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Biomedical subjects

J Ballarín

Publications and source records attributed to J Ballarín.

11 recordsLinked to original sources
PubMed2005

[Collagen IV (alpha3-alpha4) nephropathy].

Recent evidence has shown that the COL4A3, COL4A4 and COL4A5 genes are involved in different renal manifestations. Mutations in these collagen type IV genes affect the glomerular basement membrane (GBM) giving rise to a nephropathy whose symptoms range from isolated hematuria to severe renal failure. This disorder has been traditionally considered to be different entities: Autosomal Dominant Alport syndrome, Familial Benign Hematuria, Autosomal Recessive Alport Syndrome carriers. But the increased knowledge of the molecular basis of this clinical diversity prompted us to agglutinate these entities under the name of "collagen type IV nephropathy". This fact has relevant implications in diagnosis, prognosis and management.

Adult↗
PubMed2005

[New therapy strategies in secondary hyperparathyroidism on dialysis (I): new concepts, new treatments].

Secondary hyperparathyroidism (SHP) is still an early and frequent complication of chronic renal disease (CRD). Currently, CRD is an independent cardiovascular risk factor, and calcium-phosphorus metabolism is one of the modifiable related factors. In this first article, we summarize the recent SHP treatment paradigm shift in dialysis patients, derived from the better knowledge and understanding of vascular calcification. We analyze the most recent guidelines (K/DOQI), and describe the general implications of hyperphosphatemia, as well as our therapeutic approach with phosphorus-binders. Since sevelamer additionally presents some pleiotropic effects and it attenuates the progression of vascular calcification, we consider it in the first-line of treatment despite it is not yet demonstrated a survival benefit. We also minimize the use of elemental calcium to a maximum of 1000 to 1500 mg/day. Lanthanum carbonate may well be an important therapeutic agent in the near future, especially if security concerns related to metal accumulation are overcome. Ferric citrate, colestilan and nicotinamide may soon play a role. All these drugs, isolated or in combination, are important in the treatment of SHP since a great deal of its success and the avoidance of some dialysis-related complications depend on an efficient phosphorus control.

Algorithms↗
PubMed2005

[New therapeutic strategies in secondary hyperparathyroidism on dialysis (II): vitamin D analogues and calcium-mimetics].

Secondary hyperparathyroidism (SHP) is a frequent complication of dialysis patients. In this second article we will analyze the new vitamin D analogs, capable of decreasing parathyroid hormone (PTH) levels with a lower effect on intestinal calcium and phosphorus absorption. Among other advantages described in the experimental setting, paricalcitol shows a survival benefit in dialysis patients as compared to calcitriol, at least in retrospective studies, and thus it became our first-line vitamin D derivative. Calcimimetics are unique since they decrease PTH levels without increasing serum calcium and phosphorus. Actually, calcium and phosphorus decrease in a significant number of patients. These drugs will soon be authorized in Spain, and we describe the better achievement of K/DOQI guidelines as well as other beneficial effects observed in the experimental animal with them. Finally, we mention the potential benefit of mild metabolic acidosis, the use of bisphosphonates, the role of bone morphogenetic protein BMP-7, and the use of teriparatide. The future treatment of SHP will probably require the independent management of calcium, phosphorus, vitamin D and PTH. Thus, low-dose combined treatments with selective drugs may prove more effective than sequential therapies.

Animals↗
PubMed1999

Lack of effect of clinical doses of cyclosporin A on erythrocyte Na+/K+-ATPase activity.

Cyclosporin A (CsA) may exert its cytotoxic effects by altering the activity of different plasma membrane transport systems. Although CsA may act at the gene level, it has been also suggested that it can directly alter transport processes at the plasma membrane. To examine this possibility in a physiological context, we determined Na(+)/K(+)-ATPase activity in erythrocytes from two groups of subjects receiving CsA treatment: group I consisted of kidney transplant patients, and group II comprised patients with steroid-resistant idiopathic nephrotic syndrome. Group I patients showed a marked decrease (35%) in the activity of the Na(+)/K(+)-ATPase in erythrocytes immediately after surgery, before the initiation of CsA treatment. The activity remained low 2 days after the introduction of CsA, but had recovered to the original (pre-surgery) value 1 month later. Group II patients showed the same pattern of erythrocyte Na(+)/K(+)-ATPase activity as those in group I. When the blood CsA levels from all patients were plotted against the corresponding erythrocyte Na(+)/K(+)-ATPase transport activity, a significant linear correlation was found. Higher levels of CsA in the blood were correlated significantly with increased Na(+)/K(+)-ATPase activities. The blood sodium concentration was also correlated positively with both erythrocyte Na(+)/K(+)-ATPase activity and blood CsA concentration. Thus CsA treatment is not associated with inhibition of the Na(+)/K(+)-ATPase in erythrocytes.

Adult↗
PubMed1998

Bullous pemphigoid associated with acute glomerulonephritis.

We report an 82-year-old man who presented with bullous pemphigoid and who later developed an acute glomerulonephritis with the histopathological and immunofluorescence pattern of a postinfectious glomerulonephritis. Antibodies directed against 230 and 180 kDa bullous pemphigoid antigens were detected in the patient's serum by means of the immunoprecipitation technique. Staphylococcus aureus and methicillin-resistant S. aureus were isolated from the patient's skin. We consider that in this particular patient the cutaneous infection played a part in the development of the kidney complication.

Acute Disease↗
PubMed1996

Effects of cyclosporine A on Na,K-ATPase expression in the renal epithelial cell line NBL-1.

The bovine renal epithelial cell line NBL-1 has been used to monitor the effects of cyclosporine A (CsA) on Na+,K(+)-ATPase activity and expression. CsA at two single doses (0.6 mg/liter and 2.5 mg/liter) inhibits the ouabain-sensitive component of Rb+ uptake, assumed to be Na+,K(+)-ATPase, but increases the low activity of a furosemide-sensitive component corresponding to a Na+/K+/Cl- cotransporter. CsA addition also induces a slight decrease of alpha 1 subunit mRNA levels, without altering the already low beta 1 subunit mRNA amounts. Hypertonic treatment of NBL-1 cells leads to a significant increase in both Na+,K(+)-ATPase activity and alpha 1 subunit mRNA amounts, but does not modify beta 1 subunit mRNA levels. The differential response of the alpha 1 and beta 1 subunit genes may explain why hypertonic treatment does not result in higher alpha 1 protein expression, and supports the view that increased activity relies upon post-translational events, despite the likely transcriptional activation of the alpha 1 subunit gene. The addition of CsA does not alter the hypertonicity-mediated increase of Na+,K(+)-ATPase activity but blocks the accumulation of alpha 1 subunit mRNA. In conclusion, CsA may compromise the ion handling by renal cells as a result of the inhibition of basal Na+,K(+)-ATPase activity and the stimulation of Na+/K+/Cl- cotransport activity. Moreover, this is the first report showing that CsA may affect the long-term adaptation of the pump by altering its subunit gene expression.

Animals↗