Excess Calcium, Magnesium and Phosphorus Deposition in the Epigastric Artery of Dialysis Patients Undergoing Renal Transplantation

ABSTRACT Objective: Vascular calcification contributes to cardiovascular disease on dialysis patients. Arterial mineral content is modified but not well defined. We aim to define what is the concentration of calcium, magnesium and phosphorus in the epigastric artery of adult dialysis patients undergoing renal transplantation. Methods: All renal allograft recipients who underwent surgery at our centre between May 2003 and December 2005 and consented to be taken small samples of epigastric artery were included in our cross-sectional study. Histological, radiological and spectrometric methods were used to measure vascular calcification, deposits and concentrations of calcium, phosphorus and magnesium in epigastric artery, which were correlated with clinical and biochemical characteristics. Mineral vascular content was compared with corresponding samples from cadaveric renal donors free from renal disease (control group). Results: Calcium and magnesium concentrations in epigastric artery were much higher in recipients (n = 100) than in donors (n = 30). Histologically confirmed calcifications were more frequent in recipients. Calcium and magnesium content in epigastric artery were correlated directly with recipient age, pre-transplant serum P and Ca × P product. A high content of calcium and magnesium in this artery was observed in recipients with media and intimal calcification. Multivariate logistic regression showed that dialysis vintage > 3.5 years and calcium concentration in epigastric artery ≥ 4500 mg/kg wet weight were independent predictors of histological calcification. Conclusion: Excess mineral deposition is observed in the epigastric artery of dialysis patients, where the recipient's age, serum P, Ca × P product and time on dialysis play a decisive role.

Epidemiología de la patología tumoral en el trasplante renal / Epidemiology of tumoral pathology in renal transplantation

Introducción: La patología tumoral (PT) implica una morbimortalidad no despreciable después del trasplante renal, siendo la inmunosupresión un factor de riesgo potencialmente responsable de su desarrollo. El objetivo de nuestro estudio es determinar la prevalencia de malignidad durante el trasplante y estudiar su posible asociación con el uso de anticuerpos antilinfocitarios, infección por citomegalovirus y el antecedente de rechazo agudo. Métodos: Se trata de un estudio de cohorte, retrospectivo, en 1034 receptores de trasplante renal en el que se revisaron los eventos tumorales acontecidos entre abril de 1981 y marzo de 2010. Se consignaron el uso de anticuerpos antilinfocitarios (AAL), infección por CMV y episodios de rechazo agudo (RA), relacionando estas variables con el desarrollo posterior de patología tumoral. Resultados: NO se detectó mayor frecuencia de PT maligna en aquellos que recibieron AAL (13,8% vs. 17,6%, p=0,094) p=0,094). No hubo mayor frecuencia de PT en pacientes con infección por CMV (16,3% vs. 15,2%, p=0,69). Por último, hubo mayor frecuencia de PT en aquellos con antecedentes de RA, si bien con significación limítrofe (19,5% vs. 14,3%, p=0,05). Conclusiones: La patología tumoral maligna se ve potencialmente favorecida por la inmunosupresión cada vez más potente y duradera. No hemos encontrado asociación entre la administración de AAL, infección y / o enfermedad por CMV; si bien esta se ve ligeramente incrementada en aquellos pacientes con el antecedente de RA.

Introduction: Tumoral pathology (TP) implies morbidity which is significant after the renal transplantation; Immunosuppression is a risk factor which is potentially responsible for tumoral development. The aim of our study is to determine the prevalence of malignancy during transplantation and to study its possible relation with the usage of antillymphocvte antibodies, cytomegalovirus infection and the history of acute rejection. Methods: It is a cohort study, retrospective, in 1014 receptors of Kidney transplantation in which tumoral events were revised between April 1981 and March 2010. The development of tumoral pathology in recipients was related with the usage of AAL, CMV infection and AR episodes. Results: a greater frequency of malign TP was no recorded in those who received AAL (13.8% vs. 17.6%, p=0.094). There was not greater frequency of TP in patients with infection due to CMV (16,3% vs, 15.2%, p=0.69). Finally, there was greater frequency of TP in those with antecedent of AR, though with bordering significance (19.5%, vs. 14.3% p=0.05). Conclusions: Malign tumoral pathology is potentially favored by immunosuppression increasingly powerful lasting. We have not found any relationship between AAL use, infection and/ or disease due to CMV, although this is slightly increased in those patients with AR history.

Prevalencia de marcadores sericos del virus de la hepatitis B en el personal femenino de un hospital general / Prevalence of serum markers of hepatitis B virus in female personnel of a general hospital

Hemos determinado los marcadores del virus de la hepatitis B a 209 mujeres del personal de un hospital general: 12 Médicos, 90 ATS, 70 Auxiliares de clínica y de laboratorio y 37 personas de Personal de limpieza y office. La prevalencia fue del 15,31% (32 personas). Cuatro personas (1,91%) presentaron HBs-Ag. La prevalencia fue más baja que las encontradas por otros autores de nuestro país. Las prevalencias más altas se encontraron en el personal de limpieza y office, seguido de los ATS. Por Servicios, las prevalências más altas se encontraron en el personal en contacto con sangre y hemoderivados. No se encontraron marcadores en el personal de la UVI. La prevalencia aumentó y generalmente con la edad y la antigüedad. Asociamos los bajos índices de prevalencia encontrados por nosotros con los elevados porcentajes de personal joven (33,49%) tienen menos de 30 años y con poca antigüedad en el hospital (26,31% con menos de 4 años