Nefrologia kliniczna

A case of 78-year-old female patient treated with hemodialisys since 02/24/2003 due to chronic renal disease as a result of retroperitoneal fibrosis is described. In the fact of losing vascular access to extracorporeal techniques in 2011, patient switched to continous ambulatory peritoneal dialisys. The course of peritoneal dialisys proceeds without complications from 8 years now.

Chronic kidney disease amongst liver transplant recipients is common and is associated with increased risk of end-stage renal disease requiring dialysis. The underlying etiology is multifactorial. Amongst many risk factors the most important ones include: nephrotoxicity (especially dependent on immunosuppression), renal function impairment before LTx, HCV infection, hypertension, diabetes, metabolic syndrome, obesity. Due to the correlation between mortality rate and GFR, evaluation of renal function before and after LTx is crucial. Methods that can be used in clinical practice are: equations based on serum creatinine concentration, specific markers concentration, or clearance of endogenic substances.

One of the most important early complications after kidney transplantation is delayed graft function (DGF). The lack of an unambiguous definition of DGF, a multitude of factors related to the donor and the recipient of the organ, and those dependent on the transplantation procedure itself, constitute a complex clinical problem.

Frailty syndrome (FS) is the reduction of physiological reserves, weakness and fragility which are associated with aging and destruction of the body. In patients with end-stage renal disease, treated with renal replacement therapy, the symptoms of frailty syndrome occur much more frequently and at a much younger age compared to the general population.

Thrombotic microangiopathic lesions (TMA) occur in patients with organ damage, most commonly of the kidneys (acute renal failure, hematuria, proteinuria, hypertension) or the central nervous system (CNS) which is accompanied by non-immune hemolytic anemia and thrombocytopenia. The causes of TMA are very diverse and form the basis of its contemporary pathophysiological classification that directs therapeutic treatment. The diagnosis of TMA is based on the clinical picture and specialist laboratory tests (ADAMTS13 activity, anti-ADAMTS13 antibodies, PCR towards STEC, complement system tests, antiH antibodies and others).

Fungal peritonitis is a very rare but extremely serious complication of peritoneal dialysis. It is estimated that fungi cause on average 3–6% of all cases of dialysis peritonitis. Infections caused by Candida spp. are most often observed, which account for 89.3% of cases. The clinical course is characterized by high mortality, which can reach 53%, in addition to a significant percentage of patients, it is not possible to return to peritoneal dialysis.

In recent years, there is a growing interest in a personalized medicine, which aims to provide the right treatment, for the right person in the right time. One of the tools allowing creation of tailored therapies is “omic” technique, which provides a comprehensive analysis of a selected set of molecules in a given system. The paper presents a potential application of genomic techniques in nephrology.

Chronic kidney disease (CKD) causes decrease of immunity, which promotes infections and dangerous complications. Vaccinations have a significant impact on reducing the risk of infections. However, their efficacy depends on many factors, such as age or general condition of the patient, stage of CKD, but also appropriate conditions of transport and storage as well as proper preparation and administration of the vaccine.

Caring and threating of a patient with hepatitis C and renal failure is associated with many difficult symptoms in the biological and mental dimensions. That is why, it requires holistic aspects take into consideration in all approach of life including somatic, mental, social and spiritual sphere. Modern therapeutic methods increase patient safety by minimalizing the risk of side effects being a result of therapy itself.

Xenotransplantology is a branch of medical science dealing with organ transplantation between organisms of different species. Constantly increasing demand of organs, among others of the kidneys, for transplantation makes diligently seek for alternative methods of their obtaining. At present, organs for transplantation come from living humans or deceased donors (allografts).