Analysis of Kidney Donation and Its Relationship With Graft Failure of the Recipient at 1 Year.

INTRODUCTION: Currently, the shortage of organs available for kidney transplantation and a change in donors' and recipients' profiles (elderly, with cardiovascular risk, donors after cardiac death), it is becoming necessary to assess grafts from expanded-criteria donors (ECD) in order to have methods that allow us to predict viability and graft survival. OBJECTIVE: The aim of this study was to analyze the different methods of renal donor assessment (estimated glomerular filtration rate [eGFR], preimplantation biopsy, and Kidney Donor Profile Index [KDPI] score) as predictors of graft survival and renal function of our recipient at 1 year. METHODS: We performed a descriptive and retrospective study of 183 deceased donor kidney transplantations performed at our center between 2011 and 2015. We calculated the KDPI scores, donor eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration Formula equation, and biopsies were evaluated using Banff classification. RESULTS: ECDs comprised 59.60%, 93% of donors had an eGFR ≥ 60 mL/min/1.73 m2, and 41% presented with a KDPI score ≥ 90%. The most frequent range in the biopsy score was 0-3. The 1-year graft survival rate was 86.90%. Factors that negatively influenced graft survival were donor/recipient age, ECD, KDPI, and cold ischemia time (CIT). CONCLUSION: Prolonged CIT and KDPI ≥ 90% were donor variables that were related to graft failure at 1 year in our center.

Kidney transplantation with organs from donors after circulatory death type 3: a prospective multicentric Spanish study (GEODAS 3).

To increase the number of kidney donors, new strategies are needed such as living donor programs, expanded criteria donors, or donors after circulatory death (DCD) kidney transplantation programs. The GEODAS group has started an observational, prospective, multicenter clinical study, collecting data from all DCD type-3 kidney transplantations performed in seven Spanish hospitals from January 2012 to January 2014. The preliminary results have shown a delayed graft function of 40.4% and graft survival of 93.7% with a nadir creatinine of 1.3 mg/dL. From all 33 potential donors included in the study, 32 were effective and 63 kidney grafts were transplanted with a utilization rate of 98.5%. Creatinine evolution (median [range]) was in the first month: 2.1 [0.6-5.6]; third month: 1.6 [0.8, 4.2]; first year: 1.6 [0.9-2.2]. These results are similar to kidney transplantation from donors after brain death as shown in the literature, especially in the graft and recipient survival rates. In addition, the controlled programs are easier and less expensive than uncontrolled DCD programs with a higher rate of graft use.

Molecular mechanisms by which white tea prevents oxidative stress

The flavonoid content of tea (Camellia sinensis) has beneficial properties in the prevention of diseases. However, the mechanisms by which white tea can protect against oxidative stress remain unclear. To shed light on this issue, rats were given distilled water (controls), 0.15 mg/day (dose 1) or 0.45 mg/day (dose 2) of solid tea extract/kg body weight for 12 months. All the animals received an injection of adriamycin (ADR; 10 mg/kg body weight), except half of the control group, which were given an injection of saline solution. The expression of the nuclear factor, E2-related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (Nqo1), glutathione S-transferase (Gst), haem oxygenase-1 (Ho1), catalase (Cat), superoxide dismutase (Sod) and glutathione reductase (Gr) in liver was analysed by real-time PCR, and the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) was measured spectrophotometrically. ADR significantly increased the expression of Nrf2, Gst, Nqo1, Ho1, Cat, Sod and Gr with respect to the control levels and also increased the activity of CAT, SOD and GR. The intake of white tea increased in a higher degree the expression of Nrf2, Gst, Nqo1 and Ho1 in the tea + ADR group compared with the control group and C + ADR group. In addition, tea + ADR groups decreased the expression and activity of CAT, SOD and GR in a dose-dependent manner

Molecular mechanisms by which white tea prevents oxidative stress.

The flavonoid content of tea (Camellia sinensis) has beneficial properties in the prevention of diseases. However, the mechanisms by which white tea can protect against oxidative stress remain unclear. To shed light on this issue, rats were given distilled water (controls), 0.15 mg/day (dose 1) or 0.45 mg/day (dose 2) of solid tea extract/kg body weight for 12 months. All the animals received an injection of adriamycin (ADR; 10 mg/kg body weight), except half of the control group, which were given an injection of saline solution. The expression of the nuclear factor, E2-related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (Nqo1), glutathione S-transferase (Gst), haem oxygenase-1 (Ho1), catalase (Cat), superoxide dismutase (Sod) and glutathione reductase (Gr) in liver was analysed by real-time PCR, and the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) was measured spectrophotometrically. ADR significantly increased the expression of Nrf2, Gst, Nqo1, Ho1, Cat, Sod and Gr with respect to the control levels and also increased the activity of CAT, SOD and GR. The intake of white tea increased in a higher degree the expression of Nrf2, Gst, Nqo1 and Ho1 in the tea + ADR group compared with the control group and C + ADR group. In addition, tea + ADR groups decreased the expression and activity of CAT, SOD and GR in a dose-dependent manner.

Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0) / Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)

El objetivo de este trabajo es la descripción de una nueva versión de la aplicación informática GRUNUMUR, herramienta de utilidad en estudios de nutrición humana diseñada por el Grupo de investigación en Nutrición de la Universidad de Murcia. De forma similar a la primera, esta versión ofrece la posibilidad de abordar diferentes tipos de estudios: dietéticos, nutricionales y de hábitos alimentarios, epidemiológicos, así como antropométricos y clínicos. La nueva versión, denominada GRUNUMUR 2.0, compatible con la primera, dispone de un sistema de ayuda en línea para todas las funciones de la aplicación, facilitando las tareas al usuario; permite el almacenamiento seguro de un número prácticamente ilimitado de resultados, de forma ordenada y organizada, que se pueden recuperar en el momento que se precise, gracias a un sistema de copias de seguridad y mantenimiento programado y desatendido (tareas realizadas por un servidor); otra ventaja es su total accesibilidad, tanto desde la intranet universitaria (www.um.es) como desde el internet, por su funcionamiento vía navegador Web (http://senver.inf.um.es/esen); y por último, permite la exportación de los datos a Excel para su posterior tratamiento con otras aplicaciones, así como la edición de informes en PDF, para entregar a los participantes del estudio en caso necesario. La nueva versión ha sido validada por comparación de los resultados extraídos con los obtenidos de otros programas informáticos, no encontrándose diferencias significativas entre ellos para ninguna de las variables analizadas. La aplicación GRUNUMUR 2.0 es una herramienta mejorada, útil y fiable para abordar estudios de nutrición humana (AU)

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies (AU)

Nutrition and prevalence of undernutrition assessed by different diagnostic criteria in nursing homes for elderly people.

BACKGROUND: Undernutrition is the state produced by the intake of insufficient energy, macronutrients or micronutrients. The present study aimed to assess the prevalence of undernutrition using 10 different diagnostic criteria described in the literature and to assess its association with energy intake in an institutionalised elderly population. METHODS: The cross-sectional study included 213 subjects, aged 65-96 years (135 women and 78 men), who lived in seven nursing homes in the province of Murcia, on the Mediterranean coast of Spain. Dietary intake and anthropometric and biochemical parameters were assessed, and 10 different diagnostic criteria, taken from studies of elderly subjects similar to our population, were applied. RESULTS: The mean dietary intakes appeared to cover the recommended dietary intake for a Spanish elderly population. However, only 58.2% of the studied subjects consumed 100% of the recommended dietary intake and 15.5% of the subjects had an energy intake below 80% of the recommended dietary intake. Depending on the criteria used for the diagnosis, the proportion of patients with undernutrition varied between 2% and 57%. When the relationship between undernourishment, as defined by the different methods and intake deficiency, was assessed, a statistically significant relationship was only found for five of the 10 diagnostic criteria assessed. CONCLUSIONS: Research needs to focus on the development and evaluation of specific nutritional assessment tools for application to older people aiming to improve the detection of those suffering (or who are at risk of suffering) undernutrition.

[Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)]. / Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0).

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies.

[Renal cell carcinoma metastatic to the duodenum and Vater ampulla: report of two cases]. / Metástasis de cáncer renal a duodeno y ámpula de Vater; informe de dos casos.

These two cases of metastatic renal cell carcinoma to the duodenum, adds to the limited experience reported in the literature. Both patients initially presented with upper gastrointestinal bleeding years after they had a nephrectomy. After an extensive diagnostic work-up, they were both submitted to a classic pancreaticoduodenectomy (Whipple's procedure). Only the final histopathological report revealed the diagnosis. Basic recommendations on diagnosis and treatment are discussed in this article and a review of the literature is given.

[Prevalence of malnutrition and influence of oral nutritional supplementation on nutritional status in institutionalized elderly]. / Prevalencia de desnutrición e influencia de la suplementación nutricional oral sobre el estado nutricional en ancianos institucionalizados.

BACKGROUND: Nutritional supplementation might be an effective strategy for improving the nutritional status and the quality of life of institutionalized fragile elderly. OBJECTIVES: The prevalence of malnutrition and its relation with disease, and the influence of dietary supplementation by means of oral formulas on the nutritional status of elderly nursing home residents were assessed. METHODS: Two studies were carried out, one a cross-sectional survey in 31 subjects and the other a longitudinal-sectional survey in 19 subjects, both groups living in a public nursing home in the city of Murcia (SE Spain). Body mass index (BMI), serum albumin concentration (ALB) and geriatric nutritional risk index (GNRI) were assessed as markers of potential malnutrition. Illnesses were ascertained from medical records. RESULTS AND DISCUSSION: The prevalence of malnutrition of the total collective was high (39%), and especially in the fragile subjects (50%). The administration of oral nutritional supplements in the usual diet for 12 months significantly increased ALB and GNRI, and had no effect on body weigh and BMI. Jointly, these effects decreased the in the number of subjects at high nutritional risk and increased the number of subjects with a low or zero risk of malnutrition. CONCLUSION: The administration of oral nutritional supplements in the usual diet of this elderly collective is an effective clinical strategy in nutritional therapy.

Prevalencia de desnutrición e influencia de la suplementación nutricional oral sobre el estado nutricional en ancianos institucionalizados / Prevalence of malnutrition and influence of oral nutritional supplementation on nutritional status in institutionalized elderly

Introducción: La suplementación nutricional puede ser una efectiva estrategia para mejorar el estado nutricional y la calidad de vida de ancianos frágiles institucionalizados. Objetivos: Se ha valorado la prevalencia de desnutrición y su relación con el tipo de enfermedad, y la influencia de la suplementación de la dieta con fórmulas orales sobre el estado nutricional en ancianos institucionalizados. Métodos: Se realizaron dos estudios, uno de diseño transversal en el que participaron 31 ancianos, y otro de corte longitudinal con 19 ancianos, residentes en una institución pública para personas mayores de un área urbana de la Región de Murcia (España). Se ha determinado índice de masa corporal (IMC), concentración de albúmina sérica (ALB) e índice de riesgo nutricional geriátrico (GNRI) como marcadores de desnutrición y se ha registrado la enfermedad primaria y secundaria de los participantes. Resultados y discusión: La prevalencia de desnutrición en el colectivo de ancianos institucionalizados es elevada (39%), y especialmente en los residentes más frágiles (50%). La administración de suplementos nutricionales orales con la dieta habitual durante 12 meses ha incrementado significativamente la ALB y el GNRI y no ha tenido efecto sobre el peso corporal e IMC. Estos efectos beneficiosos se han traducido en la reducción en el número de ancianos con alto riesgo nutricional y aumento en el de bajo o nulo riesgo de desnutrición. Conclusión: La administración de suplementos nutricionales orales con la dieta habitual en un colectivo de estas características, es una medida clínica efectiva y justificada en su terapia nutricional (AU)

Background: Nutritional supplementation might be an effective strategy for improving the nutritional status and the quality of life of institutionalized fragile elderly. Objectives: The prevalence of malnutrition and its relation with disease, and the influence of dietary supplementation by means of oral formulas on the nutritional status of elderly nursing home residents were assessed. Methods: Two studies were carried out, one a crosssectional survey in 31 subjects and the other a longitudinal-sectional survey in 19 subjects, both groups living in a public nursing home in the city of Murcia (SE Spain). Body mass index (BMI), serum albumin concentration (ALB) and geriatric nutritional risk index (GNRI) were assessed as markers of potential malnutrition. Illnesses were ascertained from medical records. Results and discussion: The prevalence of malnutrition of the total collective was high (39%), and especially in the fragile subjects (50%). The administration of oral nutritional supplements in the usual diet for 12 months significantly increased ALB and GNRI, and had no effect on body weigh and BMI. Jointly, these effects decreased the in the number of subjects at high nutritional risk and increased the number of subjects with a low or zero risk of malnutrition. Conclusion: The administration of oral nutritional supplements in the usual diet of this elderly collective is an effective clinical strategy in nutritional therapy (AU)

Dietary intake and iron status of institutionalized elderly people: relationship with different factors.

OBJECTIVES: Aims of the study were to investigate iron status in institutionalized elderly subjects and to determine its association with different factors including: age, gender, body mass index, dietary intake, consumption of iron supplements, functional status and disease. DESIGN: A cross-sectional study. SETTING: Seven public nursing homes. PARTICIPANTS: 252 subjects, aged 65-96 years. MEASUREMENTS: Food intake was assessed by a 4-day weighed-food record. Iron status indices were measured. Barthel' s Index was used to evaluate functional status. Illnesses were ascertained from medical records. RESULTS: Anemia was found in 25.4% of subjects studied. Average dietary intakes fulfilled the amounts of Recommended Dietary Intake for Spanish elderly population, except for folate. A substantial percentage of subjects exhibited folate dietary deficit (89.2%). Mean (SD) BMI was 27.8 (6.4) kg/m2, and functional status 78.1 (26.5). Taking into account hematocrit, red blood cell count and serum iron concentration values, poor iron status was significantly more common in men (59.4, 61.4 and 16.8%, respectively) than in women (36.4, 36.4 and 6.0%, respectively). Hemoglobin concentration was positively associated with the energy and nutrient dietary intake, and negatively with age, BMI and functional status. CONCLUSIONS: Based on World Health Organization criteria, anemia was found in 25.4% of elderly subjects studied. Iron deficiency seems to be the main cause of anemia, and chronic disease the second cause of anemia. Dietary intake is not one of the principal causes of anemia in the study population, except for folate intake.

Estrategias para mejorar el valor nutricional de los menús ofertados en residencias públicas para personas mayores / Strategies for improving nutritional value of the meals offered by public nursing homes for the elderly

Introducción: En los países desarrollados, las personas mayores constituyen un grupo de alto riesgo nutricional,siendo los ancianos institucionalizados los más vulnerables de este colectivo.Objetivos: Se ha valorado nutricionalmente los menús ofertados en diferentes residencias públicas de personas mayores de la Región de Murcia (España), con el fin de estudiar su adecuación a las recomendaciones y diseñar posibles estrategias que permitan mejorar el estado nutricional de los residentes. Métodos: Se estudiaron un total de 252 menús ofertados en seis residencias y se valoró el aporte de energía y de macronutrientes, el perfil calórico, la calidad de la grasa y el contenido de fibra y colesterol. Los resultados obtenidos fueron comparados con las recomendaciones españolas para personas mayores y con las de la dieta equilibrada y mediterránea. Resultados y Discusión: El aporte energético medio de los menús superó ampliamente las cantidades recomendadas.El perfil calórico fue adecuado en proteínas, deficitario en carbohidratos y excesivo en lípidos. La calidad de la grasa se adecuó a la recomendada tanto en la dieta equilibrada como en la dieta mediterránea. Por el contrario,el aporte medio de fibra fue inferior y el de colesterol superior a los valores recomendados. Conclusiones: Entre las posibles estrategias para mejorar el valor nutricional de los menús estaría reducir el contenido de grasa y colesterol de los mismos e incrementar el de hidratos de carbono y fibra, sustituyendo algunos platos de carnes rojas por platos de legumbres,pan y cereales refinados por integrales, y productos lácteos enteros por semidesnatados (AU)

Background: In developed countries, elderly people are considered a group of high risk for possible nutritional imbalances, particularly if they are institutionalized. Objectives: In the present study, the nutritional valueof the meals offered by public nursing homes for the elderly in province of Murcia (Spain) was assessed, to compare the results with Spanish recommendations and to propose possible strategies for improving the nutritiona lstatus of the residents. Methods: We studied 252 meals offered by six nursing homes, evaluating the energy and macronutrient contents, caloric profile, fat quality and cholesterol and fiber contents. The results were compared with Spanish recommendations for elderly people, and recommendations for a balanced and Mediterranean diet. Results and Discussion: The average energy content of the meals widely fulfilled the amounts of Recommended Dietary Intake for the elderly population. The caloric profile was adequate as regards proteins, low in carbohydrates and high in lipids. The fat quality was adequate, the cholesterol content was higher and the fiber content lower that the recommended amounts. Conclusions: Among possible strategies to improve the nutritional value of the meals, could be a reduction in the fat and cholesterol contents and an increase in carbohydrate and fiber contents, by replacing some red meat dishes by legumes, bread and refined cereals by whole meal foods, and fat full dairy products by low fat equivalents (AU)

[Strategies for improving nutritional value of the meals offered by public nursing homes for the elderly]. / Estrategias para mejorar el valor nutricional de los menús ofertados en residencias públicas para personas mayores.

BACKGROUND: In developed countries, elderly people are considered a group of high risk for possible nutritional imbalances, particularly if they are institutionalized. OBJECTIVES: In the present study, the nutritional value of the meals offered by public nursing homes for the elderly in province of Murcia (Spain) was assessed, to compare the results with Spanish recommendations and to propose possible strategies for improving the nutritional status of the residents. METHODS: We studied 252 meals offered by six nursing homes, evaluating the energy and macronutrient contents, caloric profile, fat quality and cholesterol and fiber contents. The results were compared with Spanish recommendations for elderly people, and recommendations for a balanced and Mediterranean diet. RESULTS AND DISCUSSION: The average energy content of the meals widely fulfilled the amounts of Recommended Dietary Intake for the elderly population. The caloric profile was adequate as regards proteins, low in carbohydrates and high in lipids. The fat quality was adequate, the cholesterol content was higher and the fiber content lower that the recommended amounts. CONCLUSIONS: Among possible strategies to improve the nutritional value of the meals, could be a reduction in the fat and cholesterol contents and an increase in carbohydrate and fiber contents, by replacing some red meat dishes by legumes, bread and refined cereals by wholemeal foods, and fat full dairy products by low fat equivalents.

Sarcomatoid renal cell carcinoma in a renal transplant recipient.

The incidence of transplanted kidneys derived from elderly donors is increasing because of the larger waiting lists and greater age of patients with end-stage renal failure. Compared with young donors, one of the problems is the heightened risk of neoplasm transmission. We report 2 cases of kidney recipients, both of whom developed a sarcomatoid renal cell carcinoma after receiving a kidney transplant from the same 68-year-old male donor, who did not show signs of a neoplasm on a previous abdominal ultrasound or a pretransplant biopsy. The first recipient was a 66-year-old woman who developed a kidney mass with several urologic obstructive complications, tumor dissemination, and death at 9 months after kidney transplantation. The second recipient was a 48-year-old asymptomatic man with normal renal function, who was studied after the results of the first recipient, revealing another renal tumor. Transplant nephrectomy was performed and a peritoneal implant was resected. The patient is alive without evidence of a neoplasm after 18 months. Herein we have discussed the mechanisms of neoplasm transmission in kidney transplantation and possible strategies for its prevention and treatment.

Secondary amyloidosis associated with histiocytosis X.

We report a 34-year-old man diagnosed with Langerhans cell histiocytosis (LCH) or histiocytosis X in 1980. He had multiple focal osseous lesions, difficult control of the disease activity and was treated many times with chemo- and radiotherapy for symptomatic control. His kidney disease started 20 years after the diagnosis with progressive renal failure and increasing non-nephrotic proteinuria, coinciding with two flares of LCH. A percutaneous renal biopsy demonstrated amyloidosis. There is only one case described in the amyloidosis literature associated with LCH.

[Giant adrenal myelolipoma: hypertension, renal failure and spontaneous rupture]. / Mielolipoma suprarrenal gigante: hipertensión, insuficiencia renal y rotura espontánea.

Adrenal myelolipoma is a rare, benign, slow-growing tumor composed of adipose tissue and hematopoietic elements. It is usually diagnosed incidentally, although there are reports of patients with symptoms and descriptions of retroperitoneal hemorrhage due to rupture of large tumors. The condition has been associated with obesity, high blood pressure and adrenal dysfunction. We present a patient with retroperitoneal hemorrhage due to spontaneous rupture of a myelolipoma, hypertension, and renal failure secondary to nephroangiosclerosis.

In vivo dc and ac measurements at acupuncture points in healthy and unhealthy people.

OBJECTIVES: The aim of this work was to compare in vivo measurements of direct current (dc) and alternating current (ac) obtained from acupuncture points in Ukrainian and Mexican residents. METHODS: Measurements were made using the method of Voll. The participants were 43 healthy Ukrainian and 71 healthy Mexican residents aged between 20 and 30 years, as well as 24 Mexican patients with a clinical diagnosis of rheumatoid arthritis and 14 patients with a clinical diagnosis of allergy. RESULTS: The results showed that dc measurements are not directly applicable to different populations. Thus, the dc resistance of the acupuncture points in the Mexican participants was 4-5 times larger than in the Ukrainians. In contrast, the capacitance of the two groups did not differ by more than 25%. CONCLUSIONS: Impedance measurements from acupuncture points can be used as an efficient and prompt non-invasive method for diagnostic purposes.

Mielolipoma suprarrenal gigante: hipertensión, insuficiencia renal y rotura espontánea / Giant adrenal myelipoma: hypertension, renal failure and spontaneous rupture

El mielolipoma suprarrenal es un tumor raro, benigno, de lento crecimiento,compuesto por tejido graso y elementos hematopoyéticos. Suele diagnosticarse demanera incidental, aunque se han descrito casos de pacientes sintomáticos, e inclusohemorragias retroperitoneales por rotura en los de mayor tamaño. Se ha descritosu asociación con obesidad, HTA y disfunción suprarrenal. Presentamos unpaciente diagnosticado de mielolipoma, con hemorragia retroperitoneal espontáneapor rotura del mismo, e HTA, con insuficiencia renal secundaria a nefroangioesclerosis

Adrenal myelolipoma is a rare, benign, slow-growing tumor composed of adiposetissue and hematopoietic elements. It is usually diagnosed incidentally, althoughthere are reports of patients with symptoms and descriptions of retroperitonealhemorrhage due to rupture of large tumors. The condition has beenassociated with obesity, high blood pressure and adrenal dysfunction. We presenta patient with retroperitoneal hemorrhage due to spontaneous rupture of a myelolipoma,hypertension, and renal failure secondary to nephroangiosclerosis

[Embolization of non-functioning renal allograft: efficacy and control of systemic inflammation]. / Embolización del injerto renal no funcionante: eficacia y control del estado inflamatorio crónico.

BACKGROUND: The graft intolerance syndrome (fever, pain, haematuria) may lead to a chronic inflammatory disease, with cardiovascular repercussion. Nephrectomy is considered the classical treatment of these cases but nowadays renal vascular embolization has been suggested as a possible alternative treatment. The present study concerns seven cases trated with renal vascular embolization in our hospital summarizing data of graft intolerance syndrome and the chronic inflammatory disease. MATERIAL AND METHODS: Between january 2000 and december 2003 seven renal vascular embolization were performed in nonfunctioning renal allograft. The procedure was made with calibrated particles of 300-500micron. Data about complications related to the technique the same as analitic inflammatory parameters before and after treatment (CRP, ferritin, serum albumin, hemoglobin, erythropoietin) were registered. RESULTS: The patients were two men and five women, with median age of 39,7 +/- 8,8 years. The period beween the dialysis and the embolization was of 10,0 +/-8,2 months. Comparing the perion of admission in the hospital due to nephrectomy which was of 17,86+/-4,41 days, the period because of embolization was shorter, being 8,14 +/- 4,53 days. All analitic parameters studied, clearly improved after embolization with decrease of ferritin and CRP, increase of albumin and better hemoglobin level with lower erythropoietin dose. In five of the seven patients there was no renal captation with CT or gammagraphy. Four patients presented a postembolization syndrome, but no other important complication was registered. Neither reembolization nor renal nephrectomy was neccesary in any of the seven cases. CONCLUSION: Percutaneous renal embolization is a simple, easy, safety and effective technique that must be considered as an alternative treatment to nephrectomy, resolving the chronic inflammatory disease secondary to the graft intolerance syndrome.