Publications by authors named "Petra Martínez-Martínez"

2 Publications

  • Page 1 of 1

Cytomegalovirus in Renal Transplant Recipients from Living Donors with and without Valgancyclovir Prophylaxis and with Immunosuppression Based in Anti-thymocyte globulin or Basiliximab.

Int J Infect Dis 2021 Apr 13. Epub 2021 Apr 13.

Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security, Mexico.

Background: In our population, anti-thymocyte globulin (ATG) of 1 mg/Kg/day for 4 days is used; which permits not using valgancyclovir (VGC) prophylaxis in some renal transplant recipients (RTR) of moderate risk (R+), to reduce costs. Our objective was to determine the incidence and risk for the development of cytomegalovirus (CMV) with or without prophylaxis, when exposed to low doses of ATG or basiliximab (BSL).

Patients And Methods: A retrospective cohort included 265 RTRs with follow up of 12 months. Prophylaxis was used in R-/D + and only some R + . Tacrolimus (TAC), mycophenolate mofetil (MMF), and prednisone (PDN) were used in all patients. Logistic regression analysis was performed to estimate the risk of CMV in RTR with or without VGC.

Results: Cytomegalovirus was documented in 46 (17.3%) patients: twenty (43.5%) with CMV infection, and 26 (56.5%) with CMV disease. Anti-thymocyte globulin was used in 39 (85%): 32 "R+", 6 "D+/R-," and 1 "D-/R-". In 90% (27/30) of patients with CMV and without prophylaxis, ATG was used. The multivariate analysis showed an association of risk for CMV with the absence of prophylaxis (RR 2.29; CI 95%, 1,08-4.86), ATG use (RR 3.7; CI 95%, 1.50-9.13), TAC toxicity (RR 3,77; CI 95%, 1,41 -10,13), and lymphocytes at the sixth post-transplant month (RR 1,77; CI 95%, 1,0-3.16).

Conclusions: Low doses of ATG favor the development of CMV and a lower survival free of CMV compared with BSL. In scenarios where resources for employing VGC are limited, one acceptable strategy could be the use of BSL.
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April 2021

Vascular calcification in Mexican hemodialysis patients.

Arch Med Res 2013 Nov 8;44(8):628-32. Epub 2013 Nov 8.

Medical Research Unit in Renal Diseases, Specialty Hospital, CMNO, IMSS, Guadalajara, Mexico.

Background And Aims: Vascular calcification (VC) is a predictor of poor survival and cardiovascular outcome in end-stage renal disease (ESRD) patients; however, there is scarce information of VC in Latin America, and virtually no data in our setting. We undertook this study to evaluate the prevalence and characteristics of VC in a hemodialysis (HD) population from western Mexico and to determine possible associated factors.

Methods: This was a cross-sectional study performed in 52 patients. VC was evaluated using plain X-ray films (Adragao's score) of hands and pelvis; clinical and biochemical variables were also collected. Statistical analysis was carried out with Student t and χ(2) tests performed as appropriate and logistic regression to determine predictors of VC.

Results: Mean age was 43 years, 48% were female, 23% had diabetes mellitus (DM), and median time on dialysis was 46 months. Percentage prevalence was 52% with a mean calcification score of 2.0 ± 2.6; 23% of patients had severe calcification. VC was present in about 23-37% among the different vascular territories evaluated (radial, digital, femoral and iliac). Patients with calcification were significantly older, had a higher frequency of DM, higher alkaline phosphatase and lower HDL lipoproteins than those without VC. In the multivariate analysis, VC in these patients was significantly predicted only by an older age (OR [95% CI]: 1.15 [1.01-1.31], p = 0.04); lower HDL-cholesterol and higher alkaline phosphatase were marginal predictors.

Conclusions: Half of our HD patients had VC. Territories of radial, iliac, femoral and digital arteries were roughly equally affected, and 25% of patients had a calcification considered as severe. Older age was the only significant predicting variable for VC, with low HDL-cholesterol and high alkaline phosphatase as marginal predictors.
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November 2013