Publications by authors named "Ricardo Muñoz Arizpe"

6 Publications

  • Page 1 of 1

Chronic Kidney Disease in Children Aged 6-15 Years and Associated Risk Factors in Apizaco, Tlaxcala, Mexico, a Pilot Study.

Nephron 2019 5;143(4):264-273. Epub 2019 Sep 5.

Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico, Mexico,

Introduction: Tlaxcala, a small state in central Mexico, has the highest prevalence of chronic kidney disease (CKD) deaths in population aged 5-14 in Mexico, most of them with unknown etiology.

Objective: To determine the prevalence of CKD in apparently healthy pediatric population in Apizaco, Tlaxcala.

Methods: A cross-sectional pilot study was carried out in children deemed as healthy; subjects with previous diagnosis of CKD were excluded. Informed consent was obtained in all cases. A physical examination was performed, a questionnaire was applied. Blood and urine samples were obtained for serum creatinine, urinalysis, and microalbumin/creatinine ratio. A second and third evaluation was performed after 6 and 18 months in those found with urinary anomalies/CKD to confirm the diagnosis.

Results: One hundred and nine subjects completed physical examination, which are the biological samples. Median age was 12 years. CKD stage 2 was confirmed in 5 subjects in the sixth month confirmation visit (4.6%). One patient accepted renal biopsy and Alport Syndrome was found. In a robust multivariate analysis, the risk factors related to reduction in the glomerular filtration rate were males -5.15 mL/min/1.73 m2 (p = 0.002), older participants as by -1.58 mL/min/1.73 m2 per year (p < 0.0001), and among participants living close to a river -3.76 mL/min/1.73 m2 (p = 0.033).

Discussion/conclusion: The prevalence of CKD in the population studied in Apizaco Tlaxcala was confirmed in 4.6 cases per 100 inhabitants between 6 and 15 years. Males, older age, and living close to a river were the risk predictive factors. More studies are needed to determine the causes of the high CKD prevalence in this population.
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http://dx.doi.org/10.1159/000502481DOI Listing
July 2020

[Over-diagnosis of renal tubular acidosis in Mexico].

Rev Invest Clin 2012 Jul-Aug;64(4):399-401

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January 2013

Increased cyclosporine bioavailability induced by experimental nephrotic syndrome in rats.

Can J Physiol Pharmacol 2007 May;85(5):502-6

Departamento de Nefrologia, Hospital Infantil de México Federico Gómez, Dr. Marquez 162, Col. Doctores, Mexico, DF 06720, Mexico.

Components of whole blood and plasma are highly altered during the presentation of nephrotic syndrome. The present study was aimed to explore the influence of nephrotic syndrome on the pharmacokinetics of cyclosporine (CsA) (10 mg/kg) administered i.v. to control or puromycin-induced nephrotic rats (P-NS). We found an increase in CsA bioavailability in the nephrotic group compared with controls. The area under the curve of blood CsA versus time (AUCiv) increased from 27.7 +/- 5.3 to 60.6 +/- 13.8 mug.h.mL-1 in control and P-NS rats, respectively. The AUCiv augmentation was positively correlated with cholesterol levels. On the other hand, the total body clearance was significantly lower (0.38 +/- 0.06 vs. 0.17 +/- 0.03 L.(kg body mass)-1.h-1) and the volume of distribution at steady state (3.70 +/- 0.52 vs. 2.85 +/- 0.32 L/kg) was significantly smaller in nephrotic rats as compared with control. These pharmacokinetic changes lead to a longer terminal half-life of CsA in P-NS rats (11.8 +/- 1.6 vs. 6.9 +/- 0.91 h). We conclude that the physiopathologic changes induced by the nephrotic syndrome in P-NS animals result in a significant increase in CsA blood exposure by both the decrease in drug distribution and the reduction in elimination rate of CsA.
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http://dx.doi.org/10.1139/y07-025DOI Listing
May 2007

Sirolimus pharmacokinetics in pediatric renal transplant recipients receiving calcineurin inhibitor co-therapy.

Pediatr Transplant 2006 Dec;10(8):914-9

Division of Nephrology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.

We have previously reported sirolimus (SRL) pharmacokinetics (PK) in pediatric renal transplant recipients on a calcineurin inhibitor (CNI)-free protocol. We now report pediatric SRL PK in pediatric renal transplant patients receiving SRL + CNI. SRL was dosed to achieve target trough levels between 10 and 20 ng/mL. We performed 49 SRL PK profiles in pediatric renal transplant recipients receiving SRL in combination with either cyclosporine (CsA; 25 profiles), or tacrolimus (TCL; 24 profiles). Ten of the SRL + TCL profiles were obtained from children receiving SRL on a b.i.d. dosing regimen. All other SRL profiles were q.d. regimens. We calculated, the maximum concentration (C(max)), AUC, apparent clearance (aCL; dose/AUC) for dose in mg/m(2), and mean residence time (MRT). SRL levels were measured at 6 and 7 time points for b.i.d. and q.d. dosing, respectively. Regression analysis of SRL trough values vs. AUC showed good correlation in the SRL q.d. + CsA, SRL q.d. + TCL, and SRL b.i.d. + TCL groups (r(2) = 0.95, 0.68, and 0.44, respectively). SRL aCL corrected for body surface area was higher in children aged 0-5 yr receiving SRL with either CsA or TCL. SRL dosing schedule should be tailored to each patient. Higher SRL aCL may be present in younger children when administered with CNI.
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http://dx.doi.org/10.1111/j.1399-3046.2006.00541.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1636453PMC
December 2006

[Renal transplantation in children].

Rev Invest Clin 2005 Mar-Apr;57(2):230-6

Departamento de Nefrología, Hospital Infantil de México Federico Gómez, DF.

Despite being considered a high risk procedure, renal transplantation has been recognized for more than 20 years as the best therapeutic option for children with end-stage renal disease since it is superior than any available dialytic procedure in improving the neuropsychological development and the quality of life. Today pediatric patients have similar graft survival than adults, and 10 year-old children or less have better outcome than any other age group. These remarking results are due to the development of specialized pediatric transplant centers and research programs, improvement in the selection and preparation of donors and recipients, refinement of the surgical technique and the use of new immunossupressive drugs.
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May 2006