Characteristics of patients registered with chronic renal disease in Castilla y León and survival analysis of transplanted patients and their grafts.

INTRODUCTION: Chronic kidney disease (CKD) is an important public health problem. Kidney transplantation is associated with increase survival and improvement of quality of life. OBJECTIVES: To describe the sociodemographic and clinical characteristics of patients registered in Castilla y León. To perform a survival analysis of transplant patients and their grafts. To evaluate survival depending on the transplant centre. METHODS: Descriptive study with data collected until 31 December 2008 from the Registro de Diálisis y Trasplante Renal de la Comunidad de Castilla y León (REDI). The data was described differentiating prevalent and incidents patients. Survival data was assessed with the Kaplan-Meier method. RESULTS: On 31 December 2008, 2.498 patients were on Renal Replacement Therapy (RRT) (976.8 pmp); in 2008, 337 started treatment (131.8 pmp) and 94 received kidney transplant (36.8 pmp). The first cause of CKD for incident patients is diabetes (25.0%), followed by vascular diseases (18.1%). For prevalent patients: glomerulonephritis (16.5%) and diabetes (14.4%). Differences (p = 0.0021) were observed for the treatment initiation age, group of disease and prevalent patients (p <0.0001). During 11 years 1.062 transplants were performed in 1.012 patients and 879 are still functioning (83%). In this period, the survival probability for the transplant patients is 81.076% (± 0.023), and for the 838 patients with first functioning graft is 89.336% (± 0.016). Median graft survival is between 8.7 and 9.3 years (95% confidence). CONCLUSIONS: Most of the transplants during the last 11 years are still functioning. There are no differences when comparing graft survival at the approved centers in Castilla y León (p = 0.358).

Características de los pacientes registrados con enfermedad renal crónica en Castilla y León y análisis de supervivencia de los trasplantados y de sus injertos / Characteristics of patients registered with chronic renal disease in Castilla y León and survival analysis of transplanted patients and their grafts

Introducción: La enfermedad renal crónica (ERC) es un problema importante de salud pública. El trasplante renal se relaciona con el aumento de la supervivencia y con la mejora en la calidad de vida. Objetivos: Describir las características sociodemográficas y clínicas de los pacientes registrados en Castilla y León. Realizar un análisis de supervivencia de los pacientes sometidos a trasplante y de sus injertos. Evaluar la supervivencia en función del centro de trasplante. Métodos: Estudio descriptivo con datos recogidos hasta 31 de diciembre de 2008 en el Registro de Diálisis y Trasplante Renal de la Comunidad de Castilla y León (REDI). Descripción general de los pacientes, diferenciando incidentes de prevalentes. Se realizaron análisis de supervivencia utilizando el método de Kaplan-Meier. Resultados: A 31 de diciembre de 2008, había 2.498 pacientes en tratamiento sustitutivo renal (TSR) (976,8 pacientes por millón de población, pmp); en 2008, 337 iniciaron tratamiento (131,8 pmp) y 94 fueron sometidos a trasplante (36,8 pmp). La causa más frecuente de ERC en pacientes incidentes es la diabetes (25,0%), seguida de las enfermedades vasculares (18,1%). En pacientes prevalentes las causas más frecuentes son glomerulonefritis (16,5%) y diabetes (14,4%). Hay diferencias (p = 0,0021) en la edad de inicio del tratamiento, según grupo de enfermedad (en prevalentes también, p <0,0001) (AU)

Introduction: Chronic kidney disease (CKD) is an important public health problem. Kidney transplantation is associated with increase survival and improvement of quality of life. Objectives: To describe the sociodemographic and clinical characteristics of patients registered in Castilla y León. To perform a survival analysis of transplant patients and their grafts. To evaluate survival depending on the transplant centre. Methods: Descriptive study with data collected until 31 December 2008 from the Registro de Diálisis y Trasplante Renal de la Comunidad de Castilla y León (REDI). The data was described differentiating prevalent and incidents patients. Survival data was assessed with the Kaplan-Meier method. Results: On 31 December 2008, 2.498 patients were on Renal Replacement Therapy (RRT) (976.8 pmp); in 2008, 337 started treatment (131.8 pmp) and 94 received kidney transplant (36.8 pmp) (AU)

High prevalence of asthma and atopy in the Canary Islands, Spain.

OBJECTIVE: To evaluate the prevalence of and risk factors for asthma and related conditions in the Canaries, Spain. METHODS: From a randomised sample of 9506 adults aged 20-44 years who answered a short questionnaire, a random sample corresponding to 20% of the original was taken. Subjects classified as symptomatic in the previous survey and who were not included in the random sample were also invited to participate. The subjects completed a respiratory questionnaire, and underwent spirometry, bronchial hyperresponsiveness (BHR) test, skin tests and immunoglobulin E (IgE) measurements. RESULTS: The random sample included 593 subjects. The prevalence of skin sensitisation to mites was 30.3% (95%CI 26.7-34.2) and the prevalence of IgE to mites 30.5% (95%CI 26.2-35.2). A prevalence of 40.6% (95%CI 35.9-45.5) was found for atopy, 14.1% (95%CI 11.1-17.1) for BHR and 4.2% (95%CI, 2.5-5.9) for asthma. The risk factors most strongly associated with asthma were atopy (OR 4.89, 95%CI 3.07-7.78) and respiratory infection before the age of 5 years (OR 2.78, 95%CI 1.66-4.67). CONCLUSION: This study shows a high prevalence of sensitisation to mites, atopy, BHR and asthma in the Canaries, similar to that observed in English-speaking countries. We suggest that these findings could partially result from climatic conditions.

High prevalence of asthma symptoms in the Canary Islands: climatic influence?

The worldwide variation in asthma prevalence prompted us to carry out a study to assess the variability of asthma-related symptoms in young adults on the islands of Gran Canaria and Tenerife. We used the questionnaire used in the European Community Respiratory Health Survey with the addition of two questions on smoking and ancestors from the Canary Islands. In each island, this questionnaire was distributed to a random sample of 5000 subjects aged 20-44 years. Of the 10,000 subjects, 9,506 (95.06%) were considered eligible. We obtained 7,132 (75.03%) responses. The prevalence of the different symptoms was wheezing 25.3%, nocturnal thoracic tightness 18.0%, awakened by an attack of shortness of breath 13.1%, attack of nocturnal coughing 33.3%, attack of asthma 4.3%, current asthma treatment 6.2%, and nasal allergies 18.0%. Women and smokers showed a significantly higher prevalence of asthma symptoms. No significant difference in symptoms was found between subjects whose ancestors were of Canarian origin and those with ancestors born outside the Canaries. As has been observed on other islands (Great Britain and New Zealand), asthma is common in individuals from 20 to 44 years of age in the Canaries. We hypothesize that climatic conditions play an important role in the prevalence of asthma symptoms.

Creación del Registro de enfermos renales de Castilla y León / The creation of the renal patients registry of Castilla y Leon

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Abscesos hepáticos por streptococcus intermedius como primera manifestación de un carcinoma renal / Streptococcus intermedius liver abscesses as primary manifestation of a renal carcinoma

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