Nefrología : publicación oficial de la Sociedad Española Nefrologia
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Hypertension is common in type 2 diabetes with diabetic nephropathy, and increases the risk of cardiovascular complications and renal chronic insufficiency. The aim of our evaluation in these patients was: a) to study the correlation between office blood pressure (BP), self-monitored (SMBP) and 24-hour ambulatory blood pressure monitoring (ABPM). b) To study the correlation between these methods and cardiovascular and renal complications. ⋯ Decreases in BP in type 2 diabetes with diabetic nephropathy are difficult of maintain despite combinations of different antihypertensive drugs. These patients present an important WCP and worse prognosis data, such as elevation of systolic BP, increased PP, poor night BP fall and a BP rise in the early morning. Also, we can't reduced the BP during 24 hours in an important number of patients. These characteristics can be detected by combining the office BP measurement, SMBP and ABPM. The alternative possibility would be lifestyle modification, appropriate drug combinations and to start treatment at lower levels than those currently used as thresholds (the guidelines for antihypertensive treatment have been drastically shifted in this direction over the past years).
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Editorial Review Comparative Study
[Efficacy and effectiveness: a useful distinction for clinical practice and research].
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Case Reports
[Persistence of the left superior vena cava discovered during the implantation of a hemodialysis catheter].
A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of the left anterior cardinal vein that usually disappears in early embryological development as a result of compression between the left atrium and the hilum of the left lung. If it is not associated with other congenital cardiac anomalies it is usually asymptomatic but has important clinical implications in some situations. In this article, we describe a patient with bilateral SVC identified on a chest radiograph by a haemodialysis central venous catheter passing through it.