In the present study we have evaluated the effect of a single hemodialysis session on the brain-derived neurotrophic factor levels in plasma [BDNF](pl) and in serum [BDNF](s) as well as on the plasma isoprostanes concentration [F(2) isoprostanes](pl), plasma total antioxidant capacity (TAC) and plasma cortisol levels in chronic kidney disease patients. Twenty male patients (age 69.8 ± 2.9 years (mean ± SE)) with end-stage renal disease undergoing maintenance hemodialysis on regular dialysis treatment for 15-71 months participated in this study. A single hemodialysis session, lasting 4.2 ± 0.1 h, resulted in a decrease (P = 0.014) in [BDNF](s) by ~42 % (2,574 ± 322 vs. 1,492 ± 327 pg ml(-1)). This was accompanied by an increase (P< 10(-4)) of [F(2)-Isoprostanes](pl) (38 ± 3 vs. 116 ± 16 pg ml(-1)), decrease (P < 10(-4)) in TAC (1,483 ± 41 vs. 983 ± 35 trolox equivalents, μmol l(-1)) and a decrease (P = 0.004) in plasma cortisol level (449.5 ± 101.2 vs. 315.3 ± 196.3 nmol l(-1)). No changes (P > 0.05) in [BDNF](pl) and the platelets count were observed after a single dialysis session. Furthermore, basal [BDNF](s) in the chronic kidney disease patients was significantly lower (P = 0.03) when compared to the age-matched control group (n = 23). We have concluded that the observed decrease in serum BDNF level after hemodialysis accompanied by elevated [F(2)-Isoprostanes](pl) and decreased plasma TAC might be caused by enhanced oxidative stress induced by hemodialysis.
The quantitative and qualitative characteristics of cells in the peritoneal dialysate from 12 patients were examined. The number of cells in each subsequent fraction of dialysate decreased, while the differential cell count remained relatively constant for each individual patient. Macrophages, lymphocytes, granulocytes and occasionally mesothelial cells were observed. In 1 patient, plasmocytes were also found. Evident differences in cellularity and cell composition were noticed in dialysate obtained from different patients, especially in 2 patients with bacterial peritonitis there was a rise in cellularity with neutrophilia. Cytochemical (peroxidase, nonspecific esterase activity) and functional (phagocytosis, receptor expression) tests revealed that macrophages form a heterogeneous population of cells.
SummaryBackground and objectives Peginesatide is a synthetic, PEGylated, investigational, peptide-based erythropoiesisstimulating agent. We report the first assessment of its efficacy and safety in correcting renal anemia in a population of 139 nondialysis chronic kidney disease patients.Design, setting, participants, & measurements Chronic kidney disease patients who were not on dialysis and not receiving treatment with erythropoiesis-stimulating agents in the 12 weeks before study drug administration were sequentially assigned to one of 10 cohorts; cohorts differed in starting peginesatide dose (different body weight-based or absolute doses), route of administration (intravenous or subcutaneous), and frequency of administration (every 4 or 2 weeks).Results Across all cohorts, 96% of patients achieved a hemoglobin response. A dose-response relationship was evident for hemoglobin increase. Comparable subcutaneous and intravenous peginesatide doses produced similar hemoglobin responses. Rapid rates of hemoglobin rise and hemoglobin excursions Ͼ13 g/dl tended to occur more frequently with every-2-weeks dosing than they did with every-4-weeks dosing. The range of final median doses in the every-4-weeks dosing groups was 0.019 to 0.043 mg/kg. Across all cohorts, 20% of patients reported serious adverse events (one patient had a possibly drug-related serious event) and 81% reported adverse events (11.5% reported possibly drug-related events); these events were consistent with those routinely observed in this patient population.Conclusions This study suggests that peginesatide administered every 4 weeks can increase and maintain hemoglobin in nondialysis chronic kidney disease patients. Additional long-term data in larger groups of patients are required to further elucidate the efficacy and safety of this peptide-based erythropoiesis-stimulating agent.
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