Nefrología : publicación oficial de la Sociedad Española Nefrologia
-
Low y serum albumin and high C-reactive protein (CRP) have been shown to be significant predictors of mortality in hemodialysis (HD) patients. Although hypoalbuminemia has been attributed to malnutrition, it has recently been recognized evidence of inflammation that predicts serum albumin concentration in dialysis patients. ⋯ Malnutrition is a common problem in HD patients. Low dialysis dose is associated with malnutrition in some patients. We propose to normalize urea clearances to ideal body weight. Inflammatory activity is frequent in HD, probably as a result of intermittent activation of the acute phase response during the dialysis procedure. Low serum albumin in HD patients is principally associated with infection/inflammation but not with malnutrition. CRP is a sensitive marker of inflammation and an power predictor of mortality in HD patients.
-
Comparative Study
[Hormonal profile and participation of nitric oxide in salt-sensitive and salt-resistant essential arterial hypertension].
Recent studies have shown that cardiovascular events and end-organ damage occur more frequently in patients with salt-sensitive essential hypertension (SH) than in salt-resistant essential hypertension (RH). Nitric oxide (NO) plays an important role in regulating the pressure-natriuresis relationship. Therefore impaired NO synthesis may produce or aggravate salt-sensitive hypertension. ⋯ During high sodium intake SS patients became non-dippers. Our results showed that patients with salt sensitive hypertension displayed a suppressed renin-aldosterone system, an attenuated nocturnal decline in blood pressure on high-salt diet and an impairment of endothelial function. The relationship between urinary nitrate excretion and arterial pressure suggest that the salt sensitivity of arterial pressure may be related bo blunted generation of endogenous nitric oxide.
-
The serum anion gap (AG) is a calculated value defined as the difference between the sum of sodium and potassium and the sum of chloride and bicarbonate concentrations. Thus, the anion gap is equal to the unmeasured cations minus the unmeasured anions (UA). To evaluate the AG changes during HDF-on line, we studied 20 patients treated with this technique. ⋯ The increase in serum albumin and pH can mask an decreased concentration of unmeasured anions in patients treated with HDF on-line. An adjusted anion gap without effect of CAA and CAP can be obtained. With the help of this adjustments the changes in some undetermined anions organic and inorganic (sulphate and others in renal failure) can be calculated.