Bone fractures and lumbar mineral density after renal transplantation. A long-term cross-sectional study.

Background: The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD).

Patients And Methods: One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft function, biochemical mineral metabolism markers and body mass density (DEXA) were measured.

Choosing conservative therapy in chronic kidney disease.

Introduction: Incidence of use for various renal replacement therapies is well-known, but no data are available on conservative treatment use.

Objective: To assess the proportion of patients with chronic kidney failure receiving a conservative treatment.

Results: From July 1, 2013 to June 30, 2014, 232 patients with stage 5 CKD were seen in the Nephrology Department.

Effects of a single, high oral dose of 25-hydroxycholecalciferol on the mineral metabolism markers in hemodialysis patients.

Vitamin D deficiency is common in dialysis patients with chronic kidney disease. Low levels have been associated with increased cardiovascular risk and mortality. We evaluated the administration of a high, single oral dose of 25-OH cholecalciferol (3 mg of Hidroferol, 180 000 IU) in patients on chronic hemodialysis.

Subphrenic abscess as a complication of hemodialysis catheter-related infection.

We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci.

Are low levels of 25-hydroxyvitamin D a risk factor for cardiovascular diseases or malignancies in renal transplantation?

Background: Observational studies in healthy people suggest an inverse relationship between 25-hydroxy-vitamin D (25(OH)D levels) and cardiovascular diseases and malignancies. We performed an observational prospective study in renal transplant recipients to investigate the effects of vitamin D deficiency on cardiovascular and malignancy risks.

Methods: From 389 renal transplant recipients, 331 with a functioning graft at 12 months were included in the study.

A retrospective study on outcome of microscopic polyangiitis in chronic renal replacement therapy.

Background: Pauci-immune vasculitis is a heterogeneous disorder with an unfavourable prognosis. Renal involvement is frequently observed in antineutrophil cytoplasm autoantibody (ANCA)-associated small-vessel vasculitis and is an important cause of end-stage renal disease (ESRD). Renal replacement therapy (RRT) is frequently required.

Salvage of accidentally sectioned peritoneal catheter: report of three cases.

Peritoneal dialysis (PD) accounts for 6% of patients on maintenance dialysis. There are several factors responsible for this low prevalence. Transfer of patients to hemodialysis when any problem in the technique is present is probably one of the most frequent reasons.

[Retransplant].

Despite the advances in immunosuppressive therapy and in patient care, about 20-30% of patients will have lost their grafts after 3 years and this loss will continue by 3-4% per year. These patients are included in maintenance dialysis programmes and account for 4 to 10% of those admitted every year for maintenance dialysis therapy. Among those patients who loss their grafts 40-60% are included in transplant waiting lists.

[Managing a failed kidney graft. Nephrectomy versus embolisation].

The early diagnosis of the graft intolerance syndrome or a subclinical state of chronic inflammation due to a failed kidney allograft, is one of the goals that the nephrologists must fulfill to take a series of measures directed to solve this situation. Fever, haematuria, local pain and/or tenderness are the main clinical criteria to make a diagnosis. However, oftenly there are not any clinical symptoms and only the presence of parameters of chronic inflammation (elevated C-reactive protein, erythrocyte sedimentation rate, hypoalbuminemia and anemia resistant to erythropoietin therapy) are signs of this entity.

[Choosing the dialysis method for kidney transplant patients with advanced kidney disease].

The choice of the most of dialysis modality after renal graft loss is an unanswered question. Most patients start hemodialysis (HD) in this situation, because of several reasons: 1. In most dialysis programs HD predominates clearly over Peritoneal Dialysis (PD).

[Evaluating renal function and indications for starting dialysis].

EVALUATION OF THE RENAL FUNCTION: For the follow-up of the graft renal function it must be measured the glomerular filtration rate by means of formulae that use the serum creatinine. The most used equation is the brief formula MDRD. - All patients transplanted must be included in the group of Renal Chronic Disease though the glomerular filtration rate is normal and there is no evidence of renal damage.

Patient outcomes after kidney allograft loss.

Despite considerable advances in immunosuppression and in short-term graft survival, little improvement has been observed in long-term survival rates. About 30% of patients lose their graft in the first 5 years, and this percentage increases up to 50% at 10 years. Graft losses, due to causes other than death with functioning graft, are an important cause of end-stage renal disease.

Comparative effects of dietary supplementation with red grape juice and vitamin E on production of superoxide by circulating neutrophil NADPH oxidase in hemodialysis patients.

Background: Atherosclerotic cardiovascular disease is the most common cause of death among hemodialysis patients; it has been attributed to increased oxidative stress, dyslipidemia, malnutrition, and chronic inflammation. Activation of neutrophils is a well-recognized feature in dialysis patients, and superoxide-anion production by neutrophil NADPH oxidase may contribute significantly to oxidative stress.

Objective: The aim of the study was to compare the effects of dietary supplementation with concentrated red grape juice (RGJ), a source of polyphenols, and vitamin E on neutrophil NADPH oxidase activity and other cardiovascular risk factors in hemodialysis patients.

Concentrated red grape juice exerts antioxidant, hypolipidemic, and antiinflammatory effects in both hemodialysis patients and healthy subjects.

Background: Patients treated with hemodialysis frequently experience cardiovascular complications attributed, among other causes, to dyslipidemia, increased oxidative stress, and inflammation.

Objective: The aim of the study was to study the effects of dietary supplementation with concentrated red grape juice (RGJ), a source of polyphenols, on lipoprotein profile, antioxidant capacity, LDL oxidation, and inflammatory biomarkers.

Design: Twenty-six patients receiving hemodialysis and 15 healthy subjects were instructed to drink 100 mL RGJ/d for 14 d.

Lumbar bone mineral density in renal transplant patients on neoral and tacrolimus: a four-year prospective study.

Background: This prospective study was designed to investigate the long-term evolution of bone mineral density (BMD) in kidney transplant recipients.

Methods: In 86 patients with functioning grafts, 65 on tacrolimus-based immunosuppression and 21 on cyclosporine-based immunosuppression, laboratory parameters and BMD measurements in lumbar spine (L2-L4) and femoral neck (FN) were performed by DEXA in the first month after transplantation (baseline) and yearly thereafter up to the fourth year.

Results: BMD did not change at 12 months in lumbar spine nor in the FN.

Clinical outcomes and C2 cyclosporin monitoring in maintenance renal transplant recipients: 1 year follow-up study.

Background: Cyclosporin A (CsA) concentration monitoring with 2 h post-dosing levels (C2) correlates with the incidence of rejection and graft outcome in de novo renal transplant patients. The advantages of this policy beyond the first 12 months remain a matter of debate. The purpose of the present work was to evaluate the C2 target ranges on CsA monitoring after the first year in stable kidney transplant patients.

Effect of hypertension before beginning dialysis on survival of hemodialysis patients.

Background: The role of hypertension as a predictor of mortality in hemodialysis patients is controversial. The purpose of this study is to investigate the effect of hypertension before starting hemodialysis therapy on survival of patients without diabetes during renal replacement therapy.

Methods: We reviewed 184 patients starting hemodialysis therapy.