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Haarhaus M, Bratescu LO, Pana N, Gemene EM, Silva EM, Santos Araujo CAR, Macario F. Early referral to nephrological care improves long-term survival and hospitalization after dialysis initiation, independent of optimal dialysis start - a call for harmonization of reimbursement policies. Ren Fail 2024; 46:2313170. [PMID: 38357766 PMCID: PMC10877651 DOI: 10.1080/0886022x.2024.2313170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
Early treatment of kidney disease can slow disease progression and reduce the increased risk of mortality associated with end-stage kidney disease. However, uncertainty exists whether early referral (ER) to nephrological care per se or an optimal dialysis start impacts patient outcome after dialysis initiation. We determined the effect of ER and suboptimal dialysis start on the 3-year mortality and hospitalizations after dialysis initiation. Between January 2015 and July 2018, 349 patients with ≥1 month of follow-up started dialysis at nine Romanian dialysis clinics. After excluding patients with COVID-19 during follow-up, 254 patients (97 ER and 157 late referral) were included in this retrospective study. The observational period was truncated at 3 years, death, or loss to follow-up. Clinical and laboratory data were retrieved from the quality database of the nephrological care providers. Patients were followed for a median (25-75%) of 36 (16-36) months. At dialysis start, ER patients had higher hemoglobin, phosphate, and albumin levels and started dialysis less often via a central dialysis catheter (p < 0.001 for each). Logistic regression analysis demonstrated an independent lower risk for frequent hospitalizations for ER patients (odds ratio 0.22 (95% confidence interval 0.1-0.485), p < 0.001), and Cox regression analysis revealed an improved survival (hazard ratio 0.540 (95% confidence interval 0.325-0.899), p = 0.02), both independent of optimal dialysis start. In conclusion, early referral to nephrological care was associated with improved survival and lower hospitalization rates during the three years after dialysis initiation, independent of optimal dialysis start. These results strongly support the reimbursement of nephrological care before dialysis initiation.
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Affiliation(s)
- Mathias Haarhaus
- Diaverum, Malmö, Sweden
- Karolinska Institutet, Institutionen for klinisk vetenskap intervention och teknik, Stockholm, Sweden
| | | | - Nicolae Pana
- Diaverum Romania, Bucharest, Romania
- Universitatea de Medicina si Farmacie Carol Davila, Bucuresti, Romania
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Haase M, Lesny P, Anderson M, Cloherty G, Stec M, Haase-Fielitz A, Haarhaus M, Santos-Araújo C, Veiga PM, Macario F. Humoral immunogenicity and tolerability of heterologous ChAd/BNT compared with homologous BNT/BNT and ChAd/ChAd SARS-CoV-2 vaccination in hemodialysis patients : A multicenter prospective observational study. J Nephrol 2022; 35:1467-1478. [PMID: 35084719 PMCID: PMC8792133 DOI: 10.1007/s40620-022-01247-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND After the reports of severe adverse reactions to the AstraZeneca ChAdOx1-S-nCoV-19 vaccine, patients who had received one dose of ChAdOx1-S-nCoV-19 vaccine were recommended a second dose of Pfizer's BNT162b2 vaccine. In hemodialysis patients, we compared the humoral immunogenicity and tolerability of homologous vaccination with ChAdOx1-nCoV-19/ChAdOx1-nCoV-19 (ChAd/ChAd) and BNT162b2/BNT162b2 (BNT/BNT) with heterologous vaccination of first dose of ChAdOx1-nCoV-19 and a second dose with BNT162b2 (ChAd/BNT). METHODS In a multicenter prospective observational study, SARS-CoV-2 spike-IgG antibody levels, Nucleocapsid-protein-IgG-antibodies, and vaccine tolerability were assessed 6 weeks after second SARS-CoV-2 vaccination in 137 hemodialysis patients and 24 immunocompetent medical personnel. RESULTS In COVID-19-naïve hemodialysis patients, significantly higher median SARS-CoV-2-spike IgG levels were found after ChAd/BNT (N = 16) compared to BNT/BNT (N = 100) or ChAd/ChAd (N = 10) (1744 [25th-75th percentile 276-2840] BAU/mL versus 361 [25th-75th percentile 120-936] BAU/mL; p = 0.009; 1744 [25th-75th percentile 276-2840] BAU/mL versus 100 [25th-75th percentile 41-346] BAU/mL; p = 0.017, respectively). Vaccinated, COVID-19-naïve medical personnel had median SARS-CoV-2 spike-IgG levels of 650 (25th-75th percentile 217-1402) BAU/mL and vaccinated hemodialysis patients with prior COVID-19 7047 (25th-75th percentile 685-10,794) BAU/mL (N = 11). In multivariable regression analysis, heterologous vaccination (ChAd/BNT) of COVID-19-naïve hemodialysis patients was independently associated with SARS-CoV-2 spike-IgG levels. The first dose of ChAd and the second dose of BNT after the first vaccination with ChAd (heterologous vaccination, ChAd/BNT) were associated with more frequent but manageable side effects compared with homologous BNT. CONCLUSIONS Within the limitations of this study, heterologous vaccination with ChAd/BNT appears to induce stronger humoral immunity and more frequent but manageable side effects than homologous vaccination with BNT/BNT or with ChAd/ChAd in COVID-19-naïve hemodialysis patients.
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Affiliation(s)
- Michael Haase
- Diaverum Renal Care Center, Potsdam, Germany.
- Diaverum AB, Hyllie Boulevard 39, 215 37, Malmö, Sweden.
- Medical Faculty, Otto-Von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - Paul Lesny
- Diaverum Renal Care Center, Potsdam, Germany
| | - Mark Anderson
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Gavin Cloherty
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Michael Stec
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Anja Haase-Fielitz
- Brandenburg Medical School Theodor Fontane, 16816, Neuruppin, Germany
- Faculty of Health Sciences Brandenburg, 14469, Potsdam, Germany
- Institute of Integrated Health Care Systems Research & Social Medicine, Otto-Von-Guericke-University Magdeburg, 39120, Magdeburg, Germany
- Department of Cardiology, Brandenburg Heart Center, Immanuel Hospital, 16321, Bernau, Germany
| | - Mathias Haarhaus
- Diaverum AB, Hyllie Boulevard 39, 215 37, Malmö, Sweden
- Division of Renal Medicine, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Carla Santos-Araújo
- Institute of Integrated Health Care Systems Research & Social Medicine, Otto-Von-Guericke-University Magdeburg, 39120, Magdeburg, Germany
- Division of Renal Medicine, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Pedro Mota Veiga
- School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
- NECE Research Unit in Business Sciences, University of Beira Interior, Covilhã, Portugal
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Haarhaus M, Duhanes M, Leševic N, Matei B, Ramsauer B, Da Silva Rodrigues R, Su J, Haase M, Santos‐ Araújo C, Macario F. Improved immunologic response to COVID-19 vaccine with prolonged dosing interval in haemodialysis patients. Scand J Immunol 2022; 95:e13152. [PMID: 35244289 PMCID: PMC9115353 DOI: 10.1111/sji.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Vaccination against 2019 coronavirus disease (COVID-19) can reduce disease incidence and severity. Dialysis patients demonstrate a delayed immunologic response to vaccines. We determined factors affecting the immunologic response to COVID-19 vaccines in haemodialysis patients. All patients within a Swedish haemodialysis network, vaccinated with two doses of COVID-19 vaccine 2-8 weeks before inclusion, were eligible for this cross-sectional study. Severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein antibody levels were determined by EliA SARS-CoV-2-Sp1 IgG test (Thermo Fisher Scientific, Phadia AB) and related to clinical and demographic parameters. Eighty-nine patients were included. Patients were vaccinated with two doses of Comirnaty (BNT162b2, 73%) or Spikevax (mRNA-1273, 23,6%). Three patients received combinations of different vaccines. Response rate (antibody titres >7 U/mL) was 89.9%, while 39.3% developed high antibody titres (>204 U/mL), 47 (43-50) days after the second dose. A previous COVID-19 infection associated with higher antibody titres (median (25th-75th percentile) 1558.5 (814.5-3,763.8) U/mL vs 87 (26-268) U/mL, P = .002), while time between vaccine doses did not differ between groups (P = .7). Increasing SARS-CoV-2 antibody titres were independently associated with increasing time between vaccine doses (B 0.241, P = .02), decreasing serum calcium levels (B -0.233, P = .007) and previous COVID-19 (B 1.078, P < .001). In conclusion, a longer interval between COVID-19 mRNA vaccine doses, lower calcium and a previous COVID-19 infection were independently associated with a stronger immunologic vaccination response in haemodialysis patients. While the response rate was good, only a minority developed high antibody titres, 47 (43-50) days after the second vaccine dose.
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Affiliation(s)
- Mathias Haarhaus
- Diaverum ABMalmöSweden
- Department of Clinical Sciences, Intervention and TechnologyDivision of Renal MedicineKarolinska InstitutetKarolinska University HospitalStockholmSweden
| | | | | | | | | | | | - Jun Su
- Karolinska University LaboratoryKarolinska University HospitalStockholmSweden
| | - Michael Haase
- Diaverum ABMalmöSweden
- Medical FacultyOtto‐von‐Guericke University MagdeburgMagdeburgGermany
| | - Carla Santos‐ Araújo
- Diaverum ABMalmöSweden
- Faculty of MedicineCardiovascular Research and Development UnitPortoPortugal
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4
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Haase M, Lesny P, Haase-Fielitz A, Anderson M, Cloherty G, Stec M, Lucas C, Santos-Araujo C, Haarhaus M, Macario F. Immunogenicity and tolerability of COVID-19 vaccination in peritoneal dialysis patients-A prospective observational cohort study. Semin Dial 2021; 35:269-277. [PMID: 34854131 DOI: 10.1111/sdi.13043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND In peritoneal dialysis (PD) patients, information on the immunogenicity and tolerability of SARS-CoV-2 vaccination is still scarce. We compared the immunogenicity and tolerability of SARS-CoV-2 vaccination of PD patients with that of medical personnel. METHODS In a prospective observational cohort study, PD patients and immunocompetent medical personnel were evaluated for SARS-CoV-2 spike-IgG- and Nucleocapsid-IgG-antibody-levels before, 2 weeks after the first, and 6 weeks after the second SARS-CoV-2 vaccination and vaccine tolerability after the first and second vaccination. RESULTS In COVID-19-naïve PD patients (N = 19), lower SARS-CoV-2-spike-IgG-levels were found compared with COVID-19-naïve medical personnel (N = 24) 6 weeks after second vaccination (median 1438 AU/ml [25th-75th percentile 775-5261] versus 4577 [1529-9871]; p = 0.045). This finding resulted in a lower rate of strong vaccine response (spike-IgG ≥ 1000 AU/ml) of COVID-19-naïve PD patients compared with medical personnel (58% versus 92%; p = 0.013), but not for seroconversion rate (spike-IgG ≥ 50 AU/ml: 100% vs. 100%; p > 0.99). After first vaccination, COVID-naïve PD patients presented with significantly fewer side effects than medical personnel (number of any side effect: 1 [1-2] vs. 4 [1-7]; p = 0.015). A similar pattern with slightly decreased frequencies of side effects was observed for tolerability of second SARS-CoV-2 vaccination in PD patients and medical personnel (number of any side effects: 1 [1-1] vs. 2 [1-5]; p = 0.006). CONCLUSIONS SARS-CoV-2 vaccination in COVID-19-naïve PD patients appeared to induce a very high rate of seroconversion but a substantially lower rate of patients with a strong response compared with medical personnel. Vaccination appeared to be safe in the PD patients studied.
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Affiliation(s)
- Michael Haase
- Diaverum, Diaverum Renal Care Center, Potsdam, Germany.,Center of Internal Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Paul Lesny
- Diaverum, Diaverum Renal Care Center, Potsdam, Germany
| | - Anja Haase-Fielitz
- MHB, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,FGW, Faculty of Health Sciences Brandenburg, Potsdam, Germany.,Institute of Integrated Health Care Systems Research and Social Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Department of Cardiology, Brandenburg Heart Center, Immanuel Hospital, Bernau, Germany
| | - Mark Anderson
- Abbott, Abbott Infectious Disease Research, North Chicago, Illinois, USA
| | - Gavin Cloherty
- Abbott, Abbott Infectious Disease Research, North Chicago, Illinois, USA
| | - Michael Stec
- Abbott, Abbott Infectious Disease Research, North Chicago, Illinois, USA
| | | | - Carla Santos-Araujo
- Diaverum, Diaverum AB, Malmö, Sweden.,Cardiovascular Research and Development Unit, Faculty of Medicine, Porto, Portugal
| | - Mathias Haarhaus
- Diaverum, Diaverum AB, Malmö, Sweden.,Division of Renal Medicine, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Lesny P, Anderson M, Cloherty G, Stec M, Haase-Fielitz A, Haarhaus M, Santos C, Lucas C, Macario F, Haase M. Immunogenicity of a first dose of mRNA- or vector-based SARS-CoV-2 vaccination in dialysis patients: a multicenter prospective observational pilot study. J Nephrol 2021; 34:975-983. [PMID: 34050904 PMCID: PMC8164063 DOI: 10.1007/s40620-021-01076-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dialysis patients are at risk for lower SARS-CoV-2-vaccine immunogenicity than the normal population. We assessed immunogenicity to a first mRNA- or vector-based SARS-CoV-2-vaccination dose in dialysis patients. METHODS In a multicenter observational pilot study, 2 weeks after a first vaccination (BNT162b2/Pfizer-BioNTech [Comirnaty] or ChAdOx1 nCoV-19/Oxford-Astra-Zeneca [Vaxzevria]), hemodialysis patients (N = 23), peritoneal dialysis patients (N = 4) and healthy staff (N = 14) were tested for SARS-CoV-2-spike IgG/IgM, Nucleocapsid-protein-IgG-antibodies and plasma ACE2-receptor-binding-inhibition capacity. Hemodialysis patients who had had prior COVID-19 infection (N = 18) served as controls. Both response to first SARS-CoV-2 vaccination and IgG spike-positivity following prior COVID-19 infection were defined as SARS-CoV-2 spike IgG levels ≥ 50 AU/mL. RESULTS Vaccination responder rates were 17.4% (4/23) in hemodialysis patients, 100% (4/4) in peritoneal dialysis patients and 57.1% (8/14) in staff (HD vs. PD: p = 0.004, HD vs. staff: p = 0.027). Among hemodialysis patients, type of vaccine (Comirnaty N = 11, Vaxzevria N = 12, 2 responders each) did not appear to influence antibody levels (IgG spike: Comirnaty median 0.0 [1.-3. quartile 0.0-3.8] versus Vaxzevria 4.3 [1.6-20.1] AU/mL, p = 0.079). Of responders to the first dose of SARS-CoV-2 vaccination among hemodialysis patients (N = 4/23), median IgG spike levels and ACE2-receptor-binding-inhibition capacity were lower than that of IgG spike-positive hemodialysis patients with prior COVID-19 infection (13/18, 72.2%): IgG spike: median 222.0, 1.-3. quartile 104.1-721.9 versus median 3794.6, 1.-3. quartile 793.4-9357.9 AU/mL, p = 0.015; ACE2-receptor-binding-inhibition capacity: median 11.5%, 1.-3. quartile 5.0-27.3 versus median 74.8%, 1.-3. quartile 44.9-98.1, p = 0.002. CONCLUSIONS Two weeks after their first mRNA- or vector-based SARS-CoV-2 vaccination, hemodialysis patients demonstrated lower antibody-related response than peritoneal dialysis patients and healthy staff or unvaccinated hemodialysis patients following prior COVID-19 infection.
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Affiliation(s)
- Paul Lesny
- Diaverum Renal Care Center, 14469, Potsdam, Germany
| | - Mark Anderson
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Gavin Cloherty
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Michael Stec
- Abbott Infectious Disease Research, Chicago, IL, 60064-3500, USA
| | - Anja Haase-Fielitz
- Brandenburg Medical School Theodor Fontane, 16816, Neuruppin, Germany
- Faculty of Health Sciences Brandenburg, 14469, Potsdam, Germany
- Institute of Integrated Health Care Systems Research & Social Medicine, Otto-von-Guericke-University Magdeburg, 39120, Magdeburg, Germany
- Department of Cardiology, Brandenburg Heart Center, Immanuel Hospital, 16321, Bernau, Germany
| | - Mathias Haarhaus
- Diaverum AB, 21532, Malmö, Sweden
- Division of Renal Medicine, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, 17177, Stockholm, Sweden
| | - Carla Santos
- Diaverum AB, 21532, Malmö, Sweden
- Cardiovascular Research and Development Unit, Faculty of Medicine, 4200-319, Porto, Portugal
| | | | | | - Michael Haase
- Diaverum Renal Care Center, 14469, Potsdam, Germany.
- Diaverum AB, 21532, Malmö, Sweden.
- Medical Faculty, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
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Haarhaus M, Santos C, Haase M, Mota Veiga P, Lucas C, Macario F. Risk prediction of COVID-19 incidence and mortality in a large multi-national hemodialysis cohort: implications for management of the pandemic in outpatient hemodialysis settings. Clin Kidney J 2021; 14:805-813. [PMID: 33777363 PMCID: PMC7929029 DOI: 10.1093/ckj/sfab037] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
Background Experiences from the first wave of the 2019 coronavirus disease (COVID-19) pandemic can aid in the development of future preventive strategies. To date, risk prediction models for COVID-19-related incidence and outcomes in hemodialysis (HD) patients are missing. Methods We developed risk prediction models for COVID-19 incidence and mortality among HD patients. We studied 38 256 HD patients from a multi-national dialysis cohort between 3 March and 3 July 2020. Risk prediction models were developed and validated, based on predictors readily available in outpatient HD units. We compared mortality among patients with and without COVID-19, matched for age, sex and diabetes. Results During the observational period, 1259 patients (3.3%) acquired COVID-19. Of these, 62% were hospitalized or died. Mortality was 22% among COVID-19 patients with odds ratios 219.8 [95% confidence interval (CI) 80.6–359] to 342.7 (95% CI 60.6–13 595.1), compared to matched patients without COVID-19. Since the first wave of the pandemic affected most European countries during the study, the risk prediction model for incidence of COVID-19 was developed and validated in European patients only [N = 22 826 area under the ROC curve(AUC)Dev 0.64, AUCVal 0.69]. The model for prediction of mortality was developed in all COVID-19 patients (AUCDev 0.71, AUCVal 0.78). Angiotensin receptor blockers were independently associated with a lower incidence of COVID-19 in European patients. Conclusions We identified modifiable risk factors for COVID-19 incidence and outcome in HD patients. Our risk prediction tools can be readily applied in clinical practice. This can aid in the development of preventive strategies for future waves of COVID-19.
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Affiliation(s)
- Mathias Haarhaus
- Diaverum AB, Malmö, Sweden.,Department of Clinical Sciences, Intervention and Technology, Division of Renal Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Carla Santos
- Diaverum AB, Malmö, Sweden.,Faculty of Medicine, Cardiovascular Research and Development Unit, Porto, Portugal
| | - Michael Haase
- Diaverum AB, Malmö, Sweden.,Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Pedro Mota Veiga
- Polytechnic Institute of Viseu, School of Education, Viseu, Portugal.,NECE Research Unit in Business Sciences, University of Beira Interior, Covilhã, Portugal
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Kramer A, Pippias M, Noordzij M, Stel VS, Afentakis N, Ambühl PM, Andrusev AM, Fuster EA, Arribas Monzón FE, Åsberg A, Barbullushi M, Bonthuis M, Caskey FJ, Castro de la Nuez P, Cernevskis H, des Grottes JM, Garneata L, Golan E, Hemmelder MH, Ioannou K, Jarraya F, Kolesnyk M, Komissarov K, Lassalle M, Macario F, Mahillo-Duran B, Martín de Francisco AL, Palsson R, Pechter Ü, Resic H, Rutkowski B, Santiuste de Pablos C, Seyahi N, Simic Ogrizovic S, Slon Roblero MF, Spustova V, Stojceva-Taneva O, Traynor J, Massy ZA, Jager KJ. The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2015: a summary. Clin Kidney J 2018; 11:108-122. [PMID: 29423210 PMCID: PMC5798130 DOI: 10.1093/ckj/sfx149] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/22/2017] [Indexed: 12/21/2022] Open
Abstract
Background This article summarizes the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry’s 2015 Annual Report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2015 within 36 countries. Methods In 2016 and 2017, the ERA-EDTA Registry received data on patients who were undergoing RRT for ESRD in 2015, from 52 national or regional renal registries. Thirty-two registries provided individual patient-level data and 20 provided aggregated-level data. The incidence, prevalence and survival probabilities of these patients were determined. Results In 2015, 81 373 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 119 per million population (pmp). The incidence ranged by 10-fold, from 24 pmp in Ukraine to 232 pmp in the Czech Republic. Of the patients commencing RRT, almost two-thirds were men, over half were aged ≥65 years and a quarter had diabetes mellitus as their primary renal diagnosis. Treatment modality at the start of RRT was haemodialysis for 85% of the patients, peritoneal dialysis for 11% and a kidney transplant for 4%. By Day 91 of commencing RRT, 82% of patients were receiving haemodialysis, 13% peritoneal dialysis and 5% had a kidney transplant. On 31 December 2015, 546 783 individuals were receiving RRT for ESRD, corresponding to an unadjusted prevalence of 801 pmp. This ranged throughout Europe by more than 10-fold, from 178 pmp in Ukraine to 1824 pmp in Portugal. In 2015, 21 056 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 31 pmp. This varied from 2 pmp in Ukraine to 94 pmp in the Spanish region of Cantabria. For patients commencing RRT during 2006–10, the 5-year unadjusted patient survival probabilities on all RRT modalities combined was 50.0% (95% confidence interval 49.9–50.1).
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Affiliation(s)
- Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maria Pippias
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nikolaos Afentakis
- Hellenic Renal Registry, Board of Registry, Coordination and Control of RRT, General Hospital of Athens 'G. Gennimatas', Athens, Greece
| | - Patrice M Ambühl
- Swiss Dialysis Registry, Renal Division, Stadtspital Waid Zürich, Zurich, Switzerland
| | - Anton M Andrusev
- Department of Peritoneal Dialysis, City Hospital #52, Moscow, Russian Federation.,Russian Dialysis Society, Moscow, Russian Federation
| | - Emma Arcos Fuster
- Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain
| | | | - Anders Åsberg
- Department of Transplantation, Oslo University Hospital Rikshospitalet and Norwegian Renal Registry, Oslo, Norway
| | | | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Fergus J Caskey
- UK Renal Registry, Southmead Hospital, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Pablo Castro de la Nuez
- Information System of Regional Transplant Coordination in Andalucia (SICATA), Seville, Andalucia, Spain
| | - Harijs Cernevskis
- Department of Internal Medicine, Riga Stradins University, Riga, Latvia
| | | | - Liliana Garneata
- "Carol Davila" University of Medicine and Pharmacy, Department of Internal Medicine and Nephrology "Dr Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania
| | - Eliezer Golan
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar-Saba and Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Marc H Hemmelder
- Dutch Renal Registry Renine, Nefrovisie foundation, Utrecht, The Netherlands
| | - Kyriakos Ioannou
- Nephrology Department, Apollonion Private Hospital, Nicosia, Cyprus.,Nephrology Department, American Medical Center, Nicosia, Cyprus
| | - Faical Jarraya
- Research Unit 12ES14 and Nephrology Department, Sfax University, Sfax, Tunisia
| | - Mykola Kolesnyk
- State Institute of Nephrology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | - Kirill Komissarov
- Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Mathilde Lassalle
- REIN Registry, Agence de la biomédecine, Saint-Denis La Plaine, France
| | - Fernando Macario
- Portuguese Society of Nephrology, Nephrology Department, University Hospital of Coimbra, Coimbra, Portugal
| | - Beatriz Mahillo-Duran
- Spanish Renal Disease Patients Registry (REER), Organización Nacional de Trasplantes (ONT), Madrid, Spain
| | | | - Runolfur Palsson
- Division of Nephrology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ülle Pechter
- Department of Internal Medicine, Tartu University, Tartu, Estonia
| | - Halima Resic
- Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Boleslaw Rutkowski
- Polish Renal Registry, Department of Nephrology, Transplantology and Internal Medicine, Medical University, Gdansk, Poland
| | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Medical Faculty, Nephrology, Istanbul, Turkey
| | | | | | | | | | - Jamie Traynor
- The Scottish Renal Registry, Meridian Court, Information Services Division Scotland, Glasgow, UK
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018 team5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Santos M, Marinho A, Mendes S, Domingues C, Alves P, Silva Marques J, Macario F, Alberto C, Martins R, Mota A, Ferreira M, Pego M. P3345Severe ischemia on myocardial perfusion SPECT independently predicts adverse cardiovascular events after renal transplantation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pippias M, Kramer A, Noordzij M, Afentakis N, Alonso de la Torre R, Ambühl PM, Aparicio Madre MI, Arribas Monzón F, Åsberg A, Bonthuis M, Bouzas Caamaño E, Bubic I, Caskey FJ, Castro de la Nuez P, Cernevskis H, de Los Ángeles Garcia Bazaga M, des Grottes JM, Fernández González R, Ferrer-Alamar M, Finne P, Garneata L, Golan E, Heaf JG, Hemmelder MH, Idrizi A, Ioannou K, Jarraya F, Kantaria N, Kolesnyk M, Kramar R, Lassalle M, Lezaic VV, Lopot F, Macario F, Magaz Á, Martín de Francisco AL, Martín Escobar E, Martínez Castelao A, Metcalfe W, Moreno Alia I, Nordio M, Ots-Rosenberg M, Palsson R, Ratkovic M, Resic H, Rutkowski B, Santiuste de Pablos C, Seyahi N, Fernanda Slon Roblero M, Spustova V, Stas KJF, Stendahl ME, Stojceva-Taneva O, Vazelov E, Ziginskiene E, Massy Z, Jager KJ, Stel VS. The European Renal Association - European Dialysis and Transplant Association Registry Annual Report 2014: a summary. Clin Kidney J 2017; 10:154-169. [PMID: 28584624 PMCID: PMC5455253 DOI: 10.1093/ckj/sfw135] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 11/30/2022] Open
Abstract
Background: This article summarizes the European Renal Association – European Dialysis and Transplant Association Registry’s 2014 annual report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2014 within 35 countries. Methods: In 2016, the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD, from 51 national or regional renal registries. Thirty-two registries provided individual patient level data and 19 provided aggregated patient level data. The incidence, prevalence and survival probabilities of these patients were determined. Results: In 2014, 70 953 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 133 per million population (pmp). The incidence ranged by 10-fold; from 23 pmp in the Ukraine to 237 pmp in Portugal. Of the patients commencing RRT, almost two-thirds were men, over half were aged ≥65 years and a quarter had diabetes mellitus as their primary renal diagnosis. By day 91 of commencing RRT, 81% of patients were receiving haemodialysis. On 31 December 2014, 490 743 individuals were receiving RRT for ESRD, equating to an unadjusted prevalence of 924 pmp. This ranged throughout Europe by more than 10-fold, from 157 pmp in the Ukraine to 1794 pmp in Portugal. In 2014, 19 406 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 36 pmp. Again this varied considerably throughout Europe. For patients commencing RRT during 2005–09, the 5-year-adjusted patient survival probabilities on all RRT modalities was 63.3% (95% confidence interval 63.0–63.6). The expected remaining lifetime of a 20- to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 21.9 and 44.0 years, respectively. This was substantially lower than the 61.8 years of expected remaining lifetime of a 20-year-old patient without ESRD.
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Affiliation(s)
- Maria Pippias
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Nikolaos Afentakis
- Hellenic Renal Registry, Board of Registry, Coordination and Control of RRT, General Hospital of Athens 'G. Gennimatas', Athens, Greece
| | | | - Patrice M Ambühl
- Swiss Dialysis Registry, Renal Division, Stadtspital Waid, Zurich, Switzerland
| | - Manuel I Aparicio Madre
- Registro Madrileño de Enfermos Renales (REMER), Oficina Regional de Coordinación de Trasplantes, Madrid, Spain
| | | | - Anders Åsberg
- Norwegian Renal Registry, Department of Transplant Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ivan Bubic
- Department of Internal Medicine, Clinical Hospital Centre Rijeka, School of Medicine University of Rijeka, Rijeka, Croatia
| | - Fergus J Caskey
- UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, UK
| | - Pablo Castro de la Nuez
- Information System of Regional Transplant Coordination in Andalucia (SICATA), Andalucia, Spain
| | - Harijs Cernevskis
- Department of Internal Medicine, Riga Stradins University, Riga, Latvia
| | - Maria de Los Ángeles Garcia Bazaga
- Dirección General de Salud Pública, Servicio Extremeño de Salud, Consejería de Sanidad y Políticas Sociales, Junta de Extremadura, Cáceres, Spain
| | | | - Raquel Fernández González
- Registro de Enfermos Renales de Castilla y León, Coordinación de Trasplantes, Castilla y León, Spain
| | - Manuel Ferrer-Alamar
- Técnico Registro de Enfermos Renales Comunitat Valenciana, Servicio de Estudios Epidemiológicos y Registros Sanitarios, Subdirección General Epidemiología, Dirección General Salut Pública, Consellería Sanitat, Valencian Region, Spain
| | - Patrik Finne
- Department of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.,Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Liliana Garneata
- Department of Internal Medicine and Nephrology 'Dr Carol Davila' Teaching Hospital of Nephrology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - Eliezer Golan
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar-Saba and Sackler Faculty of Medicine, Tel Aviv, Israel
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Marc H Hemmelder
- Dutch Renal Registry (Renine), Nefrovisie, Utrecht, The Netherlands
| | - Alma Idrizi
- Service of Nephrology, UHC 'Mother Teresa', Tirana, Albania
| | - Kyriakos Ioannou
- Nephrology Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Faical Jarraya
- Research Unit 12ES14, Faculty of Medicine, Sfax University and Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nino Kantaria
- Department of Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia
| | - Mykola Kolesnyk
- Main Coordinator of National Register of CKD and AKI Patients, State Institute of Nephrology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | | | | | - Visnja V Lezaic
- Department of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Frantisek Lopot
- Department of Medicine, General University Hospital and 1st Charles University Medical School, Strahov, Czech Republic
| | - Fernando Macario
- Nephrology Department, Portuguese Society of Nephrology, University Hospital of Coimbra, Coimbra, Portugal
| | - Ángela Magaz
- Unidad de Información sobre Pacientes Renales de la Comunidad Autónoma del País Vasco (UNIPAR), Basque Country, Spain
| | | | - Eduardo Martín Escobar
- Registro Español de Enfermos Renales (REER), Organización Nacional de Trasplantes, Madrid, Spain
| | - Alberto Martínez Castelao
- Member of the Catalan Renal Registry Committee, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wendy Metcalfe
- Scottish Renal Registry, Meridian Court, ISD Scotland, Glasgow, UK
| | - Inmaculada Moreno Alia
- Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-La Mancha, Servicio de Epidemiología, Dirección General de Salud Pública y Consumo Castilla-La Mancha, Toledo, Spain
| | | | - Mai Ots-Rosenberg
- Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Runolfur Palsson
- Division of Nephrology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Marina Ratkovic
- Nephrology and Hemodialysis Department, Clinical Center of Montenegro, Ljubljanska, Montenegro
| | - Halima Resic
- Head of Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Boleslaw Rutkowski
- Polish Renal Registry, Department of Nephrology, Transplantology and Internal Medicine, Medical University, Gdansk, Poland
| | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | - Nurhan Seyahi
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Division of Nephrology, Istanbul University, Istanbul, Turkey
| | - María Fernanda Slon Roblero
- Consultant Nephrologist at Complejo Hospitalario de Navarra, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Koenraad J F Stas
- Dienst Nefrologie, Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium
| | - María E Stendahl
- Swedish Renal Registry, Department of Medicine, Ryhov County Hospital, Jonkoping, Sweden
| | | | - Evgueniy Vazelov
- Dialysis Clinic, 'Alexandrovska' University Hospital, Sofia Medical University, Sofia, Bulgaria
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania.,Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Nephrological Clinic, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Ziad Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Team 5, CESP UVSQ, and University Paris Saclay, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Santos T, Aguiar B, Santos L, Romaozinho C, Tome R, Macario F, Alves R, Campos M, Mota A. Invasive Fungal Infections After Kidney Transplantation: A Single-center Experience. Transplant Proc 2016; 47:971-5. [PMID: 26036497 DOI: 10.1016/j.transproceed.2015.03.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Invasive fungal infections (IFI) affecting transplant recipients are associated with increased mortality and graft dysfunction. OBJECTIVE Describe the frequency, clinical features, and outcomes of IFI (except pneumocystis infection) in kidney transplant recipients. METHOD Single-center descriptive study including every kidney transplant recipient with a culture-proven or probable IFI between 2003 and 2013, according to the EORTC-MSG criteria. RESULTS We identified 45 IFI. There were 13 cases of invasive candidiasis (C. albicans: 6 and non-C. albicans candidial spp.: 7), 11 cases of pulmonary aspergillosis (A. fumigatus: 9 and A. flavus: 2); 11 cases of subcutaneous mycosis (Alternaria spp.: 9, Paecilomyces spp.: 1, and Pseudallescheria spp.: 1); 7 cases of cryptococcosis; 2 cases of pneumonia by non-Aspergillus molds (Mucor spp.: 1 and Cunninghamella spp.: 1); and 1 case of Geotrichum capitatum pneumonia. All patients were recipients from deceased donors. Six cases occurred in the first 3 months post-transplant, 15 cases between the third and twelfth months, and 21 cases after the twelfth month. Treatment options were fluconazole for Candida infections, voriconazole or caspofungin for aspergillosis, liposomal amphotericin for cryptococcosis, and itraconazole plus excision or cryotherapy for subcutaneous mycosis. Fifteen patients died (33%). Mortality rates were 15% for invasive candidiasis, 45% for aspergillosis, 71% for cryptococcosis, 100% for non-Aspergillus molds and G. capitatum pneumonia, and 0% for subcutaneous mycosis. Six patients who survived (14%) started regular hemodialysis. CONCLUSION IFI still have a high mortality and morbidity in kidney transplant recipients, as verified in this report. We reinforce the need for a high index of suspicion and prompt treatment.
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Affiliation(s)
- T Santos
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal.
| | - B Aguiar
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - L Santos
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - C Romaozinho
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - R Tome
- Clinical Pathology Department, Coimbra University Hospital, Coimbra, Portugal
| | - F Macario
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - R Alves
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - M Campos
- Nephrology Department, Coimbra University Hospital, Coimbra, Portugal
| | - A Mota
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
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Kramer A, Stel VS, Abad Diez JM, Alonso de la Torre R, Bouzas Caamaño E, Čala S, Cao Baduell H, Castro de la Nuez P, Cernevskis H, Collart F, Couchoud C, de Meester J, Djukanovic L, Ferrer-Alamar M, Finne P, Fogarty D, de Los Ángeles García Bazaga M, Garneata L, Golan E, Gonzalez Fernández R, Heaf JG, Hoitsma A, Ioannidis GA, Kolesnyk M, Kramar R, Leivestad T, Limido A, Lopot F, Macario F, Magaz Á, Martín-Escobar E, Metcalfe W, Noordzij M, Ots-Rosenberg M, Palsson R, Piñera C, Postorino M, Prutz KG, Ratkovic M, Resic H, Rodríguez Hernández A, Rutkowski B, Serdengeçti K, Yebenes TS, Spustová V, Stojceva-Taneva O, Tomilina NA, van de Luijtgaarden MWM, van Stralen KJ, Wanner C, Jager KJ. Renal replacement therapy in Europe-a summary of the 2010 ERA-EDTA Registry Annual Report. Clin Kidney J 2013; 6:105-115. [PMID: 27818766 PMCID: PMC5094410 DOI: 10.1093/ckj/sfs164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This study provides a summary of the 2010 European Renal Association–European Dialysis and Transplant Association (ERA–EDTA) Registry Annual Report (available at www.era-edta-reg.org). Methods This report includes data on renal replacement therapy (RRT) using data from the national and regional renal registries in 29 countries in Europe and bordering the Mediterranean Sea. Individual patient data were received from 27 registries, whereas 18 registries contributed data in aggregated form. We present incidence and prevalence of RRT, transplant rates, survival probabilities and expected remaining lifetimes. The latter two are solely based on individual patient records. Results In 2010, the overall incidence rate of RRT for end-stage renal disease (ESRD) among all registries reporting to the ERA–EDTA Registry was 123 per million population (pmp) (n = 91 798). The highest incidence rate was reported by Turkey (252pmp) and the lowest reported by Montenegro (21 pmp). The overall prevalence of RRT for ESRD at 31 December 2010 among all registries reporting to the ERA–EDTA Registry was 741 pmp (n = 551 005). The prevalence varied from 124 pmp in Ukraine to 1580 pmp in Portugal. The overall number of renal transplantations performed in 2010 among all registries was 29.2 pmp (n = 21 740). The highest overall transplant rate was reported from Spain, Cantabria (73 pmp), whereas the highest transplant rate for living donor kidneys was reported from the Netherlands (28 pmp). For patients who started RRT between 2001 and 2005, the unadjusted 5-year patient survival on RRT was 46.2% [95% confidence interval (CI) 46.0–46.3], and on dialysis 38.6% (95% CI 38.5–38.8). The unadjusted 5-year patient survival after the first renal transplantation performed between 2001 and 2005 was 86.6% (95% CI 86.1–87.1) for deceased donor kidneys and 94.1% (95% CI 93.4–94.8) for living donor kidneys.
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Affiliation(s)
- Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | - Svjetlana Čala
- Nephrology and Dialysis Department, University Clinic for Internal Diseases, Sestre Milosrdnice Clinical Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Pablo Castro de la Nuez
- Coordinación Autonómica de Trasplantes, Servicios de Apoyo del SAS, Sevilla, Andalusia, Spain
| | - Harijs Cernevskis
- Department of Internal Medicine, P.Stradins Clinical University Hospital, Riga, Latvia
| | | | - Cécile Couchoud
- REIN registry, Agence de la biomédecine, Saint Denis La Plaine Cedex, Paris, France
| | - Johan de Meester
- Dept of Nephrology, Dialysis & Hypertension, AZ Nikolaas, Sint-Niklaas, Belgium
| | | | - Manuel Ferrer-Alamar
- Valencian Region Renal Registry (REMRENAL), Dir. Gral. Investigacion y Salud Publica, Conselleria de Sanitat, Valencia, Spain
| | - Patrik Finne
- Department of Nephrology, Helsinki University Central Hospital, Helsinki, Finland; Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Damian Fogarty
- Nephrology Research Group, Centre for Public Health, Queen's University and Regional Nephrology Unit, Belfast City Hospital, Belfast, UK
| | | | - Liliana Garneata
- Dr Carol Davila University of Medicine and Pharmacy, Dr Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania
| | - Eliezer Golan
- Israel Society of Nephrology & Hypertension, Dept. of Nephrology & Hypertension, Meir Medical Center, Kfar-Saba, Israel
| | | | - James G Heaf
- Department of Nephrology B, Copenhagen University Hospital at Herlev, Herlev, Denmark
| | - Andries Hoitsma
- Department of Nephrology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - George A Ioannidis
- Hellenic Renal Registry, General Hospital of Athens "G.Gennimatas", Athens, Greece
| | | | | | - Torbjørn Leivestad
- The Norwegian Renal Registry, Dept. of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Aurelio Limido
- Nephrology and Dialysis Unit, Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milano, Italy
| | - Frantisek Lopot
- General University Hospital, Department of Medicine - Strahov and Charles University Medical School, Institute of Biophysics and Informatics, Prague, Czech Republic
| | - Fernando Macario
- Portuguese Renal Disease Registry, Portuguese Society of Nephrology, Coimbra, Portugal
| | | | | | - Wendy Metcalfe
- Scottish Renal Registry, Cirrus House, Abbotsinch, Paisley, Scotland, UK
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Runolfur Palsson
- Division of Nephrology, Landspitali, The National University Hospital of Iceland and Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Celestino Piñera
- Servicio de Nefrología, Hospital Universitario Valdecilla, Santander (Cantabria), Spain
| | - Maurizio Postorino
- CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Renal and Transplantation Unit, Ospedali Riuniti, Reggio Calabria, Italy
| | - Karl G Prutz
- Department of Internal Medicine, Hospital of Helsingborg, Helsingborg, Sweden
| | - Marina Ratkovic
- Nephrology and Haemodialysis Department, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Halima Resic
- Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Boleslaw Rutkowski
- Polish Renal Registry, Department of Nephrology, Transplantology and Internal Disease, Medical University Gdansk, Gdansk, Poland
| | - Kamil Serdengeçti
- Division of Nephrology, Department of Internal Medicine, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | | | | | - Olivera Stojceva-Taneva
- Macedonian Renal Registry, University Clinic of Nephrology, University "Sts. Cyril and Methodius" Skopje, Skopje, Republic of Macedonia
| | - Natalia A Tomilina
- Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia; Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Moniek W M van de Luijtgaarden
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Karlijn J van Stralen
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Christoph Wanner
- Division of Nephrology, University Clinic, University of Würzburg, Würzburg, Germany
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Walker R, Ruderman I, Masterson R, Cohney S, Salvadori M, Conti P, Bertoni E, Durrbach A, Citterio F, Mulloy L, David-Neto E, Russ G, Vitko S, Zhang R, Xing J, Harler MB, Grinyo J, Rugiu C, Trubian A, Bernich P, Lupo A, Asbe-Vollkopf A, Pannu A, Hoefeld H, Gauer S, Gossmann J, Kachel HG, Froese S, Korom S, Geiger H, Hauser IA, Liefeldt L, Kluener C, Glander P, Giessing M, Gralla O, Neumayer HH, Budde K, Kroencke T, Liborio AB, Barros RM, Esmeraldo RM, Oliveira MLMB, Nogueira Paes FJV, Mendoza TR, Silva Junior GB, Daher EF, Siekierka-Harreis M, Bantis C, Kouri NM, Schwandt C, Rump LC, Ivens K, Slatinska J, Honsova E, Burgelova M, Slimackova E, Viklicky O, Tabernero G, Rivero K, Fernandez G, Canueto J, Garcia P, Fraile P, Lucas C, Tabernero JM, Bargnoux AS, Simon N, Garrigue V, Dupuy AM, Mourad G, Cristol JP, Yapici U, Kers J, Bemelman F, Roelofs J, Groothoff J, van der Loos C, van Donselaar-van der Pant K, Idu M, Claessen N, ten Berge I, Florquin S, Knap B, Dragonja Z, Dobnik S, Buturovic Ponikvar J, Ponikvar R, Kandus A, Bren A, Hauser IA, Kleemann J, Gauer S, Engel J, Winter S, Hoefeld H, Asbe-Vollkopf A, Brzoska M, Obermueller N, Geiger H, Schaeffeler E, Oldak M, Pazik J, Lewandowski Z, Sitarek E, Dabrowski M, Ploski R, Malejczyk J, Durlik M, Slubowska K, Urbanowicz A, Sadowska A, Lichodziejewska B, Kurnicka K, Galazka Z, Chmura A, Durlik M, Masin-Spasovska J, Spasovski G, Petrusevska G, Popov Z, Ivanovski N, Di Napoli A, Salvatori MF, Franco F, Di Lallo D, Guasticchi G, Sancho A, Gavela E, Beltran S, Kanter J, Alemany B, Crespo JF, Pallardo LM, Lionet A, Beuscart JB, Buob D, BenHenda A, Provot F, Hazzan M, Noel C, Galan-Sanchez F, Marin-Casanova P, Mazuecos A, Garcia-Alvarez T, Aznar E, Rodriguez-Iglesias M, Ossareh S, Salami M, Mohammad E, Hosseini M, Pawlik A, Chudek J, Kolonko A, Wilk J, Jalowiecki P, Wiecek A, Zyablitskaya E, Galkina E, Yushina E, Botelho C, Aires P, Santos L, Romaozinho C, Macario F, Alves R, Veiga P, Mota A, Yashi M, Yagisawa T, Kimura T, Nukui A, Fujiwara T, Sakuma Y, Ishikawa N, Iwabuchi T, Muraishi O, Glander P, Hambach P, Liefeldt L, Neumayer HH, Budde K, Esmen S, Keven K, Sengul S, Ozcan M, Ensari A, Tuzuner A, Calayoglu R, Nergizoglu G, Gullu Koca T, Koca N, Ersoy A, Faria B, Bustorff M, Barros F, Tavares I, Santos J, Ferreira I, Sampaio S, Pestana M, Keven K, Suvak B, Sengul S, Kurultak I, Calayoglu R, Tutkak H, Choi HM, Yang HN, Jo SK, Cho WY, Kim HK, Aybal Kutlugun A, Altun B, Akman U, Aki T, Turkmen E, Yildirim T, Altindal M, Yilmaz R, Yasavul U, Gullu Koca T, Koca N, Ersoy A, Thiem U, Heinze G, Gossler U, Perkmann T, Kainberger F, Muhlbacher F, Horl W, Borchhardt K, Sanchez-Escuredo A, Holgado S, Biosca C, Granada ML, Barluenga E, Lauzurica R, Romero R, Espinal A, Torregrossa V, Bayes B, Tomida K, Hamano T, Fujii N, Ichimaru N, Matsui I, Isaka Y, Rakugi H, Takahara S, Gavela E, Sancho A, Kanter J, Beltran S, Avila A, Crespo JF, Pallardo LM, Dor F, Massey E, Frunza M, Johnson R, Lennerling A, Loven C, Mamode N, Pascalev A, Sterckx S, Van Assche K, Zuidema W, Weimar W, Botelho C, Aires P, Santos L, Romaozinho C, Macario F, Alves R, Veiga P, Mota A, Allwin R, Gauer S, Roessel, Hoefeld H, Brzoska M, Buettner S, Gossmann J, Belwe V, Geiger H, Hauser IA, Apaza J, Gonzalez E, Polanco N, Bengoa I, Cadenillas C, Andres A, Morales JM, Rocha S, Fonseca I, Martins LS, Vidinha J, Dias L, Almeida M, Pedroso S, Henriques A, Cabrita A, Neretljak I, Mihovilovic K, Vidas Z, Jurenec F, Knotek M, Justa S, Minz R, Minz M, Anand S, Sharma A, Lacquaniti A, Donato V, Chirico V, Pettinato G, Buemi M, Galle J, Addison J, Perry P, Claes K, Farouk M, Guerin A, Kiss I, Winearls C, Di Giulio S, Basic-Jukic N, Slavicek J, Bubic-Filipi L, Kes P, Scholbach T, Wang HK, Yang AH, Loong CC, Wu TH, Abboud I, Antoine C, Serrato T, Lefaucheur C, Pillebout E, Gaudez F, Fieux F, Flamant M, Verine J, Viglietti D, Peraldi MN, Glotz D. Transplantation: clinical studies (2). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Santos L, Alves R, Macario F, Parada B, Campos M, Mota A. Impact of hepatitis B and C virus infections on kidney transplantation: a single center experience. Transplant Proc 2009; 41:880-2. [PMID: 19376378 DOI: 10.1016/j.transproceed.2009.01.074] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The impacts of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections on patient and renal graft survivals are controversial. This study sought to evaluate the effects of pretransplantation HCV and HBV infections on renal transplant patients and their grafts at our center. PATIENTS AND METHODS We retrospectively examined 1224 renal transplantations performed between 1992 and 2006, including 28 HBsAg positive; 64, anti-HCV; 9, anti-HCV plus HBsAg positive; and 1123, negative for anti-HCV and HBsAg. The mean posttransplantation follow-up was 5.6 +/- 4.1 years. RESULTS The prevalences of HBV infection were 6.2% in 1994 and 2.3% in 2006 and those of HCV infection were 6.8% in 1998 and 5.2% in 2006. The rejection rate was higher among HBV+ (46.4%) and HCV+ (40.6%) groups than the negative groups (31.5%), but it was not significant. There were no significant differences in patient and graft survivals among the groups. The major cause of patient death was liver failure among patients with concomitant HBV+ and HCV+ infections and cardiovascular disease among HCV+ and negative patients. CONCLUSIONS There has been a decrease in the prevalence of recipients with hepatitis virus infections over the last 15 years. Patient and graft survivals were not affected by HCV or HBV infection.
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Affiliation(s)
- L Santos
- Department of Nephrology, Rainha Santa Isabel Hospital, Torres Novas, Portugal.
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Figueiredo A, Moreira P, Parada B, Nunes P, Macario F, Bastos C, Mota A. UP-01.72. Urology 2006. [DOI: 10.1016/j.urology.2006.08.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pezzoli A, Prandini N, Matarese V, Feggi L, Pansini GC, Buldrini P, Cantarini D, Macario F, Pazzi P, Gullini S. Massive bleeding in an adult patient suffering from Meckel's diverticulum. Dig Liver Dis 2000; 32:245-8. [PMID: 10975777 DOI: 10.1016/s1590-8658(00)80829-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The case of a 22-year-old male who bled from a Meckel's diverticulum is described. The diagnosis was achieved after 99mTechnetium pertechnetate scintigraphy. With the administration of somatostatin very clear images were obtained. The histological examination confirmed the presence of ectopic gastric mucosa. The literature, over the last 10 years, has been reviewed to identify factors associated with bleeding in adults. Ectopic gastric mucosa is the most important factor predicting bleeding. The diagnostic approach to bleeding Meckel's diverticulum and the improvement in the quality of 99mTechnetium pertechnetate scintigraphy, following administration of somatostatin, is discussed.
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Affiliation(s)
- A Pezzoli
- Department of Gastroenterology, St. Anna Hospital, Ferrara, Italy
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Libanore M, Bicocchi R, Rossi MR, Montanari P, Sighinolfi L, Macario F, Ghinelli F. [Incidence of giardiasis in adults patients with acute enteritis]. Minerva Med 1991; 82:375-80. [PMID: 2067710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors report the findings of a perspective study carried out in 214 cases of acute diarrhoea to estimate the presence of giardia intestinalis infections. The incidence of 3.2% has been discussed on the bases of recent epidemiological advances.
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Affiliation(s)
- M Libanore
- Divisione Malattie Infettive, Arcispedale S. Anna, Ferrara
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Boccia S, Rollo V, Accorsi L, Macario F, Merighi A, Gullini S. Paracentesis: a new needle for an old technique. Endoscopy 1991; 23:83-4. [PMID: 2050013 DOI: 10.1055/s-2007-1010619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The increasing use of paracentesis has prompted us to look into medical devices that might be useful for making the technique quicker and safer. Therefore we have designed a sterile, disposable, painless and safe needle that allows us to perform paracentesis in 30 patients, extracting an average of 6,000 cc of ascitic fluid in about 120 minutes, without any serious complications.
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Affiliation(s)
- S Boccia
- Servizio di Gastroenterologia ed Endoscopia Digestiva Arcispedale S. Anna, Ferrara
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Gullini S, Basso O, Boccia S, Macario F, Cantarini D, Ghinelli F. [Campylobacter pylori colonization and gastroduodenal pathology]. Minerva Med 1988; 79:957-60. [PMID: 3200472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
355 patients suffering from dyspepsia with an endoscopic pathological picture were examined. Campylobacter pylori was sought histologically and by culture. Histological and cultural results were compared. There were no bacteria on the gastric mucosa of 46 patients who had no histopathological evidence of lesions. Cultural studies were performed in 40 cases on endoscopic instruments used during the examination, before and after standard sterilization. Campylobacter pylori was found on the gastric mucosa of 224 patients (63.09%); 91.93% with duodenal ulcer; 71.87% with gastric ulcer; 54.23% with erosive duodenitis; 56.71% with erosive gastritis and 54.81% with chronic gastropathy. The agreement between the two techniques was 75.39%, with a male prevalence (p = 0.05). Campylobacter pylori was present on the gastric mucosa of 10.86% of patients without histopathological evidence of lesions. Standard sterilization with alkyl-dimethyl-benzyl ammonium eliminated the campylobacter in 100% of cases.
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Affiliation(s)
- S Gullini
- U.S.L. n. 31 - Arcispedale Sant'Anna - Ferrara
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Gullini S, Boccini S, Contarini D, Macario F, Basso O, Maini P, Bicocchi R. Is transmission of Campylobacter pylori by endoscopic examination possible? Endoscopy 1988; 20:162. [PMID: 3181090 DOI: 10.1055/s-2007-1018167] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Cantarini D, Macario F, Basso O, Boccia S, Pierotti S, Armani A, Gullini S. [Ethical and medicolegal problems in digestive endoscopy]. Minerva Dietol Gastroenterol 1988; 34:177-80. [PMID: 3200467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Basso O, Macario F, Cantarini D, Boccia S, Gullini S. [Campylobacter pylori and dyspeptic symptomatology]. Recenti Prog Med 1988; 79:116-20. [PMID: 3393716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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