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1. IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy

Author

Universidad de Sevilla. Departamento de Medicina, Comunidad Autónoma de Madrid, Consejería de Salud y Familias. Junta de Andalucía, Instituto de Salud Carlos III, Red de Investigacion Renal (RedInRen), Centro Español de Investigación Biomédica en Enfermedades Cardiovasculares (CIBERCV), Ministerio de Ciencia e Innovación (MICIN). España, Sociedad Española de Nefrología (SEN), Trujillo, H., Sandino, J., Cavero, Teresa, Caravaca-Fontan, F, Gutierrez, E., Sevillano, A.M., Muñoz Terol, José Manuel, Praga, Manuel, Universidad de Sevilla. Departamento de Medicina, Comunidad Autónoma de Madrid, Consejería de Salud y Familias. Junta de Andalucía, Instituto de Salud Carlos III, Red de Investigacion Renal (RedInRen), Centro Español de Investigación Biomédica en Enfermedades Cardiovasculares (CIBERCV), Ministerio de Ciencia e Innovación (MICIN). España, Sociedad Española de Nefrología (SEN), Trujillo, H., Sandino, J., Cavero, Teresa, Caravaca-Fontan, F, Gutierrez, E., Sevillano, A.M., Muñoz Terol, José Manuel, and Praga, Manuel

Abstract

Introduction Anticoagulant-related nephropathy (ARN) is a relatively novel recognized entity characterized by hematuria-associated acute kidney injury (AKI) in the context of overanticoagulation. Preexisting or underlying kidney disease seems to be a predisposing factor; however, few studies have described histologic findings in patients with ARN. We aimed to evaluate underlying kidney pathology in patients on oral anticoagulation who presented an episode of AKI with hematuria in whom a kidney biopsy was performed. Methods Retrospective observational multicenter case study in patients treated with oral anticoagulants who developed macroscopic or intense hematuria followed by AKI. Only patients with available kidney biopsy specimens were included. Histologic findings and clinical data throughout follow-up were analyzed. Results A total of 26 patients were included with a median age of 75 years (62–80) and a follow-up period of 10.1 months. Of the patients, 80% were male, and most cases (92%) were on anticoagulation with vitamin K antagonists (VKAs). At admission, median serum creatinine (SCr) level was 4.2 mg/dl (2.8–8.2), median international normalized ratio (INR) 2.4 (1.5–3.4), and 11 patients (42%) required acute dialysis during hospitalization. Kidney biopsy results revealed that all patients except 1 had an underlying nephropathy: IgA nephropathy (IgAN) in 19, probable IgAN in 1, diabetic nephropathy in 3, nephrosclerosis in 1, and idiopathic nodular glomerulosclerosis in 1. At 12 weeks after discharge, only 6 subjects (24%) attained complete kidney recovery whereas 7 (28%) remained on chronic dialysis. Conclusion IgAN was the most common underlying kidney disease in our biopsy-proven series of ARN, in which a significant percentage of patients did not achieve kidney function recovery.

Published
2022

2. Resumen ejecutivo del documento de consenso sobre el manejo de la patología renal en pacientes con infección por el virus de la inmunodeficiencia humana

Author

Panel de Expertos del Grupo de Estudio de Sida (GESIDA), la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), la Sociedad Española de Nefrología (SEN), la Sociedad Española de Bioquímica Clínica y Patología Molecular (SEQC), Gorriz JL, Gutiérrez F, Trullàs JC, Arazo P, Arribas JR, Barril G, Cervero M, Cofán F, Domingo P, Estrada V, Fulladosa X, Galindo MJ, Gràcia S, Iribarren JA, Knobel H, López-Aldeguer J, Lozano F, Martínez-Castelao A, Martínez E, Mazuecos MA, Miralles C, Montañés R, Negredo E, Palacios R, Pérez-Elías MJ, Portilla J, Praga M, Quereda C, Rivero A, Santamaría JM, Sanz J, and Miró JM

Subjects
AIDS, Antiretroviral therapy, Chronic kidney disease, Enfermedad renal crónica, Fármacos antirretrovirales, Human immunodeficiency virus, Insuficiencia renal, Renal failure, Renal toxicity, Renal transplantation, Sida, Tenofovir, Toxicidad renal, Trasplante renal, Virus de la inmunodeficiencia humana, urologic and male genital diseases
Abstract

The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in human immunodeficiency virus (HIV)-infected patients. Renal function should be monitored in all HIV-infected patients. The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glycosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir, or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document provides indications for renal biopsy and advises on the optimal time for referral of a patient to the nephrologist. The indications for and evaluation and management of dialysis and renal transplantation are also addressed.

Published
2014

3. IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy

Author

Trujillo, H., Sandino, J., Cavero, Teresa, Caravaca-Fontan, F, Gutierrez, E., Sevillano, A.M., Muñoz Terol, José Manuel, Praga, Manuel, Universidad de Sevilla. Departamento de Medicina, Comunidad Autónoma de Madrid, Consejería de Salud y Familias. Junta de Andalucía, Instituto de Salud Carlos III, Red de Investigacion Renal (RedInRen), Centro Español de Investigación Biomédica en Enfermedades Cardiovasculares (CIBERCV), Ministerio de Ciencia e Innovación (MICIN). España, and Sociedad Española de Nefrología (SEN)

Subjects
hematuria, acute kidney injury, kidney biopsy, IgA nephropathy, anticoagulation
Abstract

Introduction Anticoagulant-related nephropathy (ARN) is a relatively novel recognized entity characterized by hematuria-associated acute kidney injury (AKI) in the context of overanticoagulation. Preexisting or underlying kidney disease seems to be a predisposing factor; however, few studies have described histologic findings in patients with ARN. We aimed to evaluate underlying kidney pathology in patients on oral anticoagulation who presented an episode of AKI with hematuria in whom a kidney biopsy was performed. Methods Retrospective observational multicenter case study in patients treated with oral anticoagulants who developed macroscopic or intense hematuria followed by AKI. Only patients with available kidney biopsy specimens were included. Histologic findings and clinical data throughout follow-up were analyzed. Results A total of 26 patients were included with a median age of 75 years (62–80) and a follow-up period of 10.1 months. Of the patients, 80% were male, and most cases (92%) were on anticoagulation with vitamin K antagonists (VKAs). At admission, median serum creatinine (SCr) level was 4.2 mg/dl (2.8–8.2), median international normalized ratio (INR) 2.4 (1.5–3.4), and 11 patients (42%) required acute dialysis during hospitalization. Kidney biopsy results revealed that all patients except 1 had an underlying nephropathy: IgA nephropathy (IgAN) in 19, probable IgAN in 1, diabetic nephropathy in 3, nephrosclerosis in 1, and idiopathic nodular glomerulosclerosis in 1. At 12 weeks after discharge, only 6 subjects (24%) attained complete kidney recovery whereas 7 (28%) remained on chronic dialysis. Conclusion IgAN was the most common underlying kidney disease in our biopsy-proven series of ARN, in which a significant percentage of patients did not achieve kidney function recovery.

Published
2022

4. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe

Author

Pablo Castro de la Nuez, Ángela Magaz, Harijs Cernevskis, Arjan van der Tol, Kirill Komissarov, Maria Fernanda Slon Roblero, Edita Ziginskiene, Nino Kantaria, Manuela Savino, Jaakko Helve, Kyriakos Ioannou, Olivera Stojceva-Taneva, Kitty J Jager, Johan De Meester, Helena Rydell, Mai Ots-Rosenberg, Faical Jarraya, Myftar Barbullushi, Bjørn Odvar Eriksen, Rianne W de Jong, Cécile Couchoud, Axel Rahmel, Samira Bell, Lucile Mercadal, Eliezer Golan, Marc H Hemmelder, José Baltar, Anton M. Andrusev, Vianda S. Stel, Nurhan Seyahi, Anneke Kramer, Julia Kerschbaum, Liliana Gârneaţă, Ziad A. Massy, Kristine Hommel, Runolfur Palsson, Evgueniy Vazelov, Oscar Zurriaga, Raymond Vanholder, HUS Abdominal Center, Nefrologian yksikkö, Department of Medicine, University of Helsinki, Helsinki University Hospital Area, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Agence de la biomédecine [Saint-Denis la Plaine], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de néphrologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Ambroise Paré [AP-HP], Recycled Materials Resource Center, RMRC Comunidad de Madrid Sociedad Española de Nefrología, SEN European Commission, EC: PP-01-2016 Universidade Paranaense, UNIPAR European Renal Association-European Dialysis and Transplant Association, ERA-EDTA, The authors would like to thank the patients and staff of all the dialysis and transplant units who have contributed data via their national and regional renal registries to the European Renal Association?European Dialysis and Transplant Association (ERA-EDTA) Registry. In addition, we would like to thank the persons and organizations listed in the paragraph ?AFFILIATED REGISTRIES? for their contribution to the work of the ERA-EDTA Registry. The authors are grateful to all nephrologists and kidney transplant surgeons who completed ?The Effect of Differing Kidney Disease Treatment Modalities and Organ Donation and Transplantation Practices on Health Expenditure and Patient Outcomes? Nephrologist survey. In addition, we would like to thank all colleagues who pretested the survey, provided advice about the ethical approval in their country, or helped to distribute the survey in their country or personal network. This study was funded by the European Union (grant PP-01-2016) and ERA-EDTA. Among others, we are grateful for support from Austria (R. Kramar and R. Oberbauer), Belarus, Belgium (F. Collart), Croatia (I. Bubic, M. Bu?i?, M. Dragovi?, and S. ?iv?i? ?osi?), Cyprus, Czech Republic (I. Rychlik and V. Tesa?), Denmark (J. Heaf and S. Schwartz S?rensen), Estonia, Finland (P. Finne and V. Rauta), Germany (M. Lingemann and C. Wanner), Greece (T. Apostolou, E. Dounousi, and G. Moustakas), Hungary (O. Deme, S. Mihaly, and G. Re?sz), Ireland (W. Plant), Italy (G. Brunori, C. Carella, P. di Ciaccio, and M. Postorino), Latvia (A. Petersons), Malta (J. Buttigieg), Moldova (A. Tanase), the Netherlands (F. van Ittersum and S. Logtenberg), North Macedonia (G. Spasovski), Norway (A. ?sberg, M. Dahl Solbu, and A. Varberg Reis?ter), Poland (S. Dudzicz and M. Nowicki), Romania (L. G?rnea?? and L. Tuta), Russia (H. Zakharova), Serbia (R. Naumovic), Slovakia (V. Spustova), Slovenia (J. Buturovic Ponikvar and D. Kovac), Spain (C. Alberich, J. Comas, M. del Pino y Pino, M. Ferrer Alamar, and B. Mahillo), Sweden (M. Evans), Switzerland (P. Amb?hl and U. Huynh-Do), Turkey (M. Arici), Ukraine (M. Kolesnyk), and United Kingdom (S. Fraser and G. Lipkin), and from the following organizations: EKITA (I. Bellini and R. Langer), ERA-EDTA (F. Trebelli), EuroPD (S. Davies), and Eurotransplant (P. Branger, M. van Meel, and U. Samuel). Affiliated registries. Albanian Renal Registry (M. Barbullushi, A. Idrizi, and E. Bolleku Likaj), Austrian Dialysis and Transplant Registry (OEDTR) (R. Kramar), Belarus Renal Registry (K.S. Komissarov, K.S. Kamisarau, and A.V. Kalachyk), Dutch-speaking Belgian Society of Nephrology (NBVN) (M. Couttenye, F. Schroven, and J. De Meester), French-speaking Belgian Society of Nephrology (GNFB) (J.M. des Grottes and F. Collart), Renal Registry Bosnia and Herzegovina (H. Resi?, Z. Stipancic, and N. Petkovic), Bulgaria (E.S. Vazelov and I. Velinova), Croatian Registry of renal replacement therapy (CRRRT) (I. Bubi? and M. Knotek), Cyprus Renal Registry (K. Ioannou and all of the renal units providing data), Czech Republic: Registry of Dialysis Patients (RDP) (I. Rychl?k, J. Potucek, and F. Lopot), Danish Nephrology Registry (DNS) (J.G. Heaf), Estonian Society of Nephrology (?. Pechter, K. Lilienthal, and M. Rosenberg), Finnish Registry for Kidney Diseases (P. Finne, A. Pylsy, and P.H. Groop), France: The Epidemiology and Information Network in Nephrology (REIN) (M. Lassalle and C. Couchoud), Georgian Renal Registry (N. Kantaria and Dialysis Nephrology and Transplantation Union of Georgia), Hellenic Renal Registry (N. Afentakis), Icelandic ESRD Registry (R. Palsson), Israel National Registry of Renal Replacement Therapy (R. Dichtiar, T. Shohat, and E. Golan), Italian Registry of Dialysis and Transplantation (RIDT) (A. Limido, M. Nordio, and M. Postorino), Latvian Renal Registry (H. Cernevskis, V. Kuzema, and A. Silda), Lithuanian Renal Registry (I.A. Bumblyte, V. Vainauskas, and E. ?iginskien?), Macedonian Renal Registry (M. Nedelkovska, N. Dimitriova, and O. Stojceva-Taneva), Norwegian Renal Registry (T. Leivestad, A.V. Reis?ter, and A. ?sberg), Polish Renal Registry (G. Korejwo, A. D?bska-?lizie?, and R. Gellert), Portuguese Renal Registry (F. Mac?rio and A. Ferreira), Romanian Renal Registry (RRR) (G. Mircescu, L. Garneata, and E. Podgoreanu), Russian Renal Registry (N. Tomilina, A. Andrusev, and H. Zakharova), Renal Registry in Serbia (N. Maksimovic, R. Naumovic, all of the Serbian renal units, and the Serbian Society of Nephrology), Slovakian Renal Registry (V. Spustov?, I. Lajdov?, and M. Karolyova), Spanish RRT National Registry at Organizaci?n Nacional de Trasplantes (ONT), Spanish Regional Registries, Spanish Society of Nephrology (SEN), and the regional registries of Andalusia Sistema de Informaci?n de la Coordinaci?n Auton?mica de Trasplantes de Andalucia (SICATA) (P. Castro de la Nuez [on behalf of all users of SICATA]), Aragon (F. Arribas Monz?n, J.M. Abad Diez, and J.I. Sanchez Miret), Asturias (R. Alonso de la Torre, J.R. Quir?s, and Registro de Enfermos Renales Cr?nicos de Asturias [RERCA] Working Group), Basque country (UNIPAR) (?. Magaz, J. Aranzabal, M. Rodrigo, and I. Moina), Cantabria (J.C. Ruiz San Mill?n, O. Garcia Ruiz, and C. Pi?era Haces), Castile and Le?n (M.A. Palencia Garc?a), Castile?La Mancha (G. Guti?rrez ?vila and I. Moreno Al?a), Catalonia (RMRC) (E. Arcos, J. Comas, and J. Tort), Extremadura (J.M. Ramos Aceitero and M.A. Garc?a Bazaga), Galicia (E. Bouzas-Caama?o), Community of Madrid (M.I. Aparicio de Madre), Renal Registry of the Region of Murcia (C. Santiuste de Pablos and I. Mar?n S?nchez), Navarre (M.F. Slon Roblero, J. Manrique Escola, and J. Arteaga Coloma), and the Valencian region (REMRENAL) (M. Ferrer Alamar, N. Fuster Camarena, and J. P?rez Penad?s), Swedish Renal Registry (SNR) (K.G. Pr?tz, M. Stendahl, M. Evans, S. Sch?n, T. Lundgren, and M. Segelmark), Swiss Dialysis Registry (P. Amb?hl and R. Winzeler), Dutch Renal Registry (RENINE) (L. Heuveling, S. Vogelaar, and M. Hemmelder), Tunisia, Sfax region (F. Jarraya and D. Zalila), Registry of the Nephrology, Dialysis and Transplantation in Turkey (TSNNR) (G. S?leymanlar, N. Seyahi, and K. Ate?), Ukrainian Renal Data System (URDS) (M. Kolesnyk, S. Nikolaenko, and O. Razvazhaieva), UK Renal Registry (UKRR) (all the staff of the UKRR and of the renal units submitting data), and Scottish Renal Registry (SRR) (all of the Scottish renal units). ERA-EDTA Registry committee members. C. Zoccali, Italy (ERA-EDTA President), Z.A. Massy, France (Chairman), F.J. Caskey, United Kingdom, C. Couchoud, France, M. Evans, Sweden, P. Finne, Finland, J.W. Groothoff, the Netherlands, J. Harambat, France, J.G. Heaf, Denmark, F. Jarraya, Tunisia, M. Nordio, Italy, and I. Rychlik, Czech Republic., Service de Néphrologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, Graduate School, APH - Methodology, ACS - Pulmonary hypertension & thrombosis, APH - Global Health, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
0301 basic medicine, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Conservative Treatment, DISEASE, 0302 clinical medicine, Germany, Medicine and Health Sciences, Registries, Renal Insufficiency, Kidney transplantation, education.field_of_study, hemodialysis, Greece, RENAL REPLACEMENT THERAPY, 3. Good health, Europe, peritoneal dialysis, Italy, Nephrology, Hemodialysis, medicine.medical_specialty, Population, hemodialysis [Keywords], Peritoneal dialysis, 03 medical and health sciences, Renal Dialysis, Internal medicine, medicine, Humans, Renal replacement therapy, education, Dialysis, Edetic Acid, Portugal, business.industry, Home hemodialysis, CARE, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Kidney Transplantation, Transplantation, 030104 developmental biology, Spain, Kidney Failure, Chronic, DONATION, business, Ireland, transplantation
Abstract

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure. European UnionEuropean Commission [PP-01-2016]; ERAEDTA This study was funded by the European Union (grant PP-01-2016) and ERAEDTA.

Published
2020
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6. Routine Kidney Graft Ultrasound After Elective Ureteric Stent Removal: Does it Help?

Author

Sosa Barrios RH, Burguera Vion V, Villa Hurtado D, Viera Ramírez ER, Galeano Álvarez C, Roncal Redín M, Fernández Lucas M, and Rivera Gorrín ME

Subjects
Humans, Stents, Kidney, Ultrasonography, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Postoperative Complications epidemiology, Ureter diagnostic imaging, Ureter surgery
Abstract

Transplantation (KTx) is considered to be the best renal replacement therapy, and improving its outcomes remains a primary challenge. KTx ureteral stenting has been used to prevent urological complications, but there is no consensus on the timing of stent removal, and literature regarding routine ultrasonography after ureteric stent removal (RUSUS) to detect complications is lacking. Point-of-care ultrasound has been gaining drive in the medical community in recent years, including nephrologists. We aimed to define the incidence of urological complications diagnosed with RUSUS, if those findings changed patient's management and ultrasound utility. Contrary to previously published data, in our cohort RUSUS allowed a timely diagnosis and early treatment of urological complications, a key factor for successful transplantation. KTx point-of-care ultrasound is a cost-effective and reproducible test that provides relevant information to guide clinical decisions, seeming most efficient when performed approximately 2 weeks post ureteral stent removal. Interventional nephrologists can promptly perform these examinations, reducing waiting times and improving graft and patient's survival., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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7. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: What parameters should a basic lipid profile include?

Author

Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Carlos Obaya J, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, and Buño Soto A

Subjects
Humans, Consensus, Lipids, Laboratories, Clinical, Cardiovascular Diseases diagnosis, Cardiovascular Diseases prevention & control
Abstract

Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Published
2023
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8. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile?

Author

Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, and Buño Soto A

Subjects
Lipid Metabolism Disorders complications, Consensus, Humans, Lipids analysis, Laboratories, Clinical, Cardiovascular Diseases diagnosis, Cardiovascular Diseases prevention & control
Abstract

Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)

Published
2023
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9. [Consensus document for the detection and management of chronic kidney disease].

Author

Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, Esmatjes E, Fácila L, Gamarra J, Gràcia S, Hernández-Moreno J, Llisterri-Caro JL, Mazón P, Montañés R, Morales-Olivas F, Muñoz-Torres M, de Pablos-Velasco P, de Santiago A, Sánchez-Celaya M, Suárez C, and Tranche S

Subjects
Consensus, Disease Progression, Glomerular Filtration Rate, Humans, Life Style, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic physiopathology, Risk Factors, Spain, Primary Health Care methods, Renal Dialysis methods, Renal Insufficiency, Chronic therapy
Abstract

Chronic kidney disease (CKD) is an important global health problem, involving to 10% of the Spanish population, promoting high morbidity and mortality for the patient and an elevate consumption of the total health resources for the National Health System. This is a summary of an executive consensus document of ten scientific societies involved in the care of the renal patient, that actualizes the consensus document published in 2007. The central extended document can be consulted in the web page of each society. The aspects included in the document are: Concept, epidemiology and risk factors for CKD. Diagnostic criteria, evaluation and stages of CKD, albuminuria and glomerular filtration rate estimation. Progression factors for renal damage. Patient remission criteria. Follow-up and objectives of each speciality control. Nephrotoxicity prevention. Cardio-vascular damage detection. Diet, life-style and treatment attitudes: hypertension, dyslipidaemia, hyperglycemia, smoking, obesity, hyperuricemia, anemia, mineral and bone disorders. Multidisciplinary management for Primary Care, other specialities and Nephrology. Integrated management of CKD patient in haemodialysis, peritoneal dialysis and renal transplant patients. Management of the uremic patient in palliative care. We hope that this document may be of help for the multidisciplinary management of CKD patients by summarizing the most updated recommendations., (Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.)

Published
2014
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10. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica].

Author

Gómez-Huelgas R, Martínez-Castelao A, Artola S, Górriz JL, and Menéndez E

Subjects
Albuminuria etiology, Blood Glucose analysis, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Diabetic Nephropathies etiology, Dyslipidemias prevention & control, Glycated Hemoglobin analysis, Humans, Hypertension epidemiology, Hypoglycemia chemically induced, Hypoglycemia etiology, Hypoglycemia prevention & control, Hypoglycemic Agents adverse effects, Hypoglycemic Agents pharmacokinetics, Platelet Aggregation Inhibitors adverse effects, Platelet Aggregation Inhibitors therapeutic use, Prognosis, Renal Insufficiency, Chronic metabolism, Vascular Diseases epidemiology, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Renal Insufficiency, Chronic complications
Abstract

Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)

Published
2014
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