Rodrigo Rosado‐Canto

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

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Luis E. Morales‐Buenrostro

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Diego Luis Carrillo‐Pérez

Tecnológico de Monterrey

María José Guerra Palmero

Hospital de Sant Pau

Josefina Alberú

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

José Sifuentes‐Osornio

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Idalia Parra‐Avila

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

José Víctor Jiménez

Yale University

Jennifer Cuéllar-Rodríguez

National Institute of Allergy and Infectious Diseases

Ana Barrera‐Vargas

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Francisco Rodríguez‐Covarrubias

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Universidad Nacional Autónoma de México

Tecnológico de Monterrey

Hospital General de México

Centro Médico ABC

Harvard University

National Institute of Health Sciences

Mexican Social Security Institute

Instituto Nacional de Cardiología

Secretaria de Salud

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Perioperative fosfomycin disodium prophylaxis against urinary tract infection in renal transplant recipients: a randomized clinical trial

Nephrology Dialysis Transplantation (2019)

Rodrigo Rosado‐Canto Idalia Parra‐Avila Javier Tejeda-Maldonado Cristopher Kauffman-Ortega Francisco Rodríguez‐Covarrubias

Symptomatic urinary tract infection (UTI) is the most common infectious complication in renal transplant recipients (RTRs). Fosfomycin (FOS) is an attractive alternative for prophylaxis because it does not interact with immunosuppressants; although 90% is excreted unchanged in the urine, it does not require adjustment for renal function for single dose prophylaxis.RTRs were recruited into this randomized, double-blind, placebo-controlled trial. Participants were randomized (1:1) to receive one 4 g dose of FOS disodium intravenously 3 h (FOS group) or placebo (placebo group) before placement and removal of a urinary catheter and before removal of a double-J ureteral stent. All participants received prophylaxis with trimethoprim/sulfamethoxazole. The main outcome was a comparison of the mean number of symptomatic UTI and asymptomatic bacteriuria (AB) episodes per patient during a 7-week follow-up period. The study was registered at ClinicalTrials.gov, NTC03235947.Eighty-two participants were included (41 in the FOS group and 41 in placebo group). The mean number of AB or symptomatic UTI episodes per patient was lower in the FOS group [intention-to-treat (ITT) 0.29 versus 0.60, P = 0.04]. The incidence of symptomatic UTI was lower in the FOS group (ITT, 7.3% versus 36.6%, P = 0.001), and there was no difference in the incidence of AB between both groups. The incidence of adverse events was similar in both groups.FOS addition is an effective and safe strategy to reduce the number of symptomatic UTIs during the first 7 weeks after renal transplant.

Fosfomycin

Trimethoprim

10.1093/ndt/gfz261

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Citations (15)

Arteriovenous fistula thrombosis with mycobacterial infection

Kidney International (2017)

Rodrigo Rosado‐Canto Braulio Martínez‐Benítez Diego Luis Carrillo‐Pérez Luis E. Morales‐Buenrostro

Erythema

10.1016/j.kint.2017.05.008

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Citations (1)

Asymptomatic bacteriuria in kidney transplant recipients: The challenge in the first 8 weeks

Transplant Infectious Disease (2018)

Rodrigo Rosado‐Canto Diego Luis Carrillo‐Pérez María José Guerra Palmero José Sifuentes‐Osornio

10.1111/tid.12895

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Citations (3)

Renal Thrombotic Microangiopathy in Proliferative Lupus Nephritis: Risk Factors and Clinical Outcomes

JCR Journal of Clinical Rheumatology (2016)

Ana Barrera‐Vargas Rodrigo Rosado‐Canto Javier Merayo‐Chalico María José Guerra Palmero Juan M. Mejía‐Vilet

Background Renal thrombotic microangiopathy (TMA) may be associated with lupus nephritis. Its relationship to other disease factors and its specific effect on prognosis are not precisely known. Evidence regarding these aspects is controversial, and information focusing on kidney-limited TMA in systemic lupus erythematosus (SLE) patients is scarce. Objectives The aims of this study were to identify risk factors for renal TMA in patients with lupus nephritis and to determine its impact on clinical outcomes. Methods A case-control study was performed. We studied 245 renal biopsies from SLE patients. We included patients with renal TMA, as well as control subjects adjusted for glomerulonephritis class, estimated glomerular filtration rate, activity and chronicity indices, and follow-up time. Serological and clinical features were measured at the time of the biopsy and during follow-up. Results Twenty-three patients with renal TMA and 21 control subjects were included. There were no differences in Systemic Lupus Erythematosus Disease Activity Index score, end-stage renal disease, or mortality between groups during follow-up. After multivariate analysis, lymphopenia (odds ratio, 10.69; 95% CI, 1.35–84.74) and anti-Ro antibody positivity (odds ratio, 8.96; 95% CI, 1.49–53.57) remained significantly associated with renal TMA. Conclusions Lymphopenia and anti-Ro positivity are independent risk factors for renal TMA in SLE patients. This increased risk could be a consequence of the potential role of these factors in endothelial dysfunction and damage. Outcomes were similar for patients with the same estimated glomerular filtration rate and biopsy characteristics, regardless of the presence of TMA.

Thrombotic microangiopathy

10.1097/rhu.0000000000000425

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Citations (23)

Seroprevalencia de virus BK en donadores y receptores de trasplante renal

Revista de la Sociedad Ecuatoriana de Nefrología Diálisis y Trasplante (2024)

Andrea Portilla Jiménez Idalia Parra‐Avila Rodrigo Rosado‐Canto R Sanchez C. Rivera

Introduction: BK virus (BKV) is highly prevalent in the general population, in renal transplant (RT) patients it is the main cause of infectious tubulointerstitial nephritis, leading to graft dysfunction or loss. The seroprevalence in the Mexican population is unknown. The present study seeks to establish the seroprevalence of VBK in renal donors and recipients in the Mexican adult population. Methods: This is a cross-sectional study conducted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City in the period June 2017, April 2018. Seroprevalence prior to renal transplantation was evaluated through qualitative BK-IgG ELISA (MyBioSource Inc, San Diego, CA), in donors and recipients of RT. Results: Qualitative measurement of IgG for BK virus by ELISA method was performed in 80 donors and 88 renal recipients. The seroprevalence in donors was 56.3% (95%CI, 45%-67%), while in recipients it was 45.5% (95%CI, 35%-56%). None of the variables analyzed showed an association with increased risk of seropositivity for BKV in either recipients or donors. Conclusion: The seroprevalence of BKV in our center was lower than expected for a developing country, having a sufficient sample size to extrapolate it to the Mexican population.

10.56867/67

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AB0546 Cryoglobulinemia in systemic lupus erythematosus: clinical and immunological features

Annals of the Rheumatic Diseases (2018)

Ana Barrera‐Vargas F.J. Antiga-López Juan Rangel‐Patiño Rodrigo Rosado‐Canto

Background

Systemic lupus erythematosus (SLE), as the prototype of systemic autoimmune diseases, has a wide array of clinical manifestations. An association between cryoglobulinemia and certain clinical and immunological features of SLE has been proposed, and there are various physiopathologic pathways that could be involved in this relationship. Although the presence of cryoglobulinemia in SLE patients may be related to specific disease features and could even have prognostic value, this association has not been addressed thoroughly.

Objectives

To describe clinical and immunological characteristics in SLE patients with cryoglobulinemia.

Methods

We performed a retrospective, case-control study, in which we included all patients with a cryoglobulin determination between ^{January 2005} and December 2016 in a third level referral centre in Mexico City. Patients with SLE and a positive cryoglobulin test (cryocrit ≥1%) were included in the case group, whereas SLE patients with a negative cryoglobulin determination were considered controls. We studied demographic, clinical and immunological characteristics at the time of the positive cryoglobulin result, as well as three months earlier, and 6 and 12 months later.

Results

Thirty-six SLE patients had a cryoglobulin determination throughout the study period. Ten patients had cryoglobulin levels≥1% and were included in the case group, whereas 26 patients with a negative determination were included as controls. Mean age was 37.7±18.3 in cases and 41.7±19.3 in controls. 70% of cases and 88.5% of controls were women. Among subjects with cryoglobulinemia, the cryocrit was 1% in 9 patients, and 3% in one. Regarding clinical and immunological characteristics, a positive lupus anticoagulant and a history of vasculitis were more frequent in patients with serum cryoglobulins (p=0.004 and 0.04, respectively). At the time of the cryoglobulin measurement, patients in the case group had lower levels of C3 and C4 (p=0.026 and p=0.003, respectively), and serum albumin (p=0.028). They also had a higher prevalence of serositis (p=0.021) and peripheral oedema (p=0.034), as well as a higher SLICC Damage Index score (p=0.014) than controls. Regarding follow-up, patients in the case group had a higher SLEDAI score after six and twelve months (p=0.009 and 0.034, respectively). Also, after 12 months they had a higher prevalence of renal activity (p=0.004) and lower C4 levels (p=0.001). Among patients with renal activity, 20% of cases and 55% of controls had achieved complete remission after 12 months.

Conclusions

Serum cryoglobulins in SLE patients were associated with positive lupus anticoagulant and hypocomplementemia. Cryoglobulinemia was also associated with specific disease manifestations, such as serositis and vasculitis, and with damage accrual. At follow-up, patients with cryoglobulinemia had a higher prevalence of renal activity, as well as an increased disease activity overall. Whether cryoglobulins could be used as a biomarker for renal activity or worse renal prognosis remains to be determined, and larger prospective studies will be needed to address this possibility.

Disclosure of Interest

None declared

Cryoglobulins

10.1136/annrheumdis-2018-eular.6058

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Citations (0)

Aspergillus infection of the larynx in a solid organ transplant recipient

Transplant Infectious Disease (2018)

Andrea Wisniowski‐Yáñez Jaqueline Ramírez‐Anguiano Rodrigo Rosado‐Canto Adolfo Valdivia‐Cayoja Teresa Pérez‐Gutiérrez

Abstract Primary laryngeal aspergillosis is a rare condition. Only a few cases have been reported in the past years. Most of them have been reported in healthy patients or with a mild immunocompromised state. We report a case of primary laryngeal aspergillosis in a solid organ transplant recipient ( SOT ), an infection not previously described in this population; we reviewed the published literature in all populations.

Solid organ

10.1111/tid.12900

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Citations (2)

Fosfomycin trometamol in the prophylaxis of post‐kidney transplant urinary tract infection: A controlled, randomized clinical trial

Transplant Infectious Disease (2018)

María José Guerra Palmero Rodrigo Rosado‐Canto Josefina Alberú Ernesto Maravilla Pedro Torres‐González

Abstract Background The aim of this controlled clinical trial was to evaluate the efficacy and safety of fosfomycin trometamol ( FOS ) in urinary tract infection ( UTI ) prophylaxis during the first 6 months after renal transplant ( RT ). Methods The intervention group received 3 g of FOS PO every 10 days and trimethoprim‐sulfamethoxazole ( TMP ‐ SMX , 160/800 mg) three times per week (Group 1), whereas the control group received TMP ‐ SMX (160/800 mg) daily (Group 2). The outcomes were the time until the first UTI (symptomatic infection or asymptomatic bacteriuria (>10 5 CFU / mL )) and the incidence of UTI during the first 6 months post RT . Intermediate analysis was conducted after one‐half of the estimated sample size of patients was enrolled. Results The recruitment of patients was stopped after the intermediate analysis due showed no emerging trends or reasonable chance of demonstrating benefit. Sixty‐seven patients were included (32 in Group 1 and 35 in Group 2). The UTI incidence (40.6% vs 42.8%, P = 0.85) and time until the first episode were similar between the groups (log rank, P = 0.862). UTI due to Klebsiella spp . was observed in both groups at equal rates (25% vs 20%, P = 0.62), episodes due to Escherichia coli were less frequent in Group 1 (12.5% vs 34.2%, P = 0.04), and Enterococcus faecalis infection only occurred in Group 2 (n = 4). Resistance to FOS was observed for Klebsiella spp .; in contrast, E. coli and E. faecalis were susceptible. Conclusions The addition of FOS to TMP ‐ SMX was not beneficial for the prevention of UTI after RT in our setting. (ClinicalTrials.gov, NCT 01820897).

Fosfomycin

Trimethoprim

Enterococcus faecalis

Sulfamethoxazole

10.1111/tid.12980

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Citations (11)

Electrolyte and Acid–Base Disturbances in End-Stage Liver Disease: A Physiopathological Approach

Digestive Diseases and Sciences (2017)

José Víctor Jiménez Diego Luis Carrillo‐Pérez Rodrigo Rosado‐Canto Ignacio García‐Juárez Aldo Torre

Transplant surgery

Liver disease

Base (topology)

10.1007/s10620-017-4597-8

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Citations (48)

Treatment Strategies and Outcome of Parvovirus B19 Infection in Kidney Transplant Recipients: A Case Series and Literature Review of 128 Patients

Revista de investigaci�n Cl�nica (2019)

Rodrigo Rosado‐Canto Diego Luis Carrillo‐Pérez José Víctor Jiménez Jennifer Cuéllar-Rodríguez Idalia Parra‐Avila

Background: There is no specific antiviral treatment for parvovirus B19 (PVB19) infection.Objective: The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature.Methods: We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature.Results: In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation.All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg).The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment.No recurrences were documented during follow-up (median 25 months).Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy.Clinical relapses were observed in 35% of 71 reported cases.Conclusions:In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.(

Immunosuppression

Regimen

10.24875/ric.19002921

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Citations (6)