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Nurmi J, Paju A, Brumley BB, Insoll T, Ovaska AK, Soloveva V, Vaaranen-Valkonen N, Aaltonen M, Arroyo D. Investigating child sexual abuse material availability, searches, and users on the anonymous Tor network for a public health intervention strategy. Sci Rep 2024; 14:7849. [PMID: 38570603 PMCID: PMC10991312 DOI: 10.1038/s41598-024-58346-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024] Open
Abstract
Tor is widely used for staying anonymous online and accessing onion websites; unfortunately, Tor is popular for distributing and viewing illicit child sexual abuse material (CSAM). From 2018 to 2023, we analyse 176,683 onion domains and find that one-fifth share CSAM. We find that CSAM is easily available using 21 out of the 26 most-used Tor search engines. We analyse 110,133,715 search sessions from the Ahmia.fi search engine and discover that 11.1% seek CSAM. When searching CSAM by age, 40.5% search for 11-year-olds and younger; 11.0% for 12-year-olds; 8.2% for 13-year-olds; 11.6% for 14-year-olds; 10.9% for 15-year-olds; and 12.7% for 16-year-olds. We demonstrate accurate filtering for search engines, introduce intervention, show a questionnaire for CSAM users, and analyse 11,470 responses. 65.3% of CSAM users first saw the material when they were children themselves, and half of the respondents first saw the material accidentally, demonstrating the availability of CSAM. 48.1% want to stop using CSAM. Some seek help through Tor, and self-help websites are popular. Our survey finds commonalities between CSAM use and addiction. Help-seeking correlates with increasing viewing duration and frequency, depression, anxiety, self-harming thoughts, guilt, and shame. Yet, 73.9% of help seekers have not been able to receive it.
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Affiliation(s)
- Juha Nurmi
- Tampere University, FI-33720, Tampere, Finland.
| | - Arttu Paju
- Tampere University, FI-33720, Tampere, Finland
| | | | - Tegan Insoll
- Suojellaan Lapsia, Protect Children ry., FI-00580, Helsinki, Finland
| | - Anna K Ovaska
- Suojellaan Lapsia, Protect Children ry., FI-00580, Helsinki, Finland
| | - Valeriia Soloveva
- Suojellaan Lapsia, Protect Children ry., FI-00580, Helsinki, Finland
| | | | - Mikko Aaltonen
- University of Eastern Finland, FI-80101, Joensuu, Finland
| | - David Arroyo
- Consejo Superior de Investigaciones Científicas, 28014, Madrid, Spain
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García-Prieto AM, Verdalles Ú, de José AP, Arroyo D, Aragoncillo I, Barbieri D, Camacho RE, Goicoechea M. Renin-angiotensin-aldosterone system blockers effect in chronic kidney disease progression in hypertensive elderly patients without proteinuria: PROERCAN trial. Hipertens Riesgo Vasc 2024; 41:95-103. [PMID: 38508877 DOI: 10.1016/j.hipert.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Evidence about nefroprotective effect with RAAS blockers in elderly patients with chronic kidney disease (CKD) without proteinuria is lacking. The primary outcome of our study is to evaluate the impact of RAAS blockers in CKD progression in elderly patients without proteinuria. MATERIALS AND METHODS Multicenter open-label, randomized controlled clinical trial including patients over 65 year-old with hypertension and CKD stages 3-4 without proteinuria. Patients were randomized in a 1:1 ratio to either receive RAAS blockers or other antihypertensive drugs and were followed up for three years. Primary outcome is estimated glomerular filtration rate (eGFR) decline at 3 years. Secondary outcome measures include BP control, renal and cardiovascular events and mortality. RESULTS 88 patients were included with a mean age of 77.9±6.1 years and a follow up period of 3 years: 40 were randomized to RAAS group and 48 to standard treatment. Ethiology of CKD was: 53 vascular, 16 interstitial and 19 of unknown ethiology. In the RAAS group eGFR slope during follow up was -4.3±1.1ml/min, whereas in the standard treatment group an increase on eGFR was observed after 3 years (+4.6±0.4ml/min), p=0.024. We found no differences in blood pressure control, number of antihypertensive drugs, albuminuria, potassium serum levels, incidence of cardiovascular events nor mortality during the follow up period. CONCLUSIONS In elderly patients without diabetes nor cardiopathy and with non proteinuric CKD the use of RAAS blockers does not show a reduction in CKD progression. The PROERCAN (PROgresión de Enfermedad Renal Crónica en ANcianos) trial (trial registration: NCT03195023).
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Affiliation(s)
- A M García-Prieto
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Ú Verdalles
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A P de José
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - D Arroyo
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - I Aragoncillo
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - D Barbieri
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - R E Camacho
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - M Goicoechea
- RICORS 2040, Instituto de Salud Carlos III, Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Caravaca-Fontán F, Stevens K, Padrón M, Huerta A, Montomoli M, Villa J, González F, Vega C, López Mendoza M, Fernández L, Shabaka A, Rodríguez-Moreno A, Martín-Gómez A, Labrador PJ, Molina Andújar A, Prados Soler MC, Martín-Penagos L, Yerovi E, Medina Zahonero L, De La Flor JC, Mon C, Ibernon M, Rodríguez Gómez A, Miquel R, Sierra M, Mascarós V, Luzardo L, Papasotiriou M, Arroyo D, Verdalles Ú, Martínez-Miguel P, Ramírez-Guerrero G, Pampa-Saico S, Moral Berrio E, Canga JLP, Tarragón B, Fraile Gómez P, Regidor D, Relea J, Xipell M, Andrades Gómez C, Navarro M, Álvarez Á, Rivas B, Quintana LF, Gutiérrez E, Pérez-Valdivia MÁ, Odler B, Kronbichler A, Geddes C, Anders HJ, Floege J, Fernández-Juárez G, Praga M. Sodium-glucose cotransporter 2 inhibition in primary and secondary glomerulonephritis. Nephrol Dial Transplant 2024; 39:328-340. [PMID: 37550217 DOI: 10.1093/ndt/gfad175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the management glomerular/systemic autoimmune diseases with proteinuria in real-world clinical settings is unclear. METHODS This is a retrospective, observational, international cohort study. Adult patients with biopsy-proven glomerular diseases were included. The main outcome was the percentage reduction in 24-h proteinuria from SGLT2i initiation to 3, 6, 9 and 12 months. Secondary outcomes included percentage change in estimated glomerular filtration rate (eGFR), proteinuria reduction by type of disease and reduction of proteinuria ≥30% from SGLT2i initiation. RESULTS Four-hundred and ninety-three patients with a median age of 55 years and background therapy with renin-angiotensin system blockers were included. Proteinuria from baseline changed by -35%, -41%, -45% and -48% at 3, 6, 9 and 12 months after SGLT2i initiation, while eGFR changed by -6%, -3%, -8% and -10.5% at 3, 6, 9 and 12 months, respectively. Results were similar irrespective of the underlying disease. A correlation was found between body mass index (BMI) and percentage proteinuria reduction at last follow-up. By mixed-effects logistic regression model, serum albumin at SGLT2i initiation emerged as a predictor of ≥30% proteinuria reduction (odds ratio for albumin <3.5 g/dL, 0.53; 95% CI 0.30-0.91; P = .02). A slower eGFR decline was observed in patients achieving a ≥30% proteinuria reduction: -3.7 versus -5.3 mL/min/1.73 m2/year (P = .001). The overall tolerance to SGLT2i was good. CONCLUSIONS The use of SGLT2i was associated with a significant reduction of proteinuria. This percentage change is greater in patients with higher BMI. Higher serum albumin at SGLT2i onset is associated with higher probability of achieving a ≥30% proteinuria reduction.
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Affiliation(s)
| | - Kate Stevens
- Department of Nephrology and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Maite Padrón
- Department of Nephrology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Ana Huerta
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Marco Montomoli
- Department of Nephrology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Juan Villa
- Department of Nephrology, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Fayna González
- Department of Nephrology, Hospital Doctor Negrín, Gran Canaria, Spain
| | - Cristina Vega
- Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
| | - Manuel López Mendoza
- Department of Nephrology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Loreto Fernández
- Department of Nephrology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Amir Shabaka
- Department of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | | | - Pedro J Labrador
- Department of Nephrology, Hospital San Pedro de Alcántara, Cáceres, Spain
| | | | | | - Luis Martín-Penagos
- Department of Nephrology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Estefanía Yerovi
- Department of Nephrology, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Carmen Mon
- Department of Nephrology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Meritxell Ibernon
- Department of Nephrology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | | | - Rosa Miquel
- Department of Nephrology, Hospital Universitario Canarias, Tenerife, Spain
| | - Milagros Sierra
- Department of Nephrology, Hospital San Pedro de Logroño, La Rioja, Logroño, Spain
| | - Victoria Mascarós
- Department of Nephrology, Hospital Francesc de Borja, Gandia, Valencia, Spain
| | - Leonella Luzardo
- Department of Nephrology, Hospital de Clínicas "Dr Manuel Quintela", Universidad de la República, Montevideo, Uruguay
| | | | - David Arroyo
- Department of Nephrology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Úrsula Verdalles
- Department of Nephrology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Saúl Pampa-Saico
- Department of Nephrology, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Esperanza Moral Berrio
- Department of Nephrology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - José Luis Pérez Canga
- Department of Nephrology, Hospital Universitario San Agustín, Avilés, Asturias, Spain
| | - Blanca Tarragón
- Department of Nephrology, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | - Pilar Fraile Gómez
- Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Dabaiba Regidor
- Department of Nephrology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Javier Relea
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Marc Xipell
- Department of Nephrology, Hospital Clinic, Barcelona, Spain
| | | | - Maruja Navarro
- Department of Nephrology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | - Álvaro Álvarez
- Department of Nephrology, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Begoña Rivas
- Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Eduardo Gutiérrez
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Balazs Odler
- Department of Medicine, University of Cambridge, Cambridge, UK
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Kronbichler
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Colin Geddes
- Department of Nephrology and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Hans-Joachim Anders
- Department of Internal Medicine IV, Hospital of the Ludwig Maximilians University, Munich, Germany
| | - Jürgen Floege
- Division of Nephrology, RWTH Aachen University Hospital, Aachen, Germany
| | | | - Manuel Praga
- Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Martínez-Majolero V, Urosa B, Hernández-Sánchez S, Arroyo D. The Moderating Role of Health Variables on the Association between Physical Exercise and Quality of Life in Patients with End-Stage Renal Disease. Healthcare (Basel) 2023; 11:2148. [PMID: 37570388 PMCID: PMC10419082 DOI: 10.3390/healthcare11152148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Scientific evidence demonstrates the positive impact that physical exercise has on the quality of life (QOL) of patients with chronic kidney disease (CKD). However, no study has proposed a model investigating the effect physical exercise has on the QOL of end-stage renal disease (ESRD) patients, considering the most frequent associated diseases (diabetes/hypertension). The objectives were (1) to explore the relationship between physical exercise and the QOL of adults with ESRD, and (2) to examine the moderating and/or mediating role of relevant patient variables. This non-interventional study utilized an ex post facto retrospective data analysis design with a sample of 310 patients with ESRD through two validated questionnaires. The dependent variables were the QOL scale (KDQOL-SF), and the physical function dimension (EFFISICA). The independent variables were the regular practice of intense physical activity (DEPINTE) and the daily time (in hours) the patient is in a sedentary attitude (TiParado). The moderating variables were the clinical situation and associated diseases. The mediator variable used was the body mass index. Bivariate and multiple regression analyses were conducted. Findings suggest implementing intense physical activity in transplant recipients and programmes to avoid sedentary lifestyles in dialysis patients have a positive effect in the QOL of ESRD patients.
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Affiliation(s)
| | - Belén Urosa
- Faculty of Human and Social Sciences, Universidad Pontificia Comillas, 28049 Madrid, Spain;
| | | | - David Arroyo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
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Carbayo J, Muñoz de Morales A, Aragoncillo I, Abad S, Arroyo D, Vega A, Goicoechea M. Impact of preoperative exercise in not initially candidates to native arteriovenous fistulas. J Vasc Access 2023; 24:689-695. [PMID: 34553628 DOI: 10.1177/11297298211045588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Native autologous arteriovenous fistula (AVFn) is the preferred vascular access for hemodialysis due to its long term patency and low complication rate. A challenging limitation is the anatomical inability to perform AVFn and failure of maturation. Preoperative isometric exercise (PIE) can increase vascular calibers and improve the rate of distal AVF. However, it is unknown whether PIE might enhance the performance of AVFn in patients who are not initially candidates. METHODS A retrospective observational study was conducted over a population of 45 patients evaluated in vascular access clinic, 23 were not initially candidates for radiocephalic (NRC-AVF) and 22 were not candidates for autologous fistula at all (NA-AVF). They were assigned to perform PIE with handgrip device and revaluated. RESULTS After 4-8 weeks of PIE, a AVFn was performed in 16 patients from NA-AVF group and a radiocephalic AVFn was performed in 21 patients from NRC-AVF group. Both groups experienced a significant and similar increase in venous caliber 0.91 ± 0.43 mm in NA-AVF versus 0.76 ± 0.47 mm in NRC-AVF (p = 0.336) and arterial caliber 0.18 ± 0.24 mm versus 0.18 ± 0.21 mm (p = 0.928), respectively. Nevertheless, primary failure rate was significantly higher in NA-AVF (n = 8, 50%) than in NRC-AVF group (n = 3, 14.3%) (p = 0.030). After 6 months, the fistula usability for dialysis was only 50% in NA-AVF, while 86.7% were dialyzed by fistula in NRC-AVF group (p = 0.038). CONCLUSIONS PIE allowed the allocation of an AVFn in patients not initially candidates, but entailed a high rate of maturation failure. Patients not candidates to radiocephalic AVF benefited from PIE and preserved a long term usability of AVF for dialysis.
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Affiliation(s)
- Javier Carbayo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Inés Aragoncillo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Soraya Abad
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - David Arroyo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Almudena Vega
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marian Goicoechea
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Esteban-Fernández A, Villar-Taibo R, Alejo M, Arroyo D, Bonilla Palomas JL, Cachero M, Joaquin C, Méndez Bailón M, Pérez-Rivera JÁ, Romero-Vigara JC, Somoza G. Diagnosis and Management of Malnutrition in Patients with Heart Failure. J Clin Med 2023; 12:3320. [PMID: 37176761 PMCID: PMC10179706 DOI: 10.3390/jcm12093320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Heart failure is a disease with an increasingly greater prevalence due to the aging population, the development of new drugs, and the organization of healthcare processes. Malnutrition has been identified as a poor prognostic factor in these patients, very often linked to frailty or to other comorbidities, meaning that early diagnosis and treatment are essential. This paper reviews some important aspects of the pathophysiology, detection, and management of malnutrition in patients with heart failure.
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Affiliation(s)
- Alberto Esteban-Fernández
- Cardiology Department, Severo Ochoa University Hospital, Calle Orellana s/n, 28911 Madrid, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
| | - Rocío Villar-Taibo
- Endocrinology Department, Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain;
| | - Mirian Alejo
- Endocrinology Department, Hospital El Bierzo, 24404 Ponferrada, Spain;
| | - David Arroyo
- Nephrology Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | - Montserrat Cachero
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Clara Joaquin
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Manuel Méndez Bailón
- Internal Medicine Department, San Carlos Clinical University Hospital, 28034 Madrid, Spain;
| | - José Ángel Pérez-Rivera
- Cardiology Department, Burgos University Hospital, 09006 Burgos, Spain;
- Faculty of Health Sciences, Isabel I University, 09003 Burgos, Spain
| | | | - Gema Somoza
- Geriatric Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain;
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Villanego F, Arroyo D, Martínez-Majolero V, Hernández-Sánchez S, Esteve-Simó V. Importance of physical exercise prescription in patients with chronic kidney disease: results of the survey of the Grupo Español Multidisciplinar de Ejercicio Físico en el Enfermo Renal [Spanish Multidisciplinary Group of Physical Exercise in Kidney Patients] (GEMEFER). Nefrologia 2023; 43:126-132. [PMID: 37003930 DOI: 10.1016/j.nefroe.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/02/2022] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION Despite the benefits of physical exercise (PE) for patients with chronic kidney disease (CKD), the number of Nephrology services that have PE programs is limited. OBJECTIVES To describe the degree of knowledge of PE benefits in patients with CKD among professionals, as well as the level of implementation and characteristics of PE programs in Nephrology services in Spain. METHODS A questionnaire on the degree of knowledge and prescription of PE in patients with CKD was designed and sent to members of the Spanish Nephrology and Nephrology Nursing Societies, as well as to physiotherapists and professionals in the Sciences of Physical Activity and Sport (PASS). RESULTS 264 professionals participated. 98.8% agreed on the importance of prescribing PE, but only 20.5% carry out an assessment of functional capacity and 19.3% have a PE program for patients with CKD in their centre. The most frequent programs are performed for haemodialysis patients and strength and aerobic resistance exercises are combined. A physiotherapist or a PASS usually participates in its prescription. The main barriers were the absence of human and/or physical resources and the lack of training. CONCLUSIONS Healthcare workers know the benefits of PE in patients with CKD. However, the implementation of these programs in Spain is low, motivated by the lack of resources and training of professionals. We must establish strategies to guarantee an adequate functional capacity within the care of our patients.
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Affiliation(s)
| | - David Arroyo
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Vicent Esteve-Simó
- Servicio de Nefrología, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
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Montomoli M, Roca L, Rivera M, Fernandez-Prado R, Redondo B, Camacho R, Moyano C, Pampa S, Gonzalez A, Casas J, Kislikova M, Sanchez Horrillo A, Cabrera Cárdena A, Quiroga B, Rabasco C, Piqueras S, Suso A, Reque J, Villa J, Ojeda R, Arroyo D. Oral Anticoagulation in Patients with Chronic Kidney Disease and Non-Valvular Atrial Fibrillation: The FAERC Study. Healthcare (Basel) 2022; 10:healthcare10122566. [PMID: 36554089 PMCID: PMC9778700 DOI: 10.3390/healthcare10122566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/30/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality. MATERIAL AND METHODS The FAERC study performed a retrospective multicentre analysis of historical cohorts in which data were collected from arrhythmia diagnosis onwards. RESULTS We analysed a Spanish cohort of 4749 patients with CKD (mean eGFR 33.9 mL/min) followed up in the nephrology clinic, observing a 12.2% prevalence of non-valvular AF. In total, 98.6% of these patients were receiving anticoagulant treatment, mainly with coumarins (79.7%). Using direct-acting oral anticoagulants (DOACs) was associated with fewer cerebrovascular events than using acenocoumarol, but in contrast with other studies, we could not corroborate the association of risk of bleeding, coronary events, or death with a type of anticoagulant prescribed. CONCLUSIONS Atrial fibrillation is highly prevalent in renal patients. Direct-acting anticoagulants seem to be associated with fewer ischemic-embolic complications, with no differences in bleeding, coronary events, or mortality rates.
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Affiliation(s)
- Marco Montomoli
- Nephrology Department, Hospital Clínico Universitario de Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain
- Correspondence:
| | - Lourdes Roca
- Nephrology Department, Hospital Universitario de La Plana, 12540 Villarreal, Spain
| | - Mariana Rivera
- Nephrology Department, Hospital Universitario Virgen de la Macarena, 41009 Sevilla, Spain
| | - Raul Fernandez-Prado
- Nephrology Department, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Beatriz Redondo
- Nephrology Department, Hospital Universitario de Cruces, 48903 Bilbao, Spain
| | - Rosa Camacho
- Nephrology Department, Hospital Universitario Severo Ochoa, 28914 Leganes, Spain
| | - Cayetana Moyano
- Nephrology Department, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Saul Pampa
- Nephrology Department, Hospital Universitario Rey Juan Carlos, 28933 Móstoles, Spain
| | - Angela Gonzalez
- Nephrology Department, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Juan Casas
- Nephrology Department, Hospital Comarcal Francesc de Borja, 46702 Gandía, Spain
| | - Maria Kislikova
- Nephrology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - Ana Sanchez Horrillo
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | | | - Borja Quiroga
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Cristina Rabasco
- Nephrology Department, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Sara Piqueras
- Nephrology Department, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain
| | - Andrea Suso
- Nephrology Department, Hospital Universitario Severo Ochoa, 28914 Leganes, Spain
| | - Javier Reque
- Nephrology Department, Hospital General Universitario de Castellón, 12004 Castelló, Spain
| | - Juan Villa
- Nephrology Department, Hospital Universitario de Badajoz, 06080 Badajoz, Spain
| | - Raquel Ojeda
- Nephrology Department, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - David Arroyo
- Nephrology Department, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain
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Noordzij M, Meijers B, Gansevoort RT, Covic A, Duivenvoorden R, Hilbrands LB, Hemmelder MH, Jager KJ, Mjoen G, Nistor I, Parshina E, Pessolano G, Tuglular S, Vart P, Zanoli L, Franssen CFM, van der Net JB, Essig M, du Buf-Vereijken PWG, van Ginneken B, Maas N, van Jaarsveld BC, Bemelman FJ, Klingenberg-Salahova F, Vervloet MG, Nurmohamed A, Vogt L, Abramowicz D, Verhofstede S, Maoujoud O, Malfait T, Fialova J, Lips J, Hengst M, Konings C, Rydzewski A, Oliveira J, Zakharova EV, Lepeytre F, Rabaté C, Rostoker G, Marques S, Azasevac T, Majstorovic GS, Fricke L, Slebe JJP, ElHafeez SA, El-Wakil HS, Verhoeven M, Logan I, Panagoutsos S, Mallamaci F, Postorino A, Cambareri F, Matceac I, Groeneveld JHM, Jousma J, van Buren M, Pereira TA, Arias-Cabrales C, Crespo M, Llinàs-Mallol L, Buxeda A, Tàrrega CB, Redondo-Pachon D, Jimenez MDA, Mendoza-Valderrey A, Martins AC, Mateus C, Alvila G, Laranjinha I, Arroyo D, Castellano S, Rodríguez-Ferrero ML, Lemahieu W, Dirim AB, Demir E, Sever MS, Turkmen A, Şafak S, Hollander DAMJ, Büttner S, Sridharan S, van der Sande FM, Christiaans MHL, Luca MD, Beerenhout C, Adema AY, Stepanov VA, Zulkarnaev AB, Turkmen K, Fliedner A, Åsberg A, Pini S, de Biase C, Kerckhoffs A, van de Logt AE, Maas R, Lebedeva O, Reichert LJM, Verhave J, Marcantoni C, van Gils-Verrij LEA, Battaglia Y, Lentini P, Cabezas-Reina CJ, Roca AM, Nauta F, Goffin E, Kanaan N, Labriola L, Devresse A, Coca A, Naesens M, Kuypers D, Desschans B, Dedinska I, Malik S, Berger SP, Sanders JSF, Özyilmaz A, Ponikvar JB, Pernat AM, Kovac D, Arnol M, Abrahams AC, Molenaar FM, van Zuilen AD, Meijvis SCA, Dolmans H, Esposito P, Krzesinski JM, Barahira JD, Gallieni M, Guglielmetti G, Guzzo G, Luik AJ, van Kuijk WHM, Stikkelbroeck LWH, Hermans MMH, Rimsevicius L, Righetti M, Islam M, Heitink-ter Braak N. Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe - Lessons for the future. Clin Kidney J 2022; 16:662-675. [PMID: 37007687 PMCID: PMC10061429 DOI: 10.1093/ckj/sfac253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Early reports on the pandemic nature of COVID-19 directed the nephrology community to develop infection prevention and control guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave.
Methods
We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between March 1, 2020 and July 31, 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of SARS-CoV-2 in dialysis centres.
Results
Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting.
Conclusions
Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.
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Affiliation(s)
- Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Björn Meijers
- Department of Nephrology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
- Belgium and Department of Microbiology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Adrian Covic
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Marc H Hemmelder
- Dept. of Internal Medicine, Div. of Nephrology, Maastricht University Medical Center / CARIM school for cardiovascular disease, University of Maastricht , Maastricht , The Netherlands
| | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam , Medical Informatics, Amsterdam , The Netherlands
- Amsterdam Public Health Research Institute , Quality of Care, Amsterdam , The Netherlands
| | - Geir Mjoen
- Department of Transplantation, Oslo University Hospital , Norway
| | - Ionut Nistor
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Ekaterina Parshina
- Nephrology and Dialysis Department, Saint Petersburg State University Hospital , Saint-Petersburg, Russia
| | - Giuseppina Pessolano
- Division of Nephrology , Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Serhan Tuglular
- Medical Faculty, Department of Internal Medicine, Marmara University , Istanbul , Turkey
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
- Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, University of Groningen , The Netherlands
| | - Luca Zanoli
- Nephrology and dialysis, San Marco Hospital, University of Catania , Catania , Italy
| | - Casper F M Franssen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
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Hemmelder MH, Noordzij M, Vart P, Hilbrands LB, Jager KJ, Abrahams AC, Arroyo D, Battaglia Y, Ekart R, Mallamaci F, Malloney SR, Oliveira J, Rydzewski A, Sridharan S, Vogt L, Duivenvoorden R, Gansevoort RT, Franssen CFM. Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA. Nephrol Dial Transplant 2022; 37:1140-1151. [PMID: 35030246 PMCID: PMC8807277 DOI: 10.1093/ndt/gfac008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. METHODS We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. RESULTS In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. CONCLUSIONS Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.
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Affiliation(s)
- Marc H Hemmelder
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, CARIM School for Cardiovascular Disease, University of Maastricht, Maastricht, The Netherlands
| | - Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Alferso C Abrahams
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - David Arroyo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Yuri Battaglia
- Department of Specialized Medicine, Division of Nephrology and Dialysis, St. Anna University Hospital, Ferrara, Italy
| | - Robert Ekart
- Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
| | - Francesca Mallamaci
- Nephrology, Dialysis and Renal Transplantation Unit, Grande Ospedale Metropolitano di Reggio Cal, Italy
| | | | - Joao Oliveira
- Centrodial (Outpatient Dialysis Center), São João da Madeira, Portugal
| | - Andrzej Rydzewski
- Department of Internal Medicine, Nephrology and Transplantation Medicine, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Internal Affairs, Warsaw, Poland
| | - Sivakumar Sridharan
- Department of nephrology, East and North Hertfordshire NHS Trust, Lister Hospital, Hertfordshire, UK
| | - Liffert Vogt
- Department of Internal Medicine, Section of Nephrology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Casper F M Franssen
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
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Quiroga B, Soler MJ, Ortiz A, Orero E, Tejedor S, Mantecón CJJ, Gómez Pérez VO, Marín Franco AJ, Alfaro Sánchez C, Puerta Carretero M, Jaldo Rodríguez MT, Carnerero Di Riso MA, Martínez S, González CC, Cervienka M, Macías Carmona N, Arroyo D, Pérez Del Valle KM, de Arriba G, Mazuecos A, Cazorla JM, Pereira M, González Parra E, Sánchez Márquez MG, Lancho Novillo C, Toyos Ruiz C, Aguilar Cervera MC, Muñoz Ramos P, Sánchez Horrillo A, Jimeno Martín I, Toapanta N, Cigarrán Guldris S, Folgueiras López M, Valero San Cecilio R, Villacorta Linaza B, Minguela Pesquera I, Santana Estupiñán R, Zamora R, Soriano S, Muñoz de Bustillo E, Pizarro Sánchez MS, Martínez Puerto AI, Yugueros A, Muñiz Pacios L, Leyva A, Rojas J, Gansevoort RT, de Sequera P. Humoral Response to Third Dose of SARS-CoV-2 Vaccines in the CKD Spectrum. Clin J Am Soc Nephrol 2022; 17:872-876. [PMID: 35551070 PMCID: PMC9269649 DOI: 10.2215/cjn.01770222] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Borja Quiroga
- Instituto de Investigación Sanitaria-La Princesa, Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - María José Soler
- Nephrology Department, Vall d'Hebrón University Hospital, Barcelona, Spain .,Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS), RICORS2040 (Kidney Disease), Spain
| | - Alberto Ortiz
- Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS), RICORS2040 (Kidney Disease), Spain .,Nephrology Department, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Álvarez de Toledo-IRSIN, Red de Investigación Renal, Instituto de Investigación Carlos III, Madrid, Spain
| | | | | | | | | | | | | | - Marta Puerta Carretero
- Nephrology Department, Hospital Universitario Infanta Leonor-Universidad Complutense de Madrid, Spain
| | | | | | | | | | | | | | - David Arroyo
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | - Mónica Pereira
- Nephrology Department, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Álvarez de Toledo-IRSIN, Red de Investigación Renal, Instituto de Investigación Carlos III, Madrid, Spain
| | - Emilio González Parra
- Nephrology Department, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Álvarez de Toledo-IRSIN, Red de Investigación Renal, Instituto de Investigación Carlos III, Madrid, Spain
| | | | | | | | | | - Patricia Muñoz Ramos
- Instituto de Investigación Sanitaria-La Princesa, Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - Ana Sánchez Horrillo
- Instituto de Investigación Sanitaria-La Princesa, Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Néstor Toapanta
- Nephrology Department, Vall d'Hebrón University Hospital, Barcelona, Spain
| | | | | | - Rosalía Valero San Cecilio
- Nephrology Department, Hospital Marqués de Valdecilla, University of Cantabria, Instituto de Investigación Marqués de Valedecilla, Santander, Spain
| | | | | | - Raquel Santana Estupiñán
- Nephrology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Rocío Zamora
- Nephrology Department, Hospital Universitario General de Villalba, Spain
| | | | | | | | | | - Alejandra Yugueros
- Nephrology Department, Hospital Lluis Alcanyis De Xátiva, Valencia, Spain
| | - Laura Muñiz Pacios
- Nephrology Department, Hospital Universitario Infanta Cristina, Madrid, Spain
| | - Alba Leyva
- Research and Development Department, Vircell Sociedad Limitada, Granada, Spain
| | - José Rojas
- Research and Development Department, Vircell Sociedad Limitada, Granada, Spain
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Melero R, Mijaylova A, Rodriguez-Benitez P, Macías N, Aragoncillo I, Rodriguez-Ferrero ML, Garcia-Prieto A, Bascuñana A, Acosta A, Gonzalez-Rojas A, de Morales AM, Carbayo J, Sanchez-Cámara L, Verdalles U, Abad S, Vega A, Verde E, Arroyo D, de Jose AP, Piñero P, Cedeño J, Anaya F, Rengel MA, Barraca D, Olmedo M, Goicoechea M. Renal long-term outcome of critically ill COVID-19 patients with acute kidney failure and continuous renal replacement therapy. Clin Kidney J 2021; 14:2449-2450. [PMID: 34754443 PMCID: PMC8573006 DOI: 10.1093/ckj/sfab150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 08/10/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rosa Melero
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Antonia Mijaylova
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Nicolas Macías
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ines Aragoncillo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Ana Garcia-Prieto
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arturo Bascuñana
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Adriana Acosta
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Angela Gonzalez-Rojas
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Javier Carbayo
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Ursula Verdalles
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Soraya Abad
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Almudena Vega
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eduardo Verde
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - David Arroyo
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Perez de Jose
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Patricia Piñero
- Servicio de Anestesiología y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jamil Cedeño
- Servicio de Medicina Intensiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fernando Anaya
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Antonio Rengel
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Barraca
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Olmedo
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marian Goicoechea
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Muñoz Ramos P, Gil Giraldo Y, Álvarez-Chiva V, Arroyo D, Sango Merino C, Moncho Francés F, Ocaña J, Reque J, Sánchez-Álvarez E, Górriz JL, Quiroga B. Proteinuria-Lowering Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in Chronic Kidney Disease Patients: A Real-World Multicentric Study. Metabolites 2021; 11:metabo11110760. [PMID: 34822418 PMCID: PMC8618891 DOI: 10.3390/metabo11110760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 01/22/2023] Open
Abstract
Control of dyslipidemia in chronic kidney disease (CKD) is not always guaranteed with statins and/or ezetimibe. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) have opened up a new era in lipid control, but their effect on renal function and proteinuria in real life have not yet been evaluated. The aim of the present study was to analyze the evolution of renal function and proteinuria in a cohort of CKD patients treated with PCSK9i. This retrospective multicentric cohort study included CKD patients treated with PCSK9i. Baseline epidemiological data, comorbidities and laboratory findings (including estimated glomerular filtration rate [eGFR], proteinuria and lipid profile) were collected. The evolution of renal function, proteinuria and lipid profile was analyzed during the 1-year follow-up. The cohort included 76 patients (68% male, mean age 66 ± 10 years). The mean baseline creatinine was 1.55 ± 0.77 mg/dL, and the mean eGFR was 52 ± 22 mL/min/1.73 m2. Reductions in LDL-cholesterol, total cholesterol and triglycerides during the first month were 51 ± 25%, 32 ± 25% and 11 ± 40%, respectively, levels that remained stable throughout the first year (p < 0.001 for LDL-cholesterol and total cholesterol trends and p = 0.002 for triglyceride trend). During follow-up, proteinuria improved from 57 (9–481) to 30 (7–520) mg/g (p = 0.021). In addition, eGFR remained stable, and no adverse events were reported. In our cohort, dyslipidemia treatment with PCSK9i was associated with decreased proteinuria in CKD patients, an effect that might be due to reduced lipid nephrotoxicity. Clinical trials are needed to further investigate whether this impact on proteinuria can significantly slow CKD progression in the long term.
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Affiliation(s)
- Patricia Muñoz Ramos
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (P.M.R.); (Y.G.G.); (V.Á.-C.)
| | - Yohana Gil Giraldo
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (P.M.R.); (Y.G.G.); (V.Á.-C.)
| | - Vicente Álvarez-Chiva
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (P.M.R.); (Y.G.G.); (V.Á.-C.)
| | - David Arroyo
- Nephrology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - Cristina Sango Merino
- Nephrology Department, Hospital de Cabueñes, 33394 Gijón, Spain; (C.S.M.); (E.S.-Á.)
| | - Francesc Moncho Francés
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain; (F.M.F.); (J.L.G.)
| | - Javier Ocaña
- Nephrology Department, Fundación Hospital de Alcorcón, 28922 Madrid, Spain;
| | - Javier Reque
- Nephrology Department, Hospital General de Castellón, 12004 Castelló de la Plana, Spain;
| | | | - José Luis Górriz
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain; (F.M.F.); (J.L.G.)
| | - Borja Quiroga
- Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (P.M.R.); (Y.G.G.); (V.Á.-C.)
- Correspondence: ; Tel.: +34-915-202-200
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14
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Hilbrands LB, Duivenvoorden R, Vart P, Franssen CFM, Hemmelder MH, Jager KJ, Kieneker LM, Noordzij M, Pena MJ, Vries HD, Arroyo D, Covic A, Crespo M, Goffin E, Islam M, Massy ZA, Montero N, Oliveira JP, Roca Muñoz A, Sanchez JE, Sridharan S, Winzeler R, Gansevoort RT. Erratum to: COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration. Nephrol Dial Transplant 2021. [PMID: 34075410 DOI: 10.1093/ndt/gfab028.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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15
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Hilbrands LB, Duivenvoorden R, Vart P, Franssen CFM, Hemmelder MH, Jager KJ, Kieneker LM, Noordzij M, Pena MJ, de Vries H, Arroyo D, Covic A, Crespo M, Goffin E, Islam M, Massy ZA, Montero N, Oliveira JP, Roca Muñoz A, Sanchez JE, Sridharan S, Winzeler R, Gansevoort RT. Erratum to: COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration. Nephrol Dial Transplant 2021; 36:1962. [PMID: 34075410 PMCID: PMC8195100 DOI: 10.1093/ndt/gfab028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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de la Torre-Abaitua G, Lago-Fernández LF, Arroyo D. A Compression-Based Method for Detecting Anomalies in Textual Data. Entropy (Basel) 2021; 23:e23050618. [PMID: 34065721 PMCID: PMC8156803 DOI: 10.3390/e23050618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/12/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022]
Abstract
Nowadays, information and communications technology systems are fundamental assets of our social and economical model, and thus they should be properly protected against the malicious activity of cybercriminals. Defence mechanisms are generally articulated around tools that trace and store information in several ways, the simplest one being the generation of plain text files coined as security logs. Such log files are usually inspected, in a semi-automatic way, by security analysts to detect events that may affect system integrity, confidentiality and availability. On this basis, we propose a parameter-free method to detect security incidents from structured text regardless its nature. We use the Normalized Compression Distance to obtain a set of features that can be used by a Support Vector Machine to classify events from a heterogeneous cybersecurity environment. In particular, we explore and validate the application of our method in four different cybersecurity domains: HTTP anomaly identification, spam detection, Domain Generation Algorithms tracking and sentiment analysis. The results obtained show the validity and flexibility of our approach in different security scenarios with a low configuration burden.
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Affiliation(s)
- Gonzalo de la Torre-Abaitua
- Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (G.d.l.T.-A.); (L.F.L.-F.)
| | - Luis Fernando Lago-Fernández
- Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (G.d.l.T.-A.); (L.F.L.-F.)
| | - David Arroyo
- Institute of Physical and Information Technologies (ITEFI), Spanish National Research Council (CSIC), 28006 Madrid, Spain
- Correspondence:
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Gorriz JL, Arroyo D, D'Marco L, Torra R, Tomás P, Puchades MJ, Panizo N, Pantoja J, Montomoli M, Llisterri JL, Pallares-Carratalá V, Valdivielso JM. Cardiovascular risk factors and the impact on prognosis in patients with chronic kidney disease secondary to autosomal dominant polycystic kidney disease. BMC Nephrol 2021; 22:110. [PMID: 33765945 PMCID: PMC7995703 DOI: 10.1186/s12882-021-02313-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent hereditary renal disease. There is an increased rate of cardiovascular disease (CVD) in ADPKD. In this study, we evaluate the prevalence of cardiovascular risk factors, the achievement rates for treatment goals and cardiovascular events (CVE) in ADPKD and their relations with asymptomatic CVD in CKD from other etiologies (CKDoe) and controls. METHODS We evaluated 2445 CKD patients (2010-2012). The information collected was: clinical, anthropometric and analytical parameters, treatments and CVD evaluation (intima-media thickness (IMT), atheromatous plaque presence and ankle-brachial index (ABI)). Laboratory, vital status, CVE and hospitalizations were collected for 4 years. RESULTS ADPKD patients had a worse renal function and worst achievement of blood pressure, higher parathormone levels but lower proteinuria compared to CKDoe. ADPKD patients presented lower IMT values than other groups, however, an intermediate rate of pathologic ABI and atheromatous plaque was present. More than half of the patients received statins, achieving LDL-c levels < 100 only in 50 and 39.8% of them (ADPKD and CKDoe respectively). The number of CVE during the follow-up period was low. In adjusted Cox regression model, ADPDK had the lowest occurrence of CVE of all three groups (HR:0.422, 95%CI 0.221-0.808, p = 0.009). CONCLUSION ADPKD patients show intermediate control rates of CVD. A better control of CVD risk seems to be related with a lower load of CVD compared to other groups, which may lead in the long term to a better prognosis. Further investigation is necessary to determine cardiovascular prognosis in ADPKD.
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Affiliation(s)
- José Luis Gorriz
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain.
| | - David Arroyo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Luis D'Marco
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain
| | - Roser Torra
- Inherited Kidney Diseases, Nephrology Department, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Medicine Department-Universitat Autónoma de Barcelona, REDinREN, nstituto de Investigación Carlos III, Barcelona, Spain
| | - Patricia Tomás
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain
| | - María Jesús Puchades
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain
| | - Nayara Panizo
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain
| | - Jonay Pantoja
- Department of Nephrology, University Dr Peset Hospital, Valencia, Spain
| | - Marco Montomoli
- Department of Nephrology, University Clinic Hospital, INCLIVA, University of Valencia, Av Blasco Ibañez 17, 46010, Valencia, Spain
| | | | - Vicente Pallares-Carratalá
- Health Surveillance Unit, Castellon Mutual Insurance Union, Castellon, Spain. Department of Medicine, Jaume I University, Castellon, Spain.
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain, 2 Statistics Department, University of Lleida, Lleida, Spain
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Srinagesh ., Singh SK, Arroyo D, Srinivas D, Suresh G, Suresh G. Ground Motion Prediction Equation For Earthquakes Along The Western Himalayan Arc. CURR SCI INDIA 2021. [DOI: 10.18520/cs/v120/i6/1074-1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Donovan PJ, Arroyo D, Pattullo C, Bell A. Trends in opioid prescribing in Australia: a systematic review. AUST HEALTH REV 2021; 44:277-287. [PMID: 32241339 DOI: 10.1071/ah18245] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/15/2019] [Indexed: 12/25/2022]
Abstract
Objective This review systematically identified studies that estimated the prevalence of prescription opioid use in Australia, assessed the prevalence estimates for bias and identified areas for future research. Methods Literature published after 2000 containing a potentially representative estimate of prescription opioid use in adults, in the community setting, in Australia was included in this review. Studies that solely assessed opioid replacement, illicit opioid usage or acute hospital in-patient use were excluded. Databases searched included PubMed, EMBASE, Web of Science and the grey literature. Results The search identified 2253 peer-reviewed publications, with 34 requiring full-text review. Of these, 20 were included in the final qualitative analysis, in addition to four publications from the grey literature. Most studies included analysed prescription claims data for medicines dispensed via Australia's national medicines subsidy scheme (the Pharmaceutical Benefits Scheme). Although data sources were good quality, all prevalence estimates were at least at moderate risk of bias, predominantly due to incompleteness of data or potential confounding. Included publications demonstrated a significant rise in opioid use up to 2017 (including a 15-fold increase in prescriptions dispensed over the 20 years to 2015), predominantly driven by a sharp rise in oxycodone use. Although opioid prescription numbers continue to escalate, usage, as measured by oral morphine equivalent per capita, may have plateaued since 2014. Codeine remains the most prevalently obtained opioid, followed by oxycodone and tramadol. There was a substantial delay (median 30 months; interquartile range 20-37 months) to publication of opioid usage data from time of availability. Conclusions Australia has experienced a marked increase in opioid prescribing since the 1990s. Current published literature is restricted to incomplete, delayed and historical data, limiting the ability of clinicians and policy makers to intervene appropriately. What is known about the topic? Opioid prescriptions in Australia have continued to increase since the 1990s and may be mirroring the epidemic being seen in the US. What does this paper add? This paper systematically identifies all publications that have examined the prevalence of prescription opioid use in Australia since 2000, and only identified prevalence estimates that were at moderate or high risk of bias, and found significant delays to publication of these estimates. What are the implications for practitioners? Because published literature on the prevalence of prescription opioid consumption is restricted to incomplete, delayed and historical data, the ability of clinicians and policy makers to appropriately intervene to curb prescription opioid use is limited. A national policy of real-time monitoring and reporting of opioid prescribing may support improvements in practice.
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Affiliation(s)
- Peter J Donovan
- Department of Clinical Pharmacology, Royal Brisbane and Women's Hospital, cnr Butterfield Street and Bowen Bridge Road, Herston, Qld 4029, Australia. ; and The University of Queensland Faculty of Medicine and Biomedical Sciences, 288 Herston Road, Herston, Qld 4066, Australia. ; and Corresponding author.
| | - David Arroyo
- The University of Queensland Faculty of Medicine and Biomedical Sciences, 288 Herston Road, Herston, Qld 4066, Australia.
| | - Champika Pattullo
- Department of Clinical Pharmacology, Royal Brisbane and Women's Hospital, cnr Butterfield Street and Bowen Bridge Road, Herston, Qld 4029, Australia.
| | - Anthony Bell
- The University of Queensland Faculty of Medicine and Biomedical Sciences, 288 Herston Road, Herston, Qld 4066, Australia. ; and The Wesley Hospital, 451 Coronation Drive, Auchenflower, Brisbane, Qld 4066, Australia.
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Claeys MJ, Roubille F, Casella G, Zukermann R, Nikolaou N, De Luca L, Gierlotka M, Iakobishvili Z, Thiele H, Koutouzis M, Sionis A, Monteiro S, Beauloye C, Held C, Tint D, Zakke I, Serpytis P, Babic Z, Belohlavev J, Magdy A, Sivagowry Rasalingam M, Daly K, Arroyo D, Vavlukis M, Radovanovic N, Trendafilova E, Marandi T, Hassenger C, Lettino M, Price S, Bonnefoy E. Organization of intensive cardiac care units in Europe: Results of a multinational survey. European Heart Journal. Acute Cardiovascular Care 2020; 9:993-1001. [DOI: 10.1177/2048872619883997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background:
The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe.
Methods:
A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14).
Results:
A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries.
Conclusion:
More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.
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Affiliation(s)
- MJ Claeys
- Department of Cardiology, Antwerp University Hospital, Belgium
| | - F Roubille
- Department of Cardiology, University Hospital of Montpellier, France
| | - G Casella
- Department of Cardiology, Ospedale Maggiore, Italy
| | | | - N Nikolaou
- Department of Cardiology, Konstantopouleio General Hospital, Greece
| | - L De Luca
- Department of Cardiology, S. Giovanni Evangelista Hospital, Italy
| | - M Gierlotka
- Department of Cardiology, University of Opole, Poland
| | | | - H Thiele
- Heart Center Leipzig, University Hospital, Germany
| | | | - A Sionis
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | | | - C Beauloye
- Cliniques Universitaires Saint Luc, UCLouvain, Belgium
| | - C Held
- Department of Medical Sciences, Uppsala Clinical Research Center, Sweden
| | - D Tint
- ICCO Clinics, Transilvania University, Romania
| | - I Zakke
- Pauls Stradins Clinical University Hospital, Latvia
| | - P Serpytis
- Faculty of Medicine, Vilnius University, Lithuania
| | - Z Babic
- University Hospital Centre, Sisters of Mercy, Croatia
| | - J Belohlavev
- 2nd Department of Medicine, Charles University, Czech Republic
| | - A Magdy
- National Heart Institution, Egypt
| | | | - K Daly
- University College Hospital, Ireland
| | - D Arroyo
- Hôpital Cantonal Fribourg, Switzerland
| | - M Vavlukis
- PHO University Clinic of Cardiology, Macedonia
| | | | | | - T Marandi
- North Estonia Medical Centre, Estonia
- Department of Cardiology, University of Tartu, Estonia
| | - C Hassenger
- Department of Cardiology, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - M Lettino
- Division of Cardiology, San Gerardo Hospital, Italy
| | - S Price
- Adult Intensive Care Unit, Royal Brompton Hospital, London
| | - E Bonnefoy
- Intensive Cardiac Care Unit, Hospices Civils de Lyon, France
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22
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Claeys MJ, Roubille F, Casella G, Zukermann R, Nikolaou N, De Luca L, Gierlotka M, Iakobishvili Z, Thiele H, Koutouzis M, Sionis A, Monteiro S, Beauloye C, Held C, Tint D, Zakke I, Serpytis P, Babic Z, Belohlavev J, Magdy A, Sivagowry Rasalingam M, Daly K, Arroyo D, Vavlukis M, Radovanovic N, Trendafilova E, Marandi T, Hassenger C, Lettino M, Price S, Bonnefoy E. Organization of intensive cardiac care units in Europe: Results of a multinational survey. European Heart Journal. Acute Cardiovascular Care 2020; 9:993-1001. [DOI: mj claeys, f roubille, g casella, r zukermann, n nikolaou, l de luca, m gierlotka, z iakobishvili, h thiele, m koutouzis, a sionis, s monteiro, c beauloye, c held, d tint, i zakke, p serpytis, z babic, j belohlavev, a magdy, m sivagowry rasalingam, k daly, d arroyo, m vavlukis, n radovanovic, e trendafilova, t marandi, c hassenger, m lettino, s price, e bonnefoy, organization of intensive cardiac care units in europe: results of a multinational survey, european heart journal.acute cardiovascular care, volume 9, issue 8, 1 december 2020, pages 993–1001, https:/doi.org/10.1177/2048872619883997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background:
The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe.
Methods:
A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14).
Results:
A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries.
Conclusion:
More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.
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Affiliation(s)
- MJ Claeys
- Department of Cardiology, Antwerp University Hospital, Belgium
| | - F Roubille
- Department of Cardiology, University Hospital of Montpellier, France
| | - G Casella
- Department of Cardiology, Ospedale Maggiore, Italy
| | | | - N Nikolaou
- Department of Cardiology, Konstantopouleio General Hospital, Greece
| | - L De Luca
- Department of Cardiology, S. Giovanni Evangelista Hospital, Italy
| | - M Gierlotka
- Department of Cardiology, University of Opole, Poland
| | | | - H Thiele
- Heart Center Leipzig, University Hospital, Germany
| | | | - A Sionis
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | | | - C Beauloye
- Cliniques Universitaires Saint Luc, UCLouvain, Belgium
| | - C Held
- Department of Medical Sciences, Uppsala Clinical Research Center, Sweden
| | - D Tint
- ICCO Clinics, Transilvania University, Romania
| | - I Zakke
- Pauls Stradins Clinical University Hospital, Latvia
| | - P Serpytis
- Faculty of Medicine, Vilnius University, Lithuania
| | - Z Babic
- University Hospital Centre, Sisters of Mercy, Croatia
| | - J Belohlavev
- 2nd Department of Medicine, Charles University, Czech Republic
| | - A Magdy
- National Heart Institution, Egypt
| | | | - K Daly
- University College Hospital, Ireland
| | - D Arroyo
- Hôpital Cantonal Fribourg, Switzerland
| | - M Vavlukis
- PHO University Clinic of Cardiology, Macedonia
| | | | | | - T Marandi
- North Estonia Medical Centre, Estonia
- Department of Cardiology, University of Tartu, Estonia
| | - C Hassenger
- Department of Cardiology, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - M Lettino
- Division of Cardiology, San Gerardo Hospital, Italy
| | - S Price
- Adult Intensive Care Unit, Royal Brompton Hospital, London
| | - E Bonnefoy
- Intensive Cardiac Care Unit, Hospices Civils de Lyon, France
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López-Neyra A, Suárez L, Muñoz M, de Blas A, Ruiz de Valbuena M, Garriga M, Calvo J, Ribes C, Girón Moreno R, Máiz L, González D, Bousoño C, Manzanares J, Pastor Ó, Martínez-Botas J, Del Campo R, Cantón R, Roy G, Menacho M, Arroyo D, Zamora J, Soriano JB, Lamas A. Long-term docosahexaenoic acid (DHA) supplementation in cystic fibrosis patients: a randomized, multi-center, double-blind, placebo-controlled trial. Prostaglandins Leukot Essent Fatty Acids 2020; 162:102186. [PMID: 33038833 DOI: 10.1016/j.plefa.2020.102186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) patients have an alteration in fatty acid (FA) metabolism, associated with increased omega-6 and low omega-3 FA. Previous studies on supplementation with omega-3 FA in CF had contradictory results, and to date there is no evidence to recommend routine use of omega-3 supplements in CF patients. We hypothesized that long-term supplementation with docosahexaenoic acid (DHA) will have beneficial effects in these patients, by reducing pulmonary, systemic and intestinal inflammation. METHODS This was a randomized, double-blind, parallel, placebo-controlled trial. CF patients (age >2 months) were randomized to receive a seaweed DHA oil solution (50 mg/Kg/day) or matching placebo for 48 weeks. Primary outcomes were pulmonary (interleukin [IL]-8), systemic (IL-8) and intestinal (calprotectin) inflammatory biomarkers. Secondary outcomes included other pulmonary (IL-1β, IL-6, neutrophil elastase, lactate and calprotectin) and systemic (serum-IL-1β, IL-6) inflammatory biomarkers, as well as clinical outcomes (FEV1, pulmonary exacerbations, antibiotic use, nutritional status and quality of life). RESULTS Ninety six CF patients, 44 female, age 14.6±11.9 years (48 DHA and 48 placebo) were included. At trial completion, there were no differences in all primary outcomes [serum-IL-8 (p=0.909), respiratory-IL-8 (p=0.384) or fecal calprotectin (p=0.948)], all secondary inflammatory biomarkers, or in any of the clinical outcomes evaluated. There were few adverse events, with similar incidence in both study groups. CONCLUSION In this study, long-term DHA supplementation in CF patients was safe, but did not offer any benefit on inflammatory biomarkers, or in clinical outcomes compared with placebo. (NCT01783613).
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Affiliation(s)
- Alejandro López-Neyra
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain.
| | - Lucrecia Suárez
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Marta Muñoz
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Ana de Blas
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Marta Ruiz de Valbuena
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - María Garriga
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Unidad de Fibrosis Quística. Servicio de Endocrinología. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Joaquim Calvo
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario La Fe. Avinguda de Fernando Abril Martorell, 106. 46026-Valencia. Spain
| | - Carmen Ribes
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario La Fe. Avinguda de Fernando Abril Martorell, 106. 46026-Valencia. Spain
| | - Rosa Girón Moreno
- Unidad de Fibrosis Quística. Servicio de Neumología. Hospital Universitario La Princesa. Instituto de Investigación Sanitaria La Princesa. Calle de Diego de León, 62. 28006-Madrid. Spain
| | - Luis Máiz
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Unidad de Fibrosis Quística. Servicio de Neumología. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - David González
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Central de Asturias. Av. Roma. 33011-Oviedo. Spain
| | - Carlos Bousoño
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Central de Asturias. Av. Roma. 33011-Oviedo. Spain
| | - Javier Manzanares
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Doce de Octubre. Avda. de Córdoba. 28041-Madrid. Spain
| | - Óscar Pastor
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Servicio de Bioquímica Clínica, UCA-CCM. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III. Av. Monforte de Lemos, 3-5. 28029-Madrid. Spain
| | - Javier Martínez-Botas
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III. Av. Monforte de Lemos, 3-5. 28029-Madrid. Spain; Servicio de Bioquímica-Investigación. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Rosa Del Campo
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Rafael Cantón
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Garbiñe Roy
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - Miriam Menacho
- Servicio de Bioquímica Clínica, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain
| | - David Arroyo
- Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Av. Monforte de Lemos, 3-5. 28029-Madrid. Spain
| | - Javier Zamora
- Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Av. Monforte de Lemos, 3-5. 28029-Madrid. Spain
| | - Joan B Soriano
- Hospital Universitario La Princesa. Universidad Autónoma de Madrid. Calle de Diego de León, 62. 28006-Madrid. Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III. Av. Monforte de Lemos, 3-5. 28029-Madrid. Spain
| | - Adelaida Lamas
- Unidad de Fibrosis Quística. Servicio de Pediatría. Hospital Universitario Ramón y Cajal. Cª Colmenar Km. 9,1. 28034-Madrid. Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Cª Colmenar Km. 9,1. 28034-Madrid. Spain
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Hilbrands LB, Duivenvoorden R, Vart P, Franssen CFM, Hemmelder MH, Jager KJ, Kieneker LM, Noordzij M, Pena MJ, de Vries H, Arroyo D, Covic A, Crespo M, Goffin E, Islam M, Massy ZA, Montero N, Oliveira JP, Roca Muñoz A, Sanchez JE, Sridharan S, Winzeler R, Gansevoort RT. COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration. Nephrol Dial Transplant 2020; 35:1973-1983. [PMID: 33151337 PMCID: PMC7665620 DOI: 10.1093/ndt/gfaa261] [Citation(s) in RCA: 273] [Impact Index Per Article: 68.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. METHODS We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. RESULTS Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 ± 13 and 67 ± 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3-30.2%] in kidney transplant and 25.0% (95% CI 20.2-30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59-1.10, P = 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n = 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation <1 year before presentation (HR adjusted for sex, age and frailty 0.20, 95% CI 0.07-0.56, P < 0.01). CONCLUSIONS The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.
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Affiliation(s)
- Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical
Center, Radboud University, Nijmegen, The Netherlands
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical
Center, Radboud University, Nijmegen, The Netherlands
- Correspondence to: Ron T. Gansevoort; E-mail:
| | - Priya Vart
- Department of Health Evidence, Radboud University
Medical Center, Radboud University, Nijmegen, The Netherlands
- Department of Cardiology, Radboud University Medical
Center, Radboud University, Nijmegen, The Netherlands
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Casper F M Franssen
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marc H Hemmelder
- Dutch Renal Registry, Nefrovisie
foundation, Utrecht, The Netherlands
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical
Informatics, Amsterdam University Medical Center, Amsterdam Public
Health Research Institute, Amsterdam, The Netherlands
| | - Lyanne M Kieneker
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marlies Noordzij
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michelle J Pena
- Department of Clinical Pharmacy &
Pharmacology, University Medical Center Groningen, Groningen, The
Netherlands
| | - Hanne de Vries
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
| | - David Arroyo
- Department of Nephrology, Hospital General
Universitario Gregorio Marañón, Madrid, Spain
| | - Adrian Covic
- Grigore T. Popa University of Medicine and
Pharmacy, Iasi, Romania, Dr Ci Parhon Hospital, Iasi, Romania
| | - Marta Crespo
- Department of Nephrology, Hospital del
Mar, Barcelona, Spain
| | - Eric Goffin
- Cliniques Universitaires Saint-Luc,
Université Catholique de Louvain, Brussels, Belgium
| | - Mahmud Islam
- Department of Nephrology, Zonguldak Ataturk State
Hospital, Zonguldak, Turkey
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré
University Hospital, APHP (Assistance Publique-Hôpitaux de Paris), UVSQ
(University Versailles-Saint-Quentin-en-Yvelines) – Paris
Saclay, Boulogne Billancourt/Paris, France
- Institut National de la Santé et de la
Recherche Médicale (INSERM), Villejuif, France
| | - Nuria Montero
- Department of Nephrology, Bellvitge University
Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Ana Roca Muñoz
- Renal Transplant Unit, Toledo University
Hospital, Toledo, Spain
| | - J Emilio Sanchez
- Department of Nephrology, Hospital Universitario de
Cabuenes, Asturias, Spain
| | | | - Rebecca Winzeler
- Institute of Nephrology, City Hospital Waid and
Triemli, Zürich, Switzerland
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical
Center Groningen, University of Groningen, Groningen, The Netherlands
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Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, Arroyo D, Vega A, Abad S, Verde E, García Prieto AM, Verdalles Ú, Barbieri D, Delgado AF, Carbayo J, Mijaylova A, Acosta A, Melero R, Tejedor A, Benitez PR, Pérez de José A, Rodriguez Ferrero ML, Anaya F, Rengel M, Barraca D, Luño J, Aragoncillo I. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int 2020; 98:27-34. [PMID: 32437770 PMCID: PMC7211728 DOI: 10.1016/j.kint.2020.04.031] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of all maintenance hemodialysis patients hospitalized with COVID-19 from March 12th to April 10th, 2020 as confirmed by real-time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and nonsurvivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died, and 7 were able to be discharged within the observation period. Clinical and radiological evolution during the first week of admission were predictive of mortality. Among the 36 patients, 18 had worsening of their clinical status, as defined by severe hypoxia with oxygen therapy requirements greater than 4 L/min and radiological worsening. Significantly, 11 of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. Compared to survivors, nonsurvivors had significantly longer dialysis vintage, increased lactate dehydrogenase (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l, P = 0.008) and C-reactive protein levels (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl, P = 0.021), and a lower lymphocyte count (0.38 ×103/µl ± 0.14 ×103/µl vs. 0.76 ×103/µl ± 0.48 ×103/µl, P = 0.04) 1 week after clinical onset. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Certain laboratory tests can be used to predict a worsening clinical course.
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Affiliation(s)
- Marian Goicoechea
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Red de Investigación Renal Instituto de Salud Carlos III (ISCIII) Red temática de investigación cooperativa en salud (RETIC) Red de Investigación Renal (REDINREN) RD016/009 (FEDER funds), Madrid, Spain.
| | | | - Nicolás Macías
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Ángela González Rojas
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arturo Bascuñana
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - David Arroyo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Almudena Vega
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Soraya Abad
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eduardo Verde
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Úrsula Verdalles
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Diego Barbieri
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Andrés Felipe Delgado
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Carbayo
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Antonia Mijaylova
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Adriana Acosta
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rosa Melero
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Alberto Tejedor
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Ana Pérez de José
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Fernando Anaya
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Rengel
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Barraca
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Luño
- Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Inés Aragoncillo
- Red de Investigación Renal Instituto de Salud Carlos III (ISCIII) Red temática de investigación cooperativa en salud (RETIC) Red de Investigación Renal (REDINREN) RD016/009 (FEDER funds), Madrid, Spain; Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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García-Prieto AM, Verdalles Ú, de José AP, Verde E, Arroyo D, Aragoncillo I, Linares T, Barbieri D, Goicoechea M. The effect of renin-angiotensin-aldosterone system blockers on the progression of chronic kidney disease in hypertensive elderly patients without proteinuria: PROERCAN study. Rationale and design. Hipertens Riesgo Vasc 2020; 37:101-107. [PMID: 32156479 DOI: 10.1016/j.hipert.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Blood pressure (BP) control is fundamental to the care of patients with chronic kidney disease (CKD), and is relevant at all stages of CKD. Renin-angiotensin-aldosterone system (RAAS) blockers have shown to be effective, not only in BP control but also in reducing proteinuria and slowing CKD progression. However, there is a lack of evidence for recommending RAAS blockers in elderly patients with CKD without proteinuria. The primary outcome of the present study is to evaluate the impact of RAAS blockers on CKD progression in elderly patients without proteinuria. MATERIALS AND METHODS The PROERCAN trial (trial registration, NCT03195023) is a multicentre open-label, randomized controlled clinical trial with 110 participants over 65 years-old with hypertension and CKD stages 3-4 without proteinuria. Patients will be randomized in a 1:1 ratio to either receive RAAS blockers or other antihypertensive drugs, and will be followed up for three years. Primary outcome is the estimated glomerular filtration rate (eGFR) decline at 3 years. Secondary outcomes include BP control, renal and cardiovascular events, and mortality. RESULTS AND CONCLUSIONS The design of this trial is presented here. The results will show if antihypertensive treatment with RAAS blockers has an impact on CKD progression in elderly patients without proteinuria. Any differences in BP control, cardiovascular events, and mortality with each antihypertensive treatment will be also clarified.
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Affiliation(s)
- A M García-Prieto
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
| | - Ú Verdalles
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - A P de José
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - E Verde
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - D Arroyo
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - I Aragoncillo
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - T Linares
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - D Barbieri
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain
| | - M Goicoechea
- Servicio Nefrología Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain; Spanish Research Network (REDINREN), Madrid, Spain
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Iwuchukwu I, Cannizzaro L, Tran V, Alireza S, Arroyo D, Talahama M, McGrade H. Chronic kidney disease is associated with hematoma retraction in patients with intracerebral hemorrhage. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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MARTINS MUNOZ JUDITH, Rubio E, Perez V, Bouarich H, Quiroga B, Gutiérrez E, Arroyo D, Corchete E, Ana Maria TR, Echarri R, Verdalles U, Espejo B, Amman R, Bautista JM, Ortiz A. FP052CLINICAL REAL EXPERIENCE OF PATIENTS WITH AUTOSOMAL DOMINANT POLYCSTIC DISEASE TREATED WITH TOLVAPTAN. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alberto Ortiz
- Hospital Universitario Fundación Jiménez Díaz, MADRID, Spain
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Bermudez-Lopez M, Forne C, Amigo N, Bozic M, Arroyo D, Bretones T, Alonso N, Cambray S, Del Pino MD, Mauricio D, Gorriz JL, Fernandez E, Valdivielso JM. An in-depth analysis shows a hidden atherogenic lipoprotein profile in non-diabetic chronic kidney disease patients. Expert Opin Ther Targets 2019; 23:619-630. [PMID: 31100024 DOI: 10.1080/14728222.2019.1620206] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Chronic kidney disease (CKD) is an independent risk factor for atherosclerotic disease. We hypothesized that CKD promotes a proatherogenic lipid profile modifying lipoprotein composition and particle number. Methods: Cross-sectional study in 395 non-diabetic individuals (209 CKD patients and 186 controls) without statin therapy. Conventional lipid determinations were combined with advanced lipoprotein profiling by nuclear magnetic resonance, and their discrimination ability was assessed by machine learning. Results: CKD patients showed an increase of very-low-density (VLDL) particles and a reduction of LDL particle size. Cholesterol and triglyceride content of VLDLs and intermediate-density (IDL) particles increased. However, low-density (LDL) and high-density (HDL) lipoproteins gained triglycerides and lost cholesterol. Total-Cholesterol, HDL-Cholesterol, LDL-Cholesterol, non-HDL-Cholesterol and Proprotein convertase subtilisin-kexin type (PCSK9) were negatively associated with CKD stages, whereas triglycerides, lipoprotein(a), remnant cholesterol, and the PCSK9/LDL-Cholesterol ratio were positively associated. PCSK9 was positively associated with total-Cholesterol, LDL-Cholesterol, LDL-triglycerides, LDL particle number, IDL-Cholesterol, and remnant cholesterol. Machine learning analysis by random forest revealed that new parameters have a higher discrimination ability to classify patients into the CKD group, compared to traditional parameters alone: area under the ROC curve (95% CI), .789 (.711, .853) vs .687 (.611, .755). Conclusions: non-diabetic CKD patients have a hidden proatherogenic lipoprotein profile.
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Affiliation(s)
- Marcelino Bermudez-Lopez
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
| | - Carles Forne
- b Biostatistics Unit , IRBLleida , Lleida , Spain.,c Department of Basic Medical Sciences , University of Lleida , Lleida , Spain
| | | | - Milica Bozic
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
| | - David Arroyo
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain.,e Servicio de nefrología , Hospital Universitario Severo Ochoa , Leganés , Spain
| | - Teresa Bretones
- f Department of Cardiology , Hospital Universitario Puerta del Mar , Cádiz , Spain
| | - Nuria Alonso
- g Endocrinology and Nutrition Department , Hospital Universitari Germans Trias i Pujol , Badalona , Spain.,h Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM) , Barcelona , Spain
| | - Serafi Cambray
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
| | | | - Didac Mauricio
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain.,h Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM) , Barcelona , Spain.,j Endocrinology and Nutrition Department , Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
| | - Jose Luis Gorriz
- k Hospital Clínico Universitario Valencia , Universitat de Valencia, INCLIVA , Lleida , Spain
| | - Elvira Fernandez
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
| | - Jose Manuel Valdivielso
- a Vascular & Renal Translational Research Group , IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
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30
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Moss K, Wyder M, Braddock V, Arroyo D, Kisely S. Compulsory community treatment and ethnicity: Findings from a culturally and linguistically diverse area of Queensland. Int J Law Psychiatry 2019; 62:154-159. [PMID: 30274852 DOI: 10.1016/j.ijlp.2018.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/31/2018] [Accepted: 09/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare the use of community treatment orders (CTOs) and forensic orders (FOs) in a culturally and linguistically diverse (CALD) population to that in a non-CALD population. METHODS We analysed the relationship between coming from a CALD background and the use of CTOs and FOs on discharge from hospital using merged data from the Metro South Addiction and Mental Health Service's Transitions of Care (ToC) and Consumer Integrated Mental Health Application (CIMHA) databases. RESULTS Nine hundred and seventy-six individual records were included in the data set, of whom eighty-six were from a CALD background (8.8%). Three hundred and eleven patients were on compulsory community treatment. Use of compulsory community treatment (CTOs and FOs) was similar for those born in Australasia, British Isles, North America and Europe but significantly higher for those born elsewhere even after adjusting for socio-demographic and clinical variables (Adj OR 2.19, 95% CI 1.36-3.52). The use of an interpreter significantly increased the likelihood of compulsory community treatment (Adj OR 2.76, 95% CI 1.20-6.35). Restricting the analyses to CTOs only did not alter these results. CONCLUSIONS Metro South residents from a CALD background outside of Europe were over-represented on compulsory community treatment orders. This could reflect the difficulties in accessing voluntary services, communication barriers, stigma associated with mental illness, discrimination, or issues related to accurately diagnosing mental illness cross-culturally. Clinicians need to be aware of the complexity of working with people from diverse cultures and apply these orders judiciously.
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Affiliation(s)
- Katherine Moss
- Metro South Addiction and Mental Health Services, University of Queensland, Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia.
| | - Marianne Wyder
- Metro South Addiction and Mental Health Services, University of Queensland, Brisbane, QLD, Australia
| | - Vivienne Braddock
- Metro South Addiction and Mental Health Services, University of Queensland, Brisbane, QLD, Australia
| | - David Arroyo
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Steve Kisely
- Metro South Addiction and Mental Health Services, University of Queensland, Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
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Ayasreh N, Bullich G, Miquel R, Furlano M, Ruiz P, Lorente L, Valero O, García-González MA, Arhda N, Garin I, Martínez V, Pérez-Gómez V, Fulladosa X, Arroyo D, Martínez-Vea A, Espinosa M, Ballarín J, Ars E, Torra R. Autosomal Dominant Tubulointerstitial Kidney Disease: Clinical Presentation of Patients With ADTKD-UMOD and ADTKD-MUC1. Am J Kidney Dis 2018; 72:411-418. [DOI: 10.1053/j.ajkd.2018.03.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 03/04/2018] [Indexed: 12/17/2022]
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Urdaneta J, Arroyo D, Mon C, Abadal J, Gálvez E, Ortiz M, Camacho R, Herrero JC. Acute hemolytic pancreatitis and hepatitis secondary to percutaneous pharmacomechanical thrombectomy of prosthetic vascular access for hemodialysis. Nefrologia 2018; 39:104-105. [PMID: 30119947 DOI: 10.1016/j.nefro.2018.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jessica Urdaneta
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - David Arroyo
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España.
| | - Carmen Mon
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - José Abadal
- Servicio de Radiología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Esther Gálvez
- Servicio de Radiología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Milagros Ortiz
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Rosa Camacho
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Juan Carlos Herrero
- Servicio de Nefrología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
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Bermúdez-López M, Betriu À, Valdivielso JM, Bretones Del Pino T, Arroyo D, Fernández E. Beyond the traditional lipid parameters in chronic kidney disease. Nefrologia 2017; 38:109-113. [PMID: 29137894 DOI: 10.1016/j.nefro.2017.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Marcelino Bermúdez-López
- Grupo de Investigación Translacional Vascular y Renal, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, España.
| | - Àngels Betriu
- Grupo de Investigación Translacional Vascular y Renal, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, España
| | - Jose M Valdivielso
- Grupo de Investigación Translacional Vascular y Renal, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, España
| | | | - David Arroyo
- Grupo de Investigación Translacional Vascular y Renal, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, España
| | - Elvira Fernández
- Grupo de Investigación Translacional Vascular y Renal, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, España
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Abajo M, Betriu À, Arroyo D, Gracia M, Del Pino MD, Martínez I, Valdivielso JM, Fernández E. Mineral metabolism factors predict accelerated progression of common carotid intima-media thickness in chronic kidney disease: the NEFRONA study. Nephrol Dial Transplant 2017; 32:1882-1891. [PMID: 27566835 DOI: 10.1093/ndt/gfw306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/14/2016] [Indexed: 11/14/2022] Open
Abstract
Background The leading cause of premature death in chronic kidney disease (CKD) is cardiovascular disease (CVD), but risk assessment in renal patients is challenging. The aim of the study was to analyse the factors that predict accelerated progression of common carotid intima-media thickness (CCIMT) in a CKD cohort after 2 years of follow-up (2010-12). Methods The study included 1152 patients from the NEFRONA cohort with CKD stages 3-5D and without a clinical history of CVD. CCIMT was measured at the far wall on both common carotids. CCIMT progression was defined as the change between CCIMT at baseline and at 24 months for each side, averaged and normalized as change per year. Accelerated progressors were defined as those with a CCIMT change ≥75th percentile. Results The median CCIMT progression rate was 0.0125 mm/year, without significant differences between CKD stages. The cut-off value for defining accelerated progression was 0.0425 mm/year. After adjustment, age was a common factor among all CKD stages. Traditional cardiovascular risk factors, such as diabetes and systolic blood pressure, were predictors of progression in CKD stages 4-5, whereas high-density lipoprotein and low-density lipoprotein cholesterol predicted progression in women in stage 3. Mineral metabolism factors predicting accelerated progression were serum phosphorus in stages 3 and 5D; low 25-hydroxyvitamin D and parathyroid hormone levels >110 pg/mL in stages 4-5 and intact parathyroid hormone levels out of the recommended range in stage 5D. Conclusions Mineral metabolism parameters might predict accelerated CCIMT progression from early CKD stages.
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Affiliation(s)
- Maria Abajo
- Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain
| | - Àngels Betriu
- Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain
| | - David Arroyo
- Department of Nephrology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Marta Gracia
- Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain
| | | | - Isabel Martínez
- Department of Nephrology, Hospital de Galdakao, Bilbao, Spain
| | - Jose M Valdivielso
- Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain
| | - Elvira Fernández
- Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.,Department of Nephrology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
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Arroyo D, Betriu A, Valls J, Gorriz JL, Pallares V, Abajo M, Gracia M, Valdivielso JM, Fernandez E. Factors influencing pathological ankle-brachial index values along the chronic kidney disease spectrum: the NEFRONA study. Nephrol Dial Transplant 2017; 32:513-520. [PMID: 27190385 DOI: 10.1093/ndt/gfw039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/03/2016] [Indexed: 11/14/2022] Open
Abstract
Background The ankle-brachial index (ABI) is widely used to diagnose subclinical peripheral artery disease (PAD) in the general population, but data assessing its prevalence and related factors in different chronic kidney disease (CKD) stages are scarce. The aim of this study is to evaluate the prevalence and associated factors of pathological ABI values in CKD patients. Methods NEFRONA is a multicentre prospective project that included 2445 CKD patients from 81 centres and 559 non-CKD subjects from 9 primary care centres across Spain. A trained team collected clinical and laboratory data, performed vascular ultrasounds and measured the ABI. Results PAD prevalence was higher in CKD than in controls (28.0 versus 12.3%, P < 0.001). Prevalence increased in more advanced CKD stages, due to more patients with an ABI ≥1.4, rather than ≤0.9. Diabetes was the only factor predicting both pathological values in all CKD stages. Age, female sex, carotid plaques, higher carotid intima-media thickness, higher high-sensitivity C-reactive protein (hsCRP) and triglycerides, and lower 25-hydroxi-vitamin D were independently associated with an ABI ≤0.9. Higher phosphate and hsCRP, lower low-density lipoprotein (LDL)-cholesterol and dialysis were associated with an ABI ≥1.4. A stratified analysis showed different associated factors in each CKD stage, with phosphate being especially important in earlier CKD, and LDL-cholesterol being an independent predictor only in Sage 5D CKD. Conclusions Asymptomatic PAD is very prevalent in all CKD stages, but factors related to a low or high pathological ABI differ, revealing different pathogenic pathways. Diabetes, dyslipidaemia, inflammation and mineral-bone disorders play a role in the appearance of PAD in CKD.
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Affiliation(s)
- David Arroyo
- Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Unit for Detection and Treatment of Atherotrombotic Disease (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Experimental Nephrology Laboratory, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Angels Betriu
- Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Unit for Detection and Treatment of Atherotrombotic Disease (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Joan Valls
- Biostatistics Unit, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Jose L Gorriz
- Nephrology Department, Hospital Universitario Doctor Peset, Valencia, Spain and
| | - Vicente Pallares
- Unidad de Vigilancia de la Salud, Unión de Mutuas, Medicine Department, Universitat Jaume I, Castellón, Spain
| | - Maria Abajo
- Experimental Nephrology Laboratory, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Marta Gracia
- Experimental Nephrology Laboratory, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Jose Manuel Valdivielso
- Experimental Nephrology Laboratory, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Elvira Fernandez
- Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Unit for Detection and Treatment of Atherotrombotic Disease (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Experimental Nephrology Laboratory, IRB-Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
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Valdivielso JM, Betriu A, Martinez-Alonso M, Arroyo D, Bermudez-Lopez M, Fernandez E. Factors predicting cardiovascular events in chronic kidney disease patients. Role of subclinical atheromatosis extent assessed by vascular ultrasound. PLoS One 2017; 12:e0186665. [PMID: 29045466 PMCID: PMC5646852 DOI: 10.1371/journal.pone.0186665] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/05/2017] [Indexed: 01/12/2023] Open
Abstract
Patients with chronic kidney disease (CKD) have an increased incidence of cardiovascular events (CVE). The contribution of subclinical atheromatosis extent, including femoral arteries, to CVE in CKD patients has not been investigated. In this paper, we examine the prognostic value of subclinical atheromatosis extent, assessed as the number of arterial territories with plaque, in predicting the incidence of major and minor CVE. The NEFRONA is a multicenter, prospective cohorts study that recruited 2445 CKD subjects and 559 controls, free from previous cardiovascular disease, in 81 medical centers across Spain. The presence of atheroma plaque was assessed by arterial ultrasound in ten arterial territories (carotid and femoral). The predictive power of the presence or absence of atheroma plaque in any territory was compared with the quantification of atheroma extent as the number of territories with plaque. During the median follow up of 48 months, 216 CVE were reported. Factors predicting the incidence of CVE in the whole cohort were being male, CKD patient, lower levels of 25(OH) vitamin D, higher levels of cholesterol and the extent of subclinical atheromatosis, yielding a higher concordance (C) index than the presence or absence of plaque. In stratified analysis including specific factors of CKD patients not on dialysis, the variables predicting CVE were the same as in the whole cohort, plus higher levels of potassium. Again, the inclusion of the information about atheromatosis as number of territories with plaque, presented a higher C index than the presence or absence of plaque. In the dialysis population, significant variables were older age, diabetes, dialysis vintage and higher levels of cholesterol and phosphate. In this case the higher C index was obtained with the information about plaque presence. Subclinical atheromatosis extent, including femoral arteries, influences CVE in CKD and its detection could improve the prediction of cardiovascular events.
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Affiliation(s)
- José M. Valdivielso
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
- * E-mail: (JMV); (EF)
| | - Angels Betriu
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | | | - David Arroyo
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - Marcelino Bermudez-Lopez
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - Elvira Fernandez
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
- * E-mail: (JMV); (EF)
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Albillos A, Zamora J, Martínez J, Arroyo D, Ahmad I, De-la-Peña J, Garcia-Pagán JC, Lo GH, Sarin S, Sharma B, Abraldes J, Bosch J, Garcia-Tsao G. Stratifying risk in the prevention of recurrent variceal hemorrhage: Results of an individual patient meta-analysis. Hepatology 2017; 66:1219-1231. [PMID: 28543862 PMCID: PMC5605404 DOI: 10.1002/hep.29267] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/09/2017] [Accepted: 05/15/2017] [Indexed: 02/06/2023]
Abstract
UNLABELLED Endoscopic variceal ligation plus beta-blockers (EVL+BB) is currently recommended for variceal rebleeding prophylaxis, a recommendation that extends to all patients with cirrhosis with previous variceal bleeding irrespective of prognostic stage. Individualizing patient care is relevant, and in published studies on variceal rebleeding prophylaxis, there is a lack of information regarding response to therapy by prognostic stage. This study aimed at comparing EVL plus BB with monotherapy (EVL or BB) on all-source rebleeding and mortality in patients with cirrhosis and previous variceal bleeding stratified by cirrhosis severity (Child A versus B/C) by means of individual time-to-event patient data meta-analysis from randomized controlled trials. The study used individual data on 389 patients from three trials comparing EVL plus BB versus BB and 416 patients from four trials comparing EVL plus BB versus EVL. Compared with BB alone, EVL plus BB reduced overall rebleeding in Child A (incidence rate ratio 0.40; 95% confidence interval, 0.18-0.89; P = 0.025) but not in Child B/C, without differences in mortality. The effect of EVL on rebleeding was different according to Child (P for interaction <0.001). Conversely, compared with EVL, EVL plus BB reduced rebleeding in both Child A and B/C, with a significant reduction in mortality in Child B/C (incidence rate ratio 0.46; 95% confidence interval, 0.25-0.85; P = 0.013). CONCLUSION Outcomes of therapies to prevent variceal rebleeding differ depending on cirrhosis severity: in patients with preserved liver function (Child A), combination therapy is recommended because it is more effective in preventing rebleeding, without modifying survival, while in patients with advanced liver failure (Child B/C), EVL alone carries an increased risk of rebleeding and death compared with combination therapy, underlining that BB is the key element of combination therapy. (Hepatology 2017;66:1219-1231).
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Affiliation(s)
- Agustín Albillos
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcalá, IRYCIS, Madrid, Spain,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain,Barts and the London School of Medicine and Dentistry, Queen Mary University of London,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martínez
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcalá, IRYCIS, Madrid, Spain
| | - David Arroyo
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Irfan Ahmad
- Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan
| | | | - Juan-Carlos Garcia-Pagán
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain,Liver Unit. Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - GH Lo
- E-DA Hospital, Kaohsiung, Taiwan
| | - Shiv Sarin
- Institute of Liver and Biliary Sciences, New Delhi, India
| | - Barjesh Sharma
- Institute of Liver and Biliary Sciences, New Delhi, India
| | - Juan Abraldes
- Cirrhosis Care Clinic, Division of Gastroenterology (Liver Unit), University of Alberta, CEGIIR, Edmonton, AB, Canada
| | - Jaime Bosch
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain,Liver Unit. Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain,Swiss Liver Center, Inselspital, Berne University, Switzerland
| | - Guadalupe Garcia-Tsao
- Yale University School of Medicine, New Haven, CT, United States,VA-CT Healthcare System, West Haven, CT, United States
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Abstract
INTRODUCTION Chronic kidney disease (CKD) is a world-wide health concern associated with a significantly higher cardiovascular morbidity and mortality. One of the principal cardiovascular risk factors is the lipid profile. CKD patients have a more frequent and progressive atheromatous disease that cannot be explained by the classical lipid parameters used in the daily clinical practice. Areas covered: The current review summarizes prevailing knowledge on the role of lipids in atheromathosis in CKD patients, including an overview of lipoprotein metabolism highlighting the CKD-induced alterations. Moreover, to obtain information beyond traditional lipid parameters, new state-of-the-art technologies such as lipoprotein subfraction profiling and lipidomics are also reviewed. Finally, we analyse the potential of new lipoprotein subclasses as therapeutic targets in CKD. Expert opinion: The CKD-induced lipid profile has specific features distinct from the general population. Besides quantitative alterations, renal patients have a plethora of qualitative lipid alterations that cannot be detected by routine determinations and are responsible for the excess of cardiovascular risk. New parameters, such as lipoprotein particle number and size, together with new biomarkers obtained by lipidomics will personalize the management of these patients. Therefore, nephrologists need to be aware of new insights into lipoprotein metabolism to improve cardiovascular risk assessment.
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Affiliation(s)
- Marcelino Bermúdez-López
- a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain
| | - David Arroyo
- a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain
| | - Àngels Betriu
- a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain
| | - Luis Masana
- b Unitat de Medicina Vascular i Metabolisme , Sant Joan University Hospital, IISPV, CIBERDEM, Universitat Rovira I Virgili , Reus , Spain
| | - Elvira Fernández
- a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain
| | - Jose M Valdivielso
- a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain
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Newton AJH, Seidenstein AH, McDougal RA, Pérez-Cervera A, Huguet G, M-Seara T, Haimerl C, Angulo-Garcia D, Torcini A, Cossart R, Malvache A, Skiker K, Maouene M, Ragognetti G, Lorusso L, Viggiano A, Marcelli A, Senatore R, Parziale A, Stramaglia S, Pellicoro M, Angelini L, Amico E, Aerts H, Cortés J, Laureys S, Marinazzo D, Stramaglia S, Bassez I, Faes L, Almgren H, Razi A, Van de Steen F, Krebs R, Aerts H, Kanari L, Dlotko P, Scolamiero M, Levi R, Shillcock J, de Kock CP, Hess K, Markram H, Ly C, Marsat G, Gillespie T, Sandström M, Abrams M, Grethe JS, Martone M, De Gernier R, Solinas S, Rössert C, Haelterman M, Massar S, Pasquale V, Pastore VP, Martinoia S, Massobrio P, Capone C, Tort-Colet N, Sanchez-Vives MV, Mattia M, Almasi A, Cloherty SL, Grayden DB, Wong YT, Ibbotson MR, Meffin H, Prince LY, Tsaneva-Atanasova K, Mellor JR, Mazzoni A, Rosa M, Carpaneto J, Romito LM, Priori A, Micera S, Migliore R, Lupascu CA, Franchina F, Bologna LL, Romani A, Saray S, Van Geit W, Káli S, Thomson A, Mercer A, Lange S, Falck J, Muller E, Schürmann F, Todorov D, Capps R, Barnett W, Molkov Y, Devalle F, Pazó D, Montbrió E, Mochol G, Azab H, Hayden BY, Moreno-Bote R, Balasubramani PP, Chakravarthy SV, Muddapu VR, Gheorghiu MD, Mimica B, Withlock J, Mureșan RC, Zick JL, Schultz K, Blackman RK, Chafee MV, Netoff TI, Roberts N, Nagaraj V, Lamperski A, Netoff TI, Grado LL, Johnson MD, Darrow DP, Lonardoni D, Amin H, Di Marco S, Maccione A, Berdondini L, Nieus T, Stimberg M, Goodman DFM, Nowotny T, Koren V, Dragoi V, Obermayer K, Castro S, Fernandez M, El-Deredy W, Xu K, Maidana JP, Orio P, Chen W, Hepburn I, Casalegno F, Devresse A, Ovcharenko A, Pereira F, Delalondre F, De Schutter E, Bratby P, Gallimore AR, Klingbeil G, Zamora C, Zang Y, Crotty P, Palmerduca E, Antonietti A, Casellato C, Erö C, D’Angelo E, Gewaltig MO, Pedrocchi A, Bytschok I, Dold D, Schemmel J, Meier K, Petrovici MA, Shen HA, Surace SC, Pfister JP, Lefebvre B, Marre O, Yger P, Papoutsi A, Park J, Ash R, Smirnakis S, Poirazi P, Felix RA, Dimitrov AG, Portfors C, Daun S, Toth TI, Jędrzejewska-Szmek J, Kabbani N, Blackwel KT, Moezzi B, Schaworonkow N, Plogmacher L, Goldsworthy MR, Hordacre B, McDonnell MD, Iannella N, Ridding MC, Triesch J, Maex R, Safaryan K, Steuber V, Tang R, Tang YY, Verveyko DV, Brazhe AR, Verisokin AY, Postnov DE, Günay C, Panuccio G, Giugliano M, Prinz AA, Varona P, Rabinovich MI, Denham J, Ranner T, Cohen N, Reva M, Rebola N, Kirizs T, Nusser Z, DiGregorio D, Mavritsaki E, Rentzelas P, Ukani NH, Tomkins A, Yeh CH, Bruning W, Fenichel AL, Zhou Y, Huang YC, Florescu D, Ortiz CL, Richmond P, Lo CC, Coca D, Chiang AS, Lazar AA, Moezzi B, Creaser JL, Lin C, Ashwin P, Brown JT, Ridler T, Levenstein D, Watson BO, Buzsáki G, Rinzel J, Curtu R, Nguyen A, Assadzadeh S, Robinson PA, Sanz-Leon P, Forlim CG, de Almeida LOB, Pinto RD, Rodríguez FB, Lareo Á, Forlim CG, Rodríguez FB, Montero A, Mosqueiro T, Huerta R, Rodriguez FB, Changoluisa V, Rodriguez FB, Cordeiro VL, Ceballos CC, Kamiji NL, Roque AC, Lytton WW, Knox A, Rosenthal JJC, Daun S, Popovych S, Liu L, Wang BA, Tóth TI, Grefkes C, Fink GR, Rosjat N, Perez-Trujillo A, Espinal A, Sotelo-Figueroa MA, Cruz-Aceves I, Rostro-Gonzalez H, Zapotocky M, Hoskovcová M, Kopecká J, Ulmanová O, Růžička E, Gärtner M, Duvarci S, Roeper J, Schneider G, Albert S, Schmack K, Remme M, Schreiber S, Migliore M, Lupascu CA, Bologna LL, Antonel SM, Courcol JD, Schürmann F, Çelikok SU, Navarro-López EM, Şengör NS, Elibol R, Sengor NS, Özdemir MY, Li T, Arleo A, Sheynikhovich D, Nakamura A, Shimono M, Song Y, Park S, Choi I, Jeong J, Shin HS, Sadeh S, Gleeson P, Angus Silver R, Chatzikalymniou AP, Skinner FK, Sanchez-Rodriguez LM, Sotero RC, Hertäg L, Mackwood O, Sprekeler H, Puhlmann S, Weber SN, Higgins D, Naumann LB, Weber SN, Iyer R, Mihalas S, Ticcinelli V, Stankovski T, McClintock PVE, Stefanovska A, Janjić P, Solev D, Seifert G, Kocarev L, Steinhäuser C, Salmasi M, Glasauer S, Stemmler M, Zhang D, Zhang C, Stepanyants A, Goncharenko J, Kros L, Davey N, de Zeeuw C, Hoebeek F, Sinha A, Adams R, Schmuker M, Psarrou M, Schilstra M, Torben-Nielsen B, Metzner C, Schweikard A, Mäki-Marttunen T, Zurowski B, Marinazzo D, Faes L, Stramaglia S, Jordan HOC, Stringer SM, Gajewska-Dendek E, Suffczyński P, Tam N, Zouridakis G, Pollonini L, Tang YY, Asl MM, Valizadeh A, Tass PA, Nold A, Fan W, Konrad S, Endle H, Vogt J, Tchumatchenko T, Herpich J, Tetzlaff C, Luboeinski J, Nachstedt T, Ciba M, Bahmer A, Thielemann C, Kuebler ES, Tauskela JS, Thivierge JP, Bakker R, García-Amado M, Evangelio M, Clascá F, Tiesinga P, Buckley CL, Toyoizumi T, Dubreuil AM, Monasson R, Treves A, Spalla D, Rosay S, Kleberg FI, Wong W, de Oliveira Floriano B, Matsuo T, Uchida T, Dibenedetto D, Uludağ K, Goodarzinick A, Schmidt M, Hilgetag CC, Diesmann M, van Albada SJ, Fauth M, van Rossum M, Reyes-Sánchez M, Amaducci R, Muñiz C, Varona P, Elices I, Arroyo D, Levi R, Cohen B, Chow C, Vattikuti S, Bertolotti E, Burioni R, di Volo M, Vezzani A, Menzat B, Vogels TP, Wagatsuma N, Saha S, Kapoor R, Kerr R, Wagner J, del Molino LCG, Yang GR, Mejias JF, Wang XJ, Song H, Goodliffe J, Luebke J, Weaver CM, Thomas J, Sinha N, Shaju N, Maszczyk T, Jin J, Cash SS, Dauwels J, Brandon Westover M, Karimian M, Moerel M, De Weerd P, Burwick T, Westra RL, Abeysuriya R, Hadida J, Sotiropoulos S, Jbabdi S, Woolrich M, Bensmail C, Wrobel B, Zhou X, Ji Z, Liu X, Xia Y, Wu S, Wang X, Zhang M, Wu S, Ofer N, Shefi O, Yaari G, Carnevale T, Majumdar A, Sivagnanam S, Yoshimoto K, Smirnova EY, Amakhin DV, Malkin SL, Zaitsev AV, Chizhov AV, Zaleshina M, Zaleshin A, Barranca VJ, Zhu G, Skilling QM, Maruyama D, Ognjanovski N, Aton SJ, Zochowski M, Wu J, Aton S, Rich S, Booth V, Budak M, Dura-Bernal S, Neymotin SA, Suter BA, Shepherd GMG, Felton MA, Yu AB, Boothe DL, Oie KS, Franaszczuk PJ, Shuvaev SA, Başerdem B, Zador A, Koulakov AA, López-Madrona VJ, Pereda E, Mirasso CR, Canals S, Masoli S, Rongala UB, Mazzoni A, Spanne A, Jorntell H, Oddo CM, Vartanov AV, Neklyudova AK, Kozlovskiy SA, Kiselnikov AA, Marakshina JA, Teleńczuk M, Teleńczuk B, Destexhe A, Kuokkanen PT, Kraemer A, McColgan T, Carr CE, Kempter R. 26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3. BMC Neurosci 2017. [PMCID: PMC5592441 DOI: 10.1186/s12868-017-0372-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gracia M, Betriu Ã, Martínez M, Arroyo D, Abajo M, Fernández E, Valdivielso JM. MP178KLOTHO GENE POLYMORPHISMS ARE ASSOCIATED WITH PROGRESSION OF ATHEROMATOSIS IN PATIENTS WITH CKD. RESULTS OF TWO YEARS FOLLOW-UP OF THE NEFRONA COHORT. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx164.mp178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sánchez E, Betriu À, Arroyo D, López C, Hernández M, Rius F, Fernández E, Lecube A. Skin Autofluorescence and Subclinical Atherosclerosis in Mild to Moderate Chronic Kidney Disease: A Case-Control Study. PLoS One 2017; 12:e0170778. [PMID: 28141808 PMCID: PMC5283665 DOI: 10.1371/journal.pone.0170778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/10/2017] [Indexed: 01/09/2023] Open
Abstract
Advanced glycation end-products (AGEs) are increased and predict mortality in patients with chronic kidney disease (CKD) who are undergoing hemodialysis, irrespective of the presence of type 2 diabetes. However, little information exits about the relationship between AGEs and subclinical atherosclerosis at the early stages of CKD. A case-control study was performed including 87 patients with mild-to-moderate stages of CKD (glomerular filtration rate from 89 to 30 ml/min/per 1.73m2) and 87 non-diabetic non-CKD subjects matched by age, gender, body mass index, and waist circumference. Skin autofluorescence (AF), a non-invasive assessment of AGEs, was measured. The presence of atheromatous disease in carotid and femoral arteries was evaluated using vascular ultrasound, and vascular age and SCORE risk were estimated. Patients with mild-to-moderate stages of CKD showed an increase in skin AF compared with control subjects (2.5±0.6 vs. 2.2±0.4 AU, p<0.001). A skin AF value >2.0 AU was accompanied by a 3-fold increased risk of detecting the presence of an atheromathous plaque (OR 3.0, 95% CI 1.4–6.5, p = 0.006). When vascular age was assessed through skin AF, subjects with CKD were almost 12 years older than control subjects (70.3±25.5 vs. 58.5±20.2 years, p = 0.001). Skin AF was negatively correlated with glomerular filtration rate (r = -0.354, p<0.001) and LDL-cholesterol (r = -0.269, p = 0.001), and positively correlated with age (r = 0.472, p<0.001), pulse pressure (r = 0.238, p = 0.002), and SCORE risk (r = 0.451, p<0.001). A stepwise multivariate regression analysis showed that age and glomerular filtration rate independently predicted skin AF (R2 = 0.289, p<0.001). Skin AF is elevated in patients with mild-to-moderate CKD compared with control subjects. This finding may be independently associated with the glomerular filtration rate and the presence of subclinical atheromatous disease. Therefore, the use of skin AF may help to accurately evaluate the real cardiovascular risk at the early stages of CKD.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department. Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Lleida, Catalonia, Spain
| | - Àngels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida. Lleida, Catalonia, Spain
| | - David Arroyo
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida. Lleida, Catalonia, Spain
| | - Carolina López
- Endocrinology and Nutrition Department. Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Lleida, Catalonia, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department. Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Lleida, Catalonia, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department. Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Lleida, Catalonia, Spain
| | - Elvira Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Nephrology Department, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida. Lleida, Catalonia, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department. Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Lleida, Catalonia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- * E-mail:
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Abad S, Vega A, Quiroga B, Arroyo D, Panizo N, Reque JE, López-Gómez JM. Toxinas unidas a proteínas: valor añadido en su eliminación con altos volúmenes convectivos. Nefrologia 2016; 36:637-642. [DOI: 10.1016/j.nefro.2016.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 04/06/2016] [Accepted: 05/04/2016] [Indexed: 12/19/2022] Open
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Arroyo D. EtCO₂ and Lactate: Correlation may be key to early sepsis detection. JEMS 2016; 41:48-49. [PMID: 29182252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Gracia M, Betriu À, Martínez M, Arroyo D, Abajo M, Fernández E, Valdivielso J. Klotho gene polymorphisms are associated with progression of atheromatosis in patients with CKD. Results of two years follow-up of the NEFRONA cohort. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sharpee TO, Destexhe A, Kawato M, Sekulić V, Skinner FK, Wójcik DK, Chintaluri C, Cserpán D, Somogyvári Z, Kim JK, Kilpatrick ZP, Bennett MR, Josić K, Elices I, Arroyo D, Levi R, Rodriguez FB, Varona P, Hwang E, Kim B, Han HB, Kim T, McKenna JT, Brown RE, McCarley RW, Choi JH, Rankin J, Popp PO, Rinzel J, Tabas A, Rupp A, Balaguer-Ballester E, Maturana MI, Grayden DB, Cloherty SL, Kameneva T, Ibbotson MR, Meffin H, Koren V, Lochmann T, Dragoi V, Obermayer K, Psarrou M, Schilstra M, Davey N, Torben-Nielsen B, Steuber V, Ju H, Yu J, Hines ML, Chen L, Yu Y, Kim J, Leahy W, Shlizerman E, Birgiolas J, Gerkin RC, Crook SM, Viriyopase A, Memmesheimer RM, Gielen S, Dabaghian Y, DeVito J, Perotti L, Kim AJ, Fenk LM, Cheng C, Maimon G, Zhao C, Widmer Y, Sprecher S, Senn W, Halnes G, Mäki-Marttunen T, Keller D, Pettersen KH, Andreassen OA, Einevoll GT, Yamada Y, Steyn-Ross ML, Alistair Steyn-Ross D, Mejias JF, Murray JD, Kennedy H, Wang XJ, Kruscha A, Grewe J, Benda J, Lindner B, Badel L, Ohta K, Tsuchimoto Y, Kazama H, Kahng B, Tam ND, Pollonini L, Zouridakis G, Soh J, Kim D, Yoo M, Palmer SE, Culmone V, Bojak I, Ferrario A, Merrison-Hort R, Borisyuk R, Kim CS, Tezuka T, Joo P, Rho YA, Burton SD, Bard Ermentrout G, Jeong J, Urban NN, Marsalek P, Kim HH, Moon SH, Lee DW, Lee SB, Lee JY, Molkov YI, Hamade K, Teka W, Barnett WH, Kim T, Markin S, Rybak IA, Forro C, Dermutz H, Demkó L, Vörös J, Babichev A, Huang H, Verduzco-Flores S, Dos Santos F, Andras P, Metzner C, Schweikard A, Zurowski B, Roach JP, Sander LM, Zochowski MR, Skilling QM, Ognjanovski N, Aton SJ, Zochowski M, Wang SJ, Ouyang G, Guang J, Zhang M, Michael Wong KY, Zhou C, Robinson PA, Sanz-Leon P, Drysdale PM, Fung F, Abeysuriya RG, Rennie CJ, Zhao X, Choe Y, Yang HF, Mi Y, Lin X, Wu S, Liedtke J, Schottdorf M, Wolf F, Yamamura Y, Wickens JR, Rumbell T, Ramsey J, Reyes A, Draguljić D, Hof PR, Luebke J, Weaver CM, He H, Yang X, Ma H, Xu Z, Wang Y, Baek K, Morris LS, Kundu P, Voon V, Agnes EJ, Vogels TP, Podlaski WF, Giese M, Kuravi P, Vogels R, Seeholzer A, Podlaski W, Ranjan R, Vogels T, Torres JJ, Baroni F, Latorre R, Gips B, Lowet E, Roberts MJ, de Weerd P, Jensen O, van der Eerden J, Goodarzinick A, Niry MD, Valizadeh A, Pariz A, Parsi SS, Warburton JM, Marucci L, Tamagnini F, Brown J, Tsaneva-Atanasova K, Kleberg FI, Triesch J, Moezzi B, Iannella N, Schaworonkow N, Plogmacher L, Goldsworthy MR, Hordacre B, McDonnell MD, Ridding MC, Zapotocky M, Smit D, Fouquet C, Trembleau A, Dasgupta S, Nishikawa I, Aihara K, Toyoizumi T, Robb DT, Mellen N, Toporikova N, Tang R, Tang YY, Liang G, Kiser SA, Howard JH, Goncharenko J, Voronenko SO, Ahamed T, Stephens G, Yger P, Lefebvre B, Spampinato GLB, Esposito E, et Olivier Marre MS, Choi H, Song MH, Chung S, Lee DD, Sompolinsky H, Phillips RS, Smith J, Chatzikalymniou AP, Ferguson K, Alex Cayco Gajic N, Clopath C, Angus Silver R, Gleeson P, Marin B, Sadeh S, Quintana A, Cantarelli M, Dura-Bernal S, Lytton WW, Davison A, Li L, Zhang W, Wang D, Song Y, Park S, Choi I, Shin HS, Choi H, Pasupathy A, Shea-Brown E, Huh D, Sejnowski TJ, Vogt SM, Kumar A, Schmidt R, Van Wert S, Schiff SJ, Veale R, Scheutz M, Lee SW, Gallinaro J, Rotter S, Rubchinsky LL, Cheung CC, Ratnadurai-Giridharan S, Shomali SR, Ahmadabadi MN, Shimazaki H, Nader Rasuli S, Zhao X, Rasch MJ, Wilting J, Priesemann V, Levina A, Rudelt L, Lizier JT, Spinney RE, Rubinov M, Wibral M, Bak JH, Pillow J, Zaho Y, Park IM, Kang J, Park HJ, Jang J, Paik SB, Choi W, Lee C, Song M, Lee H, Park Y, Yilmaz E, Baysal V, Ozer M, Saska D, Nowotny T, Chan HK, Diamond A, Herrmann CS, Murray MM, Ionta S, Hutt A, Lefebvre J, Weidel P, Duarte R, Morrison A, Lee JH, Iyer R, Mihalas S, Koch C, Petrovici MA, Leng L, Breitwieser O, Stöckel D, Bytschok I, Martel R, Bill J, Schemmel J, Meier K, Esler TB, Burkitt AN, Kerr RR, Tahayori B, Nolte M, Reimann MW, Muller E, Markram H, Parziale A, Senatore R, Marcelli A, Skiker K, Maouene M, Neymotin SA, Seidenstein A, Lakatos P, Sanger TD, Menzies RJ, McLauchlan C, van Albada SJ, Kedziora DJ, Neymotin S, Kerr CC, Suter BA, Shepherd GMG, Ryu J, Lee SH, Lee J, Lee HJ, Lim D, Wang J, Lee H, Jung N, Anh Quang L, Maeng SE, Lee TH, Lee JW, Park CH, Ahn S, Moon J, Choi YS, Kim J, Jun SB, Lee S, Lee HW, Jo S, Jun E, Yu S, Goetze F, Lai PY, Kim S, Kwag J, Jang HJ, Filipović M, Reig R, Aertsen A, Silberberg G, Bachmann C, Buttler S, Jacobs H, Dillen K, Fink GR, Kukolja J, Kepple D, Giaffar H, Rinberg D, Shea S, Koulakov A, Bahuguna J, Tetzlaff T, Kotaleski JH, Kunze T, Peterson A, Knösche T, Kim M, Kim H, Park JS, Yeon JW, Kim SP, Kang JH, Lee C, Spiegler A, Petkoski S, Palva MJ, Jirsa VK, Saggio ML, Siep SF, Stacey WC, Bernar C, Choung OH, Jeong Y, Lee YI, Kim SH, Jeong M, Lee J, Kwon J, Kralik JD, Jahng J, Hwang DU, Kwon JH, Park SM, Kim S, Kim H, Kim PS, Yoon S, Lim S, Park C, Miller T, Clements K, Ahn S, Ji EH, Issa FA, Baek J, Oba S, Yoshimoto J, Doya K, Ishii S, Mosqueiro TS, Strube-Bloss MF, Smith B, Huerta R, Hadrava M, Hlinka J, Bos H, Helias M, Welzig CM, Harper ZJ, Kim WS, Shin IS, Baek HM, Han SK, Richter R, Vitay J, Beuth F, Hamker FH, Toppin K, Guo Y, Graham BP, Kale PJ, Gollo LL, Stern M, Abbott LF, Fedorov LA, Giese MA, Ardestani MH, Faraji MJ, Preuschoff K, Gerstner W, van Gendt MJ, Briaire JJ, Kalkman RK, Frijns JHM, Lee WH, Frangou S, Fulcher BD, Tran PHP, Fornito A, Gliske SV, Lim E, Holman KA, Fink CG, Kim JS, Mu S, Briggman KL, Sebastian Seung H, Wegener D, Bohnenkamp L, Ernst UA, Devor A, Dale AM, Lines GT, Edwards A, Tveito A, Hagen E, Senk J, Diesmann M, Schmidt M, Bakker R, Shen K, Bezgin G, Hilgetag CC, van Albada SJ, Sun H, Sourina O, Huang GB, Klanner F, Denk C, Glomb K, Ponce-Alvarez A, Gilson M, Ritter P, Deco G, Witek MAG, Clarke EF, Hansen M, Wallentin M, Kringelbach ML, Vuust P, Klingbeil G, De Schutter E, Chen W, Zang Y, Hong S, Takashima A, Zamora C, Gallimore AR, Goldschmidt D, Manoonpong P, Karoly PJ, Freestone DR, Soundry D, Kuhlmann L, Paninski L, Cook M, Lee J, Fishman YI, Cohen YE, Roberts JA, Cocchi L, Sweeney Y, Lee S, Jung WS, Kim Y, Jung Y, Song YK, Chavane F, Soman K, Muralidharan V, Srinivasa Chakravarthy V, Shivkumar S, Mandali A, Pragathi Priyadharsini B, Mehta H, Davey CE, Brinkman BAW, Kekona T, Rieke F, Buice M, De Pittà M, Berry H, Brunel N, Breakspear M, Marsat G, Drew J, Chapman PD, Daly KC, Bradle SP, Seo SB, Su J, Kavalali ET, Blackwell J, Shiau L, Buhry L, Basnayake K, Lee SH, Levy BA, Baker CI, Leleu T, Philips RT, Chhabria K. 25th Annual Computational Neuroscience Meeting: CNS-2016. BMC Neurosci 2016; 17 Suppl 1:54. [PMID: 27534393 PMCID: PMC5001212 DOI: 10.1186/s12868-016-0283-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A1 Functional advantages of cell-type heterogeneity in neural circuits Tatyana O. Sharpee A2 Mesoscopic modeling of propagating waves in visual cortex Alain Destexhe A3 Dynamics and biomarkers of mental disorders Mitsuo Kawato F1 Precise recruitment of spiking output at theta frequencies requires dendritic h-channels in multi-compartment models of oriens-lacunosum/moleculare hippocampal interneurons Vladislav Sekulić, Frances K. Skinner F2 Kernel methods in reconstruction of current sources from extracellular potentials for single cells and the whole brains Daniel K. Wójcik, Chaitanya Chintaluri, Dorottya Cserpán, Zoltán Somogyvári F3 The synchronized periods depend on intracellular transcriptional repression mechanisms in circadian clocks. Jae Kyoung Kim, Zachary P. Kilpatrick, Matthew R. Bennett, Kresimir Josić O1 Assessing irregularity and coordination of spiking-bursting rhythms in central pattern generators Irene Elices, David Arroyo, Rafael Levi, Francisco B. Rodriguez, Pablo Varona O2 Regulation of top-down processing by cortically-projecting parvalbumin positive neurons in basal forebrain Eunjin Hwang, Bowon Kim, Hio-Been Han, Tae Kim, James T. McKenna, Ritchie E. Brown, Robert W. McCarley, Jee Hyun Choi O3 Modeling auditory stream segregation, build-up and bistability James Rankin, Pamela Osborn Popp, John Rinzel O4 Strong competition between tonotopic neural ensembles explains pitch-related dynamics of auditory cortex evoked fields Alejandro Tabas, André Rupp, Emili Balaguer-Ballester O5 A simple model of retinal response to multi-electrode stimulation Matias I. Maturana, David B. Grayden, Shaun L. Cloherty, Tatiana Kameneva, Michael R. Ibbotson, Hamish Meffin O6 Noise correlations in V4 area correlate with behavioral performance in visual discrimination task Veronika Koren, Timm Lochmann, Valentin Dragoi, Klaus Obermayer O7 Input-location dependent gain modulation in cerebellar nucleus neurons Maria Psarrou, Maria Schilstra, Neil Davey, Benjamin Torben-Nielsen, Volker Steuber O8 Analytic solution of cable energy function for cortical axons and dendrites Huiwen Ju, Jiao Yu, Michael L. Hines, Liang Chen, Yuguo Yu O9 C. elegans interactome: interactive visualization of Caenorhabditis elegans worm neuronal network Jimin Kim, Will Leahy, Eli Shlizerman O10 Is the model any good? Objective criteria for computational neuroscience model selection Justas Birgiolas, Richard C. Gerkin, Sharon M. Crook O11 Cooperation and competition of gamma oscillation mechanisms Atthaphon Viriyopase, Raoul-Martin Memmesheimer, Stan Gielen O12 A discrete structure of the brain waves Yuri Dabaghian, Justin DeVito, Luca Perotti O13 Direction-specific silencing of the Drosophila gaze stabilization system Anmo J. Kim, Lisa M. Fenk, Cheng Lyu, Gaby Maimon O14 What does the fruit fly think about values? A model of olfactory associative learning Chang Zhao, Yves Widmer, Simon Sprecher,Walter Senn O15 Effects of ionic diffusion on power spectra of local field potentials (LFP) Geir Halnes, Tuomo Mäki-Marttunen, Daniel Keller, Klas H. Pettersen,Ole A. Andreassen, Gaute T. Einevoll O16 Large-scale cortical models towards understanding relationship between brain structure abnormalities and cognitive deficits Yasunori Yamada O17 Spatial coarse-graining the brain: origin of minicolumns Moira L. Steyn-Ross, D. Alistair Steyn-Ross O18 Modeling large-scale cortical networks with laminar structure Jorge F. Mejias, John D. Murray, Henry Kennedy, Xiao-Jing Wang O19 Information filtering by partial synchronous spikes in a neural population Alexandra Kruscha, Jan Grewe, Jan Benda, Benjamin Lindner O20 Decoding context-dependent olfactory valence in Drosophila Laurent Badel, Kazumi Ohta, Yoshiko Tsuchimoto, Hokto Kazama P1 Neural network as a scale-free network: the role of a hub B. Kahng P2 Hemodynamic responses to emotions and decisions using near-infrared spectroscopy optical imaging Nicoladie D. Tam P3 Phase space analysis of hemodynamic responses to intentional movement directions using functional near-infrared spectroscopy (fNIRS) optical imaging technique Nicoladie D.Tam, Luca Pollonini, George Zouridakis P4 Modeling jamming avoidance of weakly electric fish Jaehyun Soh, DaeEun Kim P5 Synergy and redundancy of retinal ganglion cells in prediction Minsu Yoo, S. E. Palmer P6 A neural field model with a third dimension representing cortical depth Viviana Culmone, Ingo Bojak P7 Network analysis of a probabilistic connectivity model of the Xenopus tadpole spinal cord Andrea Ferrario, Robert Merrison-Hort, Roman Borisyuk P8 The recognition dynamics in the brain Chang Sub Kim P9 Multivariate spike train analysis using a positive definite kernel Taro Tezuka P10 Synchronization of burst periods may govern slow brain dynamics during general anesthesia Pangyu Joo P11 The ionic basis of heterogeneity affects stochastic synchrony Young-Ah Rho, Shawn D. Burton, G. Bard Ermentrout, Jaeseung Jeong, Nathaniel N. Urban P12 Circular statistics of noise in spike trains with a periodic component Petr Marsalek P14 Representations of directions in EEG-BCI using Gaussian readouts Hoon-Hee Kim, Seok-hyun Moon, Do-won Lee, Sung-beom Lee, Ji-yong Lee, Jaeseung Jeong P15 Action selection and reinforcement learning in basal ganglia during reaching movements Yaroslav I. Molkov, Khaldoun Hamade, Wondimu Teka, William H. Barnett, Taegyo Kim, Sergey Markin, Ilya A. Rybak P17 Axon guidance: modeling axonal growth in T-Junction assay Csaba Forro, Harald Dermutz, László Demkó, János Vörös P19 Transient cell assembly networks encode persistent spatial memories Yuri Dabaghian, Andrey Babichev P20 Theory of population coupling and applications to describe high order correlations in large populations of interacting neurons Haiping Huang P21 Design of biologically-realistic simulations for motor control Sergio Verduzco-Flores P22 Towards understanding the functional impact of the behavioural variability of neurons Filipa Dos Santos, Peter Andras P23 Different oscillatory dynamics underlying gamma entrainment deficits in schizophrenia Christoph Metzner, Achim Schweikard, Bartosz Zurowski P24 Memory recall and spike frequency adaptation James P. Roach, Leonard M. Sander, Michal R. Zochowski P25 Stability of neural networks and memory consolidation preferentially occur near criticality Quinton M. Skilling, Nicolette Ognjanovski, Sara J. Aton, Michal Zochowski P26 Stochastic Oscillation in Self-Organized Critical States of Small Systems: Sensitive Resting State in Neural Systems Sheng-Jun Wang, Guang Ouyang, Jing Guang, Mingsha Zhang, K. Y. Michael Wong, Changsong Zhou P27 Neurofield: a C++ library for fast simulation of 2D neural field models Peter A. Robinson, Paula Sanz-Leon, Peter M. Drysdale, Felix Fung, Romesh G. Abeysuriya, Chris J. Rennie, Xuelong Zhao P28 Action-based grounding: Beyond encoding/decoding in neural code Yoonsuck Choe, Huei-Fang Yang P29 Neural computation in a dynamical system with multiple time scales Yuanyuan Mi, Xiaohan Lin, Si Wu P30 Maximum entropy models for 3D layouts of orientation selectivity Joscha Liedtke, Manuel Schottdorf, Fred Wolf P31 A behavioral assay for probing computations underlying curiosity in rodents Yoriko Yamamura, Jeffery R. Wickens P32 Using statistical sampling to balance error function contributions to optimization of conductance-based models Timothy Rumbell, Julia Ramsey, Amy Reyes, Danel Draguljić, Patrick R. Hof, Jennifer Luebke, Christina M. Weaver P33 Exploration and implementation of a self-growing and self-organizing neuron network building algorithm Hu He, Xu Yang, Hailin Ma, Zhiheng Xu, Yuzhe Wang P34 Disrupted resting state brain network in obese subjects: a data-driven graph theory analysis Kwangyeol Baek, Laurel S. Morris, Prantik Kundu, Valerie Voon P35 Dynamics of cooperative excitatory and inhibitory plasticity Everton J. Agnes, Tim P. Vogels P36 Frequency-dependent oscillatory signal gating in feed-forward networks of integrate-and-fire neurons William F. Podlaski, Tim P. Vogels P37 Phenomenological neural model for adaptation of neurons in area IT Martin Giese, Pradeep Kuravi, Rufin Vogels P38 ICGenealogy: towards a common topology of neuronal ion channel function and genealogy in model and experiment Alexander Seeholzer, William Podlaski, Rajnish Ranjan, Tim Vogels P39 Temporal input discrimination from the interaction between dynamic synapses and neural subthreshold oscillations Joaquin J. Torres, Fabiano Baroni, Roberto Latorre, Pablo Varona P40 Different roles for transient and sustained activity during active visual processing Bart Gips, Eric Lowet, Mark J. Roberts, Peter de Weerd, Ole Jensen, Jan van der Eerden P41 Scale-free functional networks of 2D Ising model are highly robust against structural defects: neuroscience implications Abdorreza Goodarzinick, Mohammad D. Niry, Alireza Valizadeh P42 High frequency neuron can facilitate propagation of signal in neural networks Aref Pariz, Shervin S. Parsi, Alireza Valizadeh P43 Investigating the effect of Alzheimer’s disease related amyloidopathy on gamma oscillations in the CA1 region of the hippocampus Julia M. Warburton, Lucia Marucci, Francesco Tamagnini, Jon Brown, Krasimira Tsaneva-Atanasova P44 Long-tailed distributions of inhibitory and excitatory weights in a balanced network with eSTDP and iSTDP Florence I. Kleberg, Jochen Triesch P45 Simulation of EMG recording from hand muscle due to TMS of motor cortex Bahar Moezzi, Nicolangelo Iannella, Natalie Schaworonkow, Lukas Plogmacher, Mitchell R. Goldsworthy, Brenton Hordacre, Mark D. McDonnell, Michael C. Ridding, Jochen Triesch P46 Structure and dynamics of axon network formed in primary cell culture Martin Zapotocky, Daniel Smit, Coralie Fouquet, Alain Trembleau P47 Efficient signal processing and sampling in random networks that generate variability Sakyasingha Dasgupta, Isao Nishikawa, Kazuyuki Aihara, Taro Toyoizumi P48 Modeling the effect of riluzole on bursting in respiratory neural networks Daniel T. Robb, Nick Mellen, Natalia Toporikova P49 Mapping relaxation training using effective connectivity analysis Rongxiang Tang, Yi-Yuan Tang P50 Modeling neuron oscillation of implicit sequence learning Guangsheng Liang, Seth A. Kiser, James H. Howard, Jr., Yi-Yuan Tang P51 The role of cerebellar short-term synaptic plasticity in the pathology and medication of downbeat nystagmus Julia Goncharenko, Neil Davey, Maria Schilstra, Volker Steuber P52 Nonlinear response of noisy neurons Sergej O. Voronenko, Benjamin Lindner P53 Behavioral embedding suggests multiple chaotic dimensions underlie C. elegans locomotion Tosif Ahamed, Greg Stephens P54 Fast and scalable spike sorting for large and dense multi-electrodes recordings Pierre Yger, Baptiste Lefebvre, Giulia Lia Beatrice Spampinato, Elric Esposito, Marcel Stimberg et Olivier Marre P55 Sufficient sampling rates for fast hand motion tracking Hansol Choi, Min-Ho Song P56 Linear readout of object manifolds SueYeon Chung, Dan D. Lee, Haim Sompolinsky P57 Differentiating models of intrinsic bursting and rhythm generation of the respiratory pre-Bötzinger complex using phase response curves Ryan S. Phillips, Jeffrey Smith P58 The effect of inhibitory cell network interactions during theta rhythms on extracellular field potentials in CA1 hippocampus Alexandra Pierri Chatzikalymniou, Katie Ferguson, Frances K. Skinner P59 Expansion recoding through sparse sampling in the cerebellar input layer speeds learning N. Alex Cayco Gajic, Claudia Clopath, R. Angus Silver P60 A set of curated cortical models at multiple scales on Open Source Brain Padraig Gleeson, Boris Marin, Sadra Sadeh, Adrian Quintana, Matteo Cantarelli, Salvador Dura-Bernal, William W. Lytton, Andrew Davison, R. Angus Silver P61 A synaptic story of dynamical information encoding in neural adaptation Luozheng Li, Wenhao Zhang, Yuanyuan Mi, Dahui Wang, Si Wu P62 Physical modeling of rule-observant rodent behavior Youngjo Song, Sol Park, Ilhwan Choi, Jaeseung Jeong, Hee-sup Shin P64 Predictive coding in area V4 and prefrontal cortex explains dynamic discrimination of partially occluded shapes Hannah Choi, Anitha Pasupathy, Eric Shea-Brown P65 Stability of FORCE learning on spiking and rate-based networks Dongsung Huh, Terrence J. Sejnowski P66 Stabilising STDP in striatal neurons for reliable fast state recognition in noisy environments Simon M. Vogt, Arvind Kumar, Robert Schmidt P67 Electrodiffusion in one- and two-compartment neuron models for characterizing cellular effects of electrical stimulation Stephen Van Wert, Steven J. Schiff P68 STDP improves speech recognition capabilities in spiking recurrent circuits parameterized via differential evolution Markov Chain Monte Carlo Richard Veale, Matthias Scheutz P69 Bidirectional transformation between dominant cortical neural activities and phase difference distributions Sang Wan Lee P70 Maturation of sensory networks through homeostatic structural plasticity Júlia Gallinaro, Stefan Rotter P71 Corticothalamic dynamics: structure, number of solutions and stability of steady-state solutions in the space of synaptic couplings Paula Sanz-Leon, Peter A. Robinson P72 Optogenetic versus electrical stimulation of the parkinsonian basal ganglia. Computational study Leonid L. Rubchinsky, Chung Ching Cheung, Shivakeshavan Ratnadurai-Giridharan P73 Exact spike-timing distribution reveals higher-order interactions of neurons Safura Rashid Shomali, Majid Nili Ahmadabadi, Hideaki Shimazaki, S. Nader Rasuli P74 Neural mechanism of visual perceptual learning using a multi-layered neural network Xiaochen Zhao, Malte J. Rasch P75 Inferring collective spiking dynamics from mostly unobserved systems Jens Wilting, Viola Priesemann P76 How to infer distributions in the brain from subsampled observations Anna Levina, Viola Priesemann P77 Influences of embedding and estimation strategies on the inferred memory of single spiking neurons Lucas Rudelt, Joseph T. Lizier, Viola Priesemann P78 A nearest-neighbours based estimator for transfer entropy between spike trains Joseph T. Lizier, Richard E. Spinney, Mikail Rubinov, Michael Wibral, Viola Priesemann P79 Active learning of psychometric functions with multinomial logistic models Ji Hyun Bak, Jonathan Pillow P81 Inferring low-dimensional network dynamics with variational latent Gaussian process Yuan Zaho, Il Memming Park P82 Computational investigation of energy landscapes in the resting state subcortical brain network Jiyoung Kang, Hae-Jeong Park P83 Local repulsive interaction between retinal ganglion cells can generate a consistent spatial periodicity of orientation map Jaeson Jang, Se-Bum Paik P84 Phase duration of bistable perception reveals intrinsic time scale of perceptual decision under noisy condition Woochul Choi, Se-Bum Paik P85 Feedforward convergence between retina and primary visual cortex can determine the structure of orientation map Changju Lee, Jaeson Jang, Se-Bum Paik P86 Computational method classifying neural network activity patterns for imaging data Min Song, Hyeonsu Lee, Se-Bum Paik P87 Symmetry of spike-timing-dependent-plasticity kernels regulates volatility of memory Youngjin Park, Woochul Choi, Se-Bum Paik P88 Effects of time-periodic coupling strength on the first-spike latency dynamics of a scale-free network of stochastic Hodgkin-Huxley neurons Ergin Yilmaz, Veli Baysal, Mahmut Ozer P89 Spectral properties of spiking responses in V1 and V4 change within the trial and are highly relevant for behavioral performance Veronika Koren, Klaus Obermayer P90 Methods for building accurate models of individual neurons Daniel Saska, Thomas Nowotny P91 A full size mathematical model of the early olfactory system of honeybees Ho Ka Chan, Alan Diamond, Thomas Nowotny P92 Stimulation-induced tuning of ongoing oscillations in spiking neural networks Christoph S. Herrmann, Micah M. Murray, Silvio Ionta, Axel Hutt, Jérémie Lefebvre P93 Decision-specific sequences of neural activity in balanced random networks driven by structured sensory input Philipp Weidel, Renato Duarte, Abigail Morrison P94 Modulation of tuning induced by abrupt reduction of SST cell activity Jung H. Lee, Ramakrishnan Iyer, Stefan Mihalas P95 The functional role of VIP cell activation during locomotion Jung H. Lee, Ramakrishnan Iyer, Christof Koch, Stefan Mihalas P96 Stochastic inference with spiking neural networks Mihai A. Petrovici, Luziwei Leng, Oliver Breitwieser, David Stöckel, Ilja Bytschok, Roman Martel, Johannes Bill, Johannes Schemmel, Karlheinz Meier P97 Modeling orientation-selective electrical stimulation with retinal prostheses Timothy B. Esler, Anthony N. Burkitt, David B. Grayden, Robert R. Kerr, Bahman Tahayori, Hamish Meffin P98 Ion channel noise can explain firing correlation in auditory nerves Bahar Moezzi, Nicolangelo Iannella, Mark D. McDonnell P99 Limits of temporal encoding of thalamocortical inputs in a neocortical microcircuit Max Nolte, Michael W. Reimann, Eilif Muller, Henry Markram P100 On the representation of arm reaching movements: a computational model Antonio Parziale, Rosa Senatore, Angelo Marcelli P101 A computational model for investigating the role of cerebellum in acquisition and retention of motor behavior Rosa Senatore, Antonio Parziale, Angelo Marcelli P102 The emergence of semantic categories from a large-scale brain network of semantic knowledge K. Skiker, M. Maouene P103 Multiscale modeling of M1 multitarget pharmacotherapy for dystonia Samuel A. Neymotin, Salvador Dura-Bernal, Alexandra Seidenstein, Peter Lakatos, Terence D. Sanger, William W. Lytton P104 Effect of network size on computational capacity Salvador Dura-Bernal, Rosemary J. Menzies, Campbell McLauchlan, Sacha J. van Albada, David J. Kedziora, Samuel Neymotin, William W. Lytton, Cliff C. Kerr P105 NetPyNE: a Python package for NEURON to facilitate development and parallel simulation of biological neuronal networks Salvador Dura-Bernal, Benjamin A. Suter, Samuel A. Neymotin, Cliff C. Kerr, Adrian Quintana, Padraig Gleeson, Gordon M. G. Shepherd, William W. Lytton P107 Inter-areal and inter-regional inhomogeneity in co-axial anisotropy of Cortical Point Spread in human visual areas Juhyoung Ryu, Sang-Hun Lee P108 Two bayesian quanta of uncertainty explain the temporal dynamics of cortical activity in the non-sensory areas during bistable perception Joonwon Lee, Sang-Hun Lee P109 Optimal and suboptimal integration of sensory and value information in perceptual decision making Hyang Jung Lee, Sang-Hun Lee P110 A Bayesian algorithm for phoneme Perception and its neural implementation Daeseob Lim, Sang-Hun Lee P111 Complexity of EEG signals is reduced during unconsciousness induced by ketamine and propofol Jisung Wang, Heonsoo Lee P112 Self-organized criticality of neural avalanche in a neural model on complex networks Nam Jung, Le Anh Quang, Seung Eun Maeng, Tae Ho Lee, Jae Woo Lee P113 Dynamic alterations in connection topology of the hippocampal network during ictal-like epileptiform activity in an in vitro rat model Chang-hyun Park, Sora Ahn, Jangsup Moon, Yun Seo Choi, Juhee Kim, Sang Beom Jun, Seungjun Lee, Hyang Woon Lee P114 Computational model to replicate seizure suppression effect by electrical stimulation Sora Ahn, Sumin Jo, Eunji Jun, Suin Yu, Hyang Woon Lee, Sang Beom Jun, Seungjun Lee P115 Identifying excitatory and inhibitory synapses in neuronal networks from spike trains using sorted local transfer entropy Felix Goetze, Pik-Yin Lai P116 Neural network model for obstacle avoidance based on neuromorphic computational model of boundary vector cell and head direction cell Seonghyun Kim, Jeehyun Kwag P117 Dynamic gating of spike pattern propagation by Hebbian and anti-Hebbian spike timing-dependent plasticity in excitatory feedforward network model Hyun Jae Jang, Jeehyun Kwag P118 Inferring characteristics of input correlations of cells exhibiting up-down state transitions in the rat striatum Marko Filipović, Ramon Reig, Ad Aertsen, Gilad Silberberg, Arvind Kumar P119 Graph properties of the functional connected brain under the influence of Alzheimer’s disease Claudia Bachmann, Simone Buttler, Heidi Jacobs, Kim Dillen, Gereon R. Fink, Juraj Kukolja, Abigail Morrison P120 Learning sparse representations in the olfactory bulb Daniel Kepple, Hamza Giaffar, Dima Rinberg, Steven Shea, Alex Koulakov P121 Functional classification of homologous basal-ganglia networks Jyotika Bahuguna,Tom Tetzlaff, Abigail Morrison, Arvind Kumar, Jeanette Hellgren Kotaleski P122 Short term memory based on multistability Tim Kunze, Andre Peterson, Thomas Knösche P123 A physiologically plausible, computationally efficient model and simulation software for mammalian motor units Minjung Kim, Hojeong Kim P125 Decoding laser-induced somatosensory information from EEG Ji Sung Park, Ji Won Yeon, Sung-Phil Kim P126 Phase synchronization of alpha activity for EEG-based personal authentication Jae-Hwan Kang, Chungho Lee, Sung-Phil Kim P129 Investigating phase-lags in sEEG data using spatially distributed time delays in a large-scale brain network model Andreas Spiegler, Spase Petkoski, Matias J. Palva, Viktor K. Jirsa P130 Epileptic seizures in the unfolding of a codimension-3 singularity Maria L. Saggio, Silvan F. Siep, Andreas Spiegler, William C. Stacey, Christophe Bernard, Viktor K. Jirsa P131 Incremental dimensional exploratory reasoning under multi-dimensional environment Oh-hyeon Choung, Yong Jeong P132 A low-cost model of eye movements and memory in personal visual cognition Yong-il Lee, Jaeseung Jeong P133 Complex network analysis of structural connectome of autism spectrum disorder patients Su Hyun Kim, Mir Jeong, Jaeseung Jeong P134 Cognitive motives and the neural correlates underlying human social information transmission, gossip Jeungmin Lee, Jaehyung Kwon, Jerald D. Kralik, Jaeseung Jeong P135 EEG hyperscanning detects neural oscillation for the social interaction during the economic decision-making Jaehwan Jahng, Dong-Uk Hwang, Jaeseung Jeong P136 Detecting purchase decision based on hyperfrontality of the EEG Jae-Hyung Kwon, Sang-Min Park, Jaeseung Jeong P137 Vulnerability-based critical neurons, synapses, and pathways in the Caenorhabditis elegans connectome Seongkyun Kim, Hyoungkyu Kim, Jerald D. Kralik, Jaeseung Jeong P138 Motif analysis reveals functionally asymmetrical neurons in C. elegans Pyeong Soo Kim, Seongkyun Kim, Hyoungkyu Kim, Jaeseung Jeong P139 Computational approach to preference-based serial decision dynamics: do temporal discounting and working memory affect it? Sangsup Yoon, Jaehyung Kwon, Sewoong Lim, Jaeseung Jeong P141 Social stress induced neural network reconfiguration affects decision making and learning in zebrafish Choongseok Park, Thomas Miller, Katie Clements, Sungwoo Ahn, Eoon Hye Ji, Fadi A. Issa P142 Descriptive, generative, and hybrid approaches for neural connectivity inference from neural activity data JeongHun Baek, Shigeyuki Oba, Junichiro Yoshimoto, Kenji Doya, Shin Ishii P145 Divergent-convergent synaptic connectivities accelerate coding in multilayered sensory systems Thiago S. Mosqueiro, Martin F. Strube-Bloss, Brian Smith, Ramon Huerta P146 Swinging networks Michal Hadrava, Jaroslav Hlinka P147 Inferring dynamically relevant motifs from oscillatory stimuli: challenges, pitfalls, and solutions Hannah Bos, Moritz Helias P148 Spatiotemporal mapping of brain network dynamics during cognitive tasks using magnetoencephalography and deep learning Charles M. Welzig, Zachary J. Harper P149 Multiscale complexity analysis for the segmentation of MRI images Won Sup Kim, In-Seob Shin, Hyeon-Man Baek, Seung Kee Han P150 A neuro-computational model of emotional attention René Richter, Julien Vitay, Frederick Beuth, Fred H. Hamker P151 Multi-site delayed feedback stimulation in parkinsonian networks Kelly Toppin, Yixin Guo P152 Bistability in Hodgkin–Huxley-type equations Tatiana Kameneva, Hamish Meffin, Anthony N. Burkitt, David B. Grayden P153 Phase changes in postsynaptic spiking due to synaptic connectivity and short term plasticity: mathematical analysis of frequency dependency Mark D. McDonnell, Bruce P. Graham P154 Quantifying resilience patterns in brain networks: the importance of directionality Penelope J. Kale, Leonardo L. Gollo P155 Dynamics of rate-model networks with separate excitatory and inhibitory populations Merav Stern, L. F. Abbott P156 A model for multi-stable dynamics in action recognition modulated by integration of silhouette and shading cues Leonid A. Fedorov, Martin A. Giese P157 Spiking model for the interaction between action recognition and action execution Mohammad Hovaidi Ardestani, Martin Giese P158 Surprise-modulated belief update: how to learn within changing environments? Mohammad Javad Faraji, Kerstin Preuschoff, Wulfram Gerstner P159 A fast, stochastic and adaptive model of auditory nerve responses to cochlear implant stimulation Margriet J. van Gendt, Jeroen J. Briaire, Randy K. Kalkman, Johan H. M. Frijns P160 Quantitative comparison of graph theoretical measures of simulated and empirical functional brain networks Won Hee Lee, Sophia Frangou P161 Determining discriminative properties of fMRI signals in schizophrenia using highly comparative time-series analysis Ben D. Fulcher, Patricia H. P. Tran, Alex Fornito P162 Emergence of narrowband LFP oscillations from completely asynchronous activity during seizures and high-frequency oscillations Stephen V. Gliske, William C. Stacey, Eugene Lim, Katherine A. Holman, Christian G. Fink P163 Neuronal diversity in structure and function: cross-validation of anatomical and physiological classification of retinal ganglion cells in the mouse Jinseop S. Kim, Shang Mu, Kevin L. Briggman, H. Sebastian Seung, the EyeWirers P164 Analysis and modelling of transient firing rate changes in area MT in response to rapid stimulus feature changes Detlef Wegener, Lisa Bohnenkamp, Udo A. Ernst P165 Step-wise model fitting accounting for high-resolution spatial measurements: construction of a layer V pyramidal cell model with reduced morphology Tuomo Mäki-Marttunen, Geir Halnes, Anna Devor, Christoph Metzner, Anders M. Dale, Ole A. Andreassen, Gaute T. Einevoll P166 Contributions of schizophrenia-associated genes to neuron firing and cardiac pacemaking: a polygenic modeling approach Tuomo Mäki-Marttunen, Glenn T. Lines, Andy Edwards, Aslak Tveito, Anders M. Dale, Gaute T. Einevoll, Ole A. Andreassen P167 Local field potentials in a 4 × 4 mm2 multi-layered network model Espen Hagen, Johanna Senk, Sacha J. van Albada, Markus Diesmann P168 A spiking network model explains multi-scale properties of cortical dynamics Maximilian Schmidt, Rembrandt Bakker, Kelly Shen, Gleb Bezgin, Claus-Christian Hilgetag, Markus Diesmann, Sacha Jennifer van Albada P169 Using joint weight-delay spike-timing dependent plasticity to find polychronous neuronal groups Haoqi Sun, Olga Sourina, Guang-Bin Huang, Felix Klanner, Cornelia Denk P170 Tensor decomposition reveals RSNs in simulated resting state fMRI Katharina Glomb, Adrián Ponce-Alvarez, Matthieu Gilson, Petra Ritter, Gustavo Deco P171 Getting in the groove: testing a new model-based method for comparing task-evoked vs resting-state activity in fMRI data on music listening Matthieu Gilson, Maria AG Witek, Eric F. Clarke, Mads Hansen, Mikkel Wallentin, Gustavo Deco, Morten L. Kringelbach, Peter Vuust P172 STochastic engine for pathway simulation (STEPS) on massively parallel processors Guido Klingbeil, Erik De Schutter P173 Toolkit support for complex parallel spatial stochastic reaction–diffusion simulation in STEPS Weiliang Chen, Erik De Schutter P174 Modeling the generation and propagation of Purkinje cell dendritic spikes caused by parallel fiber synaptic input Yunliang Zang, Erik De Schutter P175 Dendritic morphology determines how dendrites are organized into functional subunits Sungho Hong, Akira Takashima, Erik De Schutter P176 A model of Ca2+/calmodulin-dependent protein kinase II activity in long term depression at Purkinje cells Criseida Zamora, Andrew R. Gallimore, Erik De Schutter P177 Reward-modulated learning of population-encoded vectors for insect-like navigation in embodied agents Dennis Goldschmidt, Poramate Manoonpong, Sakyasingha Dasgupta P178 Data-driven neural models part II: connectivity patterns of human seizures Philippa J. Karoly, Dean R. Freestone, Daniel Soundry, Levin Kuhlmann, Liam Paninski, Mark Cook P179 Data-driven neural models part I: state and parameter estimation Dean R. Freestone, Philippa J. Karoly, Daniel Soundry, Levin Kuhlmann, Mark Cook P180 Spectral and spatial information processing in human auditory streaming Jaejin Lee, Yonatan I. Fishman, Yale E. Cohen P181 A tuning curve for the global effects of local perturbations in neural activity: Mapping the systems-level susceptibility of the brain Leonardo L. Gollo, James A. Roberts, Luca Cocchi P182 Diverse homeostatic responses to visual deprivation mediated by neural ensembles Yann Sweeney, Claudia Clopath P183 Opto-EEG: a novel method for investigating functional connectome in mouse brain based on optogenetics and high density electroencephalography Soohyun Lee, Woo-Sung Jung, Jee Hyun Choi P184 Biphasic responses of frontal gamma network to repetitive sleep deprivation during REM sleep Bowon Kim, Youngsoo Kim, Eunjin Hwang, Jee Hyun Choi P185 Brain-state correlate and cortical connectivity for frontal gamma oscillations in top-down fashion assessed by auditory steady-state response Younginha Jung, Eunjin Hwang, Yoon-Kyu Song, Jee Hyun Choi P186 Neural field model of localized orientation selective activation in V1 James Rankin, Frédéric Chavane P187 An oscillatory network model of Head direction and Grid cells using locomotor inputs Karthik Soman, Vignesh Muralidharan, V. Srinivasa Chakravarthy P188 A computational model of hippocampus inspired by the functional architecture of basal ganglia Karthik Soman, Vignesh Muralidharan, V. Srinivasa Chakravarthy P189 A computational architecture to model the microanatomy of the striatum and its functional properties Sabyasachi Shivkumar, Vignesh Muralidharan, V. Srinivasa Chakravarthy P190 A scalable cortico-basal ganglia model to understand the neural dynamics of targeted reaching Vignesh Muralidharan, Alekhya Mandali, B. Pragathi Priyadharsini, Hima Mehta, V. Srinivasa Chakravarthy P191 Emergence of radial orientation selectivity from synaptic plasticity Catherine E. Davey, David B. Grayden, Anthony N. Burkitt P192 How do hidden units shape effective connections between neurons? Braden A. W. Brinkman, Tyler Kekona, Fred Rieke, Eric Shea-Brown, Michael Buice P193 Characterization of neural firing in the presence of astrocyte-synapse signaling Maurizio De Pittà, Hugues Berry, Nicolas Brunel P194 Metastability of spatiotemporal patterns in a large-scale network model of brain dynamics James A. Roberts, Leonardo L. Gollo, Michael Breakspear P195 Comparison of three methods to quantify detection and discrimination capacity estimated from neural population recordings Gary Marsat, Jordan Drew, Phillip D. Chapman, Kevin C. Daly, Samual P. Bradley P196 Quantifying the constraints for independent evoked and spontaneous NMDA receptor mediated synaptic transmission at individual synapses Sat Byul Seo, Jianzhong Su, Ege T. Kavalali, Justin Blackwell P199 Gamma oscillation via adaptive exponential integrate-and-fire neurons LieJune Shiau, Laure Buhry, Kanishka Basnayake P200 Visual face representations during memory retrieval compared to perception Sue-Hyun Lee, Brandon A. Levy, Chris I. Baker P201 Top-down modulation of sequential activity within packets modeled using avalanche dynamics Timothée Leleu, Kazuyuki Aihara Q28 An auto-encoder network realizes sparse features under the influence of desynchronized vascular dynamics Ryan T. Philips, Karishma Chhabria, V. Srinivasa Chakravarthy
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Panizo N, Reque J, Arroyo D, Santos A, Rengel M, Rodriguez M, Vega A, Abad S, López-Gómez J. SP651CLINICAL IMPACT OF OVERHYDRATION AND FAT EXCESS IN RENAL ALLOGRAFT RECIPIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw178.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Valdivielso J, Martinez-Alonso M, Betriu À, Gracia M, Arroyo D, Abajo M, Salgueira M, Gorriz JL, Fernandez E. MP267THE NUMBER OF ARTERIAL TERRITORIES WITH ATHEROMA PLAQUE PREDICTS THE TIME FREE FROM CARDIOVASCULAR EVENTS IN CHRONIC KIDNEY DISEASE. ANALYSIS OF THE NEFRONA STUDY AFTER 36 MONTHS OF FOLLOW-UP. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw188.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Betriu À, Farràs C, Abajo M, Martinez-Alonso M, Arroyo D, Barbé F, Buti M, Lecube A, Portero M, Purroy F, Torres G, Valdivielso JM, Fernández E. Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project. Nefrologia 2016; 36:389-96. [PMID: 27044887 DOI: 10.1016/j.nefro.2016.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/27/2016] [Accepted: 02/15/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic kidney disease (CKD) and atherosclerosis are 2 interrelated diseases that increase the risk of cardiovascular morbidity and mortality. The objectives of the ILERVAS project are: 1) to determine the prevalence of subclinical arterial disease and hidden kidney disease; 2) to assess the impact of early diagnosis of both diseases on cardiovascular morbidity and mortality and also on the progression of CKD; 3) to have a platform of data and biological samples. METHODS Randomized intervention study. From 2015 to 2017, 19,800 people (9,900 in the intervention group and 9,900 in the control group) aged between 45 and 70 years without previous history of cardiovascular disease and with at least one cardiovascular risk factor will be randomly selected from the primary health care centres across the province of Lérida. A team of experts will travel around in a mobile unit to carry out the following baseline tests on the intervention group: Artery ultrasound; (carotid, femoral, transcranial and abdominal aorta); ankle-brachial index; spirometry; determination of advanced glycation end products; dried blood spot and urine spot tests. Additionally, blood and urine samples will be collected and stored in the biobank to identify new biomarkers using omics studies. Participants will be followed up until 2025 for identification of cardiovascular events, treatment changes and changes in lifestyle. CONCLUSIONS The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.
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Affiliation(s)
- Àngels Betriu
- Institut de Recerca Biomèdica (IRBLleida), Lérida, España; Unidad de Diagnóstico y Tratamiento Enfermedades Aterotrombóticas (UDETMA), Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lérida, España
| | | | - María Abajo
- Institut de Recerca Biomèdica (IRBLleida), Lérida, España
| | | | - David Arroyo
- Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lérida, España
| | - Ferran Barbé
- Servicio de Neumología, Hospital Universitari Arnau de Vilanova, Lérida, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - Miquel Buti
- Dirección de Atención Primaria, Lérida, España
| | - Albert Lecube
- Servicio de Endocrinología, Hospital Universitari Arnau de Vilanova, Lérida, España
| | - Manuel Portero
- Grupo de Fisiopatología Metabólica, Departamento de Medicina Experimental, IRBLleida, Lérida, España
| | - Francisco Purroy
- Servicio de Neurología, Hospital Universitari Arnau de Vilanova, Lérida, España
| | - Gerard Torres
- Servicio de Medicina Interna, Hospital Universitari de Santa María, Lérida, España
| | - José Manuel Valdivielso
- Institut de Recerca Biomèdica (IRBLleida), Lérida, España; Laboratorio de Nefrología Experimental, IRBLleida, Lérida, España
| | - Elvira Fernández
- Institut de Recerca Biomèdica (IRBLleida), Lérida, España; Unidad de Diagnóstico y Tratamiento Enfermedades Aterotrombóticas (UDETMA), Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lérida, España; Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lérida, España.
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Gracia M, Betriu À, Martínez-Alonso M, Arroyo D, Abajo M, Fernández E, Valdivielso JM. Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD. Clin J Am Soc Nephrol 2015; 11:287-96. [PMID: 26668022 DOI: 10.2215/cjn.01240215] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 11/02/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our multicenter, prospective, observational study included 1553 patients with CKD (2009-2011). Carotid and femoral ultrasounds were performed at baseline and after 24 months. A subgroup of 476 patients with CKD was also randomized to undergo ultrasound examination at 12 months. Progression of atheromatosis was defined as an increase in the number of plaque territories analyzed by multivariate logistic regression. RESULTS Prevalence of atheromatosis was 68.7% and progressed in 59.8% of patients after 24 months. CKD progression was associated with atheromatosis progression, suggesting a close association between pathologies. Variables significantly predicting atheromatosis progression, independent from CKD stages, were diabetes and two interactions of age with ferritin and plaque at baseline. Given that multiple interactions were found between CKD stage and age, phosphate, smoking, dyslipidemia, body mass index, systolic BP (SBP), carotid intima-media thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (25OH vitamin D), and antiplatelet and phosphate binders use, the analysis was stratified by CKD stages. In stage 3, two interactions (age with phosphate and plaque at baseline) were found, and smoking, diabetes, SBP, low levels of 25OH vitamin D, and no treatment with phosphate binders were positively associated with atheromatosis progression. In stages 4 and 5, three interactions (age with ferritin and plaque and plaque with smoking) were found, and SBP was positively associated with atheromatosis progression. In dialysis, an interaction between body mass index and 25OH vitamin D was found, and age, dyslipidemia, carotid intima-media thickness, low cholesterol, ferritin, and uric acid were positively associated with atheromatosis progression. CONCLUSIONS Atheromatosis progression affects more than one half of patients with CKD, and predictive factors differ depending on CKD stage.
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Affiliation(s)
- Marta Gracia
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Àngels Betriu
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | | | - David Arroyo
- Nephrology, University Hospital Arnau de Vilanova, Lleida, Spain
| | - María Abajo
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | | | - José M Valdivielso
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain;
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Arroyo D, Panizo N, Abad S, Vega A, Rincón A, de José AP, López-Gómez JM. Impact of the Limitations in Fluid Overload Assessment by Bioimpedance Spectroscopy. Perit Dial Int 2015; 35:604. [PMID: 26450488 DOI: 10.3747/pdi.2015.00164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- D Arroyo
- Nephrology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - N Panizo
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - S Abad
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Vega
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Rincón
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A P de José
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J M López-Gómez
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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