Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.

Osmolality is an expression of the number of particles in a given weight of solvent (mOsm). Measured osmolality is determined by the osmometer, and calculated osmolality is estimated by 2xNa + UN/2.8 + glucose/18. The difference between measured and calculated osmolality is the osmolal gap. The purpose of the present study is to determine the measured and the calculated osmolality and the osmolal gap in hemodialyzed uremic patients, pre- and post-hemodialysis (HD). In 24 uremic patients under regular HD, blood samples pre- and post-HD were collected, and serum osmolality measured (osmometer) and calculated (2xNa + UN/2.8 + glucose/18) and the osmolal gap (measured-calculated osmolality) were determined. Also, the same parameters were determined in 22 healthy subjects (control). According to our findings, the measured osmolality in patients is significantly higher pre- and post-HD in comparison to that of controls, but post-HD is significantly lower than pre-HD. Also, calculated osmolality is significantly higher pre- and post-HD in comparison to that of controls, but the value post-HD is significantly lower than the pre-HD. The osmolal gap of patients pre-HD (11 ± 2.08) and post-HD (7.29 ± 1.94) is significantly higher (P < 0.001) in comparison to that of controls (3.18 ± 1.46); also, the value post-HD is significantly decreased in comparison to the value pre-HD (P < 0.001). Uremic hemodialyzed patients present high measured and calculated osmolality pre-HD that remains high post-HD in comparison to that of controls in spite of the significant decrease post-HD in comparison to that of pre-HD. Also, the osmolal gap is high pre-HD and, in spite of the decrease, remains high post-HD. In comparison to that of controls, the high osmolal gap indirectly indicates the presence of unidentified endogenous osmoles in the serum of uremic patients which partly are removed during HD.

No abstract

The aim of this retrospective study was to evaluate the International Normalized Ratio (INR) in hemodialyzed uremic patients under treatment with oral anticoagulation drugs. Eleven out of one hundred and forty-two uremic hemodialyzed patients in our unit were included in the study. These 11 patients aged from 70 to 85 (mean: 76 years) were under oral anticoagulation treatment for protection from thromboembolic events. They received 1 mg acenocumarol daily with the therapeutic goal of achieving an INR between 2 and 2.5 units. During the last year, the number of total INR determinations was 129. Based on the INR levels, measurements were classified into three categories of anticoagulation, termed “under-anticoagulation”, “target-anticoagulation”, and “over-anticoagulation”. The number, the percentage, and the mean value (±SD) of INR measurements for each category, respectively, were under-anticoagulation: 39, 30%, 1.78 ± 0.14; target-anticoagulation: 48, 37.5%, 2.20 ±0.14; and over-anticoagulation: 42, 32.5%, 3.14 ± 0.64. The mean value ±SD of all INR determinations (n=129) was 2.34 ±0.65. No thromboembolic or major bleeding events occurred in our patients with these INR. In conclusion, in elderly, hemodialyzed uremic patients with indications for oral anticoagulation treatment, adequate and safe INR levels can be achieved in a high proportion without serious deviations from the therapeutic goal by using low doses of drugs. Therefore, oral anticoagulation therapy should not be considered automatically contra-indicated in this patient group.

No abstract

ECDs significantly increased the kidney pool and can be utilized safely if adequate measures are taken.

MONDAYConclusion: Structured implementation resulted in a successful CNHBD programme providing 61 successful renal transplants from 35 CNHBDs' in 3 years -contributing about 35% to the total number of transplants during the period .We consider early involvement of all stakeholders contributed to the success of the programme. Donors generally reached asystole quickly despite low levels of ventilatory support and relatively little circulatory support.

Η έγκαιρη αναγνώριση της νεφρικής δυσλειτουργίας σε έναν ασθενή πού έχει υποβληθεί σε μεταμόσχευση νεφρού, ιδιαίτερα κατά την πρώιμη μετεγχειρητική περίοδο, είναι πολύ σημαντική για τη διαχείριση των ασθενών και για την έγκαιρη λήψη απόφασης για την έναρξη κατάλληλης θεραπείας έναντι της οξείας απόρριψης. Μεταξύ των διαφόρων βιοδεικτών που μελετώνται για να εκτιμηθεί η νεφρική λειτουργία του μοσχεύματος είναι η κάθαρση της κρεατινίνης, η εκτίμηση της GFR (σπειραματική διήθηση) βάσει του προσδιορισμού της κρεατινίνης (s-Cr). Η Cys-C στον ορό των ασθενών θα μπορούσε να χρησιμοποιηθεί ως εναλλακτικός και αξιόπιστος δείκτης της νεφρικής λειτουργίας στη μεταμόσχευση νεφρού και κατά δεύτερο λόγο να διερευνηθεί η σχέση των μεταβολών της Cys-C με την s-Cr και την eGFR κατά την περίοδο μετά τη μεταμόσχευση και κατά τη φάση της οξείας απόρριψης του μοσχεύματος. Θα επιχειρηθεί επομένως να αναδειχθεί η σημαντικότητα που έχει ο προσδιορισμός της Cys-C, της s-Cr και της eGFR σε ασθενείς που έχουν παρουσιάσει AR και σε αυτούς που δεν έχουν παρουσιάσει AR. Αποδεικνύεται λοιπόν, ότι η Cys-C έχεi μια ανώτερη διαγνωστική ικανότητα από την s-Cr στην ανίχνευση διαταραχών της νεφρικής λειτουργίας κατά την πρώτη περίοδο μετά τη μεταμόσχευση ακόμη και με τη χρήση κορτικοστεροειδών .