In our experience, treatment with MMF showed positive results such as decrease in the frequency of relapses, less proteinuria, and reduction in the dose of steroids administered without deterioration of glomerular filtration rates. However, more studies are needed to assess efficacy, safety, and optimal dosage.
Introducción: el trasplante renal es el tratamiento de elección para los pacientes con enfermedad renal crónica terminal. Sin embargo, un trasplante renal anticipado no siempre es posible, y muchos pacientes requieren algún tipo de terapia de reemplazo renal previo al trasplante. Este estudio tiene como objetivo evaluar los desenlaces a corto y largo plazo post-trasplante renal de acuerdo a la modalidad de diálisis previa al trasplante. Métodos: estudio tipo cohorte restropsecitva. Se incluyeron pacientes mayores de 18 años que recibieron un trasplante renal durante 2005-2018. Inicalmente se realizó estadística descriptiva. Posteriormente se realizó análisis multivariado mediante un modelo de riesgos proporcionales de Cox con el objetivo de evaluar la relación entre la supervivencia del paciente y del injerto y la necesidad de diálisis previo al trasplante. Se evaluó además la tasa de filtración glomerular durante los primeros dos años del trasplante renal. Resultados: durante 2005-2018 se realizaron 925 trasplantes renales, 289 estaban en diálisis peritoneal, 439 en hemodiálisis y 197 no estaban en diálisis. La supervivencia del paciente y del injerto a 6, 12, 24, 48, 60 meses posterior al trasplante renal fue de 97.5%, 96.7%, 96.0%, 93.7%, 92.3% y 94.5%, 92.9%, 90.5%, 84.8%, 81.1% respectivamente, sin encontrar diferencia estadísticamente significativa entre los que tuvieron diálisis peritoneal vs. hemodiálisis (p=0.402, p=0.180) tampoco se encontraron diferencias significativas en el análisis multivariado. El 8.1% de los pacientes presentó rechazo agudo en el primer año post trasplante, y el 13.2% durante todo el seguimiento, sin encontrarse diferencias significativas entre los que habían tenido diálisis peritoneal vs. hemodiálisis. No se encontraron diferencias en la TFG. Conclusiones: no se encontraron diferencias estadísticamente significativas en los desenlaces duros a corto y largo plazo según la modalidad de diálisis pre-trasplante.
Over 80% of American adults exceed their daily recommended intake of sugar (<10% kcal). While habitual sugar consumption is associated with an increased risk for diabetes and cardiovascular disease, less is known about the effects of short-term sugar consumption on metabolic health, particularly in the elderly. The purpose of this study was to test whether aged hearts are more susceptible to pathology following a short-term high sucrose (HS) diet. Specific goals were to: A) determine the effects of a 1-week HS diet exposure on the hearts of 5 month-old and 24 month-old mice; and B) test if the mitochondrial targeted peptide SS-31 can protect against HS-diet induced effects. Male CB6F1 mice were placed either on standard chow or HS diet after 1 week of receiving saline (control) or SS-31 through osmotic pumps. Heart function was assessed in vivo through echocardiography before and after treatments. One week of HS induced significant cardiac hypertrophy in the old mice compared to age-matched chow controls. Treatment with SS-31 prevented this HS induced hypertrophy. Young hearts were smaller than in the old, but size was unaffected by diet or SS-31. We observed no effect of HS (with or without SS-31) on respiration or H2O2 production in isolated mitochondria from hearts using high-resolution respirometry. These data indicate that only 1-week exposure to HS diet is enough to exacerbate cardiac hypertrophy in aging mice, but factors other than heart mitochondrial ROS may mediate this effect.
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