Importance of ultrapure dialysis liquid in response to the treatment of renal anaemia with darbepoetin in patients receiving haemodialysis
Importancia del líquido de diálisis ultrapuro en la respuesta al tratamiento de la anemia renal con darbepoetina en el paciente en hemodiálisis.
M MOLINA NEFROLOGÍA HOSPITAL SANTA MARÍA ROSELL, M.J. NAVARRO NEFROLOGÍA HOSPITAL SANTA MARÍA ROSELL, M.E. PALACIOS NEFROLOGÍA NEFROCLUB CARTHAGO, M.C
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NAVARRO NEFROLOGÍA HOSPITAL SANTA MARÍA ROSELL, M.E. PALACIOS NEFROLOGÍA NEFROCLUB CARTHAGO, M.C" "autores" => array:1 [ 0 => array:1 [ "nombre" => "M MOLINA NEFROLOGÍA HOSPITAL SANTA MARÍA ROSELL, M.J. NAVARRO NEFROLOGÍA HOSPITAL SANTA MARÍA ROSELL, M.E. PALACIOS NEFROLOGÍA NEFROCLUB CARTHAGO, M.C" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Importancia del líquido de diálisis ultrapuro en la respuesta al tratamiento de la anemia renal con darbepoetina en el paciente en hemodiálisis." ] ] "pdfFichero" => "P-E-S-A4400-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436365" "palabras" => array:3 [ 0 => "Líquido dializante ultrapuro" 1 => "Darbepoetina" 2 => "Marcadores inflamatorios" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec436366" "palabras" => array:1 [ 0 => "ultrapure dialysate, darbepoetin, renal anaemia, inflammation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Chronic inflammatory diseases and infections are a major cause of hyporesponse to erythropoiesis-stimulating factors. We conducted this prospective study in 107 patients in haemodialysis with dialysis liquid that was potentially contaminated from a bacteriological perspective in order to test the hypothesis that ultrapure dialysis liquid can improve the response to treatment with darbepoetin and reduce inflammatory markers. These patients had to have been stable in the last 8 weeks in relation to haemoglobin level and the administered dose of darbepoetin. Two filters (one of hydrophilic nylon and another of polysulfone) were added to the water treatment process, the first one prior to distribution ring output and the second before the dialyser. The patients were evaluated for 12 months. The dosage of darbepoetin was varied to maintain haemoglobin levels ranging from 11 to 14 g/dl. We measured resistance to the erythropoiesis-stimulating factor, defined as the quotient between weekly dose of darbepoetin and haemoglobin levels, baseline and every two months, the baseline and monthly endotoxin count and reactive protein C at baseline and every 6 months. 94 patients completed the study. The resistance index fell significantly during follow-up (p <0 001 and was measurable from the second month on haemoglobin levels remained within established margins with a 34 reduction in weekly dose of darbepoetin at end follow-up period both reactive protein c endotoxin count were significantly reduced p <0 001 compared to baseline after 6 and 12 months conclude the bacteriological purity of dialysis liquid reduces inflammatory markers in patients receiving haemodialysis improving response treatment with darbepoetin renal anaemia</0> </0>" ] "es" => array:1 [ "resumen" => "Las enfermedades inflamatorias crónicas y las infecciones representan una causa mayor de hiporrespuesta a los factores estimuladores de la eritropoyesis. Para comprobar la hipótesis de que un líquido dializante ultrapuro puede mejorar la respuesta al tratamiento con darbepoetina y reducir los marcadores inflamatorios, condujimos este estudio prospectivo. Se reclutaron 107 pacientes en hemodiálisis con líquido dializante potencialmente contaminado desde el punto de vista bacteriológico. Para ello, debían estar estables en las últimas 8 semanas en cuanto a niveles de hemoglobina y dosis administrada de darbepoetina. Se añadieron dos filtros (uno de nylon hidrofílico y otro de polisulfona) al tratamiento de aguas, el primero previo a la salida al anillo de distribución y el segundo previo al dializador. Los pacientes se evaluaron durante 12 meses. Las variaciones de dosis de darbepoetina se realizaron para mantener niveles de hemoglobina entre 11 y 14 gr/dl. Se determinaron índice de resistencia al factor estimulante de la eritropoyesis, definido como el cociente entre dosis semanal de darbepoetina y niveles de hemoglobina, basal y cada 2 meses, el recuento de endotoxinas basal y cada mes, y la proteina C reactiva basal y cada 6 meses. 94 pacientes completaron el estudio. El índice de resistencia se redujo de forma significativa durante todo el seguimiento (p <0 001 objetivándose desde el segundo mes los niveles de hemoglobina se mantienen dentro márgenes establecidos con una reducción la dosis darbepoetina semanal un 34 al final del periodo seguimiento p <0 001 tanto la proteina c reactiva como el recuento de endotoxinas se redujeron significativamente p <0 001 frente a las basales los 6 y 12 meses en conclusión la pureza bacteriológica del líquido dializante disminuye marcadores inflamatorios el paciente hemodiálisis así como mejora respuesta al tratamiento con darbepoetina anemia renal</0> </0> </0>" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000002/v0_201502091552/X2013251407021069/v0_201502091552/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000002/v0_201502091552/X2013251407021069/v0_201502091552/en/P-E-S-A4400-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021069?idApp=UINPBA000064" ]
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