Cassava (Manihot esculenta Crantz) is a plant that contains neurotoxins such as linamarin and lotaustraline. Its long-term consumption is associated with neuronal damage and contributes to the development of motor impairment in humans and rats. We investigated the effects of the consumption of cassava juice on renal and hepatic function and motor impairments in male rats. The rats received the vehicle, non-toxic and toxic doses of cassava juice, or linamarin as a pharmacological control, over 35 consecutive days. The effects were evaluated in an open field test, rotarod, and swim test. The toxic cassava dose and linamarin resulted in motor impairments in the rotarod and swim test from day 7 of treatment. The toxic cassava dose and linamarin increased the parameters that indicate renal and hepatic damage, with the exception of total protein and albumin levels. Behavioral variables that show motor incoordination (i.e., latency to fall in the rotarod) were negatively correlated with biochemical parameters of renal and kidney damage, whereas spin behavior was positively correlated. Our data indicate that chronic oral consumption of cassava juice caused renal and hepatic damage that was correlated with motor coordination impairment in rats, similarly to their principal neurotoxic compound, linamarin.
BackgroundErythropoietic agents (EAs) are indicated in anaemia associated with chronic kidney disease (CKD).PurposeDetermination of average dose of epoetin β and darbepoetin α required to achieve haemoglobin (Hb) levels of 10.0–12.5 g/dl in predialysis patients and rate conversion factor between both EAs.Material and methodsRetrospective study. Inclusion: CKD patients who started treatment with EAs between January and December 2012. Follow-up period: 6 months. Data collected: demographics; baseline: 3 and 6 months data analysis; EA dispensed and posology. Data: medical and pharmacotherapeutic history (Farmatools).Results81 patients. Median baseline characteristics: 59.3% men; 74 ± 10 years (30–88); stage 3a (24.7%), 3b (5.0%), 4 (57.8%) and 5 (12.5%); Hb 10.13 ± 1.16 g/dl; 63.0% had serum ferritin values >100 µg/l; 40.7% received epoetin β (average weekly dose: 7718.18 ± 6155.72 IU (500–30 000 IU)) and 59.3% darbepoetin α (average weekly dose: 20.55 ± 10.30 μg (5–50 µg)), as decided by the nephrologist. There were no statistically significant differences by type of EA (epoetin group vs. darbepoetin α group (p ≥ 0.05)) in demographics: 69.7% men vs 65.1% and 75.2 ± 8 years vs 72.3 ± 11 years, respectively; in analytical data: Hb 10.3 ± 1 g/dl vs 10.0 ± 1 g/dl and serum ferritin 258.3 ± 302 vs 261.1 ± 247 µg/l. After 3 months of treatment, 53.1% of patients had Hb 10.0–12.5 g/dl. The average weekly doses to achieve the Hb target range were 6875.0 IU of epoetin β and 20.4 µg of darbepoetin α, which represent a relationship between both doses of 337 IU/1 mg. The type of EAs influenced the response because 67.5% of patients who received darbepoetin compared with 29.2% using epoetin β achieved Hb 10.0–12.5 g/dl (p = 0.003). After 6 months of follow-up, 62.7% achieved Hb 10.0–12.5 g/dl. Average weekly dose: 7035.0 IU of epoetin β and 18.70 µg of darbepoetin α, which represent a relationship of 376 IU/1 mg.ConclusionAfter 3 and 6 months of treatment with EAs, more than 50% of patients had a response with a dose ratio between epoetin β and darbepoetin α of 300 IU/1 mg.References and/or AcknowledgementsTer Arkh 2012;84:48-52Am J Kidney Dis 2007;50:471-530No conflict of interest.
BackgroundErythropoietin (EPO) is indicated in the treatment of anaemia associated with chronic kidney disease (CKD).PurposeTo determine the average dose of epoetin β and darbepoetin α required to achieve adequate levels of haemoglobin (Hb) in patients with CKD not yet undergoing dialysis and the rate conversion factor between the two EPOs.Material and methodsRetrospective study. Patients included: stage 3 to 5 CKD who started treatment with EPO between January 2012–December 2012. Follow-up period: 6 months. Hb target range: 10.0 g/dL–12.5 g/dL. Data collected: sex, age, CKD stage; baseline, 3 and 6 months data analysis; type of EPO and posology. Data: medical and pharmacotherapeutic history (Farmatools).Results81 patients. Median baseline characteristics: 59.3% men, age 73.8 years (30–88), stage 3 CKD (29.7%), 4 (57.8%) and 5 (12.5%); Hb 10.2 ± 1.2 g/dL; 63.0% had serum ferritin values >100 ng/ml. 40.7% received epoetin β (average weekly dose: 7,718.2 ± 6,155.7 IU) and 59.3% darbepoetin α (average weekly dose: 20.6 ± 10.3 μg). 46.9% (38/81) of patients changed EPO treatment: 71.1% (27/38) dosage. Hb level increased statistically significantly after 3 (1.5 g/dL average increase, p < 0.001) and 6 months of treatment (1.6 g/dL, p < 0.001); haematocrit level also did at 3 (4.8 g/dL, p < 0.001) and 6 months (5.1 g/dL, p < 0.001). After 3 months 53.1% of patients had Hb 10.0–12.5 g/dL. Average weekly dose to achieve Hb target range: 6,875.0 IU of epoetin β and 20.4 μg of darbepoetin α, which represent a relationship between the two doses of EPOs: 337:1.ConclusionEPO increased Hb and haematocrit baseline levels statistically significantly after 3 and 6 months of treatment. The relationship between the two doses of EPOs to achieve Hb target range (epoetin β: darbepoetin α) found in our study was different from the relationship described in the Summary of Product Characteristics (337:1 vs. 200:1 respectively).References and/or AcknowledgementsNefrología 2008;(Suppl 3):63–6Nefrología 2012;32(2):221–7No conflict of interest.
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