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Biomedical subjects

J L Rodicio

Publications and source records attributed to J L Rodicio.

At least 127 records · Page 7Linked to original sources

Does an adequate control of blood pressure protect the kidney in essential hypertension?

We analyzed the clinical course of 120 patients who were diagnosed as having primary hypertension and subsequently given standard stepped-care therapy (diuretic, beta-blocker and vasodilator) for 9 years. At the end of the follow-up period, 21 patients (17.5%) had developed overt proteinuria. The initial study showed no difference in systolic blood pressure, age, sex, serum creatinine and its clearance, glucose, cholesterol and triglycerides between these patients and those who had not become proteinuric, but uric acid levels and diastolic blood pressure were higher (both P less than 0.01). An adequate control of blood pressure was obtained and maintained in all patients, who had similar therapeutic needs. During the follow-up period, uric acid levels remained significantly elevated (P less than 0.01) in the proteinuric patients, while changes in serum glucose, cholesterol and triglycerides were similar in all patients. These results indicate that long-term treatment of primary hypertensives does not fully protect kidney function and that initially elevated uric acid levels could be a predictor of a poor prognosis.

Adrenergic beta-Antagonists↗

Senior-Loken syndrome (nephronophthisis and pigmentary retinopathy) associated to liver fibrosis: a family study.

We present two sisters with nephronophthisis and pigmentary retinopathy (Senior-Loken syndrome) and associated liver fibrosis. Clinical and histological findings are discussed, as well as the importance of family studies. A comparative analysis with previous published cases is made; we found only three other references with this triad. Our report underlines the need to investigate liver disorders in all patients with nephronophthisis and the existence of liver fibrosis as an element of the hereditary 'nephronophthisis complex.'

Adolescent↗

Immunogenicity of a yeast-derived hepatitis B vaccine in hemodialysis patients.

In a multicenter study of hemodialysis patients in Spain, the immunogenicity of a yeast-derived recombinant deoxyribonucleic acid hepatitis B vaccine was evaluated. Two different vaccination schedules were examined: zero, one, two, six months and zero, one, two, 12 months. Two different dose levels (20 micrograms and 40 micrograms) were also compared. No serious adverse effects were reported by any of the vaccinees; the most frequently reported reaction was soreness at the injection site. This study also indicated that higher concentrations of antibodies are attained when more frequent doses of vaccine are administered. The yeast-derived vaccine produced an immune response similar to that of the plasma-derived vaccines.

Clinical Trials as Topic↗

[Treatment of arterial hypertension in the aged].

The response to different therapeutic schedules in arterial hypertension in the elderly is studied and compared with response to treatment in younger patients. Blood pressure in the elderly was best controlled with non pharmacologic measures and low doses of diuretics; there were no differences between both groups with respect to complications and side effects. The response to angiotensin-converting enzyme inhibitors is also evaluated, presenting good results on blood pressure control without side effects in the elderly, although efficaciousness was higher in younger patients. The possible therapeutic schedules in arterial hypertension in the aged are discussed.

Age Factors↗

Converting enzyme inhibition in chronic renal failure.

Ten patients with chronic renal failure whose hypertension was controlled with triple drug therapy consisting of propranolol-hydralazine-furosemide were switched to the angiotensin-converting enzyme (ACE) inhibitor captopril for a period of 12 months. Control of hypertension was similar with both antihypertensive regimens. Clearance of inulin and of paraaminohippuric acid increased during the first 3 months of captopril therapy and remained stable thereafter. Moreover, the decline in the reciprocal of serum creatinine over time observed during triple drug therapy was arrested during therapy with the ACE inhibitor. If the salutary effects of captopril are sustained, the results obtained in the current studies would suggest that control of hypertension by ACE inhibition may be effective in slowing progression of renal failure. Future studies to answer this important question are necessary.

Adult↗

Hematuria due to hypercalciuria and hyperuricosuria in adult patients.

We have prospectively studied 37 adult patients (15 males, 22 females; age 31 +/- 10.6 years) with previously undiagnosed isolated hematuria in which hypercalciuria or hyperuricosuria was found. Eighteen of them had had episodes of gross hematuria. Isolated hypercalciuria (4.4 to 10.4, X 5.6 +/- 1.9 mg/kg/24 hr) was found in nine patients (Group I), isolated hyperuricosuria (784 to 1500, X 1088 +/- 228 mg/24 hr) in 11 (Group II), and both hypercalciuria (4 to 8, X 4.9 +/- 1 mg/kg/24 hr) and hyperuricosuria (752 to 1476, X 1042 +/- 181 mg/24 hr) in 17 patients (Group III). Thiazide treatment for patients with hypercalciuria and allopurinol for those with hyperuricosuria were administered; calciuria and uricosuria became normal by the first month of therapy in every case. In 22 (59.4%) cases (Responder patients) hematuria resolved completely as soon as calciuria and uricosuria became normal. In the remaining 15 cases (Nonresponder patients) hematuria persisted despite the normal calcium and uric acid excretions. Several disorders that explained hematuria were diagnosed later in most of Nonresponder patients. Responder patients persisted without hematuria on the follow-up; only in three patients a transient relapse of hematuria was seen associated with a sudden increase of calciuria and uricosuria because of treatment withdrawal. There were no differences in age, male/female ratio nor in the basal values of calciuria and uricosuria between Responder and Nonresponder patients. A familial history of urolithiasis was found more frequently in Responder patients (64%) than in Nonresponders (20%) (P less than 0.05). We conclude that hypercalciuria and hyperuricosuria are definable and potentially reversible causes of hematuria in adult patients.

Adolescent↗

Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers.

The effects on renal function of an intravenous infusion of calcium gluconate at subpressor doses have been investigated in a group of seven normotensive male volunteers. In the absence of changes in blood pressure, the calcium gluconate induced a significant increase in renal plasma flow and the glomerular filtration rate (P less than 0.01) with a significant fall in the filtration fraction (P less than 0.01). Both diuresis and natriuresis increased significantly (P less than 0.01), plasma renin activity fell (P less than 0.01) and the urinary excretion of 6-keto prostaglandin F1 alpha (PGF1 alpha) and prostaglandin E2 (PGE2) increased (P less than 0.01). These results indicate that calcium infusion at subpressor doses has renal vasodilating, diuretic and natriuretic properties that appear to be facilitated by an increase in the renal production of vasodilatory and natriuretic prostaglandins.

Adult↗

Diuretic and natriuretic properties of fenoldopam in chronic renal failure.

The effect of intravenously administered fenoldopam on diuresis and natriuresis was investigated in a group of 10 patients with advanced chronic renal failure. After an initial basal period of 1 h, a fenoldopam infusion was started and maintained for 12 h at rates varying between 0.025 and 0.1 microgram/kg per min. During the study, blood pressure was measured every 10 min and urine volume, natriuresis and creatinine clearance were measured hourly. Fenoldopam induced a significant increase in urine volume, natriuresis and creatinine clearance (P less than 0.05-0.001) accompanied by a small but significant drop in blood pressure (P less than 0.05-0.01). These results show that for advanced chronic renal failure, fenoldopam has diuretic and natriuretic properties that could be of clinical relevance.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

Effects of angiotensin converting enzyme inhibitors on the progression of renal failure and proteinuria in humans.

We studied the long-term effect of an angiotensin converting enzyme (ACE) inhibitor, captopril, on the progression of chronic renal failure and on the rate of urinary protein excretion. When compared with standard triple therapy, captopril slowed the progression of renal failure. Captopril was also able to reduce the proteinuria of non-diabetic glomerular origin. This reduction was not dependent on the presence or absence of arterial hypertension but was limited by the presence of low serum albumin levels, and only occurred in patients with proteinuria in excess of 3 g/24 h.

Adult↗