{"id":4625,"date":"1994-01-01T00:00:00","date_gmt":"1994-01-01T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/1994\/01\/01\/efecto-del-calcitriol-intravenoso-sobre-la-relacion-sigmoidal-calcio-parathormona-en-enfermos-de-dialisis-con-hiperparatiroidismo-severo\/"},"modified":"1994-01-01T00:00:00","modified_gmt":"1994-01-01T00:00:00","slug":"efecto-del-calcitriol-intravenoso-sobre-la-relacion-sigmoidal-calcio-parathormona-en-enfermos-de-dialisis-con-hiperparatiroidismo-severo","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/efecto-del-calcitriol-intravenoso-sobre-la-relacion-sigmoidal-calcio-parathormona-en-enfermos-de-dialisis-con-hiperparatiroidismo-severo\/","title":{"rendered":"Efecto del calcitriol intravenoso sobre la relacion sigmoidal calcio\/parathormona en enfermos de dialisis con hiperparatiroidismo severo."},"content":{"rendered":"<h2>Tesis doctoral de <strong>  Betriu Bars M. Angeles <\/strong><\/h2>\n<p>En pacientes con insuficiencia renal cronica en tratamiento substitutivo con hemodialisis, y con hiperparatiroidismo secundario severo, estudiamos: (1) el efecto inhibidor directo del calcitriol intravenoso sobre la secrecion de parathormona (pth); (ii) el efecto del incremento secuencial de dosis elevadas de calcitriol en enfermos refractarios a dosis mas bajas; (iii) la efectividad del tratamiento a largo plazo (18 meses); (iv) comparamos dos metodos de estudio del funcionalismo glandular (curva sigmoidal calcio\/parathormona, y recta de regresion semilogaritmica calcio\/ln parathormona); (v) analizamos los posibles parametros predictivos de fracaso del tratamiento, y (vi) el indice de fracaso terapeutico y la necesidad de cirugia. Es un estudio prospectivo y secuencial en el que cada paciente es su propio control.  definimos como respuesta al tratamiento, un descenso de la parathormona maxima en un 20% respecto de los valores basales. Asi, de los 10 pacientes incluidos en el estudio, cuatro responden a la dosis inicial de 2 mcg posthemodialisis, y seis no. Al estudiar las diferencias entre los dos grupos antes del tratamiento, encontramos unos niveles significativamente inferiores de pth basal, pth minima, set-point del calcio y fosfatasas alcalinas, en el grupo de los respondedores. De los seis restantes, en tres suspendemos el tratamiento por hiperfosforemia mantenida, y a los otros tres les aumentamos la dosis de forma secuencial a 4 i 6 mcg posthemodialisis. A los tres meses de tratamiento, los 3 pacientes han respondido al aumento de dosis. En el seguimiento a largo plazo: un paciente ha dejado el tratamiento por hipercalcemia, y los 6 restantes siguen con dosis inferiores. Concluimos:  (1) hay un elevado porcentaje de pacientes refractarios a la dosis de 2mcg posthemodialisis; (2) la masa glandular es un buen predictor de la respuesta; (3) el calcio, el set-point y las fosfatasas alcalinas son indicadores de severidad y de<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Efecto del calcitriol intravenoso sobre la relacion sigmoidal calcio\/parathormona en enfermos de dialisis con hiperparatiroidismo severo.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Efecto del calcitriol intravenoso sobre la relacion sigmoidal calcio\/parathormona en enfermos de dialisis con hiperparatiroidismo severo. <\/li>\n<li><strong>Autor:<\/strong>\u00a0  Betriu Bars M. Angeles <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Lleida<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 01\/01\/1994<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jes\u00fas Montoli\u00fa Dur\u00e1n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Manuel Rubio Caballero <\/li>\n<li>Albert Martinez Vea (vocal)<\/li>\n<li>Jaime Aubia Marimon (vocal)<\/li>\n<li>Susan Webb Youndale (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Betriu Bars M. Angeles En pacientes con insuficiencia renal cronica en tratamiento substitutivo con hemodialisis, y con [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[9,851,18842,139,179],"tags":[18856,18854,14064,13713,18855,14065],"class_list":["post-4625","post","type-post","status-publish","format-standard","hentry","category-ciencias-medicas","category-endocrinologia","category-lleida","category-medicina-interna","category-nefrologia","tag-albert-Martinez-vea","tag-betriu-bars-m-angeles","tag-jaime-aubia-marimon","tag-jesus-montoliu-duran","tag-manuel-rubio-caballero","tag-susan-webb-youndale"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/4625","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=4625"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/4625\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=4625"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=4625"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=4625"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}