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

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

First evidence of a main channel generated by the Mediterranean Outflow Water after its exit from the Gibraltar Strait

An extensive terrace comprising sandy sheeted drifts characterises the proximal sector (close to the Straits of Gibraltar) of the Contourite Depositional System (CDS) of the Gulf of Cadiz and the western continental margin of Portugal. A novel morphosedimentary study over this terrace has been executed based on new multibeam echosounder data, seismic profiles, and surficial sediments samples collected during the CONTOURIBER-1 Cruise (2010). Based on that study, an impressive large channel laterally connected with the central part of the Strait of Gibraltar (Camarinal Sill) has been identified. It is associated southwestward with a huge contourite levee (sand bank), which has been generated by overflow processes related to the Mediterranean Outflow Water (MOW). In the middle to the distal part of the terrace, there are other minor channels, erosional scour alignments and depositional features. The mapping of all these features coupled with CTD data allows to further understand the pathway and deceleration of the MOW, in addition to aid the conceptual identification of contourite terrace.El sector proximal del Sistema Deposicional Contornítico (SDC) del Golfo de Cádiz y oeste de Portugal se caracteriza por una extensa terraza contornítica en la que se desarrollan drifts laminares arenosos. Sobre esta terraza se ha realizado un novedoso estudio morfosedimentario en base a datos batimétricos de ecosonda multihaz, registros sísmicos y muestras superficiales, adquiridos en la campaña oceanográfica CONTOURIBER-1 (2010). Se ha identificado un extenso canal sobre dicha terraza conectado lateralmente con la parte central del Estrecho de Gibraltar (Umbral de Camarinal) y bordeado por el SO por un dique (levee) contornítico (banco arenoso). La génesis del canal se relaciona con el desbordamiento sucesivo de la Masa de Agua Mediterránea de Salida (MOW) en el Golfo de Cádiz. En la parte media y distal de la terraza contornítica existen canales menores, surcos erosivos y rasgos deposicionales, cuya cartografía, junto al análisis de datos de CTD, permite entender mejor la circulación y deceleración de la MOW, así como la caracterización conceptual de las terrazas contorníticas.Publicado