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2. Beneficial Effects of Ketoanalogues on the Evolution of Renal Function and Bone Mineral Disorders in Patients with Advanced Chronic Kidney Disease: A Pilot Study.

Author

Kosmadakis, Georgios, Necoara, Aura, Fuentes, Fanny, Ramade, Nathalie, Baudenon, Julien, Deville, Clemence, Enache, Ioana, Gueret, Claudine, and Haskour, Abraham

Subjects
TREATMENT of chronic kidney failure, OSTEOPENIA, PROTEINURIA, BONE density, PILOT projects, PHOSPHATES, HEMOGLOBINS, CLINICAL trials, CARBOXYLIC acids, TREATMENT effectiveness, BICARBONATE ions, PARATHYROID hormone, EXPERIMENTAL design, ELECTROLYTES, DIETARY sodium, CALCIUM, LONGITUDINAL method, DIETARY proteins, COMPARATIVE studies, DIET therapy, DIET in disease, KIDNEYS, DIETARY supplements, SERUM albumin, C-reactive protein, LIVER function tests, DISEASE progression
Abstract

Introduction: The supplementation with Ketoanalogues in patients on very low-protein diets has shown a favorable effect on the evolution of renal function. The aim of the present study was to evaluate the progression of renal function in advanced chronic kidney disease patients on a low-protein diet (<0.8 g/kg/d) with or without additional Ketoanalogues. Methods: The primary criterion is the evolution of the renal function at 6, 12, and 24 months for the two groups. The secondary criteria comprise the evolution of the body weight, mean blood pressure, 24-h proteinuria, salt and protein consumption, energy consumption, hemoglobin levels, serum albumin, prealbumin, C-reactive protein, liver function tests, serum electrolyte and phosphate levels, parathormone as well as calcium levels at the same time periods. Results: There was a significant nephroprotective effect of the Ketoanalogues after 12 and 24 months with no differences in the protein consumption between the two groups. Mean blood pressure, hemoglobin levels, 24-hour proteinuria, serum electrolyte, liver function tests, salt and protein consumption, and serum albumin and prealbumin did not present any significant differences. Serum bicarbonate and calcium levels were higher while serum phosphate and parathormone levels were lower in the Ketoanalogue group at all follow-up time points. During the 24-month follow-up period, 4 patients from the Ketoanalogue group and 8 patients from the control group quit the study. Conclusion: A low-protein diet supplemented with Ketoanalogues exerts significant nephroprotective effects and better bone mineral metabolism parameters compared to a low-protein diet only. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Macular Neovascularization Type Influence on Anti-VEGF Intravitreal Therapy Outcomes in Age-Related Macular Degeneration

Author

Izquierdo-Serra, Jordi, primary, Martin-Pinardel, Ruben, additional, Moll-Udina, Aina, additional, Bernal-Morales, Carolina, additional, Garay-Aramburu, Gonzaga, additional, Sanchez-Monroy, Jorge, additional, Arruabarrena, Carolina, additional, Fernandez-Hortelano, Ana, additional, Figueroa, Marta S., additional, Abraldes, Maximino, additional, Lavid de los Mozos, Francisco Javier, additional, Zapata, Miguel Angel, additional, Ruiz-Moreno, Jose Maria, additional, Broc-Iturralde, Laura, additional, Gonzalez-Guijarro, Jacobo, additional, Escobar-Barranco, Jose Juan, additional, Gallego-Pinazo, Roberto, additional, Parrado-Carrillo, Alba, additional, Dotti-Boada, Marina, additional, Alforja, Socorro, additional, Figueras-Roca, Marc, additional, Barthelmes, Daniel, additional, Gillies, Mark C., additional, Casaroli-Marano, Ricardo P., additional, Zarranz-Ventura, Javier, additional, Izquierdo-Serra, Jordi, additional, Serrano, Alba, additional, Grau, Jose, additional, Sararols-Ramsay, Laura, additional, Londoño, Gabriel, additional, Olivera, Maximiliano, additional, Bañon, Karim, additional, Rethati, Cynthia, additional, Calvo, Pilar, additional, Sánchez, Jorge, additional, Puzo, Martín, additional, Ruiz-Moreno, Oscar, additional, Larrauri-Arana, Arantza, additional, Gómez-Moreno, Angela, additional, Rodríguez-Feijoo, David, additional, Diaz-de-Durana-Santa-Coloma, Enrique, additional, Aldazabal-Echeveste, Maialen, additional, del-Barrio-Lopez-de-Ipiña, Zuriñe, additional, Herrero-Díaz, Irene, additional, García-Arumí, José, additional, Brosa, Helena, additional, Sánchez-Vela, Laura, additional, Montejano-Milner, Rafael, additional, de Aragón, Fernando, additional, Abraldes López-Veiga, Maximino José, additional, Gómez Conde, María Lidia, additional, Rodríguez-Cid, María José, additional, Fernández Rodríguez, María Isabel, additional, Almuiña Varela, Pablo, additional, Fernández-Hortelano, Ana, additional, Zarallo-Gallardo, Jesús, additional, Cobo-Soriano, Rosario, additional, Lozano-Escobar, Inmaculada, additional, Moreno-Martín, Paula, additional, Ruiz-Moreno, Jose M., additional, Vega-González, Rocío, additional, García Zamora, María, additional, Flores-Moreno, Ignacio, additional, Valldeperas, Xavier, additional, Mira, Ferran Vilaplana, additional, Sánchez, Sandra Gómez, additional, Figueroa, Pamela Campos, additional, Fernandez-Bonet, Manel, additional, Pina-Marín, Begoña, additional, Martínez, Eva Salinas, additional, González Guijarro, Jacobo, additional, Acebes García, Muxima, additional, Sanchís, Sonia Aparicio, additional, Fernández, Jonathan Cacelliere, additional, Belmonte Grau, Marta, additional, Ascaso Puyuelo, Francisco Javier, additional, Honrubia Grijalbo, Ana, additional, Boned Murillo, Ana, additional, Díaz Barreda, María Dolores, additional, Rivasés, Guillermo Pérez, additional, El Bakkali, Ismael Bakkali, additional, Cholbi, Marta, additional, Dolz-Marco, Rosa, additional, Ciancas, Esther, additional, Gonzalez-López, Julio José, additional, Haskour, Cesar Azrak, additional, Sánchez, Alvaro Piñero, additional, Muñoz Sanz, Nélida, additional, Carreño, Ester, additional, Ventura, Nestor, additional, Carnota-Méndez, Pablo, additional, Méndez-Vázquez, Carlos, additional, Torres-Borrego, Carlos, additional, Velázquez-Villoria, Daniel, additional, García-Layana, Alfredo, additional, Saenz de Viteri, Manuel, additional, Alonso, Elena, additional, Castillón Torre, Luis J., additional, Muñoz, Pablo Catalán, additional, Sempere, María Eugenia Tena, additional, Álvarez Gil, María de Fátima, additional, Piñas García, Purificación, additional, Mantrana Bermejo, María Eugenia, additional, de los Mozos, Francisco Javier Lavid, additional, Asencio Duran, Mónica, additional, Arias-Barquet, Lluis, additional, Cobos Martín, Estefanía, additional, Parra, Daniel Lorenzo, additional, Rodríguez-Núñez, Marta, additional, Gesto, Ana Campo, additional, Pareja Esteban, Jesús, additional, Ruiz del Tiempo, María del Pilar, additional, Rodríguez-Maqueda, Mariano, additional, Espiñeira Periñan, María Angeles, additional, and Sotomayor Toribio, Magdalena, additional

Published
2023
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6. Macular Neovascularization Type Influence on Anti-VEGF Intravitreal Therapy Outcomes in Age-Related Macular Degeneration

Author

Izquierdo-Serra, Jordi, Martin-Pinardel, Ruben, Moll-Udina, Aina, Bernal-Morales, Carolina, Garay-Aramburu, Gonzaga, Sanchez-Monroy, Jorge, Arruabarrena, Carolina, Fernandez-Hortelano, Ana, Figueroa, Marta S., Abraldes, Maximino, Lavid de los Mozos, Francisco Javier, Zapata, Miguel Angel, Ruiz-Moreno, Jose Maria, Broc-Iturralde, Laura, Gonzalez-Guijarro, Jacobo, Escobar-Barranco, Jose Juan, Gallego-Pinazo, Roberto, Parrado-Carrillo, Alba, Dotti-Boada, Marina, Alforja, Socorro, Figueras-Roca, Marc, Barthelmes, Daniel, Gillies, Mark C., Casaroli-Marano, Ricardo P., Zarranz-Ventura, Javier, Zarranz-Ventura, Javier, Parrado-Carrillo, Alba, Figueras-Roca, Marc, Moll-Udina, Aina, Izquierdo-Serra, Jordi, Serrano, Alba, Grau, Jose, Bernal-Morales, Carolina, Alforja, Socorro, Casaroli-Marano, Ricardo P., Sararols-Ramsay, Laura, Londoño, Gabriel, Olivera, Maximiliano, Bañon, Karim, Rethati, Cynthia, Calvo, Pilar, Sánchez, Jorge, Puzo, Martín, Ruiz-Moreno, Oscar, Garay-Aramburu, Gonzaga, Larrauri-Arana, Arantza, Gómez-Moreno, Angela, Rodríguez-Feijoo, David, Diaz-de-Durana-Santa-Coloma, Enrique, Aldazabal-Echeveste, Maialen, del-Barrio-Lopez-de-Ipiña, Zuriñe, Herrero-Díaz, Irene, García-Arumí, José, Brosa, Helena, Sánchez-Vela, Laura, Zapata, Miguel Angel, Arruabarrena, Carolina, Montejano-Milner, Rafael, de Aragón, Fernando, Abraldes López-Veiga, Maximino José, Gómez Conde, María Lidia, Rodríguez-Cid, María José, Fernández Rodríguez, María Isabel, Almuiña Varela, Pablo, Fernández-Hortelano, Ana, Zarallo-Gallardo, Jesús, Cobo-Soriano, Rosario, Lozano-Escobar, Inmaculada, Moreno-Martín, Paula, Ruiz-Moreno, Jose M., Vega-González, Rocío, García Zamora, María, Flores-Moreno, Ignacio, Valldeperas, Xavier, Broc-Iturralde, Laura, Mira, Ferran Vilaplana, Sánchez, Sandra Gómez, Figueroa, Pamela Campos, Escobar-Barranco, Jose Juan, Fernandez-Bonet, Manel, Pina-Marín, Begoña, Martínez, Eva Salinas, González Guijarro, Jacobo, Acebes García, Muxima, Sanchís, Sonia Aparicio, Fernández, Jonathan Cacelliere, Belmonte Grau, Marta, Ascaso Puyuelo, Francisco Javier, Honrubia Grijalbo, Ana, Boned Murillo, Ana, Díaz Barreda, María Dolores, Rivasés, Guillermo Pérez, El Bakkali, Ismael Bakkali, Gallego-Pinazo, Roberto, Cholbi, Marta, Dolz-Marco, Rosa, Figueroa, Marta S., Ciancas, Esther, Gonzalez-López, Julio José, Haskour, Cesar Azrak, Sánchez, Alvaro Piñero, Muñoz Sanz, Nélida, Carreño, Ester, Ventura, Nestor, Carnota-Méndez, Pablo, Méndez-Vázquez, Carlos, Torres-Borrego, Carlos, Velázquez-Villoria, Daniel, García-Layana, Alfredo, Saenz de Viteri, Manuel, Alonso, Elena, Castillón Torre, Luis J., Muñoz, Pablo Catalán, Sempere, María Eugenia Tena, Álvarez Gil, María de Fátima, Piñas García, Purificación, Mantrana Bermejo, María Eugenia, de los Mozos, Francisco Javier Lavid, Asencio Duran, Mónica, Arias-Barquet, Lluis, Cobos Martín, Estefanía, Parra, Daniel Lorenzo, Rodríguez-Núñez, Marta, Gesto, Ana Campo, Pareja Esteban, Jesús, Ruiz del Tiempo, María del Pilar, Rodríguez-Maqueda, Mariano, Espiñeira Periñan, María Angeles, and Sotomayor Toribio, Magdalena

Abstract

To evaluate the influence of macular neovascularization (MNV) lesion type on 12-month clinical outcomes in treatment-naive eyes with neovascular age-related macular degeneration (nAMD) treated with anti-VEGF drugs nationwide.

Published
2024
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9. Hemodialysis access flow measurement: Comparison of ultrasound dilution and ultrafiltration method on NIKKISO DBB-EXA™ dialysis machine

Author

Georgios Kosmadakis, Ioana Enache, Claudine Gueret, Abraham Haskour, Aura Necoara, Clémence Deville, Julien Baudenon, and Nicole Rance

Subjects
Nephrology, Surgery
Abstract

Background: The methods of estimating vascular access (VA) flow rates are usually based on the indicator dilution theory by measuring recirculation during dialysis sessions. Methods: This is an observational study comparing the VA flow rates measured by NIKKISO DBB-EXA™ and Transonic®. Sixty-five patients (38 M/27 F, mean age 72 ± 10 years) participated in the study. We measured the VA flow rates during dialysis twice with each method and repeated the procedure 7 days later. Results: In 130 double measurements for each method on the same day, mean flow with Transonic® was 1413±715 ml/min and with DBB-EXA™ 1297 ± 664 ml/min. In Bland-Altman analysis, the mean difference between the two methods was 159 ± 211 ml/min (limits of agreement: −274 and 572 ml/min). Eighty-one out of the 130 DBB-EXA™ measurements were within 25% of the Transonic® measurements (62% accuracy). Regarding reproducibility of each method on different days, mean difference in the Bland-Altman analysis was 29 ± 620 ml/min (limits of agreement: −1186 and 1244 ml/min) for the Transonic® measurements and 132 ± 625 ml/min (limits of agreement: −1092 and 1356 ml/min) for the DBB-EXA™ measurements. The measurements on two different days were within 25% of each other for 52 of the 65 patients (80%) with the Transonic® method, and for 35 of the 65 patients (54%) with the DBB-EXA™ method. Conclusions: In conclusion, the DBB-EXA™ method underestimates VA flow rates compared to the Transonic® technique, resulting in a limited accuracy of 62%. There was poor reproducibility for both methods in different day measurements with better performance of the Transonic® technique. The DBB-EXA™ method could be used as a simple tool for a rough estimate of VA flow rates but cannot replace the Transonic® reference method.

Published
2023
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10. MO572: Effects of Ketoanalogues on the Evolution of Bone Mineral Metabolism in Patients With Advanced Chronic Kidney Disease

Author

Georgios Kosmadakis, Myriam Isnard Rouchon, Fanny Fuentes, Nathalie Ramade, Julien Baudenon, Clemence Deville, Ioana Enache, Claudine Gueret, Abraham Haskour, Aura Necoara, and Nicole Rance

Subjects
Transplantation, Nephrology
Abstract

BACKGROUND AND AIMS There is a mounting volume of evidence on the efficacy of ketoanalogues associated with low protein diets, concerning the nephroprotective effects in patients with advanced chronic kidney disease (CKD). The important number of capsules daily ingested associated with their important calcium content would potentially affect the bone mineral metabolism of this group of patients. The aim of this study is to investigate the effects of ketoanalogues on the evolution of the bone mineral metabolism parameters in patients with advanced CKD. METHOD This is a prospective non-randomized controlled comparative study of two groups of patients. The results are shown as mean ± ESM. The first group (intervention) (20 patients, 12/8 M/F, mean age 71.9 ± 2.9, 10 with diabetes) was treated with ketoanalogues associated with a low protein diet and the control group (17 patients, 9/8 M/F, mean age 68.2 ± 3.3, 8 with diabetes) had a conventional follow-up of CKD. We studied the evolution of the body weight, renal function (glomerular filtration rate measured by the CKD-EPI formula in mL/min/1.73 m2), 24 h proteinuria, salt and protein consumption, serum albumin, serum prealbumin, alkaline reserve, serum phosphate levels, serum parathormone levels and calcium levels corrected for serum albumin at baseline as well as 6, 12 and 24 months post-inclusion. We performed a T-test for independent groups in order to study the differences between the two groups in every time point of the study. P-values RESULTS The results are shown in the Table 1. There were no differences between the two groups at baseline. There was a significant nephroprotective effect of the ketoanalogues after 12 and 24 months. Alkaline reserve and serum calcium levels were significantly higher in the intervention group after 6, 12 and 24 months. Serum phosphate and serum parathormone levels were significantly higher in the control group 6 months, 1 and 2 years after the baseline. All patients were treated with the appropriate agents for the correction of the perturbed study parameters. During the 2-year follow-up, four patients from the study group (two pre-emptive renal transplantations, one death from oncologic causes and one start of dialysis) and eight patients from the control group (three deaths and five dialysis initiations) quitted the study. CONCLUSION In conclusion, the treatment with ketoanalogues and low protein diet has a significantly positive impact on the bone mineral metabolism of the patients with advanced CKD. It is unknown whether this is due to the high calcium content of the capsules or from the fact that the renal function is better preserved in the intervention group

Published
2022
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11. MO771: Haemodialysis Access Flow Measurement: Comparison of Ultrasound Dilution and Ultrafiltration Method on Nikisso DBB-EXA™ Dialysis Machine

Author

Georgios Kosmadakis, Myriam Isnard Rouchon, Julien Baudenon, Clemence Deville, Ioana Enache, Claudine Gueret, Abraham Haskour, Aura Necoara, and Nicole Rance

Subjects
Transplantation, Nephrology
Abstract

BACKGROUND AND AIMS The regular measurement of the haemodialysis vascular access (VA) flow demonstrates a protective effect over thrombotic complications [1]. Transonic® Ultrasound dilution technique was first introduced in 1995 and progressively became a method of reference for recirculation and blood flow measurement on haemodialysis VA [2]. It is based on the technique of haemodilution with a certain volume of 0.9% NaCl and the measure of recirculation with inversed lines using the ultrasound technique. Consecutively the VA flow is estimated with a certain formula. Nikisso DBB-EXA™ dialysis machine has the capacity to measure the VA recirculation rate by photometry performing a controlled rise on ultrafiltration rate. The aim of the present study is to compare the VA flow rate between the Transonic® Ultrasound dilution technique and the Nikisso DBB-EXA™ Ultrafiltration method. METHOD The primary outcome of the study is the association of VA flow measured by Transonic® and the Nikisso DBB-EXA™. During the first half of the same dialysis session, we measured the VA recirculation and flow rate twice with the two methods under a constant dialysis blood pump flow of 250–300 mL/min with the ultrafiltration and haemodiafiltration interrupted during the procedure after having reversed the dialysis lines. RESULTS The values are represented as mean ± SD. A total of 18 chronic haemodialysis patients (13 male: 5 female, mean age: 70 ± 14 years) participated in the study. They were haemodynamically stable without acute clinical conditions and were dialysed with a well-functioning arteriovenous fistula for at least 6 months. The mean value of recirculation with inverted dialysis lines for the Transonic® method was 20.79 ± 7.58% and for the Nikisso DBB-EXA™ was 24.43 ± 7.77. The mean values of VA blood flow with the Transonic® method were 1229 ± 588 mL/min and for the Nikisso DBB-EXA™ 1096 ± 490 mL/min. The measured values of the two methods presented a significant positive correlation (by Pearson) (R = 0.920, P CONCLUSION There is a significantly positive correlation concerning the VA flow measurement between the reference method of Transonic® and the Ultrafiltration method offered by the Nikisso DBB-EXA™. Larger studies are needed to confirm this correlation with an additional comparative analysis of the reproducibility of measurements.

Published
2022
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13. MO572: Effects of Ketoanalogues on the Evolution of Bone Mineral Metabolism in Patients With Advanced Chronic Kidney Disease

Author

Kosmadakis, Georgios, primary, Isnard Rouchon, Myriam, additional, Fuentes, Fanny, additional, Ramade, Nathalie, additional, Baudenon, Julien, additional, Deville, Clemence, additional, Enache, Ioana, additional, Gueret, Claudine, additional, Haskour, Abraham, additional, Necoara, Aura, additional, and Rance, Nicole, additional

Published
2022
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