Author: López, Margarita ; Martin, Pierre-Yves ; Coric-Martinovic, Valentina ; Rutkowski, Boleslaw ; Weiß, Matthias ; Malovrh, Marko ; Karsberg, Margareta ; Hahn, W ; Díaz-López, Bernardino ; Wüthrich, Rudolf ; Schmidt, Rüdiger ; Alecsandru, Radu ; Fusaro ; Krzywicki, Pawel ; Alonso-Montes, Cristina ; Stützer, Wolfgang ; Otegui, Fernando Vidaur ; Figarska, Malgorzata ; Schulz, Walter ; Brensing, Karl-August ; Gutierrez, Alberto ; Djamel, Dahmane ; González, Juan Navarro ; Iacob, Ioana ; Burnier, Michel ; Floege, Jürgen ; Kalkreuth, Klaus ; Urena, Pablo ; Farina, Marco ; Masson, Valérie ; Kulcsár, Imre ; Merscher, Sybille ; Cannata-Andía, Jorge Benito ; Verseput, G H ; Graf, Guenther ; Rossi, Giacomino ; Kreft, B ; Lüth, Johann-Borwin ; Wauters, Anne ; Du Questel, Z A ; Seguí, Rafael Giner ; Steinbach, Jutta ; Nikolay, Josef ; Arendt, Susanne ; Röckel, Arnold ; Tichy, Béla ; Rodríguez-García, Minerva ; Kalaitzidis, Kleonikos ; Macavei, Radu ; Golea, Ovidiu-Sorin ; Krause, Rolfdieter ; Mouneimne, Alex ; Palomo-Antequera, Carmen ; Herrero, Guillermina Fernández ; Rotolo, Ugo ; Striebing, Carola ; Ketteler, Markus ; Stolz ; Gallieni, Maurizio ; Hawryluk, Jaroslaw ; Newstead, Charles ; Goldsmith, David ; Rocha, Ernesto ; Moucka ; Preßler, Horst ; Gambro, Stacja Dializ ; Mas, Enrique Ajenjo ; Smithard, D ; Heidenreich, Stefan ; Giraud, Patrick ; Cassidy, Mike ; Becker, Matthias ; Bunia, J ; Reyes, Guillermo Martín ; Querques, Mario ; Schmidt-Gürtler, Hans-Jürgen ; Ostrowski, Janusz ; Stranik ; Ebbinghaus, Rolf ; Erekosima, Ibi ; Pavlovic, Drasko ; Locatelli, Francesco ; Becker, Helmut Peter ; Meneghel, Ssa Gina ; Hering, Andrea ; Jean-Baptiste, Philit ; Zoccali, Carmine ; Kiss, Heinrich ; Grzeszczyk, Miroslav ; Fernández-Gómez, Jesús ; Megido ; Beige, Joachim ; Dratwa, Max ; Jahnz, Heinrich ; Tommasi, Adalberto ; Malberti, Fabio ; Stenger, Karl-Otmar ; Materna, Joachim ; Holzmann ; Burgos, Rafael Romero ; Górriz-Teruel, José Luis ; Müller, Eckhard ; Guervas, Carlos Santiago ; Schäffer, Jürgen ; Langer, Christine ; Claus, Pierre ; Plakias, Dimitrios ; Lorenz, R ; Nachtigall, Peter ; Wilkie, Martin ; Brancaccio, Diego ; Dupuy ; Eche, Jean-Paul ; Smrzova, Jana ; Arenas, María Dolores ; Jimenez, Dolores Arenas ; Gutiérrez, Josep Prim ; Schobel, Hans-Paul ; Jean, Guillaume ; Carrera, Fernando ; Naik, Ramesh ; Massimo, Morosetti ; Bucht, Stig ; Frei, Ulrich ; Plutino, D ; Haller, Hermann ; Saveanu ; Brignon ; Brech, Wolfgang ; Solomakou, Stauroula ; Travassos, Joao Paulo ; Dziewanowski, Krzysztof ; Van Bommel, E F H ; Dehnert ; Carrero, Juan Jesús ; Schnierda ; Valkovsky ; Thomas, Kistler ; Munatetto, Giorgio ; Resina, Cristina ; Sobocki, Marek ; Grützmacher, Peter ; Van Hamersvelt, H W ; Ganzemüller, Christoph ; Metz-Kurschel, Ulrike ; Nicoud, Philippe ; Hadj ; Stamatelou, Kyriaki ; de Groot, Kirsten ; Cruz, Joao ; Jilly, Wilfried ; Tielemans, Christian ; Pavukova ; Bos, Willem-Jan ; Cuvelier, René ; Weber, Bernhard ; Rentero, Ramon ; Baerhausen ; Durlik, Magdalena ; Krumme, Bernd ; Bartholomew, St ; Brückner, Dieter ; de Paula de Pedro, Antonio ; Robl, Bernhard ; Cattanéo ; Gesualdo, Loreto ; Palla, Roberto ; Iwig, B ; Hevia-Suárez, Miguel Ángel ; Jaulin, Jean-Paul ; Kamen, Wilfried ; Kierdorf, Horst ; London, Gerard ; Verbeelen, Dierik ; Heck, Markus ; Siamopoulos, Konstantinos ; Schwietzer ; Rudka, Roman ; Oser, Bertil ; Cagnoli, Leonardo ; Loke, Olaf ; Kohnle, Wolfgang ; Bagnewski, Wolfgang ; Lodeserto, Cosimo ; Boussad, Bouali ; Lenz, Tomas ; Mark, Thomas ; Maia, Pedro Afonso Coelho ; Vleming, L ; Goller, Maximilian ; Ferenczi, Sandor ; Op De Hoek, C T ; D'Angelo, Angela ; Chantal, Bony ; Kurth, Carsten ; Hoekstra, F ; Burkhardt, Klaus ; Radermacher, Jörg ; Sanz, Aurelio ; Matzkies, Fritz ; Randazzo, Francesco ; Matulewicz-Gilewicz, Justyna ; Braasch, Eckhardt ; Heaf, James ; Scoble, John ; Lopez, Bernard ; Procaccini, Aldo ; Bounab, Mohamed Brahim ; Clasen, Wolfgang ; Ghenu, Adrian ; Martín-Carro, Beatriz ; Toledano, Daniel ; Bonomini, Mario ; Gauda, Tadeusz ; Maurice, François-Louis ; Pavlikova ; Guillodo, Marie-Paule ; Teplan, Vladimir ; Kavvadias, Dimitrios ; Sydor, Antoni ; Calvo, Maria Dolores Paz ; Kim-Seng, A N G ; Fernández-Martín, José Luis ; Ferreira, Aníbal ; Zeh, Matthias ; Duchet ; Bertocchio, Philippe ; Neyer, Ulrich ; Papantoniou, Antonis ; Wilfling, Michael ; Rodrigues, Ilídio ; Giordano, Pastori ; Ribeiro, Sílvia ; Wölbert, Bernd ; Craciun, Irinel ; Kaasjager, H A H ; Marone, Claudio ; Hoeft, Olaf Frank ; Gorriz, José Luis ; Hebgen, Oliver ; Rydzewski, Andrzej ; Lammer, Ulrich ; Daschner, M ; Roth, Rainer ; Delcroix, Catherine ; Krankenhaus, A Ö ; Sodemann ; Zahradnik ; Brockmann, Carsten ; Trudnowski, Slawomir ; Felisiak, Jacek J ; Frascà, Giovanni Maria ; Albertazzi, Alberto ; Bako, Cristian Gabriel ; Marosi, Leo ; Ludwig, Wolfgang ; Morossetti, Massimo ; Gulin, Marijana ; Grimal, Pierre ; FAN, Stanley ; Bolley ; Santoro, Antonio ; Bristogiannis, Georgios ; Fulde, Roland ; Frye, Berhard ; Guy ; Wambergue, François-Pascal ; Berweck, S ; Grieger, M ; Zins ; Philippe, Petitjean ; Eichhorn, Michael ; Dehout, François ; Spellerberg, Peter ; Memmos, Dimitrios ; Wollschläger ; Aucella, Filippo ; De Fremont, J F ; Roldan, Carmina Gomez ; Labeeuw, Michel ; Hummel, Dieter ; Ortiz, Milagros ; Schurek, H-J ; Mateos, Pedro C Rodrigo ; Pommer, Wolfgang ; Pérez, Pilar Sánchez ; Roth ; Navarro-González, Juan Francisco ; Harlos, J ; Schmaltz, Karla ; Bahlmann, Günter ; de Gregorio, Ascanio ; Frattini, Gianmaria ; Scheuerle ; Kolunen, Mari ; Bianchi, Giuseppe ; Scarlatella, Antonio ; Kramar ; Bethanien, Krankenhaus ; Selbach, Jochen ; Glowacki ; Kralj-Lopert, Simona ; Sliwicka, Dorota ; Lauerwald, Wolfang ; Majdalani, Ghandour ; Armbruster, Helmut ; Leimenstoll ; Mandelbaum, Alexander ; Will, Es ; Jeren-Strujic, Branka ; Bouchouareb ; Janning, Gottfried ; Harnett, Patrick ; Nagy, Judit ; Rikker, Csaba ; Biagini, Marco ; Gross, Wolfgang ; Liamos ; Rogland, Björn ; La Corte, Antonio ; Fernandes, João Carlos ; Dhondt, A M ; Miska, Hans-Joachim ; Pocheville, Marc ; Benedik, Mihael ; Haufe, Christoph ; Galbiati, Alberto ; Bidas, Kizysztof ; Didier, Ducloux ; Gebauer, Katrin ; Welling, Ullrich ; Wood, Morwenna ; Otte, Overlæge Kjeld ; Gaultier, Jacques ; Hohage, Helge ; Stefanidis, Ioannis ; Fischer, Hans-Christoph ; Soler, Mª Carmen Prados ; Besnier, Dominique ; Uzan, Marc ; Mann, J ; Alves, Doutor Rui ; Marinangeli, Giancarlo ; Caritas-Krankenhaus ; Gómez-Alonso, Carlos ; Árkossy, Ottó ; Ponce, Pedro Magalhaes ; Covic, Adrian ; Sanz-García, Clara ; Röger, Christoph ; Sánchez-Alvarez, Emilio ; de la Torre, Mª Josefa ; Mcclelland, Peter

ABSTRACTBackgroundAgeing often affects biomarker production. Yet, clinical/optimal thresholds to guide clinical decisions do not consider this. Serum albumin decreases with age, but hypoalbuminaemia is defined as serum albumin <4.0 g/dl. This study explores whether age might affect serum albumin levels and its association with mortality in haemodialysis patients.MethodsCOSMOS (Current Management of Secondary Hyperparathyroidism: a Multicentre Observational Study) is a prospective, open-cohort, observational study of haemodialysis patients followed for 3 years. Binary logistic and linear regression were used to analyse the association between age and hypoalbuminaemia or serum albumin (continuous). Cox proportional hazard multivariate regression was used to examine the relationship between hypoalbuminaemia and mortality in patients younger and older than 65 years. Time-dependent receiver operating characteristic (ROC) curves were used to assess the discriminatory ability of serum albumin and optimal thresholds for predicting mortality.ResultsThe present analysis included 5585 patients. The odds of experiencing hypoalbuminaemia increased with age [adjusted odds ratios = 1.56(95%CI: 1.31–1.86), 1.89(95%CI: 1.59–2.24), 2.68(95%CI: 2.22–3.23) for 56–65, 66–75, and >75 years, respectively (reference ≤55 years; P value for trend: <0.001)]. Survival analysis showed that the association between hypoalbuminaemia and mortality was weaker in patients aged ≥65 compared to <65 years [hazard ratios: 1.36(95%CI: 1.17–1.57) and 1.81(95%CI:1.42–2.31) respectively; P value for interaction 0.004]. The ability of albumin levels to predict mortality was consistently higher in younger patients. Optimal albumin thresholds for predicting mortality were 3.7 g/dl in patients younger than 65 years and 3.5 g/dl in patients 65 years and older.ConclusionsAgeing is accompanied by lower albumin levels, and the association between hypoalbuminaemia and mortality may be modified by age. Different clinical thresholds that consider age may better discriminate risks associated with hypoalbuminaemia.

01 Nov 2024·Nefrología (English Edition)

Environmental challenges in hemodialysis: Exploring the road to sustainability

Review

Author: Martín Vaquero, Natalia ; Arenas, M Dolores ; Martínez Cadenas, Rodrigo ; Duane, Brett ; Audije-Gil, Julia ; Quintela, Marta ; Gómez, Miquel ; Pereda, Gerard ; Maduell, Francesc ; Luque, Antonio ; Ortiz, Alberto ; Castaño, Itziar ; Arias-Guillén, Marta ; Portillo, Jesús

Hemodialysis (HD) is a treatment with a significant environmental impact. One dialysis cycle is equivalent to the daily consumption of 3.5-4 people, and the average annual electricity consumption of a center is equivalent to that of approximately 2.5-3 households (9 kWh/day per household). The carbon footprint (kg CO2 equivalent) measures direct and indirect greenhouse gas emissions and is influenced by the production of the various materials used, their transport, patients, and healthcare personnel. In this context, it is necessary to understand the real impact of each center on the environment and act sustainably. The aim of this review is to analyze the environmental footprint generated by dialysis, rethink processes, and propose management strategies to provide tools applicable to any unit to reduce the negative impact of this activity. Each center must measure and monitor indicators, set its own standards, design improvement plans, and carry out annual monitoring in a multidisciplinary manner.

01 Sep 2024·Nefrología (English Edition)

World Kidney Day: an opportunity to make kidney health and Nephrology visible

Article

Author: San Juan, Marta Isabel ; Vaca, Marco ; Sánchez Álvarez, Emilio ; Rodríguez Suárez, Esther ; Arroyo, David ; Ustarroz Alegre, Maider ; Muñoz Ramos, Patricia ; Bueno Zamarbide, Itziar ; Conejo Gómez, David

100 Deals associated with Fundacion Renal Iñigo Alvarez de Toledo

100 Translational Medicine associated with Fundacion Renal Iñigo Alvarez de Toledo

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