losartan-potassium and Familial-Mediterranean-Fever

Utilizing both in vivo and in vitro techniques, a great deal of information has been obtained on the structure and regulation of the hematopoietic cell lineages. A number of hematopoietic stem cells and regulators have now been well characterized and their possible physiologic relevance at least in part established. More recently, new "alternative" or primitive stem cells have been described which may provide important insights into the nature of hematopoietic regeneration and regulation. These include late CFUs, high proliferative potential colony-forming cells, colony-forming unit diffusion chamber and both bipotent and blast colonies assayed in in vitro culture systems. Regulators active at these stem cell levels are also under study and in large part appear to be produced by monocytes or lymphocytes. Cyclical hematopoiesis can be viewed as a genetic abnormality at the multipotent stem cell level with defective cell production. At present however, details of the defect await further investigation possibly including an evaluation of the role of primitive stem cells and their regulators.

Topics: Animals; Bone Marrow; Cell Communication; Cell Differentiation; Colony-Forming Units Assay; Colony-Stimulating Factors; Dogs; Erythrocytes; Erythropoietin; Familial Mediterranean Fever; Granulocytes; Hematopoiesis; Hematopoietic Stem Cells; Humans; Macrophages; Megakaryocytes; Mice; Mice, Mutant Strains; Models, Biological

Familial Mediterranean fever (FMF) is an autosomal recessive disease seen primarily in Sephardic Jews, Turks, and Armenians. The disease manifests as recurrent attacks of fever and serositis. The most important complication of FMF is the development of renal failure due to AA type amyloidosis. There has not been extensive experience with renal replacement therapy in FMF amyloidosis. Nevertheless, there may be a concern about the possibility of higher rates of morbidity and mortality in amyloidotic patients maintained on chronic hemodialysis. Moreover, there is not enough experience regarding patients on chronic peritoneal dialysis. As a result, the best treatment modality of end-stage renal disease (ESRD) in these circumstances still remains unclear. This study aimed to compare the effect of hemodialysis and peritoneal dialysis modalities on clinical outcomes in ESRD patients associated with FMF amyloidosis.. Forty FMF patients with ESRD due to amyloidosis were retrospectively analyzed. All 40 patients were on renal replacement therapy, 20 on hemodialysis (HD), 20 on peritoneal dialysis (PD). Peritoneal solute transport rates, weekly mean creatinine clearance, and daily mean ultrafiltration (UF) of the patients on chronic peritoneal dialysis were evaluated. Weekly dialysis durations, dialysis membrane properties, Kt/V values, interdialytic weight gains, and frequency of hypotension during dialysis were evaluated on hemodialysis patients. All of the patients were examined according to their demographic characteristics, laboratory results, duration time on dialysis, erythropoietin requirements, frequencies of infectious complications requiring hospitalization, and the two renal replacement modalities mentioned above were compared in terms of these parameters.. Serum albumin levels of the patients with FMF amyloidosis who were maintained on peritoneal dialysis treatment were lower (2.87 vs 3.45) and the frequency of infections of the same group was higher (4.2 vs 0.5) than the patients with ESRD secondary to other diseases in the CAPD group.. This retrospective analysis showed that peritoneal dialysis may have some disadvantages in amyloidotic patients. Due to the high frequency of hypoalbuminemia and infectious complications seen in this group, peritoneal dialysis is widely accepted as an alternative choice of treatment when hemodialysis is not appropriate.

Topics: Adult; Amyloidosis, Familial; Biomarkers; Blood Pressure; Creatinine; Dialysis Solutions; Erythropoietin; Familial Mediterranean Fever; Female; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Peritoneal Dialysis; Recombinant Proteins; Renal Dialysis; Research Design; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome; Turkey; Weight Gain