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

Nitric oxide scavenging by red blood cell microparticles and cell-free hemoglobin as a mechanism for the red cell storage lesion

Bacground-: Intravascular red cell hemolysis impairs nitric oxide (NO)-redox homeostasis, producing endothelial dysfunction, platelet activation, and vasculopathy. Red blood cell storage under standard conditions results in reduced integrity of the erythrocyte membrane, with formation of exocytic microvesicles or microparticles and hemolysis, which we hypothesized could impair vascular function and contribute to the putative storage lesion of banked blood. METHODS AND RESULTS-: We now find that s

Intervention programme to prevent bullying in adolescents in physical education classes (PREBULLPE): a quasi-experimental study

Background: Bullying is a social problem where there is a phenomenon of intentional aggression that occurs in all schools. It has multiple negative consequences for the victim’s psychological health. As school is a context for learning about life in society, strategies to prevent such attitudes and behaviours should be encouraged. Although some studies seem to indicate the potential of the subject of physical education to promote attitudes and behaviours against bullying, there is still insufficient scientific evidence to deduce a positive impact on the reduction or prevention of this phenomenon. Purpose: This study aimed to analyse the effectiveness of a specific intervention to prevent bullying in Physical Education classes in Secondary Education. 6 specific sessions inserted into the physical education curriculum to find out what bullying is, who its protagonists are and how to prevent it. Participants and setting: In the study, 764 students with an age range of 12–19 years (49.3% girls; age mean [M] = 14.80, standard deviation [SD] = 1.69) from two public educational centres participated. Among them, 439 were randomly assigned to the quasi-experimental group (48.1% girls; age M = 14.70, SD = 1.59) and 325 to the control group (51.1% girls; age M = 14.94, SD = 1.83). Data were collected at two timepoints, pre- and the post-intervention data. Data collection: The Spanish version of the European Bullying Intervention Project Questionnaire (EBIPQ) was used to measure the incidence of bullying. To measure cyberbullying, the Spanish version of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) scale was used. Data analysis: The Student t-test was performed to compare possible differences between the experimental and control groups in the pre-test. To compare the means of the factors obtained based on the variables and the instruments used, as well as the scores obtained from the subjects of the experimental and control groups at the two timepoints, linear models of repeated measurements have been established comparing the pre- and post-intervention moments and the experimental and control groups, introducing sex and grade variables to compare the effectiveness of the programme based on them. Results: There were no differences in the pre-test measurements in any of the variables. After the intervention programme in the quasi-experimental group, the bullying victimisation (F = 16,951; p = .000) and bullying aggression (F = 5,215; p = .023) rates decreased significantly more than they did the control group. Likewise, victimisation in cyberbullying (F = 6,234; p = .013) decreased significantly differently, but aggression in cyberbullying did not (F = 0,099; p = .753). Conclusion: The implementation of a specific intervention to prevent bullying inserted into the physical education curriculum seems to have decreased bullying and cyberbullying victimisation

Detailed stratified GWAS analysis for severe COVID-19 in four European populations

Given the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), a deeper analysis of the host genetic contribution to severe COVID-19 is important to improve our understanding of underlying disease mechanisms. Here, we describe an extended GWAS meta-analysis of a well-characterized cohort of 3255 COVID-19 patients with respiratory failure and 12 488 population controls from Italy, Spain, Norway and Germany/Austria, including stratified analyses based on age, sex and disease severity, as well as targeted analyses of chromosome Y haplotypes, the human leukocyte antigen (HLA) region and the SARS-CoV-2 peptidome. By inversion imputation, we traced a reported association at 17q21.31 to a ~ 0.9-Mb inversion polymorphism that creates two highly differentiated haplotypes and characterized the potential effects of the inversion in detail. Our data, together with the 5th release of summary statistics from the COVID-19 Host Genetics Initiative including non-Caucasian individuals, also identified a new locus at 19q13.33, including NAPSA, a gene which is expressed primarily in alveolar cells responsible for gas exchange in the lung

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease