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5 results on '"Arenas MD"'

1. COVID-19 in Grade 4-5 Chronic Kidney Disease Patients.

Author

Collado S, Arenas MD, Barbosa F, Cao H, Montero MM, Villar-García J, Barrios C, Rodríguez E, Sans L, Sierra A, Pérez-Sáez MJ, Redondo-Pachón D, Coca A, Maiques JM, Güerri-Fernández R, Horcajada JP, Crespo M, and Pascual J

Subjects
Aged, Aged, 80 and over, COVID-19, Coronavirus Infections complications, Fatal Outcome, Female, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral complications, Renal Insufficiency, Chronic complications, SARS-CoV-2, Betacoronavirus, Coronavirus Infections diagnostic imaging, Pneumonia, Viral diagnostic imaging, Renal Insufficiency, Chronic diagnostic imaging, Severity of Illness Index
Abstract

Introduction: Chronic kidney disease (CKD) increases the risk of mortality during coronavirus disease 2019 (COVID-19) episodes, and some reports have underlined the high incidence and severity of this infection in dialysis patients. Information on COVID-19 in nondialysis CKD patients is not available yet., Case Reports: Here we present 7 patients with grade 4-5 CKD who developed symptomatic COVID-19; they comprise 2.6% of our 267 advanced CKD patients. The estimated GFR was between 12 and 20 mL/min during the month prior to COVID-19. The 3 major symptoms were fever, cough, and dyspnea, and 5 patients showed bilateral pneumonia. Hydroxychloroquine, azithromycin, ceftriaxone, and steroids were the most frequently prescribed drugs. Two patients needed noninvasive mechanical ventilation. All patients showed minimal to moderate kidney function deterioration during admission, with an eGFR decline below 5 mL/min in 6 cases. No patient required acute dialysis. Six patients were discharged alive and remained dialysis free athe t the time of reporting, and one 76-year-old patient died., Conclusions: COVID-19 affects grade 4-5 CKD patients, but prognosis may be acceptable if prompt supportive measures are applied. These findings should be confirmed in larger cohorts, and further observations will be needed to understand the full spectrum of clinical features and the optimal approach to COVID-19 in patients with advanced CKD., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

Published
2020
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2. Pegylated interferon (alone or with ribavirin) for chronic hepatitis C in haemodialysis population.

Author

Espinosa M, Hernàndez J, Arenas MD, Carnicer F, Caramelo C, and Fabrizi F

Subjects
Adult, Aged, Antiviral Agents adverse effects, Cohort Studies, Female, Follow-Up Studies, Hepatitis C, Chronic complications, Humans, Interferon-alpha adverse effects, Male, Middle Aged, Polyethylene Glycols adverse effects, Prospective Studies, RNA, Viral blood, Recombinant Proteins administration & dosage, Recombinant Proteins adverse effects, Recombinant Proteins therapeutic use, Retrospective Studies, Ribavirin adverse effects, Treatment Outcome, Antiviral Agents administration & dosage, Antiviral Agents therapeutic use, Hepatitis C, Chronic drug therapy, Interferon-alpha administration & dosage, Interferon-alpha therapeutic use, Polyethylene Glycols administration & dosage, Polyethylene Glycols therapeutic use, Renal Dialysis, Ribavirin administration & dosage, Ribavirin therapeutic use
Abstract

Background/aims: Hepatitis C virus infection remains prevalent among patients undergoing long-term haemodialysis and has a detrimental impact on survival in this population. Antiviral therapy for chronic hepatitis C in haemodialysis patients is still a challenge to clinicians. The aim of the current study is to evaluate the efficacy and safety of therapy with pegylated interferon, alone or combined with ribavirin, for chronic hepatitis C among patients undergoing long-term hemodialysis., Methods: We conducted a retrospective, multicenter cohort trial with monotherapy (pegylated interferon) (n=21) or combined antiviral therapy (pegylated interferon plus ribavirin) (n=5) for chronic hepatitis C in patients undergoing long-term haemodialysis., Results: Sustained virological response was obtained in eleven (42%) patients. Seven (26.9%) patients interrupted prematurely the antiviral treatment due to serious side-effects, the most frequent cause of treatment withdrawal being hematological (n=3). HCV RNA load was lower in responder than non-responder patients, 5.44 (3.45; 6.36) vs. 5.86 (4.61; 6.46) log10 copies/mL, even if the difference was not significant (P=0.099). Blood transfusion requirement was greater in patients on combined antiviral therapy than those on pegylated interferon alone, 100% (5/5) vs. 0% (0/21), P=0.0001. No difference in sustained viral response occurred between patients on combined antiviral therapy and those on pegylated interferon monotherapy [40% (2/5) vs. 42.8% (9/21), P=0.90]., Conclusions: Results from this study showed that pegylated interferon alone or with ribavirin is unsatisfactory in terms of efficacy and safety. Prospective trials based on interferon-free regimens (i.e., sofosbuvir plus ribavirin or sofosbuvir plus daclatasvir) are under way in patients with hepatitis C receiving long-term hemodialysis., (© 2015 S. Karger AG, Basel.)

Published
2015
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4. Granulomatous interstitial nephritis associated with hydrochlorothiazide/amiloride.

Author

Enríquez R, Cabezuelo JB, González C, Lacueva J, Teruel A, Fernández J, and Arenas MD

Subjects
Acute Kidney Injury therapy, Aged, Amiloride therapeutic use, Female, Granuloma drug therapy, Humans, Hydrochlorothiazide therapeutic use, Hypertension drug therapy, Nephritis, Interstitial drug therapy, Prednisone therapeutic use, Acute Kidney Injury chemically induced, Amiloride adverse effects, Granuloma chemically induced, Hydrochlorothiazide adverse effects, Nephritis, Interstitial chemically induced
Abstract

A 74-year-old woman developed acute renal failure and granulomatous interstitial nephritis associated with hydrochlorothiazide/amiloride. On stopping the drug the renal function improved, but not significantly. Around 20 months after prednisone administration, the renal function had stabilized, with a moderate degree of renal insufficiency. The case is discussed, and some aspects of acute interstitial nephritis induced by diuretics are briefly reviewed.

Published
1995
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