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Mortality in Patients With Chronic Renal Disease Without Health Insurance in Mexico: Opportunities for a National Renal Health Policy

2018 , Valdez-Ortiz, Rafael , Navarro-Reynoso, Francisco , Olvera-Soto, Guadalupe , Martin-Alemañy, Geovana , Rodríguez-Matías, Adrian , Hernández-Arciniega, Clara Rocío , Cortes-Pérez, Mario , Chávez-López, Ernesto , García-Villalobos, Gloria , Hinojosa-Heredia, Héctor , Camacho-Aguirre, Ana Yetzin , Valdez-Ortiz, Ángel , Cantú Quintanilla, Guillermo Rafael , Gómez-Guerrero, Irma , Reding, Arturo , Pérez-Navarro, Monserrat , Obrador, Gregorio , Correa-Rotter, Ricardo

Despite a systematic increase in the coverage of patients with end-stage renal disease (ESRD) who have received dialytic therapies and transplantation over the past 2 decades, the Mexican health system currently still does not have a program to provide full coverage of ESRD. Our aim was to analyze mortality in patients with ESRD without health insurance.

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The effects of resistance exercise and oral nutritional supplementation during hemodialysis on indicators of nutritional status and quality of life

2016 , Martin-Alemañy, Geovana , Valdez-Ortiz, Rafael , Olvera-Soto, Guadalupe , Gómez-Guerrero, Irma , Aguire-Esquivel, Guillermo , Cantú Quintanilla, Guillermo Rafael , López-Alvarenga, Juan Carlos , Miranda-Alatriste, Paola , Espinosa-Cuevas, Ángeles

Background: Protein-energy wasting (PEW) is common in patients undergoing hemodialysis (HD). Studies have assessed the positive effect of oral nutritional supplementation (ONS) or resistance exercise (RE) on nutritional status (NS) markers in patients undergoing HD. Methods: The aim of this study was to assess the effect of ONS and RE on NS and the quality of life (QOL) of 36 patients undergoing HD. In a randomized clinical trial, patients were divided into the following two groups: a control group (ONS) that received a can of ONS during their HD sessions and an intervention group (ONS + RE) that received a can of ONS and underwent a 40-min session of RE during their HD sessions. Both interventions lasted 12 weeks. The patients' anthropometric, biochemical, dietetic and bioelectrical impedance measurements as well as their QOL, evaluated using the Kidney Disease Quality of Life Short Form, were recorded.

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Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study

2022 , Martin-Alemañy, Geovana , Pérez-Navarro, Monserrat , Wilund, Kenneth R. , García-Villalobos, Gloria , Gómez-Guerrero, Irma , Cantú Quintanilla, Guillermo Rafael , Reyes-Caldelas, Miguel Angel , Espinosa-Cuevas, Angeles , Escobedo, Galileo , Medeiros, Mara , Bennett, Paul N. , Valdez-Ortiz, Rafael

Background: Oral nutritional supplementation (ONS) with or without exercise (EX) could improve muscle mass (MM) in chronic kidney disease. Methods: Patients were randomized into two groups: (1) ONS and (2) ONS + EX. Thigh muscle area (cm2) and intramuscular lipid content via attenuation were evaluated at baseline and 6 months with computed tomography (CT) to measure MM quantity and quality. Physical function was measured by six-minute walk test (6 MWT), gait speed, handgrip strength (HGS), and Time Up and Go test (TUG) at baseline and 3 and 6 months.

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Hemodiálisis intermitente

2017 , Cantú Quintanilla, Guillermo Rafael , Gómez-Guerrero, Irma , Silva García, Carlos , Valdez-Ortiz, Rafael

Señor editor: Enviamos los resultados de una encuesta aplicada a pacientes sometidos a hemodiálisis intermitente en el Hospital General de México (HGM), con el objetivo de indagar las posibles razones de su permanencia en esa situación. ©2017, Salud Pública de México, Instituto Nacional de Salud Publica

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Effect of Oral Nutritional Supplementation With and Without Exercise on Nutritional Status and Physical Function of Adult Hemodialysis Patients: A Parallel Controlled Clinical Trial (AVANTE-HEMO Study)

2020 , Martin-Alemañy, Geovana , Espinosa-Cuevas, María de los Ángeles , Pérez Vera, Monserrat Gabriela , Wilund, Kenneth R. , Miranda-Alatriste, Paola , Cortés-Pérez, Mario , García-Villalobos, Gloria , Gómez-Guerrero, Irma , Cantú Quintanilla, Guillermo Rafael , Ramírez-Mendoza, Marcelo , Valdez-Ortiz, Rafael

Objective: Protein energy wasting affects the nutritional status (NS) and physical function (PF) of dialysis patients. Among the different anabolic strategies to improve NS and PF, oral nutritional supplementation (ONS) and resistance exercise (RE) or aerobic exercise (AE) have been shown to be effective. Nevertheless, the combination of both anabolic strategies has not been completely evaluated. The aim of this study is to assess the effect of exercise combined with ONS versus ONS without exercise during hemodialysis sessions on PF and NS indicators. Methods: Young hemodialysis patients (29 ± 9.3 years) with predominantly unknown causes of renal disease (80%) were divided into the following 3 groups during a period of 12 weeks: (1) ONS (n = 15), (2) ONS + RE (n = 15), and (3) ONS + AE (n = 15). Anthropometric, biochemical, PF, and quality of life measurements were recorded at baseline and after 3 months. Repeated measures analysis of variance and effect sizes (Cohen's d) were used to assess the effect of exercise and nutrition (ISRCTN registry 10251828).