Asunto(s)
Hepacivirus , Hepatitis C/virología , Fallo Renal Crónico/virología , Diálisis Renal , Adulto , Relación Dosis-Respuesta a Droga , Eritropoyetina/uso terapéutico , Femenino , Humanos , Hierro/uso terapéutico , Fallo Renal Crónico/sangre , Masculino , Persona de Mediana Edad , Factores de TiempoAsunto(s)
Diabetes Mellitus/etiología , Nefropatías Diabéticas/complicaciones , Nefropatías Diabéticas/etiología , Rechazo de Injerto/etiología , Trasplante de Riñón/efectos adversos , Biopsia , Nefropatías Diabéticas/patología , Femenino , Humanos , Riñón/patología , Masculino , Persona de Mediana Edad , Esclerosis , Factores de Tiempo , Trasplante HomólogoAsunto(s)
Trasplante de Riñón/efectos adversos , Pulmón/patología , Trastornos Linfoproliferativos/etiología , Trastornos Linfoproliferativos/patología , Aciclovir/uso terapéutico , Anciano , Antivirales/uso terapéutico , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Herpesvirus Humano 4/patogenicidad , Humanos , Trasplante de Riñón/patología , Trastornos Linfoproliferativos/tratamiento farmacológico , MasculinoAsunto(s)
Anticuerpos Antivirales/sangre , Derivación Arteriovenosa Quirúrgica , Catéteres de Permanencia , Hepatitis C/inmunología , Diálisis Renal , Adulto , Anciano , Infección Hospitalaria/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Pruebas SerológicasAsunto(s)
Trasplante de Riñón , Embarazo/fisiología , Adulto , Femenino , Humanos , Riñón/fisiología , Periodo Posoperatorio , Resultado del EmbarazoRESUMEN
This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300 mmol/l, were included in this study. The mean posttransplant period was 2.0 (range 0.6-6.3) years. Urinary and serum biochemical parameters, ciclosporin A level, and hematocrit were checked weekly, during Ramadan as well as 1 week before and after. Statistical analysis showed no significant changes in all parameters before, during, and after Ramadan. In conclusion, our findings indicate that fasting during the month of Ramadan does not seem to be associated with any significant adverse effects in kidney transplant recipients with normal or impaired graft function and suggest that it is safe for those patients to fast during Ramadan after 1 year of renal transplantation.
Asunto(s)
Ayuno/fisiología , Islamismo , Trasplante de Riñón/fisiología , Religión y Medicina , Adulto , Biomarcadores/sangre , Biomarcadores/orina , Ciclosporina/sangre , Ayuno/efectos adversos , Femenino , Humanos , Riñón/metabolismo , Riñón/fisiopatología , Masculino , Persona de Mediana Edad , Potasio/sangreRESUMEN
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RESUMEN
We report a 38-year-old man who developed systemic lupus erythematosus (SLE) 14 years after commencing regular hemodialysis. When he was initially diagnosed as having end-stage renal disease (ESRD) secondary to chronic glomerulonephritis, he did not have any clinical or serological criteria to suspect SLE. He did not receive, at any stage, any of the drugs known to cause SLE. He showed remarkable improvement after treatment with steroids and cyclophosphamide.
Asunto(s)
Fallo Renal Crónico/terapia , Lupus Eritematoso Sistémico/fisiopatología , Diálisis Renal , Adulto , Glomerulonefritis/complicaciones , Humanos , Fallo Renal Crónico/etiología , MasculinoRESUMEN
Estimation of red cell ferritin (RCFer) may give a good indication of iron supply to the erythron and it may therefore be clinically useful for the detection of functional iron deficiency. In a cross-sectional study of hemodialysis patients on erythropoietin (EPO) therapy and regular oral iron we have compared the RCFer levels with conventional indicators of iron status. The patients studied, 19 female, 48 male, mean age 62 +/- 3.6 years (range 20-83 years) were characterized by the following mean parameters: aluminum 1.24 +/- 0.12 mumol/L, PTH 115.7 +/- 39 pg/mL, vitamin B12 626 +/- 71.2 ng/L, serum folate 18.8 +/- 2.2 micrograms/L, and hemoglobin 9.8 +/- 0.3 g/dL (range 7.3-12.4). The median serum ferritin (SF), RCFer, total iron binding capacity (TIBC), transferrin saturation (TS), and serum iron were 68 micrograms/L, 14.1 ag ferritin/red cell, 57 mumol/L, 20% and 11.5 mumol/L, respectively. Eleven patients had a reduced RCFer (< 7 ag ferritin/red cell), 5 had a SF of < 15 micrograms/L and 22 a TS of < 16%. The occurrence of functional iron deficiency was suggested by the presence of 10 subjects with reduced RCFer despite normal SF levels (15-240 micrograms/L). Four patients with reduced SF showed acceptable levels of RCFer, suggesting that some patients may maintain an adequate iron supply despite diminished iron stores. Despite oral iron therapy, a significant number of patients (63%) on regular hemodialysis remain relatively iron deficient with a serum ferritin of less than 100 micrograms/L. It has previously been proposed that oral iron provides adequate supplementation during increased demand caused by EPO stimulation. The present study has demonstrated overt iron deficiency in five subjects and suggests functional iron deficiency in a further seven (22% of total patients). We therefore conclude that oral iron therapy cannot maximize the response to EPO.