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INTRODUCTION: Coronavirus disease 2019 (COVID-19) is public health concern across the world. Data on the epidemiology among patients on hemodialysis in Latin America and low- and middle-income countries are limited. METHODS: Using electronic medical records from the second largest dialysis network in Guatemala, we performed a retrospective analysis of all adult patients on hemodialysis with the diagnosis of COVID-19 to estimate incidence of infection and to describe the demographics, comorbidities, and outcomes. We stratified incidence rate by region. We reviewed data from May 1 to July 31, 2020, with outcome data ascertained up to August 28, 2020. RESULTS: Of 3201 patients undergoing hemodialysis, 325 patients were diagnosed with COVID-19 (incidence rate 102/1000 patients on hemodialysis, compared with 3/1000 in the general population). Incidence was higher in the Central region (207/1000) and lowest in the Southeast region (33/1000), and unlike in the general population, the incidence was lower in Guatemala City. The mean age of patients diagnosed with COVID-19 was 51.1 years (standard deviation [SD] 14.8 years), and 84 (25.8%) were female. The median length of hospital stay was 12 days (interquartile range [IQR] 10-16 days). Two hundred twenty-nine (69.8%) of the patients recovered, 90 patients died (27.7%), and 6 (1.8%) patients were still in the hospital at the time of last follow-up. CONCLUSION: The incidence of diagnosed COVID-19 in Guatemalan patients on hemodialysis was much higher than reported in the general population, with outcomes similar to those described in high-income countries. Rural regions had higher incidence rates than the major metropolitan area.
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On October 14-15, 2019, the 1st Symposium to Promote Chronic Kidney Disease (CKD) Research in Guatemala was held in Guatemala City, Guatemala. The Symposium hosted more than 50 attendees, including health care professionals, policy makers, researchers, and leaders of nongovernmental organizations. The meeting's objectives were to (1) share clinical and health delivery experiences, (2) disseminate local research, and (3) establish consensus priorities for future research. In this report, we review the state of CKD nephrology in Guatemala, summarize experiences shared during the meeting from representatives of the clinical settings in Guatemala where CKD care is provided, and describe consensus priorities for future research.
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PURPOSE: Information on genetic variants that affect the pharmacokinetics and pharmacodynamics (PK/PD) of drugs in different populations from Mexico is still an ongoing endeavor. Here, we investigate allele frequencies on pharmacogenetic targets in Mexican Mestizos and Natives from three different States and its association with drug efficacy in individuals receiving either anticoagulants or antipsychotic drugs. METHODS: Natives from three different states and Mestizo patients receiving acenocoumarol or antipsychotics were genotyped using the DMET microarray (Affymetrix). RESULTS: We provide a collection of genetic variants that indicate that there are 3-times more variation than similarities between populations from Mexico and major continental groups. These differences were observed in several relevant targets including ABCB1, SLCO1A1, NAT2, UGTs, TYMS, VKORC1, and NR1I3. Moreover, Mexican Mestizos also showed allele frequency differences when compared to Natives for variants on DPYD, ADH1A, CYP3A4, SLC28A3, and SLC28A1. Significant allele differences also arose among the three Native groups here studied, mostly for transporters of the ABC-binding cassette and the solute carrier gene family. Finally, we explored genotype-drug response associations and pinpointed variants on FMOs (coumarins), and GSTM1 (haloperidol). CONCLUSIONS: These findings confirm previous results and further delve into the pharmacogenetics of Mexican populations including different Native groups.
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Anticoagulantes/uso terapêutico , Antipsicóticos/uso terapêutico , Variantes Farmacogenômicos , Acenocumarol/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Receptor Constitutivo de Androstano , Feminino , Frequência do Gene , Genética Populacional , Genótipo , Humanos , Indígenas Norte-Americanos , Masculino , México , Pessoa de Meia-Idade , Fenótipo , Adulto JovemRESUMO
Objetivo. Detectar la presencia de anticuerpos anticitoplasma de neutrófilos en pacientes pediátricos con diferentes glomerulopatías. Diseño. Estudio clínico prospectivo. Población. Veintiseis pacientes de ambos sexos. Metodología. Durante el período de mayo 1995 a junio 1996, en la Unidad de Nefrología Pediátrica del Hospital Roosevelt se estudiaron pacientes con diversas glomerulopatías, a quienes les fue realizado la prueba de anticuerpos anticitoplasma de neutrófilos (ANCA). Se obtuvo muestra sanguínea de todos los pacientes para la determinación por inmunoflourescencia indirecta por el método de ELISA o por radioinmunoensayo. Los resultados se compararan con la evolución clínica, hallazgos de laboratorio y resultado de biopsia renal. Resultados. Los anticuerpos ANCA fueron encontrados en 11.5 por ciento de pacientes y el 60 por ciento de los pacientes con glomerulopatías se asoció a ANCA positivo. Dieciseis (61.5 por ciento) de pacientes fueron del sexo masculino y el 61.3 por ciento procedentes del área rural. La edad más frecuente osciló entre los 5 y 10 años. Los diagnósticos más frecuentemente encontrados fueron síndrome nefrótico (53.8 por ciento) y glomerulonefritis (35.6 por ciento). El tiempo de evolución de la enfermedad fue menor de un año en el 50 por ciento de los casos y el 46.1 por ciento de los pacientes recibió diuréticos y el 38.4 por ciento recibió esteroides. Conclusiones. En el estudio, no fue posible establecer la utilidad de la prueba de ANCA como indicador de pronóstico en pacientes con glomerulopatías