ABSTRACT
Lipid abnormalities are common in patients with renal disease, probably contributing to the high incidence of cardiovascular diseases in this population. In this study we determined the plasma and erythrocyte lipid profile in patients with chronic renal failure (CRF) along 30 months under hemodialysis. In the same patients the influence of cuprophane and polysulfone dialysis membranes on the fatty acid pattern of plasma and erythrocytes, before and after dialysis, was also studied. Fluidity in erythrocyte membranes was also assessed by diphenylhexatriene (DPH) fluorescence polarization measurements. Triglyceride levels were increased in the plasma and in erythrocyte membranes of CRF patients compared to healthy subjects. Plasma polyunsaturared fatty acids decreased whereas palmitic and monounsaturated acids increased in CRF patients. No changes were observed in either the fatty acid profile or DPH fluorescence anisotropy of erythrocyte membranes. The lipid composition abnormalities persisted after 18 months and they became more notorious after 30 months. Neither the plasma nor the erythrocyte membrane lipid pattern changed in CRF patients during the dialysis session, regardless of the dialysis membrane used. We conclude that CRF patients under regular hemodialysis evidence a gradual deterioration in the fatty acid and triglyceride abnormalities, a finding that might be relevant to the risk of cardiovascular disease in this setting.
Subject(s)
Cellulose/analogs & derivatives , Erythrocytes/metabolism , Kidney Failure, Chronic/blood , Lipids/blood , Renal Dialysis , Adult , Biocompatible Materials , Cardiovascular Diseases/etiology , Case-Control Studies , Erythrocyte Membrane/metabolism , Fatty Acids, Unsaturated/blood , Female , Humans , Male , Membranes, Artificial , Polymers , Renal Dialysis/adverse effects , Sulfones , Time Factors , Triglycerides/bloodABSTRACT
Lipid abnormalities are common in patients with renal disease, probably contributing to the high incidence of cardiovascular diseases in this population. In this study we determined the plasma and erythrocyte lipid profile in patients with chronic renal failure (CRF) along 30 months under hemodialysis. In the same patients the influence of cuprophane and polysulfone dialysis membranes on the fatty acid pattern of plasma and erythrocytes, before and after dialysis, was also studied. Fluidity in erythrocyte membranes was also assessed by diphenylhexatriene (DPH) fluorescence polarization measurements. Triglyceride levels were increased in the plasma and in erythrocyte membranes of CRF patients compared to healthy subjects. Plasma polyunsaturared fatty acids decreased whereas palmitic and monounsaturated acids increased in CRF patients. No changes were observed in either the fatty acid profile or DPH fluorescence anisotropy of erythrocyte membranes. The lipid composition abnormalities persisted after 18 months and they became more notorious after 30 months. Neither the plasma nor the erythrocyte membrane lipid pattern changed in CRF patients during the dialysis session, regardless of the dialysis membrane used. We conclude that CRF patients under regular hemodialysis evidence a gradual deterioration in the fatty acid and triglyceride abnormalities, a finding that might be relevant to the risk of cardiovascular disease in this setting.
ABSTRACT
Se estudiaron 34 pacientes con trasplante renal (TxR), 18 varones y 16 mujeres, con el objetivo de conocer la prevalencia de Anti HCV, en este tipo de pacientes y su influencia sobre la morbimortalidad temprana. La media de segmiento fue 8.44 DS 6.7 meses y la de edad 38.32 años DS 13.97. Todos recibieron el mismo esquema inmuno-supresor y los episodios de rechazo se trataron con pulsos de metilprednisolona. Resultaron Anti HCV r (por EIA II) de Abbott e Inmunoblotting de Péptidos Sintéticos LIA TEK Organon Teknika); 7 (20.6 por ciento) pacientes y (NR) 27 (79.4 por ciento). Recibieron injerto de donante cadavérico 4 (57.1 por ciento), Anti HCV R y 10 (37.0 por ciento) Anti HCV NR; de donante vivo relacionado 3 (42.9 por ciento) Anti HCV R y 17 (63.0 por ciento) Anti HCV NR. Tenían antecedentes de haber pedacido hepatitis 6 (85.7 por ciento) de lso 7 Anti HCV R: 2 hepatitis crónicas y 4 agudas (2 HBV y 2 no B (NABV) y 6 (22.2 por ciento) de los 27 Anti HCV NR. El tiempo medio de tratamiento hemodialítico antes del trasplante en el grupo Anti HCV r fue 63.0 DS 27.0 meses y resultó significativamente superior (P<0.05) al del grupo Anti HCV (NR) (27.3 DS 20.7). Episodios de rechazos, hepatopatías post-trasplante y sobrevida del injerto y del paciente no fueron significativamente diferentes entre los pacientes Anti HCV R y los NR.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Hepatitis C Antibodies/blood , Hepatitis C/mortality , Kidney Transplantation , Argentina , Chi-Square Distribution , Follow-Up Studies , Graft Survival , Renal Dialysis/adverse effects , Hepatitis C/transmission , PrevalenceABSTRACT
Se estudiaron 34 pacientes con trasplante renal (TxR), 18 varones y 16 mujeres, con el objetivo de conocer la prevalencia de Anti HCV, en este tipo de pacientes y su influencia sobre la morbimortalidad temprana. La media de segmiento fue 8.44 DS 6.7 meses y la de edad 38.32 años DS 13.97. Todos recibieron el mismo esquema inmuno-supresor y los episodios de rechazo se trataron con pulsos de metilprednisolona. Resultaron Anti HCV r (por EIA II) de Abbott e Inmunoblotting de Péptidos Sintéticos LIA TEK Organon Teknika); 7 (20.6 por ciento) pacientes y (NR) 27 (79.4 por ciento). Recibieron injerto de donante cadavérico 4 (57.1 por ciento), Anti HCV R y 10 (37.0 por ciento) Anti HCV NR; de donante vivo relacionado 3 (42.9 por ciento) Anti HCV R y 17 (63.0 por ciento) Anti HCV NR. Tenían antecedentes de haber pedacido hepatitis 6 (85.7 por ciento) de lso 7 Anti HCV R: 2 hepatitis crónicas y 4 agudas (2 HBV y 2 no B (NABV) y 6 (22.2 por ciento) de los 27 Anti HCV NR. El tiempo medio de tratamiento hemodialítico antes del trasplante en el grupo Anti HCV r fue 63.0 DS 27.0 meses y resultó significativamente superior (P<0.05) al del grupo Anti HCV (NR) (27.3 DS 20.7). Episodios de rechazos, hepatopatías post-trasplante y sobrevida del injerto y del paciente no fueron significativamente diferentes entre los pacientes Anti HCV R y los NR. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Comparative Study , Kidney Transplantation , Hepatitis C/mortality , Hepatitis C Antibodies/blood , Follow-Up Studies , Chi-Square Distribution , Prevalence , Argentina , Renal Dialysis/adverse effects , Hepatitis C/transmission , Graft SurvivalABSTRACT
UNLABELLED: A small series of 34 renal transplanted patients (RTx) were studied, 18 males and 16 females in order to know the prevalence of Anti HCV in this type of patients and their influence on early morbi-mortality. The follow-up mean was 8.44 months SD 6.7, and Age 38.32 SD 13.97. All patients were under the same immunosuppressive scheme, and rejection episodes were treated with methilprednisolone pulses. The results were: 7 (20.6%) Anti HCV seroreactives (R) (EIA II Abbott and Immunoblotting of synthetic Peptides LIA TEK Organon Teknika); and 27 (79.4%) non-serorectives (NR), 14 patients received grafts from cadaveric donor; 4 (57.1%) Anti HCV (R), and 10 (37.0%) Anti HCV (NR). 20 patients have received grafts from lived-related donors: 3 (42.9%) Anti HCV (R), and 17 (63.0%) Anti HCV (NR). 6 (85.7%) of the 7 patients Anti HCV (R) had hepatitis history: 2 chronic hepatitis, 4 acute hepatitis (2HBV) and 2 no A no B (NANBV) and 6 (22.2%) of the 27 Anti HCV (NR). The mean time of hemodialysis treatment before transplantation in the Anti HCV (R) group was of 63.0 months SD27.0, and it was significantly superior (P < 0.05) to the Anti HCV (NR) group with 27.3 months SD 20.7. There were no significant differences between the Anti HCV (R) and (NR) patients with regard to rejection episodes, post-transplant hepatopathies, and survival of graft and patient. CONCLUSIONS: 1) Anti HCV prevalence is of 20.6%. 2) Time of hemodialysis prior to transplantation and an hepatitis history during hemodialysis came out to be significantly higher in Anti HCV (R) RTx. 3) Morbi-mortality is no modified by the presence of Anti HCV during a mean follow-up period of 8.44 months.
Subject(s)
Hepatitis C Antibodies/blood , Hepatitis C/mortality , Kidney Transplantation , Postoperative Complications/mortality , Adolescent , Adult , Aged , Argentina , Female , Follow-Up Studies , Graft Survival , Hepatitis C/blood , Hepatitis C/transmission , Humans , Male , Middle Aged , Postoperative Complications/blood , Prevalence , Renal Dialysis/adverse effectsABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8% respectively and that for HBs Ag was 21% with 78% of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6%, but it was 9.7% in our Hospital and 54.8% in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49% were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Hepatitis B Vaccines , Hepatitis B/prevention & control , Hepatitis C/prevention & control , Renal Dialysis/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Female , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis B Antibodies/blood , Hepatitis B Antigens/blood , Hepatitis C/epidemiology , Hepatitis C/transmission , Humans , Male , Middle Aged , Prevalence , Transfusion ReactionABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8
respectively and that for HBs Ag was 21
with 78
of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6
, but it was 9.7
in our Hospital and 54.8
in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49
were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
ABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8
respectively and that for HBs Ag was 21
of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6
in our Hospital and 54.8
in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49
were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
ABSTRACT
Se presenta la patología toracopleuropulmonar que afectó a 20 pacientes de una serie de 45 casos de trasplante renal y a 3 casos sobre 17 donantes vivos relacionados. Se confirma el predominio del compromiso parenquimatoso 75% sobre el torácico 25%; a su vez el primero corresponde escencialmente a neumopatías infecciosas 88%, mientras que el segundo a osteodistrofia renal 100% con especial participaron del hiperparatirodismo secundario severo en 10%. Las neumopatías infecciosas revelaron un elevado predominio de la etiología bacteriana 80% con respecto a la parasitaria 13,3% y fúngica 6,6%. Así como una marcada prevalencia en el primer semestre 65% sobre el segundo 39% y el segundo año 5% de pos-trasplante. La distribución según origen es semejante 47% hospitalaria y 53% extrahospitalaria. El cuadro clínico mostró a la fiebre 100% tos y expectoración 80% y a un sindrome de condensación inicial (foco de rales creptandes y subcrepitantes ) 82% como los elementos relevantes. El laboratorio aportó al diagnóstico tes aspectos: a) Recuento y fórmula leucocitaria: leucopenia (menos de 5.000/mm3) en el 35% de los casos, aunque sin alcanzar neuropenia absoluta (menos de 500 mm3) en ninguno, leucocitosis 11,8%) correlacionándose con la mortalidad la neutropenia y la neutrofilia. b) Gases en sangre: se consideróa necesario en la mitad de los casos y sólo aportó hipoxemia en ods episodios con evolución opuesta (uno vivo y un fallecido), lo que le restó valor predictivo. c) cultivo de esputo: fue positiv
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Respiratory Tract Diseases/diagnosis , Kidney TransplantationABSTRACT
Se presenta la patología toracopleuropulmonar que afectó a 20 pacientes de una serie de 45 casos de trasplante renal y a 3 casos sobre 17 donantes vivos relacionados. Se confirma el predominio del compromiso parenquimatoso 75% sobre el torácico 25%; a su vez el primero corresponde escencialmente a neumopatías infecciosas 88%, mientras que el segundo a osteodistrofia renal 100% con especial participaron del hiperparatirodismo secundario severo en 10%. Las neumopatías infecciosas revelaron un elevado predominio de la etiología bacteriana 80% con respecto a la parasitaria 13,3% y fúngica 6,6%. Así como una marcada prevalencia en el primer semestre 65% sobre el segundo 39% y el segundo año 5% de pos-trasplante. La distribución según origen es semejante 47% hospitalaria y 53% extrahospitalaria. El cuadro clínico mostró a la fiebre 100% tos y expectoración 80% y a un sindrome de condensación inicial (foco de rales creptandes y subcrepitantes ) 82% como los elementos relevantes. El laboratorio aportó al diagnóstico tes aspectos: a) Recuento y fórmula leucocitaria: leucopenia (menos de 5.000/mm3) en el 35% de los casos, aunque sin alcanzar neuropenia absoluta (menos de 500 mm3) en ninguno, leucocitosis 11,8%) correlacionándose con la mortalidad la neutropenia y la neutrofilia. b) Gases en sangre: se consideróa necesario en la mitad de los casos y sólo aportó hipoxemia en ods episodios con evolución opuesta (uno vivo y un fallecido), lo que le restó valor predictivo. c) cultivo de esputo: fue positiv
