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Introduction: Kidney dysfunction is a highly significant disease, both in the United Kingdom and globally. Human leukocyte antigens (HLA) are thought to be associated with kidney function; this study aims to collate all previously reported associations between HLA and renal function, and to identify novel associations (and replicate previous findings) by analysing a cohort of subjects recruited in the UK. Secondary analysis investigated whether there is a link between Covid-19 and either HLA or renal function. Methods: A systematic review was performed to identify all studies that had looked for associations between HLA and renal function. Additionally, regression analyses were performed to test for HLA associations with renal function in a cohort of around 500,000 UK Biobank subjects aged 39-73. Seven different ethnic groups and 362 HLA types were included. The primary outcome was estimated glomerular filtration rate (eGFR), with clinical outcomes used in secondary analyses. Finally, regression analysis was performed to test for associations between Covid-19, HLA, and renal function in cohorts of up to 6,000 Covid-19 positive subjects aged 50-86. Results: 35 papers investigating the link between HLA and renal function were identified, with over 100 HLA types and haplotypes reported to be associated with kidney function. These findings were collated and published. This study revealed 33 HLA types that were linked to kidney function in white British subjects (11 hazardous and 22 beneficial). Studies of other ethnicities revealed nine significant associations, e.g., four alleles were linked to decreased function in Black African subjects. The findings relating to Covid-19 were limited. Previously reported associations were replicated (e.g., increased age and male sex were linked to increased mortality), but there were no associations found between Covid-19 and either HLA or renal function. Discussion: This thesis provides a list of all previously reported associations between HLA and renal function, and also presents a number of novel associations. Many of the associated alleles are commonly inherited together as haplotypes: HLA-A*01:01, B*08:01, C*07:01, DRB1*03:01, DQB1*02:01 has 9.5% frequency in England and each allele was associated with decreased renal function in white British subjects. This may have clinical applications and could affect the UK's organ allocation algorithm.

Objetivo: determinar la incidencia de toxicidad hematológica por linezolid. Estudiar la influencia del aclaramiento renal en su aparición y la efectividad de la piridoxina en su prevención. Método: estudio observacional retrospectivo de todos los pacientes tratados con linezolid en un hospital universitario en seis meses. Se consideró toxicidad hematológica a la disminución del 25% de la hemoglobina, del 25% de las plaquetas y/o del 50% de neutrófilos al final respecto al inicio del tratamiento. Se comparó en los pacientes con y sin fallo renal (aclaramiento de creatinina inferior a 50 mL/min), con más o menos de 30 mL/min, y con o sin piridoxina, la incidencia de toxicidad hematológica mediante Chi-Cuadrado y la disminución en el porcentaje de variables analíticas hematológicas mediante U Mann-Whitney. Resultados: se evaluaron 38 pacientes. Dieciséis (42%) presentaron toxicidad hematológica (2 por disminución de hemoglobina, 9 de plaquetas y 8 de neutrófilos). En 2 pacientes (5%) se suspendió el tratamiento por plaquetopenia. La incidencia de toxicidad fue similar en pacientes con y sin insuficiencia renal, 42% vs. 42%, p = 0,970, con más o menos de 30 mL/min, 67% vs. 40%, p = 0,369, con piridoxina o sin ella, 47,8% vs. 33%, p = 0,376. Los pacientes con fallo renal presentaron una reducción significativamente mayor de plaquetas, p = 0,0185. Conclusiones: un 42% de los pacientes presentó toxicidad hematológica, más frecuentemente disminución de plaquetas y neutrófilos. Esta no fue significativamente mayor en los pacientes con fallo renal, ni en aquellos sin piridoxina. Se halló mayor reducción de plaquetas en los pacientes con insuficiencia renal.