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Biomedical subjects

F Caravaca

Publications and source records attributed to F Caravaca.

At least 19 recordsLinked to original sources
PubMed2006

Microbial processes in the rhizosphere soil of a heavy metals-contaminated Mediterranean salt marsh: a facilitating role of AM fungi.

We investigated the relationship of the zonal pattern followed by the vegetation in a polluted Mediterranean salt marsh, in semiarid south-eastern Spain, with the microbiological and biochemical properties (labile C fractions, oxidoreductases and hydrolases) of the rhizosphere soil of two halophyte species, Arthrocnemum macrostachyum and Sarcocornia fruticosa, and with the degree of arbuscular mycorrhizal (AM) colonisation in their rhizospheres. Levels of plant biomass and cover were inversely related to heavy metal contents and salinity. The concentrations of Fe, Cu, Mn and Pb extracted with DTPA hardly varied among the different zones of the salt marsh. The dehydrogenase and phosphatase activities, the soluble C and water-soluble carbohydrates concentrations and the extent of root colonisation were greater in the salt marsh zones of lower soil salinity and lower metal concentration. Urease and beta-glucosidase activities were not detected in the salt marsh. Plant biomass and cover showed positive relationships with mycorrhizal colonisation (R=0.773, P<0.001; R=0.874, P<0.001, respectively). Mycorrhizal colonisation was negatively correlated with the contents of Pb and Zn in plant tissues. This work supports the view that reduced plant uptake of toxic metals, particularly lead, could be involved in the beneficial effects of AM fungi on plant development in Mediterranean salt marshes contaminated with mining wastes.

Acid Phosphatase↗
PubMed2006

Evolution of suboptimal renal transplantations: experience of a single Spanish center.

The increase in patients on dialysis awaiting transplantation has led to the use of grafts from suboptimal donors. The aim of this study was to analyze the function of suboptimal grafts. The secondary objectives were to study vascular and urological complications, as well as delayed renal function and acute rejection episodes. The study included 135 transplantations performed over 4 years with 27% of grafts being from suboptimal donors. Early graft loss was 12%, of which 69% were due to vascular thrombosis. These thromboses were more frequent among grafts from suboptimal donors (30% vs 4%, P < .001). There were no significant differences between the groups in the incidence of acute rejection episodes (17% vs 13%) or delayed graft function (14% vs 13%). A greater incidence of urologic complications was observed among recipients of grafts from older donors. The 1-year creatinine clearance was significantly lower among recipients of grafts from older donors (73 +/- 19 vs 51 +/- 14 mL/min, P < .0001). Sequential immunosuppressive therapy resulted in a lack of significant differences in creatinine clearance at 6 months, 1 year, or 2 years after transplantation between suboptimal grafts with cold ischemia greater or less than 20 hours or in warm ischemia greater or less than 60 minutes. Logistic regression analysis showed that the best determinant of graft loss was donor age older than 60 years. Accordingly, grafts from suboptimal donors were more likely to be lost during the first month after transplantation, particularly because of thrombosis, which was not due to a higher degree of technical complexity of the transplant operation.

Cadaver↗
PubMed2006

Differential modulation of host plant delta13C and delta18O by native and nonnative arbuscular mycorrhizal fungi in a semiarid environment.

Native, drought-adapted arbuscular mycorrhizal fungi (AMF) often improve host-plant performance to a greater extent than nonnative AMF in dry environments. However, little is known about the physiological basis for this differential plant response. Seedlings of Olea europaea and Rhamnus lycioides were inoculated with either a mixture of eight native Glomus species or with the nonnative Glomus claroideum before field transplanting in a semiarid area. Inoculation with native AMF produced the greatest improvement in nutrient and water status as well as in long-term growth for both Olea and Rhamnus. Foliar delta18O measurements indicated that native AMF enhanced stomatal conductance to a greater extent than nonnative AMF in Olea and Rhamnus.delta13C data showed that intrinsic water-use efficiency in Olea was differentially stimulated by native AMF compared with nonnative AMF. Our results suggest that modulation of leaf gas exchange by native, drought-adapted AMF is critical to the long-term performance of host plants in semiarid environments. delta18O can provide a time-integrated measure of the effect of mycorrhizal infection on host-plant water relations.

Carbon↗
PubMed2006

[Accuracy of indirect estimates of renal function in advanced chronic renal failure patients].

Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formula are indirect estimates of renal function which have been widely accepted, though their accuracies have been scarcely validated in advanced chronic renal failure. The purpose of this study was to determine the accuracy (bias and precision) of these formulas in advanced CRF patients. The study group consisted of 99 unselected patients (62 +/- 15 years, 59 females) with advanced CRF. The glomerular filtration rate (GFR) was measured by Tc(99m) DTPA. Simultaneously, estimates of GFR by CG corrected for 1.73 m2 and MDRD (formula 7) were calculated. Agreement was evaluated graphically, bias was assessed by mean and median difference, and precision by median absolute differences and Bland-Altman plots. Mean GFR by DTPA, CG and MDRD were: 16.24 +/- 4.38 and 16.77 +/- 4.65 and 13.58 +/- 4.27 ml/min/1.73 m2, respectively. MDRD equation significantly underestimated GFR-DTPA (p = 0.0001). Both CG and MDRD correlated significantly with GFR-DTPA (R = 0.53 and R = 0.62, respectively). CG formula performed better than the MDRD equation with respect to bias (0.30 vs -3.24 ml/min/1.73 m2, p = 0.0001), and precision (0.58 vs. -3.11 ml/min/1.73 m2, p = 0.0001). By multiple linear regression, the best determinants of the error of the estimation by CC formula were: serum creatinine (beta = -0.58; p < 0.0001), age (beta = -0.62; p < 0.0001), and body mass index (beta = 0.26, p = 0.004), and by MDRD formula were: serum creatinine (beta = -0.38; p < 0.0001), and body mass index (beta = -0.20, p = 0.03). In conclusion, in unselected patients with advanced chronic renal failure, estimates by CC formula were more accurate than those obtained by MDRD formula. Serum creatinine was the main source of error of the estimation of GFR by both formulas, though demographic and anthropometric characteristics influenced as well on their accuracies.

Disease Progression↗
PubMed2006

[Guidelines of the Spanish Society of Nephrology. Clinical practice guidelines for peritoneal dialysis].

In Spain and in each of its autonomous communities, the dialysis treatment of chronic renal disease stage 5 is totally covered by public health. Peritoneal dialysis, in any of its modalities, is established as the preferred home dialysis technique and is chosen by high percentage of patients as their choice in dialysis treatment. The Spanish Society of Nephrology has promoted a project of creation of performance guides in the field of peritoneal dialysis, entrusting a work group composed of members of the Spanish Society of Nephrology a with the development of these guides. The information offered is based on levels of evidence, opinion and clinical experience of the most relevant publications of the topic. In these guides, after defining the concept of << peritoneal dialysis>>, the obligations and responsibilities of the sanitation team of the peritoneal dialysis unit are determined, and protocols and performance procedures that try to include all the aspects that concern the patient with chronic renal disease in substitute treatment with this technique are developed. They propose prescription objectives based on available clinical evidence and, lacking this, on the consensus of the experts' opinions. The final aim is to improve the care and quality of the of the patient in peritoneal dialysis, optimizing in this way the survival of the patient and of the technique. In Spain, as in other neighbouring countries, peritoneal dialysis has an incidence and prevalence that is much lower than that of hemodialysis, ranging in the last evaluation by the Spanish Society of Nephrology between 5 and 24% in the different autonomous communities. The great majority of peritoneal dialysis units form part of the public network of the Spanish state, with special representation as a Satellite Unit or Concerted Center related to the public hospital of reference, on which it must depend.

Humans↗
PubMed2006

[Cystatin C as estimator of glomerular filtration rate in patients with advanced chronic renal disease].

Serum cystatin C (CysC) has been shown to be more accurate than serum creatinine (Cr) in estimating renal function, especially in patients with mildmoderate chronic renal failure. However, it is unknown whether CysC provides or not any advantage over Cr in severe chronic renal failure. The aim of this study was to establish the accuracy of CysC in estimating the glomerular filtration rate (GFR) in advanced chronic renal failure patients. The study group consisted of 94 patients (57 females, mean age 61 +/- 16 years) with advanced chronic renal failure. None of them had thyroid dysfunction or was on corticoid treatment. CFR was measured by TC99mDTPA, and simultaneously, serum CysC (particle enhanced immunonephelometry) and Cr (modified Jaffe's kinetic reaction) were also determined. Serum Cr and CysC levels were correlated with GFR, and the influences of age, sex and diabetes on these correlations were analyzed. The predictive value of CysC and Cr to estimate a GFR less than 15 ml/min/1.73 m2 was analyzed by measuring the crea-under-the-curve (AUC) with Receiver-Operating Characteristics (ROC) plots. The mean CFR was 16.49 +/- 4.65 ml/min/1.73 m2. The mean concentrations of Cr and CysC were 4.19 +/- 1.19 mg/L and 3.44 +/- 0.73 mg/L, respectively. Both Cr and CysC correlated significantly with GFR (R = 0.49, p < 0.0001 and R = 0.52, p < 0.0001, respectively). Age and sex influenced on the correlation between Cr and GFR, but these demographic characteristics did not influence on the correlation between CysC and GFR. The AUC for the prediction of a GFR less than 15 ml/min/1.73 m2 with serum Cr was 0.675 (p = 0.004), while with CysC was 0.633 (p = 0.030). In conclusion, both serum Cr and CysC are highly inaccurate markers of renal function in advanced chronic renal failure patients.

Biomarkers↗
PubMed2005

Establishment of two ectomycorrhizal shrub species in a semiarid site after in situ amendment with sugar beet, rock phosphate, and Aspergillus niger.

A field experiment was carried out to assess the effectiveness of the addition of sugar beet, rock phosphate, and Aspergillus niger directly into the planting hole, and the mycorrhizal inoculation of seedlings with Scleroderma verrucosum, for promotion of plant growth of Cistus albidus L. and Quercus coccifera L. and enhancement of soil physicochemical, biochemical, and biological properties, in a degraded semiarid Mediterranean area. One year after planting, the available phosphorus content in the amended soils of both species was about fourfold higher than in the nonamended soil. Amendment addition increased the aggregate stability of the rhizosphere of C. albidus (by 56% with respect to control soil) while the mycorrhizal inoculation increased only the aggregate stability of the rhizosphere of Q. coccifera (by 13% with respect to control soil). Biomass C content and enzyme activities (dehydrogenase, urease, protease-BAA, acid phosphatase, and beta-glucosidase) of the rhizosphere of C. albidus were increased by amendment addition but not by mycorrhizal inoculation. Both treatments increased enzyme activities of the rhizosphere of Q. coccifera. The mycorrhizal inoculation of the seedlings with S. verrucosum was the most effective treatment for stimulating the growth of C. albidus (by 469% with respect to control plants) and Q. coccifera (by 74% with respect to control plants). The combined treatment, involving mycorrhizal inoculation of seedlings and addition of the amendment directly into soil, had no additive effect on the growth of either shrub species.

Analysis of Variance↗
PubMed2005

A microcosm approach to assessing the effects of earthworm inoculation and oat cover cropping on CO2 fluxes and biological properties in an amended semiarid soil.

We designed a microcosm experiment to assess the influence of inoculation with Eisenia foetida earthworms and the establishment of an Avena sativa cover crop on biological (enzyme activities and labile carbon fractions) soil quality indicators in a soil treated with a composted organic residue, and to determine the contribution of these treatments to carbon dioxide emissions from the soil to the atmosphere of the microcosm. The microcosms were incubated for 53 days under 28 degrees C/18 degrees C day/night temperatures. The addition of earthworms and the planting of A. sativa increased dehydrogenase activity of compost amended soil by about 44% after 23 days of incubation. The metabolic potential, calculated as the ratio dehydrogenase activity/water soluble C, was higher in the compost amended soil planted with A. sativa. The highest total amount of CO2-C evolved occurred in the soil treated with composted residue and earthworms (about 40% of the total amount of CO2 evolved came from earthworm activity). The planting of A. sativa increased the decomposition rate constant of organic matter in the amended soil but decreased the potentially mineralizable C pool. In conclusion, the establishment of an A. sativa cover crop and the addition of E. foetida to a degraded agricultural soil treated with composted residue were effective treatments for improving the biological and biochemical quality and the metabolic potential of the soil.

Animals↗
PubMed2005

[Serum uric acid and C-reactive protein levels in patients with chronic kidney disease].

Either inflammation or hyperuricemia has been related with increased cardiovascular risk and mortality. A hypothetical relationship between serum uric acid levels (SUA) and inflammatory markers has never been tested in chronic kidney disease (CKD) patients. The purpose of this study was to determine the prevalence of increased C-reactive protein (CRP) levels in CKD patients, and to test the hypothesis of a relationship between SUA and CRP levels. The study group consisted of 337 patients (174 males, mean age 63 +/- 16 years) with advanced chronic renal failure not yet on dialysis. None of them had overt inflammatory or infectious diseases. High sensitivity CRP levels were analyzed as a binary (above or below median value), or continuous variable (log-transformed CRP), by multiple logistic or linear regression analysis, respectively. Demographics, clinical, and biochemical characteristics, including SUA levels, were the variables tested in these analysis. In a subset of 169 patients without diabetes, the same analysis were carried out, with the inclusion of fasting insulin levels and HOMA-IR as independent variables. Median CRP level was 3.25 mg/L, and mean SUA level was 7.59 +/- 1.94 mg/dl. Patients with CRP levels above the median had significantly higher mean SUA level than that of the rest of study patients (7.93 +/- 1.79 vs 7.24 +/- 2.03 mg/dl, p = 0.001). SUA levels correlated significantly with log-transformed CRP levels (r = 0. 16, p = 0.0022). The relationship between SUA and CRP levels remained statistically significant after adjustment for age, sex, comorbid index, obesity, residual renal function, diuretic and allopurinol treatment, in the multivariate logistic and linear regression models (OR: 1.296, p = 0.0003; and beta: 0.204, p = 0.0002). The significant association between SUA and CRP levels did not change when HOMA-IR and fasting insulin levels were included as independent variables in the subset of 169 patients without diabetes. In conclusion, SUA levels are related with CRP levels in CKD patients.

C-Reactive Protein↗
PubMed2004

Improvement of soil characteristics and growth of Dorycnium pentaphyllum by amendment with agrowastes and inoculation with AM fungi and/or the yeast Yarowia lipolytica.

The effectiveness of two microbiologically treated agrowastes [dry olive cake (DOC) and/or sugar beet (SB)] on plant growth, soil enzymatic activities and other soil characteristics was determined in a natural soil from a desertified area. Dorycnium pentaphyllum, a legume plant adapted to stress situations, was the test plant to evaluate the effect of inoculation of native arbuscular mycorrhizal (AM) fungi and/or Yarowia lipolytica (a dry soil adapted yeast) on amended and non-amended soils. Plant growth and nutrition, symbiotic developments and soil enzymatic activities were limited in non-amended soil where microbial inoculations did not improve plant development. The lack of nodules formation and AM colonization can explain the limited plant growth in this natural soil. The effectiveness and performance of inocula applied was only evident in amended soils. AM colonization and spores number in natural soil were increased by amendments and the inoculation with Y. lipolytica promoted this value. The effect of the inoculations on plant N-acquisition was only important in AM-inoculated plants growing in SB medium. Enzymatic activities as urease and protease activities were particularly increased in DOC amended soil meanwhile dehydrogenase activity was greatest in treatments inoculated with Y. lipolytica in SB added soil. The biological activities in rhizosphere of agrowaste amended soil, used as indices of changes in soil properties and fertility, were affected not only by the nature of amendments but also by the inoculant applied. All these results show that the lignocellulosic agrowastes treated with a selected microorganism and its further interaction with beneficial microbial groups (native AM fungi and/or Y. lipolytica) is a useful tool to modify soil physico-chemical, biological and fertility properties that enhance the plant performance probably by making nutrients more available to plants.

Agriculture↗
PubMed2004

[Obesity and mortality in advanced chronic renal failure patients].

A protective effect of obesity on the mortality of end-stage renal failure patients has been observed in several studies. Most of these studies have been based on prevalent dialysis population. The aim of the present study was to evaluate if obesity has beneficial effects on the survival of advanced chronic renal failure patients. The study group consisted of 376 patients (mean age 63 +/- 15 years) with advanced chronic renal failure not yet on dialysis. Obesity was defined as a body mass index (BMI) > or = 30 kg/m2. Grade of comorbidity was quantified by the method devised by Davies. Survival was analyzed as time from the referral to the predialysis outpatient clinic to patient death, censoring from contributing additional survival data to the analysis following transplantation. Kaplan-Meier analysis was used to test survival differences according to quartiles of BMI, and between obese and nonobese patients. Further analysis were performed, stratifying survival curves by comorbid scores, lean body mass, age, and sex. Cox proportional hazard regression models were used to investigate the best determinants of mortality, and the role of obesity adjusted for other covariates. Median survival time was 1,453 days. During the follow-up time, 158 patients (42%) died. Survival differences among quartiles of BMI were statistically significant (Breslow = 10.7, p = 0.017). Patients within the lowest and the highest quartiles of BMI had higher mortality than the rest of patients. Survival curves between obese and non-obese patients did not differ significantly. However, when patients without comorbidity were studied apart, those with obesity showed worse survival than the rest of patients (log-rank = 7.42, p = 0.0064). Since the effect of obesity on mortality did not follow a proportional hazard pattern throughout the study period, multivariable analysis for mortality was stratified by 18 months intervals. The variables which fitted the best model were: age (Hazard Ratio: 1.04), comorbid score (HR: 2.17), serum albumin (HR: 0.62), GFR at the study entry (HR: 0.91), male gender (HR: 1.48), and obesity (HR: 1.51). In conclusion, obesity had no survival benefit in patients with advanced chronic renal failure. Obesity had a noteworthy impact on early mortality of advanced chronic kidney disease patients without comorbidities.

Blood Chemical Analysis↗
PubMed2003

Changes in physical and biological soil quality indicators in a tropical crop system (Havana, Cuba) in response to different agroecological management practices.

The objective of our study was to assess the response of physical (aggregate stability and bulk density) and biological (enzyme activities and microbial biomass) soil quality indicators to the adoption of agroecological management practices, such as the planting of forage species (forage area) and the rotation of local crops (polycrop area), carried out in a representative tropical pasture on an integrated livestock-crop farm. The pasture system was used as control (pasture area). In all three areas, the values of water-soluble C were higher in the rainy season compared to the dry season. Pasture and forage areas had the highest percentage of stable aggregates in the rainy season, while polycrops developed soils with less stable aggregates. Soil bulk density was lower in the pasture and forage areas than in the polycrop area. In the pasture area, the microbial biomass C values, dehydrogenase, urease, protease-BAA, acid phosphatase, and beta-glucosidase activities were higher than in the forage and polycrop areas, particularly in the dry season. The highest increase in the microbial biomass C in the rainy season, with respect to the dry season, was recorded in the pasture area (about 1.2-fold). In conclusion, the planting of forage species can be considered an effective practice for carrying out sustainable, integrated livestock-crop systems, due to its general maintenance of soil quality, while the adoption of polycrop rotations appears to be less favorable because it decreases soil quality.

Agriculture↗
PubMed2003

[Hypernephroma in native kidney of patient with renal transplant].

The uremic patients, specially in periodic dialysis, may present bilateral kidneys cytes with high frequency. This pathology, known as acquired cyst renal disease, is found associated in its evolution with the emergence renal malignant disease. A patient who undergoing chronic dialysis and renal transplant subsequently developed an asymptomatic renal neoplasm. The epidemiological, clinical, diagnostic aspects and therapeutic of the acquired cysts renal and your association with renal cancer are analyzed.

Humans↗
PubMed2003

Application of composted urban residue enhanced the performance of afforested shrub species in a degraded semiarid land.

Improvement of physical-chemical soil quality is a key step for carrying out revegetation programs of degraded lands in Mediterranean semiarid areas. Organic residue addition may restore the quality of these areas. A field experiment was conducted in a silt-loam soil (Typic Petrocalcid) from a degraded semiarid Mediterranean area to evaluate the effect of the addition of a composted urban residue on soil aggregate stability, bulk density and chemical properties and on the establishment of Pistacia lentiscus and Retama sphaerocarpa seedlings. The composted residue was applied at a rate of 6.7 kg m(-2) before planting. The nutrient content (NPK), total organic C and water soluble C were increased and bulk density was decreased, in the rhizosphere soil of both shrub species, by the composted residue. The addition of composted residue significantly increased the soil aggregate stability by about 22% for both shrub species. The beneficial effect of the composted residue on soil quality still persisted 18 months after addition. Eighteen months after planting, the addition of composted residue to soil had increased significantly the production of shoot biomass by P. lentiscus and R. sphaerocarpa, by about 160% and 320% respectively, compared to control values. Composted residue addition to soil can be considered an effective preparation method of a degraded area for carrying out successful revegetation programs with Mediterranean shrubs under semiarid conditions.

Conservation of Natural Resources↗
PubMed2002

Cross-reactivity between Platanus pollen and vegetables.

BACKGROUND: Several associations have been described between tree and plant pollens and certain foods. The objective of this study is to verify whether there is cross-reactivity between Platanus pollen and vegetable origin foods. METHODS: We selected 56 patients allergic to vegetable foods and subjected them to cutaneous tests with aeroallergens and vegetable foods. A statistical analysis was performed to evaluate the association of Platanus pollen with foods and with other aeroallergens. Later, a specific IgE determination was performed as well as a RAST (radioallergosorbent) inhibition experiment, to verify the existence of cross-reactivity in vitro. RESULTS: In the cutaneous tests we found a positive correlation between Platanus pollen and hazelnut, peanut, banana and celery. The results of the RAST inhibition experiment indicate an important cross-reactivity between the pollen of Platanus acerifolia and hazelnut and banana fruit, and an intermediate cross-reactivity with celery and peanut. CONCLUSION: We have described an association between the pollen of the Platanus tree and some vegetable foods such as hazelnut, banana, peanut and celery. This association could be explained by the in vitro IgE cross-reactivity detected.

Adolescent↗
PubMed2002

[Differences between the glomerular filtration rate estimated by the MDRD equation and the measurement of creatinine and urea clearance in unselected patients with terminal renal insufficiency].

From the results of the Modification of Diet in Renal Disease (MDRD) study, a prediction equation for a more accurate estimate of glomerular filtration rate (GFR), was developed. The present study ais to compare the GFR estimated by MDRD formula and that calculated by the average of creatinine and urea clearances in unselected patients with advanced renal failure. The study group consisted of 320 (163 males) with advanced renal failure not yet on dialysis. Their mean age was 63 +/- 14 years. Diabetic nephropathy was the most common etiology of renal failure (25%). Significant comorbidity was observed in 115 patients. Serum creatinine (Cr), urea and albumin were determined in all patients. Creatinine (Ccr) and urea clearance (Cu) were calculated on a 24-hour urine collection. The GFR was estimated by summing Ccr and Cu, and dividing by two (Ccr-Cu). THe clearances were corrected for a body surface area of 1.73 m2. The MDRD formula for the estimation of GFR included the following parameters: serum Cr, BUN, age, gender and serum albumin. Linear regression analysis and Bland-Altmann plot were utilized to establish the degree of correlation and agreement between both estimations of GFR. The percent differences between the two estimations of GFR was especially analyzed in those subgroups of patients which were not included in the MDRD study (patients older than 70 years, diabetics and those with comorbid conditions). The mean GFR estimated by Ccr-Cu and by MDRD formula were 10.04 +/- 3.10 ml/min and 10.55 +/- 3.60 ml/min, respectively (p < 0.0001). The two parameters correlated significantly (R = 0.76, p < 0.0001). GFR by the MDRD formula tended to overestimate the highest values of Ccr-Cu. The mean percent difference between both methods was 6.5 +/- 23.6. MDRD predictive equation overestimated significantly Ccr-Cu in patients older than 70 years (mean overestimation of 15%), males (10%), diabetics (10%), and mainly in patients with comorbidity (17%). In conclusion, the GFR estimated by MDRD formula is very similar to Ccr-Cu in young uremic patients without comorbidity. However, major discrepancies between these two methods could be observed in older patients, and mainly in those with comorbidity.

Adolescent↗
PubMed2001

Uraemic symptoms, nutritional status and renal function in pre-dialysis end-stage renal failure patients.

BACKGROUND: Deciding on the right moment to initiate dialysis and finding the best method to establish this critical stage of chronic renal failure are both controversial issues. This study attempted to address this subject by correlating a uraemic score with the most common clinical methods for assessing renal function in pre-dialysis chronic renal failure (end-stage renal disease, ESRD) patients. METHODS: The study group consisted of 201 non-selected ESRD patients. A uraemic score, composed of the uraemic symptoms, the subjective global assessment of nutritional status, serum albumin concentration, and protein catabolic rate normalized for ideal body weight, was taken as a clinical marker of uraemic toxicity. Correlations that best fit this uraemic score with creatinine clearance (Ccr), the arithmetic mean of Ccr, urea clearance (Ccr-Cu) and Kt/V urea were then investigated. RESULTS: Thirty-six per cent of patients had malnutrition. By multiple logistic regression analysis, the presence of comorbidity, Ccr-Cu and haematocrit were the best determinants of malnutrition. The correlation that best fit Ccr or Ccr-Cu with the uraemic score was a cubic curve (r=0.38, P<0.0001, and r=0.42, P<0.0001, respectively), in which an ascending inflection was observed when Ccr and Ccr-Cu fell below 12-13 and 10 ml/min, respectively. However, the relationship between Kt/V urea and the uraemic score was less predictable, especially in male patients. CONCLUSION: Ccr or Ccr-Cu are reliable methods for establishing the degree of severity of chronic renal failure below which the development of symptoms and malnutrition are highly prevalent. In contrast, Kt/V urea may be a less sensitive and specific method for assessing the severity of uraemia in ESRD patients.

Adolescent↗