Juan Carlos Ruiz

Marqués de Valdecilla University Hospital

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Emilio Rodrigo

Marqués de Valdecilla University Hospital

Gema Fernández‐Fresnedo

Marqués de Valdecilla University Hospital

M. Arias

Marqués de Valdecilla University Hospital

Marcos López‐Hoyos

Marqués de Valdecilla University Hospital

Emilio Rodrigo

Instituto de Investigación Marqués de Valdecilla

ÁL

Ángel L.M. de Francisco

Universidad de Cantabria

Celestino Piñera

Marqués de Valdecilla University Hospital

David San Segundo

Marqués de Valdecilla University Hospital

J.G Cotorruelo

Marqués de Valdecilla University Hospital

Ana Sánchez‐Fructuoso

Hospital Clínico San Carlos

Cooperative Institutions

Marqués de Valdecilla University Hospital

313

Instituto de Investigación Marqués de Valdecilla

201

Universidad de Cantabria

197

Instituto de Salud Carlos III

180

Universitat Autònoma de Barcelona

Universitat de Barcelona

Universidad Complutense de Madrid

Hospital General Universitario Gregorio Marañón

Universidad Autónoma de Madrid

Hospital Clínic de Barcelona

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Consequences of Nephrotic Proteinuria and Nephrotic Syndrome after Kidney Transplant

Biomedicines (2024)

María José Ruiz Ortega Miguel Martínez-Belotto Cristina García-Majado Lara Belmar Covadonga López del Moral

Proteinuria is the main predictor of kidney graft loss. However, there is little information regarding the consequences of nephrotic proteinuria (NP) and nephrotic syndrome (NS) after a kidney transplant. We aimed to describe the clinical and histopathological characteristics of kidney recipients with nephrotic-range proteinuria and compare the graft surveillance between those who developed NS and those who did not. A total of 204 patients (18.6% of kidney transplants in the study period) developed NP, and 68.1% of them had NS. Of the 110 patients who underwent a graft biopsy, 47.3% exhibited ABMR, 21.8% the recurrence of glomerulonephritis, 9.1% IFTA, and 7.3% de novo glomerulonephritis. After a median follow-up of 97.5 months, 64.1% experienced graft loss. The graft survival after the onset of NP declined from 75.8% at 12 months to 38% at 5 years, without significant differences between those with and those without NS. Patients who developed NS fewer than 3 months after the onset of NP exhibited a significantly higher risk of death-censored graft loss (HR: 1.711, 95% CI: 1.147–2.553) than those without NS or those with late NS. In conclusion, NP and NS are frequent conditions after a kidney transplant, and they imply extremely poor graft outcomes. The time from the onset of NP to the development of NS is related to graft survival.

10.3390/biomedicines12040767

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Sirolimus use in de "novo renal" transplantation.

PubMed (2006)

Grinyó Jm Avelino Martı́n Manuel Arias Josep M. Campistol González Molina M

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Transplantation Proceedings (2005)

Emilio Rodrigo Gema Fernández‐Fresnedo Juan Carlos Ruiz Celestino Piñera R. Palomar

10.1016/j.transproceed.2005.02.052

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Citations (49)

1416: LONG-TERM MORTALITY FROM SEPSIS IN CATALONIA ACCORDING TO DEMOGRAPHIC VARIABLES AND COMORBIDITY

Critical Care Medicine (2023)

C. Lorencio Juan Carlos Yébenes Emili Vela Josep Trenado Juan Carlos Ruiz

Introduction: In recent years, a marked reduction in in-hospital mortality associated with sepsis has been observed, probably related to advances in early detection and improved therapeutic management. However, very few studies have evaluated the long-term mortality of those patients who have survived a hospital admission for sepsis. The objective of this study is to determine the mortality 2 years after hospital discharge of those patients who suffered sepsis in Catalonia. Methods: This is a retrospective analysis based on the records of hospital discharges from the Minimum Basic Data Set of Acute Hospitals (CMBD-HA, in spanish) of the Catalan Health System from January 1, 2005 to December 31, 2019. The CMBD-HA is a mandatory population registry of admissions in all acute care hospitals in Catalonia. Sepsis was defined by the presence of infection and at least one organ dysfunction. The ICD-9 and ICD-10 coding systems were used to identify cases (infectious process coding + organic dysfunction). Follow-up was performed on all detected cases that survived the episode for survival analysis 2 years after hospital discharge. Results: A total of 237,075 patients who survived a hospital admission for sepsis during the study period were detected. 55.9% were men, with a mean age of 72.3(+/-18.7) years and a mean hospital stay of 15.5(+/-24.8) days. Overall mortality two years after hospital discharge was 41.7%, higher in men (43.7% vs 40.4%, p< 0.0001), increased proportionally with age (< 15 years=5.5%, 15-45=10.4%, 45-64=13.9%, 65-74=22.2%, 75 -84=45.1%, >84=62.8%, p< 0.0001) and with comorbidity (Charlson Index (CI) of 0=20.6%, CI 1-2=38.1%, CI 3-4=51.2%, CI≥5=66.9%, p< 0.0001). Mortality at 2 years was different depending on the septic focus that led to admission (respiratory=45.6%, genitourinary=45%, unknown focus=42.5%, skin & soft tissue=41.3%, sepsis related to intravascular devices=34.4%, abdominal = 31.9%, neurological=17.5%, p< 0.0001). Conclusions: Despite the fact that in-hospital mortality from sepsis has decreased significantly in recent years, mortality 2 years after hospital discharge is very high. Various risk factors have been identified that increase this mortality in the long term, such as gender, age, previous comorbidity or the focus of sepsis, among others.

Vela

10.1097/01.ccm.0001003820.04248.f1

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Diesel Desulfurization Experiments in Microchannels with PEG 300: An Understanding of Extractive Deep Desulfurization

Industrial & Engineering Chemistry Research (2023)

Luiz Eduardo Pereira Santiago Maxwell G. Silva Eledir V. Sobrinho Juan Carlos Ruiz Carlos Eduardo de Araújo Padilha

Conventional methods for removing sulfur compounds perform poorly when streams are treated with refractory compounds such as dibenzothiophene (DBT) and its derivatives. Current studies have directed efforts to investigate extractive desulfurization (EDS) using microdevices. Microdevices are units with micrometer-sized channels that enhance the mass and heat transfer phenomena. For EDS in microdevices to be viable, it is essential to choose the appropriate extractor solvent. Among the possibilities, an excellent candidate is polyethylene glycol (PEG). The present work aims to analyze the use of PEG 300 for EDS in microfluidics using hexadecane as a model fuel to emulate diesel. The experiments followed the logic of a fractional experimental design that allowed extractive solvent insights into deep desulfurization. In addition, the mass transfer phenomena involved and the application of the best experimental conditions in a real diesel sample were evaluated. The results obtained with model fuel were able to achieve 99.36% DBT removal with a 1.0 min residence time, a 1:1 volumetric ratio, and three extraction cycles. Furthermore, by applying the best experimental conditions to diesel, the total sulfur concentration decreased from 1646 to 312 ppm, resulting in an extractive efficiency of 81.04%.

Dibenzothiophene

10.1021/acs.iecr.3c03323

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¿Es posible predecir la evolución de la nefropatia IgA? Validamos la calculadora de progresión de nefropatia IgA y su relación con Oxford score en nuestra población

Nefrología (2019)

Luis Martín‐Penagos Adalberto Benito María Victoria Oviedo Covadonga López del Moral Javier Martín-López

IgA nephropathy (IgAN) is the most common and heterogeneous glomerular nephropathy. Several strategies have been used to determine the risk of progression to ESRD. We evaluate the prognostic significance and correlate the IgAN progression calculator (IgANPC) and the Oxford/MEST-C score in our population.We performed a retrospective study of biopsied patients with diagnosis of IgA nephropathy from 1990 to 2015. We classified the biopsies using MEST-C score and we correlated the score to clinical evolution. We also calculated the risk of progression with the online IgANPC at the time of the biopsy.We analysed 48 biopsies, 83% of which were men with a mean age of 45 years at the time of the biopsy. Patients with a biopsy E1 according to MEST-C score had a higher IgANPC score than those with E0 (P=.021). The Pearson's correlation for the percentage of crescents and the IgANPC risk score was statistically significant (P=.014) with r=0.357. The percentage of patients with eGFR above 30 ml/min at 10 years was 100% for the low-risk group (group 1 of IgANPC), and 0% for the high-risk group (group 3), log rank P=0.001. The log rank comparison for variables of the MEST-C score, presented statistically significant results between E (0.036) and S (0.022) and the eGFR time<30 ml/min. A statistically significant relationship was also observed between T1 and eGFR<30 ml/min. The multivariate Cox regression analysis for IgANPC and eGFR<30 ml/min demonstrated a strong correlation (P=.016) between the risk group and eGFR <30 ml/min.In our study population, the IgANPC predicts the time to eGFR<30 ml/min, and adds information independent of the MEST. The MEST-C classification and IgANPC are useful and independent ÿolos for prognostic prediction, but more studies are needed to validate its use in the general population.

10.1016/j.nefro.2018.10.015

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Symptomatic Rathke's cleft cystwithamyloid stroma

Sergio Tapia Concha B P Hamilton Juan Carlos Ruiz John Donald

andvisual field defects duetoaRathke's cleft cystis presented. These cysts arecommonly foundinrandompituitaries examined atnecropsy,butrarely produce symptoms. Subtle endocrine deficiencies, however, may now beuncovered more frequently withmoderndiagnostic techniques. Anunusual andunreported feature ofthis cyst was an apudamyloid stroma. Thiswouldimply that cellsderived fromtheneural crest participate intheformation of thecyst. Recognition ofthese cysts atthetimeofoperation isimportant inavoiding confusion with pituitary adenomas andunnecessarily aggressive treatment. Small cysts ofRathke's cleft whichareasymptomatic arecommon(Bayouini, 1948; Shanklin, 1951). Occasionally, however, they mayproduce bothneurological andendocrinological symptoms(Frazier andAlpers, 1934;Berryand Schlezinger, 1959;FagerandCarter, 1966; Giuffre andGagliardi, 1968; Shuangshoti etal., 1970; Ringel andBailey, 1972), whenthey may bemistaken clinically forchromophobe adenomas.Thiscanleadtounnecessarily aggressive treatment. Reported isaRathke's cleft cyst associated with hypopituitarism and chiasmal compression. Histological studies ofthecyst unexpectedly revealed anamyloid stroma, theimplications of which arediscussed.

Confusion

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Evolution of Proteinuria After Conversion From Calcineurin Inhibitors (CNI) to Sirolimus (SRL) in Renal Transplant Patients: A Multicenter Study

Transplantation Proceedings (2005)

Juan Carlos Ruiz Fritz Diekmann Josep M. Campistol Ana Sánchez‐Fructuoso Constantino Fernández Rivera

Sirolimus

10.1016/j.transproceed.2005.09.127

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Citations (40)

Clinical Significance of Antiphospholipid Antibodies on Allograft and Patient Outcome After Kidney Transplantation

Transplantation Proceedings (2005)

Gema Fernández‐Fresnedo Marcos López‐Hoyos David San Segundo Javier Crespo Juan Carlos Ruiz

Clinical Significance

10.1016/j.transproceed.2005.10.049

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Citations (11)

Recomendaciones en el manejo de la pandemia por coronavirus SARS-CoV-2 (Covid-19) en pacientes con trasplante renal

Nefrología (2020)

Verónica López Teresa Vázquez Juana Alonso-Titos Mercedes Cabello Ángel Alonso

The SARS-CoV-2 (Covid-19) coronavirus pandemic is evolving very quickly and means a special risk for both immunosuppressed and comorbid patients. Knowledge about this growing infection is also increasing although many uncertainties remain, especially in the kidney transplant population. This manuscript presents a proposal for action with general and specific recommendations to protect and prevent infection in this vulnerable population such as kidney transplant recipients.

Pandemic

2019-20 coronavirus outbreak

Coronavirus

10.1016/j.nefro.2020.03.002

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Citations (67)