Athina Gompou

Laiko Hospital, Athínai, Attica, Greece

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Publications (7)11.21 Total impact

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    ABSTRACT: Serum creatinine (S-Cr) is the most commonly used marker for the assessment of renal function in kidney transplantation (KTx). Cystatin-C (Cys-C) has been proposed as an alternative marker of renal function for the estimated glomerular filtration rate (eGFR), which seems to be more accurate than S-Cr. The aim of this study was to investigate the relationship between changes in S-Cr, Cys-C, and eGFR measurements in KT patients during the early post-transplantation (post-Tx) period. Fifty consecutive patients, aged 15 to 70 years, were subjected to KT. Blood samples were collected at stable time-points on pre-Tx and post-Tx days 2, 6, and 14 and in the third month. Cys-C and S-Cr levels were measured, and GFR was estimated at all time-points using the Cockcroft-Gault and Le Bricon equations. S-Cr and Cys-C levels decreased significantly post-Tx in all time-point determinations compared with pre-Tx levels. Both markers showed a parallel decrease, reaching normal levels in the third month. Estimated GFR post-Tx by S-Cr and Cys-C exhibited a parallel progressive increase without significant difference between the calculations. Correlation between S-Cr and Cys-C in all time-point determinations was positive and of high significance using Pearson's correlation (r = 0.969, P < .01; r = 0.951, P < .01; r = 0.969, P < .01; r = 0.701, P < .01). Also, the correlation between the eGFR by Cys-C and S-Cr was positive and of high significance in all post-Tx calculations (r = 0.896, P < .01; r = 0.935, P < .01; r = 0.929, P < .01; r = 0.861, P < .01). Ten recipients had acute rejection and were treated successfully with antirejection therapy. Their S-Cr, cys-C, and eGFR results were analyzed separately and showed a significant difference from no-rejection patients, with Cys-C being more sensitive to earlier eGFR changes. Cystatin-C is an alternative and accurate marker of renal function in KT patients showing similar diagnostic characteristics to S-Cr. However, Cys-C appears superior to S-Cr in reflecting early GFR temporary changes, which is critical for the early detection of acute rejection. Copyright © 2015 Elsevier Inc. All rights reserved.
    Transplantation Proceedings 07/2015; 47(6):1662-74. DOI:10.1016/j.transproceed.2015.04.084 · 0.98 Impact Factor
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    ABSTRACT: Osmolality is an expression of the number of particles in a given weight of solvent (mOsm). Measured osmolality is determined by the osmometer, and calculated osmolality is estimated by 2xNa + UN/2.8 + glucose/18. The difference between measured and calculated osmolality is the osmolal gap. The purpose of the present study is to determine the measured and the calculated osmolality and the osmolal gap in hemodialyzed uremic patients, pre- and post-hemodialysis (HD). In 24 uremic patients under regular HD, blood samples pre- and post-HD were collected, and serum osmolality measured (osmometer) and calculated (2xNa + UN/2.8 + glucose/18) and the osmolal gap (measured-calculated osmolality) were determined. Also, the same parameters were determined in 22 healthy subjects (control). According to our findings, the measured osmolality in patients is significantly higher pre- and post-HD in comparison to that of controls, but post-HD is significantly lower than pre-HD. Also, calculated osmolality is significantly higher pre- and post-HD in comparison to that of controls, but the value post-HD is significantly lower than the pre-HD. The osmolal gap of patients pre-HD (11 ± 2.08) and post-HD (7.29 ± 1.94) is significantly higher (P < 0.001) in comparison to that of controls (3.18 ± 1.46); also, the value post-HD is significantly decreased in comparison to the value pre-HD (P < 0.001). Uremic hemodialyzed patients present high measured and calculated osmolality pre-HD that remains high post-HD in comparison to that of controls in spite of the significant decrease post-HD in comparison to that of pre-HD. Also, the osmolal gap is high pre-HD and, in spite of the decrease, remains high post-HD. In comparison to that of controls, the high osmolal gap indirectly indicates the presence of unidentified endogenous osmoles in the serum of uremic patients which partly are removed during HD.
    Artificial Organs 08/2011; 36(1):16-20. DOI:10.1111/j.1525-1594.2011.01293.x · 2.05 Impact Factor
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    ABSTRACT: 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. 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. 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. ECDs significantly increased the kidney pool and can be utilized safely if adequate measures are taken.
    International Urology and Nephrology 03/2011; 43(4):1211-9. DOI:10.1007/s11255-011-9930-0 · 1.52 Impact Factor
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    ABSTRACT: Vitamin K is involved in bone metabolism, and the clinical use of vitamin K antagonists as an anticoagulant may increase the risk of bone fracture. In our renal unit, approximately 140 uremic patients were hemodialyzed. From these patients, 11 have been under anticoagulant treatment for a long time. For the last 2 years, 5 patients presented with bone fracture, and 4 of them were undergoing oral anticoagulant treatment (acenocoumarol 1 mg daily). The dose was modified according to international normalized ratio (INR) units. The use of vitamin K antagonists as anticoagulants has been considered a cause of bleeding and is related to low bone-mineral density and a high risk of fracture. In our data, the number of patients who received oral anticoagulants (11 patients) and the number of them who presented with bone fracture (4 patients) raises the suspicion that there is an association between anticoagulant treatments and bone fractures.
    05/2010; 39(5):205-207. DOI:10.1002/dat.20427
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    ABSTRACT: This study assessed prealbumin in hemodialysis (HD) and renal-transplant (RT) patients, and compared it with other biochemical and anthropometric markers, clinical conditions, and treatment variables. We used a research design. Serum prealbumin was measured in 84 HD patients with a mean age of 60.47 +/- 17.81 years and a mean body mass index (BMI) of 24.38 +/- 4.87 kg/m(2), and in 154 RT patients with a mean age of 44.08 +/- 13.59 years and a mean BMI of 24.97 +/- 3.87 kg/m(2). Renal-transplant patients were divided into three groups, based on year of renal transplantation (first year, first to second year, and third to tenth year). Serum albumin, creatinine, cholesterol, glucose, triglycerides, white blood cells, BMI, midarm circumference, and triceps and biceps skinfolds were measured. Prealbumin levels were significantly higher in HD patients compared with RT patients. Both groups had prealbumin levels <30 mg/dL, but almost all RT patients in our study had prealbumin levels <20 mg/dL. Gender, age, and presence of anemia, hypertension, and diabetes did not significantly affect prealbumin levels in the two groups. Prealbumin levels were significantly positively correlated with duration of dialysis in the HD group and with albumin in the RT group. Hemodialysis patients have higher levels of prealbumin compared with RT patients. Prealbumin levels are below normal range in both groups of patients. Prealbumin reflects nutritional status in RT patients, but is also affected by other factors.
    Journal of Renal Nutrition 10/2009; 20(1):44-51. DOI:10.1053/j.jrn.2009.04.001 · 1.87 Impact Factor
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    ABSTRACT: The aim of this retrospective study was to evaluate the International Normalized Ratio (INR) in hemodialyzed uremic patients under treatment with oral anticoagulation drugs. Eleven out of one hundred and forty-two uremic hemodialyzed patients in our unit were included in the study. These 11 patients aged from 70 to 85 (mean: 76 years) were under oral anticoagulation treatment for protection from thromboembolic events. They received 1 mg acenocumarol daily with the therapeutic goal of achieving an INR between 2 and 2.5 units. During the last year, the number of total INR determinations was 129. Based on the INR levels, measurements were classified into three categories of anticoagulation, termed "under-anticoagulation", "target-anticoagulation", and "over-anticoagulation". The number, the percentage, and the mean value (+/-SD) of INR measurements for each category, respectively, were under-anticoagulation: 39, 30%, 1.78 +/- 0.14; target-anticoagulation: 48, 37.5%, 2.20 +/- 0.14; and over-anticoagulation: 42, 32.5%, 3.14 +/- 0.64. The mean value +/-SD of all INR determinations (n=129) was 2.34 +/-0.65. No thromboembolic or major bleeding events occurred in our patients with these INR. In conclusion, in elderly, hemodialyzed uremic patients with indications for oral anticoagulation treatment, adequate and safe INR levels can be achieved in a high proportion without serious deviations from the therapeutic goal by using low doses of drugs. Therefore, oral anticoagulation therapy should not be considered automatically contra-indicated in this patient group.
    The International journal of artificial organs 10/2009; 32(10):752-5. · 0.96 Impact Factor
  • Transplantation 07/2008; 86(Supplement). DOI:10.1097/ · 3.83 Impact Factor