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C Remón

Publications and source records attributed to C Remón.

6 recordsLinked to original sources
PubMed2005

[Study of the biopsied nephrotic syndrome for 20 years in the Cadiz Bay Area: histological correspondence, renal prognosis and clinical prognostic factors].

AIMS: To analyse the histological correspondence, the renal survival and the clinical prognostic factors in the nephrotic syndrome for more than 20 years in our environment as well as the influence of the nephrotic proteinuria in the renal survival in the different histological particular types of glomerulonephritis. PATIENTS AND METHODS: Among the 542 primary and secondary glomerulonephritis diagnosed by kidney biopsy for two decades in the Cadiz Bay Area, we selected 242 patients whose clinical presentation and the biopsy indication was the nephrotic syndrome. Statistics methods: means +/- typical deviation, percentiles, percentages, Kaplan-Meier curves, long-rank test, student's t-test, chi-square analysis and Cox proportional hazards model test. RESULTS: 242 patients with nephrotic syndrome (44.66% out of the total of glomerulonephritis), average age of 39.15 +/- 18 years old. Average proteinuria 6.75 +/- 4.53 g/day. ETIOLOGY: membranous nephropathy (33.85%), lupus nephritis (14.46%), minimal change disease (11.57%), focal segmental glomerulosclerosis (10.33%), renal amyloidosis (9.95%). 33%, 45%, 63% and 72% of the patients with nephrotic syndrome developed to the End-stage Renal Disease and starting point of dialysis in 5, 10, 15 and 20 years respectively. After the multivariate model, the age older than 60 years old, the high levels of proteinuria and the coexistence with hypertension or renal failure, in the moment of diagnosis, showed to be independents clinical prognostic factors. The nephrotic proteinuria had a negative influence in the prognosis in the different histological types, especially in the IgA nephropathy and the lupus nephritis. CONCLUSIONS: The nephrotic syndrome is the main indication of the renal biopsy in our environment. In general, as an independent group, its development is slowly progressive to the End-stage Renal Disease, having the possibility of being also conditioned by certain clinical factors present in the moment of the biopsy. The presence of nephrotic proteinuria is also a negative factor in the progression in many of the glomerulonephritis.

Adult↗
PubMed2005

[Darbepoetin in the treatment of the renal anaemia in the patient undergoing peritoneal dialysis previously treated with epoetin alfa].

INTRODUCTION: In 2002, it was contraindicated the use of epoetin alfa by a subcutaneous way to avoid the risk of the pure red cell aplasia in chronic renal failure patients. This forced to change the prescription in the way it was supplied, which was especially problematic in predialysis and peritoneal dialysis, as treating out-patients, that is why it was necessary to change to epoetina beta o darbepoetin, where this contraindication was not established, in order to continue using this way. The darbepoetin has an average lifetime longer than the epoetin. Its efficacy and security have been well studied, especially in pre-dialysis and haemodialysis, but little less in peritoneal dialysis. AIMS: To evaluate our experience about the efficacy and security of darbepoetin alfa, by a subcutaneous way, in our programme of peritoneal dialysis, after the conversion of the patients previously treated with epoetin alfa. PATIENTS AND METHODS: 35 patients. 7 analytical and clinical controls are evaluated, 2 before and 5 after the conversion, with an interval of 6 weeks. Statistics methods: means +/- typical deviation, medians, distribution of frequencies, Wilcoxon test and Friedman test. RESULTS: The change into darbepoetin alfa has been successful in maintaining stable haemoglobin levels in patients in peritoneal dialysis, without meaningful changes in the mean levels of haemoglobin before and after the conversion. The percentage of patients with haemoglobin in the rank 11-13 g/dl (85%) has been higher with the darbepoetin, probably due to the dose increment in the patients with previous levels of haemoglobin less than 11 g/dl. The dosages might have been widely separated (7.5 +/- 3 vs 9.2 +/- 3.2 days). The darbepoetin has been well tolerated, without any important adverse effects. CONCLUSIONS: The conversion of epoetin alfa into darbepoetin alfa in peritoneal dialysis was simple, effective, secure and well tolerated.

Adult↗
PubMed2005

[Systemic arterial hypertension in primary chronic glomerulonephritis: prevalence and its influence on the renal prognosis].

UNLABELLED: Nowadays, glomerulonephritis is one of the most common causes of End-stage Renal Disease and starting point of dialysis in Spain. Several factors may influence negatively in this prognosis; among them, we may show up the systemic arterial hypertension. Though its prevalence in the glomerulonephritis is considered higher than in other nephropathies, with variations among series, probably due to difference in ages, in geographical areas, in histological types, in time on evolution of the nephritis ... and because it is difficult to distinguish if the hypertension is a consequence of the nephritis or a consequence of the renal failure that can be present in several cases. In the same way, its negative influence in the renal prognosis may be influenced more by this renal failure, which can be its cause when it is quite severe, than by the hypertension itself. Our aims were to analyse, on the one hand the prevalence of hypertension in the 394 patients diagnosed of primary glomerulonephritis by means of a renal biopsy during two decades in the Bay of Cadiz, as well as its influence in the renal prognosis since the moment of the diagnosis, even with the absence of severe renal failure. We gathered demographic, clinical, analytical and histological data, as well as the situation of the renal function and the survival period of it at the end of each patient study. For the analysis prognosis and renal survival, Kaplan-Meier curves and the long-rank test were used. Of the 394 patients, 247 are men and 147 are women, with an average age of 36.7 +/- 17.7 years old. The global prevalence of hypertension was 39%, with a higher frequency in older patients. The gathered rate of renal survival for hypertensive patients was 54%, 28%, 20% and 4% at 5, 10, 15 and 20 years respectively; while for non-hypertensive patients, it was 83%, 75%, 66% and 62% for the same periods of time (p < 0.001). This worse tendency for hypertensive patients is observed too in each particular histological type, especially in the IgA nephropathy and membranous nephropathy. These results were the same for the patients who did not have severe renal failure in the moment of the biopsy. CONCLUSIONS: Hypertension is a common fact in the primary glomerulonephritis, which also conditions, in an important way, the renal prognosis itself in a long term, from the moment of diagnosis and even before the existence of a significant renal failure.

Adolescent↗
PubMed2001

[Clinical experience with icodextrin. Multicenter study].

UNLABELLED: The aim of this study was to analyse our experience with icodextrin in Andalusia, Spain. The study includes 51 patients (30 women and 21 men) on peritoneal dialysis (21 on CAPD and 30 on Automated Peritoneal Dialysis) treated with icodextrin for 10.3 +/- 7 months (0-41 months). Their mean age was 57 +/- 18 years (18-86 years). We have recorded the appearance of side effects, and the evolution of several biochemical parameters at baseline and after 6, 12 ans 18 months from initiation of icodextrin. We also studied drainage fluid from 12 patients after an icodextrin exchange. RESULTS: There were side effects (all cutaneous) in 4 out of 51 patients (7.8%). Two of the affected suffered from cutaneous hypersensitivity reactions, and icodextrin had to be suspended; the other two had exfoliative dermatitis affecting hands and feet that disappeared without have to withdraws icodextrin. Biochemical parameters: Serum sodium levels decreased from baseline to six months (138 +/- 6 mEq/l vs 136 +/- 3 mEq/l; p = 0.006), and then persisted at the same levels throughout the rest of the study period. There was a slight but significant decreased of serum HDL-cholesterol at six months vs baseline (55 +/- 26 mg/dl vs 51 +/- 20 mg/dl, p = 0.04), and a further decrease at twelve months vs six months (42 +/- 15 mg/dl vs 51 +/- 13 mg/dl, p = 0.054). There were no significant variations of glucose, osmolality, cholesterol, LDL-cholesterol (tendency to increase), triglycerides, beta 2 m and weight (tendency to increase; p = 0.08). In relation with the icodextrin exchange: average ultrafiltration 296 +/- 119 ml (ranging from 104 to 480 ml), creatinine clearance 1.9 +/- 0.5 litres (20.5% of daily creatinine clearance), urea clearance 2.08 +/- 0.5 litres (18.7% of daily urea clearance), total protein losses 3.2 +/- 0.9 g, albumin losses 1.4 +/- 0.5 g; urea and creatinine clearances were negatively correlated with ratios D/P4 of urea and creatinine of PET and positively correlated with ratio G4/G0. In conclusion, side effects are scarce with the use of icodextrin. As described in other studies, there is a trend to a slight decrease in serum sodium. The long-term use of icodextrin does not-prevent weight gain or deterioration of patients on peritoneal dialysis, despite the diminution of glucose load.

Adolescent↗