ABSTRACT
BACKGROUND: Recent studies have reported an increased susceptibility to infection among vitamin D-deficient kidney transplant (KT) recipients, although methodological concerns remain. METHODS: Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in 246 KT recipients at post-transplant months 1, 3, 6 and 12. Vitamin D status was analysed in terms of deficiency (Endocrine Society [<20 ng/mL] and Institute of Medicine [IoM, <12 ng/mL] criteria) and as a continuous variable. Cox models for overall, bacterial and opportunistic infection were adjusted for nutritional status and immunosuppression-related covariates. RESULTS: Median serum 25(OH)D increased from month 1 (10.5 ng/mL) to month 6 (16.3 ng/mL; P-value = 0.001). Prevalence of vitamin D deficiency at month 1 ranged from 87.0% to 61.0% (depending on the diagnostic criteria) and significantly decreased over the next months. After adjustment for age and nutritional status, vitamin D deficiency (serum 25(OH)D < 12 ng/mL) at month 1 was an independent risk factor for overall (hazard ratio [HR]: 1.70; 95% confidence interval [CI]: 1.08-2.69; P-value = 0.023) and opportunistic infection (HR: 4.05; 95% CI: 1.57-10.46; P-value = 0.004), but not for bacterial infection. A protective effect for overall (adjusted HR: 0.76; 95% CI: 0.63-0.93; P-value = 0.007) and opportunistic infection (adjusted HR: 0.62; 95% CI: 0.45-0.86; P-value = 0.004) was observed when 25(OH)D levels were analyzed per one-quartile increases. CONCLUSIONS: Vitamin D status influences the risk of infection among KT recipients, with the association being particularly evident for opportunistic events and mainly restricted to the early post-transplant period.
Subject(s)
Disease Susceptibility/blood , Infections/epidemiology , Kidney Transplantation/adverse effects , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Adult , Aged , Female , Humans , Infections/microbiology , Male , Middle Aged , Postoperative Period , Prospective Studies , Risk Factors , Spain/epidemiology , Time Factors , Vitamin D/blood , Vitamin D Deficiency/bloodABSTRACT
BACKGROUND AND OBJECTIVE: Our purpose was to evaluate the control of oral anticoagulant treatment (OAT) in capillary blood by the Coagucheck S System. PATIENTS AND METHOD: Descriptive cross-sectional study. 155 patients under treatment with oral anticoagulants were studied. The INR was determined in venous blood by the CA-6000 System (DADE-Behring Laboratories) and capillary blood was determined by the Coagulocheck S System (Roche Laboratories). RESULTS: Mean and standard deviation were: 2.64 (1.25) for the CA6000 System and 2.95 (1.58) for the Coagucheck S System. Pearson's correlation coefficient was r = 0.912. Intraclass correlation index was 0.86 (0.79-0.91) and the mean difference was 0.309 (0.202-0.417). The therapeutic attitude was the same in 80%. CONCLUSION: Both systems are interchangeable with regard to the INR measurement aimed at the control of oral anticoagulant therapy
Subject(s)
Anticoagulants/administration & dosage , International Normalized Ratio , Cross-Sectional Studies , Humans , International Normalized Ratio/methodsABSTRACT
FUNDAMENTO Y OBJETIVO: Analizar los resultados obtenidos en el control del tratamiento con anticoagulantes orales (TAO) en sangre capilar mediante el sistema Coagucheck S y su repercusión clínica. PACIENTES Y MÉTODO: Se efectuó un estudio descriptivo transversal en 155 pacientes que recibían TAO y a quienes se realizó una determinación de razón normalizada internacional (INR) en sangre venosa con el coagulómetro CA-6000 (DADE-Berhing) como método de referencia, y en sangre capilar con el sistema Coagucheck S (Roche). Se estudió asimismo, la actitud terapeútica. RESULTADOS: La media (DE) de INR obtenida fue 2,64 (1,24) con el CA6000 y 2,95 (1,58) con el Coagucheck S. El coeficiente de correlación de Pearson fue r = 0,912; el coeficiente de correlación intraclase fue de 0,86 (0,79-0,91).La media de las diferencias fue de 0,309 (0,202-0,417). La actitud terapéutica fue concordante en el 80 por ciento. CONCLUSIÓN: Los dos sistemas utilizados en la medición de INR para el control del TAO son intercambiables (AU)
