1
|
Rodríguez-Espinosa D, Morantes L, García J, Broseta JJ, Cuadrado-Payán E, Colmenero J, Torregrosa JV, Diekmann F, Esforzado N. Long-Term Outcomes of Incidental Liver Malignancies in Simultaneous Liver-Kidney Transplant Recipients. Transplant Proc 2024; 56:330-334. [PMID: 38350821 DOI: 10.1016/j.transproceed.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The pretransplant diagnosis of liver malignancies in nodular cirrhotic livers remains a diagnostic challenge despite current advances. Although the prognostic impact of incidental hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (iCC) in liver transplant recipients is well documented, there are no data on the impact in simultaneous liver kidney transplant (LKT) recipients. METHODS This is a single-center observational, retrospective study of all LKT performed from May 1993 to April 2022. Among these patients, demographic data, immunosuppressive therapy, rejection episodes, and prevalence of incidental HCC or iCC were evaluated. RESULTS One hundred eight LKTs were performed and 6 were excluded. There were 13 patients with incidental carcinomas in the explanted liver: one of them with both an HCC and iCC, one with an iCC, and the remaining with an HCC. One case of iCC died. No other recurrences occurred. There were no cases of incidental HCC nor iCC in patients with a hereditary or metabolic LKT indication. We found no differences in the 5-year patient survival, and death-censored kidney and liver graft survival rates for those LKT with an incidental HCC and those without it (76.9% vs 84.2%, P = .5; 100% vs 91.6%, P = .28; and 100% vs 94.7%, P = 0.39, respectively). Finally, there were no significant associations between explant carcinoma and rejections of the liver (7.7% vs 17.9%, P = .34) or kidney graft (0% vs 16.8%, P = 0.11). CONCLUSION Despite a high prevalence of incidental HCC or iCC, patient, kidney, and liver graft 5-year survival were unaffected by incidental HCC.
Collapse
Affiliation(s)
- Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain.
| | - Laura Morantes
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Jenmy García
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | - Josep Vicens Torregrosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Nuria Esforzado
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| |
Collapse
|
2
|
Forado-Benatar I, Caravaca-Pérez P, Rodriguez-Espinosa D, Guzman-Bofarull J, Cuadrado-Payán E, Moayedi Y, Broseta JJ, Farrero M. Tricuspid regurgitation, right ventricular function, and renal congestion: a cardiorenal triangle. Front Cardiovasc Med 2023; 10:1255503. [PMID: 37859684 PMCID: PMC10583553 DOI: 10.3389/fcvm.2023.1255503] [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: 07/08/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
There is a growing interest in the evaluation of tricuspid regurgitation due to its increasing prevalence and detrimental impact on clinical outcomes. Historically, it has been coined the "forgotten" defect in the field of valvular heart disease due to the lack of effective treatments to improve prognosis. However, the development of percutaneous treatment techniques has led to a new era in its management, with promising results and diminished complication risk. In spite of these advances, a comprehensive exploration of the pathophysiological mechanisms is essential to establish clear indications and optimal timing for medical and percutaneous intervention. This review will address the most important aspects related to the diagnosis, pathophysiology and treatment of tricuspid regurgitation from a cardiorenal perspective, with a special emphasis on the interaction between right ventricular dysfunction and the development of hepatorenal congestion.
Collapse
Affiliation(s)
| | | | - Diana Rodriguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Yasbanoo Moayedi
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Marta Farrero
- Department of Cardiology, Hospital Clínic of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Cuadrado-Payán E, Ramírez-Bajo MJ, Bañón-Maneus E, Rovira J, Diekmann F, Revuelta I, Cucchiari D. Physiopathological role of extracellular vesicles in alloimmunity and kidney transplantation and their use as biomarkers. Front Immunol 2023; 14:1154650. [PMID: 37662919 PMCID: PMC10469977 DOI: 10.3389/fimmu.2023.1154650] [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: 01/30/2023] [Accepted: 07/21/2023] [Indexed: 09/05/2023] Open
Abstract
Antibody-mediated rejection is the leading cause of kidney graft dysfunction. The process of diagnosing it requires the performance of an invasive biopsy and subsequent histological examination. Early and sensitive biomarkers of graft damage and alloimmunity are needed to identify graft injury and eventually limit the need for a kidney biopsy. Moreover, other scenarios such as delayed graft function or interstitial fibrosis and tubular atrophy face the same problem. In recent years, interest has grown around extracellular vesicles, specifically exosomes actively secreted by immune cells, which are intercellular communicators and have shown biological significance. This review presents their potential as biomarkers in kidney transplantation and alloimmunity.
Collapse
Affiliation(s)
- Elena Cuadrado-Payán
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - María José Ramírez-Bajo
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Insituto de Salud Carlos III, Madrid, Spain
| | - Elisenda Bañón-Maneus
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Insituto de Salud Carlos III, Madrid, Spain
| | - Jordi Rovira
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Insituto de Salud Carlos III, Madrid, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Insituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Revuelta
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Insituto de Salud Carlos III, Madrid, Spain
| | - David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi I Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| |
Collapse
|
4
|
Cuadrado-Payán E, Rodríguez-Espinosa D, Broseta JJ, Guillén-Olmos E, Maduell F. Safety profile and clinical results of Remdesivir in Hemodialysis patients infected with SARS-CoV-2. A single-center Spanish cohort study. J Nephrol 2023; 36:171-172. [PMID: 35716242 PMCID: PMC9206136 DOI: 10.1007/s40620-022-01364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - Elena Guillén-Olmos
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Francisco Maduell
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| |
Collapse
|
5
|
Broseta JJ, Roca M, Rodríguez-Espinosa D, López-Romero LC, Gómez-Bori A, Cuadrado-Payán E, Bea-Granell S, Devesa-Such R, Soldevila A, Sánchez-Pérez P, Hernández-Jaras J. The metabolomic differential plasma profile between dialysates. Pursuing to understand the mechanisms of citrate dialysate clinical benefits. Front Physiol 2022; 13:1013335. [PMID: 36467686 PMCID: PMC9709283 DOI: 10.3389/fphys.2022.1013335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/06/2022] [Accepted: 10/27/2022] [Indexed: 08/30/2023] Open
Abstract
Background: Currently, bicarbonate-based dialysate needs a buffer to prevent precipitation of bicarbonate salts with the bivalent cations, and acetate at 3-4 mmol/L is the most used. However, citrate is being postulated as a preferred option because of its association with better clinical results by poorly understood mechanisms. In that sense, this hypothesis-generating study aims to identify potential metabolites that could biologically explain these improvements found in patients using citrate dialysate. Methods: A unicentric, cross-over, prospective untargeted metabolomics study was designed to analyze the differences between two dialysates only differing in their buffer, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Blood samples were collected in four moments (i.e., pre-, mid-, post-, and 30-min-post-dialysis) and analyzed in an untargeted metabolomics approach based on UPLC-Q-ToF mass spectrometry. Results: The 31 most discriminant metabolomic variables from the plasma samples of the 21 participants screened by their potential clinical implications show that, after dialysis with CD, some uremic toxins appear to be better cleared, the lysine degradation pathway is affected, and branched-chain amino acids post-dialysis levels are 9-10 times higher than with AD; and, on its part, dialysis with AD affects acylcarnitine clearance. Conclusion: Although most metabolic changes seen in this study could be attributable to the dialysis treatment itself, this study successfully identifies some metabolic variables that differ between CD and AD, which raise new hypotheses that may unveil the mechanisms involved in the clinical improvements observed with citrate in future research.
Collapse
Affiliation(s)
- José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Roca
- Analytcal Unit Platform, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Aina Gómez-Bori
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sergio Bea-Granell
- Department of Nephrology, Consorci Hospital General Universitari de València, Valencia, Spain
| | - Ramón Devesa-Such
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Amparo Soldevila
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Pilar Sánchez-Pérez
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | | |
Collapse
|
6
|
Cuadrado-Payán E, Montagud-Marrahi E, Casals-Urquiza J, del Risco-Zevallos J, Rodríguez-Espinosa D, Cacho J, Arana C, Cucchiari D, Ventura-Aguiar P, Revuelta I, Piñeiro GJ, Esforzado N, Cofan F, Bañon-Maneus E, Campistol JM, Oppenheimer F, Torregrosa JV, Diekmann F. Outcomes in older kidney recipients from older donors: A propensity score analysis. Front Nephrol 2022; 2:1034182. [PMID: 37675023 PMCID: PMC10479569 DOI: 10.3389/fneph.2022.1034182] [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] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/06/2022] [Indexed: 09/08/2023]
Abstract
Background The age of patients referred for kidney transplantation has increased progressively. However, the precise influence of age on transplant outcomes is controversial. Methods Etrospective study in which graft and recipient survival were assessed in a cohort of ≥75 years old kidney recipients and compared with a contemporary younger one aged 60-65 years through a propensity score analysis. Results We included 106 recipients between 60-65 and 57 patients of ≥75 years old with a median follow-up of 31 [13-54] months. Unadjusted one- and five-year recipient survival did not significantly differ between the older (91% and 74%) and the younger group (95% and 82%, P=0.06). In the IPTW weighted Cox regression analysis, recipient age was not associated with an increased risk of death (HR 1.88 95%CI [0.81-4.37], P=0.14). Unadjusted one- and five-year death-censored graft survival did not significantly differ between both groups (96% and 83% for the older and 99% and 89% for the younger group, respectively, P=0.08). After IPTW weighted Cox Regression analysis, recipient age ≥75 years was no associated with an increased risk of graft loss (HR 1.95, 95%CI [0.65-5.82], P=0.23). Conclusions These results suggest that recipient age should not be considered itself as an absolute contraindication for kidney transplant.
Collapse
Affiliation(s)
- Elena Cuadrado-Payán
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Enrique Montagud-Marrahi
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Joaquim Casals-Urquiza
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | | | - Diana Rodríguez-Espinosa
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | - Judit Cacho
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | - Carolt Arana
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Pedro Ventura-Aguiar
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Ignacio Revuelta
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Gaston J. Piñeiro
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Nuria Esforzado
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | - Frederic Cofan
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | - Elisenda Bañon-Maneus
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Josep M. Campistol
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Federico Oppenheimer
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Josep-Vicens Torregrosa
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| |
Collapse
|
7
|
Broseta JJ, Roca M, Rodríguez-Espinosa D, López-Romero LC, Gómez-Bori A, Cuadrado-Payán E, Devesa-Such R, Soldevila A, Bea-Granell S, Sánchez-Pérez P, Hernández-Jaras J. Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism-A Targeted Metabolomics Approach. Int J Mol Sci 2022; 23:ijms231911693. [PMID: 36232995 PMCID: PMC9569767 DOI: 10.3390/ijms231911693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/30/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn’t surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are activated, leading to undesirable clinical consequences by poorly understood mechanisms. This study aims to add information that could biologically explain the clinical improvements found in patients using citrate dialysate. A unicentric, cross-over, prospective targeted metabolomics study was designed to analyze the differences between two dialysates, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Fifteen metabolites were studied to investigate changes induced in the TCA cycle, glycolysis, anaerobic metabolism, ketone bodies, and triglyceride and aminoacidic metabolism. Twenty-one patients completed the study. Citrate increased during the dialysis sessions when CD was used, without surpassing normal values. Other differences found in the next TCA cycle steps showed an increased substrate accumulation when using AD. While lactate decreased, pyruvate remained stable, and ketogenesis was boosted during dialysis. Acetylcarnitine and myo-inositol were reduced during dialysis, while glycerol remained constant. Lastly, glutamate and glutarate decreased due to the inhibition of amino acidic degradation. This study raises new hypotheses that need further investigation to understand better the biochemical processes that dialysis and the different dialysate buffers induce in the patient’s metabolism.
Collapse
Affiliation(s)
- José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
- Correspondence: ; Tel.: +34-932275498
| | - Marta Roca
- Analytical Unit Platform, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain
| | - Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | | | - Aina Gómez-Bori
- Department of Nephrology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Ramón Devesa-Such
- Department of Nephrology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Amparo Soldevila
- Department of Nephrology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Sergio Bea-Granell
- Department of Nephrology, Consorci Hospital General Universitari de València, 46014 Valencia, Spain
| | - Pilar Sánchez-Pérez
- Department of Nephrology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Julio Hernández-Jaras
- Department of Nephrology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| |
Collapse
|
8
|
Cacho J, Nicolás D, Bodro M, Cuadrado-Payán E, Torres-Jaramillo V, Gonzalez-Rojas Á, Ventura-Aguiar P, Montagud-Marrahi E, Herrera S, Rico V, Cofàn F, Oppenheimer F, Revuelta I, Diekmann F, Cucchiari D. Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection. Kidney Int 2022; 102:917-921. [PMID: 35964801 PMCID: PMC9367173 DOI: 10.1016/j.kint.2022.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/20/2022] [Revised: 07/27/2022] [Accepted: 08/04/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Judit Cacho
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - David Nicolás
- Hospital-at-Home Unit, Department of Internal Medicine, Hospital Clínic, Barcelona, Spain
| | - Marta Bodro
- Department of Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | | | - Ángela Gonzalez-Rojas
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Pedro Ventura-Aguiar
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain; Hospital-at-Home Unit, Department of Internal Medicine, Hospital Clínic, Barcelona, Spain
| | | | - Sabina Herrera
- Department of Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Veronica Rico
- Hospital-at-Home Unit, Department of Internal Medicine, Hospital Clínic, Barcelona, Spain
| | - Frederic Cofàn
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Frederic Oppenheimer
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Ignacio Revuelta
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Red de Investigación Renal (REDINREN), Madrid, Spain.
| | - David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain; Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| |
Collapse
|
9
|
Cuadrado-Payán E, Diekmann F, Cucchiari D. Medical Aspects of mTOR Inhibition in Kidney Transplantation. Int J Mol Sci 2022; 23:ijms23147707. [PMID: 35887051 PMCID: PMC9322634 DOI: 10.3390/ijms23147707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 11/16/2022] Open
Abstract
The advances in transplant immunosuppression have reduced substantially the incidence of kidney graft rejection. In recent years, the focus has moved from preventing rejection to preventing the long-term consequences of long-standing immunosuppression, including nephrotoxicity induced by calcineurin inhibitors (CNI), as well as infectious and neoplastic complications. Since the appearance in the late 1990s of mTOR inhibitors (mTORi), these unmet needs in immunosuppression management could be addressed thanks to their benefits (reduced rate of viral infections and cancer). However, management of side effects can be troublesome and hands-on experience is needed. Here, we review all the available information about them. Thanks to all the basic, translational and clinical research achieved in the last twenty years, we now use mTORi as de novo immunosuppression in association with CNI. Another possibility is represented by the conversion of either CNI or mycophenolate (MPA) to an mTORi later on after transplantation in low-risk kidney transplant recipients.
Collapse
Affiliation(s)
- Elena Cuadrado-Payán
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, 08036 Barcelona, Spain; (E.C.-P.); (F.D.)
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, 08036 Barcelona, Spain; (E.C.-P.); (F.D.)
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Red de Investigación Renal (REDINREN), 28029 Madrid, Spain
| | - David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, 08036 Barcelona, Spain; (E.C.-P.); (F.D.)
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Correspondence: ; Tel.: +34-932-2744103474
| |
Collapse
|
10
|
Rodríguez-Espinosa D, Montagud-Marrahi E, Cacho J, Arana C, Taurizano N, Hermida E, Del Risco-Zevallos J, Casals J, Rosario A, Cuadrado-Payán E, Molina-Andújar A, Rodríguez N, Vilella A, Bodro M, Ventura-Aguiar P, Revuelta I, Cofàn F, Poch E, Oppenheimer F, Vera M, Rodas LM, Cases A, Bayés B, Diekmann F, Maduell F, Broseta JJ, Cucchiari D. Incidence of severe breakthrough SARS-CoV-2 infections in vaccinated kidney transplant and haemodialysis patients. J Nephrol 2022; 35:769-778. [PMID: 35191008 PMCID: PMC8860282 DOI: 10.1007/s40620-022-01257-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 12/28/2022]
Abstract
Introduction Given the increased COVID-19 observed in kidney transplant recipients (KTRs) and haemodialysis patients, several studies have tried to establish the efficacy of mRNA vaccines in these populations by evaluating their humoral and cellular responses. However, there is currently no information on clinical protection (deaths and hospitalizations), a gap that this study aims to fill. Methods Observational prospective study involving 1,336 KTRs and haemodialysis patients from three dialysis units affiliated to Hospital Clínic of Barcelona, Spain, vaccinated with two doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 mRNA vaccines. The outcomes measured were SARS-CoV-2 infection diagnosed by a positive RT-PCR fourteen days after the second vaccine dose, hospital admissions derived from infection, and a severe COVID-19 composite outcome, defined as either ICU admission, invasive and non-invasive mechanical ventilation, or death. Results Six per cent (18/302) of patients on haemodialysis were infected, of whom four required hospital admission (1.3%), only one (0.3%) had severe COVID-19, and none of them died. In contrast, 4.3% (44/1034) of KTRs were infected, and presented more hospital admissions (26 patients, 2.5%), severe COVID-19 (11 patients, 1.1%) or death (4 patients, 0.4%). KTRs had a significantly higher risk of hospital admission than HD patients, and this risk increased with age and male sex (HR 3.37 and 4.74, respectively). Conclusions The study highlights the need for booster doses in KTRs. In contrast, the haemodialysis population appears to have an adequate clinical response to vaccination, at least up to four months from its administration. Graphical abstract ![]()
Collapse
Affiliation(s)
- Diana Rodríguez-Espinosa
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Enrique Montagud-Marrahi
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Judit Cacho
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Carolt Arana
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Taurizano
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Evelyn Hermida
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Fresenius Medical Care, Barcelona, Spain
| | - Jimena Del Risco-Zevallos
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Joaquim Casals
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Anney Rosario
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Alicia Molina-Andújar
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | | | - Anna Vilella
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Marta Bodro
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - Pedro Ventura-Aguiar
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Ignacio Revuelta
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Frederic Cofàn
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Esteban Poch
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Frederic Oppenheimer
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Manel Vera
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Lida M Rodas
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Aleix Cases
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Beatriu Bayés
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Francisco Maduell
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - José Jesús Broseta
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - David Cucchiari
- Department of Nephrology and Kidney, Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain. .,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
| |
Collapse
|
11
|
Montagud-Marrahi E, Cucchiari D, Cuadrado-Payán E, Cofan F, Torregrosa JV, Ventura-Aguiar P, Revuelta I, Bodro M, Piñeiro GJ, Esforzado N, Campistol JM, Oppenheimer F, Marcos MÁ, Bayés B, Moreno A, Diekmann F. SARS-CoV-2 Infection After Full Vaccination in Kidney Transplant Recipients. Transplantation 2021; 105:e278-e279. [PMID: 34406187 PMCID: PMC8612844 DOI: 10.1097/tp.0000000000003927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Enrique Montagud-Marrahi
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Frederic Cofan
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Josep-Vicens Torregrosa
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Pedro Ventura-Aguiar
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Ignacio Revuelta
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Marta Bodro
- Department of Infectious Diseases, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gaston J. Piñeiro
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Nuria Esforzado
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Josep M. Campistol
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Federico Oppenheimer
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M. Ángeles Marcos
- Virology Division, Microbiology Department, Biomedical Diagnosis Center, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Beatriu Bayés
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Asunción Moreno
- Department of Infectious Diseases, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Madrid, Spain
| |
Collapse
|
12
|
Maduell F, Broseta JJ, Rodríguez-Espinosa D, Hermida-Lama E, Cuadrado-Payán E, Rodas LM, Gómez M, Arias-Guillén M, Fontseré N, Vera M, Rico N. Efficacy and safety of the Clearum dialyzer. Artif Organs 2021; 45:1195-1201. [PMID: 33978975 DOI: 10.1111/aor.13993] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/19/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022]
Abstract
The Clearum dialyzer, built by Medtronic, became commercially available in several European countries in 2020, but there are still no reports of in vivo data. The aim of this study was to evaluate the efficacy and risk of hypoalbuminemia of this dialyzer compared with previously evaluated hemodialysis (HD), expanded hemodialysis (HDx), and postdilution hemodiafiltration (HDF) treatments. A prospective study was carried out in 15 patients. Each patient underwent seven dialysis sessions: FX80 Cordiax in HD, Clearum HS17 in HD, Phylther 17-SD in HDx, Theranova 400 in HDx, Phylther 17-G in postdilution HDF, Clearum HS17 in postdilution HDF, and FX80 Cordiax in postdilution HDF. The reduction ratios of urea, creatinine, ß2 -microglobulin, myoglobin, prolactin, α1 -microglobulin, α1 -acid glycoprotein, and albumin were compared intraindividually. Dialysate albumin loss was also measured. Comparison of dialysis techniques revealed no differences between small molecules, but HDx and HDF were significantly higher than HD with medium and large molecular weights. The Clearum dialyzer in HDF obtained similar results to FX80 Cordiax in HDF, was slightly superior to Phylther 17-G in HDF, and was statistically superior to both dialyzers in HDx. Albumin losses with the Clearum dialyzer were among the lowest, both in HD and HDF treatments. The highest global removal score (GRS) values were obtained with the helixone and Clearum dialyzers in HDF, with similar results both in HD and HDF. In addition, the GRS values with HDx treatments were statistically significantly higher than those with HD. The new Clearum dialyzer has excellent behavior and tolerance in HD and HDF. Its adequate permeability has been proven with its maximal performance in HDF, which could represent an upgrade versus its predecessor polyphenylene dialyzers.
Collapse
Affiliation(s)
- Francisco Maduell
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | | | | | | | - Lida María Rodas
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Miquel Gómez
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Néstor Fontseré
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Manel Vera
- Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Nayra Rico
- Department of Biochemistry, Hospital Clínic Barcelona, Barcelona, Spain
| |
Collapse
|
13
|
Cuadrado-Payán E, Montagud-Marrahi E, Torres-Elorza M, Bodro M, Blasco M, Poch E, Soriano A, Piñeiro GJ. SARS-CoV-2 and influenza virus co-infection. Lancet 2020; 395:e84. [PMID: 32423586 PMCID: PMC7200126 DOI: 10.1016/s0140-6736(20)31052-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/23/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | | | | | - Marta Bodro
- Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Miquel Blasco
- Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Esteban Poch
- Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Alex Soriano
- Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | | |
Collapse
|