Plasma erythropoietin levels in the oldest old.

UNLABELLED: Erythropoietin (EPO) regulates erythrocytes production and is synthesized mainly by the kidney. Its production is reduced during chronic renal failure but is not altered by the senescence process in spite of the morphological changes that occur in the kidney. However, there is no information regarding what happens to erythropoietin synthesis during advanced ageing. Thus, we carried out an investigation to determine whether there was any significant difference in plasma erythropoietin between adults, old and very old people. MATERIAL AND METHODS: We studied 74 healthy volunteers: 22 adults, 30 old, and 22 very old. None of them were smokers or were suffering from any disease that may intefere with hemoglobin (Hb) levels or with EPO production. Hematocrit, Hb, plasma creatinine and plasma erythropoietin were measured, and creatinine clearance was calculated from serum creatinine using two different formulae. Statistical analysis was performed using ANOVA and Bonferroni tests. RESULTS AND CONCLUSION: Among the three groups we found a significant difference in creatinine clearance (p < 0.001), but not in plasma erythropoietin levels; we conclude that normal senescence does not alter plasma erythropoietin levels, even during advanced ageing.

[Helicobacter pylori seroprevalence in dialysis patients]. / Seroprevalencia de Helicobacter pylori en hemodializados.

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofsky's index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofsky's index > 70, and 40/78 (51.3%) with Karnofsky's index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.

[Pruritus in chronic kidney insufficiency]. / Prurito en la insuficiencia renal crónica.

Itching is the dermatologic symptom more often found in patients with chronic renal failure. We have studied 80 patients with end-stage renal disease; itching was present in 56.3% of the cases. We didn't detected in this study any correlation between itching, long term hemodialysis, high calcium, phosphorus, alkaline phosphatase or phosphocalcic product levels. We have seen: 1. Those patients with itching were older than the rest. 2. Itching was important in those patients with residual diuresis less than 500 ml/day (p greater than 0.01). 3. Those men without itching had higher hematocrit levels (p greater than 0.01). 4. Histologic findings on optic and electronic microscopy were more frequent in patients who presented this symptom.

Seroprevalencia de Helicobacter pylori en hemodializados

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofsky's index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofsky's index > 70, and 40/78 (51.3%) with Karnofsky's index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.