Pub Date : 2026-01-14DOI: 10.1016/j.medcli.2025.107286
María Teresa Pérez-Gracia, Lara Martínez-Celdrán, Clara Más-Comes
Hepatitis E, caused by the hepatitis E virus (HEV), represents an emerging global public health problem, constituting one of the main causes of acute viral hepatitis. Since its first description, it has been considered a disease with an epidemiological pattern linked to the consumption of contaminated water and food, and with a higher prevalence in geographical areas with poor socio-sanitary conditions. According to WHO estimates, around 2 billion people, representing a quarter of the world's population, live in areas where HEV is endemic and are therefore at risk of infection. Improvements in diagnostic techniques have provided the data necessary to demonstrate that in developed countries, HEV infection is common, indigenous and has a different epidemiological pattern, associated with contact with domestic animals, especially pigs. Another interesting aspect is that HEV can cause chronic hepatitis in transplant and immunocompromised patients.
{"title":"Virus de la hepatitis E: un problema de salud pública emergente","authors":"María Teresa Pérez-Gracia, Lara Martínez-Celdrán, Clara Más-Comes","doi":"10.1016/j.medcli.2025.107286","DOIUrl":"10.1016/j.medcli.2025.107286","url":null,"abstract":"<div><div>Hepatitis E, caused by the hepatitis E virus (HEV), represents an emerging global public health problem, constituting one of the main causes of acute viral hepatitis. Since its first description, it has been considered a disease with an epidemiological pattern linked to the consumption of contaminated water and food, and with a higher prevalence in geographical areas with poor socio-sanitary conditions. According to WHO estimates, around 2 billion people, representing a quarter of the world's population, live in areas where HEV is endemic and are therefore at risk of infection. Improvements in diagnostic techniques have provided the data necessary to demonstrate that in developed countries, HEV infection is common, indigenous and has a different epidemiological pattern, associated with contact with domestic animals, especially pigs. Another interesting aspect is that HEV can cause chronic hepatitis in transplant and immunocompromised patients.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107286"},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107311
Ester Mínguez de la Guía , Macarena López Vázquez , Jose Javier Blanch Sancho , Raúl Calvo Córdoba , Francisco Manuel Salmeron Martínez , Miguel Corbí Pascual
Introduction
Q fever is a zoonosis caused by Coxiella burnetii. Spain reports the highest incidence in Europe. Its chronic form may present as infective endocarditis, though other cardiac complications have also been described.
Methods
We conducted a retrospective study of patients admitted for Q fever at a tertiary hospital between 2000 and 2023. Only microbiologically confirmed cases were included. Clinical presentation was analyzed, focusing on patients with cardiac involvement.
Results
A total of 42 patients were included (66.6% male, mean age 49.7 ± 20.6 years); 28 (66.7%) had acute Q fever and 14 (33.3%) chronic. Cardiac involvement was identified in 12 patients (28.5%): 7 with infective endocarditis (all chronic), 3 with myocarditis (2 progressed to dilated cardiomyopathy), and 2 with pericarditis. Overall mortality among patients with cardiac involvement was 25%.
Conclusion
Cardiac manifestations in Q fever may be underdiagnosed. In our cohort, cardiac involvement was frequent and associated with high mortality. Clinicians should maintain a high index of suspicion, especially in chronic Q fever or in patients with fever of unknown origin.
{"title":"Clinical implications of cardiac involvement in Q fever: Findings from a Spanish cohort","authors":"Ester Mínguez de la Guía , Macarena López Vázquez , Jose Javier Blanch Sancho , Raúl Calvo Córdoba , Francisco Manuel Salmeron Martínez , Miguel Corbí Pascual","doi":"10.1016/j.medcli.2025.107311","DOIUrl":"10.1016/j.medcli.2025.107311","url":null,"abstract":"<div><h3>Introduction</h3><div>Q fever is a zoonosis caused by <em>Coxiella burnetii</em>. Spain reports the highest incidence in Europe. Its chronic form may present as infective endocarditis, though other cardiac complications have also been described.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of patients admitted for Q fever at a tertiary hospital between 2000 and 2023. Only microbiologically confirmed cases were included. Clinical presentation was analyzed, focusing on patients with cardiac involvement.</div></div><div><h3>Results</h3><div>A total of 42 patients were included (66.6% male, mean age 49.7<!--> <!-->±<!--> <!-->20.6 years); 28 (66.7%) had acute Q fever and 14 (33.3%) chronic. Cardiac involvement was identified in 12 patients (28.5%): 7 with infective endocarditis (all chronic), 3 with myocarditis (2 progressed to dilated cardiomyopathy), and 2 with pericarditis. Overall mortality among patients with cardiac involvement was 25%.</div></div><div><h3>Conclusion</h3><div>Cardiac manifestations in Q fever may be underdiagnosed. In our cohort, cardiac involvement was frequent and associated with high mortality. Clinicians should maintain a high index of suspicion, especially in chronic Q fever or in patients with fever of unknown origin.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107311"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107321
María del Carmen Azorín Samper , Roberto Lozoya Trujillo , Eduardo García-Granero Ximénez , Marina Alarcón Iranzo , María Dolores Ruiz Carmona , Amparo Solana Bueno
Introduction
To evaluate whether fecal calprotectin (FC) levels after an episode of uncomplicated acute sigmoid diverticulitis are significantly associated with diverticulitis recurrence and symptomatic uncomplicated diverticular disease.
Methodology
A prospective observational study was conducted on patients diagnosed with uncomplicated acute sigmoid diverticulitis in emergency from May 2019 to November 2020. Sociodemographic, clinical, and FC variables were collected. Patients were followed up as outpatients for 19 months with clinical evaluations and simultaneous FC determinations.
Results
A total of 90 patients were included, of which 92.2% received outpatient treatment. Disease persistence at one month was 33.6%, and 13.3% required re-evaluation in the emergency department. The overall recurrence rate was 28.9%. Most patients with recurrence had significantly altered FC levels during follow-up, with a sensitivity of 96.2%, specificity of 26.6%, a positive predictive value of 34.7%, and a negative predictive value of 94.4%. A significant association was also found between FC levels and symptomatic uncomplicated diverticular disease, with a sensitivity of 94.6%, specificity of 44.1%, a positive predictive value of 73.6%, and a negative predictive value of 83.3%.
Conclusions
Elevated FC as a predictor of diverticulitis recurrence has limited utility. However, normal FC levels during follow-up after an episode of uncomplicated diverticulitis appear useful in ruling out recurrence. Elevated FC is valuable for the diagnosis and prediction of symptomatic uncomplicated diverticular disease.
{"title":"Utilidad de la calprotectina fecal en el seguimiento de la diverticulitis aguda no complicada","authors":"María del Carmen Azorín Samper , Roberto Lozoya Trujillo , Eduardo García-Granero Ximénez , Marina Alarcón Iranzo , María Dolores Ruiz Carmona , Amparo Solana Bueno","doi":"10.1016/j.medcli.2025.107321","DOIUrl":"10.1016/j.medcli.2025.107321","url":null,"abstract":"<div><h3>Introduction</h3><div>To evaluate whether fecal calprotectin (FC) levels after an episode of uncomplicated acute sigmoid diverticulitis are significantly associated with diverticulitis recurrence and symptomatic uncomplicated diverticular disease.</div></div><div><h3>Methodology</h3><div>A prospective observational study was conducted on patients diagnosed with uncomplicated acute sigmoid diverticulitis in emergency from May 2019 to November 2020. Sociodemographic, clinical, and FC variables were collected. Patients were followed up as outpatients for 19 months with clinical evaluations and simultaneous FC determinations.</div></div><div><h3>Results</h3><div>A total of 90 patients were included, of which 92.2% received outpatient treatment. Disease persistence at one month was 33.6%, and 13.3% required re-evaluation in the emergency department. The overall recurrence rate was 28.9%. Most patients with recurrence had significantly altered FC levels during follow-up, with a sensitivity of 96.2%, specificity of 26.6%, a positive predictive value of 34.7%, and a negative predictive value of 94.4%. A significant association was also found between FC levels and symptomatic uncomplicated diverticular disease, with a sensitivity of 94.6%, specificity of 44.1%, a positive predictive value of 73.6%, and a negative predictive value of 83.3%.</div></div><div><h3>Conclusions</h3><div>Elevated FC as a predictor of diverticulitis recurrence has limited utility. However, normal FC levels during follow-up after an episode of uncomplicated diverticulitis appear useful in ruling out recurrence. Elevated FC is valuable for the diagnosis and prediction of symptomatic uncomplicated diverticular disease.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107321"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107313
Ivette Casafont-Solé , Maribel Mora , Javier Narváez , Joan Miquel Nolla , Alejandro Olivé , Susana Holgado
Objectives
To evaluate the prognostic utility of the Systemic Score (SS) in a Spanish cohort of patients with adult-onset Still's disease (AOSD), with a focus on its ability to predict disease complications, need for biologic therapy and mortality.
Methods
A retrospective study was conducted in two university hospitals. Clinical, laboratory, complication-related data, biologic treatments, and deaths (AOSD-related or not) were recorded. The SS was calculated at disease onset, assigning one point to each of 12 variables. A score ≥7 is considered high risk. The association between SS and clinical course, complications, biologic treatment, and AOSD-related death was analyzed.
Results
Data from 64 patients were analyzed. SS was <7 in 78.13% and ≥7 in 21.87%. A score ≥7 was significantly associated with macrophage activation syndrome, pericarditis, pleuritis, and renal involvement. Although myocarditis, and amyloidosis were not significantly associated, most individual cases showed SS ≥ 7. Biologic treatment was more frequently required in patients with SS ≥ 7. No association was found with clinical patterns or non-AOSD-related deaths. Both AOSD-related deaths had SS ≥ 7, though the small number of cases limits interpretation.
Conclusions
SS is a valuable prognostic tool in patients with AOSD, allowing early identification of individuals at higher risk of severe complications and treatment escalation. It may help identify patients at high risk for complications and in need of biologic therapy.
{"title":"Utility of systemic score as a prognosis marker and biologic treatment indication in adults with Still's disease","authors":"Ivette Casafont-Solé , Maribel Mora , Javier Narváez , Joan Miquel Nolla , Alejandro Olivé , Susana Holgado","doi":"10.1016/j.medcli.2025.107313","DOIUrl":"10.1016/j.medcli.2025.107313","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the prognostic utility of the Systemic Score (SS) in a Spanish cohort of patients with adult-onset Still's disease (AOSD), with a focus on its ability to predict disease complications, need for biologic therapy and mortality.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in two university hospitals. Clinical, laboratory, complication-related data, biologic treatments, and deaths (AOSD-related or not) were recorded. The SS was calculated at disease onset, assigning one point to each of 12 variables. A score ≥7 is considered high risk. The association between SS and clinical course, complications, biologic treatment, and AOSD-related death was analyzed.</div></div><div><h3>Results</h3><div>Data from 64 patients were analyzed. SS was <7 in 78.13% and ≥7 in 21.87%. A score ≥7 was significantly associated with macrophage activation syndrome, pericarditis, pleuritis, and renal involvement. Although myocarditis, and amyloidosis were not significantly associated, most individual cases showed SS<!--> <!-->≥<!--> <!-->7. Biologic treatment was more frequently required in patients with SS<!--> <!-->≥<!--> <!-->7. No association was found with clinical patterns or non-AOSD-related deaths. Both AOSD-related deaths had SS<!--> <!-->≥<!--> <!-->7, though the small number of cases limits interpretation.</div></div><div><h3>Conclusions</h3><div>SS is a valuable prognostic tool in patients with AOSD, allowing early identification of individuals at higher risk of severe complications and treatment escalation. It may help identify patients at high risk for complications and in need of biologic therapy.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107313"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107316
Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano
Introduction
Pleural effusion (PE) is a frequent complication in acute heart failure (AHF), driven by hydrostatic pressure, impaired lymphatic drainage, and systemic inflammation. This study aimed to evaluate the association between carbohydrate antigen 125 (CA125) and the presence of PE, stratified by atrial fibrillation (AF).
Material and methods
This retrospective observational study analyzed 506 patients hospitalized with AHF at Ramón y Cajal University Hospital. The presence of PE was assessed through bedside thoracic ultrasound or chest radiography. A multivariable logistic regression model was employed to identify independent predictors of PE. Interaction analyses were conducted to examine the combined effect of CA125 levels and AF on the likelihood of PE.
Results
The mean (SD) age was 85.1 years (7.8) and 66.0% were women. PE was identified in 43.7% of patients at admission, AF were present in 299 (59.1%) and median values CA125 were 58.8 U/mL (43.0–89.0). After multivariable adjustment, an interaction between CA125 and AF emerged as a significant predictor of PE (p for the interaction = 0.022). Each 10U/ml increase in CA125 was associated with an OR of 1.03, 95% CI: 1.01–1.06 for every 10 U/ml increase in CA125 levels.
Conclusions
In patients with acute heart failure, the predictive value of CA125 for pleural effusion is influenced by atrial fibrillation. Elevated CA125 levels were associated with PE only in the presence of AF. Conversely, in the absence of AF, high CA125 levels did not predict PE.
{"title":"Valor del antígeno carbohidrato 125 en el derrame pleural en insuficiencia cardiaca aguda y su relación con la fibrilación auricular","authors":"Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano","doi":"10.1016/j.medcli.2025.107316","DOIUrl":"10.1016/j.medcli.2025.107316","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleural effusion (PE) is a frequent complication in acute heart failure (AHF), driven by hydrostatic pressure, impaired lymphatic drainage, and systemic inflammation. This study aimed to evaluate the association between carbohydrate antigen 125 (CA125) and the presence of PE, stratified by atrial fibrillation (AF).</div></div><div><h3>Material and methods</h3><div>This retrospective observational study analyzed 506 patients hospitalized with AHF at Ramón y Cajal University Hospital. The presence of PE was assessed through bedside thoracic ultrasound or chest radiography. A multivariable logistic regression model was employed to identify independent predictors of PE. Interaction analyses were conducted to examine the combined effect of CA125 levels and AF on the likelihood of PE.</div></div><div><h3>Results</h3><div>The mean (SD) age was 85.1 years (7.8) and 66.0% were women. PE was identified in 43.7% of patients at admission, AF were present in 299 (59.1%) and median values CA125 were 58.8 U/mL (43.0–89.0). After multivariable adjustment, an interaction between CA125 and AF emerged as a significant predictor of PE (p for the interaction<!--> <!-->=<!--> <!-->0.022). Each 10U/ml increase in CA125 was associated with an OR of 1.03, 95% CI: 1.01–1.06 for every 10 U/ml increase in CA125 levels.</div></div><div><h3>Conclusions</h3><div>In patients with acute heart failure, the predictive value of CA125 for pleural effusion is influenced by atrial fibrillation. Elevated CA125 levels were associated with PE only in the presence of AF. Conversely, in the absence of AF, high CA125 levels did not predict PE.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107316"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107291
Paula Mula , Marco Tomasino , Aitor Uribarri
Takotsubo syndrome (TTS) is an acute and transient cardiomyopathy characterised by left ventricular systolic dysfunction in the absence of obstructive coronary artery disease. Although its clinical presentation frequently resembles acute myocardial infarction, TTS is driven by distinct pathophysiological mechanisms involving sympathetic hyperactivation, catecholamine surge, coronary microvascular dysfunction, and imbalance within the brain–heart axis. Once considered a benign condition, it is now recognized to carry a significant burden of adverse events—including cardiogenic shock, malignant arrhythmias, and thromboembolic complications—with short- and long-term mortality rates comparable to those of acute coronary syndromes. Diagnosis requires the integration of clinical assessment, cardiac biomarkers, characteristic electrocardiographic changes, and advanced imaging techniques, particularly echocardiography and cardiac magnetic resonance. Management is primarily supportive and should be adapted to the predominant haemodynamic phenotype. This review provides an updated and comprehensive synthesis of the epidemiology, pathophysiology, diagnostic strategies, complications, treatment approaches, and prognosis of TTS, while highlighting current evidence gaps that warrant ongoing and future clinical trials.
{"title":"Síndrome de Takotsubo: de la fisiopatología a la práctica clínica","authors":"Paula Mula , Marco Tomasino , Aitor Uribarri","doi":"10.1016/j.medcli.2025.107291","DOIUrl":"10.1016/j.medcli.2025.107291","url":null,"abstract":"<div><div>Takotsubo syndrome (TTS) is an acute and transient cardiomyopathy characterised by left ventricular systolic dysfunction in the absence of obstructive coronary artery disease. Although its clinical presentation frequently resembles acute myocardial infarction, TTS is driven by distinct pathophysiological mechanisms involving sympathetic hyperactivation, catecholamine surge, coronary microvascular dysfunction, and imbalance within the brain–heart axis. Once considered a benign condition, it is now recognized to carry a significant burden of adverse events—including cardiogenic <em>shock</em>, malignant arrhythmias, and thromboembolic complications—with short- and long-term mortality rates comparable to those of acute coronary syndromes. Diagnosis requires the integration of clinical assessment, cardiac biomarkers, characteristic electrocardiographic changes, and advanced imaging techniques, particularly echocardiography and cardiac magnetic resonance. Management is primarily supportive and should be adapted to the predominant haemodynamic phenotype. This review provides an updated and comprehensive synthesis of the epidemiology, pathophysiology, diagnostic strategies, complications, treatment approaches, and prognosis of TTS, while highlighting current evidence gaps that warrant ongoing and future clinical trials.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107291"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107301
Emilia Fernández Fernández , Marta Costas Vila , Francisco Javier De la Hera Fernández
{"title":"Eficacia de anifrolumab en una hemorragia alveolar difusa recidivante asociada a un lupus eritematoso sistémico","authors":"Emilia Fernández Fernández , Marta Costas Vila , Francisco Javier De la Hera Fernández","doi":"10.1016/j.medcli.2025.107301","DOIUrl":"10.1016/j.medcli.2025.107301","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107301"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.medcli.2025.107308
Mylena Benitez-Valderrama , Priscila Suárez-Puga , Jimmy Martin-Delgado , Fahd Beddar-Chaib , Manuel Méndez-Bailón , Jorge Carriel-Mancilla
Introduction
Chronic kidney disease (CKD) is associated with anemia, a common complication that, in severe cases, requires red blood cell (RBC) transfusion. The optimal hemoglobin (Hb) threshold for deciding when to transfuse remains a matter of debate. This study aimed to compare the effects of a restrictive transfusion strategy (Hb ≤ 7 g/dl) versus a liberal strategy (Hb > 7 g/dl) in hospitalized patients with CKD.
Methods
A single-center retrospective cohort study was conducted between December 2022 and December 2023, including adult patients with CKD stages G3b, G4, and G5 who received RBC transfusions. Demographic data, comorbidities, clinical, laboratory, and prognostic variables were analyzed, including admission to the Intensive Care Unit (ICU), hospital length of stay, pulmonary complications, and transfusion-related adverse events.
Results
Of 934 patients evaluated, 682 met the inclusion criteria. The restrictive transfusion group (n = 341) showed a lower ICU admission rate (6.5 vs. 14.7%; P<.001) and fewer transfusion-related adverse events (P<.001). A prolonged hospital stay (> 10 days) was more frequent in the liberal group (32 vs. 10.5%; P<.001).
Conclusion
The restrictive strategy was associated with fewer complications and a shorter hospital stay, which appears to support a restrictive transfusion approach in patients with chronic kidney disease (CKD).
{"title":"Estrategia de transfusión restrictiva vs. liberal en los pacientes con enfermedad renal crónica: estudio de cohorte retrospectivo","authors":"Mylena Benitez-Valderrama , Priscila Suárez-Puga , Jimmy Martin-Delgado , Fahd Beddar-Chaib , Manuel Méndez-Bailón , Jorge Carriel-Mancilla","doi":"10.1016/j.medcli.2025.107308","DOIUrl":"10.1016/j.medcli.2025.107308","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is associated with anemia, a common complication that, in severe cases, requires red blood cell (RBC) transfusion. The optimal hemoglobin (Hb) threshold for deciding when to transfuse remains a matter of debate. This study aimed to compare the effects of a restrictive transfusion strategy (Hb<!--> <!-->≤<!--> <!-->7<!--> <!-->g/dl) versus a liberal strategy (Hb<!--> <!-->><!--> <!-->7<!--> <!-->g/dl) in hospitalized patients with CKD.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted between December 2022 and December 2023, including adult patients with CKD stages G3b, G4, and G5 who received RBC transfusions. Demographic data, comorbidities, clinical, laboratory, and prognostic variables were analyzed, including admission to the Intensive Care Unit (ICU), hospital length of stay, pulmonary complications, and transfusion-related adverse events.</div></div><div><h3>Results</h3><div>Of 934 patients evaluated, 682 met the inclusion criteria. The restrictive transfusion group (n<!--> <!-->=<!--> <!-->341) showed a lower ICU admission rate (6.5 vs. 14.7%; <em>P</em><.001) and fewer transfusion-related adverse events (<em>P</em><.001). A prolonged hospital stay (><!--> <!-->10 days) was more frequent in the liberal group (32 vs. 10.5%; <em>P</em><.001).</div></div><div><h3>Conclusion</h3><div>The restrictive strategy was associated with fewer complications and a shorter hospital stay, which appears to support a restrictive transfusion approach in patients with chronic kidney disease (CKD).</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107308"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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