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18. PREGNANCY AND THE KIDNEY

Author

Stoumpos, S., primary, McNeill, S. H., additional, McPherson, K., additional, Gorrie, M., additional, Mark, P. B., additional, Brennand, J. E., additional, Geddes, C. C., additional, Deighan, C. J., additional, Gerasimovska Kitanovska, B., additional, Zafirovska, K., additional, Bogdanovska, S., additional, Gerasimovska, V., additional, and Sikole, A., additional

Published
2014
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19. Vascular access

Author

McCullough, K. P., primary, Lok, C. E., additional, Fluck, R. J., additional, Spergel, L. M., additional, Andreucci, V. E., additional, Fort, J., additional, Krishnan, M., additional, Fissell, R. B., additional, Kawanishi, H., additional, Saran, R., additional, Port, F. K., additional, Robinson, B. M., additional, Pisoni, R. L., additional, Shinzato, T., additional, Shionoya, Y., additional, Fukui, H., additional, Sasaki, M., additional, Miwa, M., additional, Toma, S., additional, Lin, C.-C., additional, Yang, W.-C., additional, Simone, S., additional, Loverre, A., additional, Cariello, M., additional, Divella, C., additional, Castellano, G., additional, Gesualdo, L., additional, Grandaliano, G., additional, Pertosa, G., additional, Mattei, S., additional, Pignatelli, G., additional, Corradini, M., additional, Stefani, A., additional, Bovino, A., additional, Iannuzzella, F., additional, Vaglio, A., additional, Manari, A., additional, Pasquali, S., additional, Chan, J.-S., additional, Wu, T.-C., additional, Roy-Chaudhury, P., additional, Shih, C.-C., additional, Chen, J.-W., additional, Ponce, P., additional, Scholz, C., additional, Goncalves, P., additional, Grassmann, A., additional, Canaud, B., additional, Marcelli, D., additional, Suzuki, S., additional, Shibata, K., additional, Kuji, T., additional, Kawata, S., additional, Koguchi, N., additional, Nishihara, M., additional, Satta, H., additional, Toya, Y., additional, Umemura, S., additional, Corbett, R., additional, Demicheli, N., additional, Iori, F., additional, Grechy, L., additional, Khiroya, R., additional, Ellis, D., additional, Crane, J., additional, Hamady, M., additional, Gedroyc, W., additional, Duncan, N., additional, Vincent, P., additional, Caro, C., additional, Sarween, N., additional, Price, A., additional, Powers, S., additional, Allen, C., additional, Holland, M., additional, Gupta, I., additional, Baharani, J., additional, Parisotto, M. T., additional, Schoder, V., additional, Kaufmann, P., additional, Miriunis, C., additional, Moura, A., additional, Madureira, J., additional, Alija, P., additional, Fernandes, J., additional, Oliveira, J. G., additional, Lopez, M., additional, Felgueiras, M., additional, Amado, L., additional, Sameiro-Faria, M., additional, Miranda, V., additional, Vieira, M., additional, Santos-Silva, A., additional, Costa, E., additional, David, P., additional, Capurro, F., additional, Brustia, M., additional, De Mauri, A., additional, Ruva, C., additional, Chiarinotti, D., additional, Gravellone, L., additional, De Leo, M., additional, Turkvatan, A., additional, Kirkpantur, A., additional, Mandiroglu, S., additional, Afsar, B., additional, Seloglu, B., additional, Alkis, M., additional, Erkula, S., additional, GURBUZ, H. G., additional, Serin, M., additional, CALIK, Y., additional, Mandiroglu, F., additional, Balci, M., additional, Rikker, C., additional, Juhasz, E., additional, Tornoci, L., additional, Tovarosi, S., additional, Greguschik, J., additional, Rosivall, L., additional, Ibeas, J., additional, Valeriano, J., additional, Vallespin, J., additional, Fortuno, J., additional, Rodriguez-Jornet, A., additional, Cabre, C., additional, Merino, J., additional, Vinuesa, X., additional, Bolos, M., additional, Branera, J., additional, Mateos, A., additional, Jimeno, V., additional, Grau, C., additional, Criado, E., additional, Moya, C., additional, Ramirez, J., additional, Gimenez, A., additional, Garcia, M., additional, Kirmizis, D., additional, Kougioumtzidou, O., additional, Vakianis, P., additional, Bandera, A., additional, Veniero, P., additional, Brunori, G., additional, Dimitrijevic, Z., additional, Cvetkovic, T., additional, Paunovic, K., additional, Stojanovic, M., additional, Ljubenovic, S., additional, Mitic, B., additional, Djordjevic, V., additional, Aicha Henriette, S., additional, Farideh, A., additional, Daniela, B., additional, Zafer, T., additional, Francois, C., additional, Donati, G., additional, Scrivo, A., additional, Cianciolo, G., additional, La Manna, G., additional, Panicali, L., additional, Rucci, P., additional, Marchetti, A., additional, Giampalma, E., additional, Galaverni, M., additional, Golfieri, R., additional, Stefoni, S., additional, Skornyakov, I., additional, Kiselev, N., additional, Rozhdestvenskaya, A., additional, Stolyar, A., additional, Ancarani, P. P. A., additional, Devoto, E., additional, Dardano, G. G. D., additional, Coskun yavuz, Y., additional, Selcuk, N. Y., additional, Guney, I., additional, Altintepe, L., additional, Gerasimovska, V., additional, Gerasimovska-Kitanovska, B., additional, Persic, V., additional, Buturovic-Ponikvar, J., additional, Arnol, M., additional, Ponikvar, R., additional, Conti, N., additional, Scrivano, J., additional, Pettorini, L., additional, Giuliani, A., additional, Punzo, G., additional, Mene, P., additional, Pirozzi, N., additional, Kocyigit, I., additional, Unal, A., additional, Guney, A., additional, Mavili, E., additional, Deniz, K., additional, Sipahioglu, M., additional, Eroglu, E., additional, Tokgoz, B., additional, Oymak, O., additional, Gunal, A., additional, Boubaker, K., additional, Kaaroud, H., additional, Kheder, A., additional, Vidal, M., additional, Amengual, M. J., additional, Orellana, R., additional, Sanfeliu, I., additional, Marquina, D., additional, Xirinachs, M., additional, Sanchez, E., additional, Rey, M., additional, Strozecki, P., additional, Flisinski, M., additional, Kapala, A., additional, Manitius, J., additional, Gerasimovska-Kitanovska, B. D., additional, Sikole, A., additional, Weber, E., additional, Adrych, D., additional, Wolyniec, W., additional, Liberek, T., additional, Rutkowski, B., additional, Oguchi, K., additional, Nakahara, T., additional, Okamoto, M., additional, Iwabuchi, H., additional, Asano, M., additional, Rap, O., additional, Ruiz-Valverde, M., additional, Rodriguez-Murillo, J. A., additional, Mallafre-Anduig, J. M., additional, Zeid, M. M., additional, Deghady, A. A., additional, Elshair, H. S., additional, Elkholy, N. A., additional, Panagoutsos, S., additional, Devetzis, V., additional, Roumeliotis, A., additional, Kantartzi, K., additional, Mourvati, E., additional, Vargemezis, V., additional, Passadakis, P., additional, Kang, S. H., additional, Jung, S. Y., additional, Lee, S. H., additional, Cho, K. H., additional, Park, J. W., additional, Yoon, K. W., additional, and Do, J. Y., additional

Published
2013
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20. Vascular access

Author

Santos, C., primary, Ventura, A., additional, Gomes, A. M., additional, Pereira, S., additional, Almeida, C., additional, Seabra, J., additional, Segelmark, M., additional, Mattsson, L., additional, Said, S., additional, Olde, B., additional, Solem, K., additional, Yu, X., additional, Zhang, B., additional, Sun, B., additional, Mao, H., additional, Xing, C., additional, Gruss, E., additional, Portoles, J., additional, Tato, A., additional, Lopez-Sanchez, P., additional, Jimenez, P., additional, de la Cruz, R., additional, Furaz, K., additional, Martinez, S., additional, Mas, M., additional, Andres, M. M., additional, Corchete, E., additional, Kim, Y. O., additional, Kim, H. G., additional, Kim, B. S., additional, Song, H. C., additional, Choi, E. J., additional, Ibeas, J., additional, Vallespin, J., additional, Fortuno, J. R., additional, Rodriguez-Jornet, A., additional, Grau, C., additional, Merino, J., additional, Branera, J., additional, Perendreu, J., additional, Granados, I., additional, Mateos, A., additional, Jimeno, V., additional, Moya, C., additional, Ramirez, J., additional, Falco, J., additional, Gimenez, A., additional, Garcia, M., additional, Morgado, E., additional, Pinho, A., additional, Guedes, A., additional, Guerreiro, R., additional, Mendes, P., additional, Bexiga, I., additional, Silva, A., additional, Marques, J., additional, Neves, P., additional, Shibata, K., additional, Iwamoto, T., additional, Murakami, T., additional, Ono, S., additional, Kaneda, T., additional, Kuji, T., additional, Kawata, S., additional, Satta, H., additional, Tamura, K., additional, Toya, Y., additional, Yanagi, M., additional, Umemura, S., additional, Yasuda, G., additional, Yong, O. L., additional, Lim, W. W. L., additional, Yong, K. M., additional, Tay, K. H., additional, Lim, E. K., additional, Yang, W. S., additional, Tan, S. G., additional, Choong, H. L., additional, Hill, A., additional, Blatter, D., additional, Kim, S. Y., additional, Min, J.-K., additional, Park, W. D., additional, Rodriguez- Jornet, A., additional, Marcet, M., additional, Vinuesa, X., additional, Mateo, A., additional, Fernandez, M., additional, Rivera, J., additional, Shibahara, H., additional, Shibahara, N., additional, Takahashi, S., additional, Kanaa, M., additional, Wright, M. J., additional, Sandoe, J. A. T., additional, Freudiger, H., additional, Dupret, J., additional, Jacquemoud, M.-C., additional, Rossi, L., additional, Kampouris, C., additional, Hatzimpaloglou, A., additional, Karamouzis, M., additional, Pliakos, C., additional, Malindretos, P., additional, Roudenko, I., additional, Grekas, D., additional, Costa, A. C., additional, Santana, A., additional, Neves, F., additional, Costa, A. G. d., additional, Chaudhry, M., additional, Bhola, C., additional, Joarder, M., additional, Lok, C., additional, Coentrao, L., additional, Faria, B., additional, Frazao, J., additional, Pestana, M., additional, Sun, X.-f., additional, Yang, Y., additional, Wang, J., additional, Lin, H.-l., additional, Li, J.-j., additional, Yao, L., additional, Zhao, J.-Y., additional, Zhang, Z.-m., additional, Lun, L.-d., additional, Zhang, J.-r., additional, Zhang, Y.-m., additional, Li, M.-x., additional, Jiang, S.-m., additional, Wang, Y., additional, Zhu, H.-y., additional, Chen, X.-m., additional, Caeiro, F., additional, Carvalho, D., additional, Cruz, J., additional, Ribeiro dos Santos, J., additional, Nolasco, F., additional, Bartlett, R., additional, Pandya, B., additional, Viana, N., additional, Machado, S., additional, Gil, C., additional, Lucas, C., additional, Mendes, A., additional, Barata, J., additional, Freitas, L., additional, Campos, M., additional, Rikker, C., additional, Juhasz, E., additional, Toth, A., additional, Vizi, I., additional, Tornoci, L., additional, Rosivall, L., additional, Tovarosi, S., additional, Cho, S., additional, Kim, S., additional, Lee, Y.-j., additional, Kanai, H., additional, Harada, K., additional, Nasu, S., additional, Shinozaki, M., additional, Esenturk, M., additional, Zengin, M., additional, Ogun, F., additional, Akdemir, A., additional, Colak, C., additional, Pekince, G., additional, Gerasimovska, V., additional, Oncevski, A., additional, Gerasimovska-Kitanovska, B., additional, Sikole, A., additional, Kiselev, N., additional, Chernyshev, S., additional, Zlokazov, V., additional, Idov, E., additional, Bacallao Mendez, R., additional, Avila, A., additional, Salgado, J., additional, Llerena, B., additional, Badell, A., additional, Aties, M., additional, Severn, A., additional, Metcalfe, W., additional, Traynor, J., additional, Boyd, J., additional, Kerssens, J., additional, Henderson, A., additional, Simpson, K., additional, Roca-Tey, R., additional, Samon, S., additional, Ibrik, O., additional, Roda, E., additional, Gonzalez, J. C., additional, Viladoms, J., additional, Bamidis, P., additional, Liaskos, C., additional, Papagiannis, A., additional, Vrochides, D., additional, Frantzidis, C., additional, Sarafidis, P., additional, Lasaridis, A., additional, Chryssogonidis, I., additional, Nikolaidis, P., additional, Perndreu, J., additional, Moyses Neto, M., additional, Ferreira, V., additional, Martinez, R., additional, Tercariol, C. A. S., additional, Lima, D. A. F. S., additional, Figueiredo, J. F. C., additional, Costa, J. A. C., additional, Alayoud, A., additional, Hamzi, A., additional, Akhmouch, I., additional, Aatif, T., additional, Oualim, Z., additional, Jankovic, A., additional, Ilic, M., additional, Damjanovic, T., additional, Djuric, Z., additional, Popovic, J., additional, Adam, J., additional, and Dimkovic, N., additional

Published
2011
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23. Dialysis in Adults in Year 2000 in the Republic of Macedonia

Author

Polenakovic, M.H., Sikole, A., Grozdanovski, R., Amitov, V., Stojkovski, Lj., Oncevski, A., Grcevska, L., Dzikova, S., Cakalaroski, K., Bogdanovska, S., Gerasimovska, V., Gerasimovska, B., Milovanceva, M., Stojceva-Taneva, O., Krstanovski, B., Kovaceski, S., Serijat, M., Mustafa, Z., Capova, O., Bajalska, A., Nikolovski, A., Filipovic, R., Neskovski, J., Selja, Lj., Janakievska, P., Lamova, K., Hristova, V., Sarajlija, E. Karceva, Romeo, M., Mitrevski, Z., Ivanovski, K., Dimitrov, S., Velinova, B., and Panova, B.

Abstract

1,019 adult patients with terminal renal failure were treated with dialysis (D) in the first part of the year 2000 in the Republic of Macedonia. 1,010 patients (99%) were treated with chronic intermittent (maintenance) hemodialysis (HD) while nine patients (1%) were on continuous ambulatory peritoneal dialysis (CAPD). For the children, a special peritoneal dialysis program was developed; 509 patients per million of the population (PMP) were on dialysis.The Republic of Macedonia is, therefore, among those central and eastern European countries with a higher PMP number in the treatment of end-stage renal disease, following Croatia, the Czech Republic and Slovenia.The patients were treated at 18 Centers in a network of HD Centers at a distance of 30–50 km. from their place of residence in order to facilitate their access to treatment and to work. All patients who have had symptoms indicating need for treatment with D were accepted for treatment. The government payed all the expenses of the treatment and the salaries of the staff. 56% were male and 44% were female patients. The youngest patient was aged 9 and the oldest was 82 years old. There has been an increase in the age of the patients on D as well as an increase in their number. In 1993 we had 727 patients being treated with D, and now we have 1,019 with a constant increase in the number of patients with ESRD and a need for D and renal transplantation. Mortality per year at the different Centers ranged from 8–19% in 1999 and the average is 12%.Glomerulonephritis (GN) – both primary and secondary – is the main cause of renal failure (RF) in some Centers up to 45%. Tubulo-interstitial disease follows GN. ADPKD patients constitute 9.4% with a difference among the Centers of 3–29%, and diabetic nephropathy is found in 10%, 5–15% in different Centers. 11–61% of patients have an unknown etiology.352 patients are on treatment with human recombinant erythropoietin (rhuEPO) – in some Centers up to 60%. The mode of application was subcutaneous and the initial dose is 20 U/kg body weight and the mean maintenance dose of EPO per patient weekly is 4,000 U.The Cimino-Brescia arteriovenous fistula is being applied as a standard vascular access. The survival rate of our patients treated with maintenance HD at 5 years was 58%. CAPD and particularly renal transplantation are to be further developed as alternative methods in treating terminal renal failure.

Published
2002
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24. Uric acid and left ventricular hypertrophy: another relationship in hemodialysis patients.

Author

Selim G, Stojceva-Taneva O, Tozija L, Zafirova-Ivanovska B, Spasovski G, Gerasimovska V, Petronijevic Z, Trajceska L, Dzekova-Vidimliski P, Gjorgjievski N, Pavleska-Kuzmanovska S, Kabova A, and Georgievska-Ismail L

Abstract

Background: The impact of serum uric acid (UA) on morbidity and mortality in hemodialysis (HD) patients is quite controversial in relation to the general population. The aim of this study was to evaluate the association of serum UA with both mortality and left ventricular hypertrophy (LVH) in HD patients., Methods: This longitudinal study enrolled 225 prevalent HD patients who were classified into three groups according to their follow-up-averaged UA (FA-UA) levels: low FA-UA (FA-UA <400 µmol/L), intermediate/reference FA-UA (FA-UA between 400 and 450 µmol/L) and high FA-UA (FA-UA >450 µmol/L). Echocardiography was performed on a nondialysis day and the presence of LVH was defined based on a left ventricular mass index (LVMI) >131 and >100 g/m 2 for men and women, respectively. The patients were followed during a 60-month period., Results: The mean FA-UA level was 425 ± 59 µmol/L (range 294-620). There was a consistent association of higher FA-UA with better nutritional status (higher body mass index, normalized protein catabolic rate, creatinine, albumin and phosphorus), higher hemoglobin, but lower C-reactive protein and LVMI. During the 5-year follow-up, 81 patients died (36%) and the main causes of death were cardiovascular (CV) related (70%). When compared with the reference group, the hazard ratio for all-cause mortality was 1.75 [95% confidence interval (CI) 1.02-2.98; P = 0.041] in the low FA-UA group, but there was no significant association with the high FA-UA group. In contrast, FA-UA did not show an association with CV mortality neither with the lower nor with the high FA-UA group. The unadjusted odds ratio (OR) of LVH risk in the low FA-UA compared with the reference FA-UA group was 3.11 (95% CI 1.38-7.05; P = 0.006), and after adjustment for age, gender, diabetes and CV disease, ORs for LVH persisted significantly only in the low FA-UA group [OR 2.82 (95% CI 1.16-6.88,); P = 0.002]., Conclusions: Low serum UA is a mortality risk factor and is associated with LVH in HD patients. These results are in contrast with the association of UA in the general population and should be the subject of further research., (© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2019
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25. Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5.

Author

Gjorgjievski N, Dzekova-Vidimliski P, Gerasimovska V, Pavleska-Kuzmanovska S, Gjorgievska J, Dejanov P, Sikole A, and Ivanovski N

Abstract

Background: An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a "gate of life" for the patients on hemodialysis., Aim: The study aimed to analyze the predictors for primary failure of AVF such as gender, age, number and location of AVF, and primary renal disease in patients with chronic kidney disease (CKD) stage 4/5., Material and Methods: The medical records of 178 created arteriovenous fistulae in patients with CKD stage 4/5, were retrospectively studied. Primary failure of AVF was defined as thrombosis or inability for cannulation of AVF within 3 months. Adequate maturation of AVF was defined as successful cannulation of AVF treatment and blood flow of > 600 ml/min., Results: The mean age of the patients was 59.75 ± 14.65 years, and 65.16% (116/178) were men. Adequate maturation of AVF was achieved in 83.71% (149/178). Primary failure of AVF occurred in 16.29% (29/178) of the created fistulae, while 10.11% (18/178) had early thrombosis. The distal arteriovenous fistulae were significantly more frequently created in male patients (51 vs 18; p = 0.015). The female patients were significantly older than the male patients (63.27 vs 57.86 years; p = 0.018)., Conclusion: Male gender was associated with better maturation of AVF. The age, number and location of AVF, and primary renal disease in patients with CKD stage 4/5 were not associated with primary failure of AVF.

Published
2019
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26. Goodpasture Syndrome Diagnosed One Year And A Half after the Appearance of the First Symptoms (Case Report).

Author

Stojkovikj J, Zejnel S, Gerasimovska B, Gerasimovska V, Stojkovic D, Trajkovski M, Angelovska I, Debreslioska A, and Jovanovski S

Abstract

Background: Goodpasture syndrome was originally described as an association of alveolar haemorrhage and glomerulonephritis. It occurs when the immune system attacks and destroys healthy body tissue., Aim: We are presenting a patient with a clinical picture of pulmonary haemorrhage and glomerulonephritis, which is diagnosed by renal biopsy., Case Presentation: His illness began a year and a half before being diagnosed. In that period he had occasional exacerbations. He was received at our Clinic in extremely serious condition, and after stabilisation of his medical condition, there was made a biopsy of the kidney. The p-ANCA was 8.93 U/ml (neg < 3, poz > 5 U/ml). Histopathological diagnosis of biopsy of the kidney was: Glomerulonephritis extra capillaries focalis, segmentalis et globalis. Based on this he was diagnosed with Goodpasture syndrome. He received corticosteroid therapy and cyclophosphamide, with good response to treatment, and he is currently in a stable condition, receiving only corticosteroid therapy., Conclusion: Goodpasture syndrome is a severe illness caused by the formation of antibodies to the glomerular basement membrane and alveolus with consequential damage to renal and pulmonary function. With current therapy, long-term survival is more than 50%.

Published
2016
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27. Two Pregnancies with a Different Outcome in a Patient with Alport Syndrome.

Author

Kitanovska BG, Gerasimovska V, and Livrinova V

Abstract

Background: Alport syndrome is a genetic disease that progresses to chronic kidney failure, with X-linked, autosomal dominant or autosomal recessive type of inheritance. Women are generally carriers of the mutation and have a milder form of the disease. During pregnancy, they have an increased risk of impaired kidney function and preeclampsia., Case Presentation: A 27-year old woman, gravida 1, para 0, in her 23rd gestational week came to the outpatient unit of the University Clinic of Nephrology for the first time because of slowly progressing proteinuria and Alport syndrome. She was admitted to the gynaecological ward in her 29th gw for proteinuria which increased from 3.8 g/day up to 20 g/day and the serum creatinine increased to 120- 150 micromol/l. She was delivered in the 30th gestational week due to obstetrical indications with a cesarian section and delivered a baby with a birth weight of 880 g. After delivery, proteinuria decreased to 2 g/d within 2 months and an angiotensin-converting enzyme inhibitor (ACEI) was started. Her second pregnancy, after 2 years, had an uneventful course and she delivered a healthy baby weighing 3000 g in the 39th week. Six months after the second delivery, her renal function remained normal and her proteinuria was 2 g/d., Conclusions: Pre-pregnancy counselling and frequent controls during pregnancy are necessary for women with Alport syndrome, as well as regular monitoring after delivery. Recent reports are more in favour of good pregnancy and nephrological outcomes in women with Alport syndrome when renal disease is not advanced.

Published
2016
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28. Severe Endothelial Damage in Chronic Kidney Disease Patients Prior to Haemodialysis Vascular Access Surgery.

Author

Pushevski V, Dejanov P, Gerasimovska V, Petrushevska G, Oncevski A, Sikole A, Popov Z, and Ivanovski N

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers analysis, Endothelial Cells chemistry, Female, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular pathology, Humans, Hyperplasia, Hypertrophy, Immunohistochemistry, Ki-67 Antigen analysis, Male, Middle Aged, Neointima, Prospective Studies, Renal Insufficiency, Chronic diagnosis, Risk Factors, Severity of Illness Index, Transforming Growth Factor beta analysis, Treatment Failure, Veins chemistry, Vimentin analysis, Young Adult, Arteriovenous Shunt, Surgical adverse effects, Endothelial Cells pathology, Radial Artery surgery, Renal Dialysis, Renal Insufficiency, Chronic pathology, Renal Insufficiency, Chronic therapy, Veins pathology, Veins surgery
Abstract

Background: Hemodialysis as an efficient therapy for advanced CKD is the most used treatment modality all over the world. Even though primary AVF is widely accepted as a best permanent vascular access in hemodialysis patients, up to 60% of all fistulas fail to mature. The pathogenesis of early fistula failure is not very well understood. Many general and local factors are involved: patient's age, sex, primary renal disease, small vessel's diameter, presence of accessory veins, prior venipunctures, surgical skill, genetics, etc. Histological investigations have confirmed the neointimal venous hyperplasia as a major pathological finding in stenotic lesions of AVF failure, due to local inflammation, oxidative stress and migration and proliferation of myofibroblasts, fibroblasts and endothelial cells., Materials and Methods: A total of 89 patients with stadium 4-5 of CKD are involved in the study. A typical radio-cephalic AVF is created in all patients. Part of the fistula vein was taken for histological, immunohistochemical (Vimentin, TGF β and KI67) and morphometric analysis. Appriopriate statistical method was applied., Results: Up to 80% of the patients showed some degree of endothelial changes at the time of creation of AVF, among them 19 pts with substantial intimal hyperplasia, 51 with medial hypertrophy and 19 pts with normal histology. Almost two thirds of the patients did not have expression of TGFβ. More than 95% had some expression of Vimentin. None of the patients had expression of the marker KI 67., Conclusion: Medial hypertrophy is predominant preexisting pathohistological lesion prior the AVF creation, despite the presence of neointimal hyperplasia. The absence of TGFβ expression in majority of our patients could suggest that inflammation and oxidative stress are developing later, after vascular access surgery. The dominant cells within the stenosis in the veins are myofibroblasts. Their increased presence maybe a reason why some patients are prone to developing venous endothelial changes as a results of exaggerated vascular endothelial response to the effect of uremia, hypertension and other insults.

Published
2015
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29. Protocol for performing nephrological activity in the Republic of Macedonia.

Author

Polenakovic M, Bogdanovska S, Cakalaroski K, Dzikova S, Masin G, Masin-Spasovska J, Oncevski A, Gerasimovska V, Spasovski G, Grozdanovski R, Stojceva-Taneva O, Grcevska L, Sikole A, Dejanov P, Tozija L, Zafirovska K, Ivanovski N, Lozance L, and Pusevski V

Subjects
Humans, Republic of North Macedonia, Kidney Diseases therapy, Nephrology methods
Abstract

The fast development of nephrology in the world, especially in the second half of the 20 th century demanded protocol (guidelines) for nephrological activity for all levels of medical care, of doctors and specialists. The International Society of Nephrology, the European Renal Association and other national associations created their own protocol (guidelines) for nephrological activity. The Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) proclaimed the First Protocol for Performing Nephrological Activity in the Republic of Macedonia at the First Congress of the MSNDTAO, held in Ohrid 1993, and it was published in the Macedonian Medical Review, 1994; Supplement 14: 397-406 [1]. The update of the Protocol for Performing Nephrological Activity in the Republic of Macedonia was proclaimed at the Fourth Congress of MSNDTAO, held in Ohrid 2012 and it presented in this text.

Published
2014
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30. [Vascular access and chronic renal failure].

Author

Oncevski A, Dejanov P, Gerasimovska V, Cakalaroski K, Ivanovski N, and Popov Z

Subjects
Arteriovenous Fistula, Femoral Vein, Hemofiltration, Humans, Jugular Veins, Renal Dialysis instrumentation, Subclavian Vein, Arteriovenous Shunt, Surgical, Catheters, Indwelling, Kidney Failure, Chronic therapy, Renal Dialysis methods
Abstract

From 1976 to 1999 a total of 8,849 surgical procedures for vascular access prior to dialysis were performed in the Department of nephrology at Skopje hospital (Macedonia). Cases included 3,114 native arteriovenous fistula (AVF), 715 arteriovenous shunts and 4,964 temporary or indwelling catheters (4,411 (88.86%) in the femoral vein, 410 (8.26%) in the subclavian vein, 143 (2.88%) in the jugular vein and 56 PTFE vascular grafts). Femoral catheterization is the favoured solution for repeated dialysis (90.50% of the 3,440 procedures for indwelling vascular access). Subcutaneous indwelling catheters were used in 270 (7.90%) cases, with vascular access taking place in either the femoral (99 cases), subclavian (123 cases) or jugular vein (48 cases). Biosynthetic vascular grafts represent only 1.6% of all procedures for vascular access. The number of preventive AVFs has been increasing steadily from 14% in the 1980s to 20.8% in the 1990s and 31.50% in 1999. The majority of preventive AVFs (71.80%) and a large number of other surgical procedures for vascular access (44.40%) are performed in day hospital.

Published
2000

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