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Kidney transplant recipients (KTRs) are at an increased risk of infection with severe acute respiratory syndrome coronavirus 2, with mortality from 13% to over 30%. However, data concerning the influence of COVID-19 on long-term graft function in convalescents is lacking. The aim of this study was to evaluate the influence of COVID-19 on graft function at 6 months after recovery.A longitudinal controlled study was conducted in a group of 1058 KTRs. Of 180 patients with COVID-19 in the past, 77 KTRs (45 male) with a mean age 50.57 ± 13.37 years, Charlson Comorbidity Index of 3 (median; interquartile range [IQR], 3-5), Fragility Score of 3 (median; IQR, 3-3), and minimum 6 months after acute COVID-19 were included. The most common symptoms were weakness (75.33%), fever (74.03%), cough (51.95%), and loss of appetite (48.05%). Thirty-three patients were hospitalized; none required invasive ventilation therapy, but 16 required oxygen support. The treatment of COVID-19 included antibiotics (38.96%), thromboprophylaxis (25.97%), and nonsteroidal anti-inflammatory drugs, or paracetamol (25.97%).The median (IQR) values of serum creatinine 3 months before the onset and 6 months after COVID-19 were 1.25 (0.98-1.86) and 1.26 (1.03-1.78) mg/dL (nonsignificant difference); in strata analysis, there were also no differences with regards to patients with higher and lower comorbidity (3Charlson Comorbidity Index3) and fragility (3Fragility Score3). Furthermore, creatinine concentration in KTRs and controls did not differ.In the group of KTRs with a mild course of COVID-19, no negative impact of the infection on graft function was observed 6 months after transplantation.

As deviations from what is expected, anomalies are typically seen as an obstruction to making good predictions or an impulse to revise the predictive framework. Here, we consider a different possibility-that anomalies, particularly those related to cognitive processing, may be a valuable source of diagnostic information. More specifically, we hypothesize that the extent to which the prechoice information search has been atypical (anomalous) can be used to reverse-infer important latent features of the decision process. For instance, based on atypicalities in how juries examine courtroom evidence, can we infer if they were biased by media reports; or if financial traders browsed public stock market data in a way sufficiently unusual to indicate access to insider information? In our preregistered experiment, participants viewed expert opinions about financial stocks, before deciding whether to invest and get paid according to the subsequent market return, adjusted by an independent random amount. We used eye-tracking and machine-learning dimensionality reduction and anomaly detection techniques to measure the extent to which eye-movements while viewing opinions were idiosyncratic/anomalous. We found that nudging participants by disclosing the return adjustment value beforehand (thus giving them "privileged information") made their patterns of subsequently viewing opinions more idiosyncratic. With those idiosyncrasies as potential markers of top-down attentional control, we demonstrated a reverse-inference of motivation and prior knowledge from attention, predicting if people were nudged in a particular direction based on how idiosyncratically they then searched for information. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Outcomes of pregnancies after kidney transplantation were evaluated. Thirty-one pregnancies in 26 women were noted. The mean maternal age at pregnancy was 31 ± 5 years (range, 23-44 years). The interval between transplantation and conception was 54 ± 51 months (range, 7-213 months). The mean serum creatinine concentration before conception was 1.28 ± 0.4 mg/dL (range, 0.8-2.45 mg/dL), and mean estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration) was 62 ± 18 mL/min/1.73 m2 (range, 27-106 mL/min/1.73 m2). There were no maternal deaths. There was 1 case of suspected acute rejection after delivery. There was 1 case of graft loss during pregnancy. Maternal complications included edema (6/26), hypertension (7/26), increase of (2/26) or appearance of proteinuria (5/26), and preeclampsia (4/26). Mean creatinine increase during pregnancy was 0.02 mg/dL. Mean creatinine 1 year after pregnancy was 1.54 mg/dL (±0.8 mg/dL). There were 19 cesarean sections. Fetal outcomes included 25 live births, 4 abortions, and 2 stillbirths. Out of 25 live births, 22 children were considered healthy, 2 children had congenital defects, and there were 2 deaths at neonatal age. Mean pregnancy age was 35 ± 4 weeks (range, 24-40 weeks). The rate of premature deliveries was 15 of 25. Mean neonate birth weight was 2363 ± 1029 grams (range, 490-4100 grams). The rate of babies small for gestational age was 19%. During follow-up (range, 0.5-30 years) 5 of 26 patients lost grafts (between 3 and 15 years after pregnancy); most (20) of the children previously considered healthy had good long-term development. Our results confirm that risk of pregnancy in kidney transplant recipients can be accepted, and children considered healthy at delivery develop well.

Polyomavirus (PV) infection and PV-associated nephropathy (PVAN) are some of the most important problems in kidney transplantation.Our objective was to determine the incidence of PV viruria and PV replication in single-center Polish kidney transplant recipients (KTR).Urine samples from 155 cadaveric KTR were analyzed for PV viruria using quantitative real-time polymerase chain reaction and the patients were followed prospectively. The PV replication was recognized when the urine level was10Based on the PV DNA analysis, the patients were divided into 3 groups: Group 1 (n = 87; 56.1%) without viruria, Group 2 (n = 44; 28.4%) with viruria but without PV replication, and Group 3 (n =24; 15.5%) with PV replication. The presence of PV viruria was correlated with the type of immunosuppressive regimen, strongly associated with tacrolimus intake. There was no correlation between viruria and mycophenolate daily dose in the study population. In Group 3 there were 6 patients (3.9%) with high viruria (10The prevalence of BK virus infection in KTR is similar to that reported in studies from other countries. We confirmed that PV viruria can be both a good screening for PV infection and a good predictor of PVAN. Tacrolimus was the most important predictor of PV viruria and PV replication in KTR.

We compared scanpath similarity in response to repeated presentations of social and nonsocial images representing natural scenes in a sample of 30 participants with autism spectrum disorder and 32 matched typically developing individuals. We used scanpath similarity (calculated using ScanMatch) as a novel measure of attentional bias or preference, which constrains eye-movement patterns by directing attention to specific visual or semantic features of the image. We found that, compared with the control group, scanpath similarity of participants with autism was significantly higher in response to nonsocial images, and significantly lower in response to social images. Moreover, scanpaths of participants with autism were more similar to scanpaths of other participants with autism in response to nonsocial images, and less similar in response to social images. Finally, we also found that in response to nonsocial images, scanpath similarity of participants with autism did not decline with stimulus repetition to the same extent as in the control group, which suggests more perseverative attention in the autism spectrum disorder group. These results show a preferential fixation on certain elements of social stimuli in typically developing individuals compared with individuals with autism, and on certain elements of nonsocial stimuli in the autism spectrum disorder group, compared with the typically developing group.

We propose a new method of quantifying the utility of visual information extracted from facial stimuli for emotion recognition. The stimuli are convolved with a Gaussian fixation distribution estimate, revealing more information in those facial regions the participant fixated on. Feeding this convolution to a machine-learning emotion recognition algorithm yields an error measure (between actual and predicted emotions) reflecting the quality of extracted information. We recorded the eye-movements of 21 participants with autism and 23 age-, sex- and IQ-matched typically developing participants performing three facial analysis tasks: free-viewing, emotion recognition, and brow-mouth width comparison. In the emotion recognition task, fixations of participants with autism were positioned on lower areas of the faces and were less focused on the eyes compared to the typically developing group. Additionally, the utility of information extracted by them in the emotion recognition task was lower. Thus, the emotion recognition deficit typical in autism can be at least partly traced to the earliest stage of face processing, i.e. to the extraction of visual information via eye-fixations.

We performed a registered replication of the Oberman and Ramachandran (Soc Neurosci 3(3–4):348–355, 2008) study on the ‘kiki/bouba’ effect in autism spectrum conditions (ASC). The aim of the study was to test the robustness of the diminished crossmodal correspondences effect in autism, but also to verify whether this effect is not an artifact of differences in intelligence. We tested a Polish-speaking sample of 21 participants with ADOS-confirmed autism spectrum conditions (mean age 15.90) and 21 age- (mean age 15.86), sex- and IQ-matched neurotypical control participants. Procedure closely followed the replicated study. Participants’ task was to match five pairs of unfamiliar words and shapes. Matching words and shapes had similar supramodal characteristics that allowed the match. We report partial replication of the diminished ‘kiki/bouba’ effect in individuals with ASC compared to the neurotypical control group. However, we found that nonverbal intelligence also significantly contributed to task performance, but only in participants with autism, suggesting a compensatory role of intelligence. Finally, the effect of autism severity (measured by ADOS classification) was significant—crossmodal correspondences were weaker in individuals with autism, compared to those with autism spectrum diagnosis. Electronic supplementary material The online version of this article (10.1007/s00426-019-01163-9) contains supplementary material, which is available to authorized users.

Current theories propose that our sense of curiosity is determined by the learning progress or information gain that our cognitive system expects to make. However, few studies have explicitly tried to quantify subjective information gain and link it to measures of curiosity. Here, we asked people to report their curiosity about the intrinsically engaging perceptual 'puzzles' known as Mooney images, and to report on the strength of their aha experience upon revealing the solution image (curiosity relief). We also asked our participants (279) to make a guess concerning the solution of the image, and used the distribution of these guesses to compute the crowdsourced semantic entropy (or ambiguity) of the images, as a measure of the potential for information gain. Our results confirm that curiosity and, even more so, aha experience is substantially associated with this semantic information gain measure. These findings support the expected information gain theory of curiosity and suggest that the aha experience or intrinsic reward is driven by the actual information gain. In an unannounced memory part, we also established that the often reported influence of curiosity on memory is fully mediated by the aha experience or curiosity relief. We discuss the implications of our results for the burgeoning fields of curiosity and psychoaesthetics. ispartof: Cognition vol:212 pages:1-11 ispartof: location:Netherlands status: published

INTRODUCTION Sleep disturbances, similarly to constipation‑related symptoms, are common problems in patients with chronic kidney disease (CKD) and are associated with worse health-related quality of life. OBJECTIVES The aim of the study was to investigate sleep problems in conservatively treated patients with CKD and to assess association between sleep quality and constipation in that population. PATIENTS AND METHODS In this cross‑sectional study, 100 conservatively treated outpatients with CKD filled questionnaires addressing sleep quality (The Medical Outcomes Study 12‑item Sleep Scale-Revised [MOS‑Sleep‑R]) and constipation‑related symptoms (PAC‑SYM, Rome III criteria). RESULTS The T scores of none of the assessed sleep domains differed across the estimated glomerular filtration rate terciles (all P0.05). The scores from the PAC-SYM abdominal and stool subscales correlated with all assessed sleep quality domains. In both univariable and multivariable regression models adjusted for key clinical data, functional constipation, less than 7 bowel movements a week, abdominal discomfort, and pain as well as too small bowel movements were independently associated with increased prevalence ratio of decreased sleep quality. CONCLUSIONS In patients with nondialysis CKD, sleep disorders might have common etiological factors with constipation-related symptoms.

Objectives Low-density lipoprotein cholesterol (LDL-C) is the main laboratory parameter used for the management of cardiovascular disease. The aim of this study was to compare measured LDL-C with LDL-C as calculated by the Friedewald, Martin/Hopkins, Vujovic, and Sampson formulas with regard to triglyceride (TG), LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C)/TG ratio. Methods The 1,209 calculated LDL-C results were compared with LDL-C measured using ultracentrifugation-precipitation (first study) and direct (second study) methods. The Passing-Bablok regression was applied to compare the methods. The percentage difference between calculated and measured LDL-C (total error) and the number of results exceeding the total error goal of 12% were established. Results There was good correlation between the measurement and calculation methods (r 0.962–0.985). The median total error ranged from −2.7%/+1.4% (first/second study) for Vujovic formula to −6.7%/−4.3% for Friedewald formula. The numbers of underestimated results exceeding the total error goal of 12% were 67 (Vujovic), 134 (Martin/Hopkins), 157 (Samspon), and 239 (Friedewald). Less than 7% of those results were obtained for samples with TG >4.5 mmol/L. From 57% (Martin/Hopkins) to 81% (Vujovic) of underestimated results were obtained for samples with a non-HDL-C/TG ratio of Conclusions The Martin/Hopkins, Vujovic and Sampson formulas appear to be more accurate than the Friedewald formula. To minimize the number of significantly underestimated LDL-C results, we propose the implementation of risk categories according to non-HDL-C/TG ratio and suggest that for samples with a non-HDL-C/TG ratio of

Background: Constipation is a common gastrointestinal disorder that in general population is associated with worse health-related quality of life (HRQoL). The epidemiology of constipation has not been reliably determined in conservatively-treated CKD patients. We aimed to determine the prevalence of constipation and constipation-related symptoms in conservatively-treated CKD patients, to find factors associated with their altered prevalence ratio (PR), and to verify the associations between constipation and HRQoL. Methods: In this cross-sectional study, 111 conservatively-treated CKD outpatients fulfilled questionnaires that included questions addressing HRQoL (SF-36v2®), constipation-related symptoms (The Patient Assessment of Constipation-Symptoms questionnaire), the Bristol stool form scale (BSFS), Rome III criteria of functional constipation (FC), and frequency of bowel movement (BM). Results: Depending on the used definition, the prevalence of constipation was 6.6-28.9%. Diuretics and paracetamol were independently associated with increased PR of BSFS-diagnosed constipation (PR 2.86, 95% CI 1.28-6.37, P = 0.01) and FC (PR 2.67, 95% CI 1.07-6.64, P = 0.035), respectively. The most commonly reported symptoms were bloating (50.9%) and straining to pass a BM (42.7%). Abdominal discomfort (37.3%) was independently associated with worse scores in all analyzed HRQoL domains. In multiple regressions, FC and having

Background/Aims: Hypertriglyceridaemia (HTG) and reduction and dysfunction of high density lipoprotein (HDL) are common lipid disturbances in chronic kidney disease (CKD). HTG in CKD is caused mainly by the decreased efficiency of lipoprotein lipase (LPL)-mediated very low density lipoprotein triglyceride (VLDL-TG) lipolysis. It has not been clarified whether HDL dysfunction in CKD contributes directly to HTG development; thus, the aim of this study was to assess the impact of CKD progression on the ability of HDL to enhance LPL-mediated VLDL-TG lipolysis efficiency. Methods: VLDL was isolated from non-dialysis patients in CKD stages 3 and 4 and from non-CKD patients. The VLDL was incubated with LPL at the constant LPL:VLDL-TG ratio, in the absence or presence of HDL. After incubation, the VLDL was separated and the percentage (%) of hydrolyzed TG was calculated. Results: HDL presence increased the lipolysis efficiency of VLDL isolated from CKD and non-CKD patients, for the VLDL-TG> 50 mg/dl. Its effect was dependent on the VLDL-TG and HDL-cholesterol concentrations in the reaction mixtures: the higher the concentrations of VLDL-TG and HDL-cholesterol, the greater the effect. The positive impact of HDL on VLDL lipolysis was modified by CKD progression: the percentage of lipolyzed VLDL-TG in the presence of HDL decreased with a reduction in eGFR (r=0.43, p=0.009), and for patients with stage 4 CKD, no positive impact of HDL on lipolysis was observed. The percentage of lipolyzed TG correlated negatively with apoE and apoCs content in VLDL, and positively with HDL-apoCII, as well as with VLDL and HDL apoCII/ apoCIII ratios. The progression of CKD was associated with unfavourable changes in VLDL and HDL composition; apoE and apoCs levels increased in VLDL with a decrease in eGFR whereas the HDL-cholesterol level decreased. Conclusion: The progression of CKD affects lipoprotein composition and properties, and modulates the positive impact of HDL on VLDL lipolysis efficiency. In CKD patients, HDL deficiency and dysfunction can directly affect hypertriglyceridaemia development.

Existing research has shown that human eye-movement data conveys rich information about underlying mental processes, and that the latter may be inferred from the former. However, most related studies rely on spatial information about which different areas of visual stimuli were looked at, without considering the order in which this occurred. Although powerful algorithms for making pairwise comparisons between eye-movement sequences (scanpaths) exist, the problem is how to compare two groups of scanpaths, e.g., those registered with vs. without an experimental manipulation in place, rather than individual scanpaths. Here, we propose that the problem might be solved by projecting a scanpath similarity matrix, obtained via a pairwise comparison algorithm, to a lower-dimensional space (the comparison and dimensionality-reduction techniques we use are ScanMatch and t-SNE). The resulting distributions of low-dimensional vectors representing individual scanpaths can be statistically compared. To assess if the differences result from temporal scanpath features, we propose to statistically compare the cross-validated accuracies of two classifiers predicting group membership: (1) based exclusively on spatial metrics, (2) based additionally on the obtained scanpath representation vectors. To illustrate, we compare autistic vs. typically-developing individuals looking at human faces during a lab experiment and find significant differences in temporal scanpath features.

In chronic kidney disease (CKD), the level of high-density lipoprotein (HDL) decreases markedly, but there is no strong inverse relationship between HDL-cholesterol (HDL-C) and cardiovascular diseases. This indicates that not only the HDL-C level, but also the other quantitative changes in the HDL particles can influence the protective functionality of these particles, and can play a key role in the increase of cardiovascular risk in CKD patients. The aim of the present study was the evaluation of the parameters that may give additional information about the HDL particles in the course of progressing CKD. For this purpose, we analyzed the concentrations of HDL containing apolipoprotein A-I without apolipoprotein A-II (LpA-I), pre&beta, 1-HDL, and myeloperoxidase (MPO), and the activity of paraoxonase-1 (PON-1) in 68 patients at various stages of CKD. The concentration of HDL cholesterol, MPO, PON-1, and lecithin-cholesterol acyltransferase (LCAT) activity were similar in all of the analyzed stages of CKD. We did not notice significant changes in the LpA-I concentrations in the following stages of CKD (3a CKD stage: 57 &plusmn, 19, 3b CKD stage: 54 &plusmn, 15, 4 CKD stage: 52 &plusmn, 14, p = 0.49). We found, however, that the pre&beta, 1-HDL concentration and pre&beta, 1-HDL/LpA-I ratio increased along with the progress of CKD, and were inversely correlated with the estimated glomerular filtration rate (eGFR), even after adjusting for age, gender, triacylglycerols (TAG), HDL cholesterol, and statin therapy (&beta, = &minus, 0.41, p &lt, 0.001, &beta, 0.33, p = 0.001, respectively). Our results support the earlier hypothesis that kidney disease leads to the modification of HDL particles, and show that the pre&beta, 1-HDL concentration is significantly elevated in non-dialyzed patients with advanced stages of CKD.

Purpose Kidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population. Methods A representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was

Background The beneficial effect of kidney transplantation in patients requiring continuous renal replacement therapy owing to chronic kidney disease is well known and accepted. Kidney transplantation protects the patient from complications that may develop during chronic dialysis. Unfortunately, there is also evidence that kidney transplant patients are more prone to developing cancer than healthy persons. The aim of this study was to evaluate the prevalence of gastrointestinal pathologies in patients after kidney transplantation. Methods Adult patients after kidney transplantation, who are under the care of the Outpatient Department of Nephrology in Gdansk, received alarm symptom questionnaires and referral for testing for the presence of fecal occult blood. Then, in 45 selected patients (29 men and 16 women) endoscopic examination was performed. Mean age was 57.6 ± 10.1 (range, 35–83) years. Results Out of ∼940 patients after kidney transplantation, resting under supervision of outpatient department, 181 patients completed the questionnaire and 100 gave a stool sample for testing: 32 results were positive. After analyzing the questionnaires and stool results, 88 patients were qualified for further investigation. The endoscopic examination had been performed so far in 45 patients and revealed gastritis and/or duodenitis in 33 patients, diverticular colon disease in 18, esophagitis in 8, colon polyps in 14, stomach polyps in 3, inflammatory bowel disease in 7, and cancers in 3. Conclusions The preliminary results indicate that patients after kidney transplantation have significant risk of gastrointestinal pathologies and require detailed diagnostic endoscopy.

We used a perceptual closure task with Mooney images as stimuli to record eye-movement patterns in response to the same degraded image before and after perceptual learning in 21 adolescents and young adults with ASD and 23 sex-, age-, and IQ-matched typically developing individuals. In the control group, we observed changes in the eye-movement patterns between the first and the last presentation of the degraded stimulus, reflecting top-down optimization of eye-movement patterns, that is, a decrease in the number of fixations and interfixation distance, coupled with an increase in the duration of fixations. This effect was attenuated in individuals with autism, pointing to a decreased rate of perceptual learning. We also found that participants with autism displayed decreased scanpath stability, that is, a lower recurrence of fixation locations between different presentations of the same image, which may suggests a lower rate of perceptual learning or decreased predictability in the eye-movement patterns. These results provide evidence for decreased use of prior knowledge in perceptual decisions in autism. Autism Res 2019, 12: 1386-1398. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We showed autistic and typically developing participants some degraded images that were difficult to recognize for the first time, but once you knew what they represent, you could see it easily. We found that the eye-movement patterns of persons with autism did not change as much after learning what the pictures represented as in the case of typically developing participants. This means that previous experiences and knowledge change the way people with autism perceive things to a smaller extent.

Background Chronic kidney disease (CKD) associates with complex lipoprotein disturbances resulting in high cardiovascular risk. Apolipoprotein E (APOE) is a polymorphic protein with three common isoforms (E2; E3; E4) that plays a crucial role in lipoprotein metabolism, including hepatic clearance of chylomicrons and very low-density lipoprotein (VLDL) remnants, and reverse cholesterol transport. It demonstrates anti-atherogenic properties but data concerning the link between polymorphism and level of APOE in CKD patients are inconclusive. The aim of our research was to assess the relationship between APOE gene polymorphism and APOE concentration and its redistribution among lipoproteins along with CKD progression. Methods 90 non-dialysed CKD patients were included into the study. Real time PCR was used for APOE genotyping. APOE level was measured in serum and in isolated lipoprotein fractions (VLDL; IDL + HDL; HDL). Kidney function was assessed using eGFR CKD-EPI formula. Results The population was divided into three APOE genotype subgroups: E2(ε2ε3), E3(ε3ε3) and E4(ε3ε4). The highest APOE level was observed for the E2 subgroup (p

The aim of the study was not only to demonstrate whether eye-movement-based task decoding was possible but also to investigate whether eye-movement patterns can be used to identify cognitive processes behind the tasks. We compared eye-movement patterns elicited under different task conditions, with tasks differing systematically with regard to the types of cognitive processes involved in solving them. We used four tasks, differing along two dimensions: spatial (global vs. local) processing (Navon, Cognit Psychol, 9(3):353-383 1977) and semantic (deep vs. shallow) processing (Craik and Lockhart, J Verbal Learn Verbal Behav, 11(6):671-684 1972). We used eye-movement patterns obtained from two time periods: fixation cross preceding the target stimulus and the target stimulus. We found significant effects of both spatial and semantic processing, but in case of the latter, the effect might be an artefact of insufficient task control. We found above chance task classification accuracy for both time periods: 51.4% for the period of stimulus presentation and 34.8% for the period of fixation cross presentation. Therefore, we show that task can be to some extent decoded from the preparatory eye-movements before the stimulus is displayed. This suggests that anticipatory eye-movements reflect the visual scanning strategy employed for the task at hand. Finally, this study also demonstrates that decoding is possible even from very scant eye-movement data similar to Coco and Keller, J Vis 14(3):11-11 (2014). This means that task decoding is not limited to tasks that naturally take longer to perform and yield multi-second eye-movement recordings.

We investigated the effect of auditory noise added to speech on patterns of looking at faces in 40 toddlers. We hypothesised that noise would increase the difficulty of processing speech, making children allocate more attention to the mouth of the speaker to gain visual speech cues from mouth movements. We also hypothesised that this shift would cause a decrease in fixation time to the eyes, potentially decreasing the ability to monitor gaze. We found that adding noise increased the number of fixations to the mouth area, at the price of a decreased number of fixations to the eyes. Thus, to our knowledge, this is the first study demonstrating a mouth-eyes trade-off between attention allocated to social cues coming from the eyes and linguistic cues coming from the mouth. We also found that children with higher word recognition proficiency and higher average pupil response had an increased likelihood of fixating the mouth, compared to the eyes and the rest of the screen, indicating stronger motivation to decode the speech.

Introduction An increased risk of skin cancer is particularly important in patients undergoing maintenance hemodialysis (HD), who are potential transplant recipients. In transplant recipients who are exposed to immunosuppressive therapy, neoplastic skin disease my take a more aggressive course. Increased exposure to photoradiation, elderly age, a low skin phototype, sunburn during childhood, and a history of smoking are the main factors contributing to the development of skin neoplasms. Knowledge of these risk factors as well as education on sun protection should be important for such patients. Patients and methods We studied 105 HD patients (57 men, 48 women) with a mean age of 60.8 (range 25–94) years. Knowledge of skin cancer risk factors was assessed on the basis of a questionnaire regarding skin cancer risk factors. Results In the study group, 23.8% of patients claimed that they frequently and intensively engage in sunlight exposure. However, only 11.4% have started to apply sunblockers recently. Sunburn during adolescence was reported by 12.4% patients. Among the patients studied, 65.7% had skin phototype I or II, and only 34.3% had phototype III. In the investigated study group, 55.2% admitted smoking: 30.5% smoked more than 20 pack-years. Among the patients studied only 2.86% could name 3 skin cancer risk factors, 29.5% 2 risk factors, 60% 1 risk factor, and 7.6% could not name any risk factor. Conclusions The results presented prove that patients undergoing HD lack knowledge regarding skin cancer risk factors, which explains the necessity of education, particularly on the dangers of sun radiation.

Introduction Maintenance hemodialysis (HD) patients are potential transplant recipients. One of the most common cancers in the population of kidney recipients is skin neoplasm. Skin infections are also of a particular importance. In this population, especially in patients on the transplant waiting list, full dermatological examination, including dermatoscopy, should be carried out routinely. Materials and methods The research was comprised of 105 HD patients (57 men, 48 women) with a mean age of 60.8 (range 25–94) years. The patients' skin condition was assessed and a dermatoscopic examination was performed. We compared the incidence of skin diseases in the two subpopulations: HD patients (n = 89) and HD patients active on the transplant waiting list (n = 16). Results Bacterial, fungal, and viral infections in the group of HD patients occurred in 24.7%, 14.6%, and 6.7% of patients, respectively. In HD patients on the waiting list, bacterial skin diseases were reported in 12.5% of patients, and neither fungal nor viral infections were noticed. Malignant skin lesions and precancerous conditions, such as basal cell carcinoma and keratosis actinic, developed in 4.5% and 3.4% of the HD patients. These malignancies did not occur in HD patients on the waiting list. The results show proper qualification for transplantation in maintenance HD patients before the waiting list. In the group of dialysis patients, 67.4% required dermatological care, while in the HD waiting group only 12.5% required dermatological care. Conclusions The presented results prove the necessity of performing dermatological examinations on HD patients. Some dermatological skin lesions, if not diagnosed and treated, could progress to cancer after organ transplantation.

After kidney transplantation (KT), pregnancy is possible, although the risk of maternal and fetal complications is much higher than in the general population. Outcome of 22 pregnancies in 17 patients transplanted in the Gdańsk center in the period 1980-2012 was studied. Mean maternal age at pregnancy was 30 ± 5 (range, 23-39) years, interval between transplantation and conception 3.4 ± 2.5 (range, 0.6-11) years. Mean creatinine concentration before conception was 1.29 ± 0.36 (range, 0.8-2.45) mg/dL and was stable during 1 year preceding pregnancy (mean increase, 0.01 mg/dL). Nine of the 17 patients received 1 and 4 received ≥2 antihypertensive drugs, and 1 had proteinuria. Twelve of the 17 patients were primagravidas, 1 was pregnant 3 times, and 14 times. At the time of conception, 20 patients received CNI (14 cyclosporine, 6 tacrolimus), 15 antimetabolites (3 mycophenolate mofetil [MMF], 12 azathioprine), 1 mammalian target of rapamycin inhibitor (mTORi; sirolimus), and all prednisone. MMF and mTORi were discontinued before or during the 1st weeks of pregnancy. Maternal outcome: all survived the pregnancy. None experienced rejection or graft loss as a direct result of pregnancy. Maternal complications included edema (5/17), worsening of blood pressure control (5/17), and worsening (1/17) or new onset of proteinuria (2/17). Mean creatinine decrease during pregnancy was 0.06 mg/dL. Mean creatinine 1 year after pregnancy was 1.49 ± 0.53 mg/dL. There were 12 cesarean sections. Fetal outcomes: 17 live births (2 with serious congenital defects), 2 spontaneous and 1 induced abortion, 2 stillbirths. Mean pregnancy age and neonate birth weights were 35 ± 4 (range, 23-39) weeks and 2,552 ± 629 (range, 1,480-3,420) g, respectively. During mean 8.5 (range, 1-25) years of follow-up after pregnancy, 4/17 patients lost grafts. Grafts were lost in the 3rd to 7th years after pregnancy. We conclude that pregnancy does not exert a direct negative influence on patient and graft survivals; 68% of all pregnancies resulted in delivering healthy neonates.

Existing research shows that people can improve their decision skills by learning what experts 23 paid attention to when faced with the same problem. However, in domains like financial 24 education, effective instruction requires frequent, personalized feedback given at the point of 25 decision, which makes it time-consuming for experts to provide and thus prohibitively costly. 26 We address this by demonstrating an automated feedback mechanism that allows amateur 27 decision-makers to learn what information to attend to from one another, rather than from an 28 expert. In the first experiment, eye-movements of N=100 subjects were recorded while they 29 repeatedly performed a standard behavioral finance investment task. Consistent with previous 30 studies, we found that a significant proportion of subjects were affected by decision bias. In the 31 second experiment, a different group of N=100 subjects faced the same task but, after each 32 choice, they received individual, machine-learning-generated feedback on whether their pre-33 decision eye-movements resembled those made by Experiment 1 subjects prior to good 34 decisions. As a result, Experiment 2 subjects learned to analyze information similarly to their 35 successful peers, which in turn reduced their decision bias. Furthermore, subjects with low 36 Cognitive Reflection Test scores gained more from the proposed form of process feedback than 37 from standard behavioral feedback based on decision outcomes.

BACKGROUND Obesity is a well-known risk factor of many pathologies, including cardiovascular and renal diseases. The prevalence of overweight and obesity has increased markedly in an epidemic way over the past three decades, including a dramatic increase in overweight and obesity among adolescents. METHODS This study is part of the Sopkard 15 programme-a comprehensive analysis of the overall health of middle school students in the age range between 14 and 15 years with particular emphasis on the risk factors of lifestyle diseases, including metabolic syndrome, chronic kidney disease (CKD) and hypertension. Between 2006 and 2010, we examined 889 students (428 girls, 461 boys) 14 years old, and 26% of them attended classes with an extended sports curriculum. From the three separate blood pressure (BP) measurements a mean value of systolic and diastolic BP from the second and third measurements was taken into analysis. Body mass index (BMI), waist-to-height ratio (WHtR) and body fat mass calculated using bioelectrical impedance analysis (BIA), albuminuria and urine albumin-to-creatinine ratio, estimated glomerular filtration rate (eGFR) estimated on the basis of serum creatinine according to Schwartz and abbreviated Modification of Diet in Renal Disease (MDRD) formula were explored. RESULTS In the examined homogeneous population of adolescents, we found 8% of participants to be overweight and a further 8% of participants to be obese. An abnormal BMI was statistically significant and was more often present in girls compared with boys. WHtR values typical for abdominal obesity were reported in 17% of the population, significantly more often in girls 19.8 versus 12.4% in boys, P < 0.02. Albuminuria was detected in 16% of adolescents according to urinary albumin excretion (UAE) compared with 11% by an urine albumin-to-creatinine ratio (UACR) method. A higher number of participants with elevated BP were observed to be statistically significant more often in subpopulations with overweight and obesity compared with adolescents with normal weight. The relationship between obesity and hypertension was also confirmed in participants with an increased WHtR. However, no significant relationship between weight disturbances (BMI), as well as abdominal obesity (WHtR), and albuminuria was identified. CONCLUSIONS Overweight and obesity are present in a significant proportion of adolescents from a general, healthy population of middle school students in the age of 14 years. This phenomenon is strictly connected to the presence of hypertension.

We demonstrate “economies of experience” in eye-movement patterns—that is, optimization of eye-movement patterns aimed at more efficient and less costly visual processing, similar to the priming-induced formation of sparser cortical representations or reduced reaction times. Participants looked at Mooney-type, degraded stimuli that were difficult to recognize without prior experience, but easily recognizable after exposure to their undegraded versions. As predicted, eye-movement dispersion, velocity, and the number of fixations decreased with each stimulus presentation. Further analyses showed that this effect was contingent on recognition, and the selection of information from the stimulus could be informed by the identity of the presented object. Finally, our study demonstrates that after exposure to the undegraded version of the stimulus, eye-movement patterns associated with its degraded and undegraded versions become more similar. This suggests that eye-movement patterns can evolve to facilitate the optimal processing of a given stimulus via experience-driven perceptual learning.

By allocating less attention to predictable events we are able to focus on novel, unpredictable and unexpected events that require more extensive processing. This strategy should result in improved performance by optimizing the use of brain’s limited resources. Participants’ task was to look at two types of stimuli presented simultaneously at the opposite sides of a computer screen: “static” stimuli, i.e. emotionally neutral photographs; and “dynamic” stimuli, i.e. video clips presenting a moving dot. The dot moved along a predictable, semi-predictable or random trajectory. This was followed by a memory test of the static stimuli. Participants spent more time looking at the dynamic stimuli when its trajectory was less predictable. Additionally, participants who readily adjusted their dwell time allocation to the dot trajectory performed better in the memory test, as demonstrated by a positive correlation between memory test sensitivity and the rate of eye movement patterns adjustment to stimulus predictability. This suggests that people adjust gaze duration to stimulus predictability and that doing so optimizes attentional resource allocation and improves performance. However, study design did not allow to distinguish between spatial and temporal predictability, so it is impossible to estimate the impact of each type of predictability specifically.

Background The presence of chronic kidney disease (CKD) is an indicator of a worse long-term prognosis in patients with ischemic stroke (IS). Unfortunately, not much is known about renal function in the population of post-IS subjects. The aim of our study was to assess the prevalence of renal damage and impaired renal function (IRF) in the population of post-IS subjects. Methods This prospective analysis concerned 352 consecutive post-IS survivors hospitalized in Pomeranian stroke centers (Poland) in 2009. In this group estimated glomerular filtration rate (eGFR) according to MDRD (modification of diet in renal diseases) and CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formulas and urine albumin/creatinine ratio (ACR) were determined. Results Among survivors decreased eGFR (

Supplemental Digital Content is available in the text, Smouldering inflammation, thrombocytosis, and platelet hyper-reactivity are linked to malignancy. The relationships between preoperative diagnostic blood morphology parameters and cancer have been the focus of much interest, because some of these parameters are correlated with advanced cancer stages and poor patient survival rates. This study aimed to perform an observational, retrospective analysis of the intradiversity of blood platelet parameters in patients with different International Federation of Gynaecology and Obstetrics (FIGO) stages and different histological types of epithelial ovarian carcinomas (EOC), and also an analysis of the overall survival rate. In all, 94 EOC patients were included in this analysis (23 mucinous, 33 serous, 20 undifferentiated, 14 endometrioid, and 4 clear cell carcinoma cases). Peripheral blood samples were collected and analyzed before drug or surgical treatment. The platelet-to-neutrophil ratio (PNR) was related to the histological type of EOC, particularly mucinous carcinoma. In patients with mucinous cancer, the PNR was significantly lower compared with patients with nonmucinous cancer, and this parameter distinguished between mucinous and nonmucinous groups of patients (area under receiver-operating characteristic [ROC] curve 0.721 ± .056; sensitivity 82.6%; specificity 61%; P

Background: Continuous increase in the number of patients with end-stage renal disease demands early detection of chronic kidney disease (CKD). The aim of the present study was to diagnose CKD in its earliest stages in a randomly selected population using a diagnostic algorithm developed by the working group. Methods: An algorithm for the diagnostic procedure was created to identify patients with CKD requiring further nephrological care. Randomly chosen adult inhabitants of a city with a population of 60,000 were invited to participate in this study. Screening procedures included a microalbuminuria dipstick test accompanied by blood pressure measurement and medical questionnaire. In further diagnosis of CKD, estimated glomerular filtration rate (eGFR), albumin concentration in urine, urinalysis and ultrasound examination were used according to the algorithm. Multivariate logistic regression was performed to identify associations between participants’ characteristics and albuminuria. Results: Out of 9,700 invited subjects, 2,471 individuals participated in the PolNef study. Albuminuria was detected in 15.6% of the investigated population using the dipstick test and thereafter confirmed in 11.9% by the turbidimetric method. The modeling of multivariate logistic regression indicated the following independent predictors of albuminuria: male sex, diabetes, nocturia and hypertension. For people without diabetes and without hypertension, nocturia independently predicted detection of albuminuria. 481 people received a consultation with a nephrologist, and 96% of them were recognized as having CKD. At least 9% of patients with CKD had eGFR by MDRD 2. Six persons were referred for further treatment because of newly diagnosed kidney tumor. Conclusions: CKD in early stages occurs frequently in the studied population. The proposed diagnostic algorithm seems to be a powerful tool to identify subjects at risk of CKD. The role of nocturia as an independent predictor of albuminuria, both in the general population and in people without diabetes or hypertension, should be further examined.

Background Considering the increasing incidence of skin cancers in patients after renal transplantation, evaluation of skin condition in dialysis patients, from whom kidney transplant recipients are recruited, appears to be very important. Particular importance is attached to the identification of such dialysis patients in the population who require dermatologic care before qualifying for transplantation. The objective of this study was to determine the prevalence of skin diseases in the dialysis patient population. Education of the patients regarding risk factors for skin cancer and the need for sun protection was performed. Methods Full dermatologic examination, including dermatoscopy, was performed on a group of 77 dialysis patients (38 women, 39 men) and a control group of 77 healthy people (60 women, 17 men). Results Eight hemodialysis patients had healthy skin compared with 33 people from the control group. In the remaining hemodialysis patients, the following skin lesions were observed: 1) inflammatory and allergic skin disorders in 17 patients; 2) bacterial, fungal, and viral infections in 26 patients; 3) benign lesions in 39 patients; 4) malignant skin lesions and precancerous conditions in 4 patients; and 5) other skin changes in 63 patients. Conclusions Skin lesions are common in the dialysis patient population. Only 10% of the examined population had completely healthy skin, compared with 43% of the control group. More than one-half of dialysis patients required dermatologic care compared with one-third of healthy control subjects.

BACKGROUND Chronic kidney disease (CKD) has been proven to be a major risk factor of cardiovascular disease (CVD). Until now, data on the prevalence of CKD among adults in Poland were limited. The NATPOL 2011 survey is a cross-sectional observational study designed to assess the prevalence and control of CVD risk factors in Poland, and the first study capable of evaluating CKD prevalence in adult Polish citizens. METHODS Serum creatinine concentration and the urine albumin-to-creatinine ratio (ACR) were measured in 2413 randomly selected participants (ages 18-79 years) from a national survey study. CKD was diagnosed if the estimated glomerular filtration rate (eGFR) was

We investigated the clash of different types of expectations by studying event-related potentials and behavioural correlates of passive and active expectations. In the three tasks we used, target stimuli could either confirm or disconfirm both expectations, or confirm one while disconfirming the other. Depending on the task, expected events were related to either increased or decreased P300 amplitude. This was contingent on whether the expected item was probable given the context, or whether it was a target match. This suggests that the effect of expectancy on the P300 amplitude can be direct or indirect. In the case of a direct effect, the evidence suggests that most likely only unconscious, automatic estimation of stimulus probability is reflected in the size of P300 amplitude. However, active, conscious expectancies can influence the P300 activity via indirect routes, by influencing stimulus significance, by leading to the closure of perceptual epoch, or by changing the level of difficulty of processing. Such indirect effect of expectancy can have an opposite direction to the effect of automatically formed expectancies—that is, expected stimuli could be related to larger P300 amplitudes.

The aim of the study is to evaluate surgical methods for creating vascular access for hemodialysis (HD) in patients with chronic renal failure. Over the last 18 years, 1,827 surgical procedures were performed in 722 patients (399 men and 323 women, mean age 43.7 +/- 17 years) in order to provide and maintain permanent vascular access for HD. Among all the surgical procedures, 992 were based on the construction of arteriovenous fistulas (AVF) and 835 were undertaken as secondary reparative surgical procedures. A total of 992 vascular accesses have been performed, including 904 AVF on upper and 14 on lower extremities as well as insertion of 74 permanent catheters. Radiocephalic AVF (RCAVF) was the principal type of AVF (58.8%). While constructing secondary angio-access after using RCAVF on the other extremity, fistulas with usage of brachial vessels were preferred. A total of 228 AVF of this type were created, including 143 brachiocephalic (BCAVF) and 85 brachiobasilic (BBAVF) AVF. Lately, synthetic grafts (arteriovenous graft, AVG) have been used more frequently, in 90 AVF. A brachial straight graft was the main type procedure performed, with polytetrafluoroethylene (95.6%). The patency of the fistulas has been evaluated. Kaplan-Meier survival curves were calculated to determine primary, primary-assisted, and secondary patency. Log-rank analysis was used to determine differences between curves. Primary, primary-assisted, and secondary patency at 12 months and 24 months were calculated. Comparing AVF patency in two patients' age periods (18-65 years,65 years), it may be concluded that in the elderly group AVG provides better treatment for AVF. Finally, we conclude that a multidisciplinary approach to vascular access strategy offers the best option to achieve good functional AVF. Autogenous arteriovenous access should be regarded as the most suitable type in creating VA. However, individual conditions should be taken into consideration.

Hemolysis after renal transplantation in some cases is clearly related to hemolytic-uremic syndrome (HUS) and usually attributed to cyclosporine (CsA) treatment. Acute hemolysis in other recipients is related to anti-erythrocyte autoantibodies. In most cases these patients have received ABO-compatible, although ABO-nonidentical, organs, mostly from O blood group donors. We report three cases of autoimmune hemolytic anemia after renal transplantation. Two patients (patients: 1 and 2; ABO-compatible, but nonidentical kidneys) suffered acute hemolysis in the third week after transplantation. One patient (patient 3: ABO-identical kidney) suffered a chronic, subclinical course of disease beginning 5 months after transplantation. The clinical picture of this disease was completely different from HUS. The existence of severe anemia (patients 1 and 2), hyperbilirubinemia (particularly high in patient 3), increased serum lactic dehydrogenase levels, and decreased serum haptoglobin in the presence of good graft function suggested an hemolytic anemia. In all patients the direct antiglobulin test was positive. The acute or chronic symptoms of hemolysis disappeared, at 2 and 5 weeks, respectively, after conversion from CsA to tacrolimus. Hemolysis in these patients probably relates to alloantibodies derived from passenger B lymphocytes transplanted with the organs. Because hemolysis has been most frequently related to CsA therapy, it is suggested that B lymphocytes proliferated and produced antibodies because CsA effects to inhibit T-cell function generally spares B-cell activity. It is proposed that a subtype of B cells, which are resistant to CsA, produces anti-A and/or anti-B antibodies. Treatment with tacrolimus appears to be successful, probably due to its alternate, and likely more effective, manner of B-cell suppression.

Predictions optimize processing by reducing attentional resources allocation to expected or predictable sensory data. Our study demonstrates that these saved processing resources can be then used on concurrent stimuli, and in consequence improve their processing and encoding. We illustrate this “trickle-down” effect with a dual task, where the primary task varied in terms of predictability. The primary task involved detection of a pre-specified symbol that appeared at some point of a short video of a dot moving along a random, semi-predictable or predictable trajectory. The concurrent secondary task involved memorization of photographs representing either emotionally neutral or non-neutral (social or threatening) content. Performance in the secondary task was measured by a memory test. We found that participants allocated more attention to unpredictable (random and semi-predictable) stimuli than to predictable stimuli. Additionally, when the stimuli in the primary task were more predictable, participants performed better in the secondary task, as evidenced by higher sensitivity in the memory test. Finally, social or threatening stimuli were allocated more “looking time” and a larger number of saccades than neutral stimuli. This effect was stronger for the threatening stimuli than social stimuli. Thus, predictability of environmental input is used in optimizing the allocation of attentional resources, which trickles-down and benefits the processing of concurrent stimuli.

Background Cyclosporine and tacrolimus (TAC) are the most potent immunosuppressants. TAC is considered less nephrotoxic, but may be an important factor in chronic graft dysfunction. The aim of the study was to evaluate kidney function and cardiovascular risk profile in 2 groups of low immunological risk kidney allograft recipients receiving 2 TAC dosages. Materials and methods Patients were randomly assigned to 2 TAC-based treatments (group I [n = 14], standard dose; group II [n = 15], reduced dose). Patient and graft survival, graft function, occurrence of cardiovascular events (cardiac death, myocardial infarction, stroke), incidence of new-onset diabetes mellitus after transplantation, and cardiovascular risk factors were assessed over a 5-year period. Results Patient demographics and transplant characteristics were not statistically different between groups. TAC trough levels were significantly higher in group I for 24 months post transplant. Patient survival did not differ, but there were more acute rejection episodes and graft losses in group II. There were no significant differences in the rate of cardiac events. Graft function measured as serum creatinine levels and calculated glomerular filtration rate did not differ between groups. The same applies to new-onset diabetes mellitus after transplantation incidence. Office blood pressures were numerically higher in group I up to 24 months but this difference did not reach significance at any time. Similar results were obtained for serum lipids. Conclusions Immunosuppression based on low doses of tacrolimus seems to be safe in the group of low immunological risk patients but in the 60-month follow-up does not offer any clear benefits in terms of potential nephrotoxicity or cardiovascular risk.

In a perceptual decision-making task, we compared a neutral payoff and two asymmetric payoffs: a liberal one, favouring positive responses, and a conservative one, favouring negative responses. Participants were presented with ambiguous images composed of superimposed target and non-target photographs, and asked to decide whether the target dominated in the picture. Signal-detection analysis demonstrated that the liberal payoff yielded significantly higher sensitivity than other payoffs. We argue that the liberal payoff encourages confirming the target's domination, hence making it easier to ignore non-target elements of the picture. We conclude that payoff can influence perceptual decisions by changing the approach to the perceptual task, and how attention is allocated between different elements of the sensory input.

The study investigated the influence of predictions on perception—in particular, how strong but erroneous prediction coupled with poor sensory data can trigger misperceptions. Using signal detection, we tested whether predictions induced by a semantic cue change the recognition threshold (criterion) or the subjectively perceived differences between stimuli (sensitivity). In a series of 3 experiments, participants observed pictures of (a) real objects distorted to various extents (targets), (b) noise with elements corresponding to meaningful objects (foils), or (c) nonsense images (noise). Stimuli were preceded either by a semantic cue or by a blank screen with equal probability. Presence of the cue resulted in a more liberal criterion, but only for targets and foils. The cue decreased sensitivity between the distorted targets, but increased sensitivity between the targets and noise—that is, the cue increased between-class differences, but decreased within-class differences. When there was no correspondence between prediction and the sensory input, prediction actually increased the chances of correctly rejecting noise. The influence of the cue was strongest for the moderately distorted targets and foils—when uncertainty related to the bottom-up input was the highest.

SOPKARD 15 is a comprehensive programme to assess the health status of a population of teenagers. The aspects assessed in the study are: physical development, nutritional status, arterial blood pressure, lipid and carbohydrate metabolism, oral hygiene, and psychological parameters.To assess the prevalence of cardiovascular risk factors in the study population.We examined 372 children (185 girls) at the age of 14. The cut-off values for normal lipid blood levels were based on the NCEP-Peds guidelines. Body mass index was assessed on the basis of the Polish centile charts. Blood pressure values assessed against the centile charts were the mean values calculated on the basis of the second and third measurements.Systolic and diastolic blood pressure values were elevated in 15.81% and 10.90% of the subjects, respectively. Abnormal blood glucose was detected in fewer than 6% of the children. Total cholesterol was elevated in 8% and borderline in 24% of the subjects; 8.5% of children were overweight and 7.4% were obese; 5.0% of the subjects took very little physical exercise; 16.4% of boys and 23.4% of girls admitted smoking. Dental examination revealed inflamed gums in 77.6% of the subjects. The diagnosis of a depressive episode was confirmed in 4.2% of the teenagers.1. Due to the high prevalence of the risk factors there is a need to launch a comprehensive cardiovascular prevention programme among the teenagers. 2. A considerable proportion of children with lipid abnormalities indicate the need for more frequent lipid profile testing in children.

The Sopot Program of Cardiac Infarct and Stroke Prevention--SopKard 1999-2009 was established for health promotion to decrease cardio-vascular diseases mortality. To serve these purposes a new project SopKard 15 for adolescents was created. The main aim of SopKard 15 is evaluation of health status with particular attention to risk factors of civilization diseases, with chronic kidney disease (CKD) among them. In population of 14-year-old students a complex nephrological examination including medical history, blood pressure measurements, ultrasound examination, and laboratory tests with e.g. albuminuria, urinalysis, and serum creatinine and cystatin C levels was performed. Nephrology part of Program SopKard 15 aspired to early detection of CKD and verifies normal value for this age group.

Background: The world population suffering from end-stage renal disease (ESRD) is growing. The epidemiology of ESRD is relatively well documented, but data on chronic kidney disease (CKD) are missing, especially in Central and Eastern Europe (CEE). Early detection of CKD is important because it allows introduction of the therapy that slows the progression of CKD. The aim of the present study was to estimate the prevalence of CKD and ESRD in CEE. Methods: Our data are based on two independent surveys: one concerns epidemiology of CKD, the other ESRD. Moreover, we present rough results from the pilot study PolNef on early detection of CKD, performed in North Poland. Estimated glomerular filtration rate, albuminuria and ultrasound examination were the main diagnostic tools. Results: Only limited data from South-East Hungary and North Poland were available: the number of CKD patients under nephrological care and on dialysis. According to the PolNef study, using a dipstick test albuminuria was detected in 15.6% of participants but dropped to 11.9% when it was measured using the turbidimetric method. Conclusions: Data concerning epidemiology of CKD in CEE are missing. Epidemiology of ESRD in CEE seems to be similar to that in Western Europe. PolNef is the first study dealing with renal epidemiological problems in CEE. It shows that renal epidemiological problems in CEE are comparable to those of the other parts of the world. Studies concerning CKD epidemiology in different CEE countries are necessary to confirm that the incidence and prevalence of CKD are similar to those in Western Europe and other parts of the globe.

Objective Hypertension is closely associated with chronic kidney disease (CKD) and is one of the main factors of progression of CKD. Early detection of CKD allows introducing a therapy that slows the progression of CKD. Setting A prevalence of hypertension and effectiveness of its treatment were assessed during the accomplishment of the Program for Early Detection of CKD in Poland (PolNef). Results In 456 of a total of 2476 participants of PolNef program (269 females, 187 males), CKD was recognized. Diagnosis of CKD was made according to classification proposed by K/DOQI and KDIGO. Estimated glomerular filtration rate (eGFR) from serum creatinine, albuminuria and ultrasound examination were the main diagnostic tools. Hypertension was defined on the basis of actual antihypertensive treatment or on the basis of medium value (≥140 and/or ≥90) of three separate measurements of blood pressure. Frequency of hypertension and effectiveness of its treatment, frequency of overweight and obesity, microalbuminuria, and abnormalities in ultrasound examination of urinary system were studied. Conclusion Of the CKD population, 68% were hypertensive, 21% remained without antihypertensive medication, and 22% on medication were effectively treated. Kidney insufficiency with eGFR below 60 ml/min/1.73 m 2 was recognized in 9% of CKD population. Also, 63% of women and 39% of men without hypertension had normal body mass compared to 19% of people with CKD and hypertension. Microalbuminuria was found in 51% of women and 66% of men with CKD and hypertension. Increased echogenicity of kidney and simple cysts were detected significantly more often in hypertensive patients.

Sympathetic activation may contribute to both cardiovascular morbidity and the progression of chronic kidney disease. The role of the chemoreceptors in determining sympathetic nerve discharge in patients with chronic renal failure (CRF) is unknown. We tested the hypothesis that tonic activation of excitatory chemoreceptor afferents contributes to the elevated sympathetic activity in patients with CRF.Utilizing a double-blind, randomized, vehicle-controlled design, we examined the effects of chemoreflex deactivation on muscle sympathetic nerve activity (MSNA). We compared effects of breathing 100% oxygen for 15 min with effects of breathing room air for 15 min in 12 stable patients with CRF and in 12 control individuals with similar age, gender, blood pressure and body mass index.The baseline MSNA was elevated significantly in the patients with CRF as compared with the control individuals (50 +/- 2 vs 42 +/- 2 bursts/min; P0.05). Reductions in systolic blood pressure and pulse pressure in response to the administration of 100% oxygen were significantly different from those observed during administration of room air in patients with CRF. In patients with CRF, MSNA decreased by 29 +/- 7% (P0.01) during hyperoxia but did not change during administration of room air (5 +/- 6%; P = NS). By contrast, neither 100% oxygen or room air changed any measures in control individuals.Tonic activation of excitatory chemoreflex afferents contributes to increased efferent sympathetic activity to muscle circulation and to blood pressure control in patients with CRF. These findings may have important implications for understanding mechanisms underlying the link between CRF and cardiovascular disease.

Objective Chronic hemodialysis may lead to losses of carnitine from plasma and muscles. The aim of the present study was a comparison of carnitine contents in different human muscles (brachioradialis muscle and rectus muscle of abdomen) and evaluation of the correlation between plasma and tissue carnitine concentrations in patients receiving hemodialysis and healthy control patients. Methods The studies were performed in two groups of patients receiving hemodialysis. The first group included 37 patients (18 male, 19 female) (muscle specimen was taken from the brachioradialis muscle). The second group included 28 patients (15 male, 13 female) (muscle specimen was taken from the rectus muscle of abdomen). The other two separate groups of patients without renal involvement served as the controls. Results Significantly lower free plasma and free muscle carnitine (FMC) contents were noticed in patients receiving hemodialysis in comparison with the controls. Significantly higher total muscle carnitine (TMC) and FMC concentrations in the brachioradialis muscle in comparison with the rectus muscle of abdomen were observed in both the hemodialysis and control groups. Negative correlations between TMC, FMC, and FMC/TMC ratio versus duration of hemodialysis were found. No correlations between muscle and serum carnitine levels were observed. Conclusions Patients receiving hemodialysis are carnitine deficient. Tissue carnitine depletion is related to hemodialysis duration. Carnitine concentration in blood does not represent the whole carnitine stores in patients receiving hemodialysis. Brachioradialis muscle carnitine contents are significantly higher than those in the rectus muscle of abdomen.

Congenital heart diseases are the most frequent anomalies and one of the most important reasons of mortality and morbidity in neonates and infants. Coincidence of additional malformation aggravates prognosis. The frequency of incidence of other anomalies accompanying congenital hart diseases is defined as 11 to 45%.Estimation of the frequency of a coincidence of congenital kidney anomalies on the basis of the ultrasound examination (US) in children with congenital heart disease in first year of life.Abdominal US were done in 350 neonates and infants hospitalized in Department of Pediatric Cardiology Medical University of Gdansk in the first twenty-four hours after diagnosis of congenital heart disease. Examinations were performed in 187 male (53%) and 163 female (47%) in average age 54.9 days (range from 1 to 349 days).In examined population congenital kidney anomalies were found in 4.9% of children from which 18% represent hipoplasia, and another 18% dysplasia. 15.3% of examined patients were diagnosed by dilatation of collecting system, whereof 3% mild, 7% moderate, and 5% severe degree.1. The frequency of incidence of kidney anomalies and collecting system dilatation in the examined population of neonates and infants with congenital heart disease accounts for 20.2%. 2. Abdominal ultrasound screening with carefully examination of urinary tract should be performed in neonates and infants with congenital heart disease.

The results from previous trials suggested that tacrolimus-based treatment in kidney transplantation was associated with a significantly lower incidence of acute rejection, and that cyclosporine microemulsion (CsA-Me)-treated patients converted to tacrolimus had numerically better 6-year graft survival than those remaining on CsA-Me. Death with a functioning graft and chronic graft nephropathy are the leading causes of late allograft loss. While standard cardiovascular risk factors are relevant, renal function itself becomes an important risk factor for cardiovascular morbidity and mortality in kidney transplantation patients. Expected benefits of the conversion from CsA-Me to tacrolimus with respect to renal function and cardiovascular status were the rationale for this observational study. Twenty one patients underwent conversion due to nephrotoxicity of cyclosporine (n = 18) or side effects (n = 3). Two out of 21 patients did not complete the study. The patient survival after 1 year was 100% in this group of patients; graft survival 94.7%. No cases of de novo diabetes mellitus were identified. Mean serum creatinine fell from 2.13 +/- 0.4 to 1.84 +/- 0.3 mg/dL (P < .02) and calculated glomerular filtration rate increased from 49.6 +/- 14.4 to 56.2 +/- 15.5 mL/min (P < .01). Total cholesterol decreased from 229.4 +/- 50.1 to 195.9 +/- 28.5 mg/dL (P < .005) and, low-density lipoprotein cholesterol from 125.7 +/- 37.3 to 104.4 +/- 22.6 mg/dL (P < .02). No significant changes in mean systolic or diastolic pressure or blood glucose levels were observed. The results of this observational study showed that in a group of patients with raised creatinine levels at entry, conversion to tacrolimus resulted in improved graft function and a more favorable cardiovascular risk profile.

Continuous increase of the number of patients with chronic kidney failure which require renal replacement therapy, in Poland as all as over the world, demands the analysis of epidemiological situation concerning renal diseases. Early diagnosis of nephropathy permits not only an adequate treatment, but also facilitates the introduction of the therapy that slows the progression of kidney failure. The aim of the pilot study PolNef was an attempt to evaluate the epidemiology of renal diseases in Poland on the basis of a randomly selected population from a city numbering 60 thousand people. As a screening test, allowing to distinguish patients requiring further diagnostic of nephropathy, the microalbuminuria dipstick test accompanied by blood pressure measurement and questionnaire was accepted. Microalbuminuria was detected in more than 18% of the population investigated up till now. It was more frequent in male, in obese, and in smokers. More than 33% of all participants consulted by the nephrologist required permanent nephrological care and for the next 32% another nephrological consultation in 6 to 12 month should be ordered. Decreased clearance of creatinine was found in above 17% participants and 6 patients were referred for further treatment because of new diagnosis of renal tumor. Identification in investigated population patients with of an early stage of kidney disease needs further nephrological diagnosis and treatment is especially important from the point of view of every single patient and also may bring substantial economic benefits for health protection system as well.