J Teixidó

Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

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Publications (38)67.72 Total impact

  • Medicina Clínica. 07/2013; 114(20):793–794.
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    ABSTRACT: Data on routine use of continuous erythropoietin receptor activator (CERA) in peritoneal dialysis patients are scarce. This study aimed to assess the efficacy of CERA administered once monthly in maintaining stable Hb levels in patients on peritoneal dialysis under routine medical practice. This was a 12-month, observational, prospective and multicenter study. A total of 83 patients with anemia secondary to chronic kidney disease (CKD) on peritoneal dialysis for more than 3 months, on once-monthly subcutaneous CERA treatment, were followed up over a period of 1 year. Efficacy evaluation included Hb levels, mean time in which the Hb level was maintained within target range, CERA doses and number of dose changes. Median Hb level (interquartile range [IQR]) remained stable during the evaluation period [11.8 ± 1.4 g/dL at baseline, 11.8 ± 1.4 g/dL at month 6 and 11.8 ± 1.5 g/dL at month 12 (p > 0.05)]. The median (IQR) time of Hb level maintained within target range (11-13 mg/dL) was 6 (4-10) months. Ferritin, transferrin saturation index, and Fe were also stable and well maintained during the 12 months (p > 0.05). CERA mean dose (SD) was [115.4 (56.2) μg baseline; 117.2 (58.5) μg 6 months; 126.0 (65.9) μg 12 months (p = 0.127)]. The mean number of CERA dose changes per patient during the study was 1.6 (SD 1.3). Serious adverse events were not related to CERA treatment. The results suggest that once-monthly CERA successfully corrects anemia and maintains stable Hb levels within the recommended target range on peritoneal dialysis under routine medical practice.
    Renal Failure 01/2013; · 0.94 Impact Factor
  • Journal of Hypertension - J HYPERTENSION. 01/2010; 28.
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    Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 01/2010; 30(1):28-45. · 1.27 Impact Factor
  • Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 12/2009; 30(1):28-45. · 1.27 Impact Factor
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    ABSTRACT: Post-transplant diabetes mellitus (PTDM) is one of the most im-portant complications in kidney transplant patients because it has a significant impact on graft and patient survival. Diagnosis of PTDM should be based on the American Diabetic Association criteria. Recent studies show the value of performing an oral glu-cose tolerance test in all patients. Multiple risk factors promote PTDM. PTDM incidence may be reduced by controlling modifia-ble factors (immunosuppression, obesity, infections…). Accor-ding to RMRC data, patients on peritoneal dialysis are younger, but have a greater incidence rate of dyslipidemia and obesity. Recent data suggest that subclinical information, adiponectin, and ghrelin may be a significant pathogenetic factor in develop-ment of insulin resistance and diabetes mellitus. There is no clear evidence that the dialysis procedure influences the subclinical in-flammatory state and adipocytokines. According to data from the Spanish group for the study of PTDM, a relationship exists between ghrelin levels and sex in patients on peritoneal dialysis. The most common metabolic complication in patients on perito-neal dialysis is hyperglycemia. Pre-transplant hyperglycemia pro-motes the occurrence of PTDM. There is no clear evidence in the literature showing that the dialysis procedure is a risk factor for the occurrence of PTDM. Additional multicenter studies are re-quired to analyze the clinical and biological characteristics of renal patients and their relationship to PTDM.
    Nefrología. 01/2008; 6:97-102.
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    ABSTRACT: Post-transplant diabetes mellitus (PTDM) is one of the most important complications in kidney transplant patients because it has a significant impact on graft and patient survival. Diagnosis of PTDM should be based on the American Diabetic Association criteria. Recent studies show the value of performing an oral glucose tolerance test in all patients. Multiple risk factors promote PTDM. PTDM incidence may be reduced by controlling modifiable factors (immunosuppression, obesity, infections...). According to RMRC data, patients on peritoneal dialysis are younger, but have a greater incidence rate of dyslipidemia and obesity. Recent data suggest that subclinical information, adiponectin, and ghrelin may be a significant pathogenetic factor in development of insulin resistance and diabetes mellitus. There is no clear evidence that the dialysis procedure influences the subclinical inflammatory state and adipocytokines. According to data from the Spanish group for the study of PTDM, a relationship exists between ghrelin levels and sex in patients on peritoneal dialysis. The most common metabolic complication in patients on peritoneal dialysis is hyperglycemia. Pre-transplant hyperglycemia promotes the occurrence of PTDM. There is no clear evidence in the literature showing that the dialysis procedure is a risk factor for the occurrence of PTDM. Additional multicenter studies are required to analyze the clinical and biological characteristics of renal patients and their relationship to PTDM.
    Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 01/2008; 28 Suppl 6:97-102. · 1.27 Impact Factor
  • J Teixidó, N Arias, L Tarrats, R Romero
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    ABSTRACT: A prospective cohort study was undertaken to compare the rates of the infecting microorganisms of the peritoneal catheter exit-site in three periods of the prophylactic protocol of a peritoneal dialysis program. All patients treated for more than one month on Peritoneal Dialysis were included: Fourty-eight in Period 1 (P1), 48 in Period 2 (P2), and 54 in Period 3 (P3). Each period was of 3 years. Infection prophylaxis protocol: P1: hydrogen peroxide or povidone iodine and non-occlusive dressing; P2: sterile water (boiled water) instead of antiseptic agents, semi-permeable dressing for taking showers, and nasal mupirocine prophylaxis for Staphylococcus aureus carriers; P3: equal to P2, plus local application of antibiotics in equivocal exit-site for infection and argentic nitrate in granulation tissue. Main outcome measure: The rates of catheter infection and microorganisms causing infection were analysed by means of the Poisson regression method. Chi-square and ANOVA when appropriate. The proportion of catheters implanted by nephrologist or surgeon (p<0.01) and modality treatment by CAPD or CCPD (p<0.0001) were significantly different in the three periods, while the Staph. Aureus carrieres was in the limit of significance (p=0.048). Throughout the three periods, a significantly decreasing rate of total (P=0.0035) and acute infections (P<0.001), Staph. aureus (P=0.003) and peritonitis (P=0.0025) were found. The Pseudomonas aer. (P=0.006) and Gram negative Bacteria (P=0.023) decreased significantly in P2. The multiple factor analysis included eight factors: sex, age group, ESRD, DM, catheter implantation (nephrologist, surgeon), modality treatment (CAPD, CCPD), manufacturer and prophylaxis period as possible predictors of the catheter infections, the specific microorganisms and the peritonitis. That analysis revealed the prophylaxis period as the main predictive factor of the improvements found (p<0.02,- p<0.001). In contrast, the Corynebacteria spp. increased significantly (P=0.008) throughout the three periods. One half of the Corynebacteria in each period could be considered colonisers. The other half caused true infections, but not one of those episodes required catheter intervention. The non-diphtheria Corynebacteria increase was found related with the continuous cycling Peritoneal Dialysis treatment in multiple factor analysis (p=0.0023) and in the proportion analysis (P=0.039, c2). The progressive protocol applied obtained good results, without the continued use of local antiseptics or antibiotics at the exit-site. However, the non-diphtheria Corynebacteria sp. infection increment favours the consideration of an antiseptic agent for the exit-site care.
    Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 01/2007; 27(3):350-8. · 1.27 Impact Factor
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    ABSTRACT: Despite the interest generated by the increasing number of studies that measure Quality of Life among patients and caregivers, few of these studies measure the caregivers burden in Peritoneal Dialysis (PD). The main target of this study was to create a burden measure questionnaire applicable amongst caregivers of PD patients. Inclusion criteria: 1) Patients had to be in PD treatment for more than 3 months; 2) Patients had to receive help with the PD treatment from a caregiver. The study was divided into 3 phases: 1st) design and use of the initial questionnaire; 2nd) a test-retest on a modified scale; and 3rd) to provide the questionnaire-3 to two collaborative centres with similar PD programs. Four groups of caregivers were established: A1:23, A2:17, B:7 and C:16 caregivers. We applied 5 scales (5): 1--Patient Dependence on caregiver, from caregivers' view (D); 2--Complete caregiver burden (CB), including 12 items which measure the caregivers' subjective burden, 3--Reduced caregiver burden (RB), as the one before but with only 8 items, 4--Repercussions on the caregiver (R), which measures objective burden; 5--Specific PD tasks (ST), a scale that measures the effort the tasks implied in the PD treatment represent for the caregiver. We studied 63 caregivers (table I): mean age: 53.43 (SD = 12.3); Sex: Females: 86.4%, Males: 13.6%, corresponding to 63 patients: mean age: 59.79 (SD = 15.9); Sex: Males: 80.3%, Females: 19.7%. Valuable results for reliability, unidimensionality, and discrimination were obtained in the 1st and 2nd phases, except for burden scale which was compound of two factors; then one of those factors was suppressed. In the 3rd phase, ANOVA did not show any differences between centres (table II). Consequently, all caregivers could be analysed together. Reliability results for each one of the third phase scales (table III) were: D: Cronbach alpha = 0,886; CB: alpha = 0,894; RB: alpha = 0,857; R: alpha = 0,892; ST: alpha = 0,62. Although the ST scale obtained an acceptable reliability, it was suppressed in the 3rd phase due to the low correlation with other scales and the fact that it was not applicable to all caregivers. Finally, a direct correlation was found between third phase scales (table IV): D-RB: r = 0.502, p < or = 0.001; D-R: r = 0.599, p < or = 0.001; RB-R: r = 0.775, p < or = 0.001. We must headlight that both Burden scales, and the Repercussion scale, obtained a direct correlation with the Dependency scale. A questionnaire has been created to measure burden and repercussions on caregivers of peritoneal dialysis patients. It can already be applied, as requirements of both reliability and validity are fulfilled. This questionnaire can be a useful tool to prevent caregivers' burnout.
    Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 02/2006; 26(1):74-83. · 1.27 Impact Factor
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    ABSTRACT: Introduction: Despite the interest generated by the increasing number of stu-dies that measure Quality of Life among patients and caregivers, few of these stu-dies measure the caregivers burden in Peritoneal Dialysis (PD). Objective: The main target of this study was to create a burden measure ques-tionnaire applicable amongst caregivers of PD patients. Methodology: Inclusion criteria: 1) Patients had to be in PD treatment for more than 3 months; 2) Patients had to receive help with the PD treatment from a ca-regiver. The study was divided into 3 phases:1 st) design and use of the initial ques-tionnaire; 2 nd) a test-retest on a modified scale; and 3 rd) to provide the question-naire-3 to two collaborative centres with similar PD programs. Four groups of caregivers were established: A1:23, A2:17, B:7 and C:16 caregivers. We applied 5 scales (S): 1-Patient Dependence on caregiver, from caregivers' view (D); 2-Complete caregiver burden (CB), including 12 items which measure the caregi-vers' subjective burden, 3-Reduced caregiver burden (RB), as the one before but with only 8 items, 4-Repercussions on the caregiver (R), which measures objec-tive burden; 5-Specific PD tasks (ST), a scale that measures the effort the tasks implied in the PD treatment represent for the caregiver. Results: We studied 63 caregivers (table I): mean age: 53.43 (SD = 12.3); Sex: Females: 86.4%, Males: 13.6%, corresponding to 63 patients: mean age: 59.79 (SD = 15.9); Sex: Males: 80.3%, Females: 19.7%. Valuable results for reliability, unidimensionality, and discrimination were obtai-ned in the 1 st and 2 nd phases, except for burden scale which was compound of two factors; then one of those factors was suppresed. In the 3 rd phase, ANOVA did not show any differences between centres (table II). Consequently, all caregi-vers could be analysed together. Reliability results for each one of the third phase scales (table III) were: D: Cronbach α = 0,886; CB: α = 0,894; RB: α =0,857; R: α = 0,892; ST: α = 0,62. Although the ST scale obtained an acceptable reliability, it was suppresed in the 3 rd phase due to the low correlation with other scales and the fact that it was not applicable to all caregivers. Finally, a direct correlation was found between third phase scales (table IV): D-RB: r = 0.502, p ≤ 0.001; D-R: r = 0.599, p ≤ 0.001; RB-R: r = 0.775, p ≤ 0.001. We must headlight that both Bur-den scales, and the Repercussion scale, obtained a direct correlation with the De-pendency scale.
    01/2006;
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    ABSTRACT: Peripheral neuropathy is usually one of the initial symptoms of necrotizing vasculitis. Early diagnosis is essential for good prognosis. To determine which parameters are useful for early diagnosis and selection of tissue for biopsy. We analyzed the clinical, biological, electromyographic and anatomopathological characteristics of 26 patients with necrotizing vasculitis and peripheral neuropathy. Twelve patients had panarteritis nodosa, three Churg Strauss syndrome, two Wegener s syndrome, two disseminated lupus erythematosis, one sarcoidosis and one Walderstrom s macroglobulinemia. Fifteen patients had multineuritis and the remainder distal mixed polyneuropathy which was symmetrical in three cases. In five cases biopsy was normal. Sural nerve biopsy showed the diagnosis to be correct in 20% of the patients. However, when this was done on a neurophysiologically affected nerve, the tissue was seen to be altered in 61%. Biopsy of the gastrocnemius increased the degree of usefulness to 73% when electromyographic anomalies were detected in this muscle. Neurophysiological study is essential for detection of alterations in patients clinically suspected of having necrotizing vasculitis, even in cases where there is apparently no neuropathy. We recommend biopsy of the gastrocnemius muscle as the first choice in cases where sural nerve neurography is found to be normal. If the sural nerve is not normal, it is the site of choice for biopsy, and muscle biopsy is the site of second choice. When both biopsies are normal, renal biopsy should be considered to establish the diagnosis, as a third alternative.
    Revista de neurologia 01/2001; 33(11):1033-6. · 1.18 Impact Factor
  • Medicina Clínica 06/2000; 114(20):793-4. · 1.40 Impact Factor
  • Transplantation Proceedings 10/1999; 31(6):2324-5. · 0.95 Impact Factor
  • E Casado, S Holgado, J Teixidó, A Olivé
    The Journal of Rheumatology 05/1998; 25(4):822. · 3.26 Impact Factor
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    ABSTRACT: To define protein anabolism or catabolism in our patients we retrospectively studied the 24-hour balances (B24 h), dietary protein intake (DPI), anthropometric parameters [body mass index (BMI), tricipital skin fold thickness (TF), and muscular arm circumference (MAC), using the rating scheme: undernourished (U): percentile (pc) < 15; normal (N): pc > 15 to pc < 85; obese (O): pc > 85], and urea kinetics (protein equivalent of nitrogen appearance) [PNA = PCR according to the Gotch-Borah (G), Blumenkrantz (B), and Randerson (R) formulas]. Nitrogen-balance [N-B = DPI(N)-PNA(N)], metabolic ratio (MR = DPI/PNA), and metabolic index (MI = IDPI/nPNA) were calculated as metabolic indicators. There were 215 evaluations (B24 h) in 44 patients, of whom 29 were male and 15 female, 35 on continuous ambulatory peritoneal dialysis (PD), 9 on automated PD, age 58.2 +/- 15.6 years, followed-up for 15.3 +/- 10.2 months. Undernourished patients (BMI) showed higher N-B, MR, and MI irrespective of the formula used, but MR was only significant using the Blumenkrantz formula. For N-balance and metabolic index, analysis of variance (ANOVA) was significant with all formulas. The mean metabolic index (Randerson) in subgroups was: U: 1.09 +/- 0.27, n = 54; N: 0.90 +/- 0.25, n = 135; O: 0.87 +/- 0.27, n = 26 (ANOVA: P < 0.0001). The U-N and U-O subgroup comparison was significant (Newman-Keuls P < 0.01). We concluded that: (1) The metabolic index is more discriminating for protein metabolism than N-balance or metabolic ratio. (2) Most of the undernourished patients (BMI) are anabolic according to metabolic index and N-balance, and this indicates recovery. (3) Undernourished (low BMI) patients with metabolic index < 1 deserve special attention due to the risk of remaining malnourished.
    Advances in peritoneal dialysis. Conference on Peritoneal Dialysis 02/1998; 14:209-13.
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    ABSTRACT: Peritoneal dialysis patients may need solute permeability transport evaluation during acute peritonitis. The aim of this study was to assess if the simplified mass transfer coefficient (MTCS) or the peritoneal equilibration test (PET) was equivalent to the complex MTC (MTCX) in solute transport evaluation during acute peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. We studied 15 episodes of peritonitis (PTIS). Results were compared to a baseline patient study (PRE) and a control study done 30 days after diagnosis of peritonitis (POST). All peritoneal evaluation methods showed a significant increase in solute transport during acute peritonitis compared to baseline and control studies. There was an acceptable correlation between MTCX and simplified methods including the PET in the baseline and control studies. However, correlation between MTCX and simplified methods decreased during acute peritonitis. Likewise, the PET showed a better correlation with MTCX than MTCS. We conclude that the PET has an acceptable agreement with MTCX even during acute peritonitis, so the PET can be a useful tool in evaluating peritonitis-induced peritoneal permeability changes.
    Advances in peritoneal dialysis. Conference on Peritoneal Dialysis 02/1995; 11:145-8.
  • Nephrology Dialysis Transplantation 02/1995; 10(7):1257-8. · 3.37 Impact Factor
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    ABSTRACT: The association of deep vein thrombosis with systemic necrotizing vasculitis is infrequent. Herein are referred two patients with microscopic polyarteritis and one patient with overlap syndrome who developed deep vein thrombosis which complicated in two cases with pulmonary embolism. The clinical features and the pathogenic mechanisms involved in this infrequent association are analyzed. In two patients the thrombosis was simultaneous with the diagnosis of vasculitis. In one patient deep vein thrombosis was the cause of hospital admission. Advanced age and thrombocytosis are factors associated to vasculitis, which may favor the development of thromboembolic disease. The presence of antiphospholipid syndrome was discarded. Although infrequent, this association should be considered because of the potential severe complications.
    Medicina Clínica 01/1994; 101(20):782-4. · 1.40 Impact Factor
  • M C Pastor, C Sierra, J Bonal, J Teixidó
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    ABSTRACT: alpha-Tocopherol is transferred from serum to erythrocytes by high-density lipoproteins (HDL). We have studied total serum, HDL and erythrocyte tocopherol concentration in uremic patients on hemodialysis (HD; n = 18) and continuous ambulatory peritoneal dialysis (CAPD; n = 14), and the relationship between HDL and erythrocyte tocopherol content. Serum and erythrocyte tocopherol were determined by high-performance liquid chromatography. Serum tocopherol levels were higher in CAPD patients (p < 0.05) than in control (n = 30) and HD groups. Erythrocyte tocopherol was lower in HD patients than in the controls but there were no differences between CAPD patients and the control group. Bioavailable tocopherol was found to be normal in both HD and CAPD patients. HDL-tocopherol was lower in both HD and CAPD groups, but probably enough to reach a normal level of tocopherol in erythrocytes, as has been demonstrated in CAPD patients. So, although a defect in the transfer of tocopherol to red blood cells is possible, some other causes could influence it too, as a greater antioxidant consumption in HD patients.
    American Journal of Nephrology 02/1993; 13(4):238-43. · 2.62 Impact Factor
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    ABSTRACT: The mass transfer area coefficient (MTC) is the best parameter for solute transport evaluation in continuous ambulatory peritoneal dialysis (CAPD) patients. We compared three simplified MTC methods (calculated according Garred, Krediet, or Lindholm) and the peritoneal equilibration test (PET) (Twardowski) to complex MTC (MTCX) (Randerson and Farrell) for urea and creatinine, by means of 29 tests performed in 24 stable CAPD patients. There were no significant differences (paired t-test) between MTCX and each of the simplified MTC, except for creatinine MTC calculated by Krediet's method, which was significantly different (MTCX: 9.36 +/- 4.32, K-MTC: 10.48 +/- 4.55, p < 0.05). Likewise, there was an acceptable correlation between complex MTC and each of the simplified methods including the PET. However, a more detailed study of the MTC's categorizations shows poor agreement with complex MTC categorization. Better results are obtained by PET categorization, which reaches good likelihood ratios either for positive or negative events. We conclude that simplified MTC or the dialysate/plasma ratio at 240 minutes for urea and creatinine has an acceptable correlation with complex MTC and can be useful in clinical practice. There is poor agreement between solute transport categorizations of simplified MTC and complex MTC. There is a better coincidence between the PET (D/P at 240 minutes) and complex MTC categorizations.
    Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 01/1993; 13 Suppl 2:S47-9. · 2.21 Impact Factor