The mechanisms of clearance of circulating plasma DNA are not fully understood, and so we aimed to examine it in patients with impaired renal function compared with healthy individuals. We also assessed the effect of peritoneal dialysis and hemodialysis on circulating plasma cell-free DNA (cfDNA) in our treated patients. Overall, 20 healthy volunteers, 20 patients with chronic kidney disease (CKD), 18 patients undergoing peritoneal dialysis (PD), and 17 patients on hemodialysis (HD; high-flux polysulfone membrane) were examined. Cell-free DNA levels were determined using real-time GADPH gene sequence amplification. The levels of cfDNA in all groups of our patients did not differ significantly from those of healthy volunteers. In HD patients, cfDNA levels were significantly increased compared with those of CKD patients (P < 0.05) and PD-treated patients (P < 0.01). In PD-treated patients, cfDNA was detectable in overnight effluent, with its levels correlating inversely with the duration of PD treatment (r=-0.619, Spearman's coefficient, P= 0.008). Factors contributing to these differences may include changes in the quality and quantity of the cell population of the peritoneum, highlighting the need for additional studies clarifying the dynamics of cfDNA during PD. The plasma levels of cfDNA do not seem to be dramatically altered even in CKD patients or those on PD or HD (as long as they are measured prior to the procedure in the latter two). Our data suggest renal elimination is not the main mechanism of circulating cfDNA clearance.

The purpose of this study was to determine whether or not regional citrate anticoagulation (RCA) controlled by ionized calcium (iCa(2+)) would overcome thrombogenicity, prevent hemostasis, and complement activation during hemodialysis (HD). RCA was performed in 10 patients during 10 HD sessions using a polysulfone membrane in an effort to keep iCa(2+) at dialyzer outlet at < or =0.4 mmol/L. Compared to baseline, plasma levels of thrombin-antithrombin III complexes rose significantly at 240 min, and tissue factor and complement C5a component levels at 30 and 240 min of the procedure. Thrombocyte count declined significantly at 30 and 240 min, while activated clotting time (ACT) did not increase significantly, and platelet factor 4 as well as von Willebrand factor levels did not alter significantly. While ACT correlated significantly with some thrombogenicity markers, iCa(2+) did not correlate with ACT, changes in hemostasis, or C5a. We conclude the usually recommended iCa(2+) levels in the HD extracorporeal circuit did not guarantee the complete overcoming of thrombogenicity, prevention of hemostasis, and complement activation.

Based on plasma TAT levels, ECC priming with an UFH-containing solution reduces the thrombogenicity of the AN69 ST membrane. There is no significant difference between both types of priming concerning PF4 and thrombocyte count.

Chromium (Cr) is considered as an important mineral, involved in biochemical reactions in human metabolic pathways. Organically bound Cr supplementation has been suggested to improve glycemia especially in patients with type 2 diabetes mellitus, but there are conflicting reports on efficacy. Effect of Cr is not clear in prediabetes status. Seventy patients with metabolic syndrome and impaired glucose tolerance (IGT), who are observed and treated in the Center of Preventive Cardiology of the University Hospital in Pilsen, were included in the prospective, randomized, double-blind, and placebo-controlled clinical study. Effect of Cr-enriched yeast (200 μg of elementary Cr in the morning and 100 μg in the evening) on glucose, lipid metabolism, fat tissue hormones, oxidative stress, and DNA damage markers was analyzed. There were no significant changes in glucose and lipid parameters, oxidative stress, or other laboratory markers. Only resting heart rate was significantly reduced in patients treated by Cr yeast, reflecting reduced sympathetic activity. This could represent an important cardiovascular risk reduction in patients with high cardiometabolic risk.

The aim of this study was to reveal whether accumulation of the persistent organic pollutants (POPs), especially polychlorinated biphenyl (2,2 0 ,4,4 0 ,5,5 0 -hexachlorobiphenyl, PCB 153), affects plasma levels of adiponectin in obese patients. The study was designed as a longitudinal intervention trial with a control group, where 27 obese women (body mass index (BMI)430 kg/m 2 ; age 21-74 years) were studied before (OB) and after (OB-LCD) a 3-month low-calorie-diet intervention (LCD; 5 MJ daily). As the control group, 9 female volunteers without LCD intervention were used (C; BMI ¼ 19-25 kg/m 2 ; age 21-64 years). Plasma levels of PCB 153 were measured by high-resolution gas chromatography with electron capture detection; total adiponectin and insulin plasma levels were quantified by immunoassays; and adiponectin multimeric complexes were quantified by immunoblotting. Plasma levels of total adiponectin, high and medium molecular weight multimers significantly negatively correlated with plasma levels of PCB 153 in OB, but not in C or in OB-LCD, whereas the LCD intervention lowered BMI by 3.3±3.0 kg/m 2 . Our results may suggest suppression of adiponectin by PCB 153 in obese women under non-energy-restrictive regime, which may contribute to the known association of PCB 153 and other POPs with type 2 diabetes.