Papers by Nicolas Papagalanis
International Angiology, Sep 1, 1996
The long-term effects of the replacement of conventional heparin by low-molecular weight heparin ... more The long-term effects of the replacement of conventional heparin by low-molecular weight heparin (LMWH) on lipid parameters were examined in a large group of hemodialysis patients. One-year prospective investigation. Renal units. A total of 93 patients aged 12-63 years old receiving hemodialysis for 51 (1-172) months were studied. None of the patients had primary hyperlipidemia, diabetes mellitus, or other secondary causes of dyslipidemia. In all patients administration of LMWH was introduced in doses 2500-5000 units. Baseline values of lipoprotein profile prior to the intervention were compared with results obtained after 3, 6 and 12 months of LMWH. During of LMWH treatment a small but statistically significant decrease of total and HDL cholesterol (from 200 +/- 45 mg/dl to 185 +/- 42 mg/dl, p < 0.01, and from 45 +/- 11 mg/dl to 42 +/- 10 mg/dl, p < 0.05, respectively), as well as Apo B (from 128 +/- 36 mg/dl to 121 +/- 35 mg/dl, p < 0.001) was noticed. Moreover, triglycerides decreased significantly (from 175 +/- 73 mg/dl to 146 +/- 62 mg/dl, p < 0.001). The beneficial effects of LMWH were more pronounced in patients with dyslipidemia (total cholesterol > 200 mg/dl, or triglycerides > 200 mg/dl) before the replacement of conventional heparin. The long-term use of LMWH instead of conventional heparin for anticoagulation during dialysis has beneficial effects on the lipoprotein profile, especially in patients with dyslipidemia.
Renal Failure, 2008
There is no consensus about the renal function outcome after revascularization with stenting in a... more There is no consensus about the renal function outcome after revascularization with stenting in atherosclerotic renovascular disease. In the present study, the outcome in BP control and renal function in patients with renovascular disease treated with percutaneous angioplasty and stent placement is compared with the outcome in patients with renovascular disease treated with medical treatment only. Additionally, the impact of oxidative stress and eosinophil count in peripheral blood as predictors of renal function deterioration in renovascular disease irrespective of treatment is investigated. Eighty-two patients with renovascular disease were enrolled into a follow-up study (47.5+/-35.4 months). Thirty-six patients (group 1) underwent revascularization and stenting, and 46 patients (group 2) were on medical treatment only. In all patients, serum creatinine concentration, eosinophil count (EO) in peripheral blood, and estimation of oxidative stress with dROMs test were determined before and at the end of the follow-up. In revascularized patients (group 1), hypertension was cured in 11.1% and improved in 66.6%. Renal function improved in 30.5% and worsened in 36.2% of patients. In the medical treatment arm (group 2), hypertension improved in 71.4% of the patients. Renal function remained stable in 69.8% of patients and worsened in 30.2%. Cox regression analysis showed that higher levels of eosinophil count and higher levels of ROS, irrespectively of mode of treatment, were associated with renal function deterioration (i.e., serum creatinine increase more than 20% during follow-up). Revascularization was not superior to medical treatment in renal survival but had a greater positive impact on blood pressure control. Eosinophil count and oxidative stress were the stronger predictive factors for serum creatinine increase.
American Journal of Hypertension, 1993
Journal of Hypertension, 1991
Nephron, 1994
To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in ... more To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in uninephrectomized subjects with a negative Albustix test, in relation to the time since nephrectomy, the UAE was determined by a double-antibody 125I radioimmunoassay in 3-hour urine collections before and after 150 g OPL under conditions of moderate physical activity in 18 subjects who underwent unilateral nephrectomy more than 10 years (346.5 +/- 178.60 months) before evaluation and had a mean basal creatinine clearance (CCr) of 45.3 +/- 14 ml/min (group 1), in 21 subjects who underwent unilateral nephrectomy less than 10 years (31.5 +/- 28 months) before evaluation and had a mean basal CCr of 76.0 +/- 22 ml/min (group 2), and in 16 normal volunteers (controls) with a mean basal CCr of 103.1 +/- 12 ml/min. The UAE was higher in group 1 as compared with either group 2 or controls at both basal state (90.8 +/- 65, 19.6 +/- 17, and 11.0 +/- 5 micrograms/min/100 CCr for groups 1 and 2 and ...
Nephron, 1991
To evaluate the role of calcium and the parathyroid gland in the pathophysiology of essential hyp... more To evaluate the role of calcium and the parathyroid gland in the pathophysiology of essential hypertension, creatinine clearance, urinary excretion of sodium, calcium and nephrogenous cyclic adenosine monophosphate (NcAMP) and serum parathyroid hormone (PTH) levels were measured in 25 newly diagnosed essentially hypertensive patients before institution of any treatment and in 25 age- and sex-matched normal volunteers. While no significant differences in creatinine clearance, serum total calcium levels or 24-hour sodium excretion existed between the two groups, hypertensives had a higher mean ( ± SD) 24-hour calcium excretion rate (199.0 ± 44.7 vs. 152.8 ± 33.6 mg, p < 0.001), a higher mean NcAMP excretion rate (2.54 ± 0.8 vs. 1.87 ± 0.5 nmol/l00 ml glomerular filtrate, p < 0.001) and a higher mean serum PTH concentration (1.87 ± 0.6 vs. 1.53 ± 0.4 ng/ml, p < 0.001) than the normotensives. A significant positive correlation existed between calcium and sodium excretion in bot...
Renal Failure, 2011
Anemia has been linked to increased mortality and morbidity in renal hemodialysis patients. Other... more Anemia has been linked to increased mortality and morbidity in renal hemodialysis patients. Other risk factors that contribute to an adverse outcome include the variability of hemoglobin (Hb) levels and the decreased response to erythropoiesis-stimulating factors (ESFs). In this study we evaluated the effectiveness of four different ESFs (epoetin-A, epoetin-B, darbepoetin, and CERA), assessed the variability of Hb levels, and compared ESF dosages which contributed to the achievement of Hb levels in each individual patient with renal failure undergoing chronic hemodialysis maintenance. In conclusion, the four ESFs administered are equally effective in the treatment of anemia in renal hemodialysis patients and they do not influence in a different manner the variability of Hb. The administration of darbepoetin-A and CERA might possibly cause more patients to overshoot the target level of Hb.
Renal Failure, 2008
There is no consensus about the renal function outcome after revascularization with stenting in a... more There is no consensus about the renal function outcome after revascularization with stenting in atherosclerotic renovascular disease. In the present study, the outcome in BP control and renal function in patients with renovascular disease treated with percutaneous angioplasty and stent placement is compared with the outcome in patients with renovascular disease treated with medical treatment only. Additionally, the impact of oxidative stress and eosinophil count in peripheral blood as predictors of renal function deterioration in renovascular disease irrespective of treatment is investigated. Eighty-two patients with renovascular disease were enrolled into a follow-up study (47.5+/-35.4 months). Thirty-six patients (group 1) underwent revascularization and stenting, and 46 patients (group 2) were on medical treatment only. In all patients, serum creatinine concentration, eosinophil count (EO) in peripheral blood, and estimation of oxidative stress with dROMs test were determined before and at the end of the follow-up. In revascularized patients (group 1), hypertension was cured in 11.1% and improved in 66.6%. Renal function improved in 30.5% and worsened in 36.2% of patients. In the medical treatment arm (group 2), hypertension improved in 71.4% of the patients. Renal function remained stable in 69.8% of patients and worsened in 30.2%. Cox regression analysis showed that higher levels of eosinophil count and higher levels of ROS, irrespectively of mode of treatment, were associated with renal function deterioration (i.e., serum creatinine increase more than 20% during follow-up). Revascularization was not superior to medical treatment in renal survival but had a greater positive impact on blood pressure control. Eosinophil count and oxidative stress were the stronger predictive factors for serum creatinine increase.
Nephron, 1994
To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in ... more To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in uninephrectomized subjects with a negative Albustix test, in relation to the time since nephrectomy, the UAE was determined by a double-antibody 125I radioimmunoassay in 3-hour urine collections before and after 150 g OPL under conditions of moderate physical activity in 18 subjects who underwent unilateral nephrectomy more than 10 years (346.5 +/- 178.60 months) before evaluation and had a mean basal creatinine clearance (CCr) of 45.3 +/- 14 ml/min (group 1), in 21 subjects who underwent unilateral nephrectomy less than 10 years (31.5 +/- 28 months) before evaluation and had a mean basal CCr of 76.0 +/- 22 ml/min (group 2), and in 16 normal volunteers (controls) with a mean basal CCr of 103.1 +/- 12 ml/min. The UAE was higher in group 1 as compared with either group 2 or controls at both basal state (90.8 +/- 65, 19.6 +/- 17, and 11.0 +/- 5 micrograms/min/100 CCr for groups 1 and 2 and controls, respectively; p &lt; 0.001) and after OPL (92.0 +/- 65, 43.6 +/- 24, and 12.0 +/- 5 micrograms/min/100 CCr for groups 1 and 2 and controls, respectively; p &lt; 0.001). However, the increase in UAE following OPL was significant (p &lt; 0.001) only in group 2 patients. In all patients, the basal UAE was negatively correlated with basal CCr (r = 0.63; p &lt; 0.001) and positively correlated with the time since nephrectomy (r = 0.73; p &lt; 0.001) and with both systolic (r = 0.57; p &lt; 0.001) and diastolic blood pressures (r = 0.69; p &lt; 0.001). CCr calculated using 3-hour urine collections increased more in controls (11.2 +/- 44.2%) than in patient groups 1 (1.6 +/- 0.89) and 2 (7.7 +/- 3.7%; p &lt; 0.001). Basal CCr calculated using 24-hour urine collections the day before the test was negatively correlated with the time since nephrectomy in group 1 (r = -0.69; p &lt; 0.001) and positively correlated with the time since nephrectomy in group 2 (r = 0.89; p &lt; 0.001). Multiple regression analysis revealed that the relationship between CCr and duration of uninephric state was independent of age or systolic and diastolic blood pressures in both patient groups. These results suggest that UAE increase significantly after an OPL in subjects who have been nephrectomized less than 10 years before the study and have basal CCr values higher than 50% of normal.(ABSTRACT TRUNCATED AT 250 WORDS)
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Papers by Nicolas Papagalanis