Sclerostin is a protein which is involved in bone metabolism and probably also in vessel wall function. This prospective observational cohort study evaluated the prognostic significance of sclerostin in hemodialysis (HD) patients. In total, 106 HD patients and 25 healthy controls participated in the study. HD patients were prospectively followed up for five years. Sclerostin was measured in serum using standard ELISA kits by Biomedica. Sclerostin concentrations in serum were higher in HD patients compared to the controls (89.2±40.3 pmol/l vs. 32.8±13.0 pmol/l, p<0.001). Sclerostin levels were significant for cardiovascular mortality but not for overall mortality and mortality due to infection. A higher cardiovascular risk was connected to sclerostin concentrations above the median (>84 pmol/l), HR (95 % CI): 2.577 (1.0002-10.207), p=0.04. When sclerostin was evaluated together with residual diuresis in Kaplan-Meier analysis the worst prognosis due to cardiovascular events was observed in the group with high sclerostin and zero residual diuresis compared to all other patients (p=0.007). In summary, serum sclerostin levels in HD patients were increased when compared to healthy subjects. High sclerostin levels were demonstrated as a risk factor for cardiovascular mortality. Further studies are required to clarify the pathophysiological mechanisms of sclerostin action in patients with renal failure before therapeutic measures can be established.

• MeSH
• adaptorové proteiny signální transdukční krev   MeSH
• chronická renální insuficience krev   mortalita   terapie   MeSH
• dialýza ledvin mortalita   trendy   MeSH
• kardiovaskulární nemoci krev   diagnóza   mortalita   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita trendy   MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• adaptorové proteiny signální transdukční MeSH
• SOST protein, human MeSH Prohlížeč

BACKGROUND: High cardiovascular risk in patients with chronic kidney disease (CKD) may be related to mineral disorder and microinflammation. Fibroblast growth factor 23 (FGF-23) is a phosphatonin and inhibitor of calcitriol synthesis, which is associated with poor prognosis in CKD patients starting dialysis. Matrix-metalloproteinases (MMP-2, MMP-9) contribute to myocardial remodeling and arterial calcification. FGF-23 and MMPs levels are altered in CKD, however, little is known about their association and relation to cardiovascular (CV) disease. METHODS: Standard laboratory parameters, plasma levels of MMP-2, MMP-9, FGF-23, PAPP-A and CV disease history were assessed in 80 patients with CKD 1-5 and 44 healthy control subjects. RESULTS: FGF-23 and MMP-2 (assessed by ELISA) were higher in CKD patients compared to controls. FGF-23 increased from CKD 3, whereas MMP-2 increased only in CKD 5. FGF-23 was positively associated with MMP-2, adjusted to age, eGFR, phosphatemia, calcitriol and parathormone. FGF-23 independently correlated with parathormone and inversely with calcitriol, whereas MMP-2 was related to phosphatemia. FGF-23 was higher in subjects with a history of CV disease compared to those free of such history (559.0 vs.184.0 RU/ml), adjusted to age and eGFR. CONCLUSION: Our data suggest a possible relationship between FGF-23, MMP-2 and CV disease in CKD. Potential causality of this association remains to be elucidated.

• MeSH
• biologické markery MeSH
• chronické selhání ledvin komplikace   metabolismus   MeSH
• cytokiny krev   MeSH
• ELISA MeSH
• fibroblastové růstové faktory metabolismus   MeSH
• fibroblastový růstový faktor 23 MeSH
• kalcitriol krev   MeSH
• kardiovaskulární nemoci komplikace   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy krev   MeSH
• matrixové metaloproteinasy metabolismus   MeSH
• parathormon krev   MeSH
• pohlavní dimorfismus MeSH
• progrese nemoci MeSH
• senioři MeSH
• sérový albumin metabolismus   MeSH
• stárnutí fyziologie   MeSH
• vitamin D terapeutické užití   MeSH
• vitaminy terapeutické užití   MeSH
• vyšetření funkce ledvin MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• cytokiny MeSH
• FGF23 protein, human MeSH Prohlížeč
• fibroblastové růstové faktory MeSH
• fibroblastový růstový faktor 23 MeSH
• kalcitriol MeSH
• lipidy MeSH
• matrixové metaloproteinasy MeSH
• parathormon MeSH
• sérový albumin MeSH
• vitamin D MeSH
• vitaminy MeSH

This paper reports a retrospective study on the clinical and laboratory analysis of some serum and erythrocyte vitamins in our chronic renal failure patients who were treated with Continuous ambulatory peritoneal dialysis (CAPD). In the first patient and in the next 10 patients the CAPD treatment began (in years 1980-1984) at the Internal Department-Strahov of General Faculty Hospital in Prague and after 2 or 3 weeks they continued in CAPD programme at the Dialysis Centre of IVth Internal Clinic, Faculty Hospital in Kosice. In the third group of CAPD patients (among them 8 patients were treated in Prague and 5 patients in Kosice) all biochemical parameters including vitamins were determined at Nephrological laboratory of the IVth Internal Clinic in Kosice. Besides that the aim of this paper was to show the above standard relationship and a long-term cooperation between above mentioned departments, and to contribute to Czech and Slovak reciprocity and to the history of clinical nephrology. The paper was presented on the important occasion of the 30th anniversary of the first continuous ambulatory peritoneal dialysis, which was performed at Internal Department-Strahov, Prague in the year 1978.

• MeSH
• chronické selhání ledvin krev   MeSH
• dospělí MeSH
• erytrocyty chemie   MeSH
• kontinuální ambulantní peritoneální dialýza * MeSH
• lidé středního věku MeSH
• lidé MeSH
• vitaminy krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• vitaminy MeSH

• MeSH
• chronická nemoc MeSH
• hodnoty glomerulární filtrace * MeSH
• kreatinin krev   MeSH
• lidé MeSH
• nemoci ledvin dietoterapie   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH
• úvodníky MeSH
• Názvy látek
• kreatinin MeSH

• MeSH
• chronické selhání ledvin terapie   MeSH
• dialýza ledvin * statistika a číselné údaje   trendy   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH

Ghrelin was originally isolated from the rat stomach and significant amounts were found also in the kidney. Present study was designed to examine changes in ghrelin levels in renal failure and their relationship to the GH/IGF-I axis. Fourty patients with mild-to-severe CRF (19 men, 21 women, aged 62.5 +/- 2.2 years, BMI 27.57 +/- 0.73 kg/m(2)) and 34 healthy control subjects (17 men, 17 women, aged 60 +/- 2.6 years, BMI 27.55 +/- 0.79 kg/m(2)) were included in the study. Total ghrelin levels were significantly increased in patients with chronic renal failure (CRF) (p < 0.0001). Total ghrelin in CRF correlated positively with active ghrelin (p < 0.001), GH (p < 0.05), IGF-I (p < 0.05), free IGF-I (p = 0.0001), IGFBP-3 (p < 0.01), IGFBP-2 and -6 (p < 0.05). Active ghrelin in CRF correlated positively with IGF-I (p < 0.001), free-IGF-I (p < 0.005), IGFBP-2 (p < 0.05) and IGFBP-3 (p < 0.05). However, most of the correlation were markedly reduced and the significance disappeared after adjustment for different creatinine levels. Hemodialysis in patients with end stage renal disease (ESRD) resulted in a significant reduction of plasma total and active ghrelin (p < 0.01 and p < 0.001 respectively). In conclusion we demonstrated elevated plasma levels of total ghrelin in CRF, and a reduction of total and active ghrelin after a single course of hemodialysis in ESRD. The elevation of ghrelin levels could be caused by impaired clearance and/or metabolism of ghrelin in the kidney. We did not prove clearly significant relationship between ghrelin serum levels and parameters of GH/IGF-I axis in study subjects.

• MeSH
• časové faktory MeSH
• chronické selhání ledvin krev   metabolismus   MeSH
• dialýza ledvin MeSH
• ghrelin MeSH
• IGFBP-3 metabolismus   MeSH
• index tělesné hmotnosti MeSH
• insulinu podobný růstový faktor I metabolismus   MeSH
• kreatin krev   MeSH
• ledviny metabolismus   MeSH
• leptinové receptory MeSH
• lidé středního věku MeSH
• lidé MeSH
• peptidové hormony krev   chemie   metabolismus   MeSH
• protein 2 vázající insulinu podobné růstové faktory metabolismus   MeSH
• receptory buněčného povrchu chemie   MeSH
• renální insuficience krev   MeSH
• růstový hormon metabolismus   MeSH
• statistické modely MeSH
• studie případů a kontrol MeSH
• zvířata MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• ghrelin MeSH
• IGFBP-3 MeSH
• insulinu podobný růstový faktor I MeSH
• kreatin MeSH
• leptinové receptory MeSH
• peptidové hormony MeSH
• protein 2 vázající insulinu podobné růstové faktory MeSH
• receptory buněčného povrchu MeSH
• růstový hormon MeSH