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1
Peritoneal dialysis as a perpetuating cause of hyponatremia
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Open Access
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Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
José Juan Ribés Cruz , Jose Graña Fandos , Belen Alemany Sánchez , María Aparicio Aliaga , Yaiza Aznar Artiles , Esther Bea Reyes , Yolanda Blanco Mateos , Martina Mravcova , Diego Rodriguez Ortega , Miguel Ángel Candel Rosell
Yıl :
2017
Nefrología (English Edition)
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ISSN: 2013-2514
Cilt: 37
Sayı: 6
Sayfa: 659 - 660
Sınıflandırma :
2
An uncommon cause of spontaneous hemoperitoneum in a peritoneal dialysis patient
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Dergi:
Nefrología (English Edition)
Yazar(lar) :
Carlos Hidalgo-Ordoñez , Emilio Sánchez-Alvarez , Carmen Rodríguez-Suárez
Yıl :
2016
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2016.03.001
ISSN: 2013-2514
Cilt: 36
Sayı: 1
Sayfa: 80 - 81
Sınıflandırma :
3
Response to acetazolamide in a patient with tumoural calcinosis
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Venecia Landini-Enríquez , Marco Antonio Escamilla , Elena Soto-Vega , Karen Chamizo-Aguilar
Yıl :
2015
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2015.11.003
ISSN: 2013-2514
Cilt: 35
Sayı: 5
Sayfa: 503 - 505
Sınıflandırma :
4
Thermal disinfection in hemodialysis using the A0 concept as dispenser
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Néstor Gabriel Toapanta Gaibor , Luis Gil Sacaluga , Francisco de la Cerda Ojeda , José Ramón Molas Cotén , Mercedes Salgueira Lazo
Yıl :
2019
Nefrología (English Edition)
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Patients with chronic kidney disease in the hemodialysis program are exposed to large amounts of water, as this constitutes about 96% of the dialysis fluid. It is known that the use of better quality water decreases the state of chronic inflammation in dialysis patients. Disinfection as part of water treatment plays an important role in meeting the established quality standards; currently, heat disinfection is highly recommended, however the dose of it is not clearly established in the literature. The objective of this review is to know what is available in the literature on the dose of heat disinfection that should be used in hemodialysis and to present our experience with this method at a set dose of 12.000 A0. Resumen: Los pacientes con enfermedad renal crónica en programa de hemodiálisis se encuentran expuestos a grandes cantidades de agua ya que este constituye cerca del 96% del líquido de diálisis. Es conocido que el uso de agua de mejor calidad disminuye el estado de inflamación crónica en los pacientes en diálisis. La desinfección como parte del tratamiento del agua tiene un papel importante para cumplir los estándares de calidad establecidos; actualmente la desinfección por calor es altamente recomendable, sin embargo, la dosis de la misma no está claramente establecida en la literatura. El objetivo de esta revisión es conocer lo disponible en la literatura sobre la dosis de desinfección por calor que se debe utilizar en hemodiálisis, así como presentar nuestra experiencia con este método a una dosis establecida de 12.000 A0. Keywords: Thermal disinfection, Heat disinfection, Hemodialysis, Endotoxins, Concept A0, Palabras clave: Desinfección térmica, Hemodiálisis, Endotoxinas, Concepto A0
ISSN: 2013-2514
Cilt: 39
Sayı: 5
Sayfa: 482 - 488
5
Lengthening time to hemostasis in hemodialysis. Factor XI deficiency (hemophilia C): A case report
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Francisco Valga , Tania Monzón , Fernando Henriquez Palop , Gloria Antón
Yıl :
2017
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2017.04.017
ISSN: 2013-2514
Cilt: 37
Sayı: 5
Sayfa: 544 - 545
Sınıflandırma :
6
Acute renal colic: Beyond kidney stones
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Sandra Silva , Martinho Almeida , Lurdes Rodrigues , Maximino Costa
Yıl :
2016
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2016.02.001
ISSN: 2013-2514
Cilt: 36
Sayı: 2
Sayfa: 182 - 184
Sınıflandırma :
7
Application of model of incremental haemodialysis, based on residual renal function, at the initiation of renal replacement therapy
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
José L. Merino , Patricia Domínguez , Blanca Bueno , Yésika Amézquita , Beatriz Espejo , Vicente Paraíso
Yıl :
2017
Nefrología (English Edition)
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Introduction: The interest in the preservation of residual kidney function on starting renal replacement therapy (RRT) is very common in techniques such as peritoneal dialysis but less so in haemodialysis (HD). In our center the pattern of incremental dialysis (2 HD/week) has been an option for a group of patients. Here we share our experience with this regimen from March 2008. Material and methods: We included incident patients with residual diuresis >1000 ml/24 h, clinical stability, absence of edema, absence of hyperkalaemia >6.5 mEq/l and phosphoremia >6 mg/dl, with acceptable comprehension of dietetic care. Exclusion criteria were: clinical instability, no dietary or medical compliance and the afore mentioned laboratory abnormalities. Results: A total of 24 patients were included in incremental technique. The mean age at start of RRT was 60 ± 15 years. The average time on incremental technique was 19 ± 18 months (range: 7–80), with a mean time on dialysis of 31 ± 23 months (range: 12–86). The reasons for transfer to thrice-weekly HD were: in 6 patients due to laboratory tests, in 2 patients for heart failure events, one for poor compliance and 3 for receiving a kidney graft. The residual diuresis decreased in the first year from 2106 ± 606 ml/day to 1545 ± 558 (p = .17) with the urea clearance and calculated residual renal function, basal 5.7 ± 1.5 vs 3.8 ± 1.9 ml/min per year (p = .01) and basal 8.9 ± 2.4 vs 6.9 ± 4.3 per year (p = .28), respectively. Conclusions: Incremental HD treatment, with twice-weekly HD, may be an alternative in selected patients. This approach can largely preserve residual renal function at least for the first year. Although this pattern probably is not applicable to all patients starting RRT, it can and should be an initial alternative to consider.
DOI : 10.1016/j.nefroe.2017.02.005
Anahtar Kelimeler : Incremental dialysis, Residual diuresis, Mortality, Haemodialysis
ISSN: 2013-2514
Cilt: 37
Sayı: 1
Sayfa: 39 - 46
Sınıflandırma :
8
Lupus anticoagulant-hypoprothrombinemia syndrome: A rare association in systemic lupus erythematosus
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Gonzalo Carreño-Tarragona , Enrique Morales , María Carmen Jiménez-Herrero , Elena Cortés-Fornieles , Eduardo Gutierrez , Manuel Praga
Yıl :
2016
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2015.11.008
ISSN: 2013-2514
Cilt: 36
Sayı: 2
Sayfa: 186 - 188
Sınıflandırma :
9
Encapsulating peritoneal sclerosis: A review of 3 cases
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Carmen Merino Bueno , Laura del Rio García , José Joaquín Bande Fernández , Raúl García , Carlos Hidalgo Ordoñez , Carmen Rodríguez-Suárez , José Emilio Sánchez-Álvarez
Yıl :
2015
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2015.12.003
ISSN: 2013-2514
Cilt: 35
Sayı: 6
Sayfa: 588 - 590
Sınıflandırma :
10
Unlike Kt, high Kt/V is associated with greater mortality: The importance of low V
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Rafael Perez-Garcia , Maite Jaldo , Roberto Alcázar , Patricia de Sequera , Marta Albalate , Marta Puerta , Mayra Ortega , M. Caridad Ruiz , Elena Corchete
Yıl :
2019
Nefrología (English Edition)
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Introduction: Kt/V has been used as a synonym for hemodialysis dose. Patient survival improved with a Kt/V > 1; this target was subsequently increased to 1.2 and 1.3. The HEMO study revealed no significant relationship between Kt/V and mortality. The relationship between Kt/V and mortality often shows a J-shaped curve. Is V the confounding factor in this relationship? The objective of this study is to determine the relationship between mortality and Kt/V, Kt and body water content (V) and lean mass (bioimpedance). Methods: We studied a cohort of 127 prevalent hemodialysis patients, who we followed-up for an average of 36 months. Kt was determined by ionic dialysance, and V and nutrition parameters by bioimpedance. Kt/V, Kt corrected for body surface area (Kt/BSA) and target Kt/BSA were calculated. The mean data from 18,998 sessions were used as hemodialysis parameters, with a mean of 155 sessions per patient. Results: Mean age was 70.4 ± 15.3 years and 61% were male; 76 were dialyzed via an arteriovenous fistula and 65 were on online hemodiafiltration. Weight was 70.6 (16.8) kg; BSA 1.8 (0.25) m2; total body water (V) 32.2 (7.41) l and lean mass index (LMI) 11.1 (2.7) kg/m2. Mean Kt/V was 1.84 (0.44); Kt 56.1(7) l and Kt/BSA 52.8 (10.4) l. The mean target Kt/BSA was 49.7 (4.5) l. Mean Kt/BSA − target Kt/BSA + 6.4 (7.0) l. Patients with a higher Kt/V had worse survival rates than others; with Kt this is not the case. Higher Kt/V values are due to a lower V, with poorer nutrition parameters. LMI and serum albumin were the parameters that best independently predicted the risk of death and are lower in patients with a higher Kt/V and lower V. Conclusion: Kt/V is not useful for determining dialysis doses in patients with low or reduced body water. Kt or the Kt/BSA are proposed as an alternative. Resumen: Introducción: El Kt/V se ha usado como sinónimo de dosis de hemodiálisis. La supervivencia de los pacientes mejoraba con un Kt/V > 1; este objetivo posteriormente fue elevado a 1,2 y a 1,3. En el estudio HEMO no se demostró una relación significativa entre Kt/V y la mortalidad. La relación Kt/V y mortalidad con frecuencia es una curva en «J». ¿Es la V el factor de confusión de esa relación? El objetivo de este estudio es buscar la relación de la mortalidad con el Kt/V, Kt y con el contenido de agua corporal (V) y masa magra (bioimpedancia). Métodos: Se ha estudiado una cohorte de 127 pacientes prevalentes en hemodiálisis seguidos durante una media de 36 meses. Se determinó el Kt por dialisancia iónica y la V y parámetros de nutrición mediante bioimpedancia. Se ha calculado el Kt/V y el Kt alcanzado corregido para superficie corporal (Ktsc) y el Ktsc objetivo. Como parámetros de hemodiálisis se ha utilizado la media de los datos de 18.998 sesiones, con una media de 155 sesiones por paciente. Resultados: La edad media fue 70,4 (15,3) años y un 61% eran hombres; 76 se dializaban mediante fístula arteriovenosa y 65 estaban en HDF-OL. Peso: 70,6 (16,8) kg; superficie corporal: 1,8 (0,25) m2; agua corporal total: 32,2 (7,4) l; índice de masa magra (LTI): 11,1 (2,7) kg/m2. El Kt/V medio fue 1,84 (0,44); Kt: 56,1 (7) l, y el Ktsc, 52,8 (10,4) l. El Ktsc objetivo medio era de 49,7 (4,5) l. La media del Ktsc – Ktsc objetivo: +6,4 (7,0) l. Los pacientes con un Kt/V mayor tienen peor supervivencia que el resto. Con el Kt no existe esta relación. Los Kt/V mayores se deben a una V menor, con peores parámetros de nutrición. La albúmina sérica y el LTI son los parámetros que se relacionan con el riesgo de muerte de forma independiente y son menores en los pacientes con mayor Kt/V y menor V. Conclusión: El Kt/V no es útil para determinar la dosis de diálisis en pacientes con un agua corporal pequeña o disminuida. Se propone el Kt o el Ktsc como alternativa. Keywords: Kt/V, Kt, Hemodialysis, Mortality, Nutrition, Total body water, Palabras clave: Kt/V, Kt, Hemodiálisis, Mortalidad, Nutrición, Agua corporal total
ISSN: 2013-2514
Cilt: 39
Sayı: 1
Sayfa: 58 - 66
Sınıflandırma :
11
Role of photopheresis in the treatment of refractory cellular rejection in kidney transplantation
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Ernesto José Fernández , Celia López , Ana Ramírez , Rita Guerra , Lucía López , Fernando Fernández , Manuel Tapia , César García-Cantón
Yıl :
2016
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2015.06.013
ISSN: 2013-2514
Cilt: 36
Sayı: 3
Sayfa: 327 - 328
Sınıflandırma :
12
Impact of first year renal replacement therapy on the hospital admissions of a regional public health system
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Paula Lopez-Sanchez , Jose Portolés , Leyre Martín Rodríguez , Fernando Tornero , Arturo Jose Ramos Martin-Vegue , Jose Antonio Herrero , Juan Luis Cruz Bermúdez
Yıl :
2019
Nefrología (English Edition)
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Introduction and objectives: Chronic kidney disease has a high prevalence and economic impact, and an increased risk of hospitalization. Although there are public regional and country registries, we have not found references to estimate the impact of renal replacement therapy (RRT) on hospital admissions. Methods: We obtained authorization from the ethics committee and health authorities to integrate the REMER [Madrid Kidney Disease Registry] (2013-2014) and Minimum Basic Data Set (2013-2015) databases and to analyze the admissions during the first year of RRT. Results: 767 patients started RRT in all the hospitals of our region across all RRT modalities. More than a third of the patients start dialysis during a hospital admission. This unplanned start, more common in HD than PD, shows relevant differences in patient profile or admission characteristics.Without considering this initial episode, almost 60% of patients were admitted during their first year. The hospitalization rate was 1.2 admissions/patient, higher in HD than in TX or PD; the mean length of stay was 8.6 days.The estimated cost of admissions during the first year is €12,006/patient. Our analysis ensures the exhaustive inclusion of all episodes and accurate estimation based on the discharge form. Conclusion: The impact of RRT on hospitals has been underestimated and is very relevant when calculating the total cost of RRT. Results from other countries cannot be extrapolated due to differences in the health system and patient profile. The integration of clinical databases could open up an opportunity that needs only institutional support for its development. Resumen: Introducción: y objetivos La enfermedad renal crónica tiene una alta prevalencia y coste, así como un mayor riesgo de ingreso. Disponemos de registros públicos y obligatorios, pero no hay referencias recientes para estimar el impacto que el tratamiento sustitutivo renal (TSR) tiene en la actividad hospitalaria. Métodos: Tras las autorizaciones pertinentes, hemos integrado las bases de datos REMER (2013-2014) y CMBDH (2013-2015) para analizar la actividad hospitalaria durante el primer año de TSR. Resultados: Un total de 767 pacientes iniciaron TSR en los 7 hospitales de tercer nivel de la Comunidad de Madrid. Más de una tercera parte lo hicieron de forma no programada durante un ingreso. Este inicio es más frecuente en HD que en DP, pero existen diferencias clínicas relevantes en edad y en comorbilidad. Descartando este primer episodio, casi el 60% de pacientes ingresan durante el primer año. La tasa de ingreso es de 1,2 ingresos/paciente, más alta en HD que en TX y DP; la estancia media es de 8,6 días. El coste agregado de los ingresos del primer año es de 12.006 €/paciente. Nuestro análisis asegura la inclusión exhaustiva de todos los episodios y la estimación precisa de costes. Conclusiones: El impacto del TSR en la actividad hospitalaria ha sido infraestimado y es una parte importante del coste global del TSR. Los resultados de la literatura internacional no pueden extrapolarse a nuestro país por las diferencias en el modelo sanitario y perfil de paciente. La integración de bases de datos clínicas es técnicamente viable y podría abrir una vía inmensa de información que solo requiere apoyo institucional para su desarrollo. Keywords: Renal replacement therapy, Hospital admission, Economic impact, Peritoneal dialysis, Haemodialysis, Transplant, Minimum Basic Data Set, Palabras clave: terapia sustitutiva renal, ingreso hospitalario, coste, diálisis peritoneal, hemodiálisis, trasplante, CMBDH
ISSN: 2013-2514
Cilt: 39
Sayı: 6
Sayfa: 653 - 663
Sınıflandırma :
13
Glucose homeostasis changes and pancreatic β-cell proliferation after switching to cyclosporin in tacrolimus-induced diabetes mellitus
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Ana Elena Rodríguez-Rodríguez , Javier Triñanes , Esteban Porrini , Silvia Velázquez-García , Cecilia Fumero , María Jose Vega-Prieto , María Luisa Díez-Fuentes , Sergio Luis Lima , Eduardo Salido , Armando Torres
Yıl :
2015
Nefrología (English Edition)
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Background: Switching to cyclosporin A may result in a reversion of tacrolimus-induced diabetes mellitus. However, mechanisms underlying such a reversion are still unknown. Methods: Obese Zucker rats were used as a model for tacrolimus-induced diabetes mellitus. A cohort of 44 obese Zucker rats received tacrolimus for 11 days (0.3 mg/kg/day) until diabetes development; then, (a) 22 rats were euthanized at day 12 and were used as a reference group (tacrolimus-day 12), and (b) 22 rats on tacrolimus were shifted to cyclosporin (2.5 mg/kg/day) for 5 days (tacrolimus-cyclosporin). An additional cohort of 22 obese Zucker rats received the vehicle for 17 days and was used as a control group. All animals underwent an intraperitoneal glucose tolerance test at the end of the study. Results: β-Cell proliferation, apoptosis and Ins2 gene expression were evaluated. Compared to rats in tacrolimus-day 12 group, those in tacrolimus-cyclosporin group showed a significant improvement in blood glucose levels in all assessment points in intraperitoneal glucose tolerance test. Diabetes decreased from 100% in tacrolimus-day-12 group to 50% in tacrolimus-cyclosporin group. Compared to tacrolimus-day-12 group, rats in tacrolimus-cyclosporin group showed an increased β-cell proliferation, but such an increase was lower than in rats receiving the vehicle. Ins2 gene expressions in rats receiving tacrolimus-cyclosporin and rats receiving the vehicle were comparable. Conclusion: An early switch from tacrolimus to cyclosporin in tacrolimus-induced diabetes mellitus resulted in an increased β-cell proliferation and reversion of diabetes in 50% of cases.
DOI : 10.1016/j.nefroe.2015.06.006
Anahtar Kelimeler : Post-transplant diabetes mellitus, Tacrolimus, Cyclosporin A
ISSN: 2013-2514
Cilt: 35
Sayı: 3
Sayfa: 264 - 272
Sınıflandırma :
14
Benefits of a low intensity exercise programme during haemodialysis sessions in elderly patients
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Vicent Esteve Simo , Anna Junqué Jiménez , Fátima Moreno Guzmán , José Carneiro Oliveira , Miquel Fulquet Nicolas , Mónica Pou Potau , Anna Saurina Sole , Verónica Duarte Gallego , Irati Tapia Gonzalez , Manel Ramirez de Arellano
Yıl :
2015
Nefrología (English Edition)
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Background: Elderly patients on haemodialysis (HD) are a steadily increasing group. They show a high complexity, dependency and comorbidity. Multiple benefits from exercise in HD patients have been reported; however, they have not been specifically evaluated in an elderly population. Objective: To assess the effect of an adapted low intensity intradialytic exercise programme on muscle strength, functional capacity and health-related quality of life in our elderly patients (>80 years) on HD. Materials and methods: HD patients were non-randomly assigned to an exercise training group (E) or a control group (C) in a 12-week single-centre prospective study. E included a combined exercise programme using balls, weights, elastic bands and cycle movements in the first 2 h of HD sessions. C group patients received standard HD care. Endpoints were: (1) main biochemical data; (2) maximum quadriceps length strength (MQLS) and hand-grip (HG); (3) functional capacity tests: “Sit to stand to sit” (STS10) and “6-min walking test” (6MWT); (4) Beck Depressive Inventory (BDI); and (5) health-related quality of life questionnaire: EuroQol-5D (EQ-5D). Results: A total of 22 patients were included (50% men). Mean age was 83.2 years; patients had received HD for 44.1 months. Charlson index was 9.5. Main aetiology was diabetes mellitus (36.4%). Eleven patients were assigned to E group and 11 to C group. No related adverse effects were observed. At the end of the study, E group showed an overall improvement in tests (*p < 0.05): MQLS 10.5 ± 7.6 vs. 12.9 ± 10.1 kg, HG* 16.6 ± 8.7 vs. 18.2 ± 8.9 kg, STS10* 29.9 ± 10.6 vs. 25 ± 7.87 s, 6MWT* 14.6%, 234.4 vs. 274.7 m, BDI* 14.4 ± 11.5 vs. 11.7 ± 10.8 and EQ-5D 49 ± 19.1 vs. 59.5 ± 20.3. No similar changes were observed in C group. Significant differences between groups were also found for HG, MQLS, STS10, 6MWT, BDI and EQ-5D. No significant changes were found in biochemical and anthropometric data, antidepressant treatment or suitable dialysis parameters at the end of the study. Conclusions: (1) An adapted low intensity exercise programme improved muscle strength, functional capacity and health-related quality of life in our elderly patients on HD. (2) Our results highlight the benefits from exercise in HD patients even in this elderly population. (3) In elderly patients on HD, it is worth considering an adapted low intensity intradialytic exercise programme as a part of a comprehensive care.
DOI : 10.1016/j.nefroe.2015.03.005
Anahtar Kelimeler : Exercise, Elderly, Haemodialysis
ISSN: 2013-2514
Cilt: 35
Sayı: 4
Sayfa: 385 - 394
Sınıflandırma :
15
Cardiovascular calcifications in chronic kidney disease: Potential therapeutic implications
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Jordi Bover , Pablo Ureña-Torres , José Luis Górriz , María Jesús Lloret , Iara da Silva , César Ruiz-García , Pamela Chang , Mariano Rodríguez , José Ballarín
Yıl :
2016
Nefrología (English Edition)
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Cardiovascular (CV) calcification is a highly prevalent condition at all stages of chronic kidney disease (CKD) and is directly associated with increased CV and global morbidity and mortality. In the first part of this review, we have shown that CV calcifications represent an important part of the CKD–MBD complex and are a superior predictor of clinical outcomes in our patients. However, it is also necessary to demonstrate that CV calcification is a modifiable risk factor including the possibility of decreasing (or at least not aggravating) its progression with iatrogenic manoeuvres. Although, strictly speaking, only circumstantial evidence is available, it is known that certain drugs may modify the progression of CV calcifications, even though a direct causal link with improved survival has not been demonstrated. For example, non-calcium-based phosphate binders demonstrated the ability to attenuate the progression of CV calcification compared with the liberal use of calcium-based phosphate binders in several randomised clinical trials. Moreover, although only in experimental conditions, selective activators of the vitamin D receptor seem to have a wider therapeutic margin against CV calcification. Finally, calcimimetics seem to attenuate the progression of CV calcification in dialysis patients. While new therapeutic strategies are being developed (i.e. vitamin K, SNF472, etc.), we suggest that the evaluation of CV calcifications could be a diagnostic tool used by nephrologists to personalise their therapeutic decisions.
DOI : 10.1016/j.nefroe.2016.12.011
Anahtar Kelimeler : Chronic kidney disease, Vascular calcification, Chronic kidney diseaseu2013mineral and bone disorders, Phosphate, Vitamin D, Calcimimetics, Calciphylaxis
ISSN: 2013-2514
Cilt: 36
Sayı: 6
Sayfa: 597 - 608
Sınıflandırma :
16
Quantification of the risk of urinary calcium stone formation in the urine collected at 2 times of the day in a group of children studied to rule out prelithiasis
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Víctor M. García Nieto , Xochitl Illian Pérez Bastida , María Salvador Cañibano , Victoria E. García Rodríguez , Margarita Monge Zamorano , María Isabel Luis Yanes
Yıl :
2018
Nefrología (English Edition)
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Background: Various genetic and environmental factors are involved in urolithiasis. The 2 most common metabolic abnormalities are the increase in urinary calcium and low urinary citrate excretion. The ratio calculated between the concentrations of both substances is a good risk marker for the formation of calcium stones. Objectives: To determine whether the risk of urinary calcium stone formation changes throughout the day in the same patient. Methods: We studied 56 children (23 V, 33 M) to check if they had prelithiasis. Calcium, citrate, and creatinine concentrations were determined in two urine samples collected one before dinner and the other in the morning. It was collected if they had ultrasound stones and if there was a history of urolithiasis in first and/or second degree relatives. Results: In 25 patients (44.6%), renal ultrasound was positive for lithiasis (stones [n = 9] and microlithiasis [n = 16]). Forty of the 56 families (71.4%) had a history of urolithiasis. The percentage of abnormal urinary calcium (28.6%) concentrations and an abnormal calcium/citrate ratio (69.6%) was higher in the first urine of the day. The calcium/citrate ratio was the only studied parameter that was related to a family history of urolithiasis. There were no differences in urinary parameters between patients with and without ultrasound-confirmed kidney stones. Conclusions: Urinary concentrations of calcium and the calcium/citrate ratio vary throughout the day. Urine produced at night has a higher risk of urinary calcium stone formation. Resumen: Antecedentes: En la urolitiasis intervienen diversos factores genéticos y ambientales. Las 2 anomalías metabólicas más frecuentes son el incremento en la eliminación urinaria de calcio y la reducción en la de citrato. El cociente calculado entre las concentraciones de ambas sustancias es un buen marcador de riesgo de formación de cálculos cálcicos. Objetivos: Determinar si el riesgo litógeno en la orina de un mismo paciente cambia a lo largo del día. Métodos: Se estudiaron 56 niños (23 V, 33 M) para comprobar si eran portadores de prelitiasis. Se determinaron las concentraciones de calcio, citrato y creatinina en 2 muestras de orina recogidas, una, antes de cenar, y la otra, por la mañana, al levantarse. Se anotó si tenían cálculos ecográficos y si existían antecedentes de urolitiasis en los familiares de primer y/o segundo grado. Resultados: En 25 pacientes (44,6%) la ecografía renal fue positiva para litiasis (cálculos [n = 9] y microcálculos [n = 16]). En 40 de las 56 familias (71,4%) existían antecedentes de urolitiasis. El porcentaje mayor de valores anormales de la concentración urinaria de calcio (28,6%) y del cociente calcio/citrato (69,6%) correspondió a la primera orina del día. Este último parámetro fue el único entre los estudiados que se relacionó con los antecedentes familiares de urolitiasis. No se comprobaron diferencias en los parámetros urinarios al comparar a los pacientes con presencia o ausencia de litiasis renal ecográfica. Conclusiones: Las concentraciones urinarias de calcio y del cociente calcio/citrato se modifican a lo largo del día. Las orinas formadas durante la noche son más litógenas. Keywords: Urolithiasis, Calcium, Citrate, Urinary stone risk, Palabras clave: Urolitiasis, Calcio, Citrato, Riesgo litógeno
ISSN: 2013-2514
Cilt: 38
Sayı: 3
Sayfa: 267 - 272
Sınıflandırma :
17
A comparison of cyclophosphamide versus tacrolimus in terms of treatment effect for idiopathic membranous nephropathy: A meta-analysis
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Open Access
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Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Yan-Chun Li , Jing Huang , Xin Li , Su-Mei Zhao
Yıl :
2019
Nefrología (English Edition)
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Background and aims: Idiopathic membranous nephropathy (IMN), which is considered one of the most common causes of nephrotic syndrome in adult patients, is frequently managed with immunosuppressive agents. Both tacrolimus (TAC) and cyclophosphamide (CTX) are recommended as immunosuppressive agents in the management of IMN. However, profound effects and moderate evidence on the two drugs remains poorly defined at this period. The meta-analysis aims to summarize current best evidence on the efficacy as well as safety of TAC and CTX among IMN patients. Methods: We searched the publications on comparison of the safety and efficacy of TAC versus CTX for IMN up to April 2018. After rigorous reviewing on the quality, the data was extracted from eligible trials. All trials analyzed the summary hazard ratios (HRs) of the endpoints of interest. Results: Moderate-strong evidence indicated that tacrolimus and cyclophosphamide had comparable effects on remission rate (either CR or PR) (p > 0.05). No significant differences were found in the following parameters: the rates of diarrhea, glucose intolerance (or diabetes mellitus), gastrointestinal syndrome, as well as hypertension because of adverse effects (p > 0.05). However, patients with TAC therapy had a higher chance to develop urinary tract infection (p = 0.010) and tremor (p = 0.006). Additionally, remarkably higher risk existed in leukopenia among the CTX group as compared with the TAC group (p = 0.03). Conclusion: This meta-analysis presents a comprehensive assessment of current available evidence for the therapy of IMN, indicating a comparable remission rate with both TAC and CTX, while the long-term effects are needed for further verification. Nevertheless, different adverse effect profiles of two groups need careful consideration. Remarkably higher rates of urinary tract infection and tremor were observed among TAC group, while higher risk of leukopenia was found among CTX group. Further research into the treatment efficacy of both drugs is warranted to confirm the present conclusions. Resumen: Antecedentes y objetivos: La nefropatía membranosa idiopática (NMI), que se considera una de las causas más comunes del síndrome nefrótico en pacientes adultos, se trata con frecuencia con inmunodepresores. Tanto el tacrolimus (TAC) como la ciclofosfamida (CTX) se recomiendan como inmunosupresores en el tratamiento de la NMI. Sin embargo, los efectos profundos y la evidencia moderada de los 2 fármacos continúan estando mal definidas en este período. El metaanálisis pretende resumir la mejor evidencia actual sobre la eficacia y la seguridad del TAC y la CTX entre los pacientes con NMI. Métodos: Se realizaron búsquedas de publicaciones sobre comparación de seguridad y eficacia del TAC frente a la CTX para la NMI hasta abril de 2018. Después de una revisión rigurosa de la calidad, los datos se extrajeron de los ensayos idóneos. Todos los ensayos analizaron los cocientes de riesgo instantáneos resumidos de los criterios de valoración de interés. Resultados: La evidencia moderada-sólida indicó que el TAC y la CTX tuvieron efectos comparables en la tasa de remisión (remisión completa o remisión parcial) (p > 0,05). No se encontraron diferencias importantes en los siguientes parámetros: tasas de diarrea, intolerancia a la glucosa (o diabetes mellitus), síndrome gastrointestinal, así como hipertensión por efectos adversos (p > 0,05). Sin embargo, los pacientes con TAC como tratamiento tuvieron mayor probabilidad de desarrollar infección urinaria (p = 0,010) y temblor (p = 0,006). Además, existía un riesgo notablemente mayor de leucopenia entre el grupo que tomaba CTX que en el grupo que tomaba TAC (p = 0,03). Conclusión: Este metaanálisis presenta una evaluación exhaustiva de la evidencia disponible actualmente sobre el tratamiento de la NMI, que indica una tasa de remisión comparable con TAC y CTX, mientras que los efectos a largo plazo son necesarios para una comprobación adicional. Sin embargo, el perfil de diferentes efectos adversos de 2 grupos debe considerarse cuidadosamente. Se observaron tasas notablemente más altas de infección urinaria y temblor entre el grupo que tomaba TAC, mientras que se encontró mayor riesgo de leucopenia entre el grupo que tomaba CTX. Es necesaria investigación adicional sobre la eficacia del tratamiento de ambos fármacos para confirmar las conclusiones actuales. Keywords: Tacrolimus, Cyclophosphamide, Idiopathic membranous nephropathy, Meta-analysis, Palabras clave: Tacrolimus, Ciclofosfamida, Nefropatía membranosa idiopática, Metaanálisis
ISSN: 2013-2514
Cilt: 39
Sayı: 3
Sayfa: 269 - 276
Sınıflandırma :
18
Association between renal dysfunction and metalloproteinase (MMP)-9 activity in hypertensive patients
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Elena Rodríguez-Sánchez , José Alberto Navarro-García , Jennifer Aceves-Ripoll , Gloria Álvarez-Llamas , Julián Segura , María G. Barderas , Luis Miguel Ruilope , Gema Ruiz-Hurtado
Yıl :
2019
Nefrología (English Edition)
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Background and objective: Matrix metalloproteinases (MMPs) are involved in deleterious tissue remodelling associated with target organ damage in renal disease. The aim of this study was to study the association between renal dysfunction and activity of the inflammatory metalloproteinase MMP-9 in hypertensive patients with mild-moderate chronic kidney disease (CKD). Material and methods: Plasmatic active MMP-9, total MMP-9, tissue inhibitor of MMP-9 (TIMP-1), MMP-9/TIMP-1 ratio and MMP-9-TIMP-1 interaction were analysed in 37 hypertensive patients distributed by estimated glomerular filtration rate (eGFR) in 3 groups: >90, 90–60 and 60–30 mL/min/1.73 m2. Results: Total MMP-9 was not different as eGFR declines. TIMP-1 was significantly increased in hypertensive patients with eGFR 60–30 mL/min/1.73 m2 (p < 0.01 vs. >90 mL/min/1.73 m2). This relates to the significant decrease in the interaction between MMP-9-TIMP-1 observed in patients with eGFR 60–30 mL/min/1.73 m2 (p < 0.01 vs. >90 mL/min/1.73 m2). Despite the systemic elevation of TIMP-1, active MMP-9 was significantly increased in hypertensive patients with eGFR 60–30 mL/min/1.73 m2 (p < 0.05 and p < 0.01 vs. >90 and 90–60 mL/min/1.73 m2, respectively). TIMP-1, active MMP-9 and MMP-9-TIMP-1 interaction significantly correlate with the decline in renal function, which was not observed with total MMP-9. Conclusions: The progression of CKD, even in stages where the decline of renal function is still moderate, is associated with an increase in MMP-9 activity, which could be considered as a potential therapeutic target. Resumen: Antecedentes y objetivo: Las enzimas metaloproteinasas de matriz (MMP) están involucradas en el remodelado tisular deletéreo asociado al daño de órganos diana de la enfermedad renal. El objetivo de este estudio fue explorar la asociación entre la caída de la función renal y la actividad sistémica de la metaloproteinasa inflamatoria MMP-9 en el paciente hipertenso con enfermedad renal crónica (ERC) leve-moderada. Material y métodos: Se analizaron los niveles plasmáticos de MMP-9 activa, MMP-9 total, su inhibidor tisular (TIMP-1), el cociente MMP-9/TIMP-1 y la interacción entre MMP-9 y TIMP-1 en 37 pacientes hipertensos distribuidos según su tasa de filtración glomerular estimada (TFGe) en 3 grupos: > 90, 90–60 y 60–30 mL/min/1,73 m2. Resultados: La MMP-9 total no fue diferente con respecto a la disminución en la TFGe. TIMP-1 estaba significativamente incrementado en los pacientes hipertensos con TFGe entre 60–30 mL/min/1,73 m2 (p < 0,01 versus > 90 mL/min/1,73 m2). Estos resultados fueron apoyados por la disminución significativa de la interacción MMP-9-TIMP-1 observada en los pacientes con TFGe entre 60–30 mL/min/1,73 m2 (p < 0,01 versus > 90 mL/min/1,73 m2). A pesar de la elevación sistémica de TIMP-1 encontramos un incremento significativo de MMP-9 activa en los pacientes hipertensos con TFGe entre 60–30 mL/min/1,73 m2 (p < 0,05 y p < 0,01 versus > 90 y 90–60 mL/min/1,73 m2, respectivamente). Los niveles de TIMP-1, MMP-9 activa e interacción proteica MMP-9-TIMP-1 correlacionaron significativamente con el deterioro de la función renal, lo cual no se observó para la MMP-9 total. Conclusiones: La progresión de la ERC, incluso en estadios donde la caída de la función renal es aún moderada, se asocia con un aumento específico de la actividad MMP-9, lo cual podría considerarse como una potencial diana terapéutica. Keywords: Chronic kidney disease, Metalloproteinases, Matrix metalloproteinase-9, Tissue inhibitor of metalloproteinase-1, Hypertension, Palabras clave: Enfermedad renal crónica, Metaloproteinasas, Metaloproteinasa de matriz-9, Inhibidor tisular de metaloproteinasas de matriz-1, Hipertensión
ISSN: 2013-2514
Cilt: 39
Sayı: 2
Sayfa: 184 - 191
19
A Spanish version for the new ERA-EDTA coding system for primary renal disease
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Óscar Zurriaga , Carmen López-Briones , Eduardo Martín Escobar , Ramón Saracho-Rotaeche , Íñigo Moina Eguren , Luis Pallardó Mateu , José María Abad Díez , José Ignacio Sánchez Miret
Yıl :
2015
Nefrología (English Edition)
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Background: The European Renal Association and the European Dialysis and Transplant Association (ERA-EDTA) have issued an English-language new coding system for primary kidney disease (PKD) aimed at solving the problems that were identified in the list of “Primary renal diagnoses” that has been in use for over 40 years. Purpose: In the context of Registro Español de Enfermos Renales (Spanish Registry of Renal Patients [REER]), the need for a translation and adaptation of terms, definitions and notes for the new ERA-EDTA codes was perceived in order to help those who have Spanish as their working language when using such codes. Methods: Bilingual nephrologists contributed a professional translation and were involved in a terminological adaptation process, which included a number of phases to contrast translation outputs. Codes, paragraphs, definitions and diagnostic criteria were reviewed and agreements and disagreements aroused for each term were labelled. Finally, the version that was accepted by a majority of reviewers was agreed. Results: A wide agreement was reached in the first review phase, with only 5 points of discrepancy remaining, which were agreed on in the final phase. Conclusions: Translation and adaptation into Spanish represent an improvement that will help to introduce and use the new coding system for PKD, as it can help reducing the time devoted to coding and also the period of adaptation of health workers to the new codes.
DOI : 10.1016/j.nefroe.2015.03.004
Anahtar Kelimeler : Codes, Primary kidney disease, Semantics, Adaptation
ISSN: 2013-2514
Cilt: 35
Sayı: 4
Sayfa: 353 - 357
Sınıflandırma :
20
Obesity and kidney function; epidemiological study data: Prevalence of chronic kidney disease in Spain. EPIRCE study
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Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Alfonso Otero González , A.L.M. de Francisco , P. Gayoso , F. Garcia López
Yıl :
2018
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2018.01.001
ISSN: 2013-2514
Cilt: 38
Sayı: 1
Sayfa: 107 - 108
Sınıflandırma :
21
Diarrhea and malnutrition in kidney transplant recipient: A case of infection by cryptosporidiosis
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Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Raquel Castellano Carrasco , M. José Torres Sánchez , Francisco Javier de Teresa Alguacil , Antonio Osuna Ortega
Yıl :
2017
Nefrología (English Edition)
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DOI : 10.1016/j.nefroe.2017.05.004
ISSN: 2013-2514
Cilt: 37
Sayı: 3
Sayfa: 338 - 339
Sınıflandırma :
22
Our experience in emergency treatment of renal haemorrhage
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Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Cristina Pantoja Peralta , Almudena Badenes Gallardo , Raúl García Vidal , Natalia Rodríguez Espinosa , Francesc Pañella Agustí , Benet Gómez Moya
Yıl :
2019
Nefrología (English Edition)
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Introduction: Renal haemorrhage is a potentially life-threatening event requiring emergency surgery. Endovascular therapy is currently the first-line treatment option. Objectives: Review patients with renal haemorrhage who required emergency endovascular therapy at our centre. Evaluate the causes of the bleeding, the treatment performed and the clinical outcomes. Material and methods: We performed a retrospective analysis of consecutive patients with renal bleeding who underwent endovascular therapy from June 2012 to June 2017 at Hospital Universitari Joan XXIII (Tarragona, Spain). Demographic data (age, gender and comorbidity) and other related variables were collected (mechanism of injury, haemodynamic stability and anticoagulant therapy). We also studied the CT angiography findings, time from diagnosis to surgery, endovascular technique and materials used, extent of tissue embolised and outcomes. Results: Twenty-two (22) patients were included with a mean age of 63 (range 19–85). The aetiology of injuries included: renal biopsy (n = 7, 31.8%), bleeding from malignant kidney tumour (n = 5, 22.7%), trauma (n = 4, 18.2%), angiomyolipoma (n = 2, 9.1%), spontaneous bleeding (n = 2, 9.1%) and surgical complications (n = 2, 9.1%). The endovascular therapy technique was embolisation in all cases. The following materials were used: spheres (9.1%); coils (63.6%); spheres + coils (18.2%); and spheres + plug (9.1%). In 17 cases (77.3%), selective embolisation was performed and in five cases (22.7%), embolisation of the whole kidney. Clinical and technical success rates of 100% were recorded. The 30-day mortality rate was 9.1%. Conclusion: We believe that endovascular therapy is an effective modality for the management of renal bleeding which, in many cases, enables a large part of the renal tissue to be preserved. Resumen: Introducción: Los casos de hemorragia renal que provocan un compromiso para la vida del paciente requieren de una cirugía urgente. Actualmente la cirugía endovascular es el tratamiento de primera elección. Objetivo: Revisar los pacientes con una hemorragia renal que fueron intervenidos de urgencia mediante una técnica endovascular en nuestro centro. Evaluar las causas de sangrado renal, el tratamiento realizado así como los resultados obtenidos. Material y métodos: Realizamos un estudio retrospectivo de pacientes consecutivos con sangrado renal y que fueron tratados con una técnica endovascular entre junio del 2012 y junio del 2017 en el Hospital Universitari Joan XXIII (Tarragona). Se recogieron los datos demográficos (edad, sexo, comorbilidad) y otras variables relacionadas (mecanismo de la lesión, la estabilidad hemodinámica y si estaba en tratamiento anticoagulante). También se analizaron los hallazgos encontrados en la angio-TAC, el tiempo transcurrido entre el diagnóstico y la realización de la cirugía, la técnica endovascular y el material utilizado, la extensión de parénquima embolizado y los resultados obtenidos. Resultados: Incluimos a 22 pacientes con una edad media de 63 años (19-85). Las causas de lesión fueron relacionadas con punción de una biopsia renal (n=7,31; 8%), sangrado de tumoraciones malignas renales (n=5; 22,7%), traumatismos (n=4; 18,2%), angiomiolipomas (n=2; 9,1%), sangrado espontáneo (n=2; 9,1%) y complicaciones quirúrgicas (n=2; 9,1%). En todos los casos la técnica endovascular realizada fue la embolización. El material utilizado fue: esferas (9,1%), coils (63,6%), esferas + coils (18,2%), esferas+oclusor (9,1%). En 17 de los casos (77,3%) se llevó a cabo una embolización selectiva y en 5 casos (22,7%) una embolización de todo el riñón. El éxito clínico y técnico fue del 100%. La mortalidad a los 30 días fue del 9,1%. Conclusión: Creemos que el tratamiento endovascular es una técnica efectiva para el control del sangrado renal y permite, en la mayoría de casos, la preservación de gran parte de parénquima renal. Keywords: Embolisation, Haemorrhage, Kidney, Renal artery, Palabras clave: Embolización, Hemorragia, Riñón, Arteria renal
ISSN: 2013-2514
Cilt: 39
Sayı: 3
Sayfa: 301 - 308
Sınıflandırma :
23
Sacubitril/valsartan in chronic kidney disease, the nephrologist point of view
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Borja Quiroga , Antonio de Santos , David Sapiencia , Yamila Saharaui , Vicente Álvarez-chiva
Yıl :
2019
Nefrología (English Edition)
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Introduction: Sacubitril/valsartan reduces cardiovascular morbidity and mortality in patients with systolic dysfunction (SD). The aim of the present study was to assess the evolution of chronic kidney disease (CKD) patients after initiating sacubitril/valsartan. Methods: We included 66 consecutive CKD patients with SD followed up in outpatient care. Patients had to meet the inclusion criteria of having a New York Heart Association class II to IV, receiving maximum tolerated doses of optimal medical therapy and CKD stages 1–4. At baseline, comorbidities and epidemiological data were collected and low doses of sacubitril/valsartan were initiated. At month 1 and 3, doses of sacubitril/valsartan were increased up to the maximum doses if tolerated. In each visit, renal function and cardiac biomarkers were recorded. All the data were analyzed at the end of follow up (6 months). Results: Of the 66 patients, 42 (63 %) were men, with a mean age of 73 ± 15 years. Mean creatinine at baseline was 1.42 ± 0.5 mg/dl (glomerular filtration rate (GFR) estimated by CKD-EPI was 50 ± 19 ml/min/1.73 m2) and mean left ventricular ejection fraction (LVEF) was 31 ± 9 %. At the end of follow up, LVEF improved from 31 ± 9%–39 ± 15 % (p < 0.001). After one month of treatment, renal function improved up to 53 ± 21 ml/min/1.73 m2, p = 0.005. For the remaining follow-up time, GFR remained stable (mean at end of follow-up 51 ± 18 ml/min/1.73 m2). Seven patients (10.6 %) withdrew from treatment. Conclusion: In our experience, sacubitril/Valsartan is safe in CKD, offering stability in CKD progression after 6 months. Resumen: Antecedentes y objetivo: Sacubitrilo/valsartan ha demostrado ser eficaz en la reducción de la morbi-mortalidad cardiovascular en los pacientes con disfunción sistólica (DS). El objetivo del presente estudio fue analizar la evolución de pacientes con enfermedad renal crónica (ERC) tras el inicio de sacubitril/valsartán. Material y métodos: Se incluyó a 66 pacientes consecutivos que acudieron a las consultas externas de Nefrología, con ERC y DS. Los criterios de inclusión fueron: presentar una clase funcional II a IV de la New York Heart Association (NYHA) con el tratamiento médico optimizado y ERC estadios 1 a 4. Se recogieron datos basales epidemiológicos y de comorbilidad en el momento de inicio del fármaco. En los meses 1 y 3 se tituló la dosis de sacubitril/valsartán (en función de la tolerancia). En cada visita se recogieron datos analíticos de función renal y biomarcadores cardiacos, entre otros. Se analizaron los datos a los 6 meses (fin del seguimiento). Resultados: De los 66 pacientes, 42 eran varones (63%) con una edad media 73 ± 15 años. La creatinina media fue de 1,42 ± 0,5 mg/dL (filtrado glomerular CKD-EPI 50 ± 19 ml/min/1,73 m2) con una fracción de eyección del ventrículo izquierdo (FEVI) media de 31 ± 9. Al final del seguimiento, la FEVI mejoró significativamente (basal 31 ± 9 vs final 39 ± 15, p < 0,001). En cuanto a la función renal, el filtrado glomerular por CKD-EPI presentó mejoría al mes (50 ± 19 vs 53 ± 21 ml/min/1,73 m2, p = 0,005) que se mantuvo estable (filtrado glomerular al final del seguimiento 51 ± 18 ml/min/1,73 m2). Abandonaron el tratamiento 7 pacientes (10.6%). Conclusión: En nuestra experiencia, sacubitril/valsartán es seguro en los pacientes con insuficiencia renal crónica y estabiliza la función renal a los 6 meses. Keywords: Chronic kidney disease, Heart failure, Renal failure, Sacubitril/valsartan, Palabras clave: Enfermedad renal crónica, Insuficiencia cardiaca, Insuficiencia renal, Sacubitrilo/Valsartán
ISSN: 2013-2514
Cilt: 39
Sayı: 6
Sayfa: 646 - 652
24
Acute renal failure in patients with myeloma: Experience with extended high cut-off hemodialysis
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Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
María Isabel Sáez , Vanesa Camarero , Alejandro Rosales , Badawi Hijazi , María Jesus Izquierdo , Jorge Labrador , Rodolfo Alvárez , Julio Hermida , Verónica Mercado , María Dolores Badía , Raquel de Toro , Basilia González , Pedro Abaigar
Yıl :
2017
Nefrología (English Edition)
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Kaydet Alıntıla
DOI : 10.1016/j.nefroe.2016.10.012
ISSN: 2013-2514
Cilt: 37
Sayı: 4
Sayfa: 429 - 431
Sınıflandırma :
25
Cardiovascular risk prediction in chronic kidney disease patients
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Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Santiago Cedeño Mora , Marian Goicoechea , Esther Torres , Úrsula Verdalles , Ana Pérez de José , Eduardo Verde , Soledad García de Vinuesa , José Luño
Yıl :
2017
Nefrología (English Edition)
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Introduction: Scores underestimate the prediction of cardiovascular risk (CVR) as they are not validated in patients with chronic kidney disease (CKD). Two of the most commonly used scores are the Framingham Risk Score (FRS-CVD) and the ASCVD (AHA/ACC 2013). The aim of this study is to evaluate the predictive ability of experiencing a cardiovascular event (CVE) via these 2 scores in the CKD population. Material and methods: Prospective, observational study of 400 prevalent patients with CKD (stages 1–4 according the KDOQI; not on dialysis). Cardiovascular risk was calculated according to the 2 scores and the predictive capacity of cardiovascular events (atherosclerotic events:myocardial infarction, ischaemic and haemorrhagic stroke, peripheral vascular disease; and non-atherosclerotic events: heart failure) was analysed. Results: Forty-nine atherosclerotic cardiovascular events occurred in 40.3 ± 6.6 months of follow-up. Most of the patients were classified as high CVR by both scores (59% by the FRS-CVD and 75% by the ASCVD). All cardiovascular events occurred in the high CVR patients and both scores (FRS-CVD log-rank 12.2, P < 0.001, HR 3.1 [95% CI: 1.3–7.1] P: 0.006 and ASCVD log-rank 8.5 P < 0.001, HR 3.2 [95% CI: 1.1–9.4] P: 0.03) were independent predictors adjusted to renal function, albuminuria and previous cardiovascular events. Conclusion: The cardiovascular risk scores (FRS-CVD and ASCVD [AHA/ACC 2013]) can estimate the probability of atherosclerotic cardiovascular events in patients with CKD regardless of renal function, albuminuria and previous cardiovascular events.
DOI : 10.1016/j.nefroe.2017.03.005
Anahtar Kelimeler : Chronic kidney disease, Cardiovascular risk, Cardiovascular risk score, FRS-CVD, ASCVD
ISSN: 2013-2514
Cilt: 37
Sayı: 3
Sayfa: 293 - 300
26
Beneficial long-term effect of aldosterone antagonist added to a traditional blockade of the renin–angiotensin–aldosterone system among patients with obesity and proteinuria
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Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Enrique Morales , Eduardo Gutiérrez , Jara Caro , Angel Sevillano , Jorge Rojas-Rivera , Manuel Praga
Yıl :
2015
Nefrología (English Edition)
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Kaydet Alıntıla
Introduction: Over the past decade, obesity has become a risk factor for developing chronic kidney disease. Proteinuria is known to be an independent determinant of the progression of chronic kidney disease, and adipose tissue is a recognized source of components of the renin–angiotensin–aldosterone system (RAAS). Recent studies have shown that plasma aldosterone levels are disproportionately higher in patients with obesity. Drugs that block the RAAS are unable to inhibit aldosterone in the long term. The aim of our study was to analyze the renoprotective effect of an aldosterone antagonist in combination with RAAS blockers in patients with obesity and proteinuric nephropathy. Material and methods: This study is a substudy of previously published study on the renoprotective effect of mineralocorticoid receptor blockers in patients with proteinuric nephropathies. Patients with proteinuria levels >1 g/24 h who were taking spironolactone and were being treated with other RAAS blockers were divided according to body mass index (BMI) into an obesity group (BMI ≥30 kg/m2) and a control group. Results: Seventy-one patients were included in the study, with a mean age of 56.7 ± 15.1 years. More than 50% of the patients in both groups had diabetes. Thirty-two patients were included in the obesity group and 39 were included in the control group. There were no significant differences in renal function, proteinuria, blood pressure, serum potassium levels and the percentage of RAAS blockers in both groups. After a follow-up of 28.9 (14–84) months, there was a 59.4% reduction in proteinuria in the obesity group (2.8 ± 2.1 vs. 1.3 ± 1.6 g/24 h, p < .05). The reduction in proteinuria was greater than 50% in 22 (68.8%) cases, and the mean blood pressure showed a significant decrease (from 100.6 ± 9 to 92.1 ± 7.4 mm Hg, p < .05). The control group showed a 69.6% reduction in proteinuria (1.9 ± 1.4 to 0.8 ± 0.5, p < 0.05). The reduction of proteinuria was higher than 50% in 22 (68.8%) cases in obese patients and in 33 (84.6%) cases in non-obese group. Renal function remained stable in both groups during the follow-up. Nine patients (28.1%) in the obesity group experienced gynecomastia. The incidence of hyperkalemia was similar for the 2 groups (6.3%). Conclusion: Aldosterone antagonist treatment in obese patients with proteinuric nephropathies induces a drastic and sustained reduction in proteinuria but not more than the non-obese group. There was a trend toward slowing progression of renal failure with few adverse events.
DOI : 10.1016/j.nefroe.2015.11.007
Anahtar Kelimeler : Obesity, Aldosterone antagonist, Proteinuria, Nephropathy
ISSN: 2013-2514
Cilt: 35
Sayı: 6
Sayfa: 554 - 561
Sınıflandırma :
27
Berardinelli-Seip syndrome in peritoneal dialysis
Dergi Makalesi

Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
José Joaquín Bande-Fernández , Raúl García-Castro , José Emilio Sánchez-Alvarez , Carmen Rodríguez-Suárez , Diego Coronel-Aguilar , Carlos Hidalgo , Beatriz Istanbuli , Carmen Merino-Bueno , Laura del Rio-García
Yıl :
2015
Nefrología (English Edition)
Yayıncı Web Sitesi
 Piri Tam Metin Bulucu
Kaydet Alıntıla
A case of Berardinelli-Seip syndrome, a congenital generalised lipodystrophy, is reported. Symptoms first appeared when the patient was 20 years old. She showed severe insulin resistance as well as micro- and macro-angiopathic complications, including chronic kidney disease, which required renal replacement therapy with peritoneal dialysis. The patient's clinical course was reviewed since paediatric age (when initial signs of the disease being already evident) to present time. Berardinelli-Seip syndrome is very uncommon, and the present case is particularly rare because it is the only case (at least as reported in the literature) in a patient receiving dialysis.
DOI : 10.1016/j.nefroe.2015.11.005
Anahtar Kelimeler : Berardinelli-Seip syndrome, Chronic kidney disease, Diabetic nephropathy, Peritoneal dialysis
ISSN: 2013-2514
Cilt: 35
Sayı: 5
Sayfa: 493 - 496
Sınıflandırma :
28
Congenital nephrotic syndrome secondary to pertussis
Dergi Makalesi

Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Mervan Bekdas , Recep Eroz , Busra Cihan
Yıl :
2020
Nefrología (English Edition)
Yayıncı Web Sitesi
Kaydet Alıntıla
ISSN: 2013-2514
Cilt: 40
Sayı: 2
Sayfa: 205 - 206
Sınıflandırma :
29
Hypercalcemia and hypophosphatemia in a 11 years old girl with ovarian tumour
Dergi Makalesi

Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
Mercedes Ubetagoyena Arrieta , Jorge Martinez Sainz de Jubera , Nagore García de Andoin Barandiaran , José Javier Úriz Monaut , Sheila López Cuesta , Ana Domínguez Castells
Yıl :
2017
Nefrología (English Edition)
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Kaydet Alıntıla
DOI : 10.1016/j.nefroe.2017.01.023
ISSN: 2013-2514
Cilt: 37
Sayı: 1
Sayfa: 100 - 101
Sınıflandırma :
30
Low triiodothyronine is associated with elevation of N-terminal pro-brain natriuretic peptide (NT-proBNP) and mortality in dialysis patients
Dergi Makalesi

Dergi Makalesi
Open Access
Kaynak :
Directory of Open Access Journals (DOAJ)
Dergi:
Nefrología (English Edition)
Yazar(lar) :
María del Carmen Prado-Uribe , María-de-Jesús Ventura , Marcela Ávila-Díaz , Carmen J. Mora , Antonio Méndez-Durán , Diana Villanueva-Noches , Alejandra Cisneros , Begoña Ilabaca , Alfonso Cueto-Manzano , Fernando García-Contreras , Bengt Lindholm , Elvia García-López , Ramón Paniagua
Yıl :
2017
Nefrología (English Edition)
Yayıncı Web Sitesi
Kaydet Alıntıla
Background: Low thyroid hormone (TH) levels and myocardial damage are common in dialysis patients and are associated with mortality. However, little is known about the role of THs on myocardial damage as has been described in primary thyroid diseases. The aim of this study was to explore the potential relationship between low total triiodothyronine (total T3) and biomarkers of myocardial damage and the effect of their interaction on mortality, to ascertain if cardiovascular damage is the link between low THs and the risk of death in dialysis patients with CKD. Material and methods: TH plasma levels, nutritional markers, inflammation and myocardial damage were studied in 296 patients undergoing peritoneal dialysis or haemodialysis, who were followed up for 16 months to ascertain the association between biochemical variables and mortality. Results: Low total T3 levels were found in 45% of patients, which was inversely correlated with C-reactive protein (CRP) and NT-proBNP, and directly correlated with albumin and transferrin. Diabetes, CRP and total T3 were risk factors for all-cause mortality, and CRP, NT-proBNP and total T3 for cardiovascular mortality. Conclusions: Low total T3 levels are common in dialysis patients and are associated with inflammation, malnutrition and myocardial damage. The latter may be the link between low THs and all-cause and cardiovascular mortality. Resumen: Antecedentes: La disminución de hormonas tiroideas (HT) y el daño miocárdico son frecuentes en pacientes en diálisis y están asociados con la mortalidad. Sin embargo, poco se conoce de la importancia de las HT como factor de daño miocárdico, como se ha descrito en las enfermedades tiroideas primarias. El objetivo de este estudio fue explorar si existe interacción entre la disminución de triyodotironina total (tT3) y los marcadores de daño miocárdico y la relación de esta interacción entre ambos con la mortalidad, para establecer si el daño cardiovascular es el vínculo entre la disminución de HT y el riesgo de muerte en pacientes con ERC en diálisis. Material y métodos: Se estudiaron los niveles plasmáticos de HT, de marcadores de nutrición, inflamación y de daño al miocardio en 296 pacientes en diálisis peritoneal o en hemodiálisis, a los que se vigiló por 16 meses para conocer la asociación de las variables bioquímicas con la mortalidad. Resultados: En el 45% de los pacientes se encontró tT3 disminuida, lo cual tuvo correlación inversa con la proteína C reactiva (PCR) y con el NT-proBNP y directa con la albúmina y la transferrina. La diabetes, la PCR y la tT3 fueron factores de riesgo para la mortalidad por cualquier causa y la PCR, el NT-proBNP y la tT3 para mortalidad cardiovascular. Conclusiones: Los niveles bajos de tT3 son frecuentes en pacientes en diálisis, se asocian con inflamación, desnutrición y daño miocárdico: este último puede ser el vínculo entre la disminución de HT y la mortalidad por cualquier causa y la mortalidad cardiovascular. Keywords: Thyroid hormones, Triiodothyronine, Hemodialysis, Peritoneal dialysis, Mortality, NT-proBNP, Palabras clave: Hormonas tiroideas, Triyodotironina, Hemodiálisis, Diálisis peritoneal, Mortalidad, NT-proBNP
ISSN: 2013-2514
Cilt: 37
Sayı: 6
Sayfa: 598 - 607
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