Javier Nieto

Servicio de Salud de Castilla-La Mancha. Ciudad Real · Hospital General Universitario. Department of Nephrology

BACKGROUND An unmet need exists for focal segmental glomerulosclerosis (FSGS) treatment. In an 8-week, phase 2 trial, sparsentan, a dual endothelin–angiotensin receptor antagonist, reduced proteinuria in patients with FSGS. The efficacy and safety of longerterm treatment with sparsentan for FSGS are unknown. METHODS In this phase 3 trial, we enroll...

Objetivo: Se ha postulado que el uso de inhibidores del enzima de conversión de angiotensina (IECA) o de antagonistas de sus receptores AT1 (ARA) podrían favorecer la infección por SARSCov-2 al incrementar la expresión del enzima convertidor de angiotensina 2 (ECA2), sobre todo a nivel pulmonar. Por otra parte, el descenso en el efecto de angiotens...

Objetivo: La asociación de comorbilidades como la hipertensión arterial (HTA), la diabetes, la dislipidemia, la cardiopatía isquémica, la fibrilación auricular, el ictus o la enfermedad renal crónica (ERC) empeoran el pronóstico de sujetos infectados por el SARS-Cov-2. Los pacientes hipertensos tienen más riesgo de sufrir disfunción renal, ya sea p...

Background: Comorbidities such as hypertension (HTN) or chronic kidney disease (CKD) may worsen the prognosis of subjects infected by SARS-Cov-2 and hypertensives are at greater risk of suffering renal dysfunction. The purpose of this study is to assess the effect of CKD on the progression of COVID-19 in hypertensive patients. Methods: Multicenter,...

Background Chronic kidney disease (CKD) is associated with increased atherosclerotic burden and higher risk for cardiovascular events (CVE). Atherosclerosis has a significant genetic component and, in CKD, it is influenced by mineral metabolism alterations. Therefore, genetic modifications of mineral metabolism-related proteins could affect atheros...

Background Hyperkalemia is common among patients with chronic kidney disease (CKD) but there is scarce information on differential risk factors and outcomes for men and women. For instance, smoking has been suggested to be a risk factor for hyperkalemia, but specific analysis of the sex-specific impact of smoking on hyperkalemia in CKD are lacking....

Objective An increase in angiotensin-converting enzyme (ACE) type 2 levels would stimulate the infection by SARS-Cov-2. On the other hand, the inhibition of the effect of angiotensin II could decrease the inflammatory and oxidative response related to the severity of the disease. Our purpose is to assess the effect of renin-angiotensin inhibitors (...

Introducción: DAPA-CKD(NEJM,2021) ha demostrado que los i-SGLT2 (dapagliflozina), tienen un efecto nefroprotector adicional a los iSRAA e independiente de su papel como antidiabéticos. La ficha técnica ha cambiado. De no estar indicados con FG < 60ml/min(2014) a estarlo desde FGe>25ml/min(2021) porque reducen mortalidad y retrasan progresión de la ER...

Purpose To assess the relationship between particulate matter 2.5 (PM2.5) levels and the prevalence of excess weight in a representative sample of Spanish young people aged 2─14 years. Methods This was an ecological cross-sectional study using data from the 2017 wave of the Spanish National Health Survey (SNHS), a nationally representative survey...

Objective: Decision-making in the management of the COVID-19 pandemic has raised questions related to the disease progression in hypertensive patients according to their BP control and the presence of comorbidities or target organ involvement. It has been reported that HTN can worse the outcomes of patients infected by COVID-19. The aim of this stu...

Background and objectives The effect of including race in the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation on screening, recruitment, and outcomes of clinical trials is unclear. Design, setting, participants, & measurements The inclusion and outcomes of participants in the Canagliflozin and Renal Events in Diabetes with Es...

Background Novel ways of determining cardiovascular risk are needed as a consequence of population ageing and the increased prevalence of chronic kidney disease (CKD), both of which favour vascular calcification. Since the formation of arterial calcium deposits has a genetic component, single nucleotide polymorphisms (SNPs) could predict cardiovasc...

BACKGROUND Daprodustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor. In patients with chronic kidney disease (CKD) who are not undergoing dialysis, the efficacy and safety of daprodustat, as compared with the conventional erythropoiesis-stimulating agent darbepoetin alfa, are unknown. METHODS In this randomized, open-label, phas...

Background Verinurad is a human uric acid transporter (URAT1) inhibitor known to decrease serum uric acid (sUA) levels and may reduce albuminuria. In a Phase 2a study (NCT03118739), treatment with verinurad + febuxostat lowered urine albumin-to-creatinine ratio (UACR) at 12 weeks by 39% (90% confidence interval: 4%, 62%) among patients with type 2...

Background Patients with peripheral artery disease (PAD) undergoing lower extremity revascularization (LER) are at high risk of major adverse limb and cardiovascular events. VOYAGER PAD demonstrated that rivaroxaban 2.5 mg twice daily reduced first events by 15%. The benefit of rivaroxaban on total (first and subsequent) events in this population i...

Background Chronic kidney disease (CKD) patients have a high burden of atheromatous cardiovascular disease (ASCVD) not fully explained by traditional lipid parameters. Lipoprotein composition and subclass particle number information could improve ASCVD risk assessment. The objective of this study is to investigate the association of advanced lipopr...

Background: Canagliflozin reduces the incidence of kidney and cardiovascular events in people with type 2 diabetes and chronic kidney disease (CKD). We assessed the effects of canagliflozin according to age and sex in a randomized, placebo-controlled trial. Methods: The CREDENCE study randomized participants with type 2 diabetes and albuminuric CKD...

Free access through the website of the Spanish Society of Nephrology Acceso libre através de la página web de la Sociedad Española de Nefrología senefro.org URL: www.nefrologiaaldia.org/es

Background and Purpose Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Ev...

Background Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most incl...

Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stres...

Classical risk factors of atherosclerosis in the general population show paradoxical effects in chronic kidney disease (CKD) patients. Thus, low low-density lipoprotein (LDL) cholesterol levels have been associated with worse cardiovascular outcomes. Magnesium (Mg) is a divalent cation whose homeostasis is altered in CKD. Furthermore, Mg levels hav...

Purpose The Hypertension Optimal Treatment (HOT) Study investigated the relationship between target office diastolic blood pressure (BP) ≤80, ≤85 or ≤90 mmHg and cardiovascular morbidity and mortality in 18,790 patients aged 50–80 years. The home BP sub-study enrolled 926 patients and the aim was to clarify whether the separation into the BP target...

Background Canagliflozin reduced renal and cardiovascular events in people with type 2 diabetes in the CREDENCE trial. We assessed efficacy and safety of canagliflozin by initial estimated glomerular filtration rate (eGFR). Methods CREDENCE randomly assigned 4401 participants with an eGFR of 30 to <90 ml/min per 1.73 m2 and substantial albuminuria...

Background: The obesity is accompanied by many comorbidities, it could be deduced that obese patients on hemodialysis (HD) follow the same pattern and therefore would be more prone to present cardiovascular complications. However, this hypothesis has not been proven yet. In fact, several studies have observed an inverse relationship between the Bod...

BACKGROUND The angiotensin receptor–neprilysin inhibitor sacubitril–valsartan led to a reduced risk of hospitalization for heart failure or death from cardiovascular causes among patients with heart failure and reduced ejection fraction. The effect of angiotensin receptor–neprilysin inhibition in patients with heart failure with preserved ejection...

Objectives This study sought to describe baseline health-related quality of life (HRQL) in the PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HFpEF) trial, the largest heart failure with preserved ejection fraction (HFpEF) trial to date. Background There are limited data characterizing HRQL in patients with HFpEF using valid...

Background: Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure (HF) and cardiovascular death overall, in those with and without a baseline history of HF, and in other participant subgroups. Methods: The CANVAS Program (Canagliflozin Cardiovascular Assess...

Background Chronic kidney disease (CKD) patients show an increased burden of atherosclerosis and high risk of cardiovascular events (CVEs). There are several biomarkers described as being associated with CVEs, but their combined effectiveness in cardiovascular risk stratification in CKD has not been tested. The objective of this work is to analyse...

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With...

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Background Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. Methods In this...

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to...

Background. Prevalence of atherosclerotic cardiovascular disease and its rate of progression are higher in patients with chronic kidney disease (CKD) compared withthe general population. Mineral metabolism parameters have been shown to be involved in the increased velocity of atheromatosis progression. The aim of this study is to determine the role...

Background and objectives Atherosclerosis is highly prevalent in CKD. The rate of progression of atherosclerosis is associated with cardiovascular events. Fibroblast growth factor 2 (FGF-2) is a member of the FGF family with potentially both protective and deleterious effects in the development of atherosclerosis. The role of circulating FGF-2 leve...

Background and aims Vascular calcification (VC) and atherosclerosis are associated with an increased cardiovascular morbimortality in chronic kidney disease (CKD). Osteoprotegerin (OPG) and osteopontin (OPN) are involved in both VC and CKD. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) has been related to cardiovascular dise...

Background: People with diabetes and kidney disease have a high risk of cardiovascular events and progression of kidney disease. Sodium glucose co-transporter 2 inhibitors lower plasma glucose by reducing the uptake of filtered glucose in the kidney tubule, leading to increased urinary glucose excretion. They have been repeatedly shown to induce m...

BACKGROUND In a previous trial involving patients with early autosomal dominant polycystic kidney disease (ADPKD; estimated creatinine clearance, ≥60 ml per minute), the vasopressin V2-receptor antagonist tolvaptan slowed the growth in total kidney volume and the decline in the estimated glomerular filtration rate (GFR) but also caused more elevat...

Background There is limited and inconclusive information regarding the influence of the modality of renal replacement therapy on the atherosclerotic burden of patients on dialysis. The aim of this study was to compare the prevalence of asymptomatic atheromatous carotid disease, as also its rate of progression and cardiovascular outcomes, in two mat...

Introducción: Las guías de práctica clínica recomiendan una fístula arteriovenosa (FAVI) como el acceso vascular preferido para hemodiálisis. Las FAVIs autólogas son más duraderas y se asocian a menor morbimortalidad en comparación con las FAVIs protésicas. Sin embargo el fallo primario del acceso vascular (AV) no es infrecuente, sobretodo debido a...

Patients with chronic kidney disease (CKD) have an increased incidence of cardiovascular events (CVE). The contribution of subclinical atheromatosis extent, including femoral arteries, to CVE in CKD patients has not been investigated. In this paper, we examine the prognostic value of subclinical atheromatosis extent, assessed as the number of arter...

BACKGROUND Canagliflozin is a sodium–glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. METHODS The CANVAS Program integrated data from two trials involving a tota...

BACKGROUND The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes i...

Background: The prevalence of subclinical atherosclerosis and the main predictors of progression of this condition in patients undergoing peritoneal dialysis (PD) have been insufficiently investigated. Objectives and Method: Following a prospective, multicenter, observational design, we studied 237 patients who were treated with PD for ≥3 months, w...

Background: In TEMPO 3:4, the vasopressin V2-receptor antagonist tolvaptan slowed kidney growth and function decline in autosomal dominant polycystic kidney disease (ADPKD) patients with relatively preserved kidney function. Methods: Prospective, phase 3b, multi-center, randomized-withdrawal, placebo-controlled, double-blind trial of tolvaptan in A...

Aims The primary aim of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R) is to determine whether the favourable effects of inhibition of the sodium glucose co-transporter 2 (SGLT2) on blood glucose, blood pressure and body weight are accompanied by protection against adverse renal outcomes. Materials and methods CANVAS-R is a pros...

Aims The primary aim of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R) is to determine whether the favourable effects of inhibition of the sodium glucose co-transporter 2 (SGLT2) on blood glucose, blood pressure and body weight are accompanied by protection against adverse renal outcomes. Materials and methods CANVAS-R is a pros...

Introducción: El complejo de la sclerosis tuberosa (CET) es una enfermedad genética causada por mutaciones que activan la via mTOR y llevan al crecimiento de tumores como angiomiolipomas (AML) renales. Sirolimus, un inhibidor de mTOR, ha demostrado ser una alternativa al tratamiento quirúrgico de los AML. Se ha evaluado el efecto de everolimus en u...

Background Renal angiomyolipomas (AML) are usual manifestations of tuberous sclerosis complex (TSC) that may cause aneurism-related haemorrhages and renal impairment. Everolimus has emerged as an alternative to surgery/embolization. We provide further insight into everolimus safety and efficacy for TSC-related AML. Methods This was a Spanish expand...

Aim: To evaluate thresholds for serum 25(OH)D concentrations in relation to death, kidney progression and hospitalization in non-dialysis chronic kidney disease (CKD) population. Methods: Four hundred and seventy non-dialysis 3-5 stage CKD patients participating in OSERCE-2 study, a prospective, multicenter, cohort study, were prospectively eval...

Introducción: La hipertensión renovascular (HRV) debida a la estenosis de la arteria renal del injerto (EARI) es una causa conocida de HTA y disfunción del injerto con una prevalencia variable (1%- 20%)1. La ausencia de EARI con datos clínicos y hemodinámicos de HRV obliga a descartar la estenosis proximal de la arteria iliaca del injerto (EAI) com...

Introducción: La enfermedad renal crónica (ERC) presenta un perfil dislipémico específico que cambia según el estadio de enfermedad renal. Se desconoce el papel que los lípidos ejercen en el proceso aterogénico en esta población y si podrían acelerar la aparición de eventos cardiovasculares (ECV). El objetivo es analizar la asociación entre el perf...

Background The leading cause of premature death in chronic kidney disease (CKD) is cardiovascular disease (CVD), but risk assessment in renal patients is challenging. The aim of the study was to analyse the factors that predict accelerated progression of common carotid intima-media thickness (CCIMT) in a CKD cohort after 2 years of follow-up (2010–...

Background: The ankle-brachial index (ABI) is widely used to diagnose subclinical peripheral artery disease (PAD) in the general population, but data assessing its prevalence and related factors in different chronic kidney disease (CKD) stages are scarce. The aim of this study is to evaluate the prevalence and associated factors of pathological ABI...

Current therapy directed at delaying the progression of diabetic nephropathy includes intensive glycemic and optimal blood pressure control, renin angiotensin-aldosterone system blockade and multifactorial intervention. However, the renal protection provided by these therapeutic modalities is incomplete. There is a scarcity of studies analysing the...

Background Atheromatous disease (AD) is a risk factor for death in renal patients. Traditional CV risk factors do not predict the presence of AD in this population. The aim of this study is to analyze whether the etiology of the primary renal disease influences in the risk of having silent AD. Study design Observational cross-sectional study in chr...

Introducción: La irrupción de los inhibidores SGLT-2, ha revolucionado el tratamiento oral de la DM2 por su acción independiente de la insulina, que evita el fracaso terapeútico y el riesgo de hipoglucemias. Asociado al efecto diurético like y a una constante pérdida calórica (70-80 gr/día de glucosa)en forma de glucosuria, además de una reducción...

Introduccion: El tratamiento con hemodiálisis (HD) requiere un acceso vascular (AV) desarrollado. Las guias sobre AV recomiendan el uso de fístulas arteriovenosas (FAVi) autólogas ya que son más duraderas y se asocian a menor morbimortalidad en comparación con las FAVi protésicas. Sin embargo el fallo primario de funcionamiento de FAVi no es infrec...

Objetivo: Mientras que la obesidad paradójicamente parece ser protectora en la ERC, se desconoce el impacto pronóstico que tiene la distribución de la grasa en esta población. El objetivo de este estudio fue analizar el valor predictivo del depósito de grasa abdominal en la supervivencia, hospitalización y progresión renal en pacientes con ERC no e...

Introducción: La enfermedad cardiovascular sigue siendo la principal causa de morbimortalidad en los pacientes con enfermedad renal crónica (ERC). Métodos: El estudio NEFRONA reclutó 2445 pacientes en distintos estadios de ERC durante los años 2009 a 2011 para evaluar el valor de la detección de la teromatosis subclínica por ecografía en la predicc...

Introduccion: Las placas de ateroma ricas en lípidos son más vulnerables. La ecografía permite su clasificación según la ecogeneidad: lipídicas (hipoecogénicas), fibrosas (ecogeneidad intermedia) y calcificadas (muy ecogénicas). Se desconoce si la composición influye en la mortalidad cardiovascular (CV) en la enfermedad renal crónica (ERC) (placas...

Objetivo: Desde hace años se conoce la implicación de la vía del TNFalfa en la patogénesis de la nefropatía diabética (ND). Sin embargo hasta ahora no se había podido establecer la relación entre niveles circulantes de esta vía y la progresión de la ND. Recientemente se han publicado diversos estudios que relacionan los niveles circulantes de los r...

Introducción: Se desconocen los factores que influyen en la progresión de enfermedad ateromatosa (EA) en la ERC. En el presente estudio longitudinal analizamos los factores que determinan el incremento acelerado del grosor íntima-media de la carótida común (GIMcc). Pacientes y métodos: Se incluyeron 1152 pacientes con ERC, sin evento cardiovascular...

Introducción: El déficit de vitamina D se asocia a enfermedad ateromatosa (EA) en la población general, se ha descrito en la literatura un mayor déficit en los obesos. Sin embargo, se desconocen los factores que influyen en la progresión de Enfermedad ateromatosa (EA) en la ERC. En el presente estudio longitudinal analizamos los factores que determ...

Background Patients with cardiovascular (CV) disease have an increased circulating angiotensin-converting enzyme 2 (ACE2) activity, but there is little information about changes in ACE2 in chronic kidney disease (CKD) patients without history of CV disease. We examined circulating ACE2 activity in CKD patients at stages 3–5 (CKD3-5) and in dialysis...

Introduction and Aims: There are little data concerning the prevalence of vertebral fractures (VF) , risk factors for fracture and relationship between fractures and mortality in individuals with chronic kidney disease (CKD). To address this knowledge gap we conducted a "post hoc" analysis using data from the OSERCE II study (a 3-year follow-up pro...

Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up...

Background: There are little data concerning the prevalence of vertebral fractures (VF), risk factors for fracture and relationship between fractures and mortality in chronic kidney disease (CKD) patients. To address this knowledge gap we conducted a “post hoc” analysis using data from the OSERCE II study (a 3-year follow-up prospective multicenter...

AIM: This study evaluated the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus (T2DM) and within a subset of Stage 3 chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] ≥ 30 and <50 ml/min/1.73 m(2)). METHODS: In this 52-week, randomized, double-blind,...

Introduction and Aims: Change in estimated GFR (eGFR) is frequently used to track CKD progression in clinical practice, trials and cohort studies but its association with mortality has not been studied extensively. Methods: Change in eGFR was estimated as % change from the first to last eGFR (CKD-EPI creatinine) in a 2-year baseline period. We mod...

The causes of the high cardiovascular mortality observed in chronic kidney disease (CKD) are unknown. Here, we report data on prevalence of subclinical atherosclerosis in the NEFRONA population and a stratified multivariate logistic analysis of factors associated with the presence of plaque. We analysed 2445 patients with an estimated glomerular fi...

Background: Cardiovascular events (CVE) are more prevalent in chronic kidney disease (CKD) than in general population, being the main cause of morbimortality. Specific risk factors related to CKD have been suggested, because traditional factors do not fully explain this increase in cardiovascular disease rates. However, the role of atheromatosis, i...

BACKGROUND Although inhibitors of the renin–angiotensin–aldosterone system can slow the progression of diabetic kidney disease, the residual risk is high. Whether nuclear 1 factor (erythroid-derived 2)–related factor 2 activators further reduce this risk is unknown. METHODS We randomly assigned 2185 patients with type 2 diabetes mellitus and stage...

Background: Whereas the poor prognosis effect of the presence of vascular calcifications (VC) has been clearly defi ned in dialysis patients, their impact in the earlier stages of chronic kidney disease (CKD) is not well established. The present study evaluated the prevalence of the VC in non-dialysis CKD patients, its correlation with other cardi...

OSERCE is a multi-centre and cross-sectional study with the aim of analysing the biochemical, clinical, and management characteristics of bone mineral metabolism alterations and the level of compliance with K/DOQI guideline recommendations in patients with chronic kidney disease (CKD) not on dialysis. The study included a total of 634 patients from...

Background: Blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers has been shown to lessen the rate of decrease in glomerular filtration rate in patients with diabetic nephropathy. Study design: A multicenter open-label randomized controlled trial to compare the efficacy of com...

The recent discovery of a (pro)renin receptor that binds both prorenin and renin has renewed interest in prorenin. Prorenin is the precursor of renin and is synthesized mainly in the juxtaglomerular apparatus, although it is also produced outside the kidney. In clinical conditions such as diabetes mellitus, high plasma levels of prorenin are observ...

The recent discovery of a (pro)renin receptor that binds both prorenin and renin has renewed interest in prorenin. Prorenin is the precursor of renin and is synthesized mainly in the juxtaglomerular apparatus, although it is also produced outside the kidney. In clinical conditions such as diabetes mellitus, high plasma levels of prorenin are observ...

INTRODUCTION AND AIMS: Physical inactivity is common in patients undergoing dialysis and it is associated with insulin resistance as well as an over expression of muscle fibre type 2X. Thus the aim of the present study was to investigate the effects of high-load strength training in patients undergoing dialysis, on insulin sensitivity and muscle f...

Guide for the approach to comprehensive treatment of diabetic patients, including control of blood glucose, hypertension, dyslipidemia, coronary artery disease, diabetic nephropathy and antiplatelet therapy.

El sistema renina-angiotensina pivota sobre acciones reguladoras que contribuyen al mantenimiento de la homeostasis. Lejos queda la simplista visión que asociaba, exclusivamente, a este sistema con las modificaciones en el tono vascular. También resulta evidente, en la actualidad, que no uno, sino varios sistemas independientes, se encargan de modu...

ABSTRACT Since the Modification of Diet in Renal Disease (MDRD) study, the proteinuria is considered a marker of the progression of renal disease and its reduction as a therapeutic objective. Microalbuminuria is a marker for vascular damage in diabetic nephropathy and is associated to cardiovascular morbidity and mortality. In addition to these, mi...

ABSTRACT The need for a straight blood pressure control in high risk patients and/or renal disease ones has been questioned by the publication of two trial results: the ACCORD study and, more specifically devoted to renal disease, the AASK trial. Moreover, the conclusions of the ACCOMPLISH study (specifically, the renal sub-study) suggest the benef...

Objective: To analyze the degree of compliance with the K/DOQI guidelines in chronic kidney disease (CKD) patients with GFR < 60 mL/min/1.73m2 (stages 3, 4, and 5 not on dialysis) by comparing the results of the OSERCE I and OSERCE II studies. Patients and methods: The OSERCE I study is a multicenter, cross-sectional study that collected consecutiv...