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Biomedical subjects

M Morlans

Publications and source records attributed to M Morlans.

At least 19 recordsLinked to original sources

[Prevalence of chronic renal failure in primary care].

OBJECTIVE: To determine the prevalence of chronic renal failure (CRF) without replacement treatment (RT), and to describe the primary renal diseases and associated risk factors that might favour its evolution to terminal renal failure. Design. Cross-sectional, descriptive study. SETTING: Population attended at a primary care centre (PCC). PARTICIPANTS: Over-14s with a clinical history opened at the Bon Pastor PCC. RESULTS: Between the 1st of January 1997 and the 1st of December 1997, 12241 clinical histories were reviewed. 64 patients were identified who satisfied criteria of CRF without RT, a prevalence of 5228 patients per million inhabitants (95% CI, 3,950-6,510). 71.9% were men, and mean age was 72 (SD, 13.5). The most recent plasma creatinine averaged 2 mg/dl (SD, 0.66). Frequency according to kind of nephropathy was: 3 (4.7%) glomerular, 5 (7.8%) diabetic, 3 (4.7%) interstitial, 41 (64.1%) vascular (hypertension), 2 (3.1%) indeterminate and 10 (15.6%) unclassifiable. Associated risk factors in these patients were: 47 (73.4%) with hypertension, 16 (25%) diabetic, 26 (40.6%) with hypercholesterolaemia, 20 (31.3%) chronic consumers of analgesics, and 10 (15.6%) smokers. 51.6% of the patients suffered other cardiovascular illnesses. CONCLUSIONS: The estimated prevalence in the population of CRF without RT is 5,228 per million inhabitants. Hypertension is the risk factor most closely associated with this pathology.

Adult↗

End-stage renal disease and non-narcotic analgesics: a case-control study.

1. To assess the risk of end-stage renal disease (ESRD) associated with the regular use of three classes of non-narcotic analgesics, we performed a case-control study of 340 patients with ESRD on a haemodialysis maintenance program and 673 hospital controls. 2. The overall odds ratio estimate for non-narcotic analgesics taken at least every other day for 30 days or longer before the first symptom of renal disease was 2.89 (95% CI, 1.78 to 4.68). 3. The risk increased in relation to the use duration. 4. The previous regular consumption of combinations containing phenacetin was strongly associated with ESRD (odds ratio, 19.05; 95% CI, 2.31 to 157.4). The odds ratio for previous regular consumption of salicylates was 2.54 (95% CI, 1.24 to 5.20) and for pyrazolones 2.16 (95% CI, 0.87 to 5.32). 5. An analysis for possible confounding by a history of repeated headaches, arthritis, kidney stones, hypertension, and diabetes did not alter the results. 6. The odds ratio estimates for different pathological subgroups of ESRD patients in relation to previous use of any non-narcotic analgesic were glomerulonephritis. 10.57 (95% CI, 1.25 to 89.0), interstitial nephritis, 3.33 (95% CI, 1.21 to 9.17), cystic kidney disease, 0.71 (95% CI, 0.25 to 1.97), and unknown, 5.15 (95% CI, 2.29-11.57). 7. The results of this study suggest that the regular consumption of analgesics should be routinely considered as a risk factor for any non-congenital cause of chronic renal failure. They also suggest that the risk of ESRD associated with the regular consumption of phenacetin is much higher than the risk associated with other non-narcotic analgesics.

Adolescent↗

Antirifampicin antibodies in acute rifampicin-associated renal failure.

5 patients with acute renal failure (3 with thrombopenia and hemolysis) induced by the reintroduction of rifampicin are described. No correlation was found between the severity of clinical manifestations and the total dose taken by the patients. In all but 1 patient, antirifampicin antibodies were detected. Antibodies suggested to be of the IgM class were detected in all 3 patients with hematological disorders. The pattern of non-specific acute tubular necrosis found in the 2 biopsied patients, indistinguishable from that of ischemic origin, raised the possibility of a vascular-mediated damage. In 3 patients, the possibility of a triggering immunoallergic mechanism is discussed.

Acute Kidney Injury↗

[A study of anemia in 86 patients on hemodialysis (author's transl)].

Anemia is one of the complications of terminal chronic renal failure that may worsen with periodical hemodialysis because of residual blood losses in the dialyzers that may be significant if clotting occurs within the circulation system. The potential iron deficiency component of the anemia has been studied in 86 patients submitted to periodic hemodialysis by measurement of hemoglobin, serum iron, transferrin saturation, total iron binding capacity, and ferritin. The following correlations were investigated: degree of anemia and type of renal disease, months on hemodialysis and hemoglobin, months on hemodialysis and serum ferritin, and liters of blood transfused and serum ferritin. Statistically significant correlations were found between months on hemodialysis and hemoglobin, and between liters of blood transfused and serum ferritin. From the correlation between serum iron and ferritin the patients could be classified in three groups: 1, with either normal or low serum iron and ferritin, candidates to iron therapy; 2, with elevated serum iron and ferritin, needing no iron treatment; and 3, with unequal changes of serum iron and ferritin, in whom iron kinetic studies are indicated in order to discover the patents that may benefit from iron therapy.

Adolescent↗