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2. Prediabetes and CKD: Does a causal relationship exist

Author

Rico Fontalvo, Jorge, Soler, María José, Daza Arnedo, Rodrigo, Navarro-Blackaller, Guillermo, Medina-González, Ramón, Rodríguez Yánez, Tomas, Cardona-Blanco, Maria, Cabrales-Juan, Jose, Uparrela-Gulfo, Isabella, and Chávez-Iñiguez, Jonathan S.

Published
2024
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7. Análogos orales del GLP-1: perspectivas en el control glucémico y riesgo cardiorenal en pacientes con diabetes mellitus tipo 2

Author

Rico-Fontalvo, Jorge, primary, Daza-Arnedo, Rodrigo, additional, Vázquez-Jiménez, Lourdes C., additional, Rodríguez-Yánez, Tomas, additional, Raad-Sarabia, María, additional, Toapanta, Néstor, additional, Rafael-Vicente, Pérez, additional, Montejo-Hernández, Juan, additional, and Soler, María J., additional

Published
2024
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10. Usefulness of ultrasonography in performing renal biopsy puncture with the ultrasound-guided angled cortical tangential technique at the Hospital de Clinicas - FCM-UNA

Author

Kang Kwon, Alberto, Barrios, Marcelo, Vázquez Jiménez, Lourdes Carolina, Sotomayor Rojas, Alejandro Daniel, Da Ponte, Fernando, Stanley, Idalina, Nolasco, Esteban Nolasco, Rico Fontalvo, Jorge, Kang Kwon, Alberto, Barrios, Marcelo, Vázquez Jiménez, Lourdes Carolina, Sotomayor Rojas, Alejandro Daniel, Da Ponte, Fernando, Stanley, Idalina, Nolasco, Esteban Nolasco, and Rico Fontalvo, Jorge

Abstract

Objectives: To determine the usefulness of ultrasound in performing renal biopsy puncture at the Hospital de Clinicas of the Faculty of Medical Sciences of the National University of Asunción, to determine demographic data, the number of punctures performed, the number of glomeruli obtained, the histopathological di- agnoses and the complications. Materials and mthods: 47 renal biopsies performed with automatic needles and ultrasound guidance using the angled cortical tangential technique at the Hospital de Clínicas were reviewed. Patient data were obtained through a questionnaire that was completed by reviewing the medical records of each patient with an indication for renal biopsy puncture. Results: Sufficient histological material was obtained to establish a diagnosis in 47 out of 47 biopsies (100%). Complications were detected in 3 out of 47 biopsies (6%) and all of them were minor complications. Conclusion: Percutaneous renal biopsy performed with ultrasound guidance and the cortical tangential technique is a good alternative, given its effectiveness and safety, for obtaining histological samples of the kidney., Objetivos: Determinar la utilidad de la ecografía en la realización de la punción biopsia renal en el Hospital de Clínicas de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción, determinar los datos demográficos, el número de punciones realizado, la cantidad de glomérulos obtenidos, los diagnóstico his- topatológicos y las complicaciones. Material y métodos: Se revisaron 47 biopsias renales realizadas con agujas automáticas y guía ecográfica utilizando la técnica tangencial cortical angulada en el Hospital de clínicas. Se obtuvieron los datos de los pacientes a través de un cuestionario que fue completado mediante la revisión de historias clínicas de cada paciente con indicación de punción biopsia renal. Resultados: Se obtuvo material histológico suficiente para establecer un diagnóstico en 47 de 47 biopsias (100%). Se detectaron complicaciones en 3 de 47 biopsias (6%) y todas ellas fueron complicaciones menores. Conclusión: La biopsia renal percutánea realizada con guía ecográfica y la técnica tangencial cortical es una buena alternativa, dada su eficacia y seguridad, para la obtención de muestras histológicas del riñón.

Published
2024

11. Innovative medicine: a concept that goes far beyond innovations in medicine

Author

Rico Fontalvo, Jorge, Ortiz Ospino, Luis, Raad Sarabia, Maria, Daza Arnedo, Rodrigo, Rodríguez Yánez , Tomas, Vázquez Jiménez, Lourdes Carolina, Rico Fontalvo, Heidy, Rico Calvano, Florentino, Rico Fontalvo, Jorge, Ortiz Ospino, Luis, Raad Sarabia, Maria, Daza Arnedo, Rodrigo, Rodríguez Yánez , Tomas, Vázquez Jiménez, Lourdes Carolina, Rico Fontalvo, Heidy, and Rico Calvano, Florentino

Abstract

Creativity and innovation are essential in every aspect of life, from art to health-care. Developing new technologies has been considered an important aspect of modern medicine. However, we must keep in mind that the practice of medicine must go beyond health care based on technological tools. In this review, we pro- pose a concept of “innovative medicine” that brings together the technological, scientific, and human spheres to explain the current vision of the practice of medicine. Innovation medicine encompasses much more than technological innovations in medicine., En la vida moderna, la creatividad y la innovación son parte esencial de cada aspecto de la vida desde el arte hasta la atención en salud. El desarrollo de nuevas tecnologías se ha considerado un aspecto importante en la medicina moderna. Sin embargo, debemos tener en cuenta que en la actualidad la práctica de la medicina debe ir más allá de la atención en salud basada en herramientas tecnológicas. En esta revisión proponemos un concepto de “medicina de innovación” que agrupa el ámbito tecnológico, científico y humano para dar explicación a la visión actual de la práctica de la medicina. La medicina de innovación abarca mucho más que las innovaciones tecnológicas en medicina.

Published
2024

12. Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis

Author

Benítez, André, primary, Garrido, David, additional, Banegas, Andrea, additional, Mena, María Belén, additional, Osorio, Washington, additional, Rico-Fontalvo, Jorge, additional, Raad-Sarabia, Maria, additional, Daza-Arnedo, Rodrigo, additional, Cardona-Blanco, Maria, additional, Rodriguez-Yanez, Tomas, additional, and Sierra-Torres, Liseth, additional

Published
2024
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18. Bloqueo del eje renina angiontensina aldosterona (RAAS) en la enfermedad renal diabética. Más allá del control de la hipertensión arterial

Author

Rico Fontalvo, Jorge, Montejo Hernández, Juan, Vázquez Jiménez, Lourdes, Rodríguez Yánez, Tomás, Daza Arnedo, Rodrigo, Cardona Blanco, María Ximena, López Lozano, Jhon, and Plaza Rivero, Mayerlys

Subjects
Hipertensión arterial, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, hypertension, renin-angiotensin-aldosterone system, Enfermedad renal diabética, bloqueadores del receptor de angiotensina, cardiovascular disease, General Medicine, enfermedad cardiovascular, Diabetic kidney disease, eje renina angiotensina aldosterona, Inhibidores de la enzima convertidora de angiotensina
Abstract

RESUMEN La enfermedad renal diabética (ERD) es una comorbilidad con alta prevalencia a nivel mundial, siendo una de las complicaciones más frecuentes de la diabetes mellitus (DM). La ERD se relaciona con complicaciones cardiovasculares y progresión de la enfermedad renal crónica (ERC), por ello la identificación de factores modificables, como el control de la presión arterial, es uno de los pilares más importantes en el manejo integral. En esta revisión hacemos un recorrido sobre el papel de la hipertensión y el bloqueo del eje renina angiotensina aldosterona (RAAS) en el curso de la ERD y las estrategias terapéuticas orientadas a la reducción de la presión arterial (PA), el bloqueo RAAS y el impacto en resultados renales y cardiovasculares. El objetivo de este artículo es hacer una revisión de las intervenciones más importantes que actúan bloqueando el eje renina angiotensina aldosterona (RAAS) y determinar si estas medidas en los pacientes con ERD, solo tienen impacto en el control de la presión arterial o si también son estrategias de nefro y cardio-protección. Conclusión: La ERD es una de las complicaciones más frecuentes de la diabetes mellitus (DM). El control de la PA sigue siendo un pilar fundamental para lograr estos objetivos. Los bloqueadores del RAAS (iECAS y BRAs) son los antihipertensivos de elección con efecto terapéutico por el bloqueo RAAS y esto les permite tener además del control de la PA, efectos nefroprotectores y cardioprotectores importantes en pacientes con ERD, sobre todo cuando hay la presencia de albuminuria. Evaluamos que además de los inhibidores de la enzima convertidora de angiotensina (iECAs) y los bloqueadores del receptor de angiotensina (BRAs), vienen tomando importancia los antagonistas selectivos del receptor mineralocorticoide (ARM) como Finerenona. ABSTRACT Diabetic kidney disease (DKD) is a comorbidity with a high worldwide prevalence, and one of the most frequent complications of diabetes mellitus (DM). CKD is related to cardiovascular complications and the progression of chronic kidney disease (CKD), therefore the identification of modifiable factors, such as blood pressure control, is one of the most important pillars in comprehensive management. In this review, we will analyze the role of hypertension and the renin-angiotensin-aldosterone system (RAAS) and its suppression in the course of CKD, and therapeutic strategies aimed at reducing blood pressure (BP), RAAS blockade, and the impact on renal and cardiovascular outcomes. The objective of this article is to review the most important interventions that act by blocking the renin-angiotensin-aldosterone system (RAAS) and to determine if these measures in patients with CKD only have an impact on blood pressure control or if they are also nephron and cardio-protective strategies. Conclusion: DKD is one of the most frequent complications of diabetes mellitus (DM). BP control continues to be a fundamental pillar to achieve these objectives. RAAS blockers (iECAS and ARBs) are the first-line antihypertensive with a therapeutic effect due to RAAS blockade and this allows them to have, in addition to BP control, important nephroprotective and cardioprotective effects in patients with CKD, especially when there is albuminuria. We evaluated that in addition to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), selective mineralocorticoid receptor antagonists (MRA) such as Finerenone are gaining importance.

Published
2023
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22. Insulin and the kidneys: a contemporary view on the molecular basis

Author

Daza-Arnedo, Rodrigo, primary, Rico-Fontalvo, Jorge, additional, Aroca-Martínez, Gustavo, additional, Rodríguez-Yanez, Tomás, additional, Martínez-Ávila, María Cristina, additional, Almanza-Hurtado, Amilkar, additional, Cardona-Blanco, María, additional, Henao-Velásquez, Carlos, additional, Fernández-Franco, Jorge, additional, Unigarro-Palacios, Mario, additional, Osorio-Restrepo, Carolina, additional, and Uparella-Gulfo, Isabella, additional

Published
2023
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23. Utilidad del citoquímico urinario en cuidados intensivos, una herramienta olvidada

Author

Rico Fontalvo, Jorge, primary, Daza Arnedo, Rodrigo, additional, Gutiérrez Ariza, Juan, additional, Soto Guerrero, Oscar, additional, Suarez Romero, Beatriz, additional, Vásquez Jiménez, Ángel, additional, Rodelo, Dairo, additional, Díaz Suárez, Esteban, additional, Rodríguez Yánez, Tomas, additional, Ortiz Márquez, Valentina, additional, and Vázquez-Jiménez, Lourdes Carolina, additional

Published
2023
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25. Capacity for the management of kidney failure in the International Society of Nephrology Latin America region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

Author

Calice-Silva, Viviane, Neyra, Javier A., Ferreiro Fuentes, Alejandro, Singer Wallbach Massai, Krissia Kamile, Arruebo, Silvia, Bello, Aminu K., Caskey, Fergus J., Damster, Sandrine, Donner, Jo-Ann, Jha, Vivekanand, Johnson, David W., Levin, Adeera, Malik, Charu, Nangaku, Masaomi, Okpechi, Ikechi G., Tonelli, Marcello, Ye, Feng, Madero, Magdalena, Tzanno Martins, Carmen, Alvarez, Guillermo, Amouzegar, Atefeh, Arellano-Mendez, Denisse, Martinez, Gustavo Aroca, Ferrari, Roger Ayala, Bonano, Carlos, Velarde, Edwin Castillo, Chavez Iñiguez, Jonathan Samuel, Cho, Yeoungjee, Claure-Del Granado, Rolando, Correa-Rotter, Ricardo, Cueto Manzano, Alfonso M., Cusumano, Ana Maria, Davids, M. Razeen, Davison, Sara N., Diongole, Hassane M., Divyaveer, Smita, Ekrikpo, Udeme E., Ethier, Isabelle, Figueiredo, Ana Elizabeth, Wing-Shing Fung, Winston, Garcia, Guillermo Garcia, Ghimire, Anukul, Gomez, Martin, Gonzalez Bedat, Maria Carlota, Houston, Ghenette, Htay, Htay, Ibrahim, Kwaifa Salihu, Irish, Georgina, Jindal, Kailash, Kelly, Dearbhla M., Lalji, Rowena, Moura-Neto, José A., Nalado, Aisha M., Neuen, Brendon L., Noboa, Oscar, Noronha, Irene L., Olanrewaju, Timothy O., Osman, Mohamed A., Pastor Ludena, Ana Cecilia, Petrova, Anna, Pio-Abreu, Andrea, Riaz, Parnian, Rico-Fontalvo, Jorge, Rosa-Diez, Guillermo, Saad, Syed, Sakajiki, Aminu Muhammad, Santacruz, Angel Cristóbal, Santacruz, Juan, See, Emily, Soares dos Santos Junior, Augusto Cesar, Sola, Laura, Sozio, Stephen M., Tiv, Sophanny, Trimarchi, Hernan, Tungsanga, Somkanya, Viecelli, Andrea, Wainstein, Marina, Yeung, Emily K., and Zaidi, Deenaz

Abstract

Successful management of chronic kidney disease (CKD) in Latin America (LA) continues to represent a challenge due to high disease burden and geographic disparities and difficulties in terms of capacity, accessibility, equity, and quality of kidney failure care. Although LA has experienced significant social and economic progress over the past decades, there are still important inequities in health care access. Through this third iteration of the International Society of Nephrology Global Kidney Health Atlas, the indicators regarding kidney failure care in LA are updated. Survey responses were received from 22 of 31 (71%) countries in LA representing 96.5% of its total population. Median CKD prevalence was 10.2% (interquartile range: 8.4%–12.3%), median CKD disability-adjusted life year was 753.4 days (interquartile range: 581.3–1072.5 days), and median CKD mortality was 5.5% (interquartile range: 3.2%–6.3%). Regarding dialysis modality, hemodialysis continued to be the most used therapy, whereas peritoneal dialysis reached a plateau and kidney transplantation increased steadily over the past 10 years. In 20 (91%) countries, >50% of people with kidney failure could access dialysis, and in only 2 (9%) countries, people who had access to dialysis could initiate dialysis with peritoneal dialysis. A mix of public and private systems collectively funded most aspects of kidney replacement therapy (dialysis and transplantation) with many people incurring up to 50% of out-of-pocket costs. Few LA countries had CKD/kidney replacement therapy registries, and almost no acute kidney injury registries were reported. There was large variability in the nature and extent of kidney failure care in LA mainly related to countries’ funding structures and limited surveillance and management initiatives.

Published
2024
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26. Inflammation and Diabetic Kidney Disease: New Perspectives

Author

Rico-Fontalvo Jorge, Daza-Arnedo Rodrigo, Rodriguez-Yanez Tomas, Martinez-Avila Maria Cristina, Cabrales Jose, Cardona-Blanco Maria Ximena, Almanza-Hurtado Amilkar, Uparella-Gulfo Isabella, and Vergara-Serpa Oscar

Subjects
Ocean Engineering
Abstract

Diabetic Kidney Disease (DKD) can occur in approximately 30-40% of the population with type 1 or 2 diabetes mellitus around the world. In the pathogenesis and progression the Diabetic Kidney Disease (DKD), three fundamental axes are distinguished: hemodynamic, metabolic and inflammatory. The primary purpose of the review is to describe the role and mechanisms related to inflammation in the course of this disease. The pathophysiological mechanisms involved in the development and progression of DKD include different pathways present long before the clinical diagnosis of the disease. Inflammation is a complex mechanism where innate and acquired immunity play an important role, in addition to other factors such as oxidative stress and end products of glycation that in one way or another would be linked to this process of inflammation. We cannot forget the contribution in this axis of inflammation of the well-known aldosterone escape phenomenon. The blockade of the Mineralocorticoid Receptor (MRA) inactivates the action of aldosterone and prevents the genomic and non-genomic response from interacting with the receptor, thus decreasing the degree of inflammation and remodeling in the heart and kidney. Finally, there are many territories to explore in this fascinating universe of inflammation as a mechanism of kidney damage in diabetic patients. Current management of DKD with innovative interventions point to this multitarget approach.

Published
2022
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29. Novel Biomarkers of Diabetic Kidney Disease

Author

Rico-Fontalvo, Jorge, primary, Aroca-Martínez, Gustavo, additional, Daza-Arnedo, Rodrigo, additional, Cabrales, José, additional, Rodríguez-Yanez, Tomás, additional, Cardona-Blanco, María, additional, Montejo-Hernández, Juan, additional, Rodelo Barrios, Dairo, additional, Patiño-Patiño, Jhonny, additional, and Osorio Rodríguez, Elber, additional

Published
2023
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31. Update on the use of continuous renal replacement therapy (CRRT) in the critically ill patient

Author

Rodríguez-Yanez, Tomás, Daza-Arnedo , Rodrigo, Rodelo Barrios, Dairo, Patiño Patiño , Jhonny, Osorio Rodriguez , Elber, Díaz Suárez, Esteban, Montes Vargas, Julieth Paola, Rico-Fontalvo , Jorge, Rodríguez-Yanez, Tomás, Daza-Arnedo , Rodrigo, Rodelo Barrios, Dairo, Patiño Patiño , Jhonny, Osorio Rodriguez , Elber, Díaz Suárez, Esteban, Montes Vargas, Julieth Paola, and Rico-Fontalvo , Jorge

Abstract

In recent years, in critically ill patients, there has been controversy with the continuous renal replacement therapies (CRRT) associated with the modality of choice, dose and start time.Continuous renal replacement therapies (CRRT) emerge as a potential substitute strategy for conventional hemodialysis or peritoneal dialysis in critically ill patients with acute kidney injury. CRRT is the most appropriate treatment option and indicated in hemodynamically unstable patients. In this article we review its use, indication and positioning in critically ill patients, En los últimos años en pacientes críticos ha existido controversia con las técnicas de terapias de reemplazo renal existente asociado a la modalidad de elección, dosis y tiempo de inicio. Las terapias de reemplazo renal continua (TRRC) surgen como una estrategia sustituta potencial para la hemodiálisis convencional o diálisis peritoneal en pacientes en estado crítico quienes cursan con lesión renal aguda.La TRRC es la opción de tratamiento más adecuada e indicada en pacientes hemodinamicamente inestables. En el presente articulo hacemos una revisión de su uso, indicación y posicionamiento en el paciente crítico.

Published
2023

32. Hiperkalemia crónica, diagnóstico y manejo. Consenso colombiano.

Author

Rico-Fontalvo, Jorge, Rodríguez-González, María J., Yama, Erica Y., Gallego, Catalina, Montejo-Hernández, Juan, Martínez, Erika M., Lopera, John M., Echeverria, Luis, Daza, Rodrigo, Pieschacón, José R., and Gómez, Efraín A.

Subjects
*DISEASE risk factors, *RENIN-angiotensin system, *HYPERKALEMIA, *SYMPTOMS, *ACIDOSIS, *DRUG therapy
Abstract

Objective: Generate recommendations for the diagnosis, management, and follow-up of chronic hyperkalemia. Method: This consensus was made by nephrologists and cardiologists following the GRADE methodology. Results: Chronic hyperkalemia can be defined as a biochemical condition with or without clinical manifestations characterized by a recurrent elevation of serum potassium levels that may require pharmacological and or non-pharmacological intervention. It can be classified as mild (K+ 5.0 to < 5.5 mEq/L), moderate (K+ 5.5 to 6.0 mEq/L) or severe (K+ > 6.0 mEq/L). Its incidence and prevalence have yet to be determined. Risk factors: chronic kidney disease, chronic heart failure, diabetes mellitus, age = 65 years, hypertension, and drugs that inhibit the renin angiotensin aldosterone system (RAASi), among others. There is no consensus for the management of chronic hyperkalemia. The suggested pattern for patients is to identify and eliminate or control risk factors, provide advice on potassium intake and, for whom it is indicated, optimize RAASi therapy, administer oral potassium binders and correct metabolic acidosis. Conclusions: The recommendation is to pay attention to the diagnosis, management, and follow-up of chronic hyperkalemia, especially in patients with risk factors. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose

Author

Rico-Fontalvo, Jorge, primary, Correa-Guerrero, José, additional, Martínez-Ávila, María Cristina, additional, Daza-Arnedo, Rodrigo, additional, Rodriguez-Yanez, Tomás, additional, Almanza-Hurtado, Amilkar, additional, Cabrales, José, additional, Mendoza-Paternina, Carmen Julia, additional, Frías-Salazar, Alvaro, additional, and Morales-Fernández, Julio, additional

Published
2023
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37. Intoxicación por Litio

Author

Rico-Fontalvo, Jorge, primary, Cardona Blanco, Maria Ximena, additional, Daza-Arnedo, Rodrigo, additional, Sierra Torres, Liseth Paola, additional, Marrugo Yunda, Juan Carlos, additional, Rodriguez-Yanez, Tomas, additional, Raad Sarabia, Maria, additional, and Villavicencio Ceron, Elba Vanesa, additional

Published
2023
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38. Unmet Needs of Chronic Kidney Disease in Latin America: A Review from Expert Virtual Working Group

Author

Correa-Rotter, Ricardo, primary, Durán, Antonio Méndez, additional, Vallejos, Augusto, additional, Rico-Fontalvo, Jorge, additional, Cusumano, Ana María, additional, Rosa-Diez, Guillermo Javier, additional, Polo, Vicente Sánchez, additional, Goecke, Helmuth, additional, Arango, José Javier, additional, Cerón, Vanessa Villavicencio, additional, Diná, Eliana, additional, Fonseca, Fabio Hernández, additional, Valdés, Régulo Adolfo, additional, and Vanoni, Miguel, additional

Published
2023
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39. Update on diabetic kidney disease

Author

Rico Fontalvo, Jorge, primary, Vázquez Jiménez, Lourdes Carolina, additional, Rodríguez Yánez, Tomás, additional, Daza Arnedo, Rodrigo, additional, Raad Sarabia, María, additional, Montejo Hernández, Juan Diego, additional, Lopera Vargas, Mauricio, additional, and Jiménez Quintero, Javier, additional

Published
2022
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41. Consenso colombiano sobre vacunación en pacientes con enfermedad renal crónica

Author

Silva Monsalve, Edwin, primary, Roncancio Villamil, Gustavo Eduardo, additional, Forero, Jessica, additional, Mesa, Juan Gonzalo, additional, Cárdenas Aguilera, Juan Guillermo, additional, Estévez, Mayra, additional, Baquero Rodríguez, Richard, additional, Carrascal, Martha, additional, Beltrán Arroyave, Claudia Patricia, additional, Yomayusa González, Nancy, additional, Rico Fontalvo, Jorge, additional, Aroca, Gustavo, additional, Chacón Acevedo, Kelly Rocío, additional, Camacho Moreno, Germán, additional, López Mora, María José, additional, Garcés Samudio, Carlos Guillermo, additional, Cortés, Jorge Alberto, additional, Gutiérrez Tobar, Iván Felipe, additional, Torres Hernández, Daniela, additional, López, Pio, additional, and Soler Romeo, María José, additional

Published
2022
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42. Metformina y su rol en la enfermedad renal: estado del arte

Author

Rico-Fontalvo, Jorge, primary, Daza-Arnedo, Rodrigo, additional, Raad-Sarabia, María, additional, Pájaro-Galvis, Nehomar, additional, Uparella-Gulfo, Isabela, additional, Porto-Corbacho, Daniel, additional, Pomares-Lara, Alonso, additional, Meza-Santiago, Blanca, additional, Montejo-Hernández, Juan, additional, and Cardona-Blanco, María, additional

Published
2022
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43. Consenso de la Sociedad Latinoamericana de Nefrología e Hipertensión en relación con el papel de los antagonistas del receptor mineralocorticoide en enfermedad renal crónica

Author

Rico-Fontalvo, Jorge, primary, Álvarez-Estévez, Guillermo, additional, Sánchez-Polo, Vicente, additional, Diná-Batle, Eliana, additional, Lorca-Herrera, Eduardo, additional, Mascheroni, Claudio, additional, Vázquez, Lourdes C., additional, Rosa-Diez, Guillermo, additional, Raad-Sarabia, María, additional, and Correa-Rotter, Ricardo, additional

Published
2022
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44. Situación de la enfermedad renal crónica en Colombia

Author

Rico-Fontalvo, Jorge, primary, Yama-Mosquera, Erica, additional, Robayo-García, Adriana, additional, Aroca-Martínez, Gustavo, additional, Arango-Álvarez, José J., additional, Barros-Camargo, Luis, additional, Raad-Sarabia, María, additional, and Acuna-Merchán, Lizbeth, additional

Published
2022
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46. SGLT-2 inhibitors in Lupus Nephropathy. It could be considered an intervention of Nephroprotection

Author

Rico-Fontalvo, Jorge, Vázquez-Jiménez, Lourdes Carolina, Rodríguez-Yánez, Tomás, Daza-Arnedo, Rodrigo, Vergara-Serpa, Oscar, Uparella, Isabella, and Álvarez-Estévez, Guillermo

Subjects
Proteinuria, Lupus nephropathy, Riesgo cardiovascular, Systemic lupus erythematosus, Inhibidores SGLT-2, Lupus Eritematoso sistémico, Nefroprotección, Nefropatía lúpica, Nephroprotection, SGLT2 inhibitors
Abstract

Resumen: El lupus eritematoso sistémico (LES) es un trastorno reumatológico autoinmune crónico. Dentro de los órganos afectados con frecuencia se encuentran los riñones. El tratamiento habitual de la nefritis lúpica incluye medicamentos nefroprotectores, además inmunosupresores e inmunomoduladores. Los inhibidores SGLT-2, son medicamentos que llegaron inicialmente como antidiabéticos, pero en el curso de su desarrollo, se han encontrado importantes efectos cardio y nefroprotectores aún en pacientes no diabéticos. En estudios experimentales en nefritis lúpica se ha encontrado aumento en la expresión de SGLT-2, por lo tanto, este artículo tiene como objetivo hacer una revisión actualizada de la evidencia que hay del uso de los inhibidores de SGLT-2 en los pacientes con nefritis lúpica. Los grandes ensayos clínicos en general con inhibidores SGLT-2 han excluido estos pacientes. La evidencia actual de utilización de iSGLT-2 en nefritis lúpica es bastante limitada y se desprende de pequeños estudios observacionales y series de casos, en donde hay beneficios en reducción de proteinuria. Se requieren estudios que permitan evaluar sus efectos a largo plazo y beneficios potenciales. Es probable que estos medicamentos puedan beneficiar a los pacientes con nefritis lúpica. Abstract: Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune rheumatologic disorder. The kidneys are frequently affected organs. The usual treatment of lupus nephritis includes nephroprotective drugs, immunosuppressants, and immunomodulators. SGLT-2 inhibitors are drugs that initially arrived as antidiabetics. Important cardio and nephroprotective effects have been found even in nondiabetic patients. Experimental studies of lupus nephritis mentioned the expression of SGLT-2; therefore, this article aims to make an updated review of the evidence on the use of SGLT-2 inhibitors in patients with nephritis. Extensive clinical trials with SGLT-2 inhibitors have generally excluded these patients. The current evidence of the use of iSGLT-2 in lupus nephritis is quite limited and carries from small observational studies and case series, where there are benefits in reducing proteinuria. More trials are required to establish its long-term effects.

Published
2022

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