[Renal effects of GLP-1 agonists in type 2 diabetes].

The prevalence of type 2 diabetes mellitus (DM2) is increasing, generating a great impact both at individual and public health level. Nearly half of the patients with DM2 develop impaired renal function, so nephron-protection is highly important. The robust body of evidence that shifted the therapeutic focus from glycemic to cardio-renal metabolic therapy in DM2 led to the inclusion of new therapies with cardiovascular and renal benefits in international guidelines.

[Relación entre enfermedad cardiovascular y renal en una muestra de pacientes con diabetes del mundo real].

Objectives: Kidney disease is one of the microvascular complications of diabetes mellitus (DM) with little research and a strong association with cardiovascular disease (CVD). The objective of this study is to characterize the prevalence of kidney disease in a population of patients with type 2 diabetes who attend outpatient control by cardiology, to evaluate its degree of investigation and whether its presence impacts on the achievement of therapeutic goals and use of antidiabetics with cardiovascular and kidney protective effect.

Methods: Cross-sectional, observational and multicenter study, carried out in 44 centers in Argentina between May and July 2019.

[Insulin therapy in special conditions].

Hyperglycemia during hospitalization is a common condition associated with poor prognosis. To date, insulin is the best strategy to treat hyperglycemia in these patients. An adequate glycemic control is associated with better clinical results.

Glycaemic changes in patients with chronic kidney disease.

In Argentina, there have been no studies aimed at establishing the prevalence of dysglycaemia (impaired fasting glucose [IFG], impaired glucose tolerance [IGT] and diabetes mellitus [DM]) in patients with chronic kidney disease (CKD). Our group decided to conduct an observational study to evaluate the frequency with oral glucose tolerance test (OGTT) in CKD patients with no previous data for dysglycaemia in their medical records. OGTT was performed in 254 patients (60.

Adrenocortical function in hypotensive patients with end stage renal disease.

Background: Sustained hypotension among patients with end stage renal disease on dialysis (ESRDh) varies from 5.0% to 12.0%.

Do insulin resistance conditions further impair the lipid and inflammatory profile in end-stage renal disease patients on hemodialysis?

Background: Type 2 diabetes (T2DM) and chronic renal disease constitute important risk factors of atherosclerotic cardiovascular disease, associated with lipid abnormalities, and proinflammatory states. Advances in renal replacement therapy such as hemodialysis (HD) have not reduced morbi-mortality. It has not been elucidated if the concomitant presence of T2DM or metabolic syndrome with end-stage renal disease further impairs the atherogenic profiles.

Endothelial lipase activity predicts high-density lipoprotein catabolism in hemodialysis: novel phospholipase assay in postheparin human plasma.

Objective: A novel phospholipase assay was used to measure for the first time the behavior of endothelial and hepatic phospholipase activities in postheparin human plasma of hemodialyzed patients and its relationship with atherogenic and antiatherogenic lipoprotein levels.

Methods And Results: Endothelial and hepatic phospholipase activity was assessed in a total SN1-specific phospholipase assay, using (1-decanoylthio-1-deoxy-2-decanoyl-sn-glycero-3-phosphoryl) ethylene glycol as the substrate. Hemodialyzed patients presented lower values of total and hepatic phospholipase activity than controls: 4.

HDL-associated enzymes and proteins in hemodialysis patients.

Objectives: To evaluate HDL-associated proteins and enzymes and their relation with lipoprotein profile and inflammatory markers in chronic renal patients on hemodialysis.

Design And Methods: We studied 53 patients under hemodialysis and 32 healthy subjects as controls. We compared plasma lipids, Apoprotein-AI and hs-CRP, as a marker of chronic inflammation.

[Relation between paraoxonase activity, other HDL components and inflammatory state in hemodialyzed patients].

Advanced Chronic Renal Disease (CKD) is closely associated with a pro-inflammatory condition, with an increase in triglyceride-rich lipoproteins and decrease in HDL level. HDL contains antioxidant enzymes such as paraoxonase (PON), whose activity is diminished in CKD. The aim of our study was to evaluate the relationship between PON activity with HDL cholesterol, apo A1 and hs-CRP levels, which are known to be inflammatory markers in hemodialyzed patients.

Salivary testosterone for the diagnosis of androgen deficiency in end-stage renal disease.

Background: Hypogonadism is frequent in patients with end-stage renal disease (ESRD). Salivary testosterone (Sal-T) is a non-invasive tool to screen androgen deficiency in adult male with normal renal function. However, available data on its utility in ESRD are not conclusive.

Assessment of salivary urea as a less invasive alternative to serum determinations.

Objective: Experimental studies describe how urea is excreted through salivary glands and correlates with serum levels independently of salivary flow rate. This study confirms that salivary urea (SaU) is a reliable biomarker of uraemic state. In order to validate the SaU methodology, the following factors were taken into account: the independence of urea levels from saliva flow rate in healthy subjects and patients with chronic renal failure and the agreement between SaU and serum urea (U) levels in the entire population.

Prevalence of impaired fasting glycemia, impaired glucose tolerance, and type 2 diabetes in hemodialyzed patients when applying new diagnostic criteria.

Objective: Recently, the American Diabetes Association (ADA) proposed a new diagnostic entity for diabetes mellitus that has not been applied in renal failure patients so far. Our goal was to apply the new impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) criteria in a group of hemodialyzed patients to provide data on glucose alterations in chronic renal failure.

Design And Patients: We evaluated 74 hemodialyzed patients, (38 women, 36 men) without diagnosed diabetes.

Chronic renal failure in diabetic patients increases lipid risk factors for atherosclerosis.

Diabetic patients are at high risk of cardiovascular disease and the risk is amplified in the presence of nephropathy, which may be partially attributed to modifications in lipoproteins. Moreover, lipoprotein profile may be affected by incipient nephropathy, glomerulopathy, and mild or severe renal failure. The aim of our study was to evaluate whether chronic renal failure (CRF) changes lipoprotein profile and apo A-I urinary excretion in diabetic subjects with glomerulopathy in comparison with non-diabetic subjects with glomerulopathy and CRF.

[Effect of the temperature of the dialysis bath in diabetics].

During the dialysis procedure, arterial hypotension is one of the most common problems and it has been object of many studies. In hemodialysis, changes are produced in body volume through ultrafiltration that generate an increase in the production of thermic energy, which is removed during the treatment. The hypovolemia resulting from the removal of volume activates the sympathetic system, avoiding in this way heat loss and increasing body temperature that promotes vascular vasodilatation and interferes with the compensatory constrictive response to volume fall with consequent arterial hypotension.

Utility of non-high-density lipoprotein cholesterol in hemodialyzed patients.

Non-high-density lipoprotein-cholesterol (HDL-C) is proposed as a strong predictor of cardiovascular disease (CVD). Measuring non-HDL-C, as total cholesterol minus HDL-C, is convenient for routine practice because, among other advantages, fasting is not required. There are limited data of non-HDL-C in end-stage renal disease patients.

Lipoprotein alterations in hemodialysis: differences between diabetic and nondiabetic patients.

Both renal failure and type 2 diabetes may contribute synergistically to the dyslipemia of diabetic renal failure with the development of atherosclerosis as the possible consequence. It has not yet been conclusively evaluated whether diabetic patients with end-stage renal failure under maintenance hemodialysis (HD) show accentuated alterations in plasma lipids and lipoproteins in comparison to nondiabetics under HD. These abnormalities would involve hepatic lipase activity and the regulation of triglyceride-rich lipoprotein metabolism.