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(1) SLUŢBA ZA NEFROLOGIJU I HEMODIJALIZU, OPŠTA BOLNICA ZAJEĈAR, (2) PRIVATNA INTERNISTIĈKA ORDINACIJA "DR BASTAĆ", (3) SLUŢBA ZA LABORATORIJSKU DIJAGNOSTIKU, OPŠTA BOLNICA ZAJEĈAR Sažetak:Kalcifikacija srĉanih valvula je ĉest nalaz kod bolesnika u terminalnom stadijumu hroniĉne bubreţne bolesti (HBB) i udruţena je sa povećanim ukupnim i kardiovaskularnim mortalitetom. Cilj ovog istraţivanja je da se utvrdi uĉestalost i faktori rizika povezani sa kalcifikacijom srĉanih valvula kod bolesnika u IV i V stadijumu HBB koji još nisu zapoĉeli leĉenje dijalizom. Istraţivanjem je obuhvaćen 61 bubreţni bolesnik (34 M, proseĉne starosti 62,6±13,6 godina) i 22 zdrave osobe srodne po starosti i polu. Svaki ispitanik je podvrgnut kliniĉkoj proceni, laboratorijskom ispitivanju, ehokardiografskom pregledu i ultrazvuĉnom pregledu karotidnih arterija. Kalcifikacije u predelu aortne i mitralne valvule su registrovane znaĉajno ĉešće u grupi bolesnika sa HBB nego u kontrolnoj grupi (47,5% : 9,1%; p=0,001). Bubreţni bolesnici su podeljeni prema prisustvu valvularnih kalcifikacija u 2 grupe: grupu A, sa kalcifikacijama (n=29) i grupu B, bez kalcifikacija (n=32). Bolesnici iz grupe A bili su znaĉajno stariji (p<0,01), imali su niţi klirens kreatinina (p<0,01) i više nivoe P (p<0,05), proizvoda CaxP (p<0,05) i PTH (p<0,05) nego bolesnici iz grupe B. Ehokardiografskim pregledom u grupi A je utvrĊeno ĉešće prisustvo hipertrofije leve komore (LVH, p <0,01) u odnosu na grupu B. Pregledom karotidnih arterija u grupi A je izmerena veća debljina intime-medije (IMT, p<0,001) i zabeleţeno je ĉešće prisustvo kalcifikovanih plakova (p=0,005) u poreĊenju sa grupom B. Valvularne kalcifikacije su visoko zastupljene već u predijaliznom periodu HBB i udruţene su sa poremećajima mineralnog metabolizma, hipertrofijom leve komore i vaskularnim kalcifikacijama. Ključne reči:valvularna kalcifikacija, hroniĉna bubreţna bolest, faktori rizika Summary:Valvular calcification is a common finding in patients with end-stage chronic kidney disease (CKD) and associated with increased all-cause and cardiovascular mortality. The aim of the study was to determine the prevalence and risk factors associated with cardiac valve calcification in patients with stage IV and V CKD, not yet on dialysis. The study enrolled 61 CKD patients (34 M, mean age 62.6±13.6 years) and 22 ageand sex-matched healthy controls. All participants underwent a clinical assessment, laboratory analyses, echocardiography and carotid artery ultrasound. Calcification of the aortic and mitral valve was more frequently in patients with CKD stages IV-V than the healthy controls (47.5% : 9.1%, p=0.001). CKD patients were divided according to the presence of valvular calcification in 2 groups: group A with calcification (n=29) and group B without calcification (n=32). Patients from group A were significantly older (p<0.01), had lower creatinine clearance (p<0.01), and higher levels of P (p <0.05), CaxP product (p<0.05) and PTH (p<0.05) compared to patients from group B. Echocardiography showed a higher pre...

Impaired glucose tolerance is a state characterized by hyperglycemia, but with the levels of blood glucose between normal and diabetic values. Diabetic retinopathy is a complication of diabetes the pathogenesis of which is associated with oxidative stress. Metformin is currently the drug of first choice in the treatment of diabetes mellitus type 2.The objective was to determine whether there is oxidative damage to the retina in an animal model using the analysis of oxidative damage parameters, TBA reactive substances (TBARS) and advanced oxidative protein products (AOPP), and whether this damage can be mitigated by metformin tratment.The experiment was performed on 10 weeks old Wistar rats randomized into 4 groups. Impaired glucose tolerance was induced by intraperitoneal injection of streptozotocin (STZ), administered 15 minutes after an intraperitoneal injection of nicotinamide. After 4 weeks, metformin was introduced (100 mg/kg, per os). After 2 weeks, the animals were sacrificed under deep anesthesia.The concentrations of TBARS and AOPP in retinal homogenates were significantly higher in animals with impaired glucose tolerance compared to controls (TBARS: 4.09 ± 0.39 vs. 2.98 ± 0.26; p < 0.001 and AOPP: 34.49 ± 3.21 vs. 26.26 ± 3.16; p < 0.001). A strong positive correlation between serum glucose level and level of TBARS (r = 0.757, p < 0.01) and AOPP levels (r = 0.683, p < 0.01) was found. Metformin did not show any significant effects on the examined parameters.Values of the examined parameters indicate that impaired glucose tolerance causes a strong oxidative stress in the retina, which is the first step in the onset of diabetic retinopathy. Metformin therapy at a dose of 100 mg/kg, showed no significant beneficial effect on the process of lipid peroxidation and oxidation of proteins in the tissues of the retina in animals with impaired glucose tolerance.