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Transplantacija bubrega značajno poboljšava kvalitetu, ali i očekivano trajanje života bolesnika. Veliki nesrazmjer između broja dostupnih i potrebnih organa produljuje vrijeme čekanja na transplantaciju. Visoka smrtnost u populaciji bolesnika na hemodijalizi uz prihvatljive ishode transplantacije bubrega od darovatelja po proširenim kriterijima rezultirali su sve češćim transplantacijama organa od starijih darovatelja. Prikazujemo slučaj transplantacije bubrega 83-godišnjeg darovatelja primatelju starom 72 godine. Odgovarajuća priprema darovatelja nakon moždane smrti u jedinici intenzivnog liječenja, preimplantacijska biopsija i kratko vrijeme hladne ishemije bili su ključ za procjenu prihvaćanja organa za transplantaciju i rezultirali su primarnom funkcijom presatka. Primatelj starije životne dobi bez značajnijih pridruženih bolesti, kratko liječenje dijalizom uz odgovarajuće postoperativno praćenje bolesnika i imunosupresivne terapije rezultirali su brzim oporavkom bolesnika bez intraoperativnih i ranih postoperativnih komplikacija te kratkim trajanjem hospitalizacije., Kidney transplantation ensures not only the improvement of the patient’s quality of life but also extends life expectancy. A significant disproportion between the numbers of available and needed organs for transplantation has led to prolonged wait time for a kidney transplant. Since mortality rates for hemodialysis patients are manifold higher when compared to general population of the same age, organs from older donors are increasingly being accepted. We report the case of kidney transplantation in a 72-year-old recipient who received kidney from an 83-year-old deceased donor. Proper care of deceased donor in the intensive care unit, preimplantation biopsy and short cold ischemia time were crucial for organ acceptance and resulted in immediate graft function. Adequately prepared older recipient, with short period on hemodialysis, appropriate postoperative monitoring and immunosuppressive therapy resulted in quick recovery of the patient, without intraoperative or early postoperative complications, and a short inpatient stay.

Breast cancer is the most common neoplasm and the fi fth cause of death among females. The etiology and pathogenesis of this malignancy are multifactorial. The occurrence of neoplasms in solid organ recipients treated with immunosuppressive drugs is 2 to 3 times higher than in the general population. Females with kidney transplants are also in the at-risk population. The aim of this article is to review recent literature on immunosuppression and the effect it has on breast cancer prevalence in kidney transplant recipients; to discuss the proposed pathologic mechanisms of breast cancer owing to concurrent immunosuppressive treatments; and to review breast cancer screening recommendations for kidney transplant recipients. To attain relevant literature, we conducted literature search using PubMed databases, see PRISMA Diagram (Figure 1). The following MeSH Terms were used in the search: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; "immunosuppression”; and “cancer”. We reviewed a total of 409 articles after having applied exclusion criteria. These articles included randomized controlled trials, reviews, and systematic reviews. Importantly, we also utilized references from other review/primary research articles to attain additional relevant information previously not captured from our initial research. Breast cancer is the third leading malignant cause of death in Croatia, preceding lung and colorectal carcinoma. Generally, breast cancer develops due to a combination of hormonal, genetic and age-related factors. However, a signifi cant risk factor and critical motif in carcinogenesis is immunosuppression. Carcinogenic environmental factors, disturbed function of the immune system due to chronic use of immunosuppressive drugs, and genetic make-up infl uence the process of carcinogenesis in transplant patients. Immunosuppression reduces immunosurveillance that predisposes patients to increased viral oncogenesis and general carcinogenesis causing cancer to be the second most frequent cause of death in post-kidney transplant patients. Particularly, kidney transplant recipients are prone to carcinogenesis due to lifelong immunosuppressive regimens. Importantly, differences in cancer risk depend on the kidney recipient's cancer type. Certain malignancies, such as breast cancer, are not affected by immunosuppression as their relative risk is comparable to that of the general population. Due to the limited number of articles addressing post-transplant breast cancer (PTBC), we present here a comprehensive review of the topic, current understanding of its pathophysiology, and the role of screening in its diagnosis, treatment and overall management. The risk of developing PTBC in kidney transplant recipients is not increased when compared to the general population. It appears that the development of breast cancer in kidney transplant recipients is unrelated to transplantation immunosuppressive regimen and is mostly associated with aging and independent risk factors that can lead by themselves to kidney transplantation such as diabetes mellitus. Due to screening programs, PTBC is usually diagnosed early. However, if PTBC is diagnosed in advanced grades, it is associated with signifi cantly increased mortality risk. Therefore, it is recommended that patients be screened periodically compared to their age- and gender-matched counterparts from the general population. Notably, this is an area of ongoing research and requires further investigation. Due to the rarity of PTBC and scarce resources on the topic, most guidelines are extrapolated from the general population and are not corresponding to the minimal risk of developing PTBC. Similarly, treatment guidelines are inferred from the general population and do not account for the particular considerations in these patients such as graft survival, graft rejection, nephrotoxic chemotherapeutic drugs, and concurrent administration of immunosuppression. It is worth mentioning that the heterogeneity of results discussed in our review is perhaps due to differing immunosuppressive regimens, type of organ transplantation, concomitant comorbidities, length of follow-up, and screening protocols used. To draw clear guidelines tailored for this population, further investigation into the mechanisms of disease is warranted, with prolonged follow-up time in patients on differing immunosuppressive regimens to allow for subsequent comparison., Rak dojke najčešća je novotvorina i peti uzrok smrti žena. Etiologija i patogeneza ovoga zloćudnog tumora su multifaktorske. Pojava neoplazma u primatelja solidnih organa liječenih imunosupresivnim lijekovima je 2 do 3 puta veća nego u općoj populaciji. U rizičnoj populaciji su i žene s presađenim bubregom. Cilj ovoga pregleda literature je istražiti povezanost pojavnosti karcinoma dojke u primatelja bubrežnog presatka i imunosupresivnih režima, opisati njihovu ulogu u tom procesu te istražiti trenutne preporuke probira za rano otkrivanje karcinoma dojke u toj populaciji. Kako bismo pristupili potrebnoj literaturi koristili smo bazu podataka PubMed-a. MeSH pojmovi uporabljeni za pretragu baze literature su bili: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; “immunosuppression” i “cancer”. Nakon primjene kriterija isključenja ukupno je pregledano 409 članaka. Članci su uključivali randomizirana kontrolna istraživanja, preglede i sustavne preglede literature. Uporabljene su i reference s drugih pregleda literature kako bi se pribavile dodatne relevantne informacije koje potencijalno nisu bile dohvaćene pri inicijalnoj pretrazi. Karcinom dojke najdijagnosticiraniji je karcinom i ujedno peti vodeći uzrok smrti žena u svijetu. Karcinom dojke je na trećem mjestu liste malignih uzročnika smrti, odmah iza karcinoma pluća i kolorektalnog karcinoma. Karcinom dojke je uzrokovan kombinacijom hormonskih i genetskih čimbenika te čimbenika vezanih uz starenje. Značajan čimbenik procesa kancerogeneze je imunosupresija, što potvrđuje dva do tri puta češća pojavnost malignih bolesti u populaciji primatelja transplantiranih organa. Kronična imunosupresivna terapija, okolišni čimbenici (izlaganje sunčevu zračenju) i genetički zapisi pojedinaca utječu na proces razvoja malignih bolesti u primatelja transplantiranih organa. Imunosupresivni lijekovi smanjuju imuni nadzor, što pospješuje proces virusne onkogeneze te opće karcinogeneze. Primatelji bubrežnog presatka skloniji su razvoju karcinoma upravo zbog doživotne imunosupresivne terapije pa je karcinom drugi uzročnik smrtnosti kod te populacije. Od iznimne važnosti je spomenuti da razlike u procijenjenom riziku razvoja karcinoma ovise upravo o vrsti karcinoma. Pokazalo se da imunosupresija ne utječe na određene maligne bolesti poput karcinoma dojke, jer je njihov relativni rizik usporediv s onim u općoj populaciji. Zbog ograničenog broja radova koji se bave tematikom karcinoma dojke nakon transplantacije bubrega ovom prigodom predstavljamo sveobuhvatan pregled dosadašnje literature, trenutnog razumijevanja patofi ziologije bolesti, uloge probira u- njenoj dijagnozi i liječenju. Opsežnim pregledom literature došli smo do zaključka da rizik razvoja karcinoma dojke nakon transplantacije u primatelja bubrežnog presatka nije povećan u usporedbi s općom populacijom. Iz pregledanih radova proizlazi zaključak da razvoj karcinoma dojke u primatelja bubrežnog presatka nije povezan s post-transplantacijskim imunosupresivnim režimom te je uglavnom povezan sa starenjem i neovisnim čimbenicima rizika koji sami po sebi mogu dovesti do transplantacije bubrega, kao što je dijabetes melitus. Zbog programa probira za rano otkrivanje karcinoma post-transplantacijski karcinom dojke obično se dijagnosticira rano. Međutim, ako ga se dijagnosticira u uznapredovalim stadijima povezan je sa značajno lošijim ishodom i povećanom razinom smrtnosti u usporedbi s općom populacijom. Preporuka je da se probir bolesnika provodi zajedno s općom populacijom koja odgovara dobi i spolu bolesnika s presatkom, uz naglasak na individualni pristup svakom bolesniku. Iznimno je važno napomenuti da je ovo područje medicine koje zahtijeva daljnje istraživanje. Zbog rijetkosti post-transplantacijskog karcinoma dojke i oskudnih resursa na tu tematiku većina smjernica ekstrapolirana je iz opće populacije i ne odgovara minimalnom riziku od razvoja te bolesti. Slično tome, smjernice za liječenje izvedene su iz podataka opće populacije i ne uzimaju u obzir posebna razmatranja kod populacije pacijenata s bubrežnim presatkom kao: održavanje funkcionalnog presatka, odbacivanje presatka, nefrotoksične kemoterapijske lijekove i istodobnu primjenu imunosupresivnih lijekova. Potrebno je spomenuti da je heterogenost rezultata o kojima se raspravlja u našem pregledu literature posljedica različitih vrsta imunosupresivnih režima, transplantiranih organa, pridruženih bolesti, duljine praćenja bolesnika i programa probira. Kako bi se defi nirale jasne smjernice prilagođene ovoj populaciji, potrebno je daljnje istraživanje mehanizama nastanka bolesti, uz produljeno vrijeme praćenja pacijenata na različitim imunosupresivnim režimima kako bi se omogućila naknadna usporedba.

Delirium can manifest as a neurological complication after COVID-19 in immunocompromised patients. To date, several reports have described delirium associated with SARS-COV-2 infection in older patients. Herein we present a case of a younger adult with a kidney transplant, who became disoriented, confused, and restless after acute COVID-19 and was admitted to the psychiatric ward for delirium management. He recovered and had a stable allograft function in follow-up., Delirij se može manifestirati kao neurološka komplikacija nakon COVID-19 kod imunokompromitiranih bolesnika. Do danas je u nekoliko istraživanja opisan delirij u starijih osoba nakon infekcije COVID-19. Prikazali smo mlađeg bolesnika s presatkom bubrega koji je nakon preboljene infekcije SARS-CoV-2 postao dezorijentiran, zbunjen, nemiran i agresivan te je primljen na psihijatrijski odjel zbog liječenja delirija. Stanje bolesnika se postupno popravilo, a funkcija presatka bubrega ostala je stabilna.

Anemija kronične bubrežne bolesti (KBB) je multifaktorska i uključuje poremećaj željeza (apsolutni ili funkcionalni manjak), nedostatnu proizvodnju eritropoietina, gubitak krvi, stanje kronične infl amacije s povišenim hepcidinom i čimbenike vezane uz prisutno kronično stanje hipoksije (hypoxia-inducible factor, HIF). Temelj današnjeg liječenja anemije KBB čini primjena eritropoietina uz liječenje preparatima željeza, no više razine hemoglobina (Hb >130 g/L) povezane su s povišenim rizikom neželjenih kardiovaskularnih i cerebrovaskularnih događaja, trombozama vaskularnih pristupa kao i činjenici progresije u završni stadij KBB-a i ukupne smrtnosti. Liječenje anemije u bolesnika s KBB temelji se na postojećim smjernicama KDIGO (Kidney Disease: Improving Global Outcomes) iz 2012. godine. Hrvatske smjernice za liječenje anemije KBB-a objavljene su 2014. godine. Od tada do danas, temeljem brojnih istraživanja i kliničkom praksom došlo je do novih izmjena u suvremenom shvaćanju liječenja anemije KBB-a. Hipoksija-inducibilni faktori-inhibitori domene prolil hidroksilaze (HIF-PHI) nova su klasa oralno primijenjenih lijekova za liječenje anemije KBB-a, aktivirajući put osjetljivosti na razinu kisika HIF-a. Dokazana je njihova učinkovitost u prekliničkim i kliničkim studijama u korekciji i održavanju razine Hb u predijaliznih/dijaliznih bolesnika smanjujući razinu hepcidina i modulirajući metabolizam željeza, a smatra se da imaju i učinke izvan eritropoeze. Slijedom navedenog, ptikazujemo osvrt i preporuke za liječenje anemije KBB-a prilagođene trenutnim spoznajama 2021. godine., Multiple factors are involved in the pathogenesis of anemia in chronic kidney disease (CKD), including iron defi ciency, inadequate production of erythropoietin (Epo), hepcidin, and hypoxia-inducible factors (HIFs). Renal anemia is the result of CKD and deteriorates with disease progression. Erythropoiesis-stimulating agents administered either subcutaneously (sc.) or intravenously (iv.), along with iron therapy, are currently the cornerstones for treating anemia, but higher hemoglobin (Hb >130 g/L) increases the risk of cardiovascular and cerebrovascular events, vascular access thrombosis, progression to end-stage renal disease, and overall mortality. Treatment of anemia in patients with CKD is based on current guidelines. The latest version of Croatian guidelines for anemia was published in 2014. Since then, on the basis of research and clinical practice, there have been numerous changes in modern understanding the treatment of anemia in CKD. Hypoxia-inducible factor-prolyl hydroxylase domain inhibitors (HIF-PHIs) are a new class of orally administered drugs for the treatment of anemia in CKD. HIF-PHIs activate the HIF oxygen-sensing pathway and are effi cacious in correcting and maintaining Hb, reduce hepcidin and modulate iron metabolism, and are predicted to have effects beyond erythropoiesis. Consequently, we hereby publish a review on the recent recommendations for treating anemia in CKD 2021.

U cijelom je svijetu arterijska hipertenzija (AH) glavni potencijalno modificirajući čimbenik rizika za pobol i smrtnost. Mjerenje arterijskog tlaka temelj je za postavljanje dijagnoze i liječenje AH-a, a kontinuirano mjerenje arterijskog tlaka (KMAT-a) najinformativnija je od dostupnih metoda i kao takva nezaobilazna u svakodnevnome kliničkom radu. Ovaj dokument, utemeljen na smjernicama Europskoga društva za hipertenziju o kontinuiranome mjerenju arterijskoga tlaka, daje preporuke o pravilnome odabiru uređaja, načinu korištenja, indikacijama za korištenje te interpretaciju nalaza KMAT-a. Radi boljeg razumijevanja svih informacija koje KMAT daje, njihovoga značaja i terapijskih implikacija, svaki od segmenata interpretacije KMAT-a potkrijepljen je kratkim tekstovima s pojašnjenjima i osvrtima na ključne studije.

Infections are a common complication arising after kidney transplantation with a high rate of morbidity and mortality. Since the beginning of the COVID-19 pandemic, it has been reported that the kidney transplant recipient population have the worst outcome and highest rate of mortality. The pandemic greatly influences the management of chronic kidney failure and transplantation programs. This review describes clinical presentation and risk factors linked to COVID-19, the management and outcomes, COVID-19 vaccination in kidney transplant recipients, and the impact of COVID-19 on renal transplantation programs., Infekcije su česta komplikacija nakon transplantacije bubrega. Povezane su s visokom stopom pobola i smrtnosti. Od samog početka pandemije COVID-19 uočeno je da bolesnici s transplantiranim bubregom imaju lošije ishode i višu stopu smrtnosti u usporedbi s općom populacijom. Pandemija COVID-19 je značajno utjecala na zbrinjavanje bolesnika sa završnim stadijem kronične bubrežne bolesti i na transplantacijske programe. Prikazujemo klinički nastup, čimbenike rizika, liječenje i ishode COVID-19 u populaciji bolesnika s transplantiranim bubregom, kao i utjecaj pandemije na transplantacijske programe.

Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation.Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR Results In the intent-to-treat population (everolimus n=1022, MPA n=1015), the primary end point incidence was 48.2% (493) with everolimus and 45.1% (457) with MPA (difference 3.2%; 95% confidence interval, -1.3% to 7.6%). Similar between-treatment differences in incidence were observed in the subgroups of patients who received tacrolimus or cyclosporine. Treated biopsy-proven acute rejection, graft loss, or death at post-transplant month 12 occurred in 14.9% and 12.5% of patients treated with everolimus and MPA, respectively (difference 2.3%; 95% confidence interval, -1.7% to 6.4%). De novo donor-specific antibody incidence at 12 months and antibody-mediated rejection rate did not differ between arms. Cytomegalovirus (3.6% versus 13.3%) and BK virus infections (4.3% versus 8.0%) were less frequent in the everolimus arm than in the MPA arm. Overall, 23.0% and 11.9% of patients treated with everolimus and MPA, respectively, discontinued the study drug because of adverse events.Conclusions In kidney transplant recipients at mild-to-moderate immunologic risk, everolimus was non-inferior to MPA for a binary composite end point assessing immunosuppressive efficacy and preservation of graft function.

Background. The safety profiles of standard therapy versus everolimus with reduced-exposure calcineurin inhibitor (CNI) therapy using contemporary protocols in de novo kidney transplant recipients have not been compared in detail. Methods. TRANSFORM was a randomized, international trial in which de novo kidney transplant patients were randomized to everolimus with reduced-exposure CNI (N = 1014) or mycophenolic acid (MPA) with standard-exposure CNI (N = 1012), both with induction and corticosteroids. Results. Within the safety population (everolimus 1014, MPA 1012), adverse events with a suspected relation to study drug occurred in 62.9% versus 59.2% of patients given everolimus or MPA, respectively (P = 0.085). Hyperlipidemia, interstitial lung disease, peripheral edema, proteinuria, stomatitis/mouth ulceration, thrombocytopenia, and wound healing complications were more frequent with everolimus, whereas diarrhea, nausea, vomiting, leukopenia, tremor, and insomnia were more frequent in the MPA group. The incidence of viral infections (17.2% versus 29.2%; P < 0.001), cytomegalovirus (CMV) infections (8.1% versus 20.1%; P < 0.001), CMV syndrome (13.6% versus 23.0%, P = 0.044), and BK virus (BKV) infections (4.3% versus 8.0%, P < 0.001) were less frequent with everolimus. CMV infection was less common with everolimus versus MPA after adjusting for prophylaxis therapy in the D+/R− subgroup (P < 0.001). Study drug was discontinued more frequently due to rejection or impaired healing with everolimus, and more often due to BKV infection or BKV nephropathy with MPA. Conclusions. De novo everolimus with reduced-exposure CNI yielded a comparable incidence, though a distinctly different pattern, of adverse events versus current standard of care. Both regimens are safe and effective, yet their distinct profiles may enable tailoring for individual kidney transplant recipients

Zbog razvoja visoko aktivne antiretroviralne terapije (HAART) produljen je životni vijek HIV pozitivnih bolesnika zbog čega im raste rizik razvoja kroničnih bolesti među kojima je i kronična bubrežna bolest. Terapijske opcije za nadomještanje bubrežne funkcije uključuju peritonejsku dijalizu, hemodijalizu i transplantaciju bubrega. HIV infekcija je dugo bila apsolutna kontraindikacija za transplantaciju bubrega zbog bojazni od primjene imunosupresijske terapije. Danas se, zbog napretka na području antiretroviralne terapije i zbog boljeg razumijevanja farmakoloških interakcija između HAART i imunosupresije, uspješno provodi. Mi smo do sada u KBC-u Zagreb uspješno proveli transplantaciju bubrega u dva HIV pozitivna bolesnika., With development of highly active antiretroviral therapy (HAART), HIV positive patients have longer life expectancy and therefore a higher risk of developing chronic diseases such as chronic kidney disease. HIV associated nephropathy is one of the most common causes of end stage renal failure in HIV positive patients. Therapy choices for renal replacement therapy for those patients are peritoneal dialysis, hemodialysis and kidney transplantation. HIV infection was considered as absolute contraindication for transplantation due to fear from consequences of immunosuppression. Today, with HAART and better understanding in pharmacology, interactions between HAART and immunosuppression, kidney transplantation is an option in HIV positive patients. Two cases of deceased-donor kidney transplantation in HIV positive patients were performed at the Zagreb University Hospital Centre.

Transplantacija bubrega je najbolja metoda nadomještanja bubrežne funkcije za sve bolesnike sa završnim stadijem kronične bubrežne bolesti koji nemaju kontraindikacije za operativni zahvat i za primjenu imunosupresijske terapije (1). Republika Hrvatska je jedna od vodećih zemalja svijeta po broju darovatelja organa, ali i po broju transplantacija bubrega na milijun stanovnika. To je rezultat dugogodišnjih napora svih subjekata uključenih u proces donacije i transplantacije organa uz snažnu podršku medija, crkve i opće populacije.

The aim of the current study was to determine whether plasmapheresis in combination with chemotherapy could significantly remove free light chains (FLC) in multiple myeloma (MM) patients with acute kidney injury (AKI) and therefore improve renal recovery and patient survival. During the study period, 29 patients with MM and AKI presented to our unit and were treated with two different therapy modalities (plasmapheresis with chemotherapy or bortezomib). At the end of treatment, a significant decrease of FLCs was present in the group treated with plasmapheresis compared to the bortezomib group. Patients treated with plasmapheresis had similar survival compared to patients treated with bortezomib. There was a significantly higher decrease of FLCs and longer survival in patients treated with three or more plasmapheresis sessions than in patients treated with two plasmapheresis sessions. Plasmapheresis therapy still remains a useful and effective method in the treatment of AKI in MM patients. Plasmapheresis significantly reduces FLCs compared to bortezomib especially with higher number of plasma exchange sessions but it must be combined with other chemotherapy agents in order to prolong renal recovery and therefore patient survival.

Compliance is a major obstacle to achieving phosphorus control in the majority of patients with end-stage renal disease. We investigated self-reported medication adherence and its correlation with serum phosphate levels and nutritional status in hemodialysis patients. A total of 417 patients from Croatia, Montenegro and Bosnia and Herzegovina, mean age 63.82 (range, 21-92) years, were included in the study. There were 55.1% of male patients with the mean dialysis vintage of 68.67 (range, 3-456) months. A signifi cant positive correlation was found between self-reported adherence and serum phosphorus (0.192), and negative correlation with hemoglobin, prealbumin, albumin, Kt/V and residual diuresis (-0.187, -0.227, -0.100, 0.192, and -0.106, respectively). On the other hand, the number of pills taken daily correlated signifi cantly with residual diuresis, serum prealbumin, serum glucose, triglycerides, ferritin and ultrafi ltration volume (0.241, 0.154, 0.158, 0.112, 0.201 and 0.125, respectively). In conclusion, self-reported medication adherence correlates with serum phosphate levels, residual diuresis and nutritional status in hemodialysis patients., Suradljivost je glavna prepreka kontroli fosfora u većine bolesnika sa završnim stadijem kronične bubrežne bolesti. Istražili smo povezanost suradljivosti s uzimanjem lijekova, procijenjene od strane samih bolesnika, s koncentracijom fosfora u serumu i statusom uhranjenosti bolesnika na hemodijalizi. U istraživanje je uključeno 417 bolesnika iz Hrvatske, Crne Gore i Bosne i Hercegovine. Prosječna dob bila je 63,82 godine (raspon, 21-92), 55,1 % ih je bilo muškog spola, prosječno liječenih dijalizom 68,67 (raspon, 3-456) mjeseci. Nađena je statistički značajna pozitivna korelacija između suradljivosti i serumskog fosfora (0,192), a negativna s prealbuminom, albuminom, Kt/V i ostatnom diurezom (redom, -0,187, -0,227, -0,100, 0,192 i -0,106). S druge strane, broj dnevno unesenih tableta je statistički značajno korelirao s ostatnom diurezom, serumskim prealbuminom, glukozom, trigliceridima, feritinom i volumenom ultrafi ltracije (redom, 0,241, 0,154, 0,158, 0,112, 0,201 i 0,125). Zaključno, samoprocijenjena suradljivost bolesnika korelira sa serumskim fosforom, ostatnom diurezom i statusom uhranjenosti bolesnika na hemodijalizi.