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Objectives: To assess the degree of immunosuppressive medication adherence in kidney transplant patients (KTPs) and to determine if there is a difference in the rate of adherence to tacrolimus (Tac), cyclosporine (CsA) and sirolimus (Sir)., Subjects and Methods: From a total of 63 KTPs treated at the Clinic of Nephrology, Clinical Centre Niš, Serbia, 60 participated in the study by responding to questionnaires. They were divided into the adherence group (n = 43) and the nonadherence group (n = 17) according to their degree of adherence which was measured using a validated survey form, the simplified medication adherence questionnaire. The KTP adherence to the different immunosuppressive regimens (Tac, CsA and Sir) was compared. Statistical analysis was performed using the Student t test., Results: Adherence was observed in 43 (71.7%) patients, and only 17 (28.3%) did not follow the prescribed therapy. The estimated glomerular filtration rate was significantly lower in the nonadherence group (38.52 ± 18.22 ml/min) than in the adherence group (52.43 ± 16.91 ml/min, p < 0.05). With regard to the Tac level, a significant difference was also found between the adherers and the nonadherers (6.30 ± 2.06 vs. 5.0 ± 1.52 ng/ml, p < 0.05)., Conclusion: The KTPs in this study demonstrated a high level of adherence. Nonadherence was associated with worse graft function and a lower Tac level. Knowledge about the degree of adherence could help the early identification of nonadherent patients and the development of strategies to improve this., (© 2014 S. Karger AG, Basel)

Background/aim: Confusing data have been reported about the effect of ethanol or its metabolic products on blood pressure. The pressor agent, angiotensin II (Ang II), is found to be susceptible to degradation by different enzymes known as angiotensinases. We have studied the effects of ethanol and L-NAME, an inhibitor of nitric oxide synthase, consumption on rat serum and kidney ectoenzymes: aminopeptidase N (APN) and aminopeptidase A (APA)., Methods: Enzymatic activity of both enzymes was determined spectrophotometrically in serum and 10% homogenates of the rat kidney cortex using appropriate chromogenic substrates., Results: After 2 weeks of treatment with ethanol and L-NAME, blood urea and creatinine levels were significantly increased. The activities of APN (EC 3.4.11.2) and APA (EC 3.4.11.7) were reduced in serum as well as in kidney tissue during this period. L-NAME significantly attenuated activities of both enyzmes. Ethanol and L-NAME given simultaneously did not have an additional effect on the activity of investigated enzymes., Conclusion: Hypertension caused by chronic ethanol treatment as well as L-NAME administration could be associated with the reduction of APN and APA activity. Possible ethanol- and L-NAME-mediated inhibition of angiotensins degrading aminopeptidases could potentiate their effects on blood pressure., (Copyright 2007 S. Karger AG, Basel.)

Progression of some renal diseases is characterized by generation of reactive oxygen metabolites that are also involved in the pathophysiology of obstructive nephropathy. Catalase activity and lipid peroxidation were investigated in rats with unilaterally (UUL) and bilaterally ligated ureters (BUL). Forty-eight hours after ligation, the animals were sacrificed, and enzyme activity as well as the malondialdehyde (MDA) concentration were measured in the plasma, kidneys and livers. The activity of catalase was significantly reduced in the plasma of the BUL rats and in the kidneys of both investigated groups. In the liver, catalase activity was decreased only in the BUL group. The MDA concentration in the plasma and kidneys of the BUL rats was significantly increased while in the liver it remained unchanged. These results suggest that lipid peroxidation in the induced uremic state could be responsible for catalase inactivation.