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M Benítez

Publications and source records attributed to M Benítez.

5 recordsLinked to original sources

[Peritoneal equilibrium test using icodextrin and glucose at different concentrations].

UNLABELLED: The aim of this study was to compare, under standard conditions (Peritoneal Equilibrium Test, "PET"), the peritoneal permeability to water and several solutes using icodextrin and glucose (3.86% and 1.36%) dialysates. The study includes 14 patients (3 women and 11 men), mean age 64 +/- 13 years, average time on peritoneal dialysis 23.5 +/- 17 months. PETs with icodextrin were performed in all of them (n = 14); PETs with 3.86% glucose were carried out in 7, and PETs with all the three solutions were performed in 5 patients. Samples were taken at 0, 30, 60, 120, 240 minutes, and after the rinsing procedure using 1.36% glucose in order to calculate the residual volume. RESULTS: Sodium concentration in the effluent and D/P sodium did not change significantly from minute 0 to 240 with icodextrin and 1.36% glucose; but with 3.86% glucose both sodium and D/P sodium decreased at thirty minutes, remained at the same levels till the 120 minutes and then had a tendency to increase. Glucose concentration and osmolarity in the effluent did not vary throughout the time with icodextrin, but progressively decreased during the 4-hour period with 3.86% and 1.36% glucose solutions. The drainage after the 4-hour period was higher for the 3.86% glucose (2,608 +/- 388 ml, p = 0.03) than for the 1.36% glucose (2,070 +/- 120 ml) or the icodextrin (2,212 +/- 213 ml). Low molecular weight permeability: D/P creatinine after the 4-hour dwell was significantly lower for the icodextrin (0.66 +/- 0.1, p = 0.05) than for the 3.86% glucose (0.71 +/- 0.1) or the 1.36% glucose (0.72 +/- 0.1). The creatinine clearance for 3.86% glucose (7.4 +/- 0.4 ml/min p = 0.007) was higher than for icodextrin (5.6 +/- 0.5 ml/min) or for 1.36% glucose (5.8 +/- 0.6 ml/min). The clearances for total protein, albumin and beta 2-microglobulin did not show significant differences between the solutions. CONCLUSIONS: Our study confirms that the icodextrin solution remains iso-osmolar with plasma during the 4-hour dwell. The sodium profile suggests that the ultrafiltration induced by icodextrin and 1.36% glucose depends on small pore-mediated sodium and water transport; on the other hand, 3.86% glucose also induces transport of water without solutes throughout the ultra-small aquaporin-mediated, pores, producing sodium dilution in the effluent. Ultrafiltration and solute clearances for icodextrin are lower than for 3.86 glucose during a 4-hour dwell.

Adult↗

[Control of blood pressure in a population of patients with hypertension and in a subgroup with hypertension and diabetes: relationship with characteristics of the health care center and the community].

AIMS: To evaluate how well blood pressure (BP) is controlled in the population of persons with hypertension alone and with diabetes, and to evaluate the influence of characteristics of the health care center on the degree of control of BP. Design. Descriptive, cross-sectional, multicenter, retrospective study. SETTING: 31 health centers in Catalonia (Northeastern Spain). Participants. Random sample of 2240 clinical records of patients with hypertension who were seen at 31 different primary care centers in Catalonia between January and December 1996. MAIN OUTCOME MEASURES: Audit of clinical records. We recorded the two most recent BP measurements, and annotations regarding screening for and diagnosis of other cardiovascular risk factors. We also recorded health center and physician characteristics. RESULTS: 495 patients (22.1%) had diabetes in addition to hypertension. 61.2% were women. Mean age was 64.9 years (95% CI, 64.4-65.4 years). In 25.7% of the patients, BP was below 140/90 mmHg (95% CI, 23.9-27.5%), but among patients with diabetes only 6.7% had BP below 130/85 mmHg (95% CI, 4.5-8.9%). Mean systolic and diastolic BP at the end of the study period were higher at teaching centers. Diastolic BP was significantly higher at urban centers and in patients younger than 65 years. Diastolic BP was also higher in patients with at least one associated cardiovascular risk factor, and at centers less than 6 years old, although these differences were not statistically significant. We found no differences according to physician characteristics. CONCLUSIONS: Blood pressure was adequately controlled in few patients with hypertension and diabetes in Catalonia. Associated cardiovascular risk factors, age less than 65 years, and being a patient at a teaching center or an urban center, were associated with a worse degree of BP control.

Aged↗

[Clinical experience with icodextrin. Multicenter study].

UNLABELLED: The aim of this study was to analyse our experience with icodextrin in Andalusia, Spain. The study includes 51 patients (30 women and 21 men) on peritoneal dialysis (21 on CAPD and 30 on Automated Peritoneal Dialysis) treated with icodextrin for 10.3 +/- 7 months (0-41 months). Their mean age was 57 +/- 18 years (18-86 years). We have recorded the appearance of side effects, and the evolution of several biochemical parameters at baseline and after 6, 12 ans 18 months from initiation of icodextrin. We also studied drainage fluid from 12 patients after an icodextrin exchange. RESULTS: There were side effects (all cutaneous) in 4 out of 51 patients (7.8%). Two of the affected suffered from cutaneous hypersensitivity reactions, and icodextrin had to be suspended; the other two had exfoliative dermatitis affecting hands and feet that disappeared without have to withdraws icodextrin. Biochemical parameters: Serum sodium levels decreased from baseline to six months (138 +/- 6 mEq/l vs 136 +/- 3 mEq/l; p = 0.006), and then persisted at the same levels throughout the rest of the study period. There was a slight but significant decreased of serum HDL-cholesterol at six months vs baseline (55 +/- 26 mg/dl vs 51 +/- 20 mg/dl, p = 0.04), and a further decrease at twelve months vs six months (42 +/- 15 mg/dl vs 51 +/- 13 mg/dl, p = 0.054). There were no significant variations of glucose, osmolality, cholesterol, LDL-cholesterol (tendency to increase), triglycerides, beta 2 m and weight (tendency to increase; p = 0.08). In relation with the icodextrin exchange: average ultrafiltration 296 +/- 119 ml (ranging from 104 to 480 ml), creatinine clearance 1.9 +/- 0.5 litres (20.5% of daily creatinine clearance), urea clearance 2.08 +/- 0.5 litres (18.7% of daily urea clearance), total protein losses 3.2 +/- 0.9 g, albumin losses 1.4 +/- 0.5 g; urea and creatinine clearances were negatively correlated with ratios D/P4 of urea and creatinine of PET and positively correlated with ratio G4/G0. In conclusion, side effects are scarce with the use of icodextrin. As described in other studies, there is a trend to a slight decrease in serum sodium. The long-term use of icodextrin does not-prevent weight gain or deterioration of patients on peritoneal dialysis, despite the diminution of glucose load.

Adolescent↗