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Article: Efficacy and Safety of Semaglutide, a Glucagon-Like Peptide-1 Receptor Agonist in Real-Life: A Case Series of Patients in Maintenance Incremental Hemodialysis.

De la Flor, José C / Lorenzo, Javier Deira / Marschall, Alexander / Valga, Francisco / Vázquez, Tania Monzón / Cícero, Elisa Ruiz

Case reports in nephrology and dialysis

2022 Volume 12, Issue 3, Page(s) 238–247

Abstract: The glucagon-like peptide-1 receptor agonists (GLP-1RA) are among the newest treatment options available for managing of type 2 diabetes mellitus and slowing the progression of diabetes kidney disease (DKD). Subcutaneous (SC) semaglutide ( ... ...

Abstract	The glucagon-like peptide-1 receptor agonists (GLP-1RA) are among the newest treatment options available for managing of type 2 diabetes mellitus and slowing the progression of diabetes kidney disease (DKD). Subcutaneous (SC) semaglutide (Ozempic
Language	English
Publishing date	2022-11-22
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2809879-1
ISSN	2296-9705
ISSN	2296-9705
DOI	10.1159/000527919
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Percutaneous Left Atrial Appendage Closure in Patients with Non-Valvular Atrial Fibrillation and End-Stage Renal Disease on Hemodialysis: A Case Series.

Basabe, Elena / De La Flor, José C / López de la Manzanara, Virginia / Nombela-Franco, Luis / Narváez-Mejía, Carlos / Cruzado, Leónidas / Villa, Daniel / Zamora, Rocío / Tapia, Manuel / Sastre, Miguel Ángel / López Soberón, Edurne / Herrero Calvo, José A / Suárez, Alfonso / Martí Sánchez, David

Medicina (Kaunas, Lithuania)

2024 Volume 60, Issue 2

Abstract: Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia in the general population, and its prevalence increases among patients with chronic kidney disease (CKD) undergoing hemodialysis. This population presents high risk of both ... ...

Abstract	Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia in the general population, and its prevalence increases among patients with chronic kidney disease (CKD) undergoing hemodialysis. This population presents high risk of both hemorrhagic and thrombotic events, with little evidence regarding the use of oral anticoagulation treatment (OAT) and multiple complications arising from it; however, stroke prevention with percutaneous left atrial appendage closure (LAAC) is an alternative to be considered. We retrospectively describe the safety and efficacy of percutaneous LAAC in eight patients with NVAF and CKD on hemodialysis during a 12-month follow-up. The mean age was 78.8 years (range 64-86; SD ± 6.7), and seven patients were male. The mean CHA
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Stroke/etiology ; Stroke/prevention & control ; Stroke/epidemiology ; Atrial Fibrillation/complications ; Atrial Fibrillation/surgery ; Left Atrial Appendage Closure ; Retrospective Studies ; Treatment Outcome ; Hemorrhage/complications ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Renal Insufficiency, Chronic/complications ; Anticoagulants/therapeutic use ; Renal Dialysis/adverse effects ; Atrial Appendage/surgery
Chemical Substances	Anticoagulants
Language	English
Publishing date	2024-01-29
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina60020231
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Monoclonal Gammopathy of Renal Significance with Deposits of Peculiar Morphology and Injuries of Secondary Thrombotic Microangiopathy: A Case Report and Review of the Literature.

De La Flor, José C / Alonso, Marina / Sandoval, Edna / Marschall, Alexander / Rodeles, Miguel

Case reports in nephrology

2020 Volume 2020, Page(s) 6679857

Abstract: We present the case of an 82-year-old woman diagnosed with monoclonal gammopathy of renal significance (MGRS) with the presence of different and peculiar kidney lesions, who began treatment with bortezomib and dexamethasone, presenting during her ... ...

Abstract	We present the case of an 82-year-old woman diagnosed with monoclonal gammopathy of renal significance (MGRS) with the presence of different and peculiar kidney lesions, who began treatment with bortezomib and dexamethasone, presenting during her evolution a relapse. Although the bone marrow biopsy in this case showed plasma cells as pathologic clone and there was also a reduction after chemotherapeutic treatment, rituximab was proposed as a second line. We suspected that the relapse was possibly due to another precursor as B-cell or lymphoplasmacytic cell clone. We review the literature and suggest that the treatment for MGRS should be patient-tailored, preferably by consulting a multidisciplinary team. Future research is needed to better understand the disease course and establish the efficacy and safety of the therapeutic approach for the relapse of MGRS.
Language	English
Publishing date	2020-12-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627652-5
ISSN	2090-665X ; 2090-6641
ISSN (online)	2090-665X
ISSN	2090-6641
DOI	10.1155/2020/6679857
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Monoclonal Gammopathy of Renal Significance with Deposits of Infrequent Morphology: Two Case Reports of Light and Heavy Chain Deposition Disease with Atypical Presentation and Literature Review.

De La Flor, José C / Monroy-Condori, Maribel / Apaza-Chavez, Jacqueline / Arenas-Moncaleano, Iván / Díaz, Francisco / Guerra-Torres, Xavier E / Morales-Montoya, Jorge L / Lerma-Verdejo, Ana / Sandoval, Edna / Villa, Daniel / Vieru, Coca-Mihaela

Medicines (Basel, Switzerland)

2023 Volume 10, Issue 10

Abstract: Background: Monoclonal immunoglobulin deposition disease (MIDD) includes three entities: light chain deposition disease (LCDD), heavy chain deposition disease (HCDD) and light and heavy chain deposition disease (LHCDD). The renal presentation can ... ...

Abstract	Background: Monoclonal immunoglobulin deposition disease (MIDD) includes three entities: light chain deposition disease (LCDD), heavy chain deposition disease (HCDD) and light and heavy chain deposition disease (LHCDD). The renal presentation can manifest with varying degrees of proteinuria and/or nephrotic syndrome, microhematuria, and often leads to end-stage renal disease. Given the rarity of LHCDD, therapeutic approaches for this condition remain inconclusive, as clinical trials are limited. Case presentation: We report two male patients with underlying monoclonal gammopathy of renal significance (MGRS) associated with LHCDD lesions. Both cases had non-nephrotic proteinuria, moderately impaired renal function, and normal levels of C3 and C4. Light microscopy of the renal biopsies in both patients did not show lesions of nodular glomerulosclerosis. Immunofluorescence showed a staining pattern with interrupted linear IgA-κ in patient #1 and IgA-λ in patient #2 only along the glomerular basement membrane (GBM). Electron microscopy of patient #1 revealed electrodense deposits in the subendothelial and mesangial areas only along the GBM. Discussion: In this case series, we discuss the clinical, analytical, and histopathological findings of two rare cases of LHCDD. Both patients exhibited IgA monoclonality and were diagnosed with monoclonal gammopathy of undetermined significance (MGUS) by the hematology department at the time of renal biopsy. Treatment with steroids and cytotoxic agents targeting the clone cells responsible for the deposition disease resulted in a favorable renal and hematologic response.
Language	English
Publishing date	2023-10-04
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2777965-8
ISSN	2305-6320
ISSN	2305-6320
DOI	10.3390/medicines10100055
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Article: Efficacy and Safety of the Use of SGLT2 Inhibitors in Patients on Incremental Hemodialysis: Maximizing Residual Renal Function, Is There a Role for SGLT2 Inhibitors?

De La Flor, José C / Villa, Daniel / Cruzado, Leónidas / Apaza, Jacqueline / Valga, Francisco / Zamora, Rocío / Marschall, Alexander / Cieza, Michael / Deira, Javier / Rodeles, Miguel

Biomedicines

2023 Volume 11, Issue 7

Abstract: SGLT-2i are the new standard of care for diabetic kidney disease (DKD), but previous studies have not included patients on kidney replacement therapy (KRT). Due to their high risk of cardiovascular, renal complications, and mortality, these patients ... ...

Abstract	SGLT-2i are the new standard of care for diabetic kidney disease (DKD), but previous studies have not included patients on kidney replacement therapy (KRT). Due to their high risk of cardiovascular, renal complications, and mortality, these patients would benefit the most from this therapy. Residual kidney function (RKF) conveys a survival benefit and cardiovascular health among hemodialysis (HD) patients, especially those on incremental hemodialysis (iHD). We retrospectively describe the safety and efficacy of SGLT2i regarding RKF preservation in seven diabetic patients with different clinical backgrounds who underwent iHD (one or two sessions per week) during a 12-month follow-up. All patients preserved RKF, measured as residual kidney urea clearance (KrU) in 24 h after the introduction of SGLT2i. KrU levels improved significantly from 4.91 ± 1.14 mL/min to 7.28 ± 1.68 mL/min at 12 months (
Language	English
Publishing date	2023-07-06
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11071908
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Article ; Online: Waldenström's Macroglobulinemia and Cryoglobulinemic Glomerulonephritis: An Unusual Case of Monoclonal Gammopathy of Renal Significance.

De La Flor, José C / Sulca, Jesús de María / Rodríguez, Pablo / Villa, Daniel / Sandoval, Edna / Zamora, Rocío / Monroy-Condori, Maribel / Lipa, Roxana / Perez, Henry / Cieza, Michael

Medical sciences (Basel, Switzerland)

2023 Volume 11, Issue 4

Abstract: Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and dissolve upon reheating. They can induce small-vessel vasculitis with renal involvement. Cryoglobulinemic glomerulonephritis is a rare manifestation that occurs in ... ...

Abstract	Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and dissolve upon reheating. They can induce small-vessel vasculitis with renal involvement. Cryoglobulinemic glomerulonephritis is a rare manifestation that occurs in patients with monoclonal gammopathy, specifically Waldenström's macroglobulinemia. We present the case of a 52-year-old patient with a history of cutaneous vasculitis and hypothyroidism, who presented with generalized edema, moderate anemia, hypercholesterolemia, nephrotic range proteinuria of 12.69 g/day, microhematuria, arterial hypertension, and hypocomplementemia via the classical pathway, without acute kidney injury and with negative serological studies and positive cryoglobulins in the second determination. Serum and urine protein electrophoresis and immunofixation studies showed a monoclonal band of IgM and kappa light chain. Renal biopsy was consistent with cryoglobulinemic glomerulonephritis. In the context of dysproteinemia and cryoglobulinemic glomerulonephritis, bone-marrow aspiration and biopsy were performed, leading to the diagnosis of Waldenström's macroglobulinemia. Monoclonal gammopathies have been described in association with type I cryoglobulinemias. This described association is uncommon, which is why we present this case, along with a review of the literature.
MeSH term(s)	Humans ; Middle Aged ; Cryoglobulins ; Glomerulonephritis/complications ; Glomerulonephritis/diagnosis ; Monoclonal Gammopathy of Undetermined Significance/complications ; Monoclonal Gammopathy of Undetermined Significance/diagnosis ; Paraproteinemias/complications ; Paraproteinemias/diagnosis ; Waldenstrom Macroglobulinemia/complications ; Waldenstrom Macroglobulinemia/diagnosis
Chemical Substances	Cryoglobulins
Language	English
Publishing date	2023-12-05
Publishing country	Switzerland
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2754473-4
ISSN	2076-3271 ; 2076-3271
ISSN (online)	2076-3271
ISSN	2076-3271
DOI	10.3390/medsci11040077
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Article: Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review.

De La Flor, José C / Deira, Javier / Marschall, Alexander / Valga, Francisco / Linares, Tania / Monzon, Tania / Albarracín, Cristina / Ruiz, Elisa

Case reports in nephrology and dialysis

2021 Volume 11, Issue 2, Page(s) 158–166

Abstract: Hyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in ... ...

Abstract	Hyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in HD patients. Although the 2015 National Kidney Foundation-Kidney Disease Outcomes Quality Initiate (NKD-KDOQI) guidelines allow the reduction in the weekly HD dose for patients with a residual kidney urea clearance (Kur) >3 mL/min/1.73 m
Language	English
Publishing date	2021-06-28
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2809879-1
ISSN	2296-9705
ISSN	2296-9705
DOI	10.1159/000516595
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients-A Report of 10 Cases.

De La Flor, José C / Valga, Francisco / Marschall, Alexander / Monzon, Tania / Albarracín, Cristina / Ruiz, Elisa / Rodeles, Miguel

Case reports in nephrology

2021 Volume 2021, Page(s) 5575928

Abstract: Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been ... ...

Abstract	Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (
Language	English
Publishing date	2021-03-12
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627652-5
ISSN	2090-665X ; 2090-6641
ISSN (online)	2090-665X
ISSN	2090-6641
DOI	10.1155/2021/5575928
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: An Exceptional Case of Light Chain Only Variant of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits Secondary to Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature.

De La Flor, José C / Apaza, Jacqueline / Díaz, Francisco / Sandoval, Edna / Linares, Tania / Marschall, Alexander / Núñez, Patricia / Rivas-Nieto, Andrea Cecilia / Ruiz, Elisa

Case reports in nephrology

2022 Volume 2022, Page(s) 9207282

Abstract: We present the case of an 86-year-old Caucasian male with an 11-year history of low-grade chronic lymphocytic leukemia (CLL) presenting with nephrotic syndrome (NS). Renal biopsy findings showed a diffuse mesangial and endocapillary proliferative ... ...

Abstract	We present the case of an 86-year-old Caucasian male with an 11-year history of low-grade chronic lymphocytic leukemia (CLL) presenting with nephrotic syndrome (NS). Renal biopsy findings showed a diffuse mesangial and endocapillary proliferative glomerulonephritis (GN) lesion with fine granular deposits, consistent with a rare morphologic variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID)-lambda light chain (LC) only. Monthly combination therapy of rituximab (500 mg/m
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627652-5
ISSN	2090-665X ; 2090-6641
ISSN (online)	2090-665X
ISSN	2090-6641
DOI	10.1155/2022/9207282
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The impact of the correction of hyponatremia during hospital admission on the prognosis of SARS-CoV-2 infection.

de La Flor, José C / Gomez-Berrocal, Ana / Marschall, Alexander / Valga, Francisco / Linares, Tania / Albarracin, Cristina / Ruiz, Elisa / Gallegos, Gioconda / Gómez, Alberto / de Los Santos, Andrea / Rodeles, Miguel

Medicina clinica (English ed.)

2022 Volume 159, Issue 1, Page(s) 12–18

Abstract: Background: SARS-CoV-2 infection is frequently associated with hyponatremia (plasma sodium <135 mmol/L), being associated with a worse prognosis. The incidence of hyponatremia is estimated to be 20-37% according to the series, but there are no data on ... ...

Abstract	Background: SARS-CoV-2 infection is frequently associated with hyponatremia (plasma sodium <135 mmol/L), being associated with a worse prognosis. The incidence of hyponatremia is estimated to be 20-37% according to the series, but there are no data on the prognosis after correction of hyponatremia. Therefore, our objectives were: to analyse the incidence and severity of hyponatremia at hospital admission, and to determine the association of this hyponatremia with the prognosis of COVID-19. Methods: Observational and retrospective cohort study. Patients who were admitted with a diagnosis of COVID-19 infection and hyponatremia, in the period March-May 2020, were included. We recorded epidemiological, demographic, clinical, biochemical, and radiological variables of SARS-CoV-2 infection and hyponatremia at the time of diagnosis and during hospitalization. The clinical follow-up ranged from admission to death or discharge. Results: 91 patients (21.8%) of the 414 admitted for SARS-CoV-2 infection presented hyponatremia (81.32% mild hyponatremia, 9.89% moderate and 8.79% severe). The absence of correction of hyponatremia 72-96 h after hospital admission was associated with higher mortality in patients with COVID-19 (Odds Ratio 0.165; 95% confidence interval: 0.018-0.686; Conclusion: We conclude that persistence of hyponatremia at 72-96 h of hospital admission was associated with higher mortality in patients with SARS-Cov-2.
Language	English
Publishing date	2022-06-29
Publishing country	Spain
Document type	Journal Article
ISSN	2387-0206
ISSN (online)	2387-0206
DOI	10.1016/j.medcle.2021.07.021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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