Gerasimovska, Vesna

Preferred name

Gerasimovska, Vesna

Official Name

Gerasimovska, Vesna

Main Affiliation

vesna.gerasimovska@medf.ukim.edu.mk

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Goodpasture Syndrome Diagnosed One Year And A Half after the Appearance of the First Symptoms (Case Report)
(Scientific foundation Spiroski, 2016-12-15)
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Sead Zejnel
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Dragana Stojkovic
BACKGROUND: Goodpasture syndrome was originally described as an association of alveolar haemorrhage and glomerulonephritis. It occurs when the immune system attacks and destroys healthy body tissue. AIM: We are presenting a patient with a clinical picture of pulmonary haemorrhage and glomerulonephritis, which is diagnosed by renal biopsy. CASE PRESENTATION: His illness began a year and a half before being diagnosed. In that period he had occasional exacerbations. He was received at our Clinic in extremely serious condition, and after stabilisation of his medical condition, there was made a biopsy of the kidney. The p-ANCA was 8.93 U/ml (neg < 3, poz > 5 U/ml). Histopathological diagnosis of biopsy of the kidney was: Glomerulonephritis extra capillaries focalis, segmentalis et globalis. Based on this he was diagnosed with Goodpasture syndrome. He received corticosteroid therapy and cyclophosphamide, with good response to treatment, and he is currently in a stable condition, receiving only corticosteroid therapy. CONCLUSION: Goodpasture syndrome is a severe illness caused by the formation of antibodies to the glomerular basement membrane and alveolus with consequential damage to renal and pulmonary function. With current therapy, long-term survival is more than 50%
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Extended spectrum beta-lactamase (ESBL) strains of E. coli as a cause of urinary tract infections in hospitalized patients
(BMC Part of Springer Nature, 2015-06-16)
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FP092CLINICAL CHARACTERISTICS OF APPARENT TREATMENT-RESISTANT HYPERTENSION IN CHRONIC KIDNEY DISEASE PATIENTS EVALUATED BY 24 HOUR AMBULATORY BLOOD PRESSURE MONITORING
(Oxford University Press (OUP), 2015-05)
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Bogdanovska, Stevka
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Pavleska Kuzmanovska, Svetlana
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Sikole, Aleksandar
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Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5
(Scientific Foundation SPIROSKI, 2019-06-15)
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Pavleska-Kuzmanovska, Svetlana
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Gjorgievska, Julija
An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a "gate of life" for the patients on hemodialysis.
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Chronic Kidney Disease as a Long-term Consequence of Preeclampsia and Hypertensive Disorders in Pregnancy
(Walter de Gruyter GmbH/Macedonian Medical Association, 2016-12-01)
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Preeclampsia is a condition characterized by hypertension, proteinuria after 20th week of gestation, dysfunction of other maternal organs or uteroplacentary dysfunction and is associated with short-term renal damage. Recent studies report on potential association of preeclampsia with chronic kidney disease in later life. The aim of this study was to determine this potential association by literature review and our results.</jats:p> <jats:p><jats:bold>Methods.</jats:bold> A Pubmed (Medline) literature search on the association of preeclampsia and subsequent chronic kidney disease was carried out. Our study was conducted at the Department of Nephrology of the University Clinical Centre Skopje in 2010 and included women who consulted the Clinic due to hypertension or impaired renal function and who had either preeclampsia or hypertensive disorders in pregnancy. Thirty patients with decreased glomerular filtration that occurred 1-28 years after pregnancy with hypertensive disorder were included in the study.</jats:p> <jats:p><jats:bold>Results.</jats:bold> Literature search yielded 227 abstracts, of which 19 papers were selected, and they referred only to chronic kidney disease in the period after delivery in patients with preeclampsia. Various risks for emergence of chronic kidney disease in later life were reported in recent literature, varying from 1.2 to 14 for preeclampsia and in patients with superimposed preeclampsia, the risk was 45 times higher. In our study, risk of reduction in glomerular filtration rate was highest in the first 5 years (OR 3.6, 95% CI 1.06-22.5). Delivery before 27 weeks of gestation insignificantly increased the risk of reduced glomerular filtration in the later period (OR 1.33 95% CI 0.2-8.5). Preeclampsia is not a direct risk factor for chronic kidney disease, however, proteinuria over 0.3 g/24h in the group of patients with hypertension or preeclampsia in pregnancy, increased the risk of reduced glomerular filtration rate by 28 times (OR 28.5, 95% CI 2.7-30.9).</jats:p> <jats:p><jats:bold>Conclusions.</jats:bold> Patients with preeclampsia need careful monitoring in postpartal and long-term period, not only for cardiovascular but for chronic kidney disease.</jats:p>
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Quality of Health Care and Mortality - Three Years of Experience
(Macedonian Association of Anatomists and Morphologists, 2018)
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SP575FOLLOW UP OF HEMODIALYSIS PATIENTS WITH CATHETER RELATED BACTEREMIA CAUSED BY STAPHYLOCOCCUS AUREUS METICILIN RESISTANT (MRSA)
(Oxford University Press (OUP), 2019-06-01)
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HEMODIALYSIS TUNNELED CENTRAL VENOUS CATHETERS: FIVE YEARS SINGLE CENTER EXPERIENCE
(Oxford University Press (OUP), 2015-05)
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Sikole, Aleksandar
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Dialysis in Adults in Year 2000 in the Republic of Macedonia
(SAGE Publications, 2002-05)
Polenakovic, M.H.
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Sikole, A.
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Grozdanovski, R.
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Amitov, V
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Stojkovski, Lj.
<jats:p> 1,019 adult patients with terminal renal failure were treated with dialysis (D) in the first part of the year 2000 in the Republic of Macedonia. 1,010 patients (99%) were treated with chronic intermittent (maintenance) hemodialysis (HD) while nine patients (1%) were on continuous ambulatory peritoneal dialysis (CAPD). For the children, a special peritoneal dialysis program was developed; 509 patients per million of the population (PMP) were on dialysis. </jats:p><jats:p> The Republic of Macedonia is, therefore, among those central and eastern European countries with a higher PMP number in the treatment of end-stage renal disease, following Croatia, the Czech Republic and Slovenia. </jats:p><jats:p> The patients were treated at 18 Centers in a network of HD Centers at a distance of 30–50 km. from their place of residence in order to facilitate their access to treatment and to work. All patients who have had symptoms indicating need for treatment with D were accepted for treatment. The government payed all the expenses of the treatment and the salaries of the staff. 56% were male and 44% were female patients. The youngest patient was aged 9 and the oldest was 82 years old. There has been an increase in the age of the patients on D as well as an increase in their number. In 1993 we had 727 patients being treated with D, and now we have 1,019 with a constant increase in the number of patients with ESRD and a need for D and renal transplantation. Mortality per year at the different Centers ranged from 8–19% in 1999 and the average is 12%. </jats:p><jats:p> Glomerulonephritis (GN) – both primary and secondary – is the main cause of renal failure (RF) in some Centers up to 45%. Tubulo-interstitial disease follows GN. ADPKD patients constitute 9.4% with a difference among the Centers of 3–29%, and diabetic nephropathy is found in 10%, 5–15% in different Centers. 11–61% of patients have an unknown etiology. </jats:p><jats:p> 352 patients are on treatment with human recombinant erythropoietin (rhuEPO) – in some Centers up to 60%. The mode of application was subcutaneous and the initial dose is 20 U/kg body weight and the mean maintenance dose of EPO per patient weekly is 4,000 U. </jats:p><jats:p> The Cimino-Brescia arteriovenous fistula is being applied as a standard vascular access. The survival rate of our patients treated with maintenance HD at 5 years was 58%. CAPD and particularly renal transplantation are to be further developed as alternative methods in treating terminal renal failure. </jats:p>
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Uric acid and left ventricular hypertrophy: another relationship in hemodialysis patients
(Oxford Academic, 2019-12-22)
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Stojceva-Taneva, O
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Tozija, L
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Background The impact of serum uric acid (UA) on morbidity and mortality in hemodialysis (HD) patients is quite controversial in relation to the general population. The aim of this study was to evaluate the association of serum UA with both mortality and left ventricular hypertrophy (LVH) in HD patients. Methods This longitudinal study enrolled 225 prevalent HD patients who were classified into three groups according to their follow-up-averaged UA (FA-UA) levels: low FA-UA (FA-UA <400 µmol/L), intermediate/reference FA-UA (FA-UA between 400 and 450 µmol/L) and high FA-UA (FA-UA >450 µmol/L). Echocardiography was performed on a nondialysis day and the presence of LVH was defined based on a left ventricular mass index (LVMI) >131 and >100 g/m2 for men and women, respectively. The patients were followed during a 60-month period. Results The mean FA-UA level was 425 ± 59 µmol/L (range 294–620). There was a consistent association of higher FA-UA with better nutritional status (higher body mass index, normalized protein catabolic rate, creatinine, albumin and phosphorus), higher hemoglobin, but lower C-reactive protein and LVMI. During the 5-year follow-up, 81 patients died (36%) and the main causes of death were cardiovascular (CV) related (70%). When compared with the reference group, the hazard ratio for all-cause mortality was 1.75 [95% confidence interval (CI) 1.02–2.98; P = 0.041] in the low FA-UA group, but there was no significant association with the high FA-UA group. In contrast, FA-UA did not show an association with CV mortality neither with the lower nor with the high FA-UA group. The unadjusted odds ratio (OR) of LVH risk in the low FA-UA compared with the reference FA-UA group was 3.11 (95% CI 1.38–7.05; P = 0.006), and after adjustment for age, gender, diabetes and CV disease, ORs for LVH persisted significantly only in the low FA-UA group [OR 2.82 (95% CI 1.16–6.88,); P = 0.002]. Conclusions Low serum UA is a mortality risk factor and is associated with LVH in HD patients. These results are in contrast with the association of UA in the general population and should be the subject of further research.

Gerasimovska, Vesna

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