Obrador, Gregorio

Main Affiliation

Facultad de Ciencias de la Salud - CampCM

Preferred name

Obrador, Gregorio

Official Name

Tomás Obrador Vera, Gregorio

ORCID

0000-0003-3814-7449

Researcher ID

B-3054-2011

Scopus Author ID

6602806471

Now showing 1 - 10 of 77

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Current State and Challenges for Organ Donation and Transplantation in Mexico
(2019)
Reyes-Acevedo, Rafael
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Obrador, Gregorio
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Alberú-Gómez, Josefina
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Gracida-Juárez, Carmen
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Madrigal, José André
Mexico, officially called the United Mexican States, is in the southern part of North America. It is a democratic republic comprised of 32 states, in addition to its capital, Mexico City. The Mexican territory has an area of 1 964 375 km2, which makes it the 14th biggest country in the world and the third largest in Latin America. Mexico borders the United States of America in the north and Guatemala and Belize in the south (Figure 1). It is the 11th most populous country in the world, with an estimated population of over 132 million people (as of 2018). Although most people speak Spanish, the official language, there are 67 indigenous dialects. In 2015, the Human Development Index was 0.762, ranking Mexico as number 77 worldwide. The Mexican economy is the second largest in Latin America and the 11th in the world. ©2019 Transplantation NLM (Medline).
2Scopus© Citations 12 3
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Longitudinal Analysis of Participants in The KEEP Mexico's Chronic Kidney Disease Screening Program
(2013)
Obrador, Gregorio
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Olvera, Nadia
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Gutiérrez, Verónica
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Contreras, Daniela
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Reyes, Rebeca
Background and aims: The Kidney Early Evaluation Program (KEEP) is a free screening and educational program aimed at detecting chronic kidney disease (CKD) among adult individuals who are at high-risk (those with diabetes, hypertension, or family history of these conditions or CKD). Confirmation of CKD diagnosis requires persistence of albuminuria or estimated GFR <60 mL/min for at least 3 months. We undertook this study to determine in a follow-up KEEP done at least 1 year after a baseline KEEP the following: 1) CKD incidence among individuals who initially tested negative for CKD, 2) transitions between CKD stages among individuals who initially tested positive for CKD. Methods: A random sample of KEEP participants was invited to participate in a follow-up KEEP between 2008 and 2010. Paired analyses were conducted to compare CKD stages between baseline and follow-up KEEP. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.
2 12Scopus© Citations 10
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Level of renal function at the initiation of dialysis in the U.S. end- stage renal disease population
(1999)
Obrador, Gregorio
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Pradeep, Arora
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Kausz, Annamaria T.
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Ruthazer, Robin
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Pereira, Brian J.G.
Background: More than 285,000 individuals in the United States suffer from end-stage renal disease (ESRD) and are treated predominantly by dialysis. Despite the high cost and poor outcomes of dialysis treatment for ESRD, there are few data about the level of renal function at the onset of ESRD and no established medical criteria for the initiation of dialysis. Methods: We report the level of serum creatinine and glomerular filtration rate (GFR) in 90,897 patients who began dialysis in the U. S. between April 1995 through September 1997. Data were obtained from the U.S. Renal Data System. GFR was predicted by an equation developed from the Modification of Diet in Renal Disease Study. ©1999 by the International Society of Nephrology
Scopus© Citations 119 2 13
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A Report of the Lisbon Conference on the Care of the Kidney Transplant Recipient
(2007)
Abbud-Filho, Mario
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Adams, Patricia L.
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Alberú, Josefina
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Cardella, Carl
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Chapman, Jeremy
An International Conference on the Care of the Kidney Transplant Recipient was convened in Lisbon, Portugal from February 2–4, 2006 under the auspices of the National Kidney Foundation and Kidney Disease: Improving Global Outcomes (KDIGO), and in cooperation with The Transplantation Society. Conference participants included over 100 experts and leaders in kidney transplantation, representing more than 40 countries from around the world, including participants from Africa, Asia, Australia, Europe, North American, and South America (Appendix). The goal of the conference was to develop recommendations to improve the outcomes of kidney transplant recipients worldwide with regard to the following basic medical issues: cardiovascular disease (Work Group I), cancer and infection (Work Group II), and anemia, bone disease, reproductive issues, growth and development (Work Group III). Work Groups I, II, and III addressed the preand posttransplant care of kidney transplant recipients by the following components: timelines of pre- and posttransplantation, immunosuppression, level of kidney allograft function, and burden of disease (prior history of dialysis or preemptive transplant and how that history affects outcome).
Scopus© Citations 92 5 30
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Establishing a Core Outcome Measure for Fatigue in Patients on Hemodialysis: A Standardized Outcomes in Nephrology–Hemodialysis (SONG-HD) Consensus Workshop Report
(2018)
Ju, Angela
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Unruh, Mark
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Davison, Sara
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Dapueto , Juan
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Dew, Mary Amanda
Fatigue is one of the most highly prioritized outcomes for patients and clinicians, but remains infrequently and inconsistently reported across trials in hemodialysis. We convened an international Standardized Outcomes in Nephrology–Hemodialysis (SONG-HD) consensus workshop with stakeholders to discuss the development and implementation of a core outcome measure for fatigue. 15 patients/caregivers and 42 health professionals (clinicians, researchers, policy makers, and industry representatives) from 9 countries participated in breakout discussions. Transcripts were analyzed thematically. 4 themes for a core outcome measure emerged. Drawing attention to a distinct and all-encompassing symptom was explicitly recognizing fatigue as a multifaceted symptom unique to hemodialysis. Emphasizing the pervasive impact of fatigue on life participation justified the focus on how fatigue severely impaired the patient’s ability to do usual activities. Ensuring relevance and accuracy in measuring fatigue would facilitate shared decision making about treatment. Minimizing burden of administration meant avoiding the cognitive burden, additional time, and resources required to use the measure. A core outcome measure that is simple, is short, and includes a focus on the severity of the impact of fatigue on life participation may facilitate consistent and meaningful measurement of fatigue in all trials to inform decision making and care of patients receiving hemodialysis. © 2018 by the National Kidney Foundation, Inc.
2 7Scopus© Citations 91
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Genetic and environmental risk factors for chronic kidney disease
(2017)
Obrador, Gregorio
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Schultheiss, Ulla T.
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Kretzler, Matthias
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Langham, Robyn G.
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Nangaku, Masaomi
In order to change the current state of chronic kidney disease knowledge and therapeutics, a fundamental improvement in the understanding of genetic and environmental causes of chronic kidney disease is essential. This article first provides an overview of the existing knowledge gaps in our understanding of the genetic and environmental causes of chronic kidney disease, as well as their interactions. The second part of the article formulates goals that should be achieved in order to close these gaps, along with suggested timelines and stakeholders that are to be involved. A better understanding of genetic and environmental factors and their interactions that influence kidney function in healthy and diseased conditions can provide novel insights into renal physiology and pathophysiology and result in the identification of novel therapeutic or preventive targets to tackle the global public health care problem of chronic kidney disease. © Kidney International Supplements.
2 5Scopus© Citations 84
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Identifying dimensions of fatigue in haemodialysis important to patients, caregivers and health professionals: An international survey
(2019)
Ju, Angela
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Unruh, Mark
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Davison, Sara N.
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Dapueto, Juan
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Dew, Mary A.
Background: Patient-reported outcome measures of fatigue used in research in haemodialysis vary widely in the dimensions assessed; and the importance of these dimensions to patients and health professionals is unknown. This study aimed to identify the most important dimensions of fatigue to assess in patients on haemodialysis participating in trials. Methods: In an international survey, patients/caregivers and health professionals rated the absolute and relative importance of content and measurement dimensions to include in a core outcome measure of fatigue. A 9-point Likert scale (7-9 indicating critical importance) was used to assess absolute importance and best-worst scale was used to assess importance of each dimension compared to others. © 2019 Asian Pacific Society of Nephrology.
1 21Scopus© Citations 11
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Systemic complications of chronic kidney disease
(2015)
Obrador, Gregorio
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Pereira, Brian J. G.
The kidney plays a critical role in the maintenance of homeostasis. As kidney function diminishes, excretory, regulatory, and endocrine function is lost, and complications develop in essentially every organ system. Kidney failure is the last stage in the continuum of progressive CKD. Management of the complications associated with CKD mainly includes dietary counseling, adequate control of volume and blood pressure, and use of phosphate binders, calcitriol (Calcijex, Rocaltrol), and erythropoietin. Many of these complications can be prevented or attenuated with optimal CKD care, which involves early detection of progressive kidney disease, interventions to retard its progression, prevention of uremic complications, attenuation of comorbid conditions, adequate preparation for kidney replacement therapy, and timely initiation of dialysis (figure 2). Closer attention to CKD care is likely to be the key to improved outcomes among patients with kidney failure.
1 16Scopus© Citations 17
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Patient-Reported Outcome Measures for Fatigue in Patients on Hemodialysis: A Systematic Review
(2018)
Ju, Angela
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Unruh, Mark
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Davison, Sara N.
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Dapueto, Juan
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Dew, Mary Amanda
Background: Fatigue is a prevalent and debilitating symptom in patients receiving hemodialysis. We aimed to identify and evaluate the characteristics and psychometric properties of patient-reported outcome measures for fatigue in patients receiving hemodialysis, to inform the selection of a robust and feasible measure for use in randomized trials in hemodialysis. Study Design: Systematic review of outcome measures for fatigue. Setting & Population: Patients receiving hemodialysis. Search Strategy & Sources: MEDLINE, Embase, PsycINFO, and CINAHL from inception to April 2017 were searched for all studies that reported fatigue in patients receiving hemodialysis. Analytical Approach: With a focus on addressing methods, items (individual questions) from all measures were categorized into content and measurement dimensions of fatigue. We assessed the general characteristics (eg, number of items and cost) and psychometric properties of all measures. © American Journal of Kidney Diseases
2 12Scopus© Citations 92
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Prevalencia, factores de riesgo y consecuencias de la referencia tardía al nefrólogo
(2011-01)
Laris González, Almudena
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Madero, Magdalena
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Pérez-Grovas, Héctor
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Franco-Guevara, Martha
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Obrador, Gregorio
Late referral of patients with chronic kidney disease (CKD) to specialized care by the nephrologist is associated with worse patient outcomes while on dialysis. To determine the prevalence, risk factors, and consequences of late nephrology referral at a Mexican tertiary care hospital. Retrospective chart review of all adult patients who began chronic hemodialysis between 2002 and 2006 at the National Institute of Cardiology "Ignacio Chavez" (NICICh), Mexico City. Timing of referral to Nephrology Department was classified as early, late or very late if the time elapsed between referral and initiation of dialysis was < 1 month, between 1-6 months or > or = 6 months, respectively. Socio-demographic, clinical, laboratory and echocardiographic characteristics were compared according to timing of referral. Eighty four out of 150 patients were included in the analysis. Of these, 56% were referred < 1 month, and an additional 15% between 1-6 months prior to the initiation of chronic hemodialysis. In univariate analysis, being referred by a relative or friend was associated with a higher risk (p = 0.04), and being employed with a lower risk of late referral (p = 0.05). Late referred patients were more likely to require emergency dialysis and hospitalization, and of not having a permanent vascular access for their first dialysis. They also had a higher prevalence of severe anemia (hematocrit < 28%) and of residual kidney function (estimated glomerular filtration rate < 5 mL/min/1.73 m2), as well as increased left ventricular mass. Late nephrology referral is highly prevalent in our population and is associated with markers of suboptimal predialysis care at the onset of chronic dialysis.
1 49Scopus© Citations 11

Obrador, Gregorio

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