15 results on '"Fenollosa, María Ángeles"'
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2. Clinical profiles and patterns of kidney disease progression in C3 glomerulopathy
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Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Cavero, Teresa [0000-0001-5187-9906], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Allende, Natalia [0000-0001-9857-793X], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Rivas, Begoña [0000-0002-5886-9943], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], Miquel, Rosa [0000-0002-0298-7342], Mon, Carmen [0000-0001-9081-8428], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Rivas, Begoña, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Cavero, Teresa [0000-0001-5187-9906], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Allende, Natalia [0000-0001-9857-793X], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Rivas, Begoña [0000-0002-5886-9943], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], Miquel, Rosa [0000-0002-0298-7342], Mon, Carmen [0000-0001-9081-8428], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Rivas, Begoña, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, and Praga, Manuel
- Abstract
Background C3 glomerulopathy is a rare kidney disease, which makes it difficult to collect large cohorts of patients to better understand its variability. The aims of this study were to describe the clinical profiles and patterns of progression of kidney disease., Methods This was a retrospective, observational cohort study. Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. Study population was divided into clinical profiles by combining the following predictors: eGFR under/above 30 ml/min per 1.73 m2, proteinuria under/above 3.5 g/d, and histologic chronicity score under/above 4. The change in eGFR and proteinuria over time was evaluated in a subgroup with consecutive measurements of eGFR and proteinuria., Results One hundred and fifteen patients with a median age of 30 years (interquartile range 19–50) were included. Patients were divided into eight clinical profiles. Kidney survival was significantly higher in patients with a chronicity score <4 and proteinuria <3.5 g/d, both in those presenting with an eGFR under/above 30 ml/min per 1.73 m2. The median eGFR slope of patients who reached kidney failure was −6.5 ml/min per 1.73 m2 per year (interquartile range −1.6 to −17). Patients who showed a reduction in proteinuria over time did not reach kidney failure. On the basis of the rate of eGFR decline, patients were classified as faster eGFR decline (≥5 ml/min per 1.73 m2 per year), slower (<5 ml/min per 1.73 m2 per year), and those without decline. A faster eGFR decline was associated with higher probability of kidney failure., Conclusions Kidney survival is significantly higher in patients with a chronicity score <4 and proteinuria <3.5 g/d regardless of baseline eGFR, and a faster rate of decline in eGFR is associated with higher probability of kidney failure.
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- 2023
3. Clinical profiles and patterns of kidney disease progression in C3 glomerulopathy
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Caravaca-Fontán, Fernando, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Rivas, Begoña, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Instituto de Salud Carlos III, European Commission, Red de Investigación Renal (España), Comunidad de Madrid, Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Ariceta, Gema, Quintana, Luis F., Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Fernández-Juárez, Gema, Pérez de José, Ana, Pérez Gómez, Vanessa, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rivas, Begoña, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, Martín-Penagos, L., Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, and Praga, Manuel
- Abstract
14 p.-4 fig.-3 tab., Background C3 glomerulopathy is a rare kidney disease, which makes it difficult to collect large cohorts of patients to better understand its variability. The aims of this study were to describe the clinical profiles and patterns of progression of kidney disease., Methods This was a retrospective, observational cohort study. Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. Study population was divided into clinical profiles by combining the following predictors: eGFR under/above 30 ml/min per 1.73 m2, proteinuria under/above 3.5 g/d, and histologic chronicity score under/above 4. The change in eGFR and proteinuria over time was evaluated in a subgroup with consecutive measurements of eGFR and proteinuria., Results One hundred and fifteen patients with a median age of 30 years (interquartile range 19–50) were included. Patients were divided into eight clinical profiles. Kidney survival was significantly higher in patients with a chronicity score, Conclusions Kidney survival is significantly higher in patients with a chronicity score, Work in this study was supported by the Instituto de Salud Carlos III/Fondo Europeo de Desarrollo Regional (ISCIII/FEDER) grant PI16/01685 and PI19/1624, and Red de Investigación Renal (RedInRen) (RD12/0021/0029) (to MP), the Autonomous Region of Madrid (S2017/BMD-3673) (to MP). SRdeC is supported by Ministerio de Economia y Competitividad grant PID2019-104912RB-I00 y Autonomous Region of Madrid grant S2017/BMD-3673.
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- 2023
4. Segmentation of Nanocolumnar Crystals from Microscopic Images
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Frau, David Cuesta, Hernández-Fenollosa, María Ángeles, Tormos, Pau Micó, Linares-Pellicer, Jordi, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Dough, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Kamel, Mohamed, editor, and Campilho, Aurélio, editor
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- 2005
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5. Development and validation of a nomogram to predict kidney survival at baseline in patients with C3 glomerulopathy
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Instituto de Salud Carlos III, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Cavero, Teresa [0000-0001-5187-9906], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Allende, Natalia [0000-0001-9857-793X], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], Mon, Carmen [0000-0001-9081-8428], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Rivero, Marta, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Instituto de Salud Carlos III, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Cavero, Teresa [0000-0001-5187-9906], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Allende, Natalia [0000-0001-9857-793X], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], Mon, Carmen [0000-0001-9081-8428], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Rivero, Marta, Cavero, Teresa, Díaz-Encarnación, Montserrat M., Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, and Praga, Manuel
- Abstract
Background: C3 glomerulopathy is a rare and heterogeneous complement-driven disease. It is often challenging to accurately predict in clinical practice the individual kidney prognosis at baseline. We herein sought to develop and validate a prognostic nomogram to predict long-term kidney survival., Methods: We conducted a retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. The dataset was randomly divided into a training group (n = 87) and a validation group (n = 28). The least absolute shrinkage and selection operator (LASSO) regression was used to screen the main predictors of kidney outcome and to build the nomogram. The accuracy of the nomogram was assessed by discrimination and risk calibration in the training and validation sets., Results: The study group comprised 115 patients, of whom 46 (40%) reached kidney failure in a median follow-up of 49 months (range 24–112). No significant differences were observed in baseline estimated glomerular filtration rate (eGFR), proteinuria or total chronicity score of kidney biopsies, between patients in the training versus those in the validation set. The selected variables by LASSO were eGFR, proteinuria and total chronicity score. Based on a Cox model, a nomogram was developed for the prediction of kidney survival at 1, 2, 5 and 10 years from diagnosis. The C-index of the nomogram was 0.860 (95% confidence interval 0.834–0.887) and calibration plots showed optimal agreement between predicted and observed outcomes., Conclusions: We constructed and validated a practical nomogram with good discrimination and calibration to predict the risk of kidney failure in C3 glomerulopathy patients at 1, 2, 5 and 10 years.
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- 2022
6. Development and validation of a nomogram to predict kidney survival at baseline in patients with C3 glomerulopathy
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Caravaca-Fontán, Fernando, primary, Rivero, Marta, additional, Cavero, Teresa, additional, Díaz-Encarnación, Montserrat, additional, Cabello, Virginia, additional, Ariceta, Gema, additional, Quintana, Luis F, additional, Marco, Helena, additional, Barros, Xoana, additional, Ramos, Natalia, additional, Rodríguez-Mendiola, Nuria, additional, Cruz, Sonia, additional, Fernández-Juárez, Gema, additional, Rodríguez, Adela, additional, Pérez de José, Ana, additional, Rabasco, Cristina, additional, Rodado, Raquel, additional, Fernández, Loreto, additional, Pérez-Gómez, Vanessa, additional, Ávila, Ana, additional, Bravo, Luis, additional, Espinosa, Natalia, additional, Allende, Natalia, additional, Sanchez de la Nieta, Maria Dolores, additional, Rodríguez, Eva, additional, Olea, Teresa, additional, Melgosa, Marta, additional, Huerta, Ana, additional, Miquel, Rosa, additional, Mon, Carmen, additional, Fraga, Gloria, additional, de Lorenzo, Alberto, additional, Draibe, Juliana, additional, González, Fayna, additional, Shabaka, Amir, additional, López-Rubio, Maria Esperanza, additional, Fenollosa, María Ángeles, additional, Martín-Penagos, Luis, additional, Da Silva, Iara, additional, Alonso Titos, Juana, additional, Rodríguez de Córdoba, Santiago, additional, Goicoechea de Jorge, Elena, additional, and Praga, Manuel, additional
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- 2022
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- View/download PDF
7. Longitudinal change in proteinuria and kidney outcomes in C3 glomerulopathy
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Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Cabello, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, Cano-Megías, Marta, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Spanish Group for the Study of Glomerular Diseases (GLOSEN), Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Cabello, Virginia [0000-0002-0877-5498], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Cabello, Virginia, Ariceta, Gema, Quintana, Luis F., Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Fernández-Juárez, Gema, Pérez de José, Ana, Pérez Gómez, Vanessa, Sánchez de la Nieta, María Dolores, Olea, Teresa, Melgosa, Marta, Huerta, Ana, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, Martín-Penagos, L., Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, and Praga, Manuel
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Nephrology ,Adult ,medicine.medical_specialty ,Adolescent ,Glomerulonephritis, Membranoproliferative ,030232 urology & nephrology ,Kidney failure ,030204 cardiovascular system & hematology ,Lower risk ,Kidney ,03 medical and health sciences ,Joint models ,Young Adult ,0302 clinical medicine ,Glomerulonephritis ,Glomerulopathy ,Internal medicine ,medicine ,Humans ,C3 glomerulopathy ,Retrospective Studies ,Transplantation ,Proteinuria ,business.industry ,Proportional hazards model ,urogenital system ,Complement C3 ,medicine.disease ,medicine.anatomical_structure ,Kidney Failure, Chronic ,medicine.symptom ,business ,Cohort study - Abstract
11 p.-4 fig.-4 tab., Introduction: The association between a change in proteinuria over time and its impact in kidney prognosis has not been analyzed in C3 glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure., Methods: Retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modeling of linear mixed-effects models was applied to assess the underlying trajectory of a repeatedly measured proteinuria, and a Cox model to evaluate the association of this trajectory with the risk of kidney failure., Results: The study group consisted of 85 patients, 70 C3 glomerulonephritis and 15 dense deposit disease, with a median age of 26 years (range 13-41). During a median follow-up of 42 months, 25 patients reached kidney failure. The longitudinal change in proteinuria showed a strong association with the risk of this outcome, with a doubling of proteinuria levels resulting in a 2.5-fold increase of the risk. A second model showed that a ≥ 50% proteinuria reduction over time was significantly associated with a lower risk of kidney failure (HR: 0.79; 95% CI : 0.56-0.97; p < 0.001). This association was also found when the ≥50% proteinuria reduction was observed within the first 6 and 12 months of follow-up., Conclusion: The longitudinal change in proteinuria is strongly associated with the risk of kidney failure. The change in proteinuria over time can provide clinicians a dynamic prediction of kidney outcomes., This study was supported by the Instituto de Salud Carlos III/Fondo Europeo de Desarrollo Regional (ISCIII/FEDER) grant PI16/01685 and PI19/1624, and Red de Investigación Renal (RedInRen) (RD12/0021/0029) (to M.P.), the Autonomous Region of Madrid (S2017/BMD-3673) (to M.P.); E.G.d.J. was supported by the Spanish ‘Ministerio de Ciencia, Innovación y Universidades’ (RYC-2013-13395 and RTI2018-095955-B-100); S.R.d.C. was supported by Ministerio de Economía y Competitividad/FEDER grant SAF2015-66287R and Autonomous Region of Madrid grant S2017/BMD3673.
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- 2021
8. Longitudinal change in proteinuria and kidney outcomes in C3 glomerulopathy
- Author
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Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Cabello, Virginia [0000-0002-0877-5498], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Cabello, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, Cano-Megías, Marta, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Spanish Group for the Study of Glomerular Diseases (GLOSEN), Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Cabello, Virginia [0000-0002-0877-5498], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071], Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Cabello, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Espinosa, Natalia, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Draibe, Juliana, Cano-Megías, Marta, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, and Spanish Group for the Study of Glomerular Diseases (GLOSEN)
- Abstract
Introduction: The association between a change in proteinuria over time and its impact in kidney prognosis has not been analyzed in C3 glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure., Methods: Retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modeling of linear mixed-effects models was applied to assess the underlying trajectory of a repeatedly measured proteinuria, and a Cox model to evaluate the association of this trajectory with the risk of kidney failure., Results: The study group consisted of 85 patients, 70 C3 glomerulonephritis and 15 dense deposit disease, with a median age of 26 years (range 13-41). During a median follow-up of 42 months, 25 patients reached kidney failure. The longitudinal change in proteinuria showed a strong association with the risk of this outcome, with a doubling of proteinuria levels resulting in a 2.5-fold increase of the risk. A second model showed that a ≥ 50% proteinuria reduction over time was significantly associated with a lower risk of kidney failure (HR: 0.79; 95% CI : 0.56-0.97; p < 0.001). This association was also found when the ≥50% proteinuria reduction was observed within the first 6 and 12 months of follow-up., Conclusion: The longitudinal change in proteinuria is strongly associated with the risk of kidney failure. The change in proteinuria over time can provide clinicians a dynamic prediction of kidney outcomes.
- Published
- 2021
9. Gain-of-function mutations R249C and S250C in complement C2 protein increase C3 deposition in the presence of C-reactive protein
- Author
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National Science Centre (Poland), Ministerio de Economía y Competitividad (España), European Commission, Comunidad de Madrid, Urban, Aleksandra [0000-0002-7299-4935], Kowalska, Daria [0000-0002-2427-8221], Stasiłojć, Grzegorz [0000-0002-4158-1935], Kuźniewska, Alicja [0000-0002-8055-1835], Arjona, Emilia [0000-0002-0753-3657], Jongerius, Ilse [0000-0002-7759-9897], Spaapen, Robbert [0000-0002-1329-8606], Satchell, Simon [0000-0001-5276-4537], Thiel, Marcel [0000-0002-6403-9436], Oldziej, Stanislaw [0000-0002-4583-3941], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Okrój, Marcin [0000-0003-2935-2301], Urban, Aleksandra, Kowalska, Daria, Stasiłojć, Grzegorz, Kuźniewska, Alicja, Skrobi´nska, Anna, Arjona, Emilia, Castellote Alonso, Eugenia, Fenollosa, María Ángeles, Jongerius, Ilse, Spaapen, Robbert, Satchell, Simon, Thiel, Marcel, Oldziej, Stanislaw, Rodríguez de Córdoba, Santiago, Okrój, Marcin, National Science Centre (Poland), Ministerio de Economía y Competitividad (España), European Commission, Comunidad de Madrid, Urban, Aleksandra [0000-0002-7299-4935], Kowalska, Daria [0000-0002-2427-8221], Stasiłojć, Grzegorz [0000-0002-4158-1935], Kuźniewska, Alicja [0000-0002-8055-1835], Arjona, Emilia [0000-0002-0753-3657], Jongerius, Ilse [0000-0002-7759-9897], Spaapen, Robbert [0000-0002-1329-8606], Satchell, Simon [0000-0001-5276-4537], Thiel, Marcel [0000-0002-6403-9436], Oldziej, Stanislaw [0000-0002-4583-3941], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Okrój, Marcin [0000-0003-2935-2301], Urban, Aleksandra, Kowalska, Daria, Stasiłojć, Grzegorz, Kuźniewska, Alicja, Skrobi´nska, Anna, Arjona, Emilia, Castellote Alonso, Eugenia, Fenollosa, María Ángeles, Jongerius, Ilse, Spaapen, Robbert, Satchell, Simon, Thiel, Marcel, Oldziej, Stanislaw, Rodríguez de Córdoba, Santiago, and Okrój, Marcin
- Abstract
The impairment of the alternative complement pathway contributes to rare kidney diseases such as atypical hemolytic uremic syndrome (aHUS) and C3 glomerulopathy (C3G). We recently described an aHUS patient carrying an exceptional gain-of-function (GoF) mutation (S250C) in the classical complement pathway component C2 leading to the formation of hyperactive classical convertases. We now report the identification of the same mutation and another C2 GoF mutation R249C in two other patients with a glomerulopathy of uncertain etiology. Both mutations stabilize the classical C3 convertases by a similar mechanism. The presence of R249C and S250C variants in serum increases complement-dependent cytotoxicity (CDC) in antibody-sensitized human cells and elevates deposition of C3 on ELISA plates coated with C-reactive protein (CRP), as well as on the surface of glomerular endothelial cells. Our data justify the inclusion of classical pathway genes in the genetic analysis of patients suspected of complement-driven renal disorders. Also, we point out CRP as a potential antibody-independent trigger capable of driving excessive complement activation in carriers of the GoF mutations in complement C2.
- Published
- 2021
10. New low-temperature preparation method of the TiO 2 porous photoelectrode for dye-sensitized solar cells using UV irradiation
- Author
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Gutiérrez-Tauste, David, Zumeta, Inti, Vigil, Elena, Hernández-Fenollosa, Maria Angeles, Domènech, Xavier, and Ayllón, José A.
- Published
- 2005
- Full Text
- View/download PDF
11. Mycophenolate Mofetil in C3 glomerulopathy and pathogenic drivers of the disease
- Author
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Instituto de Salud Carlos III, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Lucientes, Laura [0000-0001-5596-370X], Cavero, Teresa [0000-0001-5187-9906], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Lumbreras, Javier [0000-0003-1855-0724], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Praga, Manuel [0000-0001-9270-1071], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Lucientes, Laura, Cavero, Teresa, Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Lumbreras, Javier, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Cano-Megías, Marta, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, Praga, Manuel, Instituto de Salud Carlos III, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Ministerio de Economía y Competitividad (España), Caravaca-Fontán, Fernando [0000-0002-5830-9663], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Lucientes, Laura [0000-0001-5596-370X], Cavero, Teresa [0000-0001-5187-9906], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Lumbreras, Javier [0000-0003-1855-0724], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Martín-Penagos, L. [0000-0003-0159-7358], Rodríguez de Córdoba, Santiago [0000-0001-6401-1874], Praga, Manuel [0000-0001-9270-1071], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Caravaca-Fontán, Fernando, Díaz-Encarnación, Montserrat M., Lucientes, Laura, Cavero, Teresa, Cabello-Chaves, Virginia, Ariceta, Gema, Quintana, Luis F., Marco, Helena, Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Cruz, Sonia, Fernández-Juárez, Gema, Rodríguez, Adela, Pérez de José, Ana, Rabasco, Cristina, Rodado, Raquel, Fernández, Loreto, Pérez Gómez, Vanessa, Ávila, Ana, Bravo, Luis, Lumbreras, Javier, Allende, Natalia, Sánchez de la Nieta, María Dolores, Rodríguez, Eva, Olea, Teresa, Melgosa, Marta, Huerta, Ana, Miquel, Rosa, Mon, Carmen, Fraga, Gloria, de Lorenzo, Alberto, Cano-Megías, Marta, González, Fayna, Shabaka, Amir, López-Rubio, María Esperanza, Fenollosa, María Ángeles, Martín-Penagos, L., Da Silva, Iara, Alonso Titos, Juana, Rodríguez de Córdoba, Santiago, Goicoechea de Jorge, Elena, and Praga, Manuel
- Abstract
BACKGROUND AND OBJECTIVES: C3 glomerulopathy is a complement-mediated disease arising from abnormalities in complement genes and/or antibodies against complement components. Previous studies showed that treatment with corticosteroids plus mycophenolate mofetil (MMF) was associated with improved outcomes, although the genetic profile of these patients was not systematically analyzed. This study aims to analyze the main determinants of disease progression and response to this therapeutic regimen., DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective, multicenter, observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy (n=81) or dense deposit disease (n=16) between January 1995 and March 2018 were enrolled. Multivariable and propensity score matching analyses were used to evaluate the association of clinical and genetic factors with response to treatment with corticosteroids and MMF as measured by proportion of patients with disease remission and kidney survival (status free of kidney failure)., RESULTS: The study group comprised 97 patients (84% C3 glomerulopathy, 16% dense deposit disease). Forty-two patients were treated with corticosteroids plus MMF, and this treatment was associated with a higher rate of remission and lower probability of kidney failure (79% and 14%, respectively) compared with patients treated with other immunosuppressives (24% and 59%, respectively), or ecluzimab (33% and 67%, respectively), or conservative management (18% and 65%, respectively). The therapeutic superiority of corticosteroids plus MMF was observed both in patients with complement abnormalities and with autoantibodies. However, patients with pathogenic variants in complement genes only achieved partial remission, whereas complete remissions were common among patients with autoantibody-mediated forms. The main determinant of no remission was baseline proteinuria. Relapses occurred after treatment discontinuation in 33% of the patients who had achieved remission with corticosteroids plus MMF, and a longer treatment length of MMF was associated with a lower risk of relapse., CONCLUSIONS: The beneficial response to corticosteroids plus MMF treatment in C3 glomerulopathy appears independent of the pathogenic drivers analyzed in this study.
- Published
- 2020
12. Segmentation of Nanocolumnar Crystals from Microscopic Images.
- Author
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Kamel, Mohamed, Campilho, Aurélio, Frau, David Cuesta, Hernández-Fenollosa, María Ángeles, Tormos, Pau Micó, and Linares-Pellicer, Jordi
- Abstract
This paper addresses the segmentation of crystalline Zinc oxide nanocolumns from microscopic images. ZnO is a direct band semiconductor suitable for many applications whose interest has been growing recently. One of these applications are light-collecting devices such as solar cells, using nanostructured substrates. Electrodeposition is a low cost technique very suitable for the preparation of nanostructured ZnO, producing nanocolumnar ZnO crystals with a morphology that depends on the deposition parameters and the substrate characteristics. The parameters of the sample can be determined processing images of the nanostructures, which is the objective of this study. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
13. Clinical Profiles and Patterns of Kidney Disease Progression in C3 Glomerulopathy.
- Author
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Caravaca-Fontán F, Cavero T, Díaz-Encarnación M, Cabello V, Ariceta G, Quintana LF, Marco H, Barros X, Ramos N, Rodríguez-Mendiola N, Cruz S, Fernández-Juárez G, Rodríguez A, Pérez de José A, Rabasco C, Rodado R, Fernández L, Pérez-Gómez V, Ávila A, Bravo L, Espinosa N, Allende N, Sanchez de la Nieta MD, Rodríguez E, Rivas B, Melgosa M, Huerta A, Miquel R, Mon C, Fraga G, de Lorenzo A, Draibe J, González F, Shabaka A, López-Rubio ME, Fenollosa MÁ, Martín-Penagos L, Da Silva I, Titos JA, Rodríguez de Córdoba S, Goicoechea de Jorge E, and Praga M
- Subjects
- Humans, Disease Progression, Kidney, Kidney Diseases
- Published
- 2023
- Full Text
- View/download PDF
14. Longitudinal change in proteinuria and kidney outcomes in C3 glomerulopathy.
- Author
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Caravaca-Fontán F, Díaz-Encarnación M, Cabello V, Ariceta G, Quintana LF, Marco H, Barros X, Ramos N, Rodríguez-Mendiola N, Cruz S, Fernández-Juárez G, Rodríguez A, Pérez de José A, Rabasco C, Rodado R, Fernández L, Pérez Gómez V, Ávila A, Bravo L, Espinosa N, Allende N, Sanchez de la Nieta MD, Rodríguez E, Olea T, Melgosa M, Huerta A, Miquel R, Mon C, Fraga G, de Lorenzo A, Draibe J, Cano-Megías M, González F, Shabaka A, López-Rubio ME, Fenollosa MÁ, Martín-Penagos L, Da Silva I, Alonso Titos J, Rodríguez de Córdoba S, Goicoechea de Jorge E, and Praga M
- Subjects
- Adolescent, Adult, Complement C3 analysis, Humans, Kidney, Proteinuria complications, Proteinuria etiology, Retrospective Studies, Young Adult, Glomerulonephritis complications, Glomerulonephritis epidemiology, Glomerulonephritis, Membranoproliferative, Kidney Failure, Chronic complications
- Abstract
Introduction: The association between a change in proteinuria over time and its impact on kidney prognosis has not been analysed in complement component 3 (C3) glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure., Methods: This was a retrospective, multicentre observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modelling of linear mixed-effects models was applied to assess the underlying trajectory of a repeatedly measured proteinuria, and a Cox model to evaluate the association of this trajectory with the risk of kidney failure., Results: The study group consisted of 85 patients, 70 C3 glomerulonephritis and 15 dense deposit disease, with a median age of 26 years (range 13-41). During a median follow-up of 42 months, 25 patients reached kidney failure. The longitudinal change in proteinuria showed a strong association with the risk of this outcome, with a doubling of proteinuria levels resulting in a 2.5-fold increase of the risk. A second model showed that a ≥50% proteinuria reduction over time was significantly associated with a lower risk of kidney failure (hazard ratio 0.79; 95% confidence interval 0.56-0.97; P < 0.001). This association was also found when the ≥50% proteinuria reduction was observed within the first 6 and 12 months of follow-up., Conclusions: The longitudinal change in proteinuria is strongly associated with the risk of kidney failure. The change in proteinuria over time can provide clinicians a dynamic prediction of kidney outcomes., (© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.)
- Published
- 2022
- Full Text
- View/download PDF
15. Mycophenolate Mofetil in C3 Glomerulopathy and Pathogenic Drivers of the Disease.
- Author
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Caravaca-Fontán F, Díaz-Encarnación MM, Lucientes L, Cavero T, Cabello V, Ariceta G, Quintana LF, Marco H, Barros X, Ramos N, Rodríguez-Mendiola N, Cruz S, Fernández-Juárez G, Rodríguez A, Pérez de José A, Rabasco C, Rodado R, Fernández L, Pérez Gómez V, Ávila AI, Bravo L, Lumbreras J, Allende N, Sanchez de la Nieta MD, Rodríguez E, Olea T, Melgosa M, Huerta A, Miquel R, Mon C, Fraga G, de Lorenzo A, Draibe J, Cano-Megías M, González F, Shabaka A, López-Rubio ME, Fenollosa MÁ, Martín-Penagos L, Da Silva I, Alonso Titos J, Rodríguez de Córdoba S, Goicoechea de Jorge E, and Praga M
- Subjects
- Adolescent, Adrenal Cortex Hormones therapeutic use, Adult, Child, Disease Progression, Drug Therapy, Combination, Female, Glomerulonephritis diagnosis, Glomerulonephritis immunology, Humans, Immunosuppressive Agents adverse effects, Male, Middle Aged, Mycophenolic Acid adverse effects, Recurrence, Remission Induction, Retrospective Studies, Risk Factors, Spain, Time Factors, Treatment Outcome, Young Adult, Complement C3 analysis, Glomerulonephritis drug therapy, Immunosuppressive Agents therapeutic use, Mycophenolic Acid therapeutic use
- Abstract
Background and Objectives: C3 glomerulopathy is a complement-mediated disease arising from abnormalities in complement genes and/or antibodies against complement components. Previous studies showed that treatment with corticosteroids plus mycophenolate mofetil (MMF) was associated with improved outcomes, although the genetic profile of these patients was not systematically analyzed. This study aims to analyze the main determinants of disease progression and response to this therapeutic regimen., Design, Setting, Participants, & Measurements: We conducted a retrospective, multicenter, observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy ( n =81) or dense deposit disease ( n =16) between January 1995 and March 2018 were enrolled. Multivariable and propensity score matching analyses were used to evaluate the association of clinical and genetic factors with response to treatment with corticosteroids and MMF as measured by proportion of patients with disease remission and kidney survival (status free of kidney failure)., Results: The study group comprised 97 patients (84% C3 glomerulopathy, 16% dense deposit disease). Forty-two patients were treated with corticosteroids plus MMF, and this treatment was associated with a higher rate of remission and lower probability of kidney failure (79% and 14%, respectively) compared with patients treated with other immunosuppressives (24% and 59%, respectively), or ecluzimab (33% and 67%, respectively), or conservative management (18% and 65%, respectively). The therapeutic superiority of corticosteroids plus MMF was observed both in patients with complement abnormalities and with autoantibodies. However, patients with pathogenic variants in complement genes only achieved partial remission, whereas complete remissions were common among patients with autoantibody-mediated forms. The main determinant of no remission was baseline proteinuria. Relapses occurred after treatment discontinuation in 33% of the patients who had achieved remission with corticosteroids plus MMF, and a longer treatment length of MMF was associated with a lower risk of relapse., Conclusions: The beneficial response to corticosteroids plus MMF treatment in C3 glomerulopathy appears independent of the pathogenic drivers analyzed in this study., (Copyright © 2020 by the American Society of Nephrology.)
- Published
- 2020
- Full Text
- View/download PDF
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