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

Incidence of lymphoma in HIV-HCV-infected patients. Modifications in function of the anti-hepatitis C virus therapy

The change in the incidence of lymphomas in function of the presence or absence of sustained virological response after anti-hepatitis C therapy in a cohort of human immunodeficiency (HIV)-hepatitis C (HCV) viruses coinfected patients was analyzed. A prospective cohort of 755 HIV-HCV coinfected patients who received their first anti-HCV therapy, based on interferon + ribavirin schemas, was evaluated. Incidence and histologic types of lymphomas were analyzed in two periods: (1) before administration of anti-HCV therapy and (2) after anti-HCV therapy. The association between lymphoma incidence and demographic, HIV- (minimum CD4+ cell count and CD4+ cell count at diagnosis of lymphoma, antiretroviral therapy, maximal HIV load and HIV load at diagnosis of lymphoma) and HCV-related variables (HCV load, genotype, sustained viral response to anti-HCV therapy) were analyzed. A total of 13 lymphomas [incidence rate (95% confidence interval), 0.72 (0.33–1.11) × 1000 person-years, time from HIV diagnosis to lymphoma diagnosis (median, interquartile range), 15 (11–19) years] were diagnosed. Nine of them were non-Hodgkin and four Hodgkin lymphomas. The median CD4+ T cell count at diagnosis of lymphoma was 457/mm3, with only two cases with values lower than 200/mm3. The incidence rate of non-Hodgkin lymphomas was similar pre- and post-anti HCV therapy [0.33 (0.00–0.65) vs 0.68 (0.08–1.26) × 1000 person-years, respectively, p > 0.05]. Patients with sustained virologic HCV response showed similar incidence rate of lymphomas than that of those without anti-HCV response. In conclusion, anti-HCV therapy does not modify the incidence rate of lymphomas in HIV-HCV coinfected patients.Peer reviewe

Estrategias docentes innovadoras para el estudio de las interrelaciones metabólicas entre órganos y tejidos especializados y su papel clave en diferentes estados fisiopatológicos

El objetivo principal del proyecto es facilitar el estudio del metabolismo, su regulación y las interrelaciones entre órganos y tejidos con distintos perfiles metabólicos, destacando su importancia en diversos estados fisiopatológicos. El proyecto pretende además poner de manifiesto la importancia de estos conocimientos para poder desarrollar proyectos de investigación en diferentes áreas. Con este objetivo, los estudiantes de los cinco grupos de primero de Grado en Biología, tutorizados por M Teresa Portolés (responsable del proyecto), Begoña Gómez-Miguel, Ana Saborido y Mercedes Echaide, profesoras que imparten Metabolismo en la asignatura de Bioquímica, han realizado las actividades indicadas a continuación, organizados en equipos de trabajo centrados en órganos y tejidos clave como cerebro, hígado, músculo, tejido adiposo y glóbulos rojos. - Elaboración de preguntas de examen, fijando la atención en los aspectos más importantes al finalizar el estudio de cada tema. - Realización de infografías expuestas en la Facultad de Ciencias Biológicas del 13 al 17 de mayo, para representar de forma clara, concisa y atractiva las características metabólicas de tipos celulares especializados y sus interrelaciones, facilitando su comprensión y estudio. - Elaboración de un mapa integrador interactivo del metabolismo en las aulas de informática de la Facultad de Ciencias Biológicas con la pizarra digital interactiva, destacando la interconexión de las diferentes rutas metabólicas en la que se basa el funcionamiento del organismo. Laura Casarrubios (Doctora en Biología) ha participado preparando dos vídeos explicativos de los programas Miro y BioRender. - Asistencia a charlas impartidas por las profesoras del proyecto enfocadas en sus proyectos de investigación y con la participación de Mónica Cicuéndez (PAD) experta en Metabolómica, para transmitir a los estudiantes la importancia del estudio del metabolismo en el desarrollo de actividades investigadoras en diferentes áreas. El proyecto ha contado con la participación de Lourdes Varea (Secretaria Administrativa) para la organización de los listados de los diferentes equipos y otras tareas administrativas, así como con numerosos estudiantes colaboradores de cursos anteriores que han aconsejado a los nuevos estudiantes en las actividades realizadas. El proyecto es interfacultativo e interdepartamental, ya que los componentes del equipo pertenecen a las Facultades de Ciencias Químicas, Ciencias Biológicas y Farmacia, y a los Departamentos de Bioquímica y Biología Molecular y Química en Ciencias Farmacéuticas. El equipo cuenta con 5 miembros PDI (1 Catedrática de Universidad, 3 Profesoras Titulares de Universidad y 1 Profesora Ayudante Doctor), 2 miembros PAS y estudiantes de cursos anteriores. El elevado número de estudiantes (alrededor de 400) que han desarrollado las diferentes actividades, pone de manifiesto el entusiasmo del alumnado y deja constancia de la motivación y el interés que el proyecto ha despertado en los estudiantes de primero de Grado en Biología.Depto. de Bioquímica y Biología MolecularDepto. de Química en Ciencias FarmacéuticasFac. de Ciencias QuímicasFac. de Ciencias BiológicasFac. de FarmaciaFALSEsubmitte

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Delaying surgery for patients with a previous SARS-CoV-2 infection

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