ABSTRACT
Contexto la procalcitonina (PCT) podría ser útil en la evaluación de la función del injerto renal (IR) en el postrasplante inmediato, ya que sus niveles se incrementan posterior a la elevación de citocinas inflamatorias (IL-6, TNF-ß) durante eventos de disfunción renal. Objetivo determinar la asociación de la PCT sérica con la función del injerto renal en el periodo postrasplante inmediato. Metodología cohorte retrospectiva de septiembre del 2018 a abril del 2019 en la División de Nefrología y Trasplantes, del Centro Médico Nacional de Occidente (CMNO), del Instituto Mexicano del Seguro Social (IMSS). Se incluyeron 62 receptores de trasplante renal de donante vivo (DV) y fallecido (DF) con determinación de PCT antes del séptimo día del TR y el registro de eventos de disfunción temprana del injerto (DTI), comparados con pacientes sin DTI (sDTI). Resultados los receptores con DTI presentaron niveles más altos de PCT (13,90, 3,90, 1,22 ng/mL) comparado con el grupo sin DTI (0,32, 0,31 y 0,22 ng/ml) en los días 1, 3 y 5 respectivamente; p < 0,05. Conclusiones la PCT es un marcador biológico asociado a DTI en el postrasplante renal inmediato.
Background Procalcitonin (PCT) could be useful for evaluation of the renal allograft (RG) in the immediate post-transplant since its levels increase after elevation of the inflammatory cytokines (IL-6, TNF-ß) during events of renal failure. Purpose Our objective was to determine the association of serum PCT with the function of the RG in the immediate post-transplant. Methodology A retrospective cohort from September 2018- April 2019 in the National Western Medical Center of the Mexican Social Security Institute (IMSS), was performed. Sixty-two recipients of living donor (LD) and deceased donor (DD) renal transplant (RT) with PCT evaluation before the seventh days of RT were included; and, events of early renal allograft failure (EAF) were recorded and compared to patients no EAF (nEAF). Results The recipients with EAF presented with higher PCT levels (13.90, 3.90, 1.22 ng/mL) compared to the nEAF group (0.32, 0.31, and 0.22 ng/ml) on days 1, 3, and 5, respectively (p < 0.05). Conclusions The PCT is a biological marker associated with EAF in the immediate post-transplant.
ABSTRACT
BACKGROUND: Head-out water immersion has been proposed as an adjuvant treatment in refractory ascites and hepatorenal syndrome. We undertook this study to present the results of management of patients with refractory ascites. METHODS: We included 10 patients with diagnosis of hepatic cirrhosis and refractory ascites. Variables were measured in four stages: stage I (basal); II (at the end of water immersion); III (72 h after water immersion); IV (1 week after water immersion concludes). Clinical and laboratory variables were measured and included general exams and renal function tests. Friedman test was used for statistics to establish differences between variables at the end of stage IV. We considered statistical significance when p<0.05. RESULTS: Median age was 53.8 years, corresponding to seven men and three women with a Child's classification of B or C. Statistically significant variables were weight (p=0.02) and abdominal circumference (p=0.003), as a result of an increased urine output (p=0.03) and glomerular filtration rate (p<0.002). Renal plasma rate increased until stage III, returning to basal level in stage IV. Serum potassium levels decreased but the difference was marginal (p=0.052). During follow-up, two patients died as a consequence of liver insufficiency. CONCLUSIONS: Head-out water immersion showed a decrease in weight and abdominal circumference, which means reduction of ascites. There was a transitory improvement in renal function. No collateral events were reported. Water immersion could be proposed as an adjuvant treatment in patients with refractory ascites and liver cirrhosis.
