Publications by authors named "Torregrosa J"

Fracture risk assessment in patients with chronic kidney disease (CKD) has been included in the CKD-MBD ("Chronic Kidney Disease-Mineral and Bone Disorders") complex in international and national nephrology guidelines, suggesting for the first time the assessment of bone mineral density (BMD) if the results can influence therapeutic decision-making. However, there is very little information on actual clinical practice in this population. The main objective of the ERCOS (ERC-Osteoporosis) study is to describe the profile of patients with CKD G3-5D with osteoporosis (OP) and/or fragility fractures treated in specialized nephrology, rheumatology and internal medicine clinics in Spain.

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Background: The pretransplant diagnosis of liver malignancies in nodular cirrhotic livers remains a diagnostic challenge despite current advances. Although the prognostic impact of incidental hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (iCC) in liver transplant recipients is well documented, there are no data on the impact in simultaneous liver kidney transplant (LKT) recipients.

Methods: This is a single-center observational, retrospective study of all LKT performed from May 1993 to April 2022.

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Background: The age of patients referred for kidney transplantation has increased progressively. However, the precise influence of age on transplant outcomes is controversial.

Methods: Etrospective study in which graft and recipient survival were assessed in a cohort of ≥75 years old kidney recipients and compared with a contemporary younger one aged 60-65 years through a propensity score analysis.

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Background: There are currently no models for the transition of patients with metabolic bone diseases (MBDs) from paediatric to adult care. The aim of this project was to analyse information on the experience of physicians in the transition of these patients in Spain, and to draw up consensus recommendations with the specialists involved in their treatment and follow-up.

Methods: The project was carried out by a group of experts in MBDs and included a systematic review of the literature for the identification of critical points in the transition process.

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  • Proper management of phosphorus levels is crucial for patients with chronic kidney disease (CKD), as high levels increase mortality risk.
  • A survey conducted during "Phosphorus Week" revealed insights from Spanish nephrologists regarding phosphorus control in CKD and renal replacement therapies.
  • The findings showed varying success rates in achieving target phosphorus levels, with kidney transplant patients faring best, but significant improvements are still needed for patients on hemodialysis and peritoneal dialysis.
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  • The Spanish Society of Nephrology (SEN) has released an updated adaptation of the 2017 KDIGO guidelines on Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) to better fit their local context.
  • While many questions in the field remain unanswered, advancements from recent clinical trials and new medications highlight the importance of this update.
  • The document suggests slight changes to recommended biochemical targets, emphasizes the role of vitamin D in treating hyperparathyroidism, and underscores the need for proactive diagnosis and treatment of bone abnormalities in kidney disease patients.
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  • Myeloproliferative neoplasms in the blastic phase (MPN-BP) have a poor prognosis, but a study on five patients showed promising results with a new treatment combining azacytidine, venetoclax, and ruxolitinib.* -
  • The patients, aged between 72 and 84, had an overall response rate of 80%, with 40% achieving complete remission during a median follow-up of 10 months.* -
  • There were no unexpected toxicities from the treatment, and the patients experienced an improved quality of life, with a median overall survival of 13.4 months.*
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Background: Fabry disease (FD) is an X-linked condition caused by variants in the GLA gene. Since females have two X chromosomes, they were historically thought to be carriers. Although increased knowledge has shown that females often develop the disease, data from Spain and other countries reported that females were undertreated.

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Political tensions have grown throughout Europe since the beginning of the new century. The consecutive crises led to the rise of different social movements in several countries, in which the political changed. These changes included an increment of the different tensions underlying politics, as has been reported after many other political and economical crises during the twentieth century.

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Background: Calciphylaxis is not uniquely observed in uraemic patients, as some cases have also been reported in patients with normal renal function or moderate chronic kidney disease (CKD), in association with severe vasculopathy or systemic inflammation. A particular subset worthy of studying is represented by those patients who develop calciphylaxis after kidney transplantation (KT).

Methods: Analysis of the local series of calciphylaxis after KT ( = 14) along with all the other cases reported in the literature from 1969 to 2019 ( = 31), for a total population of 45 patients, is presented.

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Extremism has grown as a global problem for society in recent years, especially after the apparition of movements such as jihadism. This and other extremist groups have taken advantage of different approaches, such as the use of Social Media, to spread their ideology, promote their acts and recruit followers. The extremist discourse, therefore, is reflected on the language used by these groups.

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Primary membranous nephropathy (PMN) is an autoimmune disease limited to the kidney that is characterized by the presence of circulating PLAR2 antibodies in 70% of the cases and usually positivity for PLA2R and IgG4 by immunohistochemistry (IHC) staining. We report the first documented case of PMN (PLA2R positive) in a deceased kidney donor, transplanted to two different recipients and their clinical and immunological evolution through serial biopsies. Recipient A's first allograft biopsy (Day 26) was compatible with a MN with both positive PLA2R and IgG4 subepithelial deposits in IHC.

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Article Synopsis
  • Thrombocytopenia in MDS and CMML:
  • Despite being moderate in prevalence for low-risk myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML), thrombocytopenia poses significant risks for severe bleeding, and current treatment options remain limited.
  • Efficacy of Eltrombopag (ELT):
  • In a retrospective study involving 61 patients (50 with MDS and 11 with CMML), ELT demonstrated a platelet response in 77% of patients, with a median duration of response lasting about 8 months, and none of the patients who stopped treatment relapsed within a follow-up period.
  • Safety and Comp
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Chronic kidney disease-mineral bone disorder (CKD-MBD) after kidney transplantation is a mix of pre-existing disorders and new alterations. The final consequences are reflected fundamentally as abnormal mineral metabolism (hypercalcemia, hypophosphatemia) and bone alterations [high or low bone turnover disease (as fibrous osteitis or adynamic bone disease), an eventual compromise of bone mineralization, decrease bone mineral density and bone fractures]. The major cause of post-transplantation hypercalcemia is the persistence of severe secondary hyperparathyroidism, and treatment options include calcimimetics or parathyroidectomy.

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Vascular and valvular calcifications are highly prevalent in kidney transplant recipients (KTRs) and are associated with an increased risk of cardiovascular events, which represent the leading cause of long-term mortality in these patients. However, cardiovascular calcification has been traditionally considered as a condition mostly associated with advanced chronic kidney disease stages and dialysis, and comparatively fewer studies have assessed its impact after kidney transplantation. Despite partial or complete resolution of uraemia-associated metabolic derangements, KTRs are still exposed to several pro-calcifying stimuli that favour the progression of pre-existing vascular calcifications or their de novo development.

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The multiple myeloma (MM) non transplant eligible (NTE) population is growing in line with the aging of the population in Western countries. Historically, this population has been known for having a greater risk of treatment related toxicity, and therefore drug development was slow and rather oriented towards the improvement of safety profile than the optimization of disease control. However, NTE MM patients, at least for the fit/non frail patients in recent years, seemed to have benefited more from a less palliative care to improve the depth of response and then prolong survival.

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The dialysis-based definition of Delayed Graft Function (dDGF) is not necessarily objective as it depends on the individual physician's decision. The functional definition of DGF (fDGF, the failure of serum creatinine to decrease by at least 10% daily on 3 consecutive days during the first week post-transplant), may be more sensitive to reflect recovery after the ischemia-reperfusion injury. We retrospectively analyzed both definitions in 253 deceased donor kidney transplant recipients for predicting death-censored graft failure as primary outcome, using eGFR < 25 ml/min/1.

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Kidney transplant recipients might be at higher risk for severe coronavirus disease 2019 (COVID-19). However, risk factors for relevant outcomes remain uncertain in this population. This is a multicentric kidney transplant cohort including 104 hospitalized patients between March 4 and April 17, 2020.

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Background: It is commonly believed that mTOR inhibitors (mTORi) should not be used in high-immunological risk kidney transplant recipients due to a perceived increased risk of rejection. However, almost all trials that examined the association of optimal-dose mTORi with calcineurin inhibitor (CNI) have excluded hypersensitized recipients from enrollment.

Methods: To shed light on this issue, we examined 71 consecutive patients with a baseline calculated panel reactive antibody (cPRA) ≥50% that underwent kidney transplantation from June 2013 to December 2016 in our unit.

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Article Synopsis
  • Tertiary hyperparathyroidism is a significant cause of hypercalcemia in kidney transplant patients, leading to various health risks.
  • A study compared the long-term effectiveness of subtotal parathyroidectomy versus cinacalcet, finding that parathyroidectomy showed better control of hypercalcemia after 5 years.
  • While both treatments did not significantly differ in terms of kidney function or fractures, cinacalcet users experienced more recurrence of hypercalcemia than those who had surgery.
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