No indicar el trasplante de vivo es una mala práctica / No disponible

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Actividad de donación y trasplante renal en España 2006 / Donation and kidney transplantation activity in Spain. 2006. ONT rapport

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Actividad de donación y trasplante renal y pancreático en España 2005 / No disponible

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Donación y trasplante renal en España durante 2004 / Renal donation and transplantation in Spain 2004

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El empeño en valorar la actividad sanitaria / Efforts to quantity health care activity

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[Metastatic calcification in forearm simulating bone tumor in a patient in hemodialysis]. / Calcificación metastásica en antebrazo en paciente en hemodiálisis que simula tumor óseo.

We report a patient treated with periodic hemodialysis, who suffered the appearance of a mass in the forearm with compression of flexor muscles, median nerve and arteriovenous fistula. X-ray examination revealed a calcified and multiloculated mass which displace forearm vessels. We discuss the physiopathology, differential diagnosis and surgical treatment of the process.

Growth hormone response to acute growth hormone releasing hormone administration in uraemic patients on haemodialysis.

To examine the response of growth hormone (GH) to growth hormone releasing factor (GHRF) in patients on haemodialysis, we performed the acute GHRF test (50 micrograms administered intravenously as a bolus) in 10 uraemic male patients on haemodialysis and eight normal controls. Each patient was tested before and after a haemodialysis session (at 08.30 and 12.30). Controls were tested on the same time schedule. At 08.30, patients had significantly greater basal and peak GH values (2.5 +/- 0.6 and 27.8 +/- 5.5 micrograms/l) than controls (0.68 +/- and 11.5 +/- 4 micrograms/l). After the haemodialysis session, basal and peak values declined significantly (P less than 0.01) in the uraemic group (0.5 +/- 0.03 and 3.1 +/- 1.1 micrograms/l), whereas the controls did not show such a change in the 12.30 test. Basal and intratest glycaemic values were comparable both before and after haemodialysis. After dialysis test results did not change either with the use of glucose-free dialysate or with bicarbonate buffer. Uraemic patients display a greater GH response to GHRF injection than normal subjects, and this response decreases after haemodialysis. The degree of reduction has no relationship with either glycaemia or the dialysate buffer. We suggest that other GH secretion regulating factors are altered by the haemodialysis procedure.

[Acute anuric renal failure in a patient with diabetic neurogenic bladder]. / Fracaso renal agudo anúrico en paciente con vejiga neurógena diabética.

Herein we describe a patient with noninsulin dependent diabetes mellitus who developed acute anuric renal failure following eye surgery. This condition, ascribable to diabetic neurogenic bladder and probably to the use of anticholinergic agents, improved following placement of a urethral catheter. The physiopathological mechanisms and treatment are discussed.

Anticardiolipin antibodies and lupus anticoagulant in end-stage renal disease.

Anticardiolipin antibodies are autoantibodies clinically associated with hypercoagulability. Systemic thrombosis and thrombosis of the vascular access for haemodialysis coexist with immunoregulation abnormalities in end-stage renal disease (ESRD). The aim of the present study was to analyse the incidence of thrombotic episodes and the presence of anticardiolipin antibodies and lupus anticoagulant in 73 patients with ESRD--51 on haemodialysis and 22 on conservative treatment. Four (18%) patients on conservative treatment had IgG-anticardiolipin, three of them also having lupus anticoagulant. Sixteen (31%) patients on haemodialysis showed IgG-anticardiolipin and 11 (22%) lupus anticoagulant; overall, 19 (37%) patients on haemodialysis had IgG-anticardiolipin and/or lupus anticoagulant. This greater incidence in haemodialysis was associated with a more frequent use of cuprophane membranes (68% versus 34%, P less than 0.05). Six patients with ESRD--one on conservative treatment--met criteria for the diagnosis of primary antiphospholipid syndrome, clinically characterised by thrombosis of the vascular access. IgG-anticardiolipin and/or lupus anticoagulant are frequently found in ESRD and their incidence increases with haemodialysis, probably due to some kind of membrane bioincompatibility. IgG-anticardiolipin and lupus anticoagulant can be associated with thrombotic episodes, being constituents of an ESRD-related antiphospholipid syndrome.

[Acute renal failure of obstructive etiology caused by uterine prolapse]. / Fracaso renal agudo de etiología obstructiva originado por prolapso uterino.

We describe a 76-year-old woman with severe uterine prolapse with secondary bilateral ureterohydronefrosis and acute renal failure, which improved after the reposition of the uterus. Physiopathological mechanisms and treatment of obstructive uropathy related with uterine prolapse are discussed.

[Protocol study and results of the use of midecamycin for bacterial infections of the upper respiratory tract]. / Estudio protocolizado y resultados del empleo de midecamicina en infecciones bacterianas de vías respiratorias altas.

Planned study of 110 patients suffering infections of the upper respiratory tract. Soon after a smear of the focus for bacterial examination was taken a treatment with diacetyl-midecamycin was scheduled during 7 days. Thereafter another control smear and checking of the clinical status was realized. The issue of the study was very good, excepting 3 cases in which the drug was discontinued owing to gastrointestinal intolerance.

[Treatment of anemia with recombinant human erythropoietin and the bone marrow response in uremic patients undergoing periodic hemodialysis]. / Tratamiento de la anemia con eritropoyetina humana recombinante y respuesta medular en pacientes urémicos en hemodiálisis periódicas.

Treatment of anemia with human recombinant erythropoietin (EPO-R) and its effect on bone marrow was studied in 10 anemic patients on periodic hemodialysis (HD). Blood transfusion was not required once treatment started. Hemoglobin (Hb) levels normalized at six months in all patients (7.2 +/- 0.2 vs 12.4 +/- 3 g/dl, p less than 0.01). Serum ferritin levels decreased progressively as Hb increased (r = -0.5609), and six patients needed iron supplement since the third month. Bone marrow iron deposits decreased significantly (p less than 0.001), together with an increase of cellularity and improvement of erythrodysplasia. EPO-R was associated with worsening hypertension in previously hypertensive patients, although it could be controlled with more aggressive treatment. Thrombotic events either systemic or at the vascular access, were not observed. EPO-R corrects the anemia in uremic patients undergoing HD. Iron stores and blood pressure in hypertensive patients on treatment with EPO-R must be monitored regularly.

[Prolactin response to acute administration of growth hormone releasing hormone in patients with uremia]. / Respuesta de la prolactina a la administración aguda de la hormona liberadora de la hormona de crecimiento en pacientes urémicos.

The Growth Hormone Releasing Hormone (GH-RH) constitutes the most potent and specific stimulus for Growth Hormone secretion. Nevertheless, in some pathologic situations a Prolactin (PRL) response to GH-RH stimulus is also observed. In order to evaluate the possible effect of GH-RH over seric levels of PRL in uremic patients we carried out a study in a group of ten male patients on hemodialysis (HD), who were given an acute stimulus of GH-RH (an IV 50 mcg. bolus) immediately before and after the HD session, with blood extractions at times -15, 0, 15, 30, 45, 60, and 90 minutes for PRL determinations. The same procedure was carried out in 8 healthy controls. Basal PRL levels in the HD group (14 +/- 3.2 micrograms/L) were significantly greater (p less than 0.01) than control group (3.8 +/- 1.4 micrograms/L). There was no PRL response to GH-RH either in uremic patients before or after HD or in healthy controls. Our results show that there is a significant increase in PRL levels in uremic patients both before and after dialysis with a GH-RH response comparable to healthy subjects.