Search PubMed⌕ Search

Biomedical subjects

E Gallego

Publications and source records attributed to E Gallego.

At least 37 records · Page 2Linked to original sources
PubMed1998

Androgens for the treatment of anemia in peritoneal dialysis patients.

Before the advent of recombinant human erythropoietin (EPO), androgens were used for treatment of anemia in dialysis patients. However, after the availability of recombinant EPO in the 1980s, the use of these substances was abondoned. We have previously reported that androgens have beneficial actions on anemia in selected hemodialysis patients. In the present study we have analyzed the effects of androgen administration on hematologic parameters in peritoneal dialysis patients. We evaluated 9 patients treated for 6 months with nandrolone decanoate (200 mg/week intramuscularly). Hemoglobin and hematocrit values experienced a significant increment with respect to basal values during the study (9.2 +/- 0.7 g/dL and 27.7% +/- 2.3% at basal vs. 11.9 +/- 0.5 g/dL and 35.3% +/- 1.6% at month 6, respectively; P < 0.001). In addition to the effects on the hematologic parameters, androgen administration also had beneficial anabolic actions with a significant increment in the serum concentration of total proteins and albumin (basal, 6.1 +/- 0.3 g/dL and 3.1 +/- 0.4 g/dL vs. 6.7 +/- 0.4 g/dL and 3.8 +/- 0.4 g/dL at month 6, respectively, P < 0.01). The only adverse effect was a rise in the serum concentration of triglycerides (176 +/- 54 mg/dL vs. 144 +/- 53 mg/dL, P < 0.01). In conclusion, androgen administration has beneficial effects on erythropoiesis as well as positive anabolic actions in patients under peritoneal dialysis.

Aged↗
PubMed1998

Effects of losartan on the treatment of posttransplant erythrocytosis.

Erythrocytosis is a relatively common complication of renal transplantation. Recent observations indicate that angiotensin-converting enzyme inhibitors correct renal transplant erythrocytosis. Other drugs to inhibit the renin-angiotensin system have been developed recently. The newest of these is losartan, a specific antagonist of the angiotensin II type I receptor. We report three patients in which the use of losartan controlled posttransplant erythrocytosis. Our findings suggest that losartan can be effective and safe in the treatment of posttransplant erythrocytosis.

Adult↗
PubMed1997

Hemodialysis urea rebound and membrane biocompatibility: accuracy of Kt/V estimations.

To date, the magnitude, causes, and factors that govern urea rebound are not clearly defined. This study was undertaken to determine the possible influence of the biocompatibility of dialyzer membrane on urea rebound and to assess the participation of rebound in the calculation of Kt/V-urea by different methods. Blood urea samples were obtained before, and at 2, 30, and 60 min posthemodialysis in 8 patients undergoing dialysis with 2 different membranes, Cuprophan and polyacrylonitrile (24 sessions with each membrane). Urea rebound was documented in all patients. The degree of rebound was large, 20%, and it was achieved within 30 min after the end of dialysis. Urea rebound was observed with both Cuprophan and polyacrylonitrile membranes, without significant differences. Kt/V-urea significantly decreased (p < 0.001) by all methods when urea rebound was incorporated. We conclude that urea rebound is clinically very important and is not influenced by the biocompatibility of the dialyzer membrane. This phenomenon must be taken into account in the calculation of Kt/V; otherwise, it might be overestimated.

Acrylic Resins↗
PubMed1997

Serum magnesium concentration and PTH levels. Is long-term chronic hypermagnesemia a risk factor for adynamic bone disease?

The observation that some subjects with low PTH had elevated plasma magnesium (Mg) levels prompted us to analyze in 41 patients on maintenance hemodialysis for 44 +/- 36 months, their serum Mg concentrations, and the relationship between plasma Mg and PTH levels. The mean serum Mg concentration was 2.4 +/- 0.2 mg/dl. Twenty-four out of the 41 subjects (58.5%) had hypermagnesemia (serum Mg above 2.5 mg/dl). Patients were classified into 3 groups according to their PTH level: Group A, low PTH (below 120 pg/ml); group B, adequate PTH (120-250 pg/ml); and group C, high PTH (above 250 pg/ml). There were no differences among groups according to number of subjects, age, sex, time on dialysis, renal disease, serum calcium, phosphorus, bicarbonate, vitamin D or aluminum concentrations. Doses of calcium carbonate and aluminium hydroxide were also similar in all groups. Curiously, although the differences were not statistically significant, the total cumulative intake of calcium and aluminium were less in group A than in the other groups. Interestingly, patients with low PTH had a significantly higher serum Mg concentration than patients with adequate or high PTH (2.8 +/- 0.2 mg/dl vs 2.3 +/- 0.1 mg/dl and 2.2 +/- 0.1 mg/dl, respectively, p < 0.01). Moreover, regression analysis showed a negative linear correlation between serum PTH level and plasma Mg concentration (r = -0.6059, p < 0.001). Based on these findings, chronic hypermagnesemia could have a suppressive effect on PTH secretion, and it could be a risk factor for the development of adynamic bone disease in dialysis patients.

Adult↗
PubMed1997

Calcium salts of keto-amino acids, a phosphate binder alternative for patients on CAPD.

Control of hyperphosphoremia is crucial to the prevention of secondary hyperparathyroidism. Calcium salts of keto-amino acids (KAA) were employed as phosphate binders in hemodialysis patients. We wanted to assess the efficacy of these substances as quelating agents in patients under continuous ambulatory peritoneal dialysis (CAPD). Also, as an amino acid supplement, we determined their possible effect on some parameters related to nutritional status. We studied 13 patients (7 M; 6 F) with a mean age of 45.2 +/- 17 years and a mean time on CAPD of 18.4 +/- 11.4 months. None had severe secondary hyperparathyroidism and/or clinically relevant aluminium intoxication. They were not receiving calcitriol and none were using low-calcium peritoneal dialysis fluids. All were under aluminum hydroxide (AlOH3) treatment and 8 patients also received calcium carbonate. These quelating agents were withdrawn and after 21 days (wash-out period) KAA were initiated. We analyzed serum levels of bone metabolism parameters (calcium, phosphate, osteocalcin [OC], intact parathyroid hormone [iPTH], alkaline phosphatase [AP]) and nutritional parameters (total protein, albumin, pre-albumin, transferrin) in four periods: (A) during AlOH3; (B) immediately after the washout period; (C) after 1.5 months; and (D) after 3 months of KAA therapy. In 5 patients serum aluminum level was also measured in periods (A) and (D). The serum phosphate level at period (B) was significantly higher than in other periods. After 3 months of treatment phosphate levels decreased significantly (A = 1.77 +/- 0.3 mmol/l vs D = 1.48 +/- 0.2; p < 0.05). Serum calcium levels increased, while iPTH and OC decreased (p = ns). AP remained stable during the study. All nutritional parameters increased at the end of the study (p = ns). Calcium salts of keto-amino acids showed to be an effective alternative to aluminum-containing phosphate binders. They were well tolerated, without relevant side-effects. These compounds could also represent an additional source of oral amino acid supplementation with improvement of nutritional status.

Administration, Oral↗
PubMed1997

Effects of angiotensin-converting enzyme inhibitors on anemia and erythropoietin requirements in peritoneal dialysis patients.

In an attempt to assess the effect of angiotensin-converting enzyme inhibitors (ACEIs) on anemia and recombinant human erythropoietin (rHuEPO) requirements in peritoneal dialysis patients, we evaluated 5 patients treated with ACEIs for one year, and the results were compared with data from a control group (N = 5). In response to ACEIs, the mean hemoglobin value decreased progressively, reaching statistical significance after 6 months and thereafter (basal, 10.7 +/- 0.8; month 6, 10.3 +/- 0.9; month 12, 10.3 +/- 0.5 g/dL, p < 0.05), with no variations in the control group. The rHuEPO requirements experienced a progressive increase in ACEI-treated patients, from 4400 +/- 1516 U/week at basal to 8600 +/- 2880 U/week at the conclusion of the study (p < 0.01). Serum erythropoietin concentration remained stable during the study in both groups of patients. In conclusion, rHuEPO requirements necessary to maintain a stable hemoglobin concentration are greater in subjects under ACEI therapy. ACEI may be an important cause of resistance to rHuEPO, an effect not mediated by a decrease in endogenous erythropoietin.

Aged↗
PubMed1992

Familial IgA nephropathy associated with bilateral sensorineural deafness.

Alport's syndrome is the most frequent disorder with familial nephritis and deafness, but other types of nephropathy have been occasionally associated with hereditary hearing loss. The familial occurrence of IgA nephropathy has been well documented. We report a family with hereditary, bilateral, sensorineural deafness spanning four generations. Three of five members with deafness had microscopic hematuria. Renal histology of the two deaf members undergoing biopsy showed mesangial glomerulonephritis with mesangial IgA deposits, without ultrastructural abnormalities of the glomerular basement membranes. Familial nephritis with deafness should not be equated with the diagnosis of Alport's syndrome.

Deafness↗