No description available.

No description available.

Administrative data was anonymously linked to a clinical registry, to evaluate the validity of diabetes algorithms in youth. In addition, incident youth with T2DM (n=342) in Manitoba (1-18 years) from Jan.1986-2009 identified from the clinical registry were anonymously linked to healthcare records in order to evaluate complications, compared to youth with type 1 diabetes (T1DM) (n=1011) and non-diabetes (non-DM) controls (n=1710). The algorithm including 1 or more hospitalizations or two or more outpatient claims over two years was the most valid. Youth with T2DM had a 47% increased risk of any complication and a 2.29 fold increased risk of renal complication. Age at diagnosis, HgA1c and ace inhibitor/angiotensin receptor blocker use (ACE/ARB) were significant risk factors for any complication. Risk factors for renal complications included ACE/ARB use, albuminuria and diagnosis prior to 2000. Survival at 10 years was 91.4% (T2DM) vs. 99.5% (T1DM) vs. 100% (non-DM); p<0.0001.

Objetivo: Determinar si el estado nutricional está asociado a la sobrevida de pacientes dializados período 2007-2012. Materiales y Métodos: Población diana: pacientes dializados entre el periodo 2007–2012; diseño de estudio: analítica–cohorte retrospectivo. Tiempo de seguimiento de 5 años (2007–2012). Tamaño muestral: 276 personas, muestreo aleatorio simple. Se utilizó estadística descriptiva y, análisis bivariado y multivariado para medir asociación entre estado nutricional y sobrevida. Resultados: La edad media fue de 63,33 años. El 54,35% fueron hombres y 45,65% mujeres. La comorbilidad más frecuente fue la diabetes mellitus (31,52%). Hubo 53 pacientes fallecidos (19%). El 82,93% de los pacientes que presentaban diabetes mellitus más daño de órgano fallecieron. Se observó que la supervivencia para los pacientes que presentaron diabetes mellitus más daño de órgano comparado con los que no la presentaron fue 80% (P < 0,001). En el análisis bivariado se observó que las mujeres tenían un 65% más riesgo de morir comparado con los hombres. En el análisis multivariado las variables significativas fueron sexo, tipo de diálisis, diabetes mellitus con daño de órgano (HR = 6,77), albúmina (HR = 0,26) y urea (HR =0,99); es decir son factores independientes para supervivencia en el estudio. Conclusiones: Se determinó que el mal estado nutricional albúmina y colesterol), sexo femenino, hemodiálisis y presencia de diabetes mellitus más daño de órgano están asociado a una menor sobrevida demostrado mediante el análisis multivariado.

It has been reported that the presence of Fc receptor blocking antibodies is associated with normal pregnancy and improved cadaver donor renal transplant survival. The demonstration of the development of such antibody activity in the animal model during one or more pregnancies and the effect of these pregnancies on the survival of a subsequent renal allograft form the major aims of the studies presented in this thesis.A microsurgical laboratory was therefore established at Aberdeen University and the rat renal transplant model developed. Fc receptor blocking activity was assessed using the EA inhibition assay.The results indicate that:I Fc receptor blocking activity was not found in the sera of virgin rats.2 Significant levels of these antibodies were only found after two pregnancies and they occurred in 50% of such cases3 Primiparous animals and those multiparous animals which did not develop EA inhibiting activity rejected renal allografts from the paternal strain in the same time as virgin animals.4 Only multiparous rats sharing over 30% EA inhibition failed to reject transplants carrying paternal specificities. Those animals were capable of rejecting grafts from third party donors suggesting that the Fc receptor blocking antibodies were directed towards paternal antigens.It is therefore suggested that Fc receptor blocking activity occurring as a result of pregnancy in the rat renal transplant model may enhance a renal allograft from the paternal strain. These antibodies may therefore represent a form of donor specific immunosuppression.

Administrative data was anonymously linked to a clinical registry, to evaluate the validity of diabetes algorithms in youth. In addition, incident youth with T2DM (n=342) in Manitoba (1-18 years) from Jan.1986-2009 identified from the clinical registry were anonymously linked to healthcare records in order to evaluate complications, compared to youth with type 1 diabetes (T1DM) (n=1011) and non-diabetes (non-DM) controls (n=1710). The algorithm including 1 or more hospitalizations or two or more outpatient claims over two years was the most valid. Youth with T2DM had a 47% increased risk of any complication and a 2.29 fold increased risk of renal complication. Age at diagnosis, HgA1c and ace inhibitor/angiotensin receptor blocker use (ACE/ARB) were significant risk factors for any complication. Risk factors for renal complications included ACE/ARB use, albuminuria and diagnosis prior to 2000. Survival at 10 years was 91.4% (T2DM) vs. 99.5% (T1DM) vs. 100% (non-DM); p<0.0001.

No description available.

No description available.

L-carnitine is an endogenous compound that has important roles in fatty acid oxidation. Patients with end-stage renal disease (ESRD) who are undergoing haemodialysis may develop a secondary L-carnitine deficiency. Following oral administration of L-carnitine, enterobacteria generate ??-butyrobetaine and trimethylamine with the latter substance extensively N-oxygenated in the liver, to form trimethylamine-N-oxide. Given that patients with ESRD have qualitatively different and higher bacterial populations in the small intestine as compared with healthy subjects, increased formation of trimethylamine and accumulation of trimethylamine-N-oxide would be expected. The clinical significance of these amines is related to their potential to form the carcinogen N-nitrosodimethylamine, contribution to neurological toxicity and "uraemic breath". / The pharmacokinetics of oral L-carnitine display clear non-linearity above a dose of 0.5 g three times a day with an associated increase in plasma concentrations of trimethylamine and trimethylamine-N-oxide. Oral administration of L-carnitine to patients with ESRD undergoing haemodialysis increased plasma concentrations of this substance to levels seen in individuals with normal kidney function and evidence was provided for the accumulation of trimethylamine-N-oxide. / Thesis (PhD)--University of South Australia, 2006.

L-carnitine is an endogenous compound that has important roles in fatty acid oxidation. Patients with end-stage renal disease (ESRD) who are undergoing haemodialysis may develop a secondary L-carnitine deficiency. Following oral administration of L-carnitine, enterobacteria generate ??-butyrobetaine and trimethylamine with the latter substance extensively N-oxygenated in the liver, to form trimethylamine-N-oxide. Given that patients with ESRD have qualitatively different and higher bacterial populations in the small intestine as compared with healthy subjects, increased formation of trimethylamine and accumulation of trimethylamine-N-oxide would be expected. The clinical significance of these amines is related to their potential to form the carcinogen N-nitrosodimethylamine, contribution to neurological toxicity and "uraemic breath". / The pharmacokinetics of oral L-carnitine display clear non-linearity above a dose of 0.5 g three times a day with an associated increase in plasma concentrations of trimethylamine and trimethylamine-N-oxide. Oral administration of L-carnitine to patients with ESRD undergoing haemodialysis increased plasma concentrations of this substance to levels seen in individuals with normal kidney function and evidence was provided for the accumulation of trimethylamine-N-oxide. / Thesis (PhD)--University of South Australia, 2006.