RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Eficiência de um hidrociclone de geometria "rietema" para pré-filtragem de água para irrigação Efficiency of a hydrocyclone of "rietema" geometry for pre-filtering of water for irrigation

O hidrociclone é um equipamento amplamente utilizado pela indústria em processos envolvendo separação sólido-líquido, porém ainda pouco utilizado na agricultura irrigada no Brasil. Neste trabalho, avaliou-se o desempenho deste equipamento como pré-filtrante de partículas sólidas, oriundas dos processos erosivos e do assoreamento dos recursos hídricos. Os testes foram realizados com um hidrociclone de geometria "Rietema", possuindo diâmetro de 19,2 cm na parte cilíndrica, operando com vazões variando entre 10 m³ h-1 e 27 m³ h-1. Os materiais particulados usados em suspensão foram: solo franco-argiloso e areia de rio. Os resultados mostraram que a perda de carga máxima média foi de 52 kPa e 47 kPa para as suspensões aquosas de areia e solo, respectivamente. Seu melhor desempenho ocorreu operando com suspensão aquosa de areia, apresentando eficiência total de 92,3% para a vazão de 26,9 m³ h-1. Concluiu-se que o equipamento avaliado é mais eficiente para remoção de partículas de areia, podendo ser utilizado como pré-filtro em sistemas de irrigação.<br>The hydrocyclone is an equipment widely used by industry in cases involving solid-liquid separation, but still little used in irrigated agriculture in Brazil. This study evaluated the performance of this equipment as a pre-filter of solid particles, from erosive processes and the silting of water resources. The tests were performed with a hydrocyclone of "Rietema" geometry, with a diameter of 19.2 cm at the cylindrical part operating with outflows ranging between 10 m³ h-1 and 27 m³ h-1. The materials used in particulate suspension were clay loam soil and sand from river. The results showed that the average maximum head loss was 52 kPa and 47 kPa for aqueous suspensions of sand and soil, respectively. Its best performance occurred operating with slurry of sand, presenting total efficiency of 92.3% for 26.9 m³ h-1 of flow rate. It was concluded that such equipment is most effective to remove particles of sand, thus it can be used as a pre-filter in irrigation systems

Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice : A multicentre cohort study

Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods: Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). Results: We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. Conclusions: EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads