Estudio comparativo del manejo extrarrenal de potasio en sujetos controles, pacientes hipertensos y diabéticos / Comparison of extra renal potasium disposal in hypertensive, diabetic and normal subjects

Background: Sodium and potassium ions are involved in the regulation of blood pressure and the genesis of hypertension. Aim: to assess internal potassium balance, as a measure of sodium pump activity, in subjects with essential hypertension and diabetic patients. Patients and methods: Eleven hypertensive subject, 5 non-insulindependent diabetics and 16 age matched controls were studied. An acute oral load of 0.8 mEq/Kg body weight of KCI was administered and blood samples were drawn every 30 min thereafter, until 120 min, to measure plasma K+ levels. Urinary K+ excretion during this period was also measured. In eight hypertensive patients, the test was repeated after two week of supplentation with 60 mEq/day of KCI. The maximal increase in plasma potassium levels and the time required to achieve the maximum concentration was recorded. Results: All patients had normal serum creatinine levels. Mean fasting blood glucose of diabetic patients was 133 ñ 15.1 mg/dl. No difference between patients and controls in maximal increase plasma potassium increase, was observed. In hypertensive patients the lapse to achieve the maximal potassium concentration was longer than in controls. After the period of potassium supplementation in hypertensive patients, tbere was a significant increase in basal plasma K+ levels and the temporal pattern of plasma potassium increase was similar to that of controls. Between 63 and 68 percent of retained K+ load was translocated to the intracellular space at 120 min in all study groups. Conclusions: Internal potassium balance is not significantly altered in subjects with essential hypertension or in non-insulin-dependent diabetics

Doce años de tratamiento de la insuficiencia renal crónica términal mediante trasplante renal en el Hospital San Juan de Dios / 12 years in the treatment of terminal chronic renal insufficiency with kidney transplants at San Juan de Dios Hospital

Se analiza retrospectivamente una serie de 31 trasplantes renales realizados en el Hospital San Juan de Dios entre 1978 y 1990. El 68% de los casos fueron hombres y el 32% mujeres con edad promedio de 29,5 años ñ 12,0 y un rango de 7 a 55 años. El 87% de ellos fueron previamente hemodializados durante un tiempo promedio de 22,9 meses. El 71% de los trasplantes se efectuaron con riñones de donantes vivos y sólo el 29% con riñones de cadáveres. En 19 casos se tipificaron sólo los antígenos A y B de histocompatibilidad y en los otros 12 casos también los antígenos DR. En el 90% de los casos el tratamiento inmunosupresor utilizado fue prednisona-azatioprina. La ciclosporina sólo se empleó desde el inicio en 10% y esporádicamente en 20%. Al cabo de un período de observación promedio de 35 meses, el injerto se encuentra funcionando en el 71% de los casos y ha fallecido el 12,9% de los pacientes. La sobrevida actuarial de los enfermos es 91% a los 3 años y la de los injertos de 77%