Publications by authors named "Maria D Sanchez de la Nieta"
Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy.
Kidney Int Rep
August 2023
Introduction: Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.
Methods: This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH.
Key Points: Kidney survival in C3 glomerulopathy is significantly higher in patients with a disease chronicity score <4 and proteinuria <3.5 g/d, regardless of baseline eGFR. A faster eGFR decline in C3 glomerulopathy is associated with higher probability of kidney failure.
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- C3 glomerulopathy is a rare kidney disease that affects how the complement system works, making it hard to predict individual patient outcomes.
- Researchers conducted a study involving 115 patients across 35 nephrology centers to develop a nomogram that forecasts long-term kidney survival using factors like estimated glomerular filtration rate (eGFR), proteinuria, and chronicity score from kidney biopsies.
- The final nomogram showed high accuracy (C-index of 0.860) in predicting kidney failure risk at 1, 2, 5, and 10 years, demonstrating reliable calibration between predicted and actual outcomes.
Article Synopsis
- This study investigates how changes in protein levels in urine (proteinuria) over time relate to kidney health in patients with complement component 3 (C3) glomerulopathy.
- Conducted across 35 nephrology departments in Spain, the research analyzed patient data from 1995 to 2020, focusing on the link between proteinuria trends and kidney failure risk.
- Findings reveal that higher proteinuria levels significantly increase the risk of kidney failure, while a reduction of 50% or more in proteinuria is associated with a decreased risk, highlighting proteinuria changes as useful indicators for predicting kidney outcomes.
Article Synopsis
- A study aimed to validate a previously proposed prognostic histologic index for C3 glomerulopathy (C3G) by analyzing kidney biopsy findings in a new patient cohort from Spain.
- The research included 111 patients from various nephrology departments, with assessments focusing on demographic data, clinical parameters, and specific C3G scoring systems.
- Results showed that 43% of patients developed kidney failure, with significant predictors identified, including eGFR, proteinuria, and specific histological features like tubular atrophy and interstitial fibrosis.
Article Synopsis
- - The study investigates C3 glomerulopathy, a kidney disease linked to abnormalities in the complement system, to identify factors influencing treatment outcomes with corticosteroids and mycophenolate mofetil (MMF).
- - Conducted across 35 nephrology departments in Spain, the research analyzed data from 97 patients diagnosed with C3 glomerulopathy or dense deposit disease to evaluate remission rates and kidney survival.
- - Results showed that treatment with corticosteroids plus MMF led to significantly better outcomes (79% remission; 14% kidney failure) compared to other treatments, especially in patients with autoantibody-mediated forms, while those with genetic variants had only partial remissions.
IgA Nephropathy in Elderly Patients.
Clin J Am Soc Nephrol
August 2019
Article Synopsis
- The study investigates the increasing incidence of IgA nephropathy among older adults (aged ≥65) and analyzes various clinical aspects of the disease based on a cohort of 151 patients diagnosed between 1990 and 2015.
- Researchers observed a significant rise in diagnoses over the years, with common symptoms including asymptomatic urinary issues and acute kidney injury (AKI), particularly related to hematuria.
- The study found that age, serum creatinine levels, and kidney biopsy findings were linked to worse outcomes, while treatment with specific medications showed potential benefits for survival rates.
Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.
View Article and Find Full Text PDFAntagonists of tumor necrosis factor-alpha (ATNF) are used for the treatment of multiple diseases such as psoriatic arthritis, Crohn's disease, ankylosing spondylitis and juvenile idiopathic arthritis, usually, when they are refractory to first-line treatment. The use of ATNF has been associated with the induction of autoimmune diseases such as systemic lupus erythematosus-like disease, vasculitis, sarcoidosis-like diseases and, recently, acute granulomatous tubulointerstitial nephritis. We report a case of acute nongranulomatous tubulointerstitial nephritis in an HLA-B27-positive patient with axial spondyloarthritis and Crohn's disease being treated with adalimumab.
View Article and Find Full Text PDFIntroduction: Henoch-Schönlein purpura is a systemic disease with frequent renal involvement, characterized by IgA mesangial deposits. Streptococcal infection can induce an abnormal IgA immune response like Henoch-Schönlein purpura, quite similar to typical acute post-infectious glomerulonephritis. Indeed, hypocomplementemia that is typical of acute glomerulonephritis has also been described in Henoch-Schönlein purpura.
View Article and Find Full Text PDFPure red cell aplasia (PRCA) is a severe, non-regenerative form of anaemia, with selective erythroid aplasia of the bone marrow. It appears as a severe complication of treatment for anaemia of end-stage renal insufficiency with erythropoiesis-stimulating agents. There is no definite treatment.
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