0000000000174375

AUTHOR

Alfonso Miguel

Continuous ambulatory peritoneal dialysis as a therapeutic alternative in patients with advanced congestive heart failure.

Aims Continuous ambulatory peritoneal dialysis (CAPD) has been proposed as an additional therapeutic resource for patients with advanced congestive heart failure (CHF). The objective of this study was to determine the therapeutic role of CAPD, in terms of surrogate endpoints, in the management of patients with advanced CHF and renal dysfunction. A total of 57 candidates with New York Heart Association (NYHA) class III/IV CHF, renal dysfunction (glomerular filtration rate , 60 mL/min/1.73 m 2 ), persistent fluid congestion despite loop diuretic treatment, and at least two previous hospitalizations for acute heart failure (AHF) were invited to be included in the CAPD programme; however, 25 pa…

research product

Importance of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis: Its Influence on Different Parameters of Renal Replacement Treatment

<i>Objective:</i> To study the influence of residual renal function (RRF) on different parameters of the renal substitutive treatment offered by peritoneal dialysis. <i>Methods:</i> We analyzed the impact of RRF on dialysis dose, nutrition parameters, anemia and phosphocalcic metabolism in 37 patients with end-stage renal disease (ESRD) treated by continuous ambulatory peritoneal dialysis (CAPD). Analytical controls were done every 6 months after an initial assessment at the end of the first month of treatment. Multiple lineal regression models were used as the statistical method to analyze the influence of RRF on different theoretically dependent factors. RRF was ca…

research product

Continuous ambulatory peritoneal dialysis and clinical outcomes in patients with refractory congestive heart failure.

A B S T R A C T Introduction and objectives: Peritoneal dialysis has been proposed as a therapeutic alternative for patients with refractory congestive heart failure. The objective of this study was to assess its effect on long-term clinical outcomes in patients with advanced heart failure and renal dysfunction. Methods: A total of 62 patients with advanced heart failure (class III/IV), renal dysfunction (glomerular filtration<60 mL/min/1.73 m 2 ), persistent fluid congestion despite loop diuretic treatment and at least 2 previous hospitalizations for heart failure were invited to participate in a continuous ambulatory peritoneal dialysis program. Of these, 34 patients were excluded and adj…

research product

Klotho urinario determinado por ELISA como biomarcador precoz de fracaso renal agudo en pacientes sometidos a cirugía cardiaca o angiografía coronaria

ResumenIntroducción y objetivos: El fracaso renal agudo (FRA) es una complicación frecuente tras la cirugía cardiaca y las intervenciones percutáneas coronarias cuya aparición empeora el pronóstico de manera marcada. En los últimos años se han identificado nuevos biomarcadores precoces de FRA, pero aún quedan muchos aspectos importantes por resolver. Klotho es una proteína pleiotrópica que actúa como un factor paracrino y endocrino en múltiples órganos. En diversos modelos animales de FRA se ha demostrado niveles disminuidos de Klotho renal. No se ha publicado ningún estudio en el que se haya probado Klotho como marcador precoz de FRA en humanos. El objetivo de este trabajo es investigar la…

research product

Diálisis peritoneal ambulatoria continua y evolución clínica de pacientes con insuficiencia cardiaca congestiva refractaria

Introduccion y objetivos Se ha propuesto el empleo de la dialisis peritoneal como alternativa para los pacientes con insuficiencia cardiaca congestiva refractaria. El objetivo de este estudio es evaluar su efecto en la evolucion clinica a largo plazo de los pacientes con insuficiencia cardiaca avanzada y disfuncion renal. Metodos Se invito a un total de 62 pacientes, con insuficiencia cardiaca avanzada (clase III/IV), disfuncion renal (filtrado glomerular < 60ml/min/1,73 m2), congestion persistente por exceso de liquidos a pesar del tratamiento con diureticos de asa y al menos dos hospitalizaciones previas por insuficiencia cardiaca, a participar en un programa de dialisis peritoneal ambula…

research product

Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease…

research product

Antigen carbohydrate 125 in heart failure: Not just a surrogate for serosal effusions?

Wehave readwith interest the letter CA-125andheart failure:Deja vu or “still to be seen” by Topatan B and Basaran A [1] where the authors concisely reviewed the current pathophysiological knowledgeof CA125 in heart failure (HF). As discussed by these authors, the pathogenesis of this biomarker's elevation inHF is complex andmultifactorial,with apparently different driven forces. For instances, a proinflammatory stimulus (IL-1, tumour necrosis factor-α, lipopolysaccharide) and mesothelial-induced stress appear thekeymechanisms related to the increaseof this biomarker in HF [1–5]. However, no clear evidence exists in regard to how these two mechanisms differentially participate in CA-125 elev…

research product

P1296 : Blocking NMDA receptors prolongs survival in rats with acute liver failure by dual protective mechanisms in kidney and brain

were 1094.67±239.37mIU/ml. The difference in values between these groups was statistically significant (p = 0.004). There was a statistically significant difference in total leucocyte count, serum creatinine, INR and cleaved CK18 M30 levels among those that survived vs expired. Multivariate analysis found that all these independently predict mortality. A receiver operating characteristic curve was drawn for the new score. The score found was compared with the King’s College criteria and the MELD score, the new scoring system was found to have higher sensitivity and specificity for mortality compared with other standard prognostic markers in ALF, and has a better diagnostic accuracy (Table 1…

research product