Browsing by Autor "Daniela Ponce"

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Acute kidney disease in patients with COVID-19. A prospective, multicenter, multinational study in Latin America
(Sociedade Brasileira de Nefrologia, 2025) Raúl Lombardi; Alejandro Ferreiro; Joanna Yanissa Venegas Justiniano; Mariana Batista Pereira; Cristina Carlino; Rolando Claure‐Del Granado; Daniela Ponce; Daniel Molina Comboni; Agustina Zinoveev
Our data endorse a comprehensive approach based on the concept of AKD. This integrative approach, encompassing the structural and functional continuum of AKI, AKD, and CKD, enables timely interventions and the implementation of preventive and therapeutic strategies.
Acute kidney injury requiring renal replacement therapy during the COVID-19 pandemic: what are our options for treating it in Latin America?
(Elsevier BV, 2020) Lilia Rizo‐Topete; Rolando Claure‐Del Granado; Daniela Ponce; Raúl Lombardi
Development of a Prediction Score for In-Hospital Mortality in COVID-19 Patients with Acute Kidney Injury: A Machine Learning Approach
(2021) Daniela Ponce; Luís Gustavo Modelli de Andrade; Rolando Claure‐Del Granado; Alejandro Ferrero Fuentes; Raúl Lombardi
<title>Abstract</title> <bold>Introduction:</bold> Acute kidney injury (AKI) is frequently associated to COVID-19, and is considered an indicator of severity of disease and is thus associated with increased mortality risk”. <bold>Objective:</bold> The aim of the study was to develop and validate a prognostic score at hospital admission for predicting in-hospital mortality in COVID-19 patients with AKI (AKI-COV score).<bold>Design:</bold> Cross-sectional multicenter prospective cohort study.<bold>Setting:</bold> The Latin America AKI COVID-19 Registry has been conducted in 57 cities in 12 countries from Latin America. Model training was performed on a cohort of patients admitted from May 1 to December 31, 2020. <bold>Participants:</bold> Eight hundred and seventy COVID-19 patients with AKI defined according KDIGO serum creatinine criteria were included between 01 May to 31 December 2020.<bold>Material and Methods:</bold> We evaluated four categories of predictor variables available at the time of AKI diagnosis: (1) demographic data; (2) comorbidities and condition at admission; (3) laboratory exams at admission; (4) characteristics and causes of AKI. We used a machine learning approach to fit models in the training set using 10-fold-cross validation. Predictors with more than 30% missing were removed. We select the best model and confirm the accuracy in a validation cohort using the area under the receiver operating characteristic curve (AUC-ROC). <bold>Main Outcome Measured: </bold>In-hospital mortality.<bold>Results:</bold> There were 544 (62.5%) in-hospital deaths. Increasing age, mechanical ventilation, use of vasopressors, leukocytes number[RC1] transaminases levels, hypertension, severe condition at admission, AKI ethiology, and need kidney replacement therapies (KRT) were associated with increased risk of death. Longer time from symptoms to hospitalization or to AKI diagnosis, and higher urine output were associated with reduced risk of death. The coefficients of the best model (Elastic Net) were used to build the predictive ImAgeS score. The final model has an AUC-ROC of 0.823 [95% CI 0.761 – 0.885] in the validation cohort. <bold>Conclusion:</bold> We developed a predictive model using only demographic data, comorbidities, hospital admission condition, laboratory variables and causes of AKI that shows good accuracy and is easily applicable. The use of AKI-COV score may assist health-care workers in identifying hospitalized COVID-19 patients with AKI that may require more intensive monitoring and can be used for resource allocation.
Development of a prediction score for in-hospital mortality in COVID-19 patients with acute kidney injury: a machine learning approach
(Nature Portfolio, 2021) Daniela Ponce; Luís Gustavo Modelli de Andrade; Rolando Claure‐Del Granado; Alejandro Ferreiro-Fuentes; Raúl Lombardi
Doença renal aguda em pacientes com COVID-19: um estudo prospectivo, multicêntrico e multinacional na América Latina
(Sociedade Brasileira de Nefrologia, 2025) Raúl Lombardi; Alejandro Ferreiro; Joanna Yanissa Venegas Justiniano; Mariana Batista Pereira; Cristina Carlino; Rolando Claure‐Del Granado; Daniela Ponce; Daniel Molina Comboni; Agustina Zinoveev
Resumo Introdução: A doença renal aguda (DRA) é definida como anormalidades renais funcionais e/ou estruturais, com implicações para saúde e duração ≤90 dias. O objetivo foi avaliar a DRA como uma abordagem mais apropriada para essas condições, utilizando uma coorte com COVID-19, onde o comprometimento renal é expresso por proteinúria e/ou perda de função. Métodos: Estudo de coorte observacional, prospectivo, longitudinal, multinacional realizado em cinco países latino-americanos. Foram incluídos pacientes adultos com diagnóstico de COVID-19. Na internação, realizou-se urinálise ou teste de urina com tira reagente. Caso a proteína não fosse detectada, uma investigação de acompanhamento era feita cinco dias depois. Os pacientes foram classificados em quatro categorias de DRA: doença não renal, somente proteinúria, somente injúria renal aguda (IRA), proteinúria e IRA. Resultados: Foram incluídos 360 pacientes. A DRA esteve presente em 273 (75,8%), dos quais 142 (52,0%) apresentaram somente proteinúria, 11 (4,1%) IRA sem proteinúria e 120 (43,9%) apresentaram proteinúria e IRA. No geral, a proteinúria, com ou sem IRA, foi observada em 262 pacientes (72,8%). A IRA, com ou sem proteinúria, ocorreu em 131 pacientes (36,4%). A IRA foi predominantemente grave, não oligúrica e adquirida no hospital. A mortalidade hospitalar aumentou com a gravidade da DRA: doença não renal 9,5%, somente proteinúria 22,8%, somente IRA 56,7%, proteinúria mais IRA 53,0% (p = 0,001). Conclusões: Nossos dados endossam uma abordagem abrangente baseada no conceito de DRA. Essa abordagem integrativa, englobando o continuum estrutural e funcional de IRA, DRA e DRC, permite intervenções oportunas e a implementação de estratégias preventivas e terapêuticas.
Latin American Registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course
(2021) Raúl Lombardi; Alejandro Ferreiro; Daniela Ponce; Rolando Claure‐Del Granado; Gustavo Aroca; Yanissa Venegas; Mariana Batista Pereira; Jonathan S. Chávez-Íñiguez; Nelson Rojas; Ana Villa
Abstract The Latin American Society of Nephrology and Hypertension carried out a cohort prospective, multinational registry of patients with kidney impairment associated to COVID-19 in Latin America through open invitation in order to describe the characteristics of the disease in the region. A population of 870 patients from 12 countries were included. Median age was 63 years (54-74), most of patients were male (68.4%) and had comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome (MODS) due to COVID-19 and volume depletion were the main causes of AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%. Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in 62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, higher mortality and MODS was severe. On the other hand, patients with de novo proteinuria had lower burden of comorbidities and near normal sCr at admission, but showed adverse course of disease and higher in-mortality. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality was 57.4%, and it was associated to age, chronic cardiac disease, fluid depletion, COVID-19 MODS, non-recovery of renal function, ICU admission, vasopressors, in-hospital complications and hospital stay. In conclusion, our study contributes to a better knowledge of this condition and highlights the relevance of the detection of proteinuria throughout the clinical course.
Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course
(Public Library of Science, 2022) Raúl Lombardi; Alejandro Ferreiro; Daniela Ponce; Rolando Claure‐Del Granado; Gustavo Aroca; Yanissa Venegas; Mariana Batista Pereira; Jonathan S. Chávez-Íñiguez; Nelson Rojas; Ana Villa
The Latin American Society of Nephrology and Hypertension conducted a prospective cohort, multinational registry of Latin American patients with kidney impairment associated to COVID-19 infection with the objective to describe the characteristics of acute kidney disease under these circumstances. The study was carried out through open invitation in order to describe the characteristics of the disease in the region. Eight-hundred and seventy patients from 12 countries were included. Median age was 63 years (54-74), most of patients were male (68.4%) and with diverse comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome (MODS) due to COVID-19 and volume depletion were the main factors contributing to AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%. Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in 62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, and MODS was severe. On the other hand, patients with de novo proteinuria had lower incidence of comorbidities and near normal sCr at admission, but showed adverse course of disease. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality of the general population was 57.4%, and it was associated to age, sepsis as cause of AKI, severity of condition at admission, oliguria, mechanical ventilation, non-recovery of renal function, in-hospital complications and hospital stay. In conclusion, our study contributes to a better knowledge of this condition and highlights the relevance of the detection of proteinuria throughout the clinical course.
Multisystemic Support Therapies for AKI in Latin America: Current Status and Preliminary Report
(American Society of Nephrology, 2024) Lilia María Rizo Topete; Dario Xavier Jimenez Acosta; Rolando Claure‐Del Granado; Olynka Vega‐Vega; Alejandra Molano‐Triviño; Daniela Ponce; David Andres Ballesteros Castro
Renal Replacement Therapy for Acute Kidney Injury in COVID-19 Patients in Latin America
(Karger Publishers, 2020) Rolando Claure‐Del Granado; Gustavo Casas-Aparicio; Guillermo Rosa-Díez; Lilia Rizo‐Topete; Daniela Ponce
The incidence of acute kidney injury (AKI) in hospitalized patients with COVID-19 is\nbroad and ranges from 0.5 to 29% according to early reports from China and Italy [1, 2]. A\nrecent multicenter retrospective cohort in New York showed a higher incidence (37%) and\nmortality (35%). AKI was primarily seen in COVID-19 patients with respiratory failure; 89.7%\nof patients who were on mechanical ventilation developed AKI as compared to just 21.7% of\nnon-ventilated patients. Furthermore, 96.8% of patients who required renal replacement\ntherapy (RRT) were on ventilators [3]. From these first reports, AKI emerges at the same time\nas the acute respiratory distress syndrome, and the development of AKI is usually found in\npatients who progress to phase 3 of the extra-pulmonary systemic hyper-inflammation\nsyndrome [4]. Hirsch et al. [3] reported that up to 37.3% of AKI cases occurred within the first\n24 h of hospital admission, and AKI frequently coincides with the development of the hyperinflammation\nphase
SARS-CoV-2 Vaccination Reduces the Frequency of Acute Kidney Disease in COVID-19 Patients: A Prospective Multicenter Multinational Study
(American Society of Nephrology, 2023) Raúl Lombardi; Alejandro Ferreiro; Joanna Yanissa Venegas Justiniano; Mariana Batista Pereira; M. Carlino; Rolando Claure‐Del Granado; Daniela Ponce; Maria A. Zinoveev