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J Duclos

Publications and source records attributed to J Duclos.

31 records · Page 2Linked to original sources
PubMed1993

[Is it necessary to supplement with folic acid patients in chronic dialysis treated with erythropoietin?].

The need for folate supplementation in patients on chronic hemodialysis receiving erythropoietin (EPO) remains to be determined. Thirty five patients on chronic hemodialysis were studied; of these 10 did not receive EPO nor folic acid, 12 received EPO with folic acid supplementation and the rest only EPO. In these groups, after 9 +/- 2.9 months of treatment, serum folate levels were normal, although higher in those patients supplemented with folate. An additional group of 8 patients, previously supplemented with 2 mg/week of folate, was studied during the first 10 weeks of EPO treatment. In these patients a significant decrease in serum folate was observed from the first to the tenth week (from 18 +/- 29 to 7 +/- 4 ng/ml). Red cell folate had an unexplained raise during the first four weeks and went back to near basal levels during the next weeks. As expected serum ferritin levels decreased at the end of the study period, but remained over 100 ng/ml Red blood cell protoporphyrin remained normal. We thus recommend the measurement of serum and red cell folate levels during the first and tenth weeks of the induction phase of EPO treatment. Also, folic acid supplementation in doses of 2 mg/week is recommended to maintain adequate body stores, specially in extremely anorectic hemodialysis patients or those in whom strict diets without fruits are prescribed.

Adult↗
PubMed1993

[Is it justifiable to use antiplatelet drugs as a universal protection in patients with chronic glomerular damage?].

In many renal diseases, glomerular thrombosis may play an important role in the development of glomerular sclerosis and progression of renal failure. The aim of this study was to assess the effect of antiplatelet agents on the evolution of patients with chronic glomerular disease. Twenty four patients aged 48 +/- 17 years (21 with idiopathic glomerulonephritis, one with systemic lupus erythematosus and two with type II diabetes mellitus) were treated with aspirin and dipyridamole or aspirin alone during 23.9 +/- 17.5 months. The patients were followed during 31.8 +/- 23 months; seven patients had a progressive deterioration of renal failure requiring dialysis or transplantation (Group A) and 17 had a stable or improving renal function (Group B). Initial serum creatinine was significantly higher in group A than in group B (3.6 +/- 1.6 vs 1.5 +/- 1.5 mg/dl respectively p = 0.003); no other significant differences in the initial assessment were observed between both groups. It is concluded that antiplatelet agents may delay the progression of renal disease when started in patients with normal or slightly deteriorated renal function.

Adolescent↗
PubMed1992

[Acute renal insufficiency secondary to the use of angiotensin converting enzyme inhibitors in 2 patients without renal artery stenosis].

Two female patients who developed acute renal failure secondary to the use of angiotensin converting enzyme (ACE) inhibitors for hypertension are presented. None had renal artery stenosis on angiography or duplex doppler ultrasound examination. A 66 year old patient with a single functioning kidney recovered basal renal function; the other patient, aged 77 years, remained with a permanent severe renal damage. Risk factors were advanced age, mild chronic renal failure due to nephrosclerosis and diuretic use. We conclude that acute renal failure related to ACE inhibitors may be severe and can occur even in patients without renal artery stenosis. Diuretics, associated to ACE inhibitors, should be prescribed with caution, specially in older hypertensive patients with pre-existing chronic renal failure. Diabetic patients are at special risk due to the high incidence of small vessel disease in them.

Acute Kidney Injury↗
PubMed1992

[Reappearance of pica symptoms during erythropoietin treatment].

Absolute or functional iron deficiency decreases the effectiveness of erythropoietin in patients undergoing hemodialysis. We describe a patient who developed pica associated to a ferritin level of 800 ng/ml during recombinant human erythropoietin treatment. The symptom subsided after supplementation with iron dextran. Therefore we recommend iron supplementation during the initial phase of treatment with erythropoietin until serum ferritin levels raise above 1000 ng/ml.

Adult↗
PubMed1991

[Parenteral iron and folic acid in patients on chronic hemodialysis: requirements, monitoring, and effective use].

Iron and folic acid metabolism were prospectively studied over a 7 year period in 12 patients on chronic hemodialysis. Three protocols of iron and folic acid administration were successively used: in Phase A (mean 35.5 months) iron dextran intravenously was used at high dose (mean 416 mg monthly) with folic acid 1 mg/day; in Phase B (mean 8.1 months) iron and folic acid were not given, and in Phase C low dose iron dextran (mean of 10 mg monthly) and folic acid 3 mg per week were administered. No other medications, except for blood transfusion or Aluminum hydroxide were used throughout. A good correlation was found between serum ferritin levels and bone marrow iron stores. No side effects of iron administration were noted. A significant rise in Hb levels was observed (9.21 g/dl in Phase A to 10.3 g/dl in Phase C). Red cell protoporphyrin levels remained normal. With folic acid supplement of 3 mg per week, serum folate level remained within normal limits.

Adult↗
PubMed1991

[Chronic dialysis in advanced age patients: a reasonable therapeutic alternative?].

Thirty two elderly patients (mean age 68.8 +/- 6.95 years) were treated by maintenance hemodialysis or intermittent peritoneal dialysis. 28.1% were diabetics and no survivors in this group were observed after 24 months. Median survival for non diabetic patients was 72.4 months vs 9.03 months in diabetics (p < 0.01). The main cause of death was discontinuation of dialysis (33%) or cardiovascular disease. Thus, chronic dialysis is a reasonable treatment for elderly patients with end stage renal disease. However, diabetes is associated to a poor prognosis.

Aged↗