Epidemiology of Fabry disease in patients in hemodialysis in the Madrid community.

Unlabelled: This study screened for Fabry disease (FD) in patients in hemodialysis (HD) in the region of Madrid (CAM) with a cross-sectional design to evaluate HD-prevalent patients, followed by a three-year period prospective design to analyze HD-incident patients.

Inclusion Criteria: patients older than 18 years on HD in the CAM, excluding patients diagnosed with any other hereditary disease with renal involvement different from FD, that sign the Informed Consent (IC).

Exclusion Criteria: underaged patients or not agreeing or not being capable of signing the IC.

Transitions in an integrated model of renal replacement therapy in a regional health system.

Introduction And Objectives: The choice of renal replacement therapy (RRT) is an important decision that determines the quality of life and survival. Most patients change from one RRT modality to another to adapt RRT to clinical and psychosocial needs. This has been called «integrated model of RRT» that implies new questions about the best sequence of techniques.

The hidden diabetic kidney disease in a university hospital-based population: a real-world data analysis.

Background: Correct identification of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients is crucial to implement therapeutic interventions that may prevent disease progression.

Methods: We compared the real prevalence of DKD in T2DM patients according to actual serum and urine laboratory data with the presence of the diagnostic terms DKD and/or CKD on the electronic medical records (EMRs) using a natural language processing tool (SAVANA Manager). All patients ˃18 years of age and diagnosed with T2DM were selected.

Transitions in an integrated model of renal replacement therapy in a regional health system.

Introduction And Objectives: The choice of renal replacement therapy (RRT) is an important decision that determines the quality of life and survival. Most patients change from one RRT modality to another to adapt RRT to clinical and psychosocial needs. This has been called «integrated model of RRT» that implies new questions about the best sequence of techniques.

How should we analyze and present mortality in our patients?: A multicentre GCDP experience.

Introduction: There are different strategies to analyse mortality in peritoneal dialysis (PD) with different definitions for case, event, time at risk, and statistical tests. A common method for the different registries would enable proper comparison to better understand the actual differences in mortality of our patients.

Methods: We review and describe the analysis strategies of regional, national and international registries.

Cinacalcet treatment for secondary hyperparathyroidism in dialysis patients: an observational study in routine clinical practice.

Background: Cinacalcet reduces intact parathyroid hormone (iPTH), Ca and P serum levels in patients with secondary hyperparathyroidism (SHPT).

Methods: This Spanish, multicenter, observational, retrospective study collected data from SHPT dialysis patients 12 weeks before and up to 72 weeks after starting cinacalcet in clinical practice.

Results: Data from 428 patients with uncontrolled SHPT despite receiving standard of care (29% with baseline iPTH 501-800 pg/ml; 51% with >800 pg/ml) were collected.

[Doxazosine associated to renin-angiotensin blockers and calcioantagonists in chronic renal failure patients].

Objective: To evaluate the safety and effectiveness of the alfa-blocker doxazosin GITS in CRF patients.

Design And Methods: The study recruited 203 CRF patients (creatinine > 1,4 mg/dl for males, creatinine > 1,2 mg/dl for females, or creatinine clearance < 80 ml/min). All patients were receiving ACE inhibitores (63.

Lercanidipine in patients with chronic renal failure: the ZAFRA study.

Objective: The objective was primary to evaluate the safe use of a new calcium channel blocker, lercanidipine, in patients with chronic renal failure (CRF). The secondary objective was to study the protective effect of calcium channel blocker on renal function in CRF patients previously treated with ACE inhibitors or angiotensin receptor blockers.

Design And Methods: The study recruited 203 CRF patients (creatinine >1.

[Lercanidipine in diabetic patients with renal failure].

Objective: To evaluate the safe use of a new calcium channel blocker, lercanidipine, in diabetic chronic renal failure (CRF) patients.

Design And Methods: The study recruited 42 diabetic CRF patients (creatinine > 1.4 mg/dl for males, creatinine > 1.

Comorbidity and mortality in peritoneal dialysis: a comparative study of type 1 and 2 diabetes versus nondiabetic patients. Peritoneal dialysis and diabetes.

We conducted a retrospective study with 750 peritoneal dialysis (PD) patients in a Spanish multicenter registry between 1993 and 1999 to analyze comorbidity and mortality in type 1 diabetes (T1D), type 2 diabetes (T2D) and nondiabetic (ND) patients. 163 patients (21.7%) were diabetic--96 T1D (58.

[Apolipoprotein C-II and C-III anomalies in normolipemic and hyperlipemic patients with chronic kidney failure].

The high incidence of arteriosclerotic disease in patients with chronic renal failure seems to be due to certain peculiarities in their lipid metabolism. These are principally a disorder in the transportation of lipoproteins and a concomitant defect in triglyceride metabolism causing an accumulation of triglyceride-rich-lipoproteins which predispose to atherosclerosis. We studied the disturbances in concentration of apolipoproteins, notably Apo C-II and C-III, which modulate the activity of lipoprotein lipase (LPL), in patients with chronic renal failure (CRF) without replacement therapy and in hemodialysis patients with and without hyperlipidemia.

Hemodialysis with acetate, DL-lactate and bicarbonate: a hemodynamic and gasometric study.

Using invasive techniques we have studied various hemodynamic and gasometric parameters in the course of hemodialysis (HD) with different buffers in an animal model. HD sessions of 180 minutes at zero ultrafiltration were carried out on three groups of eight uremic dogs each, under anesthesia and constant mechanical ventilation. The three groups differed only in the buffer used: acetate (Group AC), equal proportions of DL-lactate and acetate (Group AC+LA), and bicarbonate (Group BC).

Heme biosynthesis in uremic patients on CAPD or hemodialysis.

We have analyzed some parameters of porphyrin metabolism in 60 patients with end-stage renal failure, 20 of them on CAPD and the remaining on HD. In comparison with 56 control subjects, both groups of patients showed the three following findings: low erythrocyte aminolevulinate dehydrase activity, inhibition ability for the activity of this enzyme when their plasma was incubated in vitro with normal erythrocytes, and increased plasma porphyrin levels. Like anemia, these abnormalities were more remarkable in patients on HD who also exhibited increased erythrocyte protoporphyrin levels and compensatory porphobilinogen deaminase activities.

Iron deficiency anemia after successful renal transplantation.

In patients with chronic renal failure, renal transplantation improves anemia and the production of erythropoietin. In patients undergoing hemodialysis the administration of recombinant human erythropoietin improves anemia with a decrease in bodily iron stores. Therefore, one would expect a similar decrease after kidney transplantation.

Post-transplant renal artery stenosis: a possible immunological phenomenon.

A retrospective review of 110 consecutive kidney transplants performed during 4 years revealed the development of renal artery stenosis in 9 patients (8.18%). A comparison of this group with a control group similar in patient age and interval elapsed since transplantation revealed no significant differences in donor and recipient ages, degree of HLA compatibility or serum creatinine levels.

Treatment of hyperlipemia in diabetic patients on dialysis with a physiological substance.

Hyperlipemia is a very frequent complication of the diabetic patient on dialysis. There is difficulty of treatment with the diet, because the dietary restriction already imposed on these patients and the secondary effects and toxicity of the available drugs in uremics aggravate the problem. We have treated 22 diabetic patients on dialysis (8 on hemodialysis and 14 on continuous ambulatory peritoneal dialysis) suffering from hyperlipemia with pantethine, a physiological substance and coenzyme A precursor in the Krebs cycle.

Peritoneal clearances, protein losses and ultrafiltration in diabetic patients after four years on CAPD.

Peritoneal clearances of urea (C(urea)) and creatinine (Ccr), peritoneal protein losses (PL) and ultrafiltration (UF) were retrospectively evaluated in 12 diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) during a four year study. The average of three determinations each year was calculated. There were not significant differences in C(urea) (ml/24 hours), Ccr (ml/24 hours), PL (g/24 hours) and UF (ml/24 hours) between the four years and basal values or in the year to year studies.

Fructosamine levels in CAPD: its value as glycemic index.

We have studied fructosamine (measured by colorimetric methods) and glycosylated hemoglobin (HbA1c) using a high pressure liquid chromatography (HPLC) in 20 uremic patients managed conservatively (8 diabetics and 12 non-diabetics) and 20 patients treated with continuous ambulatory peritoneal dialysis (CAPD) including 12 diabetics and 8 non-diabetics. Twenty healthy subjects were used as control group. We have correlated the mean blood glucose (MBG) of the preceding days to fructosamine and HbA1c measurements.