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Ymittos Athens, Greece

Karatzas T.,National and Kapodistrian University of Athens | Gompou A.,National Transplant Organization of Greece | Bokos J.,Kidney Transplantation Unit | Dimitroulis D.,National and Kapodistrian University of Athens | And 4 more authors.
International Urology and Nephrology | Year: 2011

Background The utilization of kidney grafts from expanded criteria donors (ECDs) needs to be evaluated within the context of critical organ shortage and graft function and survival. The impact of donor risk variables on kidney transplantation (KTx) outcome was investigated. Methods A retrospective review of 75 KTxs from ECDs over a 5-year period was performed. Donor risk factors were analyzed separately and correlated with recipients graft function and survival. Results Sixty-four recipients out of 75 (85.3%) had functioning grafts 5 years post-transplant. The overall actuarial graft survival rates at 1 through 5 years were 87.5, 68.1, 57.3, 55.4, and 47.3%, respectively. Forty-seven kidneys (62.7%) had early function with actuarial survival of 100.0, 88.3, 75.8, 75.8, and 68.4% at 1-5 years post-transplant, and 28 (37.3%) grafts presented delayed function with substantially decreased actuarial survival, ranging from 66.7 to 23.2%. KTxs from elderly donors had remarkable actuarial survival rates ranging from 100.0 to 67.0%, at 1-5 years, being the best graft survival rates among KTxs from other donor categories. The other donor risk variables when associated with old age had an adverse effect on recipient graft function and survival, but none alone or a combination of the two, showed any significant statistical variability. Conclusion ECDs significantly increased the kidney pool and can be utilized safely if adequate measures are taken. © 2011 Springer Science+Business Media, B.V. Source

Chatzipavlou M.,401 General Military Hospital of Athens | Magiorkinis G.,University of Oxford | Koutsogeorgopoulou L.,General Hospital Laiko | Kassimos D.,Rheumatology Unit
Rheumatology International | Year: 2014

Dietary interventions have been suggested to be a safe cost-efficient way to control hyperuricemia. The aim of the study is to assess the potential of mediterranean diet as intervention to control the level of urate in patients with hyperuricemia in a small sample of patients. Patients with asymptomatic hyperuricemia were recruited from outpatient clinics and were enrolled into personal Mediterranean diet-based programs. Body mass index (BMI), serum urate, lipid profile and indirect calorimetry were measured at the beginning and then monthly for the first 3 months and then at the sixth month. At the same time, patients' compliance with the Mediterranean diet was assessed by a formal interview and standard questionnaire. Only six out of twelve patients managed to complete the diet (dropout rate 50%). Their BMI remained constant during the trial period in the level of 1st degree obesity (BMI = 31.46). The mean value of serum urate at the beginning of the study was 9.12 mg/dl. After the first month, there was a reduction in urate by 20% with mean urate at 6.92 mg/dl. The second, third and sixth month mean urate levels were 6.32, 6.1 and 6.4 mg/dl, respectively. The effect of the mediterranean diet was rapid at the first month and remained constant throughout the dietary intervention, suggesting that it might have a clinically significant effect on urate level thus providing a cost-efficient and safe alternative to pharmaceutical intervention as first-line treatment of hyperuricemia. © Springer-Verlag 2013. Source

Raikou V.D.,National and Kapodistrian University of Athens | Tentolouris N.,National and Kapodistrian University of Athens | Kyriaki D.,General Hospital Laiko | Evaggelatou A.,General Hospital Laiko | Tzanatou H.,National and Kapodistrian University of Athens
Nephron - Clinical Practice | Year: 2011

Background/Aim: Pulse pressure (PP) is a result of arterial stiffness seen in dialysis patients, but may be a consequence of fluid overload. We examined the role of β 2-microglobulin (β 2M) in PP in relation to metabolic alterations in patients on different hemodialysis (HD) modalities. Methods: We studied 76 hemodialyzed patients on regular HD (n = 34), predilution bagged hemodiafiltration (n = 19) and online predilution hemodiafiltration (n = 23). β 2M levels were measured by radioimmunoassay, and the clearance of β 2M was assessed by Kt/V for β 2M. Arterial stiffness was measured as carotid-femoral pulse wave velocity, and PP was derived. Insulin levels were measured using immunoradioassay, and insulin resistance was calculated using homeostasis model assessment insulin resistance (HOMA-IR). Serum bicarbonate levels were measured using a blood gas analyzer, and percent sodium removal was calculated. Results: β 2M levels predict increased PP (p = 0.02) adjusting for age, HD modalities, HD duration, HOMA-IR and percent sodium removal. β 2M was positively associated with HOMA-IR (r = 0.306, p = 0.007). Serum bicarbonate levels and carotid-femoral pulse wave velocity were inversely associated (r = -0.719, p = 0.001). Conclusions: β 2M levels were positively associated with PP, which was influenced mainly by dialysis modality fluid and sodium balance and less by arterial stiffness. β 2M levels were positively associated with insulin resistance. Uremic acidosis may contribute to arterial stiffness. Copyright © 2010 S. Karger AG, Basel. Source

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