COVID-19 and its impact on the kidney and the nephrology community

COVID-19; NephrologyCOVID-19; NefrologiaCOVID-19; NefrologíaThis article is part of a supplement supported by Fresenius Medical Care without any influence on its content

Control de artrópodos fitófagos en cítricos con aldicarb y efectos sobre entomofauna auxiliar

Aldicarb es un plaguicida utilizado en el cultivo de los agrios. Se ha estudiado su efecto con el objetivo de conocer la acción sobre ciertas plagas, el impacto sobre insectos beneficiosos, la influencia en el desarrollo vegetativo y la cosecha, así como la absorción y evolución de sus metabolitos en el suelo, hojas y frutos. Hemos observado que aldicarb controla de forma adecuada las siguientes plagas: aleiródidos, áfidos, el pseudoócido Planococcus citri Risso y el ácaro rojo Panonychus citri MacGregor. Al mismo tiempo, reduce la población y daños del minador de los cítricos, nemátodos y la araña roja Tetranychus urticae Kock. Influye poco en cochinillas diaspinas. Respecto a enemigos naturales de las plagas, se ha constatado escaso impacto. Hemos constatado que la máxima abundancia de éstos, se produce en los meses correspondientes a primavera, aunque en algunos casos, encontramos máximos poblacionales durante todo el año. Se ha observado efectos cuantitativos en la brotación y cosecha. Sin embargo, no se ha constatado relación alguna con el contenido en elementos minerales de las hojas. Con la utilización de aldicarb a la dosis de 20 g i.a./árbol, con dos aplicaciones año, pueden superarse los LMRs establecidos en España (0,2 mm/Kg), sin embargo, con una aplicación, los resuduos en fruta se encuentran, o por ebajo, o en el límite de detección.Soler Feliu, J. (2000). Control de artrópodos fitófagos en cítricos con aldicarb y efectos sobre entomofauna auxiliar [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/5952Palanci

Looking for students' enthusiasm: flipped classroom

The “flipped classroom” is a pedagogical model that consists of putting certain learning processes outside the classroom so that the teacher can devote more class time to students’ acquisition of practical skills, for example. In this way, the teacher is not limited to the transmission of course content, but in addition assumes the role of a mediator in the cognitive process, allowing students to actively construct their own knowledge. In this role, the teacher’s main task is to encourage students to become independent learners. This paper describes the implementation and initial results of the application of the flipped classroom in higher education. This study is part of a larger research project to improve our students’ motivation through the use of the flipped learning. The sample consisted of about 3000 students taking 17 different subjects, in Management and Administration Business, Finance and Accounting, Marketing and Market Research, and Chemistry, at the University of Málaga, and in Accounting and Administration, Business Communication and Marketing at the Polytechnic of Porto. According to our results, students’ motivation and class attendance increased with the application of this model; a comparison of the final exam results from two years with traditional classes and from two years with flipped learning shows that the proportion of students failing the exam decreased, which confirms that the use of this pedagogic model improves student learning.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. This project is financed by Educational Innovation Projects 2017-2019 from Malaga University

Gamificacion in education and active methodologies at Higher education

In recent years, there has been an increasing interest in applying Gamification in Education, which can be defined as the application of game design elements to learning activities. Its purpose is to motivate students by creating an engaging learning experience that can keep students focused on the learning task and its application in the classroom, is still in its emergent stages. Gamification is a great challenge for education, particularly in Higher Education Institutions (HEI) in such a traditional context, as is the case with courses like Management and Administration Business, Finance and Accounting, Marketing and Market Research, Chemistry, Accounting and Administration and Business Communication. This paper presents a study, applied in the 2016/2017 and 2017/2018 academic years, in which the teaching method focuses on a blended learning approach, through the implementation of a flipped classroom model and also through the introduction of online gamification activities such Kahoot! application. Kahoot is a game-based learning platform, used as educational technology that can easily be used for initial, formative and summative assessment of students’ knowledge using individual or collaborative team work mode, adding vitality, student engagement, and also meta-cognitive supports to higher education classrooms with limited instructor or student training required. The participants, in the study, were about 3 000 students of 17 different subjects from the aforementioned courses, of the Malaga University and Polytechnic of Porto. The results of this study suggest that this model improves student learning and are of relevance to researchers, educators and game-based learning designers.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Anti-phospholipase A2 receptor antibody and spontaneous remission in membranous nephropathy

Anti-phospholipase A2 receptor antibody; Membranous nephropathy; Spontaneous remissionAnticòs del receptor anti-fosfolipasa A2; Nefropatia membranosa; Remissió espontàniaAnticuerpo del receptor anti-fosfolipasa A2; Nefropatía membranosa; Remisión espontáneaMembranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in native kidney biopsies from adults. In 2009, antibodies to the M-type receptor of phospholipase A2 (anti-PLA2R) were identified in idiopathic MN patients, both within the kidney and in the circulation. The clinical course of idiopathic MN is variable and ranges from spontaneous remission to end-stage renal disease. Clinical variables such as proteinuria levels, patient sex, age and renal function at diagnosis have been associated with renal MN progression. In this editorial, we update the importance of anti-PLA2R levels as a prognostic marker in idiopathic MN at the diagnosis of the diseas

Sodium-glucose cotransporter inhibitors: beyond glycaemic control

SGLT2; Chronic kidney disease; Diabetic nephropathySGLT2; Malaltia renal crònica; Nefropatia diabèticaSGLT2; Enfermedad renal crónica; Nefropatía diabéticaDiabetes increases the risk of adverse cardiovascular and renal events. Recently, sodium-glucose co-transporter 2 (SGLT2) inhibitors have been demonstrated to reduce cardiovascular complications and slow diabetic kidney disease progression in patients with type 2 diabetes. The glycaemic control exerted by these drugs is not greater than the one achieved with other classical glucose-lowering medications such as sulphonylureas. For that reason, plausible renoprotective mechanisms independent from glycaemic control have been proposed such as blood pressure control, body weight loss, intraglomerular pressure reduction and a decrease in urinary proximal tubular injury biomarkers. Interestingly, the hypothesis that SGLT2 inhibitors have a direct renoprotective effect has been addressed in diabetic and non-diabetic models. In this editorial, we update the different postulated mechanisms involved in the cardiorenal protection afforded by SGLT2 inhibition in chronic kidney disease.The authors are current recipients of research grants from the FONDO DE INVESTIGACIÓN SANITARIA-FEDER, ISCIII, PI17/00257 and REDINREN, RD16/0009/0030

Transjugular Kidney Biopsy as a Safe Method to Increase the Etiological Diagnosis in Kidney Disease

Biopsia renal transyugular; Diagnóstico etiológico; Enfermedad renalBiòpsia renal transjugular; Diagnòstic etiològic; Malaltia renalTransjugular Kidney Biopsy; Etiological Diagnosis; Kidney Diseas

Immunotherapy and the Spectrum of Kidney Disease: Should We Individualize the Treatment?

Chronic kidney disease; Dialysis; ImmunotherapyEnfermedad renal cronica; Diálisis; InmunoterapiaMalaltia renal crònica; Diàlisi; ImmunoteràpiaThe new targeted cancer therapies including immune checkpoint inhibitors (ICIs) have been demonstrated to improve the survival of oncological patients, even in cases of metastatic cancer. In the past 5 years, several studies have revealed that ICI can produce several immune-mediated toxicities involving different organs, such as the skin, the gastrointestinal tract, the liver, and, of course, the kidney. The most frequent lesion of immunotoxicity in the kidney is acute interstitial nephritis (AIN), although other nephropathies have also been described as a consequence of the use of ICI, such as glomerulonephritis and acute thrombotic microangiopathy, among others. In addition, kidney rejection has also been reported in kidney transplant patients treated with ICI. Normally randomized clinical trials with ICI exclude patients with end-stage kidney disease, namely, patients undergoing dialysis and kidney transplant patients. Several important questions need to be addressed in relation to immunotherapy and patients with kidney disease: (a) when to start corticosteroid therapy in a patient with suspected acute kidney injury (AKI) related to ICI, (b) the moment of nephrologist referral and kidney biopsy indication, (c) management of ICI in patients undergoing dialysis, and (d) the effect of ICI in kidney transplantation, immunosuppressive personalized treatment, and risk of allograft rejection in kidney transplant patients. The objective of this review was to summarize the recently published literature on a wide spectrum of kidney disease patients with cancer and ICI. This review will address three main important groups of individuals with kidney disease and cancer immunotherapy, AKI associated with ICI, patients undergoing dialysis, and kidney transplant recipients. We believe that the information provided in this review will enlighten the personalized ICI treatment in individuals with a broader spectrum of kidney diseases.This research was funded by ISCIIII-FEDER and ISCIII-RETICS REDinREN, Grant Numbers PI17/00257, PI21/01292, RD16/0009/0030, and RICORS RD21/0005/0016. Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), enfermedades glomerulares complejas

Coronavirus disease 2019 in chronic kidney disease

The clinical spectrum of coronavirus disease 2019 (COVID-19) infection ranges from asymptomatic infection to severe pneumonia with respiratory failure and even death. More severe cases with higher mortality have been reported in older patients and in those with chronic illness such as hypertension, diabetes or cardiovascular diseases. In this regard, patients with chronic kidney disease (CKD) have a higher rate of all-type infections and cardiovascular disease than the general population. A markedly altered immune system and immunosuppressed state may predispose CKD patients to infectious complications. Likewise, they have a state of chronic systemic inflammation that may increase their morbidity and mortality. In this review we discuss the chronic immunologic changes observed in CKD patients, the risk of COVID-19 infections and the clinical implications for and specific COVID-19 therapy in CKD patients. Indeed, the risk for severe COVID-19 is 3-fold higher in CKD than in non-CKD patients; CKD is 12-fold more frequent in intensive care unit than in non-hospitalized COVID-19 patients, and this ratio is higher than for diabetes or cardiovascular disease; and acute COVID19 mortality is 15-25% for haemodialysis patients even when not developing pneumonia

Intravenous fluid therapy in accordance with kidney injury risk: when to prescribe what volume of which solution

Acute kidney injury; Colloid solution; Intravenous fluid therapyLesión renal aguda; Solución coloidal; Fluidoterapia intravenosaLesió renal aguda; Solució col·loïdal; Fluidoteràpia intravenosaAcute kidney injury (AKI) is common in hospitalized patients while common risk factors for the development of AKI include postoperative settings, patients with baseline chronic kidney disease (CKD) or congestive heart failure. Intravenous (IV) fluid therapy is a crucial component of care for prevention and treatment of AKI. In this narrative review, we update the approach to IV fluid therapy in hospitalized patients including the timing of fluid prescription, and the choice of fluid type, amount and infusion rate along with the potential adverse effects of various crystalloid and colloid solutions, addressing specifically their use in patients with acute kidney disease, CKD or heart failure, and their potential impact on the risk of hospital-acquired AKI