Obrador, Gregorio
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Obrador, Gregorio
Official Name
Tomás Obrador Vera, Gregorio
Alternative Name
gobrador
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ORCID
Scopus Author ID
6602806471
Researcher ID
B-3054-2011

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Patients with Fabry disease on dialysis in the United States

2002 , Thadhani, Ravi , Wolf, Myles , West, Michael L. , Tonelli, Marcello , Ruthazer, Robin , Pastores, Gregory M. , Obrador, Gregorio

Background: Fabry disease results from an X-linked deficiency of lysosomal alpha-galactosidase A and is a rare cause of end-stage renal disease. Little is known about the characteristics of patients with Fabry disease that initiate dialysis in the United States, although data from Europe suggests these individuals have a poor survival. Methods: Using the United States Renal Disease System database, we first studied in detail 42 Fabry patients who initiated dialysis between April 1995 (following the introduction of the new detailed HCFA 2728 form) and July 1998. To examine crude survival in a larger cohort, 95 Fabry patients were studied who initiated dialysis between 1985 and 1993, similar to the European Registry. Diabetic and non-diabetic controls matched by age, gender, race, year of dialysis initiation, and initial dialysis modality were examined for comparison. ©Copyright © Elsevier Inc.,

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Prevalencia de enfermedad renal en niños aparentemente sanos con antecedente familiar de terapia de reemplazo renal

2015 , Medeiros, Mara , Andrade Veneros, Gioconda Daniela , Toussaint Martínez de Castro, Georgina , Ortiz Vásquez, Lourdes , Hernández Sánchez, Ana María , Olvera, Nadia , Obrador, Gregorio , Velásquez Jones, Luis

Introducción: Se ha mencionado que tener un familiar directo con enfermedad renal es un factor de riesgo para el padecimiento. El objetivo del estudio fue conocer la prevalencia de enfermedad renal temprana en niños familiares de pacientes con enfermedad renal crónica terminal (ERCT). Métodos: Se realizó un estudio de tamiz en niños aparentemente sanos, familiares en primer o segundo grado de pacientes con ERCT en programa reemplazo renal (hemodiálisis o trasplante renal). Previa firma de consentimiento informado se realizó el examen físico completo. Se tomó una muestra de sangre para la determinación de creatinina y electrolitos séricos, así como examen general de orina.

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Patient-Reported Outcome Measures for Fatigue in Patients on Hemodialysis: A Systematic Review

2018 , Ju, Angela , Unruh, Mark , Davison, Sara N. , Dapueto, Juan , Dew, Mary Amanda , Fluck, Richard , Germain, Michael , Jassal, Sarbjit Vanita , Obrador, Gregorio , O’Donoghue, Donal , Tugwell, Peter , Craig, Jonathan C. , Ralph, Angelique F. , Howell, Martin , Tong, Allison

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

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Cyborg mini-trainer

2009 , Mosso Vázquez, José Luis , Nieto, Jesús J. , Carbajal, Manuel F. , Marmolejo, Jorge , Ochoa, Enrique , Fuente, Mireya De La , Almazan, Andrew , Obrador, Gregorio

We present the smallest surgical trainer with a total weight of 400 gr, built in aluminum of 25 cm large and 24 cm wide, and 23 cm high. It's a system integrated by a small and open module, a lamp and a microcamera connected to a Head Mounted display. It holds two endoscopic instruments, and items to make knots or sutures and enhance visual-motor coordination. The vision we got is by a small microcamera displayed to a Head Mounted Display HMD. This surgical trainer is the smallest in the worldwide, easy to install, and easy to carry.

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Mortality in Patients With Chronic Renal Disease Without Health Insurance in Mexico: Opportunities for a National Renal Health Policy

2018 , Valdez-Ortiz, Rafael , Navarro-Reynoso, Francisco , Olvera-Soto, Guadalupe , Martin-Alemañy, Geovana , Rodríguez-Matías, Adrian , Hernández-Arciniega, Clara Rocío , Cortes-Pérez, Mario , Chávez-López, Ernesto , García-Villalobos, Gloria , Hinojosa-Heredia, Héctor , Camacho-Aguirre, Ana Yetzin , Valdez-Ortiz, Ángel , Cantú Quintanilla, Guillermo Rafael , Gómez-Guerrero, Irma , Reding, Arturo , Pérez-Navarro, Monserrat , Obrador, Gregorio , Correa-Rotter, Ricardo

Despite a systematic increase in the coverage of patients with end-stage renal disease (ESRD) who have received dialytic therapies and transplantation over the past 2 decades, the Mexican health system currently still does not have a program to provide full coverage of ESRD. Our aim was to analyze mortality in patients with ESRD without health insurance.

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Prevalence of chronic kidney disease in the Kidney Early Evaluation Program (KEEP) México and comparison with KEEP US

2010 , Obrador, Gregorio , García-García, Guillermo , Villa, Antonio R. , Rubilar, Ximena , Olvera, Nadia , Ferreira, Evangelina , Virgen, Margarita , Gutiérrez-Padilla, José Alfonso , Plascencia-Alonso, Melissa , Mendoza-García, Martha , Plascencia-Pérez, Salvador

The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community screening program aimed at early detection of kidney disease among high-risk individuals. A pilot phase of KEEP México began in 2008 in México City and Jalisco State. Adults with diabetes, hypertension, or family history of diabetes, hypertension, or chronic kidney disease (CKD) were invited to participate through advertising campaigns. All participants completed a questionnaire. Blood pressure, weight, and height were measured; blood and urine tests included albuminuria and serum creatinine to estimate glomerular filtration rate using the Modification of Diet in Renal Disease Study equation. Mean age of KEEP México City and KEEP Jalisco participants was 46 and 53 years, respectively; >70% were women. CKD prevalence was 22% in KEEP México City and 33% in KEEP Jalisco, not significantly different from reported KEEP US prevalence of 26%. CKD stages 1 and 2 were more frequent in KEEP México and stage 3 in KEEP US. In KEEP México City, CKD prevalence was higher than the overall prevalence among participants with diabetes (38%) or diabetes and hypertension (42%). Most KEEP México participants were unaware of the CKD diagnosis, despite that 71% in KEEP México City had seen a doctor in the previous year. CKD is highly prevalent, underdiagnosed, and underrecognized among high-risk individuals in México. KEEP is an effective screening program that can successfully be adapted for use in México.

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Management of Anemia in Nondialysis Chronic Kidney Disease: Current Recommendations, Real-World Practice, and Patient Perspectives

2020 , Guedes, Murilo , Robinson, Bruce M. , Obrador, Gregorio , Tong, Allison , Pisoni, Ronald L. , Pecoits-Filho, Roberto

In nondialysis CKD (ND-CKD), anemia is a multifactorial and complex condition in which several dysfunctions dynamically contribute to a reduction in circulating hemoglobin (Hb) levels in red blood cells. Anemia is common in CKD and represents an important and modifiable risk factor for poor clinical outcomes. Importantly, symptoms related to anemia, including reduced physical functioning and fatigue, have been identified as high priorities by patients with CKD. The current management of anemia in ND-CKD (i.e., parameters to initiate treatment, Hb and iron indexes targets, choice of therapies, and effect of treatment on clinical and patient-reported outcomes) remains controversial. In this review article, we explore the epidemiology of anemia in ND-CKD and revise current recommendations and controversies in its management. Exploring data from real-world clinical practices, particularly from the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps), we highlight the current challenges to translating current recommendations to clinical practice, providing patients' perspectives of anemia and how it affects their quality of life. Finally, we summarize recent advances in the field of anemia that may change the way this condition will be managed in the future. Copyright © 2020 by the American Society of Nephrology.

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Mismatch Between Kidney Disease Burden and Nephrology Workforce in Mexico

2020 , Obrador, Gregorio , Arrigunaga, Sofía De , Cuadra, Montserrat , Villa Romero, Antonio Rafael

End-stage kidney disease (ESKD) is highly prevalent worldwide and is associated with high mortality, morbidity, and cost. It has been estimated that, in 2010, a total of 2.6 million people received kidney replacement therapy (KRT) globally, and that between 4.9 and 9.7 million patients needed KRT. For the Latin American and Caribbean regions, the number of patients receiving versus needing KRT was 373,000 versus 626,000. 1 Although a national dialysis registry is lacking in Mexico, in 2005, it was estimated that there were approximately 130,000 patients with ESKD and that only half of them had access to KRT. 2 Furthermore, the burden of disease attributed to chronic kidney disease (CKD) has increased dramatically. Among all diseases, CKD went from being ranked #16 in 1990 to #2 in 2013 for years of life lost due to premature death.© 2020 International Society of Nephrology. Published by Elsevier Inc.

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Study design and baseline characteristics of patients on dialysis in the ASCEND-D trial

2021 , Singh, Ajay K. , Blackorby, Allison , Cizman, Borut , Carroll, Kevin , Cobitz, Alexander R. , Davies, Rich , Jha, Vivekanand , Johansen, Kirsten L. , Lopes, Renato D. , Kler, Lata , Macdougall, Iain C. , McMurray, John J. V. , Meadowcroft, Amy M. , Obrador, Gregorio , Perkovic, Vlado , Solomon, Scott , Wanner, Christoph , Waikar, Sushrut S. , Wheeler, David C. , Wiecek, Andrzej

Background: The Anemia Studies in chronic kidney disease (CKD): Erythropoiesis via a Novel prolyl hydroxylase inhibitor Daprodustat-Dialysis (ASCEND-D) trial will test the hypothesis that daprodustat is noninferior to comparator epoetin alfa or darbepoetin alfa for two co-primary endpoints: hemoglobin (Hb) efficacy and cardiovascular (CV) safety. Methods: We report the trial design, key demographic, clinical and laboratory findings, and baseline therapies of 2964 patients randomized in the open-label (sponsor-blinded) active-controlled, parallel-group, randomized ASCEND-D clinical trial. We also compare baseline characteristics of ASCEND-D patients with patients who are on dialysis (CKD G5D) enrolled in other large CV outcome trials (CVOTs) and in the most relevant registries. © The Author(s) 2021. Published by Oxford University Press on behalf of the ERA-EDTA.

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Decreased kidney function and agricultural work: a cross-sectional study in middle-aged adults from Tierra Blanca, Mexico

2020 , Aguilar-Ramirez, Diego , Raña-Custodio, Alejandro , Antonio Rafael , Villa Romero , Olvera, Nadia , Rubilar, Ximena , Escobar, Alejandro , Johnson, Richard J. , Sánchez-Lozada, Laura Gabriela , Obrador, Gregorio , Madero, Magdalena

Background: We aimed to determine the prevalence of decreased kidney function in a potential chronic kidney disease (KD) of unknown aetiology hotspot in Mexico, assess its distribution across occupations and examine the associated risk factors. Methods: A cross-sectional study collected sociodemographic, occupational, medical and biometric data from 616 men and women aged 20-60 years who were residents of three communities within the Tierra Blanca region in Mexico. Kidney function was assessed by standardized serum creatinine and estimated glomerular filtration rate (eGFR) and semi-quantitative albumin-to-creatinine ratio (ACR). To examine the distribution of decreased kidney function within the population, age- and sex-adjusted prevalence of low eGFR (≤60 mL/min/1.73 m2) was estimated for all participants and across occupations. Multivariable logistic regression was used to assess the association of occupation with having low eGFR.

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