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and apoptosis are important in the pathogenesis of the ADR-induced nephrosis. Background. In recent studies increased amounts of nitric oxide (NO) and apoptosis have been implicated Keywords: adriamycin-induced nephropathy; aminoin various pathological conditions in the kidney. We guanidine; apoptosis; isolated perfused rat kidney; have studied the role of NO and its association with nitric oxide apoptosis in an experimental model of nephrotic syndrome induced by a single injection of adriamycin (ADR). Methods. The alteration in the NO pathway was Introduction assessed by measuring nitrite levels in serum/urine and by evaluating the changes in vascular reactivity of the Nitric oxide (NO) is a small signalling molecule reguisolated perfused rat kidney (IPRK ) system. Rats were lating a variety of diverse cellular functions including stratified into control groups and ADR-induced many physiological and pathophysiological processes nephropathy groups. These two groups were then ranging from regulation of vascular tonus to neuronal divided into: group 1, animals receiving saline; and transmission, from apoptosis to inflammation. Most group 2, animals receiving aminoguanidine (AG) of the physiological actions are mediated by NO bursts which is a specific inhibitor of inducible-NO synthase. generated by constitutive isoforms of nitric oxide synOn day 21, rats were sacrificed after obtaining material thase (cNOS). On the other hand, when produced by for biochemical analysis. inducible NOS (iNOS), in large amounts for long Results. Histopathological examination of the kidneys periods, NO can be a cytotoxic agent [1–4]. Under of rats treated with ADR revealed focal areas of inflammatory conditions, glomerular mesangial cells, mesangial proliferation and mild tubulointerstitial endothelial cells, macrophages, neutrophils and vascuinflammation. They also had significantly higher levels lar smooth muscle cells can express iNOS. The NO of proteinuria compared with control and treatment produced by iNOS, may be one of the key elements in groups (P

BACKGROUND Protein-energy malnutrition (PEM) is associated with increased morbidity and mortality in haemodialysis (HD) patients. Insulin-like growth factor I (IGF-I) has proved to be a sensitive marker of malnutrition, while interleukin-1 (IL-1beta) and tumour necrosis factor (TNF) have been found to be raised in catabolic states. METHODS We have investigated the nutritional status of 17 chronic renal failure (CRF) paediatric patients (8 boys, 9 girls) on maintenance HD. Eight predialysis CRF children (5 boys and 3 girls; mean creatinine 5.1+/-3.2 mg/dl) and 10 healthy children served as control groups. PEM was defined according to anthropometric measurements (triceps skinfold thickness (TST), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC)). These were correlated with serum IGF-I, IL-1, TNF-alpha, transferrin, and albumin (all sampled before the HD session). RESULTS In the HD group, TST was reduced in 41.2% of the patients, whereas MAC and MAMC were reduced in 82.4 and 76.5% respectively. TST was depleted in only one of the predialysis CRF children. The degree of reduction in MAC and MAMC were 62.5 and 62.5% respectively. Median serum IGF-I level was decreased in both HD and predialysis CRF patients (205.1 interquartile range (IQR) 194.4 microg/l and 258.8 IQR 155.0 microg/l respectively) compared to the healthy children (418.0 IQR 310.5 microg/l) (P=0.0009 and P=0.01 respectively). Within the HD group, IGF-I levels were lower in patients with malnutrition defined according to TST (145.0 IQR 125.5 microg/l) compared to children with normal TST (301.2 IQR 218.8 microg/l) (P=0.05). IGF-I levels of the HD patients with malnutrition according to TST was also lower than the predialysis CRF patients and healthy children (P=0.04 and P=0.002 respectively). Serum IL-1beta was undetectable in all groups. Median serum TNF-alpha levels were higher in HD and predialysis CRF patients compared to healthy children, albeit statistically insignificant. There was no correlation between TNF-alpha, transferrin or albumin and anthropometric parameters. CONCLUSIONS Our results support the high prevalence of malnutrition in CRF children, which becomes more pronounced when treatment by HD is initiated. We suggest that determination of IGF-I levels in childhood HD patients in conjunction with anthropometric measurements is useful for identification of malnutrition. We have not been able to demonstrate the catabolic effects of cytokines on this state of protein energy malnutrition.