Nefrologia最新文献

{"title":"Tuberculosis latente vs. tuberculosis activa en pacientes en diálisis: enseñanzas de un estudio epidemiológico en Orense","authors":"Maria Hernansanz Perez, María Jesús Camba Caride, Cristina Pérez Melón, Beatriz Millán Diaz","doi":"10.1016/j.nefro.2023.04.008","DOIUrl":"10.1016/j.nefro.2023.04.008","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000693/pdfft?md5=6cd849145247c84d791e0cd2fa3cca9a&pid=1-s2.0-S0211699523000693-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45196902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hipomagnesemia familiar con hipercalciuria y nefrocalcinosis asociada a hipoacusia neurosensorial","authors":"Javier Burgos Martín, Marina Almenara Tejederas, Salia Pol Heres, Francisco de la Prada Álvares, Mercedes Salgueira Lazo","doi":"10.1016/j.nefro.2021.11.005","DOIUrl":"10.1016/j.nefro.2021.11.005","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699521002629/pdfft?md5=d037e97cdf3067eb24b68a843d2b9152&pid=1-s2.0-S0211699521002629-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46550256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obinutuzumab en el tratamiento de la glomerulonefritis membranosa PLA2R positiva resistente a tratamiento","authors":"Francisco José de la Prada Álvarez, Melissa Cintra Cabrera, Marina Almenara Tejederas, Javier Burgos Martin, Fabiola Alonso García, Mercedes Salgueira Lazo","doi":"10.1016/j.nefro.2023.03.003","DOIUrl":"10.1016/j.nefro.2023.03.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000413/pdfft?md5=ac197f4551c1c6b6bdf1ef31f961fe81&pid=1-s2.0-S0211699523000413-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47273852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asociación de la rigidez aórtica con calcificaciones vasculares abdominales y coronarias en pacientes con enfermedad renal crónica estadios 3 y 4","authors":"Juan Carlos Hidalgo Santiago ,&nbsp;Jary Perelló Martínez ,&nbsp;Javier Vargas Romero ,&nbsp;José Luis Pallares ,&nbsp;Alfredo Michan Doña ,&nbsp;Pablo Gómez-Fernández","doi":"10.1016/j.nefro.2023.06.002","DOIUrl":"10.1016/j.nefro.2023.06.002","url":null,"abstract":"<div><h3>Rationale and objectives</h3><p>Increased central (aortic) arterial stiffness has hemodynamic repercussions that affect the incidence of cardiovascular and renal disease. In chronic kidney disease (CKD) there may be an increase in aortic stiffness secondary to multiple metabolic alterations including calcification of the vascular wall (VC).</p><p>The objective of this study was to analyze the association of central aortic pressures and aortic stiffness with the presence of VC in abdominal aorta (AAC) and coronary arteries (CAC).</p></div><div><h3>Materials and methods</h3><p>We included 87 patients with CKD stage 3 and 4. Using applanation tonometry, central aortic pressures and aortic stiffness were studied. We investigated the association of aortic pulse wave velocity (Pv_c-f) and Pv_c-f adjusted for age, blood pressure, sex and heart rate (Pv_c-f index) with AAC obtained on lumbar lateral radiography and CAC assessed by multidetector computed tomography. AAC and CAC were scored according to Kauppila and Agatston methods, respectively. For the study of the association between iPv_c-f index, Kauppila score, Agatston score, central aortic pressures, clinical parameters and laboratory data, multiple and logistic regression were used. We investigated the diagnosis performance of the Pv_c-f index for prediction of VC using receiver-operating characteristic (ROC).</p></div><div><h3>Results</h3><p>Pv_c-f and Pv_c-f index were 11.3<!--> <!-->±<!--> <!-->2.6<!--> <!-->m/s and 10.6<!--> <!-->m/s, respectively. The Pv_c-f index was higher when CKD coexisted with diabetes mellitus (DM). AAC and CAC were detected in 77% and 87%, respectively.</p><p>Albuminuria (<em>β</em> <span>=</span> <!-->0.13, <em>p</em> <span>=</span> <!-->0.005) and Kauppila score (<em>β</em> <span>=</span> <!-->0.36, <em>p</em> <span>=</span> <!-->0.001) were independently associated with Pv_c-f index. In turn, Pv_c-f index (<em>β</em> <span>=</span> <!-->0.39, <em>p</em> <span>=</span> <!-->0.001), DM (<em>β</em> <span>=</span> <!-->0.46, <em>p</em> <span>=</span> <!-->0.01), and smoking (<em>β</em> <span>=</span> <!-->0.53; <em>p</em> <span>=</span> <!-->0.006) were associated with Kauppila score, but only Pv_c-f index predicted AAC [OR: 3.33 (95% CI: 1.6–6.9; <em>p</em> <span>=</span> <!-->0.001)].</p><p>The Kauppila score was independently associated with the Agatston score (<em>β</em> <span>=</span> <!-->1.53, <em>p</em> <span>=</span> <!-->0.001). The presence of AAC identified patients with CAC with a sensitivity of 73%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 38%.</p><p>The Vp_c-f index predicted the presence of CAC [OR: 3.35 (95% CI: 1.04–10.2, <em>p</em> <span>=</span> <!-->0.04)]. In the ROC curves, using the Vp_c-f index, the AUC for AAC and CAC was 0.82 (95% CI: 0.71–0.93, <em>p</e","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000942/pdfft?md5=8422146c50f5a11e6702ae664ff150ed&pid=1-s2.0-S0211699523000942-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48933325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgA de novo en trasplante renal tras vacunación frente a SARS-CoV-2","authors":"Marta Alonso ,&nbsp;Florentino Villanego ,&nbsp;Óscar Segurado ,&nbsp;Luis Alberto Vigara ,&nbsp;Cristhian Orellana ,&nbsp;Pedro Quiros ,&nbsp;Teresa García ,&nbsp;Auxiliadora Mazuecos","doi":"10.1016/j.nefro.2021.11.002","DOIUrl":"10.1016/j.nefro.2021.11.002","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39792716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esteatosis hepática metabólica y nefropatía diabética: una llamada a la acción","authors":"Salvador Benlloch ,&nbsp;Francesc Moncho ,&nbsp;Jose Luis Górriz","doi":"10.1016/j.nefro.2023.08.005","DOIUrl":"10.1016/j.nefro.2023.08.005","url":null,"abstract":"<div><p>Non-alcoholic fatty liver disease or metabolic-associated fatty liver disease (MAFLD) is a common condition with increasing prevalence and incidence, specially in patients with type 2 diabetes mellitus (DM2). Both cardiovascular and renal disease are clearly increased in these patients, particularly in those with diabetic nephropathy. In the liver–heart–kidney–metabolic axis, the common pathophysiological basis of MAFLD, cardiovascular disease (CVD), chronic kidney disease (CKD), and DM2 is the same. The clinical relationship between all of them is clear and is multidirectional: MAFLD may precede the development of cardiovascular and renal disease, and may also worsen the prognosis of these complications once developed. In this review we emphasize the importance of targeting MAFLD in diabetic kidney disease, with the goal of detecting high-risk patients in order to improve their prognosis.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001303/pdfft?md5=a164520f2ef0d878073739de806745a0&pid=1-s2.0-S0211699523001303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46793369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision making – Should we perform kidney transplantation on a patient with a positive RT-PCR test for SARS-CoV-2?","authors":"Diogo Francisco ,&nbsp;Gonçalo Ávila ,&nbsp;Cristina Jorge ,&nbsp;Kamal Mansinho ,&nbsp;Cristina Toscano ,&nbsp;André Weigert","doi":"10.1016/j.nefro.2022.04.007","DOIUrl":"10.1016/j.nefro.2022.04.007","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manejo de la osteoporosis en el paciente con enfermedad renal crónica (Estudio ERCOS): un desafío en la asistencia nefrológica","authors":"Jordi Bover ,&nbsp;Carlos Gómez-Alonso ,&nbsp;Enrique Casado ,&nbsp;Minerva Rodríguez-García ,&nbsp;María Jesús Lloret ,&nbsp;Cristina Castro-Alonso ,&nbsp;Laia Gifre ,&nbsp;Fernando Henríquez-Palop ,&nbsp;Águeda Prior-Español ,&nbsp;Virginia López de la Manzanara ,&nbsp;Ana María Láiz ,&nbsp;Àngels Martínez-Ferrer ,&nbsp;Josep Vicens Torregrosa ,&nbsp;Secundino Cigarrán ,&nbsp;José Luis Górriz ,&nbsp;Marco Montomoli ,&nbsp;Nayara Panizo ,&nbsp;Ester Costa ,&nbsp;Daniel Martínez-Laguna ,&nbsp;Mariano Rodríguez ,&nbsp;Juan F. Navarro-González","doi":"10.1016/j.nefro.2023.05.002","DOIUrl":"10.1016/j.nefro.2023.05.002","url":null,"abstract":"<div><p>Fracture risk assessment in patients with chronic kidney disease (CKD) has been included in the Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD) complex in international and national nephrology guidelines, suggesting for the first time the assessment of bone mineral density (BMD) if the results will impact treatment decisions. However, there is very little information on actual clinical practice in this population. The main objective of the ERC-Osteoporosis (ERCOS) study is to describe the profile of patients with CKD G3-5D with osteoporosis (OP) and/or fragility fractures treated in specialized nephrology, rheumatology and internal medicine clinics in Spain. Fifteen centers participated and 162 patients (mostly women [71.2%] postmenopausal [98.3%]) with a median age of 77 years were included. Mean estimated glomerular filtration rate (eGFR) was 36<!--> <!-->ml/min/1.73<!--> <!-->m² and 38% of the included patients were on dialysis. We highlight the high frequency of prevalent fragility fractures ([37.7%], mainly vertebral [52.5%] and hip [24.6%]), the disproportionate history of patients with glomerular disease compared to purely nephrological series (corticosteroids) and undertreatment for fracture prevention, especially in nephrology consultations. This study is an immediate call to action with the dissemination of the new, more proactive, clinical guidelines, and underlines the need to standardize a coordinated and efficient multidisciplinary care/therapeutic approach to these patients to avoid current discrepancies and therapeutic nihilism.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000711/pdfft?md5=6fc790a25674c01f7b046e9a50caf655&pid=1-s2.0-S0211699523000711-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46583634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un fracaso renal relacionado con el mundo felino","authors":"Adriana María Cavada Bustamante ,&nbsp;Clara Sanz García ,&nbsp;Natalia Menéndez García ,&nbsp;María Gago Fraile ,&nbsp;Blanca Vivanco Allende ,&nbsp;José Joaquín Bande Fernández","doi":"10.1016/j.nefro.2023.04.003","DOIUrl":"10.1016/j.nefro.2023.04.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000644/pdfft?md5=cf3f49a98f856eb338eafab45b639945&pid=1-s2.0-S0211699523000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49664094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herramientas para un ajuste de dosis de tacrolimus más personalizado en el seguimiento de los pacientes con transplante renal. Fenotipo metabolizador según polimorfismos genéticos del CYP3A vs. el cociente concentración-dosis","authors":"Anna Vidal-Alabró ,&nbsp;Helena Colom ,&nbsp;Pere Fontova ,&nbsp;Gema Cerezo ,&nbsp;Edoardo Melilli ,&nbsp;Núria Montero ,&nbsp;Ana Coloma ,&nbsp;Anna Manonellas ,&nbsp;Alexandre Favà ,&nbsp;Josep M. Cruzado ,&nbsp;Joan Torras ,&nbsp;Josep M. Grinyó ,&nbsp;Núria Lloberas","doi":"10.1016/j.nefro.2022.12.005","DOIUrl":"10.1016/j.nefro.2022.12.005","url":null,"abstract":"<div><h3>Background and justification</h3><p>The strategy of the concentration–dose (C/D) approach and the different profiles of tacrolimus (Tac) according to the cytochrome P450 polymorphisms (CYPs) focus on the metabolism of Tac and are proposed as tools for the follow-up of transplant patients. The objective of this study is to analyse both strategies to confirm whether the stratification of patients according to the pharmacokinetic behaviour of C/D corresponds to the classification according to their CYP3A4/5 cluster metabolizer profile.</p></div><div><h3>Materials and methods</h3><p>Four hundred and twenty-five kidney transplant patients who received Tac as immunosuppressive treatment have been included. The concentration/dose ratio (C/D) was used to divided patients in terciles and classify them according to their Tac metabolism rate (fast, intermediate, and slow). Based on CYP3A4 and A5 polymorphisms, patients were classified into three metabolizer groups: fast (<em>CYP3A5*1</em> and <em>CYP34A*1/*1</em> carriers), intermediate (<em>CYP3A5*3/3</em> and <em>CYP3A4*1/*1</em>) and slow (<em>CYP3A5*3/*3</em> and <em>CYP3A4*22</em> carriers).</p></div><div><h3>Results</h3><p>When comparing patients included in each metabolizer group according to C/D ratio, 47% (65/139) of the fast metabolizers, 85% (125/146) of the intermediate and only 12% (17/140) of the slow also fitted in the homonym genotype group. Statistically lower Tac concentrations were observed in the fast metabolizers group and higher Tac concentrations in the slow metabolizers when compared with the intermediate group both in C/D ratio and polymorphisms criteria. High metabolizers required approximately 60% more Tac doses than intermediates throughout follow-up, while poor metabolizers required approximately 20% fewer doses than intermediates. Fast metabolizers classified by both criteria presented a higher percentage of times with sub-therapeutic blood Tac concentration values.</p></div><div><h3>Conclusion</h3><p>Determination of the metabolizer phenotype according to CYP polymorphisms or the C/D ratio allows patients to be distinguished according to their exposure to Tac. Probably the combination of both classification criteria would be a good tool for managing Tac dosage for transplant patients.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699522002004/pdfft?md5=3426efe7c94d9341a8551d9c29021e41&pid=1-s2.0-S0211699522002004-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41300451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}