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M Fernández Lucas

Publications and source records attributed to M Fernández Lucas.

At least 19 recordsLinked to original sources
PubMed2006

[Temperature dialysate and hemodialysis tolerance].

In this study, the effect of dialysate temperature on hemodynamic stability, patients' perception of dialysis discomfort and postdialysis fatigue were assessed. Thirty-one patients of the morning shift were eligible to participate in the study. Three patients refused. Patients were assessed during 6 dialysis sessions: in three sessions the dialysate temperature was normal (37 degrees C) and in other three sessions the dialysate temperature was low (35.5 degrees C). To evaluate the symptoms along the dialysis procedure and the postdialysis fatigue, specific scale questionnaires were administered in each dialysis session and respective scores were elaborated. Low temperature dialysate was associated with higher postdialysis systolic blood pressure (122 +/- 24 vs. 126 +/- 27 mmHg, p < 0.05), and lower postdialysis heart rate (82 +/- 13 vs. 78 +/- 9 beats/min, p < 0.05) with the same ultrafiltration rate. Dialysis symptoms score and postdialysis fatigue score were better with the low dialysate temperature (0.7 +/- 0.9 vs. 0.4 +/- 1 vs. p < 0.05, and 1.3 +/- 1 vs. 1 +/- 0.9 p < 0.05, respectively). Furthermore, low temperature dialysate shortened the post-dialysis fatigue period (5.4 +/- 6.3 vs. 3.1 +/- 3.3 vs. hours, p < 0.05). The clinical improvement experimented with the low temperature dialysate was not universal. A beneficial effect was exclusively observed in the patients with higher dialysis symptoms and postdialysis fatigue scores or having more than one episode of hypotension in a week. The patients were asked about their temperature preference, 7 patients (23%) request a dialysate at 37 degrees C, 19 patients (61%) prefered to be dialysed with the low temperature dialysate, and 5 patients (16%) were indifferent. The later two groups of the patients continued with the low temperature dialysate during other 4 weeks. At the end of that period, the clinical improvement remained unchanged. In summary, low temperature dialysate is particularly beneficial for highly symptomatic patients.

Adult↗
PubMed2006

[Chronic renal failure secondary to hyperoxaluria following small bowel syndrome].

A 70-year-old woman was admitted in the Department of Nephrology because of renal insufficiency. Six years previously, as consequence of a venous mesenteric thrombosis, she underwent an extense intestinal resection with subsequent short intestine syndrome. Five years after the surgery an increase in the creatinine concentration was observed (1.4 mg/dl). One year later, it increased up to 3.1 mg/dl and the patient was remitted to our Department. The radiological study revealed calcifications on both kidney silhouettes. In the next year, renal function worsened and the calcifications increased. Coinciding with the beginning of the chronic hemodialysis treatment she suffered a renal colic with passage of a calcium oxalate stone.

Aged↗
PubMed2004

[Therapy with interferon plus ribavirin in hemodialysis patient with PCR-positive viral hepatitis C].

Traditionally, the treatment of viral hepatitis C (positive Polymerase Chain Reaction -PCR-) was with Interferon. A combination of Interferon plus Ribavirin has been producing better results in last years. Currently, Ribavirin is not indicated for patients with Chronic Kidney Disease because of a high risk of severe anaemia. In a few cases, this treatment is producing good results with previous dose adjustment. We show a case of a 28-year-old man with Chronic Kidney Disease on treatment with periodical hemodialysis and chronic hepatopathy HCV Positive RNA HCV (> 1,000,000 copies/ml) and persistent transaminase elevation. Before kidney transplantation, we decided to use Interferon (3,000,000 IU/48 hours) and Ribavirin (200 mg/24 hours) treatment. After 15 days, we saw normal transaminase values and HCV RNA was negative. The patient required temporary suspension of Ribavirin and two red blood cell transfusions due to severe anaemia. Ribavirin was reintroduced 200 mg/48 h posthemodialysis. The patient did not present any complication again, and could be treated for 14 months. After next 11 months of evolution the patient has normal rates of liver function and negative HCV RNA values.

Adult↗
PubMed2004

[Membranous nephropathy associated to autoimmune thyroiditis, chronic pancreatitis and suprarrenal insufficiency].

A 33 year old female was admitted to the hospital to study aedema and bocio, A nephrotic syndrome was diagnosed and the renal biopsy demonstrated membranous glomerulonephritis, stage II. She was also diagnosed of Hashimoto's autoinmmune thyroiditis: TSH (41.5 uUl/ml), T4 (0.07 ng/dl), antithyroglobuline (1/2560) and antimicrosome (1/6400). Four year latter she was diagnosed of autoinmmune pancreatitis, without evidence of diabetes mellitus or exocrine pancreatic insufficiency. Eight years latter she was diagnosed of primary autoimmune suprarrenal insufficiency: basal cortisol: 2.7 mcg/dl, post ACTH estimulated cortisol: 5.6 mcg/dl, antinuclear antibody (1/160) and antiparietal (1/320). We present a pluriglandular autoimmune syndrome with membranous glomerulonephritis, thyroiditis, pancreatitis and suprarrenal insufficiency. To the best of our knowledge this complex syndrome has not been previously described.

Adrenal Insufficiency↗
PubMed2000

Differences between blood flow as indicated by the hemodialysis blood roller pump and blood flow measured by an ultrasonic sensor.

BACKGROUND/AIM: The ultrasonic transit time is currently the best method for measuring the blood flow rate in the extracorporeal hemodialysis circuit. The purpose of this study was to analyze the differences between blood flow as indicated by the hemodialysis blood roller pump (prescribed blood flow) and by an ultrasonic flowmeter (delivered blood flow). METHODS: The ultrasonic blood flow was measured in 20 patients on chronic hemodialysis who were dialyzed through an arteriovenous fistula. During each dialysis session the ultrasonic blood flow was measured at three different blood roller pump flow rates (300, 350, and 400 ml/min). In order to analyze the influence of inflow and outflow pressures on blood flow, this study was conducted during nine consecutive dialysis sessions during which needles of different sizes were used. RESULTS: The ultrasonic flow was always lower than indicated by the blood roller pump: 265+/-12, 304+/-15, and 341+/- 19 ml/min for blood roller pump flow rates of 300, 350, and 400 ml/min, respectively (variability: -11.6, -13.1, and -14.8%, respectively). An univariate regression analysis showed that the reduction in flow recorded ultrasonically correlated with both venous blood line pressure (r = -0.2679, p<0.001) and negative arterial blood line pressure (r = 0. 6773, p<0.001). By multivariate analysis, only the arterial blood line pressure has a predictive value. When all measurements were grouped by arterial blood line pressure ranges, the variability between ultrasonic blood flow and blood roller pump flow was found to be similar in those groups with the same arterial blood line pressure, regardless of the blood roller pump flow rate. CONCLUSIONS: The blood flow indicated by the dialysis blood roller pump is always greater than the delivered blood flow, and this difference is in turn conditioned by the negative pressure induced by the blood roller pump in the arterial blood line.

Blood Flow Velocity↗
PubMed1996

Effect of rHuEpo therapy in dialysis patients on endogenous erythropoietin synthesis after renal transplantation.

UNLABELLED: We have undertaken a prospective study to examine the effect of recombinant human erythropoietin (rHuEpo) therapy during dialysis on Epo levels after renal transplantation and to evaluate the impact of this therapy on the immediate graft function. Between December 1991 and December 1993, 91 renal transplant recipients were studied. There were 34 females and 57 males and the mean age was 38 years. Forty-two patients were treated during dialysis with rHuEpo due to anemia and 49 patients did not receive it. Endogenous Epo (eEpo), hemoglobin concentration, hematocrit level and serum creatinine were determined on days 0, 2, 4, 8, 15, 30, 60 and 180 after transplantation. Ferritin level was determined pretransplant and on day 60. RESULTS: Patients not treated with rHuEpo during dialysis experienced a transient increase in endogenous Epo after renal transplant that was not observed in treated patients (26 +/- 3.3 vs. 9 +/- 1.5 mU/ml, p < 0.001). The eEpo peak was similar in patients with early or delayed graft function (23 +/- 4.3 vs. 32 +/- 5.4 mU/ml, NS). The recovery of the anemia after a successful renal transplant took place in patients treated as well as those not treated with rHuEpo without significant differences. In the treated group, the pretransplant hematocrit level was similar in patients with early or delayed graft function (31 +/- 3.5% vs. 32 +/- 4.8%), but in the untreated group, the hematocrit level was lower in patients with early renal function (28.5 +/- 4% vs. 32 +/- 3%, p < 0.05). However, these patients also had a significantly shorter warm ischemia time (53 +/- 13.8 vs. 64 +/- 14.5 min). Fifty-two percent of the rHuEpo-treated patients and 36% of the untreated patients had delayed graft function. In conclusion, different courses of eEpo levels after renal transplant were observed depending on whether or not patients had been treated with rHuEpo during dialysis. Untreated patients experienced a transient increase which was not observed in the treated group. Immediate or delayed graft function did not modify eEpo levels. No association was found between rHuEpo therapy during dialysis and delayed graft function.

Adolescent↗