Hipovitaminosis D en pacientes hemodiálizados (HD): factores relacionados e influencia sobre la fuerza muscular / Hypovitaminosis D in patients on hemodialysis (HD): related factors and influence on muscle strength

Introducción: La deficiencia de 25 (OH) vitamina D es una alteración prevalente en los pacientes con enfermedad renal crónica (ERC) , sin embargo en nuestro medio no es medida de manera rutinaria y por ende no suele hacerse reposición vitamínica. Nuestro objetivo fue determinar la prevalencia y los factores relacionados a deficiencia de 25 (OH) D en pacientes con ERC en hemodiálisis (HD), particularmente la relación con la función y masa muscular. Métodos: Efectuamos un estudio prospectivo, multicéntrico, en pacientes adultos en HD crónica que no estuvieran recibiendo ningún derivado de la vitamina D. Se midieron en sangre los niveles de 25(OH) D, Hemoglobina, PCR, Albúmina, Ca, P, FAL, PTHi. Se realizó la medición de la fuerza del puño con dinamómetro, y la prueba de sentado-parado. Se aplicó el índice de Karnofsky para clasificar el estado funcional., Se realizó una bioimpedanciometría (BCM; Frese nius Medical Care) en aquellos pacientes sin, contraindicación. Resultados: Se incluyeron 138 pacientes. La 25(OH) vitamina fue de 20.43 ± 10.5 ng/ml, la prevalencia de insuficiencia /defi ciencia 87% (37% con menos de 15 ng/ml). Las concentraciones de vitamina D/deficiencia mostraron correlación/relación significativa con la edad, la presencia de diabetes, los niveles de hemoglobina y albúmina, la fuerza y la masa muscular y la clase funcional (p<0.05) . Conclusión: Alta prevalencia de hipovitaminosis D en pacientes hemodializados particularmente gerontes y diabéticos. Esto estaría relacionado con la desnutrición, anemia, clase funcional y la fuerza/masa muscular de los pacientes, estos últimos dos factores no reportados hasta ahora. Todos estos factores deben ser considerados al momento de la sustitución vitamínica y en la evaluación de la efectividad de la misma.

Background: 25 (OH) vitamin D deficiency is a prevailing alteration in patients with chronic kidney disease (CKD); however, in our environment, it is not routinely measured and, therefore, vitamin replacement is unusual. Our purpose was assessing the prevalence of and the factors related to 25 (OH) vitamin D deficiency in patientswith CKD in hemodialysis (HD), especially the relation to function and muscle mass. Methods: We conducted a prospective, multicenter study in adult patients on chronic HD who were not receiving any vitamin D derivative. Blood levels of 25 (OH) D, Hemoglobin, CRP, Albumin, Ca,P, ALP and PTHi were measured. The handgrip strength was measured with a dynamometer and the sitting-rising test was carried out. A bioimpedance analysis (BCM; Fresenius Medical Care) was conducted in the patients who had no contraindications. Results: 138 patients were included. The levels of 25 (OH) vitamin D were 20.43±10.5 ng/ml; the insufficiency/deficiency had 87% prevalence (and 37% prevalence with less than 15 ng/ml). Vitamin D concentrations/ deficiency showed a significant correlation with/ relation to age, diabetes, hemoglobin and albumin levels, muscle strength and mass, and functional class (p<0.05). Conclusion: High prevalence of hypovitaminosis D in patients on hemodialysis, particularly in the elderly and in patients with diabetes. This should be related to undernutrition, anemia, the functional class and the muscle strength/mass of patients, the latter two being unreported factors until now. All these factors should be considered when vitamin replacement is conducted and when its effectiveness is assessed.

Hipovitaminosis D en pacientes hemodiálizados (HD): factores relacionados e influencia sobre la fuerza muscular / Hypovitaminosis D in patients on hemodialysis (HD): related factors and influence on muscle strength

Introducción: La deficiencia de 25 (OH) vitamina D es una alteración prevalente en los pacientes con enfermedad renal crónica (ERC) , sin embargo en nuestro medio no es medida de manera rutinaria y por ende no suele hacerse reposición vitamínica. Nuestro objetivo fue determinar la prevalencia y los factores relacionados a deficiencia de 25 (OH) D en pacientes con ERC en hemodiálisis (HD), particularmente la relación con la función y masa muscular. Métodos: Efectuamos un estudio prospectivo, multicéntrico, en pacientes adultos en HD crónica que no estuvieran recibiendo ningún derivado de la vitamina D. Se midieron en sangre los niveles de 25(OH) D, Hemoglobina, PCR, Albúmina, Ca, P, FAL, PTHi. Se realizó la medición de la fuerza del puño con dinamómetro, y la prueba de sentado-parado. Se aplicó el índice de Karnofsky para clasificar el estado funcional., Se realizó una bioimpedanciometría (BCM; Frese nius Medical Care) en aquellos pacientes sin, contraindicación. Resultados: Se incluyeron 138 pacientes. La 25(OH) vitamina fue de 20.43 ± 10.5 ng/ml, la prevalencia de insuficiencia /defi ciencia 87% (37% con menos de 15 ng/ml). Las concentraciones de vitamina D/deficiencia mostraron correlación/relación significativa con la edad, la presencia de diabetes, los niveles de hemoglobina y albúmina, la fuerza y la masa muscular y la clase funcional (p<0.05) . Conclusión: Alta prevalencia de hipovitaminosis D en pacientes hemodializados particularmente gerontes y diabéticos. Esto estaría relacionado con la desnutrición, anemia, clase funcional y la fuerza/masa muscular de los pacientes, estos últimos dos factores no reportados hasta ahora. Todos estos factores deben ser considerados al momento de la sustitución vitamínica y en la evaluación de la efectividad de la misma.(AU)

Background: 25 (OH) vitamin D deficiency is a prevailing alteration in patients with chronic kidney disease (CKD); however, in our environment, it is not routinely measured and, therefore, vitamin replacement is unusual. Our purpose was assessing the prevalence of and the factors related to 25 (OH) vitamin D deficiency in patientswith CKD in hemodialysis (HD), especially the relation to function and muscle mass. Methods: We conducted a prospective, multicenter study in adult patients on chronic HD who were not receiving any vitamin D derivative. Blood levels of 25 (OH) D, Hemoglobin, CRP, Albumin, Ca,P, ALP and PTHi were measured. The handgrip strength was measured with a dynamometer and the sitting-rising test was carried out. A bioimpedance analysis (BCM; Fresenius Medical Care) was conducted in the patients who had no contraindications. Results: 138 patients were included. The levels of 25 (OH) vitamin D were 20.43±10.5 ng/ml; the insufficiency/deficiency had 87% prevalence (and 37% prevalence with less than 15 ng/ml). Vitamin D concentrations/ deficiency showed a significant correlation with/ relation to age, diabetes, hemoglobin and albumin levels, muscle strength and mass, and functional class (p<0.05). Conclusion: High prevalence of hypovitaminosis D in patients on hemodialysis, particularly in the elderly and in patients with diabetes. This should be related to undernutrition, anemia, the functional class and the muscle strength/mass of patients, the latter two being unreported factors until now. All these factors should be considered when vitamin replacement is conducted and when its effectiveness is assessed.(AU)

[Measuring Kt by ionic dialysance is a useful tool for assessing dialysis dose in critical patients]. / La determinación del Kt por dialisancia iónica es una herramienta útil para la evaluación de la dosis de diálisis en pacientes críticos.

AIM: To evaluate the Kt assessed through ionic dializance (KtOCM) in UCI patients undergoing renal replacement therapy for acute kidney injury, comparing the results with those obtained through the urea removal rate method determined by dialyzate collection (Kturea). MATERIAL AND METHODS: 18 adult UCI staying individuals suffering from renal replacement therapy requiring oliguric acute kidney injury were included in this study. RRT consisted in intermittent or extended hemodialysis performed through a Fresenius 4008E dialysis machine equipped with an on-line clearance monitor (OCM Fresenius). The KtOCM results were provided automatically. The Spearman correlation test was used to assess the relationship between the two exploratory methods and the Student s t test to compare the results obtained by the KtOCM and the Kturea. RESULTS: 35 treatments were analyzed. There were not statistically significant differences between the results form the KtOCM and the Kturea (34.9 +/- 10.69 vs 32.78 +/- 11.31, p = NS). A remarkable association was find between both methods (r = 0.87; 95CI, 0.76-0.94; p < 0.001). CONCLUSIONS: The assessment of Kt through ionic dialyzance is a simple method to estimate the dose of dialysis in critically ill patients and is and useful tool to monitor and adjust the RRT in real time according to a target dose.

La determinación del Kt por dialisancia iónica es una herramienta útil para la evaluación de la dosisde diálisis en pacientes críticos / Measuring Kt by ionic dialysance is a useful tool for assessing dialysis dose in critical patients

Objetivo: Evaluar la determinación de Kt (KtOCM) por dialisancia iónica en los pacientes sometidos a terapia de reemplazo renal (TRR) por insuficiencia renal aguda (IRA) atendidos en una unidad de cuidados intensivos (UCI), comparándola con el Kt obtenido mediante el cálculo del índice de remoción de urea obtenido por recogida del dializado (Kturea). Materiales y métodos: Se incluyeron 18 pacientes adultos, con IRA oligúrica ingresados en la UCI, con requerimiento de TRR, tratados con hemodiálisis intermitente y/o diálisis extendida. Las TRR fueron realizadas con equipos Fresenius 4008E equipados con un monitor de aclaramiento «on-line» (OCM Fresenius). La determinación de KtOCM fue realizada automáticamente por el monitor. Se efectuaron la correlación y la comparación entre KtOCM y Kturea utilizando el análisis de correlación de Spearman y el test de la t, respectivamente. Resultados: Sobre 35 tratamientos efectuados, la media de KtOCM no fue estadísticamente diferente de la del Kturea (34,9 ± 10,69 frente a 32,78 ± 11,31; NS). Se obtuvo una importante correlación y una relación lineal significativa entre los dos métodos (r = 0,87; p <0,001; intervalo de confianza [IC] 95%, 0,76-0,94%). Conclusiones: La determinación del Kt por dialisancia iónica es un método simple para estimar la dosis de diálisis en pacientes críticos y es una herramienta útil para monitorizar y ajustar las TRR en tiempo real de acuerdo con una dosis objetivo (AU)

Aim: To evaluate the Kt assessed through ionic dializance (KtOCM) in UCI patients undergoing renal replacement therapy for acute kidney injury, comparing the results with those obtained through the urea removal rate method determined by dialyzate collection (Kturea). Material and methods: 18 adult UCI staying individuals suffering from renal replacement therapy requiring oliguric acute kidney injury were included in this study. RRT consisted in intermitent or extended hemodialysis performed through a Fresenius 4008E dialysis machine equiped with an on-line clearance monitor (OCM Fresenius). The KtOCM results were provided automatically. The Spearman correlation test was used to assess the relationship between the two exploratory methods and the Student´s t test to compare the results obtained by the KtOCM and the Kturea. Results: 35 treatments were analyzed. There were not statistically significant differences between the results form the KtOCM and the Kturea (34.9 ± 10.69 vs 32.78 ± 11.31, p = NS). A remarkable association was find between both methods (r = 0.87; 95CI, 0.76-0.94; p <0.001). Conclusions: The assessment of Kt through ionic dialyzance is a simple method to estimate the dose of dialysis in critically ill patients and is and useful tool to monitor and adjust the RRT in real time according to a target dose (AU)

Seroprevalencia de Helicobacter pylori en hemodializados

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofsky's index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofsky's index > 70, and 40/78 (51.3%) with Karnofsky's index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.

Seroprevalencia de Helicobacter pylori en hemodializados / xxx

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofskys index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofskys index > 70, and 40/78 (51.3%) with Karnofskys index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population. (AU)

[Helicobacter pylori seroprevalence in dialysis patients]. / Seroprevalencia de Helicobacter pylori en hemodializados.

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofsky's index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofsky's index > 70, and 40/78 (51.3%) with Karnofsky's index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.

Seroprevalencia de Helicobacter pylori en hemodializados. / [Helicobacter pylori seroprevalence in dialysis patients]

AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofskys index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3

) dialyzed patients and 55 out of 93 (53.6

) controls were Hp positive (ns). Forty-one out of 76 patients (53.9

) with a serum albumin level 3.5 g/dl and 3/17 (17.6

) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95

CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2

) with Kt/V > 1.2 and 6/13 (43.8

) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95

CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7

) with Karnofskys index > 70, and 40/78 (51.3

) with Karnofskys index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95

CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.

[Kidney and pancreas transplantation: initial experience at a single transplant center in Argentina]. / Trasplante renopancrático. Experiencia inicial en un centro de trasplante en Argentina.

After more than 10,000 cases reported all over the world until 1998, simultaneous kidney and pancreas transplantation has become a safe clinical practice, and it may probably represent the best treatment available for diabetic patients in end-stage renal disease. Here we present our results after 12 cadaveric pancreas transplants (8 whole organ, and 4 islet transplants), performed on insulin-dependent diabetic patients. Eleven of these patients received a kidney simultaneously, and one of them required a kidney retransplantation. All vascularised pancreatic grafts were positioned intraperitoneally, anastomosed to the iliac vessels, and bladder drained. One year patient, whole pancreas, and kidney survival rates were 86%, 86% and 71%, respectively. All of these patients remain insulin and dialysis-free, the longest for 37 months. Islets for transplantation were obtained from single cadaveric donors. Fresh, unpurified cells were transplanted intraperitoneally by laparoscopy (equivalent islet yields: 3 x 10(5), 4 x 10(5), 1 x 10(6) and 5 x 10(5)). None of the islet recipients resulted insulin-independent but they all reduced daily requirements in about 40%, with better metabolic control (mean HbA1c pretransplant 9.4 +/- 1.8, vs 7.9 +/- 1.6 posttransplant). One kidney graft was lost due to venous thrombosis. Simultaneous kidney and pancreas transplantation offers the diabetic patient in end-stage renal disease a chance of independence both from dialysis and exogenous insulin. Whole pancreas transplantation has better functional outcome than islet transplantation. Nevertheless, for those diabetic patients who do not meet the criteria to receive a vascularised graft, pancreatic cells may still improve carbohydrate metabolism with minor surgical risk.

Trasplante renopancrático. Experiencia inicial en un centro de trasplante en Argentina. / [Kidney and pancreas transplantation: initial experience at a single transplant center in Argentina]

After more than 10,000 cases reported all over the world until 1998, simultaneous kidney and pancreas transplantation has become a safe clinical practice, and it may probably represent the best treatment available for diabetic patients in end-stage renal disease. Here we present our results after 12 cadaveric pancreas transplants (8 whole organ, and 4 islet transplants), performed on insulin-dependent diabetic patients. Eleven of these patients received a kidney simultaneously, and one of them required a kidney retransplantation. All vascularised pancreatic grafts were positioned intraperitoneally, anastomosed to the iliac vessels, and bladder drained. One year patient, whole pancreas, and kidney survival rates were 86

, 86

and 71

, respectively. All of these patients remain insulin and dialysis-free, the longest for 37 months. Islets for transplantation were obtained from single cadaveric donors. Fresh, unpurified cells were transplanted intraperitoneally by laparoscopy (equivalent islet yields: 3 x 10(5), 4 x 10(5), 1 x 10(6) and 5 x 10(5)). None of the islet recipients resulted insulin-independent but they all reduced daily requirements in about 40

, with better metabolic control (mean HbA1c pretransplant 9.4 +/- 1.8, vs 7.9 +/- 1.6 posttransplant). One kidney graft was lost due to venous thrombosis. Simultaneous kidney and pancreas transplantation offers the diabetic patient in end-stage renal disease a chance of independence both from dialysis and exogenous insulin. Whole pancreas transplantation has better functional outcome than islet transplantation. Nevertheless, for those diabetic patients who do not meet the criteria to receive a vascularised graft, pancreatic cells may still improve carbohydrate metabolism with minor surgical risk.

Alteraciones en la actividad del calcio-magnesio ATPasa en la membrana de los eritrocitos en pacientes litiasicos con hipercalciuria / Alterations in the calcium-magnesium activity ATPase in the membrane of the erytrosites in lithiasic patients with hypercalciuria

La CaMgATPasa es una enzima involucrada en los movimientos de calcio a través de las membranas biológicas. Nosotros testeamos la actividad de dicha enzima en membranas de eritrocitos de 17 pacientes hipercalciúricos y la comparamos con 8 controles sanos. Los pacientes con hipercalciuria tuvieron una actividad de CaMgATPasa que fue significativamente superior a los controles (18,02 2,83 vs 14,69 1,78 nM . mg-1 p<0,01). La excreción de urinaria de calcio en 24 hs (UCa.V) estuvo directa y significativamente relacionada con la actividad de la enzima (UCa.V: 36,31 x CaMgATPasa - 371,08 r:0,65 p<0,05) sólo en pacientes con hipercalciuria. Cuando agrupamos los pacientes acorde al diagnóstico fisiopatológico en hipercalciuria absortiva (HCA) e hipercalciuria renal (HCRT) encontramos que la actividad enzimática estuvo sólo significativamente elevada en aquellos portadores de HCA al compararlos con los controles (19,17 3,49 vs 14,68 1,79 nM . mg-1 .min-1 p<0,025).No encontramos diferencias estadísticamente significativas entre HCRT y controles (16,83 1,99nM . mg-1 . min-1; p:NS) y en HCRT vs HCA (p<0,14). Concluimos que las alteraciones en el transporte de calcio en la hipercalciuria dependería de anormalidades en la actividad de la CaMgATPasa

Alteraciones en la actividad del calcio-magnesio ATPasa en la membrana de los eritrocitos en pacientes litiasicos con hipercalciuria / Alterations in the calcium-magnesium activity ATPase in the membrane of the erytrosites in lithiasic patients with hypercalciuria

La CaMgATPasa es una enzima involucrada en los movimientos de calcio a través de las membranas biológicas. Nosotros testeamos la actividad de dicha enzima en membranas de eritrocitos de 17 pacientes hipercalciúricos y la comparamos con 8 controles sanos. Los pacientes con hipercalciuria tuvieron una actividad de CaMgATPasa que fue significativamente superior a los controles (18,02 2,83 vs 14,69 1,78 nM . mg-1 p<0,01). La excreción de urinaria de calcio en 24 hs (UCa.V) estuvo directa y significativamente relacionada con la actividad de la enzima (UCa.V: 36,31 x CaMgATPasa - 371,08 r:0,65 p<0,05) sólo en pacientes con hipercalciuria. Cuando agrupamos los pacientes acorde al diagnóstico fisiopatológico en hipercalciuria absortiva (HCA) e hipercalciuria renal (HCRT) encontramos que la actividad enzimática estuvo sólo significativamente elevada en aquellos portadores de HCA al compararlos con los controles (19,17 3,49 vs 14,68 1,79 nM . mg-1 .min-1 p<0,025).No encontramos diferencias estadísticamente significativas entre HCRT y controles (16,83 1,99nM . mg-1 . min-1; p:NS) y en HCRT vs HCA (p<0,14). Concluimos que las alteraciones en el transporte de calcio en la hipercalciuria dependería de anormalidades en la actividad de la CaMgATPasa

Alteraciones en la actividad del calcio-magnesio ATPasa en la membrana de los eritrocitos en pacientes litiasicos con hipercalciuria / Alterations in the calcium-magnesium activity ATPase in the membrane of the erytrosites in lithiasic patients with hypercalciuria

La CaMgATPasa es una enzima involucrada en los movimientos de calcio a través de las membranas biológicas. Nosotros testeamos la actividad de dicha enzima en membranas de eritrocitos de 17 pacientes hipercalciúricos y la comparamos con 8 controles sanos. Los pacientes con hipercalciuria tuvieron una actividad de CaMgATPasa que fue significativamente superior a los controles (18,02 2,83 vs 14,69 1,78 nM . mg-1 p<0,01). La excreción de urinaria de calcio en 24 hs (UCa.V) estuvo directa y significativamente relacionada con la actividad de la enzima (UCa.V: 36,31 x CaMgATPasa - 371,08 r:0,65 p<0,05) sólo en pacientes con hipercalciuria. Cuando agrupamos los pacientes acorde al diagnóstico fisiopatológico en hipercalciuria absortiva (HCA) e hipercalciuria renal (HCRT) encontramos que la actividad enzimática estuvo sólo significativamente elevada en aquellos portadores de HCA al compararlos con los controles (19,17 3,49 vs 14,68 1,79 nM . mg-1 .min-1 p<0,025).No encontramos diferencias estadísticamente significativas entre HCRT y controles (16,83 1,99nM . mg-1 . min-1; p:NS) y en HCRT vs HCA (p<0,14). Concluimos que las alteraciones en el transporte de calcio en la hipercalciuria dependería de anormalidades en la actividad de la CaMgATPasa