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Article: Impaired fertility in women and men with chronic kidney disease.

Kuczera, Piotr / Więcek, Andrzej / Adamczak, Marcin

Advances in clinical and experimental medicine : official organ Wroclaw Medical University

2022 Volume 31, Issue 2, Page(s) 187–195

Abstract: Chronic kidney disease (CKD) is accompanied by a great number of comorbidities. One of the most clinically important, present in women as well as in men, is infertility. In this review paper, the entire issue of impaired fertility in women and men with ... ...

Abstract	Chronic kidney disease (CKD) is accompanied by a great number of comorbidities. One of the most clinically important, present in women as well as in men, is infertility. In this review paper, the entire issue of impaired fertility in women and men with CKD is discussed. In both genders, impaired fertility is caused by the interconnection of several factors. In women, these are as follows: the accumulation of uremic toxins; endocrine disorders (e.g., reduced renal clearance of different hormones, disturbed activity of the pituitary-gonadal axis); the impairment of the ovarian function; a reduced ovarian reserve; sexual function disorders; and depression. In men, quite similarly: the accumulation of uremic toxins; endocrine disorders; the impairment of spermatogenesis; direct testicular damage; erectile dysfunction (ED); and depression. The prevalence of impaired fertility increases with the degree of kidney function deterioration in women and men. The highest prevalence of these disturbances is observed in patients with CKD stage 5. Successful kidney transplantation (KTx) in women reduces the accumulation of uremic toxins, restores the function of the endocrine system and improves, but does not normalize, fertility. Similarly in men, KTx restores the function of the endocrine system and improves fertility up to a point, but cannot fully reverse the morphological damage already done to the gonads by the uremia itself. Infertility is one of the important, yet sometimes depreciated complications in women and men with CKD. The etiology and pathogenesis of infertility in CKD is complicated. Kidney transplantation alleviates, but does not fully reverse fertility impairment in CKD patients.
MeSH term(s)	Female ; Fertility ; Humans ; Kidney Failure, Chronic/complications ; Kidney Transplantation ; Male ; Renal Insufficiency, Chronic/complications ; Uremia/complications
Language	English
Publishing date	2022-02-17
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	2270257-X
ISSN	1899-5276 ; 1230-025X
ISSN	1899-5276 ; 1230-025X
DOI	10.17219/acem/141188
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Article ; Online: Serum testosterone concentrations in male patients with end-stage kidney disease treated with haemodialysis.

Kuczera, Piotr / Więcek, Andrzej / Adamczak, Marcin

Endokrynologia Polska

2021 Volume 72, Issue 4, Page(s) 347–352

Abstract: Introduction: Testosterone deficiency is frequently found in male patients with chronic kidney disease (CKD) and may participate in the pathogenesis of osteoporosis, sarcopaenia, anaemia, impotence, infertility, and other comorbidities observed in these ...

Abstract	Introduction: Testosterone deficiency is frequently found in male patients with chronic kidney disease (CKD) and may participate in the pathogenesis of osteoporosis, sarcopaenia, anaemia, impotence, infertility, and other comorbidities observed in these patients. The aim of the study was the evaluation of the frequency of testosterone deficiency in male patients with CKD on maintenance haemodialysis (HD). Material and methods: In 79 male HD patients, serum total (TT), free (FT) testosterone, C-reactive protein (CRP), and interleukin 6 (IL-6) serum concentrations were assessed before an HD procedure. Patients were divided into three subgroups based on age categories: 19-39 years (18 patients), 40-59 years (34 patients), and ≥ 60 years (27 patients). TT insufficiency and deficiency were diagnosed when the serum TT concentration was below 4.0 ng/mL and 2.9 ng/mL, respectively. FT deficiency was diagnosed in patients with serum FT concentration below 8.9, 6.6, and 4.9 pg/mL in the abovementioned age subgroups, respectively. Results: In the abovementioned age subgroups the serum TT concentration was 5.9 (4.6-7.1), 4.8 (3.9-5.4), and 4.6 (3.9-5.3) ng/mL, respectively. The serum FT concentration was 7.9 (5.2-10.1), 6.1 (5.1-7.2), and 6.0 (5.0-7.1) pg/mL, respectively. In the whole group TT insufficiency was found in 40%, TT deficiency in 15% of patients, and FT deficiency in 50% of patients. Significant negative correlations were found between both serum TT and FT concentrations and age (r = -0.23, p = 0.05 and r = -0.27, p = 0.02, respectively). Additionally, negative correlations were found between both serum TT and FT and IL-6 concentrations (r = -0.43, p < 0.05 and r = -0.29, p < 0.05), respectively. Conclusions: 1. Testosterone deficiency is common in male patients with chronic kidney disease treated with HD. 2. In HD patients the serum testosterone concentration decreases with age. 3. Chronic inflammation may participate in the pathogenesis of testosterone deficiency in haemodialysis patients.
MeSH term(s)	Adult ; Humans ; Hypogonadism ; Interleukin-6 ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Male ; Renal Dialysis ; Renal Insufficiency, Chronic ; Testosterone ; Young Adult
Chemical Substances	Interleukin-6 ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2021-05-19
Publishing country	Poland
Document type	Journal Article
ZDB-ID	419270-9
ISSN	2299-8306 ; 0423-104X
ISSN (online)	2299-8306
ISSN	0423-104X
DOI	10.5603/EP.a2021.0042
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Article ; Online: One-shot cardioplegia for minimally invasive mitral valve repair-a comparison of del Nido and Bretschneider Histidine-Tryptophan-Ketoglutarate solutions.

Gerber, Witold / Sanetra, Krzysztof / Gerber, Agnieszka Drzewiecka- / Jankowska-Sanetra, Justyna / Kuczera, Małgorzata / Białek, Krzysztof / Buszman, Piotr Paweł / Bochenek, Andrzej

Perfusion

2022 Volume 38, Issue 4, Page(s) 763–770

Abstract: Background: Minimally invasive procedures are demanding in terms of cardioprotection. In many leading centres Bretschneider HTK solution is used for mitral valve surgery. The study was designed to provide comparison of the del Nido and Bretschneider HTK ...

Abstract	Background: Minimally invasive procedures are demanding in terms of cardioprotection. In many leading centres Bretschneider HTK solution is used for mitral valve surgery. The study was designed to provide comparison of the del Nido and Bretschneider HTK protocol. Methods: Patients who underwent minimally invasive mitral valve repair for primary mitral regurgitation and received single delivery of either del Nido (Group 1) or Bretschneider HTK cardioplegia (Group 2) were matched on basis of age, gender and length of the cross-clamp time. The groups were compared in terms of major adverse cardiac and cerebrovascular events (death, myocardial infarction, stroke), high sensitivity troponin T (hs-TnT) and creatine kinase- MB isoenzyme (CK-MB) release at 12 h and 24 h following the surgery, incidence of low cardiac output syndrome (LCOS), postoperative arrhythmia, transfusions and postoperative renal function. Results: Case control matching selected 38 pairs of patients. None of patients died, nor suffered from myocardial infarction or stroke. Troponin values did not differ at 12 h (median: 281.0 pg/mL vs 313.0 pg/mL; Conclusions: Del Nido cardioplegia can be used safely as an alternative for Bretschneider HTK for minimally invasive mitral valve surgery.
MeSH term(s)	Humans ; Mitral Valve/surgery ; Cardioplegic Solutions/therapeutic use ; Heart Arrest, Induced/methods ; Myocardial Infarction/etiology ; Retrospective Studies
Chemical Substances	Bretschneider cardioplegic solution ; Cardioplegic Solutions
Language	English
Publishing date	2022-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591221080653
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Article ; Online: The Prevalence of Metabolic Acidosis in Patients with Different Stages of Chronic Kidney Disease: Single-Centre Study.

Kuczera, Piotr / Ciaston-Mogilska, Dorota / Oslizlo, Barbara / Hycki, Anna / Wiecek, Andrzej / Adamczak, Marcin

Kidney & blood pressure research

2020 Volume 45, Issue 6, Page(s) 863–872

Abstract: Background: Metabolic acidosis (MA) is one of the most common consequences of CKD. MA is also a risk factor of CKD progression and increased mortality in these patients.: Aim: The aim of this retrospective, cross-sectional study was to assess the ... ...

Abstract	Background: Metabolic acidosis (MA) is one of the most common consequences of CKD. MA is also a risk factor of CKD progression and increased mortality in these patients. Aim: The aim of this retrospective, cross-sectional study was to assess the prevalence of MA in different stages of CKD and renal replacement therapy (RRT) modalities - haemodialysis (HD) and peritoneal dialysis (PD). Additionally, the relationship between the prevalence of MA and aetiology of kidney disease was analysed. Methods: One thousand five patients in different stages of CKD, or modalities of RRT were enrolled into this single-centre cross-sectional study. Forty-one patients were ruled out because of oral bicarbonate supplementation. In the remaining 964 patients (698 CKD stages 1-5, 226 HD, 40 PD), venous blood HCO3- concentration, as well as serum Cr and urea concentrations were assessed. MA was diagnosed when blood HCO3- concentration was below 22 mmol/L. Results: The prevalence of MA increased among all stages of CKD. Patients on HD had lower prevalence of MA in comparison with CKD 5 patients with no RRT (38.5 vs. 56.0%; p = 0.02) In PD patients, the prevalence of MA was significantly lower than in HD patients (2.5 vs. 38.5%; p < 0.001). In the whole study group, there were no significant differences in the prevalence of MA between different aetiologies of CKD (glomerulonephritis 24%, hypertension 23%, diabetes 25%, and tubule-interstitial diseases 24%). Also, when only patients in stages CKD 3-5 were compared, no significant differences in the prevalence of acidosis were found (glomerulonephritis 28%, hypertension 22%, diabetes 24%, and tubule-interstitial 21%). Conclusions: (1) MA is more frequent in patients with more advanced stages of CKD. (2) RRT reduces the prevalence of MA. (3) In PD patients, MA is rare. (4) Aetiology of CKD seems not to have a significant impact on MA prevalence.
MeSH term(s)	Acidosis/blood ; Acidosis/etiology ; Acidosis/pathology ; Adult ; Carbonates/blood ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/pathology ; Retrospective Studies
Chemical Substances	Carbonates
Language	English
Publishing date	2020-10-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1326018-2
ISSN	1423-0143 ; 1420-4096
ISSN (online)	1423-0143
ISSN	1420-4096
DOI	10.1159/000508980
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Article ; Online: Dew point temperature of wet air stream at variable pressure

Ptaszyński Bogusław / Kuczera Zbigniew / Łuczak Rafał / Życzkowski Piotr

E3S Web of Conferences, Vol 46, p

2018 Volume 00013

Abstract: One of the examples of how atmospheric air could be utilized includes its use as a carrier of mechanical energy transmitted by various devices, e.g. air compressors, constituting parts of various technical systems. In many of them, atmospheric air is ... ...

Abstract	One of the examples of how atmospheric air could be utilized includes its use as a carrier of mechanical energy transmitted by various devices, e.g. air compressors, constituting parts of various technical systems. In many of them, atmospheric air is subjected to significant changes in static pressure. This research paper specifies the effect of the variable static pressure on the dew point temperature of wet air. This issue was presented both analytically and graphically. The knowledge will allow to effectively identify these areas in which the water vapour contained in the air will be subject to phase changes, unfavourable for humans.
Keywords	Environmental sciences ; GE1-350
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	EDP Sciences
Document type	Article ; Online
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Article: The Relationship between Initial Tacrolimus Metabolism Rate and Recipients Body Composition in Kidney Transplantation.

Kolonko, Aureliusz / Pokora, Patrycja / Słabiak-Błaż, Natalia / Czerwieńska, Beata / Karkoszka, Henryk / Kuczera, Piotr / Piecha, Grzegorz / Więcek, Andrzej

Journal of clinical medicine

2021 Volume 10, Issue 24

Abstract: There are several premises that the body composition of kidney transplant recipients may play a role in tacrolimus metabolism early after transplantation. The present study aimed at analyzing the relationship between the body composition parameters ... ...

Abstract	There are several premises that the body composition of kidney transplant recipients may play a role in tacrolimus metabolism early after transplantation. The present study aimed at analyzing the relationship between the body composition parameters assessed by bioimpedance analysis (BIA) and initial tacrolimus metabolism. Immediately prior to transplantation, BIA using InBody 770 device was performed in 122 subjects. Tacrolimus concentration-to-dose (C/D) ratio was calculated based on the first blood trough level measurement. There was no difference in phase angle, visceral fat area, lean body mass index (LBMI) and the proportion of lean mass as a percentage of total body mass between the subgroups of slow and fast metabolizers. However, subjects with LBMI ≥ median value of 18.7 kg/m
Language	English
Publishing date	2021-12-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10245793
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Article ; Online: Energy efficiency of ground-air heat exchanger in the ventilation and airconditioning systems

Łuczak Rafał / Ptaszyński Bogusław / Kuczera Zbigniew / Życzkowski Piotr

E3S Web of Conferences, Vol 46, p

2018 Volume 00015

Abstract: In the article, analysis of heat exchangers, working together with air-conditioning system, are presented. For an object with known requirement to hot and cold, air heat exchanger (ground type) is designed. For that defined system, the energy analysis of ...

Abstract	In the article, analysis of heat exchangers, working together with air-conditioning system, are presented. For an object with known requirement to hot and cold, air heat exchanger (ground type) is designed. For that defined system, the energy analysis of heat exchanger’s energy work in yearly cycle, including a work of air treatment with full (cooling - desiccation and heating of air in the summer, heating and moisturizing in the winter) and not quite full (cooling of air in the summer, heating of air in the winter) air-conditioning are examined. Effects connected with a reduction of energy costs needed for heat treatment of air blown to the room are specified included the climatic conditions like air heating and cooling degree-hours.
Keywords	Environmental sciences ; GE1-350
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	EDP Sciences
Document type	Article ; Online
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Article ; Online: Treatment Based on Cinacalcet Reduces Oxidative Stress in Hemodialysis Patients with Secondary Hyperparathyroidism.

Kuczera, Piotr / Adamczak, Marcin / Machnik, Grzegorz / Okopien, Boguslaw / Wiecek, Andrzej

Nephron

2018 Volume 139, Issue 4, Page(s) 286–292

Abstract: Background/aims: Oxidative stress is one of the leading factors contributing to increased mortality in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (sHPT). Cinacalcet is now commonly used in the treatment of sHPT in ... ...

Abstract	Background/aims: Oxidative stress is one of the leading factors contributing to increased mortality in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (sHPT). Cinacalcet is now commonly used in the treatment of sHPT in patients with CKD. The aim of this study was to assess the influence of treatment with cinacalcet on the oxidative stress markers in patients on hemodialysis with sHPT. Methods: In 58 hemodialysed patients with sHPT (parathyroid hormone [PTH] > 300 pg/mL) plasma Advanced Oxidation Protein Products (AOPP), serum total antioxidant capacity - ImAnOx (TAS/TAC), serum PTH, calcium and phosphate concentrations were assessed before the first dose of cinacalcet and after 6 months of treatment. Results: Serum PTH concentration decreased significantly from 895 (748-1,070) to 384 (289-510) pg/mL after 6 months of treatment; p < 0.0001. Mean serum concentrations of -calcium and phosphate remained stable. Plasma AOPP concentration decreased significantly from 152 (126-185) to 49 -(43-57) µmol/L after 6 months of treatment; p < 0.0001. ImAnOx significantly increased from 260 (251-270) to 272 (264-280) µmol/L; p = 0.04. After 6 months of treatment, a significant, positive correlation was found between ImAnOx and the daily dose of cinacalcet (r = 0.30; p = 0.02). Also, the change of serum ImAnOx during treatment with cinacalcet significantly correlated with the daily dose of cinacalcet r = 0.35; p = 0.01. No significant correlations were found between plasma AOPP concentration or ImAnOx and PTH, or their changes in time. Conclusions: (1) Six-month treatment based on cinacalcet seems to reduce oxidative stress markers in maintenance hemodialysis patients with sHPT. (2) This benefit may be related rather to the direct action of cinacalcet than to the serum PTH concentration decrease.
MeSH term(s)	Adult ; Advanced Oxidation Protein Products/urine ; Aged ; Calcium/blood ; Calcium-Regulating Hormones and Agents/therapeutic use ; Cinacalcet/therapeutic use ; Female ; Humans ; Hyperparathyroidism, Secondary/complications ; Hyperparathyroidism, Secondary/drug therapy ; Hyperparathyroidism, Secondary/metabolism ; Male ; Middle Aged ; Oxidative Stress/drug effects ; Parathyroid Hormone/blood ; Phosphates/blood ; Prospective Studies ; Renal Dialysis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/therapy ; Treatment Outcome
Chemical Substances	Advanced Oxidation Protein Products ; Calcium-Regulating Hormones and Agents ; Parathyroid Hormone ; Phosphates ; Calcium (SY7Q814VUP) ; Cinacalcet (UAZ6V7728S)
Language	English
Publishing date	2018-06-07
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	207121-6
ISSN	2235-3186 ; 1423-0186 ; 1660-8151 ; 0028-2766
ISSN (online)	2235-3186 ; 1423-0186
ISSN	1660-8151 ; 0028-2766
DOI	10.1159/000489278
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Article ; Online: Serum sex hormones concentrations in young women in the early period after successful kidney transplantation.

Sikora-Grabka, Ewelina / Adamczak, Marcin / Kuczera, Piotr / Wiecek, Andrzej

Endokrynologia Polska

2018 Volume 69, Issue 2, Page(s) 150–155

Abstract: Background: Hormonal disorders are frequently present in hemodialysed patients with chronic kidney disease (CKD). In women with CKD sex hormones abnormalities may lead to irregular, often anovulatory cycles, sexual dysfunction and infertility. Kidney ... ...

Abstract	Background: Hormonal disorders are frequently present in hemodialysed patients with chronic kidney disease (CKD). In women with CKD sex hormones abnormalities may lead to irregular, often anovulatory cycles, sexual dysfunction and infertility. Kidney transplantation done in young women tends to ameliorate most of the aforementioned disorders and improve fertility. The aim of this study was to assess the changes of serum sex hormones concentration in young women before, and after the first 6 months after successful KTx Material and methods: Fourteen chronic hemodialysis women with CKD undergoing kidney transplantation and 46 apparently healthy women in similar age (control group) were enrolled into the study. In all women serum concentration of: FSH, LH, PRL and estradiol determined. Measurements in the transplanted group were done four times: immediately before surgery, in the 14th - and 30th - day and 6 months after the transplantation. The results are presented as means and 95% CI. Results: All of the women that have finished the study presented an excellent function of the transplanted kidney - mean serum creatinine concentration was 92.54 (74.85 - 110.23) µmol/l. After successful KTx a significant decrease in the serum concentrations of FSH and LH was observed. Decrease of serum PRL concentration after KTx did not reach statistical significance in the multiple comparisons analyses, but returned to the values observed in healthy controls. KTx did not significantly influence serum estradiol concentration. Conclusions: Successful kidney transplantation leads to the normalization of serum concentrations of hormones linked to fertility disorders in women with chronic kidney disease. < p > < /p >.
MeSH term(s)	Adolescent ; Adult ; Estradiol/blood ; Female ; Fertility ; Follicle Stimulating Hormone/blood ; Gonadal Steroid Hormones/blood ; Humans ; Kidney Transplantation ; Luteinizing Hormone/blood ; Postoperative Period ; Prolactin/blood ; Renal Insufficiency, Chronic/surgery ; Young Adult
Chemical Substances	Gonadal Steroid Hormones ; Estradiol (4TI98Z838E) ; Prolactin (9002-62-4) ; Luteinizing Hormone (9002-67-9) ; Follicle Stimulating Hormone (9002-68-0)
Language	English
Publishing date	2018-06-28
Publishing country	Poland
Document type	Journal Article
ZDB-ID	419270-9
ISSN	2299-8306 ; 0423-104X
ISSN (online)	2299-8306
ISSN	0423-104X
DOI	10.5603/EP.2018.0019
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Article: Endocrine Abnormalities in Patients with Chronic Kidney Disease.

Kuczera, Piotr / Adamczak, Marcin / Wiecek, Andrzej

Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)

2016 Volume 36, Issue 2, Page(s) 109–118

Abstract: In patients with chronic kidney disease the alterations of the endocrine system may arise from several causes. The kidney is the site of degradation as well as synthesis of many different hormones. Moreover, a number of concomitant pathological ... ...

Abstract	In patients with chronic kidney disease the alterations of the endocrine system may arise from several causes. The kidney is the site of degradation as well as synthesis of many different hormones. Moreover, a number of concomitant pathological conditions such as inflammation, metabolic acidosis and malnutrition may participate in the pathogenesis of endocrine abnormalities in this group of patients. The most pronounced endocrine abnormalities in patients with chronic kidney disease are the deficiencies of: calcitriol, testosterone, insulin-like growth factor and, erythropoietin (EPO). Additionally accumulation of several hormones, such as: prolactin, growth hormone and insulin frequently also occur. The clinical consequences of the abovementioned endocrine abnormalities are among others: anemia, infertility and bone diseases.
MeSH term(s)	Endocrine System/metabolism ; Endocrine System/physiopathology ; Endocrine System Diseases/diagnosis ; Endocrine System Diseases/epidemiology ; Endocrine System Diseases/metabolism ; Endocrine System Diseases/physiopathology ; Female ; Hormones/metabolism ; Humans ; Kidney/metabolism ; Kidney/physiopathology ; Male ; Prognosis ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/metabolism ; Renal Insufficiency, Chronic/physiopathology
Chemical Substances	Hormones
Language	English
Publishing date	2016-06-23
Publishing country	North Macedonia
Document type	Journal Article ; Review
ZDB-ID	2743787-5
ISSN	1857-8985 ; 1857-9345
ISSN (online)	1857-8985
ISSN	1857-9345
DOI	10.1515/prilozi-2015-0059
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