«I can't imagine it without my nurse¼: Experiences of people with chronic kidney disease in the evaluation process as kidney transplant candidates.

This qualitative study aimed to explore the experiences of 11 adults with chronic kidney disease (CKD) undergoing evaluation for kidney transplant (KT) and examine the role played by the nurse in the process. Employing a descriptive phenomenology approach, semi-structured interviews were conducted between October 2022 and July 2023. Thematic analysis, facilitated by Atlas. ti software, revealed a systemic management diagram with "The candidate for kidney transplant and their reality" at the center, followed by "The process of chronic kidney disease and kidney transplantation," and concluding with the most distal category centered on "The kidney transplant access nurse." This organizational framework provided insights into the layers of relationships between emerging themes. The findings underscored the complexity and multidimensionality of the CKD and KT process, emphasizing the nurse's pivotal role as a guide and protector throughout the evaluation process for accessing kidney transplantation. The convergence of results with existing literature highlighted the need to address challenges such as lack of time, resources, and emotional support to enhance the quality of care. Recognizing the nurse's crucial importance in this process, the study emphasizes the significance of addressing these challenges to improve patient care and calls for attention to the nurse's role in guiding individuals through the intricate journey of CKD and kidney transplantation.

Complex management and descriptive cost analysis of kidney transplant candidates: a descriptive cross-sectional study.

BACKGROUND: The organisational care needs involved in accessing kidney transplant have not been described in the literature and therefore a detailed analysis thereof could help to establish a framework (including appropriate timing, investment, and costs) for the management of this population. The main objective of this study is to analyse the profile and care needs of kidney transplant candidates in a tertiary hospital and the direct costs of studying them. METHODS: A descriptive, cross-sectional study was conducted using data on a range of variables (sociodemographic and clinical characteristics, study duration, and investment in visits and supplementary tests) from 489 kidney transplant candidates evaluated in 2020. RESULTS: The comorbidity index was high (> 4 in 64.3%), with a mean of 5.6 ± 2.4. Part of the study population had certain characteristics that could hinder their access a kidney transplant: physical dependence (9.4%), emotional distress (33.5%), non-adherent behaviours (25.2%), or language barriers (9.4%). The median study duration was 6.6[3.4;14] months. The ratio of required visits to patients was 5.97:1, meaning an investment of €237.10 per patient, and the ratio of supplementary tests to patients was 3.5:1, meaning an investment of €402.96 per patient. CONCLUSIONS: The study population can be characterised as complex due to their profile and their investment in terms of time, visits, supplementary tests, and direct costs. Management based on our results involves designing work-adaptation strategies to the needs of the study population, which can lead to increased patient satisfaction, shorter waiting times, and reduced costs.

Differential response of bacteria and fungi to drought on the decomposition of Sarcocornia fruticosa woody stems in a saline stream.

Inland saline ecosystems suffer multiple stresses (e.g., high radiation, salinity, water scarcity) that may compromise essential ecosystem functions such as organic matter decomposition. Here, we investigated the effects of drought on microbial colonization and decomposition of Sarcocornia fruticosa woody stems across different habitats in a saline watershed: on the dry floodplain, submerged in the stream channel and at the shoreline (first submerged, then emerged). Unexpectedly, weight loss was not enhanced in the submerged stems, while decomposition process differed between habitats. On the floodplain, it was dominated by fungi and high cellulolytic activity; in submerged conditions, a diverse community of bacteria and high ligninolytic activity dominated; and, on the shoreline, enzyme activities were like submerged conditions, but with a fungal community similar to the dry conditions. Results indicate distinct degradation paths being driven by different stress factors: strong water scarcity and photodegradation in dry conditions, and high salinity and reduced oxygen in wet conditions. This suggests that fungi are more resistant to drought, and bacteria to salinity. Overall, in saline watersheds, variations in multiple stress factors exert distinct environmental filters on bacteria and fungi and their role in the decomposition of plant material, affecting carbon cycling and microbial interactions.

Temporo-Parieto-Occipital Disconnection by Robot-Assisted Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Refractory Epilepsy in a Pediatric Patient: Proof-of-Principle Case Report and Surgical Nuances.

OBJECTIVE: Magnetic resonance imaging-guided laser interstitial thermal therapy (MRIgLITT) has been proven safe and effective for the treatment of focal epilepsy of different etiologies. It has also been used to disconnect brain tissue in more extensive or diffuse epilepsy, such as corpus callosotomy and hemispherotomy. METHODS: In this study, we report a case of temporo-parieto-occipital disconnection surgery performed using MRIgLITT assisted by a robotic arm for refractory epilepsy of the posterior quadrant. A highly realistic cadaver simulation was performed before the actual surgery. RESULTS: The patient was a 14-year-old boy whose seizures began at the age of 8. The epilepsy was a result of a left perinatal ischemic event that caused a porencephalic cyst, and despite receiving multiple antiepileptic drugs, the patient continued to experience daily seizures which led to the recommendation of surgery. CONCLUSIONS: A Wada test lateralized language in the right hemisphere. Motor and sensory function was confirmed in the left hemisphere through magnetic resonance imaging functional studies and NexStim. The left MRIgLITT temporo-parieto-occipital disconnection disconnection was achieved using 5 laser fibers. The patient followed an excellent postoperative course and was seizure-free, with no additional neurological deficits 24 months after the surgery.

Creating the nursing care map in the evaluation of kidney transplant candidates: A scoping review and narrative synthesis.

AIMS: To analyse the aspects involved in the care of individuals assessed as kidney transplant candidates and to identify the role of nurses in providing specialised care for this population. DESIGN: Scoping review. The results were summarised using a narrative synthesis technique. DATA SOURCES: A review of the literature published between 2001 and 2021 was conducted between October and November 2021 using PubMed, CINAHL and SciELO. REVIEW METHODS: The research team agreed on a search strategy based on clinical practice guidelines for assessing kidney transplantation candidates. Quantitative, qualitative and mixed methods studies published in peer-reviewed journals in English, Spanish, French and Portuguese were included. RESULTS: A total of 377 studies were identified, and 49 articles were included after the inclusion and exclusion criteria were applied. The narrative synthesis was structured into four themes: Physical needs; Psychological and quality of life needs; Education and adherence needs; and Nurses' role. CONCLUSION: Nursing assessment of kidney transplantation candidates should encompass physical, psychosocial and adherence aspects. A variety of methodologies and resources are available for this assessment. Nurses contribute to coordinating access to kidney transplantation, aiming to improve adherence to an appropriate lifestyle to prevent patients from being excluded from kidney transplantation or suffering from kidney transplantation-related complications. IMPACT: Based on our findings, we managed to design a nursing care map for kidney transplantation candidates combining the main elements of nursing care that should be incorporated into this process. Advanced practice nursing professionals play a crucial role in accessing renal transplant care.

Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study.

OBJECTIVES: To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model. DESIGN: Descriptive, cross-sectional study. PARTICIPANTS AND MEASUREMENTS: All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the 'Advanced Practice Nurse Role Definition Instrument (IDREPA)' were administered to assess the nurses' level of competence development. RESULTS: Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activity and 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of 'expert care planning' and 'comprehensive care'. Three (11.1%) nurses met all criteria for advanced nursing practice. CONCLUSION: The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses. IMPLICATIONS FOR CLINICAL PRACTICE: Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.

The role of Advanced Practice Nurses in creating the Kidney Transplant candidate care map (APN-preKT): a convergent-parallel mixed methods research protocol.

BACKGROUND: Waiting time for kidney transplants (KT) is an important health determinant for patients with chronic kidney disease (CKD). During this time, ongoing evaluation and participation is necessary in order to guarantee the quality and suitability of the proposed treatment. There is no existing literature on the potential impact of inclusion of an Advanced Practice Nurse (APN) role in the hospital setting on care for CKD patients who are candidates for KT. The main objectives of this protocol are: to analyse outpatient nursing activity in the care of individuals with KT in Spain; to identify the needs of individuals who are KT candidates; and to measure the impact of the APN role through patient outcomes and experiences. These objectives are fulfilled through 5 specific related substudies. METHODS: A convergent parallel mixed methods approach will be conducted between July 2021 and April 2024. Quantitative and qualitative data will be collected and analysed separately to ascertain whether the findings confirm or contradict one another. Each of the 5 substudies of the project require a specific design, sampling method, and data collection procedure in order to meet the overall objectives for the project. DISCUSSION: The results of the project are expected to inform the design of future nursing roles and contribute to future improvements in the quality of care provided. The data that may be obtained from this protocol are limited to the specific context of the study facility and may be extrapolated but not compared to other settings due to the variability of care pathways for KT candidates internationally. TRIAL REGISTRATION: This project was approved by the Clinical Research Ethics Committee (no.2020/9418/I). The study was supported by the "Strategic Plan for Health Research and Innovation" from the Generalitat de Catalunya, registration number SLT017/20/000001, with a contribution of 57,239 euros.

Necesidades asistenciales durante el estudio de personas candidatas a donantes de riñón “PREMIO SEDEN SOBRE DONACIÓN Y TRASPLANTE 2021” / Care needs during the study of kidney donor candidates

Objetivos: Describir las necesidades asistenciales del candidato a donante de riñón; sus características sociodemográficas y clínicas; y analizar los resultados desde una perspectiva de género.Material y Método: Estudio observacional descriptivo transversal. Se recogieron datos clínicos; sociodemográficos; y el número y tipo de visitas y pruebas realizadas durante el año 2020.Resultados: Se incluyeron 60 candidatos a donantes de riñón (n=37 mujeres; 61,67%) con una media de 51,98±14,50 años y una mediana de 2,5 [RIQ (0,69-5,29)] meses de estudio. 16 (26,67%) fueron aptos para la donación, correspondiendo al 14,16% de la actividad en Trasplante Renal (TR) del centro de referencia. Se requirieron 757 visitas (20,60% de la actividad) de las que 341 (45,05%) fueron visitas con la enfermera. Se requirieron 423 pruebas (19,60% de la actividad) durante el estudio. Se identificó una media de 1,87±1,35 factores de riesgo cardiovascular en la muestra analizada, siendo de 1,56±0,81 en los que finalmente fueron donantes. Más mujeres (n=12; 75%) que hombres (n=4; 25%) fueron finalmente donantes renales.Conclusiones: El estudio del candidato a donante de riñón es complejo e implica el doble de actividad que en el de los candidatos a receptores de trasplante renal. El proceso finaliza en donación en el 27% de los candidatos estudiados. La enfermera concentra el 45% de las visitas que se requieren. Es necesario explorar estrategias para optimizar el proceso de estudio. Hay diferencias de género en cuanto a la predisposición para estudiarse voluntariamente como candidata a donante renal. (AU)

Objetives: To describe the care needs of the kidney donor candidate; the socio-demographic and clinical characteristics; and to analyse the results from a gender perspective.Material and Method: Cross-sectional descriptive observational study. Clinical and socio-demographic data, number and type of visits and clinical tests performed during 2020 were collected.Results: Sixty kidney donor candidates (n=37 women; 61.67%) with a mean age of 51.98±14.50 years and a median of 2.5 [RIQ (0.69-5.29)] months of study were included. 16 (26.67%) were eligible for donation, corresponding to 14.16% of the Renal Transplant (RT) activity of the reference centre. 757 visits were required (20.60% of the activity) of which 341 (45.05%) were visits with a nurse. 423 tests (19.60% of the activity) were required during the study. A mean of 1.87±1.35 cardiovascular risk factors was identified in the sample analysed, being 1.56±0.81 in those who were donors. More women (n=12; 75%) than men (n=4; 25%) were ultimately renal donors.Conclusions: The study of kidney donor candidates is complex and involves twice as much activity as that of kidney transplant recipient candidates. The process ends in donation in 27% of the candidates studied. The nurse concentrates 45% of the visits required. Strategies need to be explored to optimise the study process. There are gender differences in the predisposition to be studied voluntarily as a kidney donor candidate. (AU)

Robot-assisted, real-time, MRI-guided laser interstitial thermal therapy for pediatric patients with hypothalamic hamartoma: surgical technique, pitfalls, and initial results.

OBJECTIVE: Real-time, MRI-guided laser interstitial thermal therapy (MRgLITT) has been reported as a safe and effective technique for the treatment of epileptogenic foci in children and adults. After the recent approval of MRgLITT by the European Medicines Agency in April 2018, the authors began to use it for the treatment of hypothalamic hamartomas (HHs) in pediatric patients with the assistance of a robotic arm. In this study, the authors report their initial experience describing the surgical technique, accuracy of the robotic arm, safety, and efficacy. METHODS: The laser fiber was placed with the assistance of the stereotactic robotic arm. The accuracy of the robotic arm for this procedure was calculated by comparing the intraoperative MRI to the preoperative plan. Common demographic and seizure characteristics of the patients, laser ablation details, complications, and short-term seizure outcomes were prospectively collected. RESULTS: Sixteen procedures (11 first ablations and 5 reablations) were performed in 11 patients between 15 months and 17 years of age (mean age 6.4 years) with drug-resistant epilepsy related to HHs. The mean target point localization error was 1.69 mm. No laser fiber needed to be repositioned. The mean laser power used per procedure was 4.29 W. The trajectory of the laser fiber was accidentally ablated in 2 patients, provoking transient hemiparesis in one of these patients. One patient experienced postoperative somnolence and syndrome of inappropriate antidiuretic hormone secretion, and 2 patients had transient oculomotor (cranial nerve III) palsy. Fifty-four percent of the patients were seizure free after the first ablation (mean follow-up 22 months, range 15-33 months). All 5 patients who experienced an epilepsy relapse underwent a second treatment, and 4 remain seizure free at least 5 months after reablation. CONCLUSIONS: In the authors' experience, the robotic arm was sufficiently accurate for laser fiber insertion, even in very young patients. MRgLITT appears to be an effective treatment for selected cases of HH. MRgLITT for HH is a minimally invasive procedure with appealing safety features, as it allows delivery of energy precisely under real-time MRI control. Nonetheless, complications may occur, especially in voluminous HHs. The amount of delivered energy and the catheter cooling system must be closely monitored during the procedure. A larger sample size and longer follow-up duration are needed to judge the efficacy and safety of MRgLITT for HH more rigorously. This initial experience was very promising.

[Monitoring and telematic control of people with kidney transplant and suspected COVID-19 infection.] / Seguimiento y control telemático a personas con trasplante renal y sospecha de infección por COVID-19.

OBJECTIVE: People with Kidney Transplantation require immunosuppressant treatments and this classifies them as a population at risk for virus and/or bacterial infections. The objective of the study was to describe the follow-up of transplanted people with suspected COVID19 infection. METHODS: Descriptive, cross-sectional, observational study with prospective follow-up carried out between March and June 2020. Sociodemographic and clinical data were recorded for the assessment, control and follow-up of the cases. The results were expressed with means and standard deviation, median and interquartile range, or frequencies and percentages. The chi-square test was used to compare qualitative variables and the Student's T test to compare quantitative variables with normal distribution. If they did not follow a normal distribution, the Mann Whitney U test was used. The level of statistical significance was established at p<0.05. RESULTS: A total of 56 patients were included, with a mean of 62.73±13.01 years and a median of 39.5 [7.5; 93] months transplanted. 2.48±2.69 calls/patient were made during a period of 3.46±4.41 days. Virtual follow-up was performed with 100% (n=56) and 71.43% (n=40) required hospital admission at some point. 28.57% (n=16) of the people evaluated were managed at home. The PCR test was performed on 85.71% (n=48) of the study population, being positive in 48.21% (n=27). 29.62% (n=8) of the positive cases required invasive mechanical ventilation and 33.33% (n=9) died. The mortality rate in the study population is 4.17 times higher than that presented in the data from the registries in the general population. CONCLUSIONS: According to the mortality data, it is essential to maintain close contact with the main objective of referring the case to the hospital system at the slightest suspicion of complication. Remote monitoring is offered as a positive opportunity for the control of transplant recipients who require close monitoring by the nursing team.

OBJETIVO: Las personas con Trasplante Renal requieren tratamientos con inmunosupresores y esto los clasifica como población de riesgo para infecciones de virus y/o bacterias. El objetivo del estudio fue describir el seguimiento a personas trasplantadas con sospecha de infección por COVID-19. METODOS: Estudio observacional descriptivo de corte transversal con seguimiento prospectivo llevado a cabo entre marzo y junio de 2020. Se registraron datos sociodemográficos y clínicos para la valoración, control y seguimiento de los casos. Los resultados se expresaron con medias y desviación estándar, mediana y rango intercuartílico o frecuencias y porcentajes Se utilizó el test de chi-cuadrado para comparar variables cualitativas y la prueba T de student para comparar variables cuantitativas con distribución normal. Si no seguían una distribución normal se utilizó el test U de Mann Whitney. Se estableció el nivel de significación estadística en p<0,05. RESULTADOS: Se incluyó a un total de 56 pacientes con una media de 62,73± 13,01 años y una mediana de 39,5 [7,5; 93] meses trasplantados. Se realizaron 2,48±2,69 llamadas/paciente durante un periodo de 3,46±4,41 días. Se realizó seguimiento virtual con el 100% (n=56) y el 71,43% (n=40) requirió ingreso hospitalario en algún momento. El 28,57% (n=16) de las personas valoradas se logró controlar en domicilio. Se realizó el test PCR al 85,71% (n=48) de la población estudiada, siendo positivo en el 48,21% (n=27). El 29,62% (n=8) de los casos positivos requirió de ventilación mecánica invasiva y el 33,33% (n=9) falleció. La tasa de mortalidad en la población estudiada es 4,17 veces superior a la presentada en los datos de los registros en población general. CONCLUSIONES: Según el dato de mortalidad, se hace indispensable mantener el contacto estrecho con el objetivo principal de derivar el caso al sistema hospitalario a la menor sospecha de complicación. El seguimiento a distancia se ofrece como una oportunidad positiva para el control de las personas trasplantadas que requieran un seguimiento estrecho por parte del equipo de enfermería.

Fragilidad y estado nutricional en el periodo pre-trasplante. ¿Existe relación? / Frailty and nutritional status in the pre-transplant period. Is there a relationship?

Introducción: La malnutrición en la enfermedad renal crónica (ERC) está asociada al aumento del riesgo de mortalidad y complicaciones. Sin embargo, el estado nutricional de los pacientes con ERC en lista de espera (LE) de trasplante renal (TR), y su relación con el estado de fragilidad ha sido poco evaluado. Objetivo: Analizar el estado nutricional y funcional de una cohorte de pacientes en lista de espera de trasplante renal y su relación con la fragilidad. Pacientes y Método: Estudio retrospectivo de los pacientes incluidos en LE de TR desde Junio 2016 hasta Junio 2017. Se evaluaron a los pacientes mediante distintas escalas de valoración, recogiendo parámetros antropométricos, analíticos y de bioimpedanciometría (BCM). Resultados: De los 177 pacientes incluidos, 55 (31.1%) se definieron como frágiles. Dicho grupo eran de mayor edad (64.2 vs 61.2 años; p=0.08), sexo femenino (56.4% vs 32.8%, p<0.01), IMC mayor (29.3±5.8 vs 27.3±5,6 kg/m²; p=0.03) y más frecuentemente diabéticos (DM2) (43.6% vs 30.3%; p=0.08). La evaluación mediante BCM demostró que los pacientes frágiles tenían menos índice de tejido magro (12.3±2.4 vs 14.1±4 kg/m²; p<0.01) y mayor índice de tejido graso (16.2±6.1 vs 11.8±5.6 kg/m²; p<0.01) que los no frágiles. Conclusión: En nuestra lista de espera de TR, los pacientes frágiles son de mayor edad, sexo femenino, mayor grado de obesidad, DMII y con menor masa muscular. Las estrategias encaminadas a liberalizar dietas, aumentar la ingesta proteica y fomentar el ejercicio físico pueden ser relevantes para mejorar los resultados a corto y largo plazo del TR (AU)

Introduction: Malnutrition in chronic kidney disease (CKD) is associated with increased risk of mortality and complications. However, the nutritional status of patients with CKD on the renal transplant waiting list and their relationship to the frailty status has been poorly evaluated. Aim: To analyze the nutritional and functional status of a cohort of patients on the waiting list for renal transplantation and its relation to frailty. Patients and method: Retrospective study of patients included in waiting list of renal trasplantation from June 2016 to June 2017. Patients were evaluated through different assessment scales, taking anthropometric, analytical and bioimpedancometry (BCM) parameters. Results: Of the 177 patients included, 55 (31.1%) were defined as frailty. This frailty group was older (64.2 vs 61.2 years, p = 0.08), higher number of females (56.4% vs 32.8%, p <0.01), higher BMI (29.3 ± 5.8 vs 27.3 ± 5.6 kg / m², p = 0.03) and more frequently diabetic (DMII) (43.6% vs 30.3%, p = 0.08). The BCM evaluation showed that the frailty patients had a lower index of lean tissue (12.3 ± 2.4 vs 14.1 ± 4 kg / m², p <0.01) and a higher fat index (16.2 ± 6.1 vs 11.8 ± 5.6 kg / m²; <0.01) than non-frailty ones. Conclusions: In our waiting list for renal transplantation, the frailty patients are older, female, more obese, DMII and with lower muscle mass. Strategies to liberalize diets, increase protein intake and promote physical exercise may be relevant to improve the short- and long-term results of the renal transplantation (AU)

Obesidad, diabetes y trasplante / Obesity, diabetes and transplantation

El trasplante renal es la mejor opción terapéutica en términos de supervivencia y calidad de vida para los pacientes con enfermedad renal crónica. Los pacientes trasplantados son cada vez más mayores y con más pluripatologia asociada. Los avances en inmunosupresión y en el tratamiento han hecho que los pacientes trasplantados fallezcan con el injerto renal funcionante. Existe un incremento de peso del 10% durante el primer año del trasplante, la obesidad se relaciona con la aparición de diabetes mellitus postrasplante. Con el objetivo de analizar la incidencia de obesidad y los factores de riesgo relacionados, en una cohorte de pacientes trasplantados renales realizamos un estudio observacional y prospectivo de estos pacientes, desde enero del 2014 hasta marzo del 2015, con seguimiento de 1 año. Obteniendo como resultado, que los grupos son homogéneos en sexo, tiempo en terapia renal sustitutiva pero distintos en edad. A partir de los 3 meses los pacientes con índice de masa corporal mayor a 25 presentaron mayor incidencia de diabetes mellitus post trasplante respecto al grupo de pacientes con índice de masa corporal inferior a 25 (AU)

Renal transplantation is the best therapeutic option in terms of survival and quality of life for patients with chronic kidney disease. The transplanted patients are becoming older and with more pluripatologia associated. Advances in immunosuppression and in treatment have caused the transplanted patients to die with the functioning renal graft. There is a 10% weight gain during the first year of transplantation, obesity is related to the onset of post-transplant diabetes mellitus. In order to analyze the incidence of obesity and related risk factors in a cohort of renal transplant patients, we conducted an observational and prospective study of these patients, from January 2014 to March 2015, with a 1-year follow-up. As a result, the groups are homogeneous in sex, time in renal replacement therapy but different in age. After 3 months, patients with a body mass index greater than 25 had a higher incidence of post-transplant diabetes mellitus than the group of patients with a body mass index below 25 (AU)

C-reactive protein isoforms differentially affect outer blood-retinal barrier integrity and function.

The retinal pigment epithelium (RPE) forms the outer blood-retinal barrier (oBRB) and is the prime target of early age-related macular degeneration (AMD). C-reactive protein (CRP), a serum biomarker for chronic inflammation and AMD, presents two different isoforms, monomeric (mCRP) and pentameric (pCRP), that may have a different effect on inflammation and barrier function in the RPE. The results reported in this study suggest that mCRP but not pCRP impairs RPE functionality by increasing paracellular permeability and disrupting the tight junction proteins ZO-1 and occludin in RPE cells. Additionally, we evaluated the effect of drugs commonly used in clinical settings on mCRP-induced barrier dysfunction. We found that a corticosteroid (methylprednisolone) and an anti-VEGF agent (bevacizumab) prevented mCRP-induced ARPE-19 barrier disruption and IL-8 production. Furthermore, bevacizumab was also able to revert mCRP-induced IL-8 increase after mCRP stimulation. In conclusion, the presence of mCRP within retinal tissue may lead to disruption of the oBRB, an effect that may be modified in the presence of corticosteroids or anti-VEGF drugs.