Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Aug 2019
Long-term outcome of renal transplantation: a 10-year follow-up of 765 recipients.
Renal transplantation is a treatment of choice for patients with end‑stage renal disease. The main goal of transplant care is to achieve the best long‑term patient survival (PS) and graft survival (GS). ⋯ The effect of IS protocols on long‑term outcomes varies depending on patient subpopulations. Immunosuppressive therapy solves rejection‑related problems but does not address the increasing mortality of RTRs due to cardiovascular diseases, malignancies, or infections. Therefore, treatment recommendations should be individualized and posttransplant care, provided mainly by internists, should be carefully structured to improve long‑term outcomes of renal transplantation.
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Pol. Arch. Med. Wewn. · Aug 2019
Estimation of 24-hour urinary sodium, potassium, and creatinine excretion in patients with hypertension: can spot urine measurements replace 24-hour urine collection?
Owing to inconvenience of a 24‑hour urine collection, diagnostic methods based on spot urine samples are becoming increasingly popular. Spot urine sodium measurements could replace 24‑hour urinary sodium (24hUNa) excretion, considered a surrogate measure of dietary sodium intake. Spot urine-based approaches to estimating 24hUNa and 24‑hour urinary potassium (24hUK) excretion are potentially useful in patients with hypertension, for example, to identify increased urinary potassium excretion in individuals with primary aldosteronism and high dietary sodium intake in those with resistant hypertension. ⋯ We also confirmed the general utility of the equations for estimating 24hUCr excretion in hypertensive individuals but with significant differences between various equations, the best formulas being Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) and Rule. Compared with the combined PAHO/CKD‑EPI formula, the Tanaka and Kawasaki equations underestimated increased 24hUNa and 24hUK excretion. Thus, the combined PAHO/CKD‑EPI formula might be the best for identifying increased 24hUNa and 24hUK excretion in patients with hypertension.