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dc.contributor.authorCavero, Teresaes_ES
dc.contributor.authorArjona, Emiliaes_ES
dc.contributor.authorSoto, Karinaes_ES
dc.contributor.authorCaravaca-Fontán, Fernandoes_ES
dc.contributor.authorRabasco, Cristinaes_ES
dc.contributor.authorBravo, Luises_ES
dc.contributor.authorde la Cerda, Franciscoes_ES
dc.contributor.authorMartín, Nadiaes_ES
dc.contributor.authorBlasco, Miqueles_ES
dc.contributor.authorÁvila, Anaes_ES
dc.contributor.authorHuerta, Anaes_ES
dc.contributor.authorCabello-Chaves, Virginiaes_ES
dc.contributor.authorJarque, Anaes_ES
dc.contributor.authorAlcázar, Concepciónes_ES
dc.contributor.authorFulladosa, Xavieres_ES
dc.contributor.authorCarbayo, Javieres_ES
dc.contributor.authorAnaya, Saraes_ES
dc.contributor.authorCobelo, Carmenes_ES
dc.contributor.authorRamos, Nataliaes_ES
dc.contributor.authorIglesias, Elenaes_ES
dc.contributor.authorBaltar, Josées_ES
dc.contributor.authorMartínez-Gallardo, Rocíoes_ES
dc.contributor.authorPérez, Lourdeses_ES
dc.contributor.authorMorales-Ruiz, E.es_ES
dc.contributor.authorGonzález, Robertoes_ES
dc.contributor.authorMacía, Manueles_ES
dc.contributor.authorDraibe, Julianaes_ES
dc.contributor.authorPallardó, Luises_ES
dc.contributor.authorQuintana, Luis F.es_ES
dc.contributor.authorEspinosa, Marioes_ES
dc.contributor.authorBarros, Xoanaes_ES
dc.contributor.authorPereira, Fernandoes_ES
dc.contributor.authorCao, Mercedeses_ES
dc.contributor.authorMoreno, Juan Antonioes_ES
dc.contributor.authorRodríguez de Córdoba, Santiagoes_ES
dc.contributor.authorPraga, Manueles_ES
dc.date.accessioned2019-08-16T11:18:12Z-
dc.date.available2019-08-16T11:18:12Z-
dc.date.issued2019-05-31-
dc.identifier.citationKidney International (2019)es_ES
dc.identifier.issn0085-2538-
dc.identifier.urihttp://hdl.handle.net/10261/188359-
dc.description.abstractMalignant hypertension is listed among the causes of secondary thrombotic microangiopathy (TMA), but pathogenic mutations in complement genes have been reported in patients with hypertension-induced TMA. Here we investigated the frequency and severity of hypertension in 55 patients with primary atypical hemolytic uremic syndrome (aHUS). A genetic analysis was performed in all patients, and funduscopic examination was performed in all the patients with Grades 2 and 3 hypertension. A cohort of 110 patients with malignant hypertension caused by diseases other than aHUS served as control. Thirty-six patients with aHUS presented Grade 2 or Grade 3 hypertension and funduscopic examination showed malignant hypertension in 19. Genetic abnormalities in complement were found in 19 patients (37% among patients with malignant hypertension). Plasmapheresis was performed in 46 patients and 26 received eculizumab. Renal and hematological responses were significantly lower after plasmapheresis (24%) than after eculizumab (81%). Renal survival was significantly higher in patients treated with eculizumab (85% at one, three and five years) compared to patients who did not receive this treatment (54%, 46% and 41%), respectively. Response to eculizumab was independent of hypertension severity and the presence of complement genetic abnormalities. Among patients with malignant hypertension caused by other diseases the prevalence of TMA was very low (5%). Thus, severe and malignant hypertension are common among patients with aHUS and eculizumab treatment leads to a higher renal survival when compared to plasmapheresis. However, TMA is uncommon among patients presenting with malignant hypertension caused by diseases other than aHUS.es_ES
dc.description.sponsorshipWork in this study was supported by the Instituto de Salud Carlos III /Fondo Europeo de Desarrollo Regional (ISCIII/FEDER) grants PI13/02502, PICI14/00350, and PI16/01685 (to MP), and grants PI13/00802, PI14/00883 and PI17/00130 (to JAM.); the ISCIII/FEDER Programa Miguel Servet, grants CP10/00479 and CPII16/00017 (to JAM); the Spanish “Ministerio de Economía y Competitividad/FEDER” [SAF2015-66287-R] (to SRdeC); the Autonomous Region of Madrid (S2017/BMD-3673) (to SRdeC, EA and MP); Red de Investigación Renal (RedInRen) (RD12/0021/0029) (to MP), the “Fundación Inocente” (Madrid, Spain).] (to SRdC), and the Spanish Society of Nephrology and Fundación Renal Ínigo Álvarez de Toledo (FRIAT) (to JAM).es_ES
dc.language.isoenges_ES
dc.publisherElsevieres_ES
dc.relationMINECO/ICTI2013-2016/SAF2015-66287-Res_ES
dc.relationS2017/BMD-3673/COMPLEMENTO II-CMes_ES
dc.rightsclosedAccesses_ES
dc.subjectAtypical hemolytic uremic syndromees_ES
dc.subjectComplementes_ES
dc.subjectEculizumabes_ES
dc.subjectMalignant hypertensiones_ES
dc.titleSevere and malignant hypertension are common in primary atypical hemolytic uremic syndromees_ES
dc.typeartículoes_ES
dc.identifier.doihttp://dx.doi.org/10.1016/j.kint.2019.05.014-
dc.description.peerreviewedPeer reviewedes_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.kint.2019.05.014es_ES
dc.identifier.e-issn1523-1755-
dc.contributor.funderInstituto de Salud Carlos IIIes_ES
dc.contributor.funderEuropean Commissiones_ES
dc.contributor.funderMinisterio de Economía y Competitividad (España)es_ES
dc.relation.csices_ES
oprm.item.hasRevisionno ko 0 false*
dc.identifier.funderhttp://dx.doi.org/10.13039/501100004587es_ES
dc.identifier.funderhttp://dx.doi.org/10.13039/501100003329es_ES
dc.identifier.funderhttp://dx.doi.org/10.13039/501100000780es_ES
dc.contributor.orcidCavero, Teresa [0000-0001-5187-9906]es_ES
dc.contributor.orcidArjona, Emilia [0000-0002-0753-3657]es_ES
dc.contributor.orcidSoto, Karina [0000-0002-6977-9361]es_ES
dc.contributor.orcidCaravaca-Fontán, Fernando [0000-0002-5830-9663]es_ES
dc.contributor.orcidBlasco, Miquel [0000-0003-0789-7992]es_ES
dc.contributor.orcidHuerta, Ana [0000-0003-3342-7628]es_ES
dc.contributor.orcidFulladosa, Xavier [0000-0003-1974-9874]es_ES
dc.contributor.orcidRamos, Natalia [0000-0001-9832-326X]es_ES
dc.contributor.orcidMorales-Ruiz, E. [0000-0002-5824-6973]es_ES
dc.contributor.orcidDraibe, Juliana [0000-0002-2819-8560]es_ES
dc.contributor.orcidQuintana, Luis F. [0000-0001-7582-8476]es_ES
dc.contributor.orcidBarros, Xoana [0000-0001-9690-9769]es_ES
dc.contributor.orcidCao, Mercedes [0000-0002-8389-1800]es_ES
dc.contributor.orcidRodríguez de Córdoba, Santiago [0000-0001-6401-1874]es_ES
dc.contributor.orcidPraga, Manuel [0000-0001-9270-1071]es_ES
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