[The social environment of patients on peritoneal dialysis]. / El entorno social de los pacientes en diálisis peritoneal.

Patients suffering chronic illnesses, such as those on replacement therapy, condition and are conditioned by their family, work, and social environment. A continuous psychophysical impairment occurs and alters the hormonal stress mediators from the central nervous system and the hypothalamic-pituitary-adrenal axis. Such stress situation causes a pathological effect additional to the factors inherent to the disease. Psychological disorders (depression, anxiety, and others) are associated to an increased morbidity, directly acting upon treatment course, subsequent treatment failure, and personal perception of one's own state of health. Individual factors (sex, lifestyles, health and dietary habits, spirituality, financial and family situation, personal skills for coping with disease, cultural level, and social status) condition morbidity in these patients, and the course and complications of peritoneal dialysis. Interactions between healthcare staff and patients on peritoneal dialysis cause these patients to have a more active attitude and a greater involvement in their treatment, which has an impact on the course of disease and clinical status.

[Renal tubular acidosis in the kidney transplant]. / Acidosis tubular renal en el trasplante renal.

UNLABELLED: Renal tubular acidosis is a syndrome of disordered renal acidification, we have studied a group of patients transplanted. Their cases clinic patients have been analyzed with no-present infectious disease, or tubulointerstitial diseases or urinary infection, immunosuppression with prednisone and azatioprine only, no have to ingest cyclosporine and period graft superior 3 months. We haven't neither patient with proximal renal tubular acidosis. We have been reported 7 cases of distal renal tubular acidosis. All the patients have make the furosemide test. Only one case hyperkalemia renal tubular acidosis. Histologic kidney had been chronic rejection. CONCLUSION: renal tubular acidosis is not infrequent of kidney transplantation and this syndrome connect with chronic rejection.

[Doxazosin, of modified liberation, in hemodialyzed patients]. / Doxazosina, de liberación modificada, en pacientes de hemodiálisis.

INTRODUCTION: Valuation of doxazosin, system formulation modified, in the hypertension in the hemodialysis population. METHOD: Arterial Hypertension (AHT) has been studied in 77 patients (p) subjected to hemodialysis (HD). Mean age (mag) was 61 years (y), range 84y-25y; 66% were males. The underlying etiology was glomerular in 19%, tubulo-interstitial in 18%, congenital in 18%, vascular in 19% and diabetic in 26%. RESULTS: Doxazosin (system formulation modified, single daily dose (4 mg), treatment follow-up was completed in 16 patients subjected to HD for 24 weeks (wk). CONCLUSION: It is concluded that AHT is of great importance in HD, and can be adequately controlled with the new antihypertensive drugs. In this context, doxazosin affords excellent therapeutic control, efficiency and good pharmacological tolerance.

[Bioenergetic radiographic absorptiometry in hemodialysis]. / Absorciometría radiográfica bienergética en hemodiálisis.

UNLABELLED: In order to assess bone loss in uremic renal osteodystrophy (URO), we have measured total and regional mineral bone density (TMBD and RMBD, respectively) by using bioenergetic radiographic absorptiometry (BRA) in a population of patients on hemodialysis (HD). Thirty one patients have been evaluated, with a mean age of 55 and a mean time on hemodialysis of 31 mo. (range 2-120 mo.). Bone absorptiometry consisted of measurement of total body (TMBD) and regional analysis of head, upper limb, lower limb, ribs, pelvis and spine (RMBD). TMBD inversely correlated with alkaline phosphatase and parathyroid hormone levels; it also correlated inversely with age, but only in females. TMBD showed significantly lower values in HD patients than in chronic renal failure patients and controls. All the regional parameters correlated inversely with alkaline phosphatase levels. CONCLUSION: BRA is a non invasive method which quantifies TMBD and RMBD with a very low radiologic exposure and correlates adequately with levels of alkaline phosphatase and parathyroid hormone in URO. TMBD measures total cortical bone of the skeleton with good accuracy, RMBD allows a selective analysis of regional bone changes and a evolutive control in these patients, given the nonuniform decrease of mineral density in the skeleton.

Doxazosina, de liberación modificada, en pacientes de hemodiálisis / Doxazosin, system formulation modified, in hemodialysis patients

Introducción: Valorar la doxazosina, de liberación modificada, en pacientes en hemodiálisis. Método: Hemos estudiado la hipertensión arterial (HTA) en una población de 77 pacientes (p) en tratamiento en hemodiálisis con unas características de edad, media (med) 61 años (a) rango (84a-25a), varones 66 por ciento. La etiología ha sido glomerular era 19 por ciento, tubulointersticial 18 por ciento, congénitas 18 por ciento, vascular 19 por ciento y diabetes 26 por ciento. Resultados: Hemos completado un seguimiento terapéutico con 16 pacientes en HD durante 24 semanas (se) con doxazosina, de liberación modificada, a dosis única diaria de 4 mg. Conclusión: La HTA tiene una gran importancia en la HD, su control es aceptable con los nuevos antihipertensivos, consiguiendo con doxazosina, de liberación modificada, un excelente control terapéutico, una eficiencia y una buena tolerancia farmacológica en pacientes con HTA en hemodiálisis (AU)

Introduction: Valuation of doxazosin, system formulation modified, in the hipertension in the hemodialysis population. Method: Arterial Hypertension (AHT) has been studied in 77 patients (p) subjected to hemodialysis (HD). Mean age (mag) was 61 years (y), range 84y-25y; 66% were males. The underlying etiology was glomerular in 19%, tubulo-interstitial in 18%, congenital in 18%, vascular in 19% and diabetic in 26%. Results: Doxazosin (system formulation modified, single daily dose (4 mg), treatment follow-up was completed in 16 patients subjected to HD for 24 weeks (wk). Conclusion: It is concluded that AHT is of great importance in HD, and can be adequately controlled with the new antihipertensive drugs. In this context, doxazosin affords excellent therapeutic control, efficency and good pharmacological tolerance (AU)