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R. Mihaylov, B. Pencheva, D. Stoeva and A. Ruseva

Abstract

Detecting new units of pathogenesis in the liver fibrosis due to alcoholism, chronic viral Hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), autoimmune, parasitic and metabolic diseases and other, reveals perspective for new non-invasive serum biomarkers. In fibrosis, from the wide variety of markers enzymes, proteins and cytokines are mainly used. While direct biomarkers reflect the stage of fibrosis and fibrinogenesis, indirect markers allow assessment of the general liver functions. The combination of direct and indirect markers increases the diagnostic reliability and therefore these panels and indices are investigated quite intensively in recent years in order to decrease the number of liver biopsies without completely replace it, which is still regarded as the reference method.

Open access

R. Mihaylov, B. Pencheva, D. Stoeva, N. Marinova, S. Krivoshiev and G. Michailov

Summary

Vitamin D deficiency is fequently observed in chronic kidney disease. We conducted this study to determine the concentration of the above-mentioned parameters and the correlation between them in order to optimize therapy with vitamin D in patients with end-stage renal disease (ESRD) on hemodialysis. In 53 patients on hemodialysis due to ESRD, vitamin D [Calcidiol (25(OH)D], parathyroid hormone (PTH), calcium, phosphorus, albuminuria, albumin:creatinine ratio (ACR) and other parameters have been followed up. Analysis of the levels of vitamin D has been carried out by High Performance Liquid Chromatography (HPLC), the PTH is determined by the system Centaur XP, Siemens Diagnostic, Electro-chemiluminescence immunoassay (ECLIA), and for albumin in urine we used immunological method [Miltigent microalbumin assay (Abbott Laboratories Diagnostics). We found out deficiency and insufficiency of vitamin D in 56.6% and 37.7%, as well as average 4.5 times increase in the PTH, hyperphosphatemia, hypocalcemia, albuminuria (A2 or A3), over 10 times increase in the ACR, secondary hyperparathyroidism. We registered a negative correlation between vitamin D and PTH. We confirmed the increase in creatinine and cystatin C in the patients on hemodialysis. There are few literature data for patients on hemodialysis, however, regarding the extent of the vitamin deficiency and its relationship with PTH, albuminuria, calcium, phosphorus, etc. Our data have indicated that patients on hemodialysis due to ESRD are associated with high incidence of vitamin D insufficiency or deficiency.

Open access

Stoyanka Tancheva, Stefka V. Valcheva-Kuzmanova, Radko Zl. Radev, Miroslav D. Marinov, Borislav Boychev, Temenuga Stoeva, Svetlozara K. Boyadjieva and Kiril Sv. Nenov

Abstract

The objective of the study was to create a model of acute hematogenous pyelonephritis in the rat without causing urinary retention by ligation of the ureter.

Mixed bacterial suspension containing 1.5×106 colony-forming units (CFU) of S. aureus and 3.0×106 CFU of E. coli was inoculated in the caudal vein at a dose of 0.5 ml/kg. Control animals received the same amount of saline solution. Pyelonephritis was confirmed by lab urine tests and histopathological study of the kidneys.

Infected animals initially developed sepsis with a significant increase of leukocytes and Creactive protein in the blood. Originally only bacteriuria was found in the urine of experimental animals, but later, in the course of the development of pyelonephritis (12-18 days), leucocyturia and active leukocytes (glitter cells) were also available in urine. The levels of β-2 microglobulin in the urine of infected animals (4.02 ± 0.04 mmol/l on day 16 and 4.18 ± 0.07 mmol/l on day 18) were significantly highly increased (p < 0.0001) in comparison with the value of the control group (0.088 ± 0.005 mmol/l). In the early days the histopathological examination of the kidneys established erythrocyte stasis. Later leukocyte infiltrates were observed in the interstitial tissue around the kidney tubules, glomeruli and vascular walls, and inflammatory cell infiltration and degenerative changes were present in the epithelium of the canaliculi.

Combined hematogenous infection with S. aureus and E. coli led to the development of pyelonephritis in rats. The pathology in the kidney tubules was confirmed by histopathological study and by the elevated levels of β-2 microglobulin and the presence of active leukocytes in urine.