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2.
Prostate Cancer and Prostatic Diseases ; 25(1), 2022.
Article in English | EMBASE | ID: covidwho-1821574
4.
Blood Purification ; 50(SUPPL 1):7, 2021.
Article in English | EMBASE | ID: covidwho-1816950

ABSTRACT

Background: During COVID - 19 pandemia, Obesity has been associated by several authors with worse outcomes in ICU. Acute kidney injury (AKI) is highly prevalent In ICU patients and a main determinant of ominous ICU outcomes. We wanted to evaluate the association between obesity and AKI as a predictor of mortality and need of RRT. Methods: We retrospectively selected from our critical Care Nephrology database in LaCardio hospital in Bogotá- Colombia, adult patients admitted in our ICUs between February to august 2020. Those patients with diagnosis at admission of AKI (according to KDIGO criteria), serum creatinine > 2,5 mg/dL or those receiving dialysis (acute or chronic) or kidney transplantation were excluded. We analyzed obese patients (BMI > 30) admitted to ICU, incidence of AKI, need of replacement therapy (RRT) and mortality during ICU hospitalization. Results: From 1204 new ICU patients, according to selection criteria, we found 490 patients, with mean age 61,3 y.o (18-98). 37% were women. Mean BMI was 26,5 in the overall population. We found 102 obese patients (45,1%), with a mean BMI of 33,6 (30- 46,9). There were 198 patients with acute COVID- 19 (40,4%), of whom 50 patients were obese: 49% (p NS). Basal creatinine value was 1,02 mg/dL at start of hospitalization and 0,91 mg/dL at ICU admission. In the whole group (n 490) there were 160 patients with some AKI KDIGO stage (32%). There was AKI KDIGO 1 or 2 in 27 obese patients, and KDIGO 3 in 8 obese patients (7,8%). There was requirement of RRT in 13 obese patients (12,7%) and 52 in the overall analyzed population (10,6%). We found no statistically significative differences in AKI incidence with non-obese patients. (Table 1) Mean ICU stay was 11,8 days (1-62): in obese patients mean time was 11,4 and in non-obese patients 1,9 days. Mortality was the outcome in 19,2% of our population, in 13 of obese patients (12,7%) and 81 (20,9%) of non-obese patients. Conclusion: In patients admitted to ICU without previous AKI, there was an incidence of newly developed AKI of 32%, and we found no difference between obese or non-obese patients in AKI incidence, mortality or time in ICU. In our hospital, Obese patients with diagnosis of COVID 19 admitted to ICU, did not have more frequent AKI than non-obese COVID patients.

6.
Central European Journal of Urology ; 75(1):102-109, 2022.
Article in English | ProQuest Central | ID: covidwho-1811063

ABSTRACT

Ultimately, the following search string was used to collect COVID-19 articles: TS=('2019-nCoV' OR 'COVID-19' OR covid19 OR 'SARS-CoV-2' OR 'HCoV-2019' OR 'hcov' OR 'NCOVID-19' OR ncovid19 OR 'severe acute respiratory syndrome coronavirus 2' OR 'severe acute respiratory syndrome corona virus 2' OR 'coronavirus' OR 'corona virus') AND WC=(Urology & Nephrology) AND PY=(2020-2021) AND LA=(English) AND (DT=(Article) OR DT=(Review) OR DT=(EARLY ACCESS) OR DT=(NEWS ITEM)). The increased mortality and ICU admission for patients with COVID-19 infection and chronic kidney disease (CKD) and/or acute kidney injury (AKI) prompted investigations on the association between COVID-19, CKD, haemodialysis, and other kidney disorders [14]. Repercussions on mental health, quality of life and sexuality Studies focused on the effects of social distancing on sexual desire, activity and satisfaction, which led to anxiety, depression, especially in women and elderly [31, 32]. Impact on healthcare providers High impact on mental stress, anxiety, and changes in sexual attitudes was reported also among health professionals [33].

8.
Indian Journal of Nephrology ; 32(2):184-185, 2022.
Article in English | ProQuest Central | ID: covidwho-1810675
9.
Indian Journal of Nephrology ; 32(2):110-115, 2022.
Article in English | ProQuest Central | ID: covidwho-1810673

ABSTRACT

Introduction: Since COVID-19 has been announced as a pandemic, outcome of dialysis patients in terms of morbidity and mortality from India is lacking. We studied the clinical, epidemiological features of COVID-19 along with outcome in terms of mortality in our dialysis cohort. Methods: Data of End-Stage Kidney Disease (ESKD) patients who were admitted in COVID-19 designated hospital block as positive and suspected patients from 1st April 2020 to 31st July 2020 was retrieved. Data about epidemiological characteristics, clinical features, mortality outcomes of COVID-19 positive and negative patients were analyzed. Results: A total of 97 ESKD patients were admitted during the study period, of which 44 (45.4%) and 53 (54.6%) patients were found to be COVID-19 positive and negative respectively. The mean age of COVID positive patients was 46 years with 54.5% being female. Only three patients (6.8%) remained asymptomatic throughout the course of illness. Amongst COVID-19 positive, 20 (45.45%) were severely ill while 18 (40.9%) were having mild illnesses. Breathlessness (65.9%) and fever (61.4%) were common symptoms. The death occurred in 17 (38.6%) and 25 (47.1%) COVID-19 positive and negative ESKD patients respectively. 14 (82.3%) patients who expired amongst COVID-19 positive were having severe illness and significantly more were associated with negligible residual renal function. Conclusions: Breathlessness and fever were common symptoms amongst COVID-19 ESKD patients. Very few patients remained asymptomatic in our cohort and significantly more mortality is observed in severely ill patients and those with negligible residual renal function.

10.
Indian Journal of Nephrology ; 32(2):191-192, 2022.
Article in English | ProQuest Central | ID: covidwho-1810672
11.
International Braz J Urol ; 48(3):600-601, 2022.
Article in English | Web of Science | ID: covidwho-1808665

ABSTRACT

Introduction: Surgical training will be complemented by digitalisation, as the COVID 19 pandemic continues (1). Proximie is an augmented reality (AR) platform that can display up to 4 native camera views, with live or semi live telementoring. It can optimise ergonomics of the surgeon at the console (2), and robotic instrument orientation. We describe the utilisation of Proximie as a step-by-step guide in a robotic assisted radical prostatectomy (RARP). Surgical Technique: Author V. P. performed a transperitoneal multiport da Vinci Xi RARP with the Proximie platform: a laptop computer, multiple HD webcams, microphones and speakers. Using an HDMI cable to the Intuitive Surgical tower, output display from the console and an additional laparoscopic tower is shown. Each webcam was mounted to the side armrests of the console, directed at the surgeon's hands. An independent 'drop in' laparoscope via an additional 5mm left upper quadrant port was utilised. Observers can visualise the AR platform's recordings on a laptop and/or smartphone. A PTZ (pan-tilt-zoom) camera can capture the operating room, bedside assistant, ports and patient position. Our video demonstrates three of four camera views for posture, forearm, wrist, hand, and finger orientation, relative to the translated robotic steps. A pincer grasp of the endowrist manipulator during anastomosis allows optimal robotic wrist rotation. The second laparoscopic camera view demonstrated intracorporeal angles of robotic arm and bedside assistant's instrument position for critical steps such as nerve sparing and anastomosis (3). The console time was 100 minutes, no intraoperative complications, or delay in image transmission occurred with utilising the platform. Considerations: An AR platform can create deeper learning for RARP in real time or recorded sessions. Two-way verbal and visual communication with ability to annotate on screen, allows long distance mentoring. The platform's utility can be accessed in anywhere, to project surgeons beyond their immediate environment. This allows for democratisation of access to high volume institutions and their evolution of techniques (4), to assist patients globally. Potential developments are artificial intelligence (AI) networks analysing repository of such recorded data, to identify intraoperative hand motion and robotic instrument tracking. AR is a pertinent building block to enhance robotic training, skill dissemination, precision medicine (5) and surgery overall.

12.
J Investig Med High Impact Case Rep ; 10:23247096221093888, 2022.
Article in English | PubMed | ID: covidwho-1808264

ABSTRACT

We report a case of dialysis dependence in a patient with COVID-19-associated nephropathy (COVAN) who had minimal respiratory manifestations. A 25-year-old man with a history of multiple sclerosis in remission presented with mild dyspnea due to COVID-19 pneumonia and was found to have rapidly worsening kidney function. He only required nasal cannula and was able to be weaned off within a few days. Despite having only mild respiratory disease, his kidney function worsened and urgent hemodialysis was started for hyperkalemia and uremic encephalopathy. Kidney biopsy demonstrated collapsing glomerulopathy due to COVID-19 with moderate interstitial fibrosis and tubular atrophy. His kidney function did not recover, and he unfortunately now has been dependent on hemodialysis for over 3 months. Multiple case reports have described COVAN causing dialysis dependence, but to our knowledge this is the first reported case of COVAN causing dialysis dependence in a patient with such mild respiratory disease. Currently the indications for intensive COVID-19 therapies are based on oxygen requirements. This case demonstrates that the oxygen requirement may not fully reflect the severity of COVID-19 and raises the question of whether these therapies should be considered in patients with COVAN.

13.
JCI Insight ; 2022.
Article in English | PubMed | ID: covidwho-1807764

ABSTRACT

COVID-19 infection causes collapse of glomerular capillaries and loss of podocytes, terminating in a severe kidney disease called COVID-19 associated nephropathy (COVAN). The underlying mechanism of COVAN is unknown. We hypothesized that cytokines induced by COVID-19 trigger expression of pathogenic APOL1 via JAK-STAT signaling, resulting in podocyte loss and COVAN phenotype. Here, based on nine biopsy-proven COVAN cases, we demonstrated for the first time that APOL1 protein is abundantly expressed in podocytes and glomerular endothelial cells (GECs) of COVAN kidneys but not in controls. Moreover, a majority (77.8%) of COVAN patients carried two APOL1 risk alleles. We showed that recombinant cytokines induced by SARS-CoV-2 act synergistically to drive APOL1 expression through the JAK-STAT pathway in primary human podocytes, GECs, and kidney micro-organoids derived from a carrier of two APOL1 risk alleles but was blocked by JAK1/2-inhibitor, baricitinib. We demonstrated for the first time that cytokine-induced JAK-STAT-APOL1 signaling reduced the viability of kidney organoid podocytes but was rescued by baricitinib. Together, our results support the conclusion that COVID-19-induced cytokines are sufficient to drive COVAN-associated podocytopathy via JAK-STAT-APOL1 signaling and that JAK-inhibitor could block this pathogenic process. These findings suggest that JAK-inhibitors may have therapeutic benefits for managing cytokine-induced APOL1-mediated podocytopathy.

14.
Journal of Urology ; 207(5):1142-1142, 2022.
Article in English | Web of Science | ID: covidwho-1801391
15.
Clinical Kidney Journal ; : 2, 2022.
Article in English | Web of Science | ID: covidwho-1799438
16.
BMJ Open ; 12(4): e061864, 2022 Apr 15.
Article in English | MEDLINE | ID: covidwho-1794490

ABSTRACT

INTRODUCTION: Regulatory T cell (Treg) therapy has been demonstrated to facilitate long-term allograft survival in preclinical models of transplantation and may permit reduction of immunosuppression and its associated complications in the clinical setting. Phase 1 clinical trials have shown Treg therapy to be safe and feasible in clinical practice. Here we describe a protocol for the TWO study, a phase 2b randomised control trial of Treg therapy in living donor kidney transplant recipients that will confirm safety and explore efficacy of this novel treatment strategy. METHODS AND ANALYSIS: 60 patients will be randomised on a 1:1 basis to Treg therapy (TR001) or standard clinical care (control). Patients in the TR001 arm will receive an infusion of autologous polyclonal ex vivo expanded Tregs 5 days after transplantation instead of standard monoclonal antibody induction. Maintenance immunosuppression will be reduced over the course of the post-transplant period to low-dose tacrolimus monotherapy. Control participants will receive a standard basiliximab-based immunosuppression regimen with long-term tacrolimus and mycophenolate mofetil immunosuppression. The primary endpoint is biopsy proven acute rejection over 18 months; secondary endpoints include immunosuppression burden, chronic graft dysfunction and drug-related complications. ETHICS AND DISSEMINATION: Ethical approval has been provided by the National Health Service Health Research Authority South Central-Oxford A Research Ethics Committee (reference 18/SC/0054). The study also received authorisation from the UK Medicines and Healthcare products Regulatory Agency and is being run in accordance with the principles of Good Clinical Practice, in collaboration with the registered trials unit Oxford Clinical Trials Research Unit. Results from the TWO study will be published in peer-reviewed scientific/medical journals and presented at scientific/clinical symposia and congresses. TRIAL REGISTRATION NUMBER: ISRCTN: 11038572; Pre-results.

17.
Acta Medica Peruana ; 38(4):249-256, 2022.
Article in Spanish | EMBASE | ID: covidwho-1791272

ABSTRACT

Introduction: Kidney failure is one of the most frequent extrapulmonary complications in patients hospitalized with COVID-19, leading to poorer outcomes, and this may have serious consequences for the Peruvian health system. Nonetheless, there are studies comparing patients with acute kidney failure (AKF) and chronic kidney failure (CKF) against healthy subjects. Objective: To determine the clinical characteristics of hospitalized patients with COVID-19 and kidney failure, and to assess the effect of the type of kidney failure and undergo hemodialysis with respect to negative clinical outcomes. Methods: This is a descriptive cohort study that included patients with some kind of kidney failure and COVID-19 who were hospitalized between March and June 2020, and who had a consultation with the nephrology service. Kidney failure was classified as acute, chronic, and stage V chronic undergoing chronic hemodialysis. Data with respect to mortality, inotrope use, mechanical ventilation, and acute hemodialysis was collected. Results: Two-hundred and seventy-nine patients were included, 22.6% had acute kidney failure, 33.3% had chronic kidney failure, and 44.1 had stage V chronic kidney failure. General mortality rate was 32.0%, and 27% received inotrope agents and underwent mechanical ventilation. Amongst patients with AKF and CKF, 12.9% underwent hemodialysis for the first time. Studied adult subjects with CKD and stage V CKD undergoing hemodialysis had lower frequency of diabetes mellitus (23.7% and 43.9%, respectively) and high blood pressure (31.2% and 59.4%, respectively) compared with adult subjects with AKF (81.0 and 73%, respectively) (p<0.001). The occurrence of AKF was associated with mechanical ventilation (RPa: 6.46), inotrope use (RPa: 7.02), and death (RPa: 2.41), compared with those who had CKF. Amongst those subjects who had AKF or CKF, those who underwent dialysis for the first time were more likely to die (RPa: 2.95;95% CI: 2.20-3.94) compared with those who did not undergo hemodialysis. Acute hemodialysis may be an effect modifier for the association between the type of kidney failure (AKF or CKF) and negative clinical outcomes (p<0.001). Conclusion: It is important to identify hospitalized patients with COVID-19 that may develop AKF and/or who may need acute hemodialysis, since they are at high risk for a poor clinical outcome.

18.
Journal of Urology ; 207(1):218-+, 2022.
Article in English | Web of Science | ID: covidwho-1781945
19.
American Journal of Kidney Diseases ; 79(4):S50-S50, 2022.
Article in English | Web of Science | ID: covidwho-1777263
20.
American Journal of Kidney Diseases ; 79(4):S48-S48, 2022.
Article in English | Web of Science | ID: covidwho-1777237
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