Revista de nefrología y terapéutica

Numerous trials have shown that chronic kidney disease increases the risk of cardiovascular disease. Dyslipidemias have been shown to accelerate progression of kidney disease. Statins have assumed a pivotal role in management of hyperlipidemia. However their effect on renal function is still not fully understood. Some clinical trials have shown some renoprotective effect of statins but there is still need for more data to clarify effects of statins on renal function.

Introduction: High blood pressure (HBP) that is a leading cause of end-stage renal disease (ESRD) in black African populations and is frequently associated to autosomal polycystic kidney disease (ADPKD). This study aimed to describe prevalence and severity of HBP in black Africans with ADPKD and to identify associated risk factors. Patients and methods: We performed a retrospective study of 65 ADPKD patients regularly followed in outpatient nephrology clinic between 1995 and 2009. ADPKD was diagnosed according to recent unified criteria (2009). Statistical analyses were done with SPSS 16.0. Results: We included 65 patients (36 males and 29 females) with a mean age of 47 ± 5 years. Hypertension was found in 73.8 % of patients and it preceded diagnosis of ADPKD in 23 patients (median delay of 28 months). Mean systolic/diastolic blood pressure was 168 ± 30 /96 ± 16 mm Hg respectively. All hypertensive patients presented retinopathy and left ventricular hypertrophy. Two patients presented stroke. Fifty one percent of patients were treated with angiotensin converting enzyme inhibitors alone and 29% received combinations of anti-hypertensive drugs. One third of them had their blood pressure normalized. Patients with HBP at diagnosis showed a similar proportion of ESRD in comparison with normotensive patients (p=0.12). At univariate analysis, HBP was correlated with age, gender, BMI, GFR and proteinuria. Multiple regression analysis identified age (OR=1.95, p=0.05) and glomerular filtration rate (OR=2.33, p=0.001) as independently associated to HBP. Conclusion: Hypertension with organ damage is frequent in Senegalese patients with ADPKD. Age and glomerular filtration rate at diagnosis were the main risk factors of HBP identified in our patients.

Objetivo: La hipotensión es bastante común en cualquier unidad de diálisis y, a pesar de las mejoras significativas de las técnicas de hemodiálisis en los últimos años, la frecuencia de episodios recurrentes de hipotensión intradialítica se ha mantenido casi sin cambios. Nuestro estudio tiene como objetivo definir la patogenia de la hipotensión intradialítica e intenta describir medidas efectivas para los pacientes de hemodiálisis propensos a la hipotensión de forma individual. Diseño: Se trata de un estudio prospectivo de 100 pacientes de hemodiálisis observados durante 12 meses en el Lilavati Hospital and Research Centre, Mumbai, India. Se diagnosticó IDH a los sujetos con más de dos episodios/mes de hipotensión en diálisis. Resultados: Se encontró hipotensión intradialítica en el 18% de los sujetos. Se encontró que el peso corporal ideal evaluado incorrectamente era la causa más común de hipotensión intradialítica. Se encontró que la evaluación del volumen y el ajuste del peso corporal ideal eran fundamentales para el problema de la prevención de la hipotensión intradialítica. Conclusión: Este estudio muestra que la hipotensión intradialítica es un fenómeno común, incluso en un centro de atención terciaria. Se deben desarrollar estrategias preventivas en cada unidad para disminuir el riesgo futuro de hipotensión intradiálisis en pacientes específicos.