirm that early anemia correction in aged chronic renal failure patients permits improvement of the quality of life, of exercise performance, and of cognitive functions. Reduced transfusion need and regression of left ventricular hypertrophy favor a minor incidence of cardiac morbidity and contribute to reduce health costs.
Soluble Osteopontin and Vascular Calcification in Hemodialysis Patients
Authors: Nitta Kosaku , Ishizuka Tsutomu , Horita Shigeru , Hayashi Tetsuo , Ajiro Akiko , Uchida Keiko , Honda Kazuho , Oba Takashi , Kawashima Akira , Yumura Wako , Kabaya Takashi , Akiba Takashi , Nihei Hiroshi 
Published: April 2003

<i>Background:</i> Vascular calcification often occurs in patients with uremia. As osteopontin (OPN) is not only involved in the physiological but also the pathological calcification of tissues, OPN may be associated with the pathogenesis of aortic calcification in hemodialysis (HD) patients. <i>Methods:</i> We examined the expression of OPN in atherosclerotic aortas of HD patients. In addition, we performed a prospective longitudinal study by using CT scans to detect aortic calcifications and by measuring the plasma OPN concentration by ELISA in HD patients (20 men, 16 women; mean age 55.2 ± 21.3 years) and in healthy volunteers (18 men, 17 women; mean age 54.0 ± 13.2 years). <i>Results:</i> By immunohistochemical staining, OPN was abundantly localized in atherosclerotic plaques of HD patients. The macrophages surrounding the atheromatous plaques were identified as the OPN-expressing cells. We furthermore found that the concentration of soluble plasma OPN was significantly higher in HD patients as compared with the concentrations in age-matched healthy volunteers (837.3 ± 443.2 vs. 315.1 ± 117.4 ng/ml, p < 0.01). The OPN concentration was positively correlated with the aortic calcification index in HD patients (r = 0.749, p < 0.01). <i>Conclusion:</i> These data suggest that OPN, secreted by macrophages, plays a role in the calcification of atheromatous plaques in HD patients.
Pruritus and Hydration State of Stratum corneum in Hemodialysis Patients
Authors: Kato Akihiko , Hamada Mayumi , Maruyama Takanori , Maruyama Yukitaka , Hishida Akira 
Published: April 2003

<i>Background: </i>Xerosis is the most frequent cutaneous manifestation in hemodialysis (HD) patients, but the association between dry skin and pruritus remains to be clarified. Since the skin surface hygrometer can detect the changes of water content in the stratum corneum more sensitively, we re-examined the relationship between the severity of pruritus and water content in dialysis patients. <i>Methods:</i> Fifty patients who had been undergoing regular HD were examined for the degree of pruritus by clinical grading. Water contents in the stratum corneum at volar forearm and lower leg were assessed by measurement of high-frequency conductance using a skin surface hygrometer both at pre- and postdialysis. <i>Results:</i> Thirty-seven (74%) of dialysis patients complained of pruritus. High-frequency conductance values were significantly lower in HD patients compared to those of age-matched control subjects (n = 13) both at forearm (35.1 ± 3.0 vs. 73.3 ± 10.4 µS, p < 0.01) and lower leg (14.2 ± 1.1 vs. 52.4 ± 7.5 µS, p < 0.01). There was no relationship between the severity of pruritus and age, gender, HD duration, underlying renal disease, or removing fluid volume. A significant reduction of itching score was found in patients using polysulfone membrane. A single HD session using cellulose triacetate or polysulfone membrane significantly increased water content both at forearm and lower leg (p < 0.05). However, the degree of pruritus did not correlate with the skin water content both at the beginning and the end of HD session, respectively. <i>Conclusion:</i> It follows from these findings that water content in the stratum corneum was reduced in HD patients, but did not correlate with the severity of pruritus.
Identifying Patients at Risk for Hemodialysis Underprescription
Authors: Leon Janeen B. , Sehgal Ashwini R. 
Published: April 2003

Underprescription of hemodialysis is an important barrier to adequate delivery of dialysis. We sought to determine which patient factors are associated with hemodialysis underprescription and to examine variation in prescription across facilities. For 721 randomly selected patients from all 22 chronic hemodialysis units in northeast Ohio, we calculated prescribed Kt/V based on dialyzer urea clearance at prescribed blood and dialysate flow (K), prescribed treatment time (t), and anthropometric volume (V). A minimum ‘prescribed Kt/V’ of 1.3 has been recommended to ensure an adequate ‘delivered Kt/V’ of 1.2. Using this criterion, 15% of patients had a low prescribed Kt/V. Prescribed Kt was strongly related to patient anthropometric volume but not to other patient characteristics (age, gender, race, cause of renal failure, number of years on dialysis, number of comorbid conditions). A 10-liter increase in V was associated with an 8.3-liter increase in prescribed Kt. However, a 13-liter increase in prescribed Kt would be needed to maintain a prescribed Kt/V of 1.3. As a result, the proportion of patients with low prescriptions increased from 2% of patients with V <35 liters to 42% of patients with V ≧50 liters. In addition, the prevalence of low prescriptions varied dramatically across facilities (range 0–47%) even after accounting for volumes of individual patients. Of the 109 patients with low prescription, 75% would achieve a prescribed Kt/V of 1.3 with less than 30 min of additional treatment time. In conclusion, large patients and patients at specific facilities are at increased risk for underprescription of hemodialysis. Most patients with low prescriptions would achieve a prescribed Kt/V of 1.3 with a modest increase in treatment time.
Expression of Fc Gamma Receptor III (CD16) on Monocytes during Hemodialysis in Patients with Chronic Renal Failure
Authors: Kawanaka Norikuni , Nagake Yoshio , Yamamura Masahiro , Makino Hirofumi 
Published: April 2003

<i>Background/Aims:</i> Circulating CD14+CD16+ monocytes, a potent phagocytosing and antigen-presenting monocyte population, have been reported to be expanded in patients on hemodialysis (HD). In this study, changes in the population of CD14+CD16+ monocytes were analyzed during a single session of HD therapy, and the influence of dialyzer membrane materials on these monocytes was investigated. <i>Methods:</i> Nine patients were hemodialyzed using regenerated cellulose (RC) membranes and thereafter polysulfone (PS) membranes. Peripheral blood cells were taken from these subjects, and these cells were stained with anti-CD14 and anti-CD16 antibodies. The percentages of CD14- and CD16-expressing monocytes were analyzed by two-color flow cytometric analysis. Moreover, the serum soluble CD14 (sCD14) levels were measured with an ELISA kit. <i>Results:</i> It was found that CD14+CD16+ monocytes before HD were significantly increased in patients on HD as compared to healthy controls. In the RC group, CD14+CD16+ monocytes were decreased at both 30 and 240 min after the initiation of HD. The reduction rate of CD14+CD16+ monocytes in the RC group was higher than that in the PS group. There was no significant difference in sCD14 levels between the two groups. <i>Conclu</i><i>sion:</i> Monocytes are activated in patients on HD. Furthermore, the population of CD14+CD16+ monocytes was stimulated to a greater extent during HD in the RC group than in the PS group. The significant reduction in CD14+CD16+ monocytes by RC membranes indicated that the level of CD14+CD16+ monocytes is a sensitive marker for the biocompatibility of HD membranes.
Antihypertensive Treatment Decreased Serum Leptin Levels in Severe Preeclampsia during Pregnancy
Authors: Anato Verónica , Garmendia Jenny V. , Bianco Nicolas E. , De Sanctis Juan B. 
Published: April 2003

<i>Background:</i> Plasma leptin levels in preeclamptic patients have been reported to be similar compared to those of normotensive pregnant women. Nonetheless, no reports have dealt with the effect of antihypertensive treatment and leptin in preeclamptic patients. <i>Methods:</i> The study involved three groups of a similar age, body mass index and weeks of gestation. The groups were 30 normal pregnant women and 23 pregnant women with severe preeclampsia (SPE). The SPE patients were not treated prior to admission and the treatment was a single dose of α-methyldopa or hydralazine alone or in combination. The samples were taken at random in the afternoon (isotonic saline or pharmacological treatment) and 1 h before and after the treatment was given. Leptin serum levels were determined by a commercial sandwich ELISA assay. <i>Results:</i> Leptin levels of the SPE group prior to the treatment were similar to the levels recorded for the normal pregnant women. However, after 1 h leptin levels were significantly higher (p < 0.001) in the nontreated patients (8.0 ± 1.5) compared with those treated (5.15 ± 0.9). <i>Conclusion:</i> These marked differences between treated and nontreated patients suggest that leptin levels may be modulated by a single antihypertensive treatment in preeclamptic patients with a discrete increase in blood pressure.