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1.
Prilozi ; 31(2): 17-25, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21258274

RESUMEN

AIM: To determine differences between groups with hypertension in pregnancy and assess risk factors associated with preeclampsia. PATIENTS AND METHODS: In the period 2008-10 at the Department of Nephrology in Skopje, Macedonia, a prospective and a longitudinal study study comprising 134 pregnant women was carried out. They had regular monthly check-ups in pregnancy and after delivery (1-8), when groups were defined as gestational hypertension, pre-existing hypertension, superimposed preeclampsia, and preeclampsia. A total of 134 women were regularly controlled by 24-hour ambulatory monitoring of blood pressure (24ABPM), blood and urine, D-dimers, and a resistance index of the Doppler of the umbilical artery (RI a.umb), and a questionnaire on risk factors was filled in for every pregnant woman. RESULTS: Superimposed preeclampsia was found in 22 (16.4%) and preeclampsia was found in 20 women (14.9%). Daily diastolic blood pressure of 24-hour blood pressure monitoring at the last check-up before delivery was significantly higher in the group with superimposed preeclampsia (SP) 87.6±9.5 and in the group with preeclampsia (PE) 87.9±7.7 mm Hg. Previous preeclampsia (OR=3.28), primiparity (OR=2.35), methyldopa (OR=3.76), number of check-ups (OR=2.3), positive family history (OR=1.4) and in vitro fertilisation (OR=1.15) were found as risk factors associated with the occurrence of preeclampsia and preeclampsia superimposed on preexisting hypertension. CONCLUSIONS: Early determination of risk factors should prompt more frequent check-ups in hypertensive pregnancies in order to determine timely delivery and avoid adverse outcomes in the mother and child.


Asunto(s)
Preeclampsia/epidemiología , Resultado del Embarazo/epidemiología , Adulto , Femenino , Humanos , Preeclampsia/terapia , Embarazo , Atención Prenatal , Estudios Prospectivos , Factores de Riesgo
2.
Hippokratia ; 11(1): 39-43, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19582176

RESUMEN

BACKGROUND: Cardiovascular diseases are the most common causes of death among hemodialysis (HD) patients, yet the risk factors for these events have not been well established. Our study objective was to determine predictors of cardiovascular mortality, considering the non-traditional/disease-related and treatment-related/ cardiovascular risk factor in HD patients. MATERIAL AND METHODS: Disease-related cardiovascular risk factors, such as anaemia, calcium-phosphate disorders, nutrition-inflammation and treatment/dialysis-related cardiovascular risk factors such as HD dose, using the index Kt/V were analyzed in 214 patients on HD. Mortality was monitored prospectively over a two year period. RESULTS: Fifty-three of the 214 HD patients died during the follow-up period and the main cause of death was cardiovascular events (56.6%), followed by infection/sepsis (26.4%). The patients who died were significantly older than those alive, had significantly lower serum levels of hemoglobin (Hb), albumin and Kt/V. Serum levels of calcium, C-reactive protein (CRP) and fibrinogen were significantly higher in patients who died during the follow-up period. Kaplan-Meier analysis showed that the all cause and cardiovascular mortality was considerably higher in patients with Hb<110 g/l, albumin <40 g/l, CRP>8 mg/l and spKt/V<1.2 (log rank, p=0.000/p=0.000, p=0.000/ p=0.001, p=0.000/p=0.000, p=0.000/p=0.000), respectively. No difference in cardiovascular mortality was observed between the fibrinogen <4 g/l> levels. High CRP, low Hb levels and low spKt/V were significant predictors of all-cause mortality, but low albumin and high fibrinogen levels were not in the Cox proportional hazards analysis. When only cardiovascular mortality was entered into the Cox model, high CRP and low Hb levels were the only significant predictors for mortality. CONCLUSIONS: It can be concluded that, inflammation (elevated CRP) and anaemia (decreased Hb), were identified as significant independent non-traditional, disease-related cardiovascular risk factors that predict cardiovascular mortality in HD patients.

3.
Prilozi ; 27(1): 133-44, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16985487

RESUMEN

Among non-traditional cardiovascular risk factors both malnutrition and inflammation appear to be strong predictors of mortality and morbidity in haemodialysis (HD) patients. Our study objective was to determine predictors of all-cause and cardiovascular mortality, considering the nutritional and immunologic parameters, in a cohort of HD patients treated in a single haemodialysis centre. 216 patients on HD were analyzed for clinical, nutritional-serum albumen and BMI, immunologic-serum CRP (C-reactive protein) and fibrinogen and dialysis parameters -- ultrafiltration, length of dialysis in hours, HD dose (using spKt/V and eKt/V). Mortality was monitored prospectively over a two-year period. Fifty-five of the 216 HD patients died during the follow-up period and the main cause of death was cardiovascular disease (CVD) -- 33 patients out of 55 (60%), followed by infection/sepsis (13 pts, 24%). The patients who died were significantly older, had a significantly shorter duration of HD in hours, ultrafiltration was significantly less, HD doses were significantly lower, as were serum levels of albumin (36.06 +/- 4.17 vs. 39.74 +/- 3.31; p=0.000) and Hg (93.14 +/- 15.43 vs. 109,16 +/- 12,08; p=0.000), but they had significantly higher serum levels of CRP (40.26 +/- 34.75 vs. 8.71 +/- 7.68, p=0.000) and fibrinogen (5.28 +/- 1.28 vs. 4.42 +/- 0.97, p=0.000). Kaplan-Meier survival estimates showed that the group with the lowest levels of albumin (< 3.5 g/L), and with the greatest levels of CRP (>20 mg/l) and fibrinogen (>5 g/L) had the lowest survival (log-rank test p=0.0008, p=0.00000, p=0.0000). However, in the Cox proportional hazards model, a high CRP and low Hg level (chi-square=96.467, p=0.0000) were predictors of all-cause mortality, whereas serum level of albumin did not show to be predictive. When only cardiovascular mortality is entered into the Cox model, CRP and Hg levels are still more important in predicting mortality (chi-square=70.055, p=0.0000) and only if CRP is not taken into account in the multivariate analysis, serum albumin level remains, after Hg, the strongest predictor for both overall and cardiovascular mortality (chi-square=76,564, p=0.0000; chi-square 50.619 p=0.0000). It can be concluded that inflammation predicted all-cause and cardiovascular mortality in our study group, because high CRP, as a marker of inflammation and low haemoglobin, as a result of inflammation, remained powerful predictors of both overall and cardiovascular death.


Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Diálisis Renal/efectos adversos , Biomarcadores/análisis , Proteína C-Reactiva/análisis , Enfermedades Cardiovasculares/etiología , Causas de Muerte , Femenino , Fibrinógeno/análisis , Humanos , Inflamación , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Diálisis Renal/mortalidad , Factores de Riesgo , Albúmina Sérica/análisis
4.
Prilozi ; 27(2): 37-47, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17211290

RESUMEN

The epidemiology data of renal replacement therapy are collected by national renal registries and extended to international registries as the European Renal Association Renal Registry. The extent and accuracy of data vary widely among countries. The aim of this study was to compare combined data from the national renal registries of Balkan countries contributing the ERA-EDTA Registry or from other sources, with combined data from renal registries of the Western and Northern European Countries and regions contributing the ERA-EDTA Registry. Data regarding incident and prevalent patients in 2003, mean age of incident and prevalent patients, incidence and prevalence by cause of renal failure and prevalence by established therapy were compared between the countries of the Balkan region and the countries of Western and Northern Europe contributing to the ERA-EDTA Registry. Data were obtained by the Annual Report 2003 of the ERA-EDTA Registry, and for Romania by the study of G. Mirescu published in NDT 2004. Some data were obtained by the questionarries sent to people responsible for the national registries. The results showed the following: the incident number of patients per million population (pmp) at day 1 of RRT, as well as at day 91, adjusted for age and gender, did not statistically differ between the Balkans and Western Europe: 119.2 +/-25.1 vs. 123.3 +/- 25.9 and 110.9 +/- 34.7 vs. 106.5 +/- 18.3, respectively. The mean age of incident patients at day 91 of RRT significantly differed between the Balkans and Western Europe, 57.7 +/- 4.49 vs. 63.3 +/- 2.2, p < 0.005. The percentage of incident patients by cause of renal failure at day 91 of RRT did not significantly differ between the Balkans and Europe. The mean incidence of the percentage of DM as a cause of renal failure between the Balkans and Western Europe did not differ, 23.05+/- 4.5 vs. 20.3 +/- 7.2. When adjusted for age and gender, the significant difference in prevalent number of ESRD patients between the Balkans and Western Europe disappeared. The mean age of prevalent patients between the Balkans and Europe did not significantly differ, 54.3 +/- 4.2 vs. 58.2 +/- 2.8. The percentage of primary renal disease in prevalent patients did not significantly differ, except for policystic kidney disease which is significantly more frequent in Western Europe compared to the Balkans, 9.2 +/- 1.9 vs. 6.8 +/- 1.8, p < 0.01. Diabetes mellitus and hypertensive nephropathy are much more frequent in incident patients compared to prevalent ones. Transplantation is significantly more frequent in Western Europe, predominantly cadaveric, whereas dialysis is more frequent in the Balkans. It can be concluded that no difference exists between the incidence and prevalence of diabetes mellitus as a primary renal disease in ESRD patients between the Balkan and European countries, indicating that the epidemic of diabetes is already present in the Balkans and imposing, perhaps, efforts to be undertaken for planning prevention strategies; kidney transplantation is significantly less represented as RRT in Balkan countries compared to Western and Northern Europe, and efforts should be made for its increase, particularly the cadaveric one, and moreover, because the population on RRT is significantly younger in the Balkans.


Asunto(s)
Fallo Renal Crónico/epidemiología , Terapia de Reemplazo Renal/estadística & datos numéricos , Europa (Continente)/epidemiología , Europa Oriental/epidemiología , Humanos , Incidencia , Fallo Renal Crónico/terapia , Prevalencia
5.
Transplant Proc ; 37(2): 563-4, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15848457

RESUMEN

Due to the increase of organ shortage and still inadequate development of cadaver transplantation, many end-stage patients from the Balkan region travel mostly to India to buy a kidney. Despite all the ethical dilemmas and discussions, organ sales is present nowdays in Third-World countries. Sixteen patients (13 from Macedonia and 3 from Kosovo, SCG) were observed clinically during a period of 10 years. Recipients of mean age 36.5 years (range 10 to 58) displayed the following underlying diseases: chronic glomerulonephritis (n = 5), urethral valves with reflux (n = 2), ADPKD (n = 1), hypertensive nephropathy (n = 4), lithiasis (n = 1), and unknown cause of ESRD (n = 3). The donor population was young (22 to 29 years). Most patient records did not include data on HLA, cross-match, MLC, kind of surgery, or usual pretransplant workup. The immunosuppressive protocol included CyA, PRED, and AZA or MMF. All transplanted patients were followed on an outpatient basis in our department; patients with complications were hospitalized. The 1, 3, 5, and 10 year Kaplan Meier graft survival rates were 78.6%, 50.2%, 33.3%, and 18.8%, respectively. Seven patients were lost (43.7%), two during the first month after transplantation, two at the end of the first year, and three at 5, 6, and 8 years thereafter. The main reasons for death were severe pulmonary infections with sepsis, hepatitis B with liver cirrhosis, Kala Azar, CMV, and cancer of the colon. Five grafts were lost due to repeated rejection episodes and chronic graft nephropathy. The last three cases remained with good renal function and actual serum creatinine values of 135 +/- 9. In view of this experience, the authors cannot recommend this type of transplantation, not only from the ethical point of view, but also from frequent medical and surgical complications which are sometimes life threatening.


Asunto(s)
Selección de Donante/economía , Trasplante de Riñón/fisiología , Donadores Vivos , Complicaciones Posoperatorias/epidemiología , Adolescente , Adulto , Niño , Honorarios y Precios , Femenino , Supervivencia de Injerto , Humanos , India , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/mortalidad , Masculino , Persona de Mediana Edad , Nepal , Complicaciones Posoperatorias/clasificación , República de Macedonia del Norte , Análisis de Supervivencia , Resultado del Tratamiento
6.
Ann Transplant ; 9(2): 48-9, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15478919

RESUMEN

BACKGROUND: As elsewhere, the growing organ shortage is a main problem for organ transplantation. To solve the problem, we started accepting genetically unrelated, but emotionally related living donors. METHODS: In the period of 1998-2002, 14 LERT are performed in the University Clinical Centre in Skopje, Republic of Macedonia. As suitable donors are used predominantly spouses, but also mother and brother in law. The immunosuppression included a quadruple protocol with Interleukin-2R antagonists, late cyclosporin A, MMF and steroids. The two-year graft and patients survival of LERT was compared with 22 living genetically related donor transplantation (LRT) performed in the same time. RESULTS: The two years graft survival was 100% in LERT and 92% in LRT. There are not any significant difference among the medical and surgical complications between the two groups of pts. The actual serum creatinin was 101+22 in LERT compared with 142+34 in LRT. CONCLUSION: The authors recommend the LERT as a valid alternative especially in the countries where the regular cadaver transplantation is not yet established.


Asunto(s)
Emociones , Relaciones Familiares , Trasplante de Riñón , Donadores Vivos/psicología , Adulto , Anciano , Creatinina/sangre , Supervivencia de Injerto , Humanos , Terapia de Inmunosupresión , Trasplante de Riñón/efectos adversos , Persona de Mediana Edad , República de Macedonia del Norte , Análisis de Supervivencia , Resultado del Tratamiento
7.
Clin Nephrol ; 55(4): 309-12, 2001 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11334317

RESUMEN

AIM: Efforts to increase the donor pool and available organs included some unconventional kidney transplantation. One of these was including elderly donors for both, living and cadaver kidney transplantation. The aim of the study was to review our single centre experience with living donor transplants from elderly advanced age donors. PATIENTS AND METHODS: During a period of 7 years, 71 living related renal transplantations were performed. Twenty-six of them were over 65 (mean 69+/-4, range 65 to 81), but 10 were over 70 years of age. The survival rate was compared with 45 transplants from younger donors (mean age 51+/-6, range 24 to 59). The cold and warm ischemia time, the preservation procedure and blood vessels anastomosis time were comparable in both donor groups. The immunosuppression included sequental quadruple protocol with ATG, PRED, AZA and CyA replacing ATG after 7 days. The triple drug (AZA, PRED, CyA) maintenance therapy was applied to all recipients. RESULTS: Kaplan-Meier 1-, 3- and 5-year graft survival was 88.0%, 79.2% and 68%, respectively, for advanced donor age group and 90.2%, 82.4% and 74%, respectively, for younger donor group. The difference was slightly statistically significant (p < 0.05). In 6 patients who received graft from elderly donors, a delayed graft function was observed, whereas only in one in the younger donor group. CONCLUSION: Despite the worse results in the elderly donors' transplants, we consider the advanced age donors as an important source of kidneys contributing to solving the actual organ shortage, especially in our region.


Asunto(s)
Factores de Edad , Trasplante de Riñón , Donadores Vivos , Anciano , Anciano de 80 o más Años , Supervivencia de Injerto , Humanos , Inmunosupresores/administración & dosificación , Persona de Mediana Edad
8.
Acta Med Croatica ; 54(4-5): 157-60, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-11379479

RESUMEN

A number of laboratory tests are available for evaluation of hypertension in pregnancy. These tests can be used to either predict and/or prognosticate preeclampsia and other hypertensive disorders of pregnancy. The aim of this study was to evaluate alterations in fibronectin homeostasis in normotensive pregnancy and in hypertensive disorders of pregnancy subclassified into chronic hypertension, preeclampsia superimposed on chronic hypertension, and pregnancy induced hypertension. A prospective, longitudinal study was conducted in 115 pregnant women aged 20-39 years, divided into four groups: normotensive (n = 40), chronic hypertension (n = 18), preeclampsia superimposed on chronic hypertension (n = 20), and pregnancy induced hypertension (n = 37). Plasma concentrations of fibronectin were measured by using single radial immunodiffusion assay (RIA) in the 8th, 18th, 23rd, 28th, 32nd and 36th week of gestation. Plasma fibronectin concentration showed no significant changes in normotensive pregnancy, but was significantly elevated in the third trimester in women destined to become preeclamptic or with preeclampsia in whom it reached a mean (+/- SD) of 0.40 +/- 0.09 g/L in the 36th week of gestation. In the groups with preeclampsia superimposed on chronic hypertension and with pregnancy induced hypertension, there was a significant difference between plasma fibronectin concentrations in 32nd (p < 0.01) and 36th (p < 0.001) week of gestation compared with either other levels in the respective group (in the 8th, 18th, 23rd and 28th week of gestation) or those recorded in other groups in the same period of pregnancy. These results suggested that the measurement of plasma fibronectin might be of diagnostic value in preeclampsia but could not be considered a useful predictor for preeclampsia.


Asunto(s)
Fibronectinas/sangre , Hipertensión/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Adulto , Enfermedad Crónica , Femenino , Humanos , Preeclampsia/sangre , Embarazo , Estudios Prospectivos
9.
J Hypertens ; 17(9): 1317-22, 1999 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10489110

RESUMEN

OBJECTIVE: To determine the relationship between endothelin-1 (ET-1), human atrial natriuretic peptide (hANP), plasma-renin activity (PRA) and 24-h urinary excretion of aldosterone (U-Ald) in pregnancy-induced hypertension (PIH). DESIGN AND METHODS: Plasma hANP (pg/ml), ET-1 (pg/ml), PRA (ng/ml per h) and U-Ald (microg/24 h) were measured and 24 h ambulatory mean arterial pressure (MAP) was monitored in 178 normotensive subjects (NT) and 79 gravidas with PIH at the 8th, 18th, 23rd, 28th, 32nd and 36th weeks. RESULTS: The PIH group had higher MAP than the NT group from the 23rd week (91.64 +/- 8.76 versus 83.48 +/- 4.36 mmHg, P< 0.01) until the end of the pregnancy. ET-1 levels (pg/ml) in both groups were identical at the beginning of pregnancy and different in the 23rd week [(NT versus PIH) (35.11 +/- 17.42 and 40.2 +/- 19.51, respectively, P < 0.05)] and the 36th week (37.36 +/- 18.07 and 42.7 +/- 16.43, P< 0.05). hANP levels (pg/ml) in the NT group decreased insignificantly from the 8th till the 32nd week, then increased to 101.94 +/- 17.4 in the 36th (P< 0.001 versus any other week). In the PIH group, hANP increased from 104.8 +/- 26.8 pg/ml at the 8th week to 161.3 +/- 28.6 pg/ml at the 36th week (P< 0.0001). hANP correlated with MAP in the NT group (r = 0.252, P< 0.0005) but not the PIH group. U-Ald in the NT group increased from 23.52 +/- 6.83 microg/24 h at the 8th week to 54.07 +/- 19.62 microg/24 h at the 36th week (P < 0.0001) and in the PIH group it increased from 27.90 +/- 11.6 to 53.66 +/- 20.4 microg/24 h (P< 0.0001). In the PIH group, PRA was lower compared with the NT group from the 8th (2.99 +/- 1.26 versus 4.10 +/- 1.82 ng/ml per h, P< 0.05) until the 36th week (3.34 +/- 2.16 versus 4.46 +/- 2.13 ng/ml per h). In the forced multiple regression analysis model with hANP as a dependent variable, a value of P< 0.003 was found with PRA, U-Ald and MAP, which indicates an interaction between the two vasoactive and homeostatic systems: the renin-angiotensin-aldosterone system and hANP. CONCLUSIONS: In PIH, elevated hANP might be important as a counterbalance to the presence of the active vasopressors and sodium retention. By inhibiting renin release, enhancing the transcapillary fluid migration and with its action as vasodilator, it acts as a corrective factor of the imbalance between the contracted circulating fluid volume and the vasoconstricted vascular bed.


Asunto(s)
Aldosterona/orina , Factor Natriurético Atrial/sangre , Endotelina-1/sangre , Hipertensión/sangre , Complicaciones Cardiovasculares del Embarazo/metabolismo , Renina/sangre , Adolescente , Adulto , Femenino , Humanos , Estudios Longitudinales , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/orina , Estudios Prospectivos , Análisis de Regresión , Factores de Tiempo
11.
Srp Arh Celok Lek ; 124 Suppl 1: 197-9, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-9102905

RESUMEN

In 24 young normotensive subjects (mean age 22.25 +/- 5.65 years) with one hypertensive parent (FH(+)-), 22 subjects (mean age 23.55 +/- 5.17 years) with two hypertensive parents (FH+ +/-), and a control group of 16 age and gender matched subjects (mean age 22.50 +/- 6.00 years) with two normotensive parents (FH--), creatinine clearances and microalbuminuria (MA) were measured. Blood pressure was monitored for 24 hours and mean arterial pressure (MAP) was calculated and compared between groups. No significant differences were recorded. FH(+)- and FH++ subjects had significantly higher MAP over the sleeping period than FH-- subjects (78.63 +/- 1.71, 78.95 +/- 1.27; and 72.91 +/- 1.35 mmHg respectively; p < 0.02). Creatinine clearance was higher in FH(+)- and FH++ group compared to FH-- subjects (2.39 +/- 0.17; 2.29 +/- 0.17; and 1.66 +/- 0.11 ml/sec respectively; p < 0.01). Hyperfiltration correlated with MAP in FH++ subjects (2.29 +/- 0.17 ml/sec; 92.45 +/- 7.39 mmHg; r = 0.52 i p < 0.03). MA correlated neither with creatinine clearance nor with MAP. Our results suggest that hypertension may develop as a consequence of the long-lasting, higher GFR, which may accelerate the age-related process of sclerosis both in the small arterioles and the glomeruli.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/genética , Riñón/fisiopatología , Adulto , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología
12.
Srp Arh Celok Lek ; 124 Suppl 1: 214-6, 1996.
Artículo en Serbio | MEDLINE | ID: mdl-9102912

RESUMEN

In 48 men, 42, 1 +/- 8.8 yrs old, with untreated mild essential hypertension, serum uric acid, total cholesterol triglycerides and glucose were examined at 8 a.m after 16 hour overnight fasting. All patients were overweight, with body mass index: 26.9 +/- 2.4 kg/m2, (normal value: 19-24.9); serum uric acid 293.1 +/- 89.3 mmol/l; cholesterol 6.3 +/- 1.4; triglycerides 2.0 +/- 1.3 and glucose 5.4 +/- 0.9 mmol/l. File out of 48 (10.4%) patients had hyperuricemia, nine (18.7%) had hypercholesterolemia, twenty (41.7%) had hypertriglyceridemia and 19 (39.6%) had hyperglycemia. Significant correlation between serum uric acid and triglycerides only (r = 0.35; p < 0.01), was found. A correlation exists between the diastolic blood pressure and cholesterol (r = 0.35; p < 0.01); as well as, between mean arterial blood pressure and cholesterol (r = 0.34; p < 0.02). Only three out of 48 (6.2%) patients with hypertension had all four biochemical parameters above normal levels. Our results suggest that interrelation of all these metabolic disorders are important in essential hypertension, and especially the association of high serum uric acid and triglyceride level.


Asunto(s)
Glucemia/análisis , Hipertensión/sangre , Lípidos/sangre , Ácido Úrico/sangre , Adulto , Humanos , Masculino
13.
Ren Fail ; 16(4): 525-34, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-7938760

RESUMEN

We present a case of an extremely rare form of Ewing sarcoma--primary disseminated, with fulminating course, severe hypercalcemia, extensive calcium deposition in parenchymatous organs, including kidneys, and acute renal failure as a clinical consequence. Correction of hypercalcemia was followed by prompt restoration of the glomerular filtration rate (GFR), suggesting that hypercalcemia had a direct effect on its regulation independent of the renal tubular damage. The effectiveness of the treatment with indomethacin indirectly supports the possibility of prostaglandin-mediated humoral hypercalcemia of malignancy.


Asunto(s)
Lesión Renal Aguda/etiología , Hipercalcemia/etiología , Sarcoma de Ewing/complicaciones , Lesión Renal Aguda/patología , Adulto , Tasa de Filtración Glomerular/fisiología , Humanos , Hipercalcemia/tratamiento farmacológico , Hiperparatiroidismo Secundario/etiología , Indometacina/uso terapéutico , Riñón/patología , Masculino , Hormona Paratiroidea/metabolismo , Prostaglandinas E/metabolismo
14.
Ren Fail ; 15(1): 51-4, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8095099

RESUMEN

Ten patients, mean age 51.50 +/- 3.03 years, with degenerative rheumatism on NSAID treatment without any sign of renal disease, and 11 control subjects, mean age 43.50 +/- 1.51 years, were studied. NSAID treatment was of 11.30 +/- 5.60 weeks duration in average, with ibuprofen, naproxen, or indomethacin. Urinary excretion of three specific renal tubular enzymes--AAP: alanine-amino-peptidase, GGT: gamma-glutamyl-transpeptidase, and beta-NAG: beta-N-acetyl-glucosaminidase, were determined in 8-h overnight urine samples, as well as GFR creatinine clearance/1.73 m2, urinary volume/8 h, specific gravity of the urine, proteinuria and glucosuria. In the group treated with NSAIDs, urinary excretion of the enzymes was significantly higher than in the control group--AAP: 1414.20 +/- 317.60, 864.20 +/- 94.42, p < 0.00001; GGT: 8034.6 +/- 1378.55, 5095.64 +/- 614.40, p < 0.00001, and beta-NAG: 1644.60 +/- 299.97, 964.82 +/- 142.00, p < 0.00001. Patients on NSAID treatment showed abnormal urinary excretion of AAP in 7/10 cases, of GGT in 6/10, and of beta-NAG in 7/10 cases. Duration of the treatment did not correlate with the urinary excretion of the enzymes. Age was in correlation with the urinary excretion of the enzymes only in the control group, r = 0.52, p < 0.005 for AAP, r = -0.43, p < 0.02 for GGT, and r = -0.23, p < 0.05 for beta-NAG.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Acetilglucosaminidasa/orina , Aminopeptidasas/orina , Antiinflamatorios no Esteroideos/uso terapéutico , gamma-Glutamiltransferasa/orina , Antiinflamatorios no Esteroideos/efectos adversos , Antígenos CD13 , Tasa de Filtración Glomerular , Humanos , Enfermedades Renales/inducido químicamente , Enfermedades Renales/diagnóstico , Enfermedades Renales/orina , Persona de Mediana Edad , Osteoartritis/tratamiento farmacológico , Factores de Tiempo
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