Background/Aim. Catheter-related infections are a significant morbidity and mortality cause in patients on hemodialysis. The objective of this study was to determine the incidence, to analyze risk factors and to identify etiological causes of catheter-related infections in these patients. Methods. The study was carried out at the Clinic for Nephrology and Clinical Immunology of the Clinical Centre of Vojvodina, from August, 2012 to May, 2015. One hundred and thirteen patients on chronic hemodialysis participated in the study. The risk factors of catheterrelated infections in the infected patients were to those in the control group, as follows: demographic and laboratory parameters, co-morbidities and the use of immunosuppressive therapy, the length of hemodialysis treatment, urgent catheter placement, the position and placement difficulties, the number of insertions and catheter maneuvering, the existence of permanent vascular access in maturation or without a vascular access in the course of catheter positioning, catheter life, surgical procedures (≤ 30 days from catheter placing), the length of hospitalization and isolated infection causes. Results. One hundred and Key words: renal dialysis; catheter-related infections; risk factors.Apstrakt Uvod/Cilj. Infekcije povezane sa kateterom i dalje predstavljaju značajan uzrok morbiditeta i mortaliteta kod bolesnika na hemodijalizi. Cilj ovog ispitivanja je bio da se utvrdi incidencija, analiziraju faktori rizika i identifikuju etiološki uzročnici kateter infekcija kod ovih bolesnika. Metode. Ispitivanje je sprovedeno na Klinici za nefrologiju i kliničku imunologiju Kliničkog centra Vojvodine u periodu od avgusta 2012. do maja 2015. godine. Ispitivanjem je bilo obuhvaćeno 113 bolesnika lečenih hroničnim hemodijalizama. Upoređivani su faktori rizika od infekcija povezanih sa kateterom kod bolesnika sa dokazanom infekcijom u odnosu na kontrolnu grupu. Analizirani su demografski i laboratorijski parametri, komorbiditeti i upotreba imunosupresivne terapije, dužina dijaliziranja, urgent-no plasiranje, pozicija i otežano plasiranje katetera, broj mesta insercije i manipulacija kateterom, postojanje trajnog vaskularnog pristupa u maturaciji ili bez vaskularnog pristupa tokom plasiranja katetera, dužina trajanja katetera, hiruške intervencije (≤ 30 dana od plasiranog katetera), dužina hospitalizacije i izolovani uzročnici infekcija. Rezultati. Kod 113 bolesnika plasirano je 197 katetera, od kojih su 182 bila privremena. Ukupni broj dana katetera iznosio je 17,842, a incidencija infekcija je bila 3.53 slučajeva na 1,000 kateter dana. Tokom perioda praćenja potvrđene su 63 kateter-povezane infekcije, 54 (85.7%) privremenih i 9 (14.3%) trajnih katetera. Multivarijantnom logistističkom regresionom analizom (granične vrednosti određene receiver operating curve -ROC analizom), kao nezavisni prediktori kateter-povezanih infekcija dobijeni su: vrednost hemoglobina < 95 g/l (p < 0.001) i albumina < VOJNOSANITETSKI PREGLED Vol. 75,No 2 33g/l (p = 0.041), trajanje katetera > 90 dana (p...

In regard to physical health of transplantation patients (TP) it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40%) than in hemodialysis patients (HD) (19%), while family relationships were most damaged in pts on HD (28.57%). Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good: 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good.

A median weekly dose of etelcalcetide was 15 mg (7.5-22.5 mg) and did not differ between naïve patients or switched from cinacalcet.After the switch of treatment, none of the patients developed clinical intolerance or new adverse effects. Etelcalcetide was more effective than cinacalcet in controlling secondary hyperparathyroidism. The dose conversion factor for the switch was [etelcalcetide/week] ¼ 0.277Â[mg cinacalcet/day], indicating that single dose of etelcalcetide (2.5 mg per session) is functionally slightly less than single dose of cinacalcet (30 mg per day). Conclusions: These results indicate that the signs of assumed autonomous parathyroid glands adenoma could predict therapeutic response of etelcalcetide better than PTH level.

Background/Aim. Development of inflammatory changes, fibrosis and loss of morphological structures of the interstitium have an important role in pathogenesis of primary glomerulonephritis, affecting the development, course and prognosis of the disease. The aim of this study was to determine the influence of changes in the interstitium on the prognosis of primary glomerulonephritis. Methods. The research included 216 patients suffering from different types of primary glumeronephritis treated at the Clinic for Nephrology and Clinical Immunology of the Clinical Center of Vojvodina, Serbia who were being monitored on average for 77.5 months. After determining on pathohistological diagnosis of the type of glomerulonephritis, renal changes in the interstitium were quantified. Numerical density in the tissue volume unit and structure of infiltrates of the interstitium were established by using the Weibel system (M42) incorporated into light microscope. Routine analyses were performed by using standard laboratory procedure. Results. During the research period the highest numerical density of infiltrates was verified in extracapillary glomerulonephritis (147,869 × mm-3), slightly less in membranoproliferative siju bubrežne insuficijencije. Zaključak. Gustina infiltrata u intersticijumu kod primarnih glomerulonefritisa je važan, rani prognostički prediktor progresije bubrežne insuficijencije. Ključne reči: glomerulonefritis; bubreg, hronična insuficijencija; vezivno tkivo; prognoza; histološke tehnike.

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Early introduction of continuous veno-venous hemodiafiltration with other intensive therapy measures led to complete recovery in a hemodinamically instable patient.

Background and Aims Patients with cognitive dysfunction (CD)are at greater risk of having a poor quality of life, hospitalization and mortality. Although CD in chronic kidney disease is current, most of the studies performed are cross-sectional. The aim of this cross-sectional study was to determine the presence of CD in the patients on peritoneal dialysis (PD)and to identify possible risk factors associated with CD. Method We performed a study to evaluate the CD of 30 PD patients in our institution using the mini-mental state (MMSE), and a score of &lt;25 was considered to indicate cognitive dysfunction. Demographic, clinical and laboratory parameters, adequacy of dialysis and drugs were analyzed. The statistical analysis included the chi-square test, t-test of independent samples, Mann-Whitney, and correlation. Results We evaluated 30 patients mean age of 57.27 years (SD±12.086); 56.7% were male. About 66.7% of our patients were in marriage, 73.3% were not actively working, 13.3 had a lower level of education, and 56.7% lived in a city. The most prevalent comorbidities were glomerulonephritris and hypertension, both with 30.0%. 19 (57.6%) patients had average fast membrane characteristics. 15 of them (50%) had a daily dose of calcium phosphate binder &gt;2g.MMSE test with a score lower than 25 was present in 36,7% of patients (IQR=4). Statistical analysis revealed a positive correlation between MMSE and weekly total Kt/V urea index (WTKt/V), and the t-test of independent samples showed that patients with better MMSE score values have significantly higher average WTKt/V values (t=-3.062, p&lt;0.011). Conclusion MMSE test with a score less than 25 was present in 36.7% of patients and patients with better MMSE scores have significantly higher average WTKt/V values.

Background/Aim. End-stage renal disease (ESRD) is characterized by significant impairment of platelet functions which may cause bleeding or thrombotic complications. The iam of this study was the aim of this study was the assessement of platelet turnover and function and their correlation with inflammatory and procoagulant markers in ESRD patients as well as platelet indicies comparison between ESRD diabetic and ESRD non-diabetic patients. Methods. The prospective, observational clinical study included 63 ESRD patients and 30 age and sex matched healthy volunteers. Following laboratory parameters of platelet turnover and function (platelet count, reticulated platelets, platelet indices, whole blood impedance platelet aggregation), inflammatory and procoagulant markers (number of neutrophils, neutrophil to lymphocyte ratio, C-reactive protein, plasma fibrinogen, D dimer, von Willebrand factor) were obtained. Results. Platelet turnover (% of reticulated platelets) was significantly higher (3.8 ? 2.3 vs. 2.3 ? 1.3; p < 0.01) and platelet aggregation tests induced by thrombin receptor activiting peptide (TRAP) (p < 0.01), adenosine diphospate (ADP) (p < 0.05), arachidonic acid (ASPI) (p < 0.05) and collagen (p < 0.05) were markedly increased in the ESRD patients compared to the control group. The comparison of chronic inflammation and procoagulant markers revealed higher values in all patients comparing to the group of healthy subjects (p < 0.01 regarding all parameters). There was no difference between the ESRD diabetic and ESRD non-diabetic patients. Conclusion. Results point out increased platelet turnover in ESRD as a consequence of platelet activation and consumption induced by clotting system hyperactivity and chronic inflammation. None of the examined parameters do not predict bleeding occurrence.