Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Trasplantament de ronyó; RemdesivirCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Trasplante de riñón; RemdesivirCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Kidney transplantation; RemdesivirIntroduction Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time to recovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acute kidney injury have been reported. Scant data are available on the use and safety of remdesivir in kidney transplant recipients. Methods We present a multicenter cohort study of 51 kidney transplant recipients with COVID-19 treated with remdesivir. Outcomes and safety were assessed. Results Mean age at diagnosis was 60 years, with a median time since kidney transplant of 4.5 years. Mean time since admission to remdesivir was 2 days. Twenty-eight patients (54.9%) required mechanical ventilation (19 noninvasive). Mortality was 18.9% and markedly higher if aged ≥65 years (45% vs. 3.2% in younger patients). Acute kidney injury was present in 27.7% of patients, but was diagnosed in 50% before treatment. No patients required remdesivir discontinuation because of adverse events. We did not find significant hepatoxicity or systemic symptoms resulting from the drug. Conclusion In our cohort of kidney transplant recipients, remdesivir was well tolerated and safe in renal and hepatic toxicity, but randomized trials are needed to assess its efficacy

Outcomes of Frail Patients While Waiting for Kidney Transplantation : Differences between Physical Frailty Phenotype and FRAIL Scale

Frailty is associated with poorer outcomes among patients waiting for kidney transplantation (KT). Several different tools to measure frailty have been used; however, their predictive value is unknown. This is a prospective longitudinal study of 449 KT candidates evaluated for frailty by the Physical Frailty Phenotype (PFP) and the FRAIL scale. During the study period, 296 patients received a KT, while 153 remained listed. Patients who did not get receive a transplant were more frequently frail according to PFP (16.3 vs. 7.4%, p = 0.013). Robust patients had fewer hospital admissions during the 1st year after listing (20.8% if PFP = 0 vs. 43.4% if ≥1, and 27.1% if FRAIL = 0 vs. 48.9% if ≥1) and fewer cardiovascular events (than FRAIL ≥ 1) or major infectious events (than PFP ≥ 1). According to PFP, scoring 1 point had an impact on patient survival and chance of transplantation in the univariate analysis. The multivariable analysis corroborated the result, as candidates with PFP ≥ 3 had less likelihood of transplantation (HR 0.45 [0.26-0.77]). The FRAIL scale did not associate with any of these outcomes. In KT candidates, pre-frailty and frailty according to both the PFP and the FRAIL scale were associated with poorer results while listed. The PFP detected that frail patients were less likely to receive a KT, while the FRAIL scale did not

Validation of a survival benefit estimator tool in a cohort of European kidney transplant recipients

Producción CientíficaPre-transplant prognostic scores help to optimize donor/recipient allocation and to minimize organ discard rates. Since most of these scores come from the US, direct application in non-US populations is not advisable. The Survival Benefit Estimator (SBE), built upon the Estimated Post-Transplant Survival (EPTS) and the Kidney Donor Profile Index (KDPI), has not been externally validated. We aimed to examine SBE in a cohort of Spanish kidney transplant recipients. We designed a retrospective cohortbased study of deceased-donor kidney transplants carried out in two different Spanish hospitals. Unadjusted and adjusted Cox models were applied for patient survival. Predictive models were compared using Harrell’s C statistics. SBE, EPTS and KDPI were independently associated with patient survival (p ≤ 0.01 in all models). Model discrimination measured with Harrell’s C statistics ranged from 0.57 (KDPI) to 0.69 (SBE) and 0.71 (EPTS). After adjustment, SBE presented similar calibration and discrimination power to that of EPTS. SBE tended to underestimate actual survival, mainly among high EPTS recipients/high KDPI donors. SBE performed acceptably well at discriminating posttransplant survival in a cohort of Spanish deceased-donor kidney transplant recipients, although its use as the main allocation guide, especially for high KDPI donors or high EPTS recipients requires further testing.Rio Hortega contract (ISCIII-11453)Fondo de Investigaciones Sanitarias - Fondo Europeo de Desarrollo Regional (project PI16/0617)Redinren (project RD16/0009/001

The Research Journey as a Challenge Towards New Trends

The academic community of the department of Risaralda, in its permanent interest in evidencing the results of the research processes that are carried out from the Higher Education Institutions and as a product of the VI meeting of researchers of the department of Risaralda held in November 2021 presents its work: “The journey of research as a challenge towards new trends”, which reflects the result of the latest research and advances in different lines of knowledge in Agricultural Sciences, Health Sciences, Social Sciences and Technology and Information Sciences, which seek to solve and meet the demands of the different sectors. This work would not have been possible without the help of each of the teachers, researchers and authors who presented their articles that make up each of the chapters of the book, to them our gratitude for their commitment, dedication and commitment, since their sole purpose is to contribute from the academy and science to scientific and technological development in the search for the solution of problems and thus contribute to transform the reality of our society and communities. We also wish to extend our gratitude to the institutions of the Network that made this publication possible: UTP, UCP, UNAD, UNIREMINGTON; UNISARC, CIAF, Universidad Libre, Uniclaretiana, Fundación Universitaria Comfamiliar and UNIMINUTO, institutions that in one way or another allowed this work to become a reality, which we hope will be of interest to you.Preface............................................................................................................................7 Chapter 1. Technologies and Engineering Towards a humanization in Engineering using soft skills in training in Engineers.............................................................................................................11 Omar Iván Trejos Buriticá1, Luis Eduardo Muñoz Guerrero Innovative materials in construction: review from a bibliometric analysis....................................................................................................................27 Cristian Osorio Gómez, Daniel Aristizábal Torres, Alejandro Alzate Buitrago, Cristhian Camilo Amariles López Bibliometric review of disaster risk management: progress, trends, and challenges.........................................................................................................51 Alejandro Alzate Buitrago, Gloria Milena Molina Vinasco. Incidence of land coverage and geology, in the unstability of lands of the micro-basin of the Combia creek, Pereira, Risaralda....................................73 Alejandro Alzate Buitrago, Daniel Aristizábal Torres. Chapter 2. Arts, Humanities, and Social Sciences Training experience with teachers teaching mathematics using the inquiry methodology ...............................................................................................95 Vivian Libeth Uzuriaga López, Héctor Gerardo Sánchez Bedoya. Interpretation of the multiple representations of the fears associated to the boarding of limited visual patients in the elective I students’ written productions and low vision ...................................................................................113 Eliana Bermúdez Cardona, Ana María Agudelo Guevara, Caterine Villamarín Acosta. The relevance of local knowledge in social sciences............................................131 Alberto Antonio Berón Ospina, Isabel Cristina Castillo Quintero. Basic education students’ conceptions of conflict a view from the peace for the education....................................................................................................143 Astrid Milena Calderón Cárdenas,Carolina Aguirre Arias, Carolina Franco Ossa, Martha Cecilia Gutiérrez Giraldo, Orfa Buitrago. Comprehensive risk prevention in educational settings: an interdisciplinary and socio-educational approach ............................................................................163 Olga María Henao Trujillo, Claudia María López Ortiz. Chapter 3. Natural and Agricultural Sciences Physicochemical characterization of three substrates used in the deep bedding system in swine .......................................................................................175 Juan Manuel Sánchez Rubio, Andrés Felipe Arias Roldan, Jesús Arturo Rincón Sanz, Jaime Andrés Betancourt Vásquez. Periodic solutions in AFM models........................................................................187 Daniel Cortés Zapata, Alexander Gutiérrez Gutiérrez. Phenology in flower and fruit of Rubus glaucus benth. Cv. Thornless in Risaralda: elements for phytosanitary management .........................................199 Shirley Palacios Castro, Andrés Alfonso Patiño Martínez, James Montoya Lerma, Ricardo Flórez, Harry Josué Pérez. Socio-economic and technical characterization of the cultivation of avocado (Persea americana) in Risaralda..............................................................217 Andrés Alfonso Patiño Martínez, Kelly Saudith Castañez Poveda, Eliana Gómez Correa. Biosecurity management in backyard systems in Santa Rosa de Cabal, Risaralda................................................................................................................227 Julia Victoria Arredondo Botero, Jaiver Estiben Ocampo Jaramillo, Juan Sebastián Mera Vallejo, Álvaro de Jesús Aranzazu Hernández. CONTENTS Physical-chemical diagnosis of soils in hillside areas with predominance of Lulo CV. La Selva production system in the department of Risaralda.............241 Adriana Patricia Restrepo Gallón, María Paula Landinez Montes, Jimena Tobón López. Digestibility of three concentrates used in canine feeding....................................271 María Fernanda Mejía Silva, Valentina Noreña Sánchez, Gastón Adolfo Castaño Jiménez. Chapter 4. Economic, Administrative, and Accounting Sciences Financial inclusion in households from socioeconomic strata 1 and 2 in the city of Pereira ..................................................................................................285 Lindy Neth Perea Mosquera, Marlen Isabel Redondo Ramírez, Angélica Viviana Morales. Internal marketing strategies as a competitive advantage for the company Mobilautos SAS de Dosquebradas........................................................................303 Inés Montoya Sánchez, Sandra Patricia Viana Bolaños, Ana María Barrera Rodríguez. Uses of tourist marketing in the tourist sector of the municipality of Belén de Umbría, Risaralda.............................................................................................319 Ana María Barrera Rodríguez, Paola Andrea Echeverri Gutiérrez, María Camila Parra Buitrago, Paola Andrea Martín Muñoz, Angy Paola Ángel Vélez, Luisa Natalia Trejos Ospina. Territorial prospective of Risaralda department (Colombia), based on the SDGS...............................................................................................................333 Juan Guillermo Gil García, Samanta Londoño Velásquez. Chapter 5. Health and Sports Sciences Performance evaluation in times of pandemic. What do medical students think?.......................................................................................................353 Samuel Eduardo Trujillo Henao, Rodolfo A. Cabrales Vega, Germán Alberto Moreno Gómez. The relevance of the therapist’s self and self-reference in the training of psychologists.....................................................................................................371 Maria Paula Marmolejo Lozano, Mireya Ospina Botero. Habits related to oral health which influence lifestyle of elder people in a wellness center for the elderly in Pereira 2020. .............................................387 Isadora Blanco Pérez, Olga Patricia Ramírez Rodríguez, Ángela María Rincón Hurtado. Analysis of the suicide trend in the Coffee Region in Colombia during the years 2012-2018 ..............................................................................................405 Germán Alberto Moreno Gómez, Jennifer Nessim Salazar, Jairo Franco Londoño, Juan Carlos Medina Osorio. Hind limb long bone fractures in canines and felines...........................................419 María Camila Cruz Vélez, Valentina Herrera Morales, Alba Nydia Restrepo Jiménez, Lina Marcela Palomino, Gabriel Rodolfo Izquierdo Bravo. Prevalence of overweight and obesity in children in the rural and urban area of Risaralda....................................................................................................439 Angela María Álvarez López, Angela Liceth Pérez Rendón, Alejandro Gómez Rodas, Luis Enrique Isaza Velásquez. Chapter 6. Architecture, Design and Advertising The artisan crafts of Risaralda, characteristics, importance, and risks within the Colombian Coffee Cultural Landscape, CCCL....................................457 Yaffa Nahir Ivette Gómez Barrera, Javier Alfonso López Morales

Proposta de intervenção para reduzir o índice de pacientes diabéticos com dislipidemias

Doença como a diabetes mellitus e dislipidemia configuram importantes problemas de saúde coletiva no Brasil. Observa-se que a falta de informação por parte dos diabéticos sobre o problema, bem como, os hábitos de vida inadequados dos mesmos, perpetuam a dislipidemia entre eles. Este estudo objetiva reduzir o percentual de diabéticos com dislipidemia na área de abrangência da Estratégia de Saúde Família Joaquim de Lima do município Três Marias-Minas Gerais, pelo aumento do nível de informação dos pacientes, do melhoramento da estrutura da Unidade Básica de Saúde (UBS) e da promoção de mudança de hábitos daqueles pacientes. A metodologia está embasada no método do Planejamento Estratégico Situacional (PES), por meio do qual, após processados os problemas identificados no diagnóstico situacional foi elaborado um plano ação para enfrentamento do problema priorizado. Espera-se diminuir a ocorrência no território de internações e óbitos relacionados a essa patologias

Diabetes mellitus: a single cardiorenal syndrome umbrella

Diabetes and chronic kidney disease are among the fastest-growing causes of death worldwide. An optimized conceptual framework on the pathogenesis of diabetic kidney disease and its interplay with cardiovascular disease will facilitate the development of monitoring and therapeutic strategies to decrease the risk for severe clinical events and early mortality. In this issue of ckj, Pinier et al. provide data supporting the existence in diabetic patients of a single cardiorenal syndrome umbrella, rather than separate cardiorenal or renocardiac entities (e.g. acute cardiorenal syndrome or chronic renocardiac syndromes)

Impact of recurrent acute kidney injury on patient outcomes

BACKGROUND/AIMS: Recurrent acute kidney injury (AKI) is common among patients after a first hospitalized AKI. However, little is known about the prognosis of recurrent AKI episodes in chronic kidney disease (CKD) development, cardiovascular events and mortality. METHODS: A retrospective study included patients admitted to our Hospital from 2000 to 2010. AKI was defined according to the Acute Dialysis Quality Initiative criteria. In the follow-up period after the first AKI episode, clinical, laboratory data and the number of repeated AKI episodes, etiology and severity were recorded. RESULTS: Among the 359 AKI survivor patients included, 250 new AKI episodes were observed in 122 patients (34%). Variables independently associated to new episodes were: type 2 DM [OR 1.2, 95%CI 1.2-3.8, p=0.001], ischemic heart disease [OR 1.9; 95%CI 1.1-3.6, p=0.012], and SCr at the first AKI event>2,6 mg/dl [OR 1.2; 95%CI 1.03-1.42, p=0.02]. Development of CKD during four years follow-up was more frequent in patients with recurrent AKI, HR [2.2 (95% CI: 1.09-4.3, p=0.003)] and 44% of recurrent AKI patients who developed CKD occurred during the first 6 months after the initial event. Cardiovascular events were more frequent among patients with recurrent AKI patients than in those with one AKI episode (47.2% vs 24%, p=0.001). Mortality at 4 years was higher in the patient subgroup with several episodes of AKI as compared with those with a single episode [HR: 4.5 (95% CI 2.7-7.5) p<0.001]. CONCLUSION: Episodes of recurrent AKI have a high potential to be associated with relevant complications such as cardiovascular events, mortality and CKD development

Factors associated with the compensation of renal function after nephrectomy of a kidney donor

Introduction: Kidney transplant donors lose 50% of their renal mass after nephrectomy. The remaining kidney compensates for this loss and it is estimated that 70% of the baseline renal function prior to donation is recovered. Factors associated with post-donation renal compensation are not well understood. Methods: Retrospective study of 66 consecutive kidney donors (mean age 48.8 years, 74.2% women). We analyzed the potential factors associated with the compensatory mechanisms of the remaining kidney by comparing donors according to their renal compensation rate (RCR) (Group A, infra-compensation [70%]). Results: We compared Group A (n = 38) and group B (n = 28). Predictors for RCR > 70% were higher baseline creatinine (A vs. B: 0.73 ± 0.14 vs. 0.82 ± 0.11; p = 0.03) and a lower baseline glomerular filtration rate (GFR), estimated both by MDRD-4 (A vs. B: 97.7 ± 18.8 vs. 78.6 ± 9.6 ml/min; p 70% compensation (MDRD-4, OR = 0.94 [95% CI 0.8–0.9], p = 0.01). The compensation rate decreased by 0.4% (p  70%]). Resultados: Comparamos los grupos A (n = 38) y B (n = 28). Los factores predictores de una TCR > 70% fueron una mayor creatinina basal (A vs. B 0,73 ± 0,14 vs. 0,82 ± 0,11; p = 0,03) y menor filtrado glomerular (FG), tanto estimado mediante MDRD-4 (A vs. B 97,7 ± 18,8 vs. 78,6 ± 9,6 ml/min; p  70% (MDRD-4, odds ratio [OR] = 0,94 [IC 95%: 0,8-0,9], p = 0,01). La tasa de compensación era 0,4% (p < 0,001) y 0,3% (p = 0,006), menor por cada ml/min de FG basal más, por MDRD-4 y CKD-EPI respectivamente. Conclusiones: Un año después de la donación renal el riñón remanente compensa parcialmente la función renal basal. En nuestra experiencia el FGe basal se asocia de forma inversamente proporcional a la tasa de compensación renal al año. Keywords: Living kidney donor, Nephrectomy, Renal compensation rate, Renal function, Palabras clave: Donante renal vivo, Nefrectomía, Tasa compensación renal, Función rena

Factores asociados a la compensación de la función renal tras la nefrectomía para donación

Resumen: Introducción: Los donantes renales pierden la mitad de su masa renal tras la nefrectomía. Se estima que el riñón remanente compensa idóneamente un 70% de la función renal previa a la donación. Los factores asociados con el grado de compensación posdonación no están bien establecidos. Métodos: Análisis retrospectivo de 66 donantes renales consecutivos. Edad media 48,8 años; 74,2% mujeres. Se estudiaron los potenciales factores asociados con la compensación del riñón remanente comparando donantes según su tasa de compensación renal (TCR) (grupo A, infra-compensación [ 70%]). Resultados: Comparamos los grupos A (n = 38) y B (n = 28). Los factores predictores de una TCR > 70% fueron una mayor creatinina basal (A vs. B 0,73 ± 0,14 vs. 0,82 ± 0,11; p = 0,03) y menor filtrado glomerular (FG), tanto estimado mediante MDRD-4 (A vs. B 97,7 ± 18,8 vs. 78,6 ± 9,6 ml/min; p  70% (MDRD-4, odds ratio [OR] = 0,94 [IC 95%: 0,8-0,9], p = 0,01). La tasa de compensación era 0,4% (p  70%]). Results: We compared Group A (n = 38) and group B (n = 28). Predictors for RCR > 70% were higher baseline creatinine (A vs B: 0.73 ± 0.14 vs 0.82 ± 0.11; P = .03) and a lower baseline glomerular filtration rate (GFR), estimated both by MDRD-4 (A vs B: 97.7 ± 18.8 vs 78.6 ± 9.6 ml/min; P  70% compensation (MDRD-4, OR = 0.94 [95% CI 0.8–0.9], P = .01). The compensation rate decreased by 0.4% (P < .001) and 0.3% (P = .006) for every ml/min increase in baseline eGFR estimated by MDRD-4 and CKD-EPI, respectively. Conclusions: One year after living donor nephrectomy, the remaining kidney partially compensates baseline renal function. In our experience, baseline eGFR is inversely proportional to the one-year renal compensation rate. Palabras clave: Donante renal vivo, Nefrectomía, Tasa compensación renal, Función renal, Keywords: Living kidney donor, Nephrectomy, Renal compensation rate, Renal functio