The epidemiology of renal replacement therapy in two different parts of the worldThe Latin American Dialysis and Transplant Registry versus the European Renal Association-European Dialysis and Transplant Association Registry

Publisher Copyright: © 2018 Pan American Health Organization. All rights reserved.Objective: To compare the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in Latin America and Europe, as well as to study differences in macro-economic indicators, demographic and clinical patient characteristics, mortality rates, and causes of death between these two populations. Methods: We used data from 20 Latin American and 49 European national and subnational renal registries that had provided data to the Latin American Dialysis and Renal Transplant Registry (RLADTR) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, respectively. The incidence and prevalence of RRT in 2013 were calculated per million population (pmp), overall and by subcategories of age, sex, primary renal disease, and treatment modality. The correlation between gross domestic product and the prevalence of RRT was analyzed using linear regression. Trends in the prevalence of RRT between 2004 and 2013 were assessed using Joinpoint regression analysis. Results: In 2013, the overall incidence at day 91 after the onset of RRT was 181 pmp for Latin American countries and 130 pmp for European countries. The overall prevalence was 660 pmp for Latin America and 782 pmp for Europe. In the Latin American countries, the annual increase in the prevalence averaged 4.0% (95% confdence interval (CI): 2.5%-5.6%) from 2004 to 2013, while the European countries showed an average annual increase of 2.2% (95% CI: 2.0%-2.4%) for the same time period. The crude mortality rate was higher in Latin America than in Europe (112 versus 100 deaths per 1 000 patient-years), and cardiovascular disease was the main cause of death in both of those regions. Conclusions. There are considerable differences between Latin America and Europe in the epidemiology of RRT for ESRD. Further research is needed to explore the reasons for these differences.Peer reviewe

Mineral and bone disorder related to chronic renal disease in prevalent Chronic Dialysis patients in a 3 years period 2011-2013 in Argentina

Introduction: There are few data concerning variation over time of mineral and bone metabolism disorder (MBD) in prevalent chronic dialysis patients (CD) in Argentina. Methods: 3-years-period time 2011-2013 data from Argentine Registry of Chronic Dialysis was used. Demography, Chronic Renal failure etiology (CRF) and MBD biochemical variables in CD prevalent patients, were analyzed. Results: Prevalent population grew from 26572 to 27966 patients between 2011 and 2013, basically as a consequence of incidents growth. Age increased from 57.2 (± 17.0) to 57.5 (±16.9). In both sexs =65 years old rate increased, more in men. Diabetic Nephropathy is the first etiology (27.2%). Between 2011 and 2013 there is a significant decrease of PTHi (p=0.001) average values. In 2013, 25.5% showed between 150 to 300 pg/ml values, 22.9% 600 pg/ml values. The lowest PTHi values can be observed in elderly, males, diabetic pattiens and in the first years under CD treatment. Conclusions: Average PTHi, as well as patients with over 600 pg/ml percentage decreased, but the adequate range patients percentage (150-300) remained unchanged. Average PTHi decrease is due to the progressive increase of sub-populations less likely to develop hyperparathyroidism: elderlypeople, males, diabetics and new patients

Comparison of wood smoke PM2.5 obtained from the combustion of FIR and beech pellets on inflammation and DNA damage in A549 and THP-1 human cell lines

The aim of this study was to investigate the effect on the induction of interleukin-8 of particulate matter (PM) from fir and beech pellets burnt in domestic appliances on two human cells lines, namely the lung epithelial cell line A549 and the promyelocytic cell line THP-1. The effects of PM2.5 obtained from combustion of beech and fir pellets were compared to reference diesel exhaust particulates (DEP). In parallel, wood smoke PM-induced genotoxicity and oxidative stress were also investigated in A549 cells. Cells were treated for different times (3\u201372 h) with increasing concentrations of PM2.5 obtained from sequential combustions of fir and beech pellets or reference DEP. Cell viability was assessed by lactate dehydrogenase leakage, and the release of interleukin-8 or CXCL8 (IL-8) was measured to evaluate the pro-inflammatory effect. Oxidative stress was evaluated by the 5(6)-carboxy-2\u2032,7\u2032dichlorofluorescein diacetate (DCFH-DA) assay and DNA damage by the alkaline comet assay and micronucleus frequency by flow cytometry. Both A549 and THP-1 cells responded in a dose- and time-related manner to wood smoke PM2.5 with IL-8 release, particles obtained from late combustions being the most active. THP-1 cells were more sensitive than A549 cells. On a mass base, similar effects were observed for both fir and beech PM2.5. However, the combustion of beech pellets generated approximately three times more PM2.5 than fir pellets. Regarding the mechanism of PM2.5 uptake, in both THP-1 and A549 cells, cytochalasin D prevented PM2.5-induced IL-8 mRNA expression and cytokine release, indicating a key role for actin polymerization in particles uptake and that the production of IL-8 correlated with particle phagocytosis. As signal transduction pathway involvement, in both THP-1 and A549 cells, PM2.5-induced IL-8 release could be completely blocked by the selective inhibitor SB203580, indicating a role of p38 MAPK activation. PM2.5 from both fir and beech pellets also induced modest DNA lesions dose related, measured as strand breaks, whereas no increase in the number of micronucleus was observed. Similar effects were observed with DEP, arguing against less dangerous effects of wood smoke particles than other categories of combustion-derived particles in the same size range. Overall, results suggest that combustion conditions can significantly affect the characteristics of particles and the consequent toxicity, and that different woods can generate different amounts of PM2.5