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Persistent Vitamin D Deficiency in Pediatric Patients with Cystic Fibrosis
(MDPI AG, 2025)
Reyes-Apodaca, Magali
;
Lezana-Fernández, José L.
;
Vázquez Frias, Rodrigo
;
Rendón-Macías, Mario Enrique
;
González-Molina, Aline
Background/Objectives: Cystic fibrosis (CF) is a multisystem disease caused by CFTR gene variants, with a high prevalence of vitamin D (VitD) deficiency despite the supplementation and schedules specifically developed for this population. Lower VitD levels have been associated with an increased risk of respiratory infections and pulmonary exacerbations in CF, with some pilot studies indicating the potential benefits of supplementation during acute episodes. This study aimed to describe the occurrence of VitD deficiency according to the supplemented dose in pediatric patients with CF. Methods: A cross-sectional analytical study was conducted to assess serum VitD levels in a pediatric population with cystic fibrosis. Clinical and biochemical data were collected, along with information on VitD intake and pancreatic enzyme dosage at the time of evaluation. Results: A total of 48 patients were included in the study. Normal VitD levels were observed in 41.7% of the patients, insufficiency in 31.3%, and deficiency in 27%. The median VitD intake was 2050 IU. A statistically significant difference was observed in patients with a daily intake exceeding 2000 IU. Only 10% of patients achieved levels above 30 ng/mL with a lower dose. No statistically significant association was identified between the pancreatic enzyme dosage and vitamin D levels. Conclusions: Vitamin D deficiency/insufficiency is a persistent problem in the pediatric CF population; the interventions targeting factors associated with this condition are required to refine supplementation schedules. These findings underscore the need for personalized strategies to optimize vitamin D status in PwCF. Ideally, these strategies should consider all associated factors, including genetic variants; however, with limited resources, our results suggest that a daily dose of 2000 IU of vitamin D may represent a reasonable and effective starting point for supplementation. © The authors © MDPI .
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Análisis de las características sociodemográficas de los pacientes con enfermedad renal crónica terminal: Diferencias en un periodo de seis años
(2012-07)
Cantú Quintanilla, Guillermo Rafael
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Rodríguez, Graciela
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Luque Coqui, Mercedes
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Romero, Benjamín
;
Valverde, Saúl
Background. Chronic renal disease (CRD) is a disease with a strong impact on the childhood Mexican population with short-range limiting and serious consequences. Poverty and a social environment devoid of social justice hinder timely medical attention and long-range rehabilitation. The aim of this study was to determine the differences regarding sociodemographic features in patients under treatment at Hospital Infantil de México Federico Gómez, with a 6-year difference: patients diagnosed in 2003 as compared to those diagnosed in 2009. Methods. A retrospective comparative study was carried out with end-stage chronic renal disease (ESRD) patients with information obtained from the clinical files. Data were obtained on age, gender, renal insufficiency etiology, socioeconomic level, type of financing, place of origin, and whether patient entered a rehabilitation program (dialysis or transplant).
14 1
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Nephrology in Mexico
(2021)
García-García, Guillermo
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Chávez-Iñiguez, Jonathan Samuel
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Vázquez-Rangel, Armando
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Cervantes-Sánchez, Cynthia Gabriela
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Paniagua, Ramón
Nephrology in Mexico started in 1955 with the opening of the nephrology department at Mexico’s National Heart Institute, where the first nephrology training program began in 1958. Pediatric nephrology care was first offered at Mexico’s Federico Gomez Children’s Hospital in 1953, among the first pediatric nephrology programs in the world. Kidney transplantation began in 1963 at the IMSS General Hospital. The Sociedad Mexicana de Nefrologia, the first Mexican nephrology society, was established in 1967, followed by the publication of Nefrologia Mexicana, its official journal, in 1980. Chronic kidney disease has emerged as a public health problem in Mexico. However, the fragmentation of the health system has resulted in unequal access to renal replacement therapy. Seguro Popular, a public health-care insurance for the poor, does not cover renal replacement therapy. As a consequence, many uninsured patients refuse dialysis, eventually abandon their treatment, or lose their kidney grafts because sustaining dialysis or immunosuppression becomes unaffordable. The lack of a national dialysis registry results in a vacuum of information on the burden of treated end-stage renal disease and its outcomes. In addition to the high burden of traditional risk factors (i.e., diabetes mellitus), a number of “hotspots” of chronic kidney disease of unknown origin have been recently described in the country. Despite the increased burden of chronic kidney disease, strategies to prevent chronic kidney disease have not been part of the nation’s noncommunicable disease health policies. Chronic kidney disease screening is not part of the National Health Surveys. Peritoneal dialysis continues to be the dialysis modality of choice, although a significant shift to hemodialysis has been observed over the last two decades. The number of nephrologists (9.1 per million population) is insufficient to match the demand imposed by the burden of chronic kidney disease. In conclusion, after 65 years of the beginning of nephrology in Mexico, kidney disease care remains unjust, unequal, and below the quality of international standards. The current infrastructure and resources are insufficient to satisfy the demand of renal care in our society. Therefore, it is important to consider it as a public health priority and to implement a comprehensive program for the prevention and control of this illness. The establishment of a national public policy for the prevention and treatment of chronic kidney disease is urgently needed. © Springer Nature
Scopus© Citations 2 15 2
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Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study
(2022)
Martin-Alemañy, Geovana
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Pérez-Navarro, Monserrat
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Wilund, Kenneth R.
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García-Villalobos, Gloria
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Gómez-Guerrero, Irma
Background: Oral nutritional supplementation (ONS) with or without exercise (EX) could improve muscle mass (MM) in chronic kidney disease. Methods: Patients were randomized into two groups: (1) ONS and (2) ONS + EX. Thigh muscle area (cm2) and intramuscular lipid content via attenuation were evaluated at baseline and 6 months with computed tomography (CT) to measure MM quantity and quality. Physical function was measured by six-minute walk test (6 MWT), gait speed, handgrip strength (HGS), and Time Up and Go test (TUG) at baseline and 3 and 6 months.
Scopus© Citations 15 9 2
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Utilidad del método Delphi para la construcción de acuerdos en la asignación de riñones de donante fallecido en seis hospitales de México
(2010-09)
Cantú Quintanilla, Guillermo Rafael
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Reyes, Alfonso
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Romero Navarro, Benjamín
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Luque Coqui, Mercedes
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Rodríguez Ortega, Graciela
Objetivos: Conocer los criterios médicos y su prioridad en la asignación de riñones de paciente fallecido en Pediatría, entre los integrantes de los Comités Internos de Trasplantes de seis hospitales. Valorar si con el método Delphi es posible construir consensos para mejorar la heterogeneidad de criterios en la asignación de órganos para trasplante renal entre los médicos adscritos a los servicios de Nefrología y Cirugía en seis centros hospitalarios de México. Metodología: Se realizó un estudio con el método de expertos Delphi con tres fases y dos circulaciones para identificar comportamientos y tendencias con la sinergia del debate en un grupo. Se aplicó el índice de Kappa para evaluar concordancia de los resultados. Resultados: Los resultados de la primera circulación muestran la heterogeneidad de criterios para la asignación de órganos de donador fallecido dentro de cada hospital y de los seis hospitales comparados entre si. Con los resultados de la segunda circulación en cuatro hospitales aumentó el consenso para la elección tanto del primer como del segundo receptor. El cociente de Kappa muestra la habilidad de los resultados. Conclusión: Vemos necesario desarrollar un sistema de puntaje para la asignación de órganos de donador fallecido en México, en el que será conveniente incluir el HLA. El método Delphi permite conocer la prioridad de los criterios médicos para la asignación de riñones de donador fallecido, y ayuda a construir consensos que permitan a los Comités Internos de Trasplantes de México minimizar la subjetividad del personal involucrado en la asignación de órganos.
Scopus© Citations 3 52 1
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National Survey Carried Out by the Mexican Society of Transplantation in 2009 Regarding Deceased-Donor Kidney Allocation
(2010)
Cantú Quintanilla, Guillermo Rafael
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Alberú, Josefina
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Reyes-Acevedo, Rafael
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Romero-Navarro, Benjamín
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Noyola-Villalobos, Héctor Faustino
Background: The Mexican Health Law stipulated that the criteria to be taken into account for deceased donor kidney allocation should include the following: "seriousness of recipient's condition, opportunity of transplant, expected benefits, compatibility with recipient, and all other accepted medical criteria." The practical application of these criteria has been perceived by several members of transplantation committees as allowing inequity in kidney allocation. The aims of this study were to learn the opinions of transplantation committees regarding current national allocation policies, and to obtain their opinions about the advantages of a point-score system.
Scopus© Citations 2 15 2
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A Comparative Study of the Traditional Method, and a Point-Score System for Allocation of Deceased-Donor Kidneys: A National Multicenter Study in Mexico
(2011)
Cantú Quintanilla, Guillermo Rafael
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Alberú-Gomez, Josefina
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Reyes-Acevedo, Rafael
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Medeiros, Mara
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Villa, María De La Salud
Background: The National Transplant Center in Mexico has ruled that deceased-donor kidney allocation is a function of each hospital's Internal Transplant Committee. The aim of this study was to compare and analyze results for of the traditional method and a point-score system in the allocation of deceased patient's kidneys. Methods: The 12 major kidney transplant centers in the country having a deceased-donor program were invited to participate. Only 3 of them replied to the invitation during 2010. A point-score system was proposed to them, comprising blood group, waiting list time, HLA type, and donor and recipient ages. Once the final recipient was chosen, an explanation of reasons for the choice was requested. Thirty-eight transplants were presented. Kappa coefficient was used to measure degree of agreement in both allocation systems. Organs donated for transplantation came from patients between 4 and 54 years old, including 52% female, 52% O+ blood type, 31% A+, and 11% B+, 44% cranial-encephalic trauma, and 44% brain hemorrhage.
Scopus© Citations 1 16 1
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Prevalencia de enfermedad renal en niños aparentemente sanos con antecedente familiar de terapia de reemplazo renal
(2015)
Medeiros, Mara
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Andrade Veneros, Gioconda Daniela
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Toussaint Martínez de Castro, Georgina
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Ortiz Vásquez, Lourdes
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Hernández Sánchez, Ana María
Background: Having a first- or second-degree relative with chronic kidney disease (CKD) has been reported as a risk factor for CKD development. The aim of the study was to determine the prevalence of CKD in children with a first- or second-degree relative undergoing renal replacement therapy (hemodialysis or renal transplant). Methods: A screening study was performed in asymptomatic children with a family history of CKD in a first- or second-degree relative undergoing renal replacement therapy. Informed consent was obtained in all cases. A clinical examination was performed. Blood and urine samples were obtained for serum creatinine, serum electrolytes, urinalysis, and microalbumin/creatinine ratio.
Scopus© Citations 4 32 2
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Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire
(2015)
Ferris, María E.
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Cohen, Sarah E.
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Haberman, Cara
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Javalkar, Karina
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Massengill, Susan F.
Introduction The Self-Management and Transition to Adulthood with Rx = Treatment (STARx) Questionnaire was developed to collect information on self-management and health care transition (HCT) skills, via self-report, in a broad population of adolescents and young adults (AYAs) with chronic conditions.
Scopus© Citations 107 15 1
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Self-Management and Transition Readiness Assessment: Concurrent, Predictive and Discriminant Validation of the STARx Questionnaire
(2015)
Cohen, Sarah E.
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Hooper, Stephen R.
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Javalkar, Karina
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Haberman, Cara
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Fenton, Nicole
Introduction: The STARx Questionnaire was designed with patient and provider input, to measure self-management and transition skills in adolescents and young adults (AYA) with chronic health conditions. With proven reliability and an empirically-based factor structure, the self-report STARx Questionnaire requires further validation to demonstrate its clinical and research utility. In this study we examine the concurrent, predictive, and discriminant validity of the STARx Questionnaire.
Scopus© Citations 72 10 2

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