Nefrologia最新文献

{"title":"Desafíos ambientales en hemodiálisis: explorando la ruta hacia la sostenibilidad","authors":"Marta Arias-Guillén ,&nbsp;Rodrigo Martínez Cadenas ,&nbsp;Miquel Gómez ,&nbsp;Natalia Martín Vaquero ,&nbsp;Gerard Pereda ,&nbsp;Julia Audije-Gil ,&nbsp;Jesús Portillo ,&nbsp;Marta Quintela ,&nbsp;Itziar Castaño ,&nbsp;Antonio Luque ,&nbsp;Francesc Maduell ,&nbsp;Alberto Ortiz ,&nbsp;Brett Duane ,&nbsp;M. Dolores Arenas ,&nbsp;en representación del Grupo de Trabajo de Hemodiálisis en Centro de la Sociedad Española de Nefrología y del Grupo de Trabajo de Sostenibilidad en Nefrología","doi":"10.1016/j.nefro.2024.06.001","DOIUrl":"10.1016/j.nefro.2024.06.001","url":null,"abstract":"<div><div>Hemodialysis is a treatment with a significant environmental impact. One dialysis cycle is equivalent to the daily consumption of 3.5-4 people, and the average annual electricity consumption of a center is equivalent to that of approximately 2.5 to 3 households (9 kWh/day per household). The carbon footprint (kg CO₂ equivalent) measures direct and indirect greenhouse gas emissions and is influenced by the production of the various materials used, their transport, patients, and healthcare personnel. In this context, it is necessary to understand the real impact of each center on the environment and act sustainably. The aim of this review is to analyze the environmental footprint generated by dialysis, rethink processes, and propose management strategies to provide tools applicable to any unit to reduce the negative impact of this activity. Each center must measure and monitor indicators, set its own standards, design improvement plans, and carry out annual monitoring in a multidisciplinary manner.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 784-795"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406564","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":"Microangiopatía trombótica tras el tratamiento de infección por parvovirus B19 en trasplantado renal. Una presentación infrecuente","authors":"","doi":"10.1016/j.nefro.2024.01.004","DOIUrl":"10.1016/j.nefro.2024.01.004","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 750-752"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000043/pdfft?md5=4aa0df1a1d337bcc3ee7371dc9c7580b&pid=1-s2.0-S0211699524000043-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139633407","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":"Perfilando la hipersensibilidad al dializador de hemodiálisis","authors":"","doi":"10.1016/j.nefro.2024.03.005","DOIUrl":"10.1016/j.nefro.2024.03.005","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 747-749"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000274/pdfft?md5=50a278cc15d55d2fcc88ea794ba4c71d&pid=1-s2.0-S0211699524000274-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402969","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":"Gender distribution among editorial boards and authors of nephrology and urology journals","authors":"","doi":"10.1016/j.nefro.2024.02.004","DOIUrl":"10.1016/j.nefro.2024.02.004","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 764-766"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000158/pdfft?md5=9ea3498ec756896046ef6ba6864f73c2&pid=1-s2.0-S0211699524000158-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140092340","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":"¿Es posible alcanzar el objetivo de catéteres propuesto por las guías? Razones que determinan el uso de catéter en pacientes prevalentes en hemodiálisis","authors":"","doi":"10.1016/j.nefro.2023.12.004","DOIUrl":"10.1016/j.nefro.2023.12.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the recommendations of the clinical guidelines, the percentage of central venous catheters (CVC) continues to be above the recommended standards. We do not know whether the increasing use of catheters is due to unavoidable or avoidable factors and, in the latter case, it would be in our power to modify these results.</p><p>The aim of this study was to analyze the causes that condition the use of CVC in a prevalent hemodialysis (HD) population in order to identify those modifiable factors on which to act in order to achieve the objectives of the guidelines.</p></div><div><h3>Methods</h3><p>Retrospective, descriptive and observational study in all prevalent patients on chronic hemodialysis belonging to seven hemodialysis centers in Madrid, Castilla y León and Galicia in a cross-sectional study carried out in June 2021 (637 patients). The following were analyzed: age, sex, nationality, etiology of CKD, the vascular access with which they started hemodialysis, the number of previous failed arteriovenous fistulas (AVF), time since the start of HD, time since the placement of the CVC for the first time, the situation with respect to surgery and the causes of being a CVC carrier. In patients whose cause was refusal to undergo AVF, patients were asked about the cause of the refusal by directed questioning.</p></div><div><h3>Results</h3><p>Of the 637 patients studied, 255 (40%) had a CVC, 346 had an AVF (54.3%) and 36 (5.7%) had a prosthesis. Of the 255 patients with CVC, 20.4% (52 patients) were awaiting vascular access (AVF/prosthesis), 10.2% (26 patients) had an AVF but could not be used and 69.4% (177 patients) were not considered candidates for surgery (due to vascular surgery (16.9%; 43 patients), nephrology (16.5%, 42 patients) and patient refusal (36%; 92 patients). The most frequent cause for refusal of AVF was fear and patient preference. One of the most important factors associated with CVC use in prevalent patients was having started hemodialysis with a CVC. The greatest use of CVC at the start of HD was significantly associated with having more than one AVF performed or starting HD urgently and not having been followed up and evaluated in the ACKD consultation.</p></div><div><h3>Conclusions</h3><p>There is a high percentage of patients with a central venous catheter due to modifiable causes, which makes it necessary to systematically evaluate the process of creating AVF in order to enhance the planning, creation and maintenance of vascular access from the ACKD clinic, and to achieve the objective of the guidelines.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 700-708"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001923/pdfft?md5=0fff231597c8f510f752854c4820974b&pid=1-s2.0-S0211699523001923-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193262","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":"Sialoadenitis por contrastes iodados en pacientes con insuficiencia renal crónica, papel de la hemodiálisis","authors":"","doi":"10.1016/j.nefro.2024.01.001","DOIUrl":"10.1016/j.nefro.2024.01.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 761-762"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000018/pdfft?md5=fc7f8f50d772884cc4a3ef42a8f26ae3&pid=1-s2.0-S0211699524000018-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139392036","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":"¿Qué significa el hallazgo de cilindros de amiloide en el mieloma múltiple?","authors":"","doi":"10.1016/j.nefro.2024.02.007","DOIUrl":"10.1016/j.nefro.2024.02.007","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 752-755"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000183/pdfft?md5=a9d4c54efb8802dfe84e78d72d962e1c&pid=1-s2.0-S0211699524000183-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140092246","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":"Factores de progresión en pacientes con ERC-3 KDOQI (estudio PROGRESER)","authors":"","doi":"10.1016/j.nefro.2024.02.009","DOIUrl":"10.1016/j.nefro.2024.02.009","url":null,"abstract":"<div><h3>Introduction</h3><p>The PROGRESER study is a multicentre, prospective, observational, 3-year follow-up study of a cohort of patients with stage<!--> <!-->3 chronic kidney disease (CKD) from different nephrology departments of hospitals in the Spanish healthcare system. The primary study objective was to analyse risk factors for CKD progression, identifying possible differences between patients with and without diabetes mellitus (DM). The secondary objective was to analyse the factors associated with hospitalizations and mortality.</p></div><div><h3>Patients and methods</h3><p>A total of 462 patients (342 men and 120 women; mean age 66.5<!--> <!-->±<!--> <!-->11.5 years) were recruited from 25 participating sites in Spain. Clinical, epidemiological and analytical data were recorder in an electronic register each six months. Biological samples were obtained and frozen for a biobank record at baseline and at 18 and 36 months.</p></div><div><h3>Results</h3><p>The initial mean glomerular filtration rate estimated by MDRD and after that reestimated by CKD-EPI was 43.9<!--> <!-->±<!--> <!-->7.9<!--> <!-->mL/min/1.73<!--> <!-->m²; and 29<!--> <!-->±<!--> <!-->6,8<!--> <!-->mL/min/1,73<!--> <!-->m² at 3<!--> <!-->years. 27.3% of patients had microalbuminuria and 22.5% had macroalbuminuria. Two-thirds of the patients (66.2%) presented renal damage progression according to the study criteria (decrease of more than 15% in eGFR over the baseline value). 38.7% presented a reduction in eGFR ≥<!--> <!-->30%; 20.3% had a reduction in eGFR ≥<!--> <!-->40%; 10.4% had a reduction ≥<!--> <!-->50% and 6.9% had a reduction ≥<!--> <!-->57%. Of the 199 diabetics, 134 (67.3%) suffered renal damage progression. Of the 263 non-diabetics, 172 (65.3%) presented progression (<em>P</em> <!-->=<!--> <!-->.456). 27.3% of patients had microalbuminuria and 22.5% proteinuria. The study found that CKD progression to a higher stage was not greater in diabetic compared to non-diabetic patients. Multivariate analysis revealed that the presence of arterial hypertension bordered on significance as a progression factor in non-diabetic patients (<em>P</em> <!-->=<!--> <!-->.07), and that, in diabetic patients, lower calcium levels and elevated intact parathyroid hormone levels at baseline were associated with progression.</p></div><div><h3>Conclusion</h3><p>In our study we have not found new factors for progression of renal damage, different from the yet well known traditional factors. DM <em>per se</em> was not a differential factor for progression in relation with non DM patients. Progression of renal damage in patients with CKD-3 KDOQI may be interpreted in a multifactorial context. The search for new biomarkers, different from traditional ones, is necessary to establish new therapeutic strategies to prevent the progression of CKD.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 689-699"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000201/pdfft?md5=883c8bad19442d231ff24c58b5d724c1&pid=1-s2.0-S0211699524000201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281521","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":"Alogliptina y nefritis tubulointersticial: una complicación potencial","authors":"","doi":"10.1016/j.nefro.2024.03.006","DOIUrl":"10.1016/j.nefro.2024.03.006","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 755-757"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699524000286/pdfft?md5=2fc9f2821c894788568fd8ef0c9ce6c5&pid=1-s2.0-S0211699524000286-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402947","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":"40 años de experiencia en síndrome de Bartter","authors":"","doi":"10.1016/j.nefro.2023.11.004","DOIUrl":"10.1016/j.nefro.2023.11.004","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 5","pages":"Pages 766-768"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001753/pdfft?md5=d921612100f3220212d982aa270cfd2b&pid=1-s2.0-S0211699523001753-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139297624","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}