Publications by authors named "Gema Fernandez Fresnedo"
Article Synopsis
- The PROGRESER study is a 3-year, multicenter observational study in Spain aiming to identify risk factors for the progression of stage 3 chronic kidney disease (CKD), specifically comparing patients with and without diabetes mellitus.
- A total of 462 patients (average age 66.5) were monitored biannually for clinical data, with biological samples collected for analysis.
- Results showed that approximately two-thirds of patients experienced renal damage progression, with similar rates in diabetic (67.3%) and non-diabetic (65.3%) patients, suggesting that diabetes did not significantly increase the risk of CKD progression compared to other factors like hypertension.
Article Synopsis
- Chronic kidney disease of unknown etiology (CKDUE) is a leading global cause of kidney failure, and the GENSEN Study aimed to explore its genetic causes through extensive genetic testing on a large patient population.
- The study involved 818 patients under 45 with advanced CKDUE, discovering pathogenic gene variants in about 25% of them, with type IV collagen genes being the most commonly affected.
- The research revealed significant previously undiagnosed genetic kidney diseases, suggesting that genomic testing can be a valuable approach in understanding and treating CKDUE.
Article Synopsis
- Primary glomerular disease (PGD) is a leading factor in end-stage kidney disease (ESKD), prompting the need for kidney replacement therapy (KRT), with the study analyzing trends in KRT incidence and patient outcomes across Europe from 2000 to 2019.
- The study included data from nearly 70,000 patients, revealing an average incidence of 16.6 per million, with significant variations across countries, and identifying immunoglobulin A nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) as the most common types.
- Findings showed that while overall incidence declined initially, it stabilized after 2013, and patient survival rates varied among PGD subgroups,
Background: Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with high maternal and fetal morbidity and mortality and increased future risk of cardiovascular complications.
Objective: To analyze whether women who have had PE with severe features in their pregnancy have higher arterial stiffness (AS) parameters than those whose PE course was without signs of severity.
Methods: Sixty-five women who developed PE during their gestation were evaluated, divided into two groups: PE group without severe features or non-severe PE (n=30) and PE group with severe features or severe PE (n=35).
Anemia is a common complication of chronic kidney disease (CKD) and is associated with a decrease in quality of life and an increased risk of transfusions, morbidity and mortality, and progression of CKD. The Anemia Working Group of the Sociedad Española de Nefrología conducted a Delphi study among experts in anemia in CKD to agree on relevant unanswered questions by existing evidence. The RAND/UCLA consensus methodology was used.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on the clinical features of autosomal dominant polycystic kidney disease (ADPKD) in young adults aged 18-30, highlighting their morbidity despite the disease typically appearing in adulthood.
- In a cohort of 346 young adults, the average age of hypertension diagnosis was just over 21, with a prevalence of 28%, which increased with age.
- The findings suggest that young adults with ADPKD experience significant health issues, underscoring the importance of early detection and management of hypertension in this group.
New Insights into Renal Failure in a Cohort of 317 Patients with Autosomal Dominant Forms of Alport Syndrome: Report of Two Novel Heterozygous Mutations in COL4A3.
J Clin Med
August 2022
Article Synopsis
- Alport syndrome (AS) is a genetic disorder with varying severity, categorized into X-linked, autosomal recessive, and autosomal dominant forms, each showing different clinical traits and progression.
- This study analyzed 317 patients with autosomal dominant AS (ADAS) carrying mutations in COL4A3/4, revealing that most patients showed early symptoms like urinalysis changes before age 40, with adverse kidney events common between ages 30-70.
- Findings indicate significant sex differences in the onset of end-stage kidney disease (ESKD), with males experiencing deterioration earlier than females, underscoring the need for consistent monitoring of patients with these mutations.
Different immune-mediated diseases have been described after SARS-CoV-2 vaccination, with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) being one of the possible side effects. In this study, a total of 35 patients presented ANCA for the first time during 2021, with the number during 2019 being 15. Twenty-seven out of thirty-five patients developed ANCA after vaccination.
View Article and Find Full Text PDFArticle Synopsis
- * In this study, researchers followed 49 patients with IgAN over a median of 4 years, measuring Gd-IgA1 levels using a new, simpler method, along with APRIL levels.
- * Results indicated that higher Gd-IgA1 levels significantly correlated with an increased risk of advancing to stage 5 CKD, highlighting its potential as a prognostic marker in IgAN patients, while no
Background And Objective: About 25% of patients with IgA nephropathy (IgAN) progress to stage 5 chronic kidney disease (CKD) after years of evolution. Various tools have been developed in recent years designed to predict which of the patients will had poorer outcomes. The value of circulating galactosyl-deficient IgA1 (Gd-IgA1) has been related to a worse evolution of IgAN in several studies.
View Article and Find Full Text PDFArticle Synopsis
- * A significant prevalence of these antibodies was found, with 54.9% in pre-eclampsia patients compared to 22.9% in the control group, and their presence was strongly associated with the development of pre-eclampsia (OR = 5.4).
- * Additionally, a positive correlation was observed between IgM anti-phosphatidylserine/prothrombin and pulse wave velocity, indicating potential endothelial dysfunction
Author's reply.
Nefrologia (Engl Ed)
November 2020
Objectives: Induction therapy with rabbit antithymocyte globulin is frequently used in kidney transplant recipients and contributes to regulating the humoral alloantibody response. However, the effect of rabbit antithymocyte globulin on B-cell subpopulations, including plasma cells, has not been previously studied in humans in vivo.
Materials And Methods: We prospectively studied a cohort of 39 adult kidney transplant recipients.
Is it possible to predict the evolution of IgAN? Validation of the IgA nephropathy progression calculator and its relationship with MEST-C score in our population.
Nefrologia (Engl Ed)
August 2020
Article Synopsis
- IgA nephropathy (IgAN) is the most common type of glomerular nephropathy, and this study evaluates the effectiveness of the IgAN progression calculator (IgANPC) and the MEST-C score in predicting the disease's progression to end-stage renal disease (ESRD).
- A retrospective analysis of 48 biopsy patients (83% men, average age 45) showed that higher MEST-C scores correlated with greater risks of declining kidney function, particularly with results showing strong relationships between certain MEST-C categories and future eGFR levels.
- The findings suggest that both IgANPC and the MEST-C classification are valuable tools for prognostic predictions, though further research is necessary to confirm their applicability
Article Synopsis
- Hyperkalaemia is a common electrolyte imbalance in chronic kidney disease (CKD) patients, with varying prevalence among different treatment groups: 9.6% in CKD patients not on dialysis, 16.4% in those undergoing haemodialysis, and 10.6% in those on peritoneal dialysis.
- Factors associated with hyperkalaemia include decreased kidney function (measured as GFR), higher plasma creatinine levels, and the use of RAAS inhibitors, particularly in patients with diabetes or heart failure.
- New treatments that can help lower potassium levels by binding it in the gut may help CKD patients continue to benefit from RAASi without the risk of hyperkalaemia.
Background: Regulatory T (Treg) cells play a role in limiting kidney transplant rejection and can potentially promote long-term transplant tolerance. There are no large prospective studies demonstrating the utility of peripheral blood Treg cells as biomarkers for long-term graft outcome in kidney transplantation. The aim of our study was to analyze the influence of the absolute number of peripheral blood Treg cells after transplantation on long-term death-censored graft survival.
View Article and Find Full Text PDFBackground: IgA nephropathy (IgAN) may recur in kidney transplant recipients. B-cell-activating factor (BAFF), a proliferation-inducing ligand (APRIL), and α-defensins are involved in the pathogenesis of native IgAN; however, their role on IgAN recurrence has not been previously analyzed.
Methods: Thirty-five patients with IgAN who received a kidney transplant in our center between January 1, 1993, and December 31, 2015, were included.
Article Synopsis
- Patients with end-stage renal disease have a high mortality rate, primarily due to cardiovascular issues, particularly arrhythmias, which contribute to about 50% of deaths in those on hemodialysis.
- The study aimed to explore the connection between alterations in the QTc interval (due to electrolyte imbalances or genetic variants) and sudden cardiac deaths in hemodialysis patients.
- Findings showed a potential link between long QTc intervals and increased mortality, with genetic analysis revealing rare variants in some patients who experienced sudden death, suggesting the importance of monitoring QTc intervals and conducting genetic tests for patients with long QTc post-dialysis.