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Amaro JM, Villanego F, Naranjo J, Orellana C, Vigara LA, Narváez CE, Torrado J, Cazorla JM, Rodríguez C, Mazuecos A. Treatment with PCSK9 inhibitors in patients with chronic kidney disease at very high cardiovascular risk. Nefrologia 2023; 43 Suppl 2:133-135. [PMID: 38296719 DOI: 10.1016/j.nefroe.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- José Manuel Amaro
- Nephrology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Javier Naranjo
- Nephrology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Cristhian Orellana
- Nephrology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | | | - Julia Torrado
- Nephrology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Claudia Rodríguez
- Hospital Pharmacy Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
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2
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Singh-Singh A, Vigara LA, Aguilera A, Carrasco D, Alonso M, Amaro JM, Cazorla JM, Villanego F, Mazuecos A, García T. Benefits of Routine Screening for Renal Cell Carcinoma of Native Kidney in Renal Transplant Recipients. Transplant Proc 2023; 55:2262-2265. [PMID: 37977996 DOI: 10.1016/j.transproceed.2023.09.010] [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: 08/30/2023] [Accepted: 09/23/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Renal-cell carcinoma (RCC) is the most common solid organ cancer in kidney transplantation recipients (KTRs). BACKGROUND Analyze the incidence, prognosis, and evolution of primitive kidney RCC in KTRs at our institution. MATERIAL AND METHODS Observational descriptive retrospective study in which all KTRs from January 2000 to December 2022 were included. We performed an annual abdominal ultrasound in all KTRs. Demographic and clinical data were collected. The surgical approach, location, size, histologic type, and tumor grade were analyzed. We assessed the coexistence of risk factors. We reported the appearance of tumors in other locations, changes in immunosuppressants (IS) after the diagnosis, and survival and recurrence rates observed during follow-up. RESULTS Eighteen RCCs of native kidneys were diagnosed with an incidence in our population of 1.08%. The majority were men (77.8%), with a mean age of 59.9 years. The pathologic analysis revealed 11 clear cell carcinomas, 6 papillary carcinomas, and 1 chromophobe cell carcinoma. The median tumor size was 2.7 cm. TNM stage was T1aN0M0 in 15 cases. Laparoscopy was performed to remove the tumor in most cases. All our patients underwent changes in IS therapy, with conversion to mammalian target of rapamycin inhibitors when possible and reduction of IS in all of them. After a mean follow-up of 78.6 months, survival was 100% without tumor recurrence. Seven of the patients were diagnosed with a new tumor in another location. CONCLUSION In our experience, annual abdominal ultrasound in KTRs may be an option for the early detection of RCC in native kidneys.
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Affiliation(s)
| | | | - Aurora Aguilera
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
| | - Daniel Carrasco
- Department of Pathology, Hospital Puerta del Mar, Cadiz, Spain
| | - Marta Alonso
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
| | | | | | | | | | - Teresa García
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
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Cazorla JM, Villanego F, Aguilera A, Garcia T, Orellana C, Trujillo T, Gómez AM, Mazuecos A. Humoral Response After 5 Successive Doses of COVID-19 Vaccine in Kidney Transplant Patients: Comment. Transplantation 2023; 107:e319. [PMID: 37870884 DOI: 10.1097/tp.0000000000004756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
- Juan Manuel Cazorla
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | | | - Aurora Aguilera
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Garcia
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Cristhian Orellana
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Trujillo
- Department of Microbiology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Ana María Gómez
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
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Cazorla JM, Villanego F, Aguilera A, Garcia T, Orellana C, Trujillo T, Gómez AM, Mazuecos A. Humoral Response After Five Successive Doses of SARS-CoV-2 mRNA Vaccine in Kidney Transplant Patients. Transplantation 2023; 107:e188-e189. [PMID: 37170412 DOI: 10.1097/tp.0000000000004628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Juan Manuel Cazorla
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | | | - Aurora Aguilera
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Garcia
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Cristhian Orellana
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Trujillo
- Department of Microbiology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Ana María Gómez
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
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5
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Manuel Amaro J, Villanego F, Naranjo J, Orellana C, Vigara LA, Narváez CE, Torrado J, Cazorla JM, Rodríguez C, Mazuecos A. Tratamiento con inhibidores de PCSK9 en pacientes con enfermedad renal crónica de muy alto riesgo cardiovascular. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.11.006] [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: 11/18/2022] Open
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6
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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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7
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Villanego F, Cazorla JM, Vigara LA, Garcia T, Trujillo T, Montiel N, Rodriquez-Iglesias M, Mazuecos A. Protecting kidney transplant recipients against SARS-CoV-2 infection: A third dose of vaccine is necessary now. Am J Transplant 2022; 22:1275-1276. [PMID: 34467623 PMCID: PMC8653302 DOI: 10.1111/ajt.16829] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 01/25/2023]
Affiliation(s)
| | - Juan Manuel Cazorla
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Luis Alberto Vigara
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Garcia
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Teresa Trujillo
- Department of Microbiology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Natalia Montiel
- Department of Microbiology, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | | | - Auxiliadora Mazuecos
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain,Correspondence Auxiliadora Mazuecos, Department of Nephrology, Hospital Universitario Puerta del Mar, Cadiz, Spain.
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8
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Quiroga B, Soler MJ, Ortiz A, Bernat A, Díaz ABM, Mantecón CJJ, Pérez VOG, González CC, Cervienka M, Mazuecos A, Cazorla JM, Riso MCD, Martínez S, Diaz MO, Valverde RL, Márquez MGS, Novillo CL, Parra EG, Gracia-Iguacel C, De Tomas MTR, Cervera MCA, Giorgi M, Ramos PM, Carmona NM, Toapanta N, Guldris SC, Millán JCRS, Estupiñán RS, Crespo M, Linaza BV, Martín MIJ, Jiménez LRO, Soriano S, Ferri DG, Sánchez MSP, Yugueros A, Leyva A, Rojas J, Gansevoort RT, de Sequera P, Carretero MP, Tocora DG, Rodríguez MJ, Zanón TT, Suárez ER, Santolaya AJS, Calero RC, Cobo PA, Martin-Cleary C, Sánchez-Rodríguez J, Pereira M, Ramos-Verde A, Sánchez C, Giraldo YG, Horrillo AS, Suárez PR, Perpén AF, Ramos AF, Villanueva LS, Cortiñas A, Arias PAD, Cárdenas AC, de Santos A, Núñez A, Cuadrado GB, Repollet R, Moreso F, Azancot MA, Ramos N, Bestard O, Cidraque I, Bermejo S, Agraz I, Prat O, Medina C, Pardo E, Saiz A, Vila MAM, Granados NM, Cabo MJC, Alarcón WL, Alexandru S, Suarez LGP, Saico SP, Tapia MP, Hernández RS, García-Fernández N, Moreno PLM, González NA, Ortiz AS, Iñarrea MNB, López RO, Peregrí CM, Morales MLA, Cabello MDN, Ribera AMT, Valcarce EG, Vergara EG, García T, Narváez C, Orellana C, Ganga PLQ, Carrión FV, Herrera ALG, Chamoun B, Barbosa F, Faura A, Pachón DR, Castro NB, Cendrero RMRC, Hidalgo-Barquero MVM, Gallego RH, Alvarez Á, Leo EV, León JLP, García MAM, Jiménez BG, Moya JDDR, Espinosa DL, Herrador AJ, Zurita MN, Álvarez LD, Martínez ÁG, Arroyo SB, Fernández RR, Vargas MJS, Casero RC, Useche G, de Miguel CS, Palacios Á, Henningsmeyer B, Calve EO, Moya JL, Sato Y, Marín MS, Torres I, Conde PD, Alfaro G, Halauko O, Rifai FEL, Martínez AD, Ávila PJ, Franco AM, Sainz MS, Martín JMB, García LDR, Canga JLP, Ochoa PMV, Pacios LM, Machado LL, Morales AQ, Cavalotti IM, Zorita IN, López SO, González SO, Montañez CS, Rubio AB, Gilsanz GDP, Gonzalez MO, Villanueva RS, Oliva MOL, Varela JC, Enríquez AG, Casas CC, Alonso PO, Tabares LG, Barreiro JML, Solla LP, Gándara A, de la Garza WN, Fleming FF, Goyanes MGR, Feijoo CC, Plaza MMM, Juan CB, Cecilio RVS, Haces CP, Kislikova M, Rodrigo E, Contreras FJP, Lara NB, Llorente EMDB, Díaz LS, Bustamante AMC, Ruiz JM, Rodríguez EG, Perez VLDLM, Arevalo MC, Calvo JAH, Carratalá MRL, Rodríguez LMM, Salazar MS, Prieto BB, Pérez JMP, Rueda DA, Ferrero MLR, Martínez AV, Estébanez SA, Paraíso AG, Huarte E, Lanau M, Campos RA, Ubé JM, Pérez PS, Godoy IB, Aguilera ET, Alea RT, Saldaña MSDR, Salvetti ML, Valmajor MC, Sánchez MP, Barragán ML, Aunatell LR, Salgueira M, Aresté N, de Los Ángeles Rodríguez M, Collantes R, Martínez AI, Moyano MJ, Víbora EJ, Gash SC, Martínez LR, Prieto BA, Toyos C, Rio JM, Acosta AR, Zamacona AC, Ortega SB, Ruiz MIG, Rubio AH, Ledesma PG, Alvarez AG, de Briñas EPL, Cucchiari D, Monzo JB, Cabrera BE, Hernández APR, Rebollo MSG, Hernández JMR, Alonso JC, Más AM, Calvé M, Cardona MG, Balaguer VC, Pesquera JIM, Serrano AG, Simó PT, Mancilla HDR, Gómez MP, Gumpert JV, de la Fuente GDA, Del Valle KP, de la Rosa EC, Santarelli DR, Garcia AS, Martin-Caro AC, Santamaria IM, Umpierrez AM, Ruiz EH, Corbella AM, Perdomo KT, Martín YM, de la Pisa AMU, Monzon LS, Anachuri KA, Garcia EH, Gomez VO, Amado FV, Borges PP, Vázquez RM, Beloso MD, Alonso FA, Felpete NP, Ameneiro AM, Mera MC, Casares BG, Larrondo SZ, Kareaga NM, Del Valle AISS, García ARM, Del Toro Espinosa N, Perico PE, Oliva JMS, Manrique J, Castaño I, Purroi C, Gómez N, Mansilla C, Utzurrum A. Loss of humoral response 3 months after SARS-CoV-2 vaccination in the CKD spectrum: the multicentric SENCOVAC study. Nephrol Dial Transplant 2022; 37:994-999. [PMID: 35022757 PMCID: PMC9383183 DOI: 10.1093/ndt/gfac007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 01/02/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Borja Quiroga
- Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - María José Soler
- Nephrology Department, Vall d'Hebrón University Hospital, Barcelona, Spain.,RICORS2040 (Kidney Disease)
| | - Alberto Ortiz
- RICORS2040 (Kidney Disease).,IIS-Fundación Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | - Mayra Ortega Diaz
- Nephrology Department, Hospital Universitario Infanta Leonor - Universidad Complutense de Madrid, Spain
| | - Rafael Lucena Valverde
- Nephrology Department, Hospital Universitario Infanta Leonor - Universidad Complutense de Madrid, Spain
| | | | | | - Emilio González Parra
- IIS-Fundación Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III, Madrid, Spain
| | - Carolina Gracia-Iguacel
- IIS-Fundación Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III, Madrid, Spain
| | | | | | - Martín Giorgi
- Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | | | | | - Néstor Toapanta
- Nephrology Department, Vall d'Hebrón University Hospital, Barcelona, Spain
| | | | | | - Raquel Santana Estupiñán
- Nephrology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Marta Crespo
- Nephrology Department, Hospital del Mar, Barcelona, Spain
| | | | | | | | | | | | | | - Alejandra Yugueros
- Nephrology Department, Hospital Lluis Alcanyis De Xátiva, Valencia, Spain
| | - Alba Leyva
- R&D Department, VIRCELL SL, Granada, Spain
| | - José Rojas
- R&D Department, VIRCELL SL, Granada, Spain
| | - Ron T Gansevoort
- Dept. Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Patricia de Sequera
- RICORS2040 (Kidney Disease).,Nephrology Department, Hospital Universitario Infanta Leonor - Universidad Complutense de Madrid, Spain
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Moreno-Ramírez M, Villanego F, Caro A, Cazorla JM, García A, García T, Pérez J, Baez JM, Mazuecos A. Glomerulocytis kidney: an unexpected finding in preimplantation biopsy. J Nephropathol 2020. [DOI: 10.34172/jnp.2021.02] [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] [Indexed: 11/09/2022] Open
Affiliation(s)
| | | | - Alejandro Caro
- Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Juan Manuel Cazorla
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Ana García
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Teresa García
- Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - José Pérez
- Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Jose Maria Baez
- Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
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Villanego F, Naranjo J, Vigara LA, Cazorla JM, Montero ME, García T, Torrado J, Mazuecos A. Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis. Nefrologia 2020; 40:237-252. [PMID: 32305232 DOI: 10.1016/j.nefro.2020.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 09/10/2019] [Revised: 11/25/2019] [Accepted: 01/19/2020] [Indexed: 01/22/2023] Open
Abstract
Physical exercise may offer multiple benefits to patients with chronic kidney disease (CKD). However, it was not traditionally recommended because of the possibility of impairing renal function and increasing proteinuria. The objective of this study is to review the clinical trials on physical exercise in patients with CKD and describe its effect on the progression of kidney disease and other factors associated. Randomized clinical trials (RCT) comparing an intervention that included an exercise component with a control group without physical exercise in non-dialysis patients with CKD from 2007 to 2018 in English and Spanish were included. PubMed, Scopus, Embase, Ovid (Medline) and PEDro databases were used for the search. Effects of physical exercise were summarized by the standardized mean difference (SMD). No differences were found in glomerular filtration rate or proteinuria between the intervention group and the control group: SMD -0.3 (P=.81); SMD 26.6 (P=.82). Positive effects were obtained on peak oxygen consumption: SMD 2.5 (P<.001), functional capacity: SMD 56.6 (P<.001), upper limb strength: SMD 6.8 (P<.001) and hemoglobin: SMD 0.3 (P=.003). An improvement on the quality of life was also evident using the KDQOL-36 survey: SMD 3.56 (P=.02) and the SF-36 survey: SMD 6.66 (P=.02). In conclusion, the practice of low-intensity physical exercise routinely has no negative impact on renal function. On the contrary, it improves aerobic and functional capacity, impacting positively on the quality of life.
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Affiliation(s)
| | - Javier Naranjo
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Luis Alberto Vigara
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Juan Manuel Cazorla
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Maria Elisa Montero
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Teresa García
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Julia Torrado
- Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
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Vigara LA, Villanego F, Cazorla JM, Naranjo J, Mínguez MDC, Garcia AM, Arca J, Galan F, Garcia T, Mazuecos A. Characteristics and Evolution of Renal Transplant Recipients Infected by Carbapenemase-Producing Klebsiella pneumoniae. Transplant Proc 2020; 52:519-522. [PMID: 32029311 DOI: 10.1016/j.transproceed.2019.09.017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/22/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Renal transplant (RT) recipients are especially susceptible to carbapenem-resistant Klebsiella pneumoniae carbapenemase (KPC) infections. However, published experience is limited. OBJECTIVE To analyze the characteristics and evolution of RT recipients with KPC infection in our hospital. METHODS We performed a retrospective cohort study of all RT recipients with KPC infection in our hospital from December 1, 2017 (first case), to July 31, 2019. For each RT recipient infected with KPC, 3 controls were selected. RESULTS During the study period, 8 RT recipients presented KPC infection. Seven were detected in the first year post-RT. The most common site of infection was urine. In 2 cases the germ was isolated in blood. The number of patients with diabetes was significantly higher in the group with KPC infection (P = .023), and urologic interventions were more frequent in those patients (P = .039). No differences were found in the immunosuppressive treatment. A total of 62.5 % of patients required readmission after the KPC infection. One patient died of septicemia by KPC. In all these cases, the clone of KPC isolated was KPC ST512. CONCLUSION KPC infection is more frequent in the first months after the RT and causes an important number of hospital admissions. It can be cause of death in RT recipients, especially in those with isolation of the germ in blood. Diabetes and urologic interventions were more frequent in this population. The analysis by molecular typing suggests exposure to a common source, highlighting the importance of preventive isolation measures and surveillance for limiting the transmission of this bacteria.
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Affiliation(s)
| | | | | | - Javier Naranjo
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
| | | | | | - Jorge Arca
- Department of Microbiology, Hospital Puerta del Mar, Cadiz, Spain
| | - Fatima Galan
- Department of Microbiology, Hospital Puerta del Mar, Cadiz, Spain
| | - Teresa Garcia
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
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Moreno-Ramirez M, Villanego F, Vigara LA, Cazorla JM, Naranjo J, Garcia T, Merino MJ, Mazuecos A. Direct-Acting Antiretroviral Therapy in Renal Transplant Recipients With Human Immunodeficiency Virus-Hepatitis C Virus Coinfection: Report of Our Experience and Literature Review. Transplant Proc 2020; 52:523-526. [PMID: 32035678 DOI: 10.1016/j.transproceed.2019.12.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/19/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
A minor graft and patient survival are described in renal transplant recipients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection than in recipients infected with only HIV. The high efficacy of direct-acting antivirals could improve the results. The experience reported in renal transplant recipients with coinfection is very limited. MATERIAL AND METHODS We analyzed the evolution of renal recipients with HIV-HCV coinfection treated with direct-acting antivirals in our center. Clinical, analytical, and microbiological variables were collected before and after treatment. RESULTS From 2001 to 2018 we performed 11 renal transplants in patients with HIV infection, and 6 (54.5%) had HIV-HCV coinfection. One patient lost the graft before the development of direct-acting antivirals. Another patient with functioning graft has refused to receive any treatment. Four patients have been treated with direct-acting antivirals. One was treated 18 months before the transplant; 3 received treatment after transplant. All received sofosbuvir-based therapies. All had a sustained virologic response after 12 weeks and an improvement of liver function. In the patients treated after renal transplant, time post transplant at the beginning of treatment was 99.6 (SD, 22.8) months, and follow-up after treatment in all patients was 40.2 (SD, 8.16) months. To modify immunosuppressive regimen was not necessary, although 2 patients required an increase of tacrolimus doses. We do not observe deterioration of renal function. All have maintained a good immunologic and microbiological control without requiring changes in antiretrovirals. We do not observe complications associated with treatment. CONCLUSIONS Direct-acting antivirals therapy is safe and effective and may offer new possibilities to patients with HIV-HCV coinfection.
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Affiliation(s)
| | | | | | | | - Javier Naranjo
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
| | - Teresa Garcia
- Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain
| | - M Jose Merino
- Department of Nephrology, Hospital Juan Ramón Jiménez, Huelva, Spain
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