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1. Humoral response after the fourth dose of the SARS-CoV-2 vaccine in the CKD spectrum

Author

Borja, Quiroga, María José, Soler, Alberto, Ortiz, Carlos Jesús, Jarava Mantecón, Virginia Olinda, Gomes Pérez, Antoni, Bordils, José, Lacueva, Antonio José, Marin Franco, Pablo, Delgado Conde, Patricia, Muñoz Ramos, Carmen, Calderón González, Juan Manuel, Cazorla López, Jinny, Sanchez-Rodriguez, Ana, Sánchez Horrillo, Tania Raquel, Monzón Vázquez, Alba, Leyva, José, Rojas, Ron T, Gansevoort, Patricia, de Sequera, María Teresa Jaldo, Rodríguez, Rafael Lucena, Valverde, Marta Puerta, Carretero, Mayra Ortega, Díaz, Daniel Gaitán, Tocora, Esther Rodriguez, Suárez, Alfredo José Sáenz, Santolaya, Patricia Arribas, Cobo, Tamar, Talavan, Raquel Cerrajero, Calero, Carolina, Gracia-Iguacel, Emilio, González-Parra, Mónica, Pereira, Catalina, Martin-Cleary, Ana, Ramos-Verde, Martín, Giorgi, Carmen, Sánchez, Yohana Gil, Giraldo, Ana Sánchez, Horrillo, Pablo Ruano, Suárez, Antonio Fernández, Perpén, Andrés Fernández, Ramos, Laura Salanova, Villanueva, Alejandra, Cortiñas, Pablo A Díez, Arias, Alicia Cabrera, Cárdenas, Antonio, de Santos, Almudena, Núñez, Guillermina Barril, Cuadrado, Loreto Mariscal, de Gante, Raquel, Repollet, Concepción Redondo, Polo, Francesc, Moreso, María Antonieta, Azancot, Natalia, Ramos, Oriol Bestard Nestor, Toapanta, Ignacio, Cidraque, Sheila, Bermejo, Irene, Agraz, Oreto, Prat, Carlota, Medina, Emma, Pardo, Alejandro, Saiz, Maria Antònia Munar, Vila, Secundino Cigarrán, Guldris, Nicolás Menéndez, Granados, María Jesús Corton, Cabo, Walter López, Alarcón, Soledad Pizarro, Sánchez, Simona, Alexandru, Laura García Puente, Suarez, Saul Pampa, Saico, Marisol Poma, Tapia, Rocío, Zamora, Rosa Sánchez, Hernández, Laura Rodríguez, Osorio, Nuria, García-Fernández, Paloma Leticia Martin, Moreno, Noelia Ania, González, Ana Sabalza, Ortiz, María Nieves Bastida, Iñarrea, Sagrario Soriano, Cabrera, Raquel Ojeda, López, Cayetana Moyano, Peregrí, Maria Luisa Agüera, Morales, Maria Dolores Navarro, Cabello, Auxiliadora, Mazuecos, Teresa, García, Carlos, Narváez, Cristhian, Orellana, María Gabriela Sánchez, Márquez, Carolina Lancho, Novillo, Pedro Luis Quirós, Ganga, Fernando Vallejo, Carrión, Antonio Luis García, Herrera, Natalia Blanco, Castro, Rosa María Ruiz-Calero, Cendrero, María Victoria Martín, Hidalgo-Barquero, Román Hernández, Gallego, Álvaro, Alvarez, Eva Vázquez, Leo, José Luis Pizarro, León, Manuel Antonio Martínez, García, Benaldina García, Jiménez, Virginia Olinda Gómez, Pérez, Juan, de Dios Ramiro Moya, Diana López, Espinosa, Alejandro Jiménez, Herrador, Manuel Navarro, Zurita, Leonardo Díaz, Álvarez, Álvaro González, Martínez, Sandra Báez, Arroyo, Raquel Reina, Fernández, Marlyn Janella Suárez, Vargas, Rocío Calurano, Casero, Gustavo, Useche, Amparo Bernat, García, Ana Beatriz Muñoz, Díaz, Carmen Santamaría, de Miguel, Ángel, Palacios, Brenda, Henningsmeyer, Esther Orero, Calve, José Lacueva, Moya, Yurika, Sato, Marta Serra, Marín, Sandra, Tejedor, Shaida Martínez, Vaquera, Manuel Carnerero, di Riso, Irene, Torres, Georgina, Alfaro, Olga, Halauko, Fouad E L, Rifai, Ana Dolores, Martínez, Pablo Justo, Ávila, Christian Alfaro, Sánchez, Marta Sanz, Sainz, José María Baltar, Martín, Laura, Del Río García, José Luis Pérez, Canga, Paola Milena Villabón, Ochoa, Laura Muñiz, Pacios, Lina León, Machado, Augusto Quiroz, Morales, Ignacio Manzur, Cavalotti, Itziar Navarro, Zorita, Sol Otero, López, Sara Outon, González, Carlos Soto, Montañez, Auxiliadora Bajo, Rubio, Gloria, Del Peso Gilsanz, Marta Ossorio, Gonzalez, Rafael Sánchez, Villanueva, Maria Ovidia Lopez, Oliva, Jesús Calviño, Varela, Alba García, Enríquez, Carmen Cobelo, Casas, Pablo Otero, Alonso, Lourdes González, Tabares, José María Lamas, Barreiro, Luisa Palomares, Solla, Arginino, Gándara, Walfred Nájera, de la Garza, Francisco Fernández, Fleming, María Gloria Rodríguez, Goyanes, Cintia Caramés, Feijoo, María Mercedes Moreiras, Plaza, Cristina Bayón, Juan, Gabriel de Arriba, de la Fuente, Katia Pérez, Del Valle, Francisco Javier Pérez, Contreras, Noelia Balibrea, Lara, Dioné González, Ferri, Eduardo Muñoz, de Bustillo Llorente, Enriqueta González, Rodríguez, Virginia Lopez, De La Manzanara Perez, Marta Calvo, Arevalo, Jose Antonio Herrero, Calvo, María Rosario Llópez, Carratalá, Leyre María Martin, Rodríguez, Marisa Serrano, Salazar, Begoña Bravo, Prieto, José María Portolés, Pérez, Antonio Gil, Paraíso, Emma, Huarte, M, Lanau, Rodrigo Avellaneda, Campos, José Manuel, Ubé, Isabel Berdud, Godoy, Esther Torres, Aguilera, Rolando Tello, Alea, Margie Soledad, Del Rosario Saldaña, Mercedes, Salgueira, Nuria, Aresté, María, de Los Ángeles Rodríguez, Rocío, Collantes, Ana Isabel, Martínez, María Jesús, Moyano, Elena Jiménez, Víbora, Sandra Castellano, Gash, Lara Ruíz, Martínez, María Cinta Aguilar, Cervera, María Teresa Rodrigo, De Tomas, Beatriz Azcue, Prieto, Carmen, Toyos, José Molina, Del Rio, Adriana Restrepo, Acosta, Amagoia Celayeta, Zamacona, Ma Isabel Jimeno, Martin, Saioa Bilbao, Ortega, Ma Isabel Gallardo, Ruiz, Ainhoa Hernando, Rubio, Paula Garcia, Ledesma, Alvaro Goyoaga, Alvarez, Esteban, Poch, David, Cucchiari, José Broseta, Monzo, Beatriz Escamilla, Cabrera, Aurelio Pastor Rodríguez, Hernández, María Sagrario García, Rebollo, Juana Margarita Rufino, Hernández, Alejandra Yugueros, González, Juan Carlos, Alonso, Amparo Martínez, Más, Manuel, Calvé, Marina Garces, Cardona, Vanesa Canto, Balaguer, José Ignacio Minguela, Pesquera, Eva Cotilla, de la Rosa, David Rodríguez, Santarelli, Alba Santos, Garcia, Antonio Cabezas, Martin-Caro, Inmaculada Martinez, Santamaria, Michal, Cervienka, Ana María Urraca, de la Pisa, Lidia Sendino, Monzon, Karina Ampuero, Anachuri, Esther Hernández, Garcia, Victoria Oviedo, Gomez, Raquel Santana, Estupiñán, Francisco Valga, Amado, Patricia Pérez, Borges, Marta Durán, Beloso, Fernanda Arroyo, Alonso, Noemí Pérez, Felpete, Ana Meizoso, Ameneiro, Mónica Cunha, Mera, Beatriz Gil, Casares, Sofía Zarraga, Larrondo, Naroa Maruki, Kareaga, Ainhoa Inza San Salvador, Del Valle, Ana Rosa Muñoz, García, Blanca Villacorta, Linaza, Nuria, Del Toro Espinosa, Paola Estupiñan, Perico, José Manuel Sánchez, Oliva, Joaquín, Manrique, Itziar, Castaño, Carolina, Purroi, Nerea, Gómez, Cristina, Mansilla, Ane, Utzurrum, Manuel Ramírez, de Arellano Serna, Luis Guirado, Perich, María Muñiz, Rincón, Jesús Grande, Villoria, and Alfonso Pobes Martínez, De Salinas

Subjects
kidney transplant, Transplantation, Nephrology, SARS-CoV-2, CKD, COVID-19, dialysis, vaccines
Abstract

Background There is scarce evidence on the fourth dose of severe acute respiratory syndrome coronavirus 2 vaccines in chronic kidney disease (CKD) patients. We evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), haemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. Methods This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analysed factors associated with persistent negative humoral response and higher anti-Spike antibody titres as well as the efficacy of vaccination on coronavirus disease 2019 (COVID-19) severity. Results Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titres in HD (P = .001) and ND-CKD (P = .014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titres at 12 months were independently associated with repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titres and not being a KT recipient. Breakthrough COVID-19 was registered in 137 (6%) patients, 5% of whom required admission. Admitted patients had prior titres Conclusions A fourth vaccine dose increased anti-Spike antibody titres or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titres or KT recipients) derived the least benefit in terms of antibody titres. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titres.

Published
2023

10. The timely construction of arteriovenous fistulae: a key to reducing morbidity and mortality and to improving cost management

Author

J Alvarez-Grande, Francisco Ortega, Jose Ma Baltar, Carmen Díaz-Corte, T Ortega, and Pablo Rebollo

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Cohort Studies, Arteriovenous Shunt, Surgical, Catheters, Indwelling, Renal Dialysis, medicine, Humans, Survival rate, Dialysis, Aged, Transplantation, business.industry, Proportional hazards model, Health Care Costs, Middle Aged, medicine.disease, Surgery, Survival Rate, Nephrology, Relative risk, Emergency medicine, Kidney Failure, Chronic, Female, Hemodialysis, business, Cohort study, Kidney disease
Abstract

Background. Some investigators have shown that the initial placement of a catheter or graft, instead of the timely construction of an arteriovenous fistula (AVF), late referral to nephrology services and unplanned dialysis increase morbidity and mortality in chronic haemodialysis (CHD) patients. Furthermore, a delay in providing an adequate AVF entails significant increases in treatment-related costs. This study was limited to the analysis of the effects of the lack of an adequate vascular access for CHD on morbidity and mortality. Methods. According to the vascular access they had in the first 3 months of CHD treatment 96 patients were divided into three groups (VA group): Group 1 (G1), having an adequate AVF in the first 3 months; Group 2 (G2), starting with a catheter but finishing with an AVF; and Group 3 (G3) starting and finishing with a catheter. Time-dependent Cox regression analysis was performed to identify variables associated with survival, and the standardized mortality index (SMI) was calculated. Finally, we studied cost-effectiveness. Results. Time-dependent Cox regression and logistic regression analyses showed the statistically significant variable to be the VA group. To ensure that mortality was comparable between VA groups, eliminating age bias, the findings were adjusted applying SMI. G1 patients appear to have a lesser risk of death (relative risk, 0.39) than G2 and G3 patients, as do G2 relative to G3 patients. Also, after adjustment with SMI, patients over 65 years, presumably at greater risk of death, have a lower mortality than the � 65 age group. Patients with an adequate and functioning AVF lived longer than the others, and the cost of each ‘death prevented’ was lower (E3318/patient). Conclusions. The lack of an adequate AVF at the start of haemodialysis decreases survival significantly— even if patients are not diabetic, are referred to a nephrologist early and planned haemodialysis is initiated. It also increases the cost of each prevented death.

Published
2005

11. Alloimmune haemolytic anaemia resulting from anti-A and anti-B antibody induced by group O graft in renal transplant recipients

Author

Francisco Ortega, P Rodríguez, Ramón Peces, A. Laures, C Sanzo, Rafael A. Navascués, J García-Gala, J Alvarez-Grande, and J Baltar

Subjects
Male, Hemolytic anemia, Tacrolimus, ABO Blood-Group System, Isoantibodies, medicine, Humans, Transplantation, Kidney, biology, business.industry, Alloimmunity, Middle Aged, medicine.disease, Ciclosporin, Kidney Transplantation, medicine.anatomical_structure, Nephrology, Immunology, Cyclosporine, biology.protein, Anemia, Hemolytic, Autoimmune, Antibody, business, Immunosuppressive Agents, medicine.drug, Kidney disease
Published
1998

12. Haemolytic-uraemic syndrome in a heroin addict

Author

J Baltar, M Seco, J Alvarez-Grande, Carmen Díaz-Corte, and Ramón Peces

Subjects
Adult, Male, Narcotics, Hemolytic anemia, medicine.medical_specialty, Heroin, Renal Dialysis, Internal medicine, medicine, Humans, Illicit drug, Heroin addicts, Transplantation, Heroin Dependence, business.industry, medicine.disease, Surgery, Nephrology, Hemolytic-Uremic Syndrome, Histopathology, Haemolytic-uraemic syndrome, Complication, business, Methadone, Kidney disease, medicine.drug
Published
1998

16. The timely construction of arteriovenous fistulae: a key to reducing morbidity and mortality and to improving cost management.

Author

Teresa Ortega, Francisco Ortega, Carmen Diaz-Corte, Pablo Rebollo, Jose Ma Baltar, and Jaime Alvarez-Grande

Subjects
ARTERIOVENOUS fistula, MORTALITY, HEMODIALYSIS, CATHETERIZATION
Abstract

Background. Some investigators have shown that the initial placement of a catheter or graft, instead of the timely construction of an arteriovenous fistula (AVF), late referral to nephrology services and unplanned dialysis increase morbidity and mortality in chronic haemodialysis (CHD) patients. Furthermore, a delay in providing an adequate AVF entails significant increases in treatment-related costs. This study was limited to the analysis of the effects of the lack of an adequate vascular access for CHD on morbidity and mortality.Methods. According to the vascular access they had in the first 3 months of CHD treatment 96 patients were divided into three groups (VA group): Group 1 (G1), having an adequate AVF in the first 3 months; Group 2 (G2), starting with a catheter but finishing with an AVF; and Group 3 (G3) starting and finishing with a catheter. Time-dependent Cox regression analysis was performed to identify variables associated with survival, and the standardized mortality index (SMI) was calculated. Finally, we studied cost-effectiveness.Results. Time-dependent Cox regression and logistic regression analyses showed the statistically significant variable to be the VA group. To ensure that mortality was comparable between VA groups, eliminating age bias, the findings were adjusted applying SMI. G1 patients appear to have a lesser risk of death (relative risk, 0.39) than G2 and G3 patients, as do G2 relative to G3 patients. Also, after adjustment with SMI, patients over 65 years, presumably at greater risk of death, have a lower mortality than the =65 age group. Patients with an adequate and functioning AVF lived longer than the others, and the cost of each death prevented was lower (€3318/patient).Conclusions. The lack of an adequate AVF at the start of haemodialysis decreases survival significantlyeven if patients are not diabetic, are referred to a nephrologist early and planned haemodialysis is initiated. It also increases the cost of each prevented death. [ABSTRACT FROM AUTHOR]

Published
2005
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18. Treatment of cyclosporin-induced gingival hyperplasia with azithromycin.

Author

Gómez, E, Sánchez-Nuñez, M, Sánchez, J E, Corte, C, Aguado, S, Portal, C, Baltar, J, and Alvarez-Grande, J

Abstract

BACKGROUND: Gingival hyperplasia is a known complication of cyclosporin therapy. Although plaque control has been shown to be of benefit, gingival surgery is occasionally necessary. The aim of this study was to review the effect of a short-course therapy with azithromycin in renal transplant patients with cyclosporin-induced gingival hyperplasia. METHODS: Thirty-eight patients received 500 mg/day of azithromycin for 3 consecutive days. The degree of gingival hyperplasia was classified as: 0, no gingival overgrowth; 1, mild overgrowth; 2, moderate overgrowth, and 3, severe overgrowth. Gingival bleeding and evolution of gingival hyperplasia were determined at 0 (pretreatment), 7, 30, 90 and 180 days. Cyclosporin, serum creatinine and ALT levels were simultaneously determined on the same days. RESULTS: Seven patients were excluded, leaving a total of 31 included in the trial. Eleven had a score of 3, 17 a score of 2, and 3 a score of 1. The degree of gingival hyperplasia was unrelated to the dose and levels of cyclosporin. Gingival hyperplasia improved in all patients (P < 0.001, Friedman test). The degree of improvement was better when the degree of hyperplasia was lower. In 27 patients gingival hyperplasia remained absent 6 months later, 3 patients required a second course of treatment, and another required gingival surgery. Gingival bleeding, present in 28 patients when diagnosed, disappeared in all cases in 2.2 +/- 1.2 (1-7) days. No adverse effects were observed. Cyclosporin, serum creatinine, and ALT levels were not affected by treatment. CONCLUSIONS: Azithromycin improves cyclosporin-associated gingival hyperplasia, especially when administered early in the process. [ABSTRACT FROM PUBLISHER]

Published
1997

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