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    Steroid Withdrawal in Pediatric Kidney Transplant Allows Better Growth, Lipids and Body Composition: A Randomized Controlled Trial
    (2013)
    Veronica Mericq
    ;
    Paulina Salas
    ;
    Viola Pinto
    ;
    Francisco Cano
    ;
    Loreto Reyes
    <jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Glucocorticoid immunosuppressant therapy in pediatric kidney transplant (Tx) recipients does not allow the improvement of growth after Tx. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To determine the effect of early steroid withdrawal (SW) on longitudinal growth, insulin sensitivity (IS), and body composition (BC). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; This was a prospective, randomized, multicenter study in Tx. Insulin-like growth factor (IGF)-I, IGF-binding protein 3 (IGFBP3), IS, and BC (DEXA/pQCT) were determined at baseline and up to 12 months after Tx. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A total of 30 patients were examined; 14 patients were assigned to the SW group (7 male, 7 female; 12 in Tanner stage I) and 16 patients were assigned to the steroid control (SC) group (10 male, 6 female;12 in Tanner stage I). Their chronological age was 7.8 ± 4.3 years, height was -2.3 ± 0.99 SD scores (SDS), and body mass index -0.3 ± 1.2 SDS. After 1 year, the SW group showed an increase in height SDS (+1.2 ± 0.22 vs. +0.60 ± 0.13 SDS in the SC group, p &lt; 0.02), lower IGFBP3 (p &lt; 0.05), cholesterol (p &lt; 0.05), and higher high-density lipoprotein cholesterol (p &lt; 0.05). SW patients had lower trunk fat with no differences in IS. Only in prepubertal patients, the SW group had lower glycemia (p &lt; 0.05), very low-density lipoprotein cholesterol (p &lt; 0.01), triglycerides (p &lt; 0.05), triglycerides/glycemia index (TyG; p &lt; 0.02), and better lean mass. Both groups showed an improvement in lean mass after kidney Tx. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; SW improved longitudinal growth, lipid profile, and trunk and lean fat in Tx patients. In prepubertal recipients, the decrease in TyG suggests better IS.</jats:p>
      2Scopus© Citations 25
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    The mini-PET in pediatric peritoneal dialysis: A useful tool to predict volume overload?
    (2013)
    Francisco Cano
    ;
    Angelica Rojo
    ;
    Marta Azocar
    ;
    Maria Jose Ibacache
    ;
    Angela Delucchi
    Scopus© Citations 12  1
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    Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis
    (2011)
    Francisco Cano
    ;
    Claudia Alarcon
    ;
    Marta Azocar
    ;
    Carolina Lizama
    ;
    Ana Maria Lillo
    Scopus© Citations 23  1
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    Urinary Extracellular Vesicles as a Source of NGAL for Diabetic Kidney Disease Evaluation in Children and Adolescents With Type 1 Diabetes Mellitus
    (2022)
    Francisca Ugarte
    ;
    Daniela Santapau
    ;
    Vivian Gallardo
    ;
    Carolina Garfias
    ;
    Anahí Yizmeyián
    <jats:sec><jats:title>Background</jats:title><jats:p>Tubular damage has a role in Diabetic Kidney Disease (DKD). We evaluated the early tubulointerstitial damage biomarkers in type-1 Diabetes Mellitus (T1DM) pediatric participants and studied the correlation with classical DKD parameters.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirty-four T1DM and fifteen healthy participants were enrolled. Clinical and biochemical parameters [Glomerular filtration Rate (GFR), microalbuminuria (MAU), albumin/creatinine ratio (ACR), and glycated hemoglobin A1c (HbA1c)] were evaluated. Neutrophil gelatinase-associated lipocalin (NGAL), Hypoxia-inducible Factor-1α (HIF-1α), and Nuclear Factor of Activated T-cells-5 (NFAT5) levels were studied in the supernatant (S) and the exosome-like extracellular vesicles (E) fraction from urine samples.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the T1DM, 12% had MAU &amp;gt;20 mg/L, 6% ACR &amp;gt;30 mg/g, and 88% had eGFR &amp;gt;140 ml/min/1.72 m<jats:sup>2</jats:sup>. NGAL in the S (NGAL-S) or E (NGAL-E) fraction was not detectable in the control. The NGAL-E was more frequent (p = 0.040) and higher (p = 0.002) than NGAL-S in T1DM. The T1DM participants with positive NGAL had higher age (p = 0.03), T1DM evolution (p = 0.03), and serum creatinine (p = 0.003) than negative NGAL. The NGAL-E correlated positively with tanner stage (p = 0.0036), the median levels of HbA1c before enrollment (p = 0.045) and was independent of ACR, MAU, and HbA1c at the enrollment. NFAT5 and HIF-1α levels were not detectable in T1DM or control.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Urinary exosome-like extracellular vesicles could be a new source of early detection of tubular injury biomarkers of DKD in T1DM patients.</jats:p></jats:sec>
      2Scopus© Citations 18  2
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    Impaired phosphorylation of JAK2-STAT5b signaling in fibroblasts from uremic children
    (2016)
    Francisca Ugarte
    ;
    Carlos Irarrazabal
    ;
    Jun Oh
    ;
    Anne Dettmar
    ;
    María L. Ceballos
      10Scopus© Citations 8
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    FREE WATER TRANSPORT AND ITS ASSOCIATION WITH CARDIOVASCULAR STATUS IN CHILDREN ON PERITONEAL DIALYSIS
    (2019)
    Lilian Bolte
    ;
    Maria Jose Ibacache
    ;
    Francisco Cano
    ;
    DELGADO BECERRA, OROZIMBA IRIS  
    <jats:sec><jats:title>Background</jats:title><jats:p>Volume overload is one of the most important factors associated with left ventricular hypertrophy (LVH) and cardiovascular disease in chronic peritoneal dialysis (PD) patients. MiniPET is a reliable tool to evaluate free water transport (FWT). In a clinical setting, the significance of FWT has not been evaluated in terms of outcome in children on PD. The objective was to define a FWT value of clinical significance in children on PD, fixing its relationship to left ventricular mass index (LVMI) as a well-known outcome parameter.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>MiniPET was performed with 3.86% glucose, 1-h long, to measure FWT in PD patients &gt; 6 years old. An echocardiogram (ECG) was performed within 2 months of the MiniPET. Left ventricular hypertrophy was defined as LVMI ≥ 38.6 g/height<jats:sup>2.7</jats:sup>(95th percentile). Receiver operating characteristic curve (ROC) analysis was used to determine the cut-off value of FWT searching the highest sensitivity and specificity to differentiate patients with normal/abnormal LVMI. A p &lt; 0.05 was considered significant.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Forty-six studies were performed on 32 patients, 16 males; mean age 11.59 ± 3.07 years. Mean normalized FWT (nFWT) was 144.4 ± 84.8 mL/m<jats:sup>2</jats:sup>, corresponding to 46.7% of total ultrafiltration. Mean LVMI was 42 ± 11.3 g/m<jats:sup>2.7</jats:sup>with a negative correlation to nFWT ( p &lt; 0.01). Eighteen out of 32 patients had LVH. The ROC analysis (nFWT vs LVMI) showed an area under the curve of 0.71 (95% confidence interval [CI], 0.53 – 0.89; p = 0.04), allowing a cut-off nFWT value of 110 mL/m<jats:sup>2</jats:sup>to be defined, dividing the population into 2 groups of patients according to the LVMI cut-off value of 38,6 g/m<jats:sup>2.7</jats:sup>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The nFWT showed an inverse correlation to LVMI. A nFWT value &lt; 110 mL/m<jats:sup>2</jats:sup>was significantly associated with LVH. The negative relationship observed between nFWT and LVMI, and the cut-off level for nFWT according to the 95th percentile of LVMI, suggest that the regular evaluation of nFWT could become a useful tool in assessing the capacity of PD treatment to keep patients’ volume status under control, avoiding cardiovascular impairment.</jats:p></jats:sec>
      24Scopus© Citations 1