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Biomedical subjects

F Alvarez-Ude

Publications and source records attributed to F Alvarez-Ude.

25 records · Page 2Linked to original sources
PubMed1976

Role of the kidney in regulating plasma immunoreactive beta-melanocyte-stimulating hormone.

An analysis of the factors that influence the increase in plasma immunoreactive beta-melanocyte-stimulating hormone (beta-MSH) concentration in chronic renal failure showed that: (a) the increase correlated with the increase in serum creatinine concentrations; (b) beta-MSH was not cleared from the plasma by haemodialysis; (c) beta-MSH concentrations increased with length of time on dialysis and increased further after bilateral nephrectomy but there was no further increase with time; (d) beta-MSH levels decreased to normal after renal transplantation; and (e) beta-MSH was excreted in urine only when plasma levels rose to well above those of chronic renal failure (in Nelson's syndrome). These findings suggest that the kidney regulated plasma beta-MSH by a non-excretory mechanism and is the major site of beta-MSH metabolism.

Antibodies↗
PubMed1976

Long term therapy with 1,25(OH)2D3 in dialysis bone disease.

Five patients with haemodialysis bone disease were treated with 1 to 1.5 mug of 1,25 (OH)2D3 daily for periods ranging from 6 -8 months. There was a significant improvement in calcium absorption but no troublesome hypercalcaemia was encountered. Secondary hyperparathyroidism improved, both histologically and radiologically, and there was a fall in serum PTH and return of serum alkaline phosphatase to within normal limits. There was also improvement in the patients' mineralisation status, but this change was slower and less marked. Muscle power improved significantly, both clinically and electromyographically.

Calcium↗
PubMed1975

Clofibrate-induced muscle damage in patients with chronic renal failure.

Muscle weakness and tenderness together with a rise in serum creatine kinase (C.K.) were noted in five uraemic patients treated with 1-2 g of clofibrate ('Atromid-S') daily. Excessive accumulation of both total and free serum chlorophenoxyisobutyric acid (C.P.I.B.), the active circulating metabolite after clofibrate therapy, was found in three patients in whom it was sought. It is suggested that chronic renal failure should be regarded as a contraindication to the use of clofibrate for the treatment of any coexisting hyperlipidaemia. If such therapy is contemplated it must be cautiously instituted at low dosage and the patient monitored by regular assessment of serum C.K. and levels of both total and free C.P.I.B.

Adult↗
PubMedDate not supplied

[Nutritional status, comorbidity, and inflammation in hemodialysis].

UNLABELLED: Low y serum albumin and high C-reactive protein (CRP) have been shown to be significant predictors of mortality in hemodialysis (HD) patients. Although hypoalbuminemia has been attributed to malnutrition, it has recently been recognized evidence of inflammation that predicts serum albumin concentration in dialysis patients. AIM: To establish, in our HD patients, the factors associated with malnutrition, hypoalbuminemia and elevated levels of C-reactive protein to determine its influence in the incidence and cause of death during a one year follow-up period. METHODS: A cross sectional study was performed in 64 patients (35 males, 13% diabetics; mean age 64 +/- 12), who had beep on HD for 64 +/- 58 months. We assessed nutritional status by anthropometric and biochemical parameters and estimated protein and calorie intake by diet recall. The dialysis dose was measure by KT/V normalized for actual and ideal body weight (BW). Comorbidity (total and cardiovascular) were measured using a modified M. Charlson index. CRP was used as a marker of inflammation. During a one year follow-up period we determined the incidence and cause of death. RESULTS: According to Bilbrey index only seven patients (11%) were well nourished. The variables associated with malnutrition were civil status (not married) and dialysis dose estimated by KT/V normalized to ideal BW. Serum albumin (mean 4.1 +/- 0.3 g/dl) was associated with creatinine, comorbidity age and infection. 37.5% of the patients had CRP > 1 mg/dl and they had more cardiovascular comorbidity and lower serum albumin, and they used higher doses of erythropoietin (table III). Patients using modified cellulosic membranes had higher levels of CRP. Multivariate analysis showed that high global comorbidity, low serum cholesterol, and high level of CRP and hematocrit predicted death. The principal cause of mortality was infection. CONCLUSIONS: Malnutrition is a common problem in HD patients. Low dialysis dose is associated with malnutrition in some patients. We propose to normalize urea clearances to ideal body weight. Inflammatory activity is frequent in HD, probably as a result of intermittent activation of the acute phase response during the dialysis procedure. Low serum albumin in HD patients is principally associated with infection/inflammation but not with malnutrition. CRP is a sensitive marker of inflammation and an power predictor of mortality in HD patients.

Aged↗
PubMedDate not supplied

[Physical symptoms and emotional disorders in patient on a periodic hemodialysis program].

OBJECTIVES: To establish the frequency and severity of somatic symptoms and emotional distress (anxiety and/or depression) among our chronic hemodialysis (CHD) patients and to study the relationship between them as well as their influence on the perceived health status. PATIENTS AND METHODS: All patients who had been on CHD for a minimum of three months were eligible for the study. Eight of them were excluded: six because they were unable to answer the questionnaires and two because they refused to participate. The 58 remaining patients were the subject of our study (median age 68.5 years; median duration of HD 29.5 months). Diverse sociodemographic and clinical data were recorded. The patients answered the following questionnaires: 1) The "physical symptoms" dimension of the Kidney Disease Questionnaire; 2) A measure of anxiety (STAI); 3) A measure of depression (Beck Depression Inventory and Cognitive Depression Index); and 4) The Nottingham Health Profile (NHP). RESULTS: The most frequent and severe symptoms were tiredness, itching, thirst, bone and joint pain and sleep disturbance. The severity of the symptoms was positively associated with female sex, and the presence of clinically relevant degrees of anxiety and/or depression. A quarter of the patients were anxious and almost half of them suffered from depression. Emotional disturbances were associated with the severity of somatic symptoms and comorbidity. Only anxiety and depression were significantly associated with the global NHP score; they explained 47% of its variance. A score of 50 or more in the "Emotional Reactions" dimensions with the NHP detected 69% of the patients with anxiety and 81% of those with depression. CONCLUSIONS: Somatic symptoms are common among patients on CHD and they appear to be associated with emotional distress (anxiety and depression) that influences significantly the perceived health status. Measuring the perceived health status by means of generic and specific questionnaires, may help to establish the diagnosis of these problems.

Aged↗