Emilia Condés

Hospital Universitario de Móstoles, Madrid, Madrid, Spain

Are you Emilia Condés?

Claim your profile

Publications (27)75.39 Total impact

  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Predicting the progression of kidney failure in patients with chronic kidney disease is difficult. The aim of this study was to assess the predictors of rapid kidney decline in a cohort of patients referred to a single outpatient nephrology clinic. Design. Longitudinal, prospective cohort study with a median follow-up of 3.39 years. Methods. Data were obtained from 306 patients with chronic renal failure based on serum creatinine-estimated glomerular filtration rate ( e G F R c r e a t ) < 90 mL/min/1.73 m 2 . After excluding patients who died ( n = 30 ) and those who developed end-stage renal failure ( n = 6 ), 270 patients were included. This population was grouped according to the rate of kidney function decline. Rapid kidney function decline was defined as an annual e G F R c r e a t loss > 4 mL/min/1.73 m 2 . We recorded nonfatal cardiovascular events at baseline and during follow-up in addition to biochemical parameters. Results. The mean loss in renal function was 1.22 mL/min/1.73 m 2 per year. The mean age was 75 ± 8.8 years old, and the mean baseline e G F R c r e a t was 42 ± 14 mL/min/1.73 m 2 . Almost one-fourth of the sample (23.3% [63 patients]) suffered a rapid decline in renal function. In a logistic regression model with rapid decline as the outcome, baseline characteristics, lower serum albumin (OR: 0.313, 95% CI: 0.114–0.859), previous cardiovascular disease (OR: 1.903 95% CI: 1.028–3.523), and higher proteinuria (g/24 h) (OR: 1.817 CI 95%: 1.213–2.723) were the main predictors of rapid kidney decline. On multivariate analysis, including baseline and follow-up data, we obtained similar adjusted associations of rapid kidney decline with baseline serum albumin and proteinuria. The follow-up time was also shorter in the group with rapid rates of decline in renal function. Conclusion. Renal function remained stable in the majority of our population. Previous cardiovascular disease and cardiovascular incidents, lower serum albumin, and higher proteinuria at baseline were the main predictors of rapid kidney decline in our population.
    Preview · Article · Dec 2015
  • Article: PP.19.19
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Serum ferritin levels are often elevated in metabolic syndrome (MS) and are sometimes associated with a true mild-to-moderate hepatic iron overload. Our purpose was to analyse the relationship between MS and serum ferritin levels in patients with essential hypertension (EH). Design and method: Observational, crossectional study in patients with a diagnosis of EH. We measured serum ferritin and transferrin saturation index (TSI): serum-iron ([mu]gr/dl) x 100/transferrin (mg/dl) x 1.41). MS was defined according to ATP-III criteria. Patients with type 2 DM were excluded. Results: The ferritin values did not differ between patients with/ without MS: (150 vs. 145 [mu]gr/l, p = 0.628). The TSI was lower in patients with MS (23.5% vs. 25%, p = 0.021). The number of MS factors did not correlate with ferritin levels (r = .011, p = 0.774) but had a negative correlation with the TSI (r = -.079, p = 0.017). Ferritin levels were positively correlated with age (r = .355, p < 0.0001), haematocrit (r = .142, p < 0.0001), serum uric acid levels (r = .126, p < 0.0001), triglycerides (r = .108, p = 0.001), GGT (r = .154, p < 0.0001), GOT (r = .230, p < 0.0001), GPT (r = .268, p < 0.0001) and HOMA index (r = .107, p = 0.007) and negatively correlated with HDL-cholesterol (r = -.123, p < 0.0001) and HbA1c (r = -. 129, p < 0.0001). BMI, waist circumference and fasting glucose did not show correlations with ferritin levels. In multivariate analysis the only independent determinants of serum ferritin levels were GOT values (beta = 3.8, 95% CI: 1.5-6, p = 0.001), GGT (beta = 0.83, 95% CI: 0.30-1.36, p = 0.002), HOMA index (beta = 10.8, 95% CI: 3.7-18, p = 0.003) and HbA1c (beta = -76.8, 95% CI -116.9 to -36.7, p < 0.0001 Conclusions: In our patients with EH, the presence of MS was not associated with higher levels of serum ferritin and even showed a lower TSI. The presence of insulin resistance seems to be more related than MS to the serum ferritin levels in our hypertensive population. Copyright
    No preview · Article · Jun 2015 · Journal of Hypertension
  • Article: PP.19.13
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Vitamin D deficiency has been linked to obesity. Different mechanisms have been postulated, including the sequestration of vitamin D in adipose tissue or a volumetric dilution effect. Our aim was to study this association in patients with essential hypertension (EH). Design and method: Cross-sectional, observational study including 633 patients (51% women), aged 59 (14) years, with a EH diagnosis. We excluded patients with diabetes mellitus. Routine analysis were obtained from each patient, including levels of 25(OH)D, (ECLIA, Roche Diagnostics). We define vitamin D deficiency as a serum 25(OH)D < 20 ng./ml. Results: BMI was 30 (11), BP 136 (17) / 75 (11) mm Hg. 43% were obese. Serum levels of 25(OH)D were 30 (12) ng/ml, with no differences between genders (male 29 (12) ng/ml and women 30 (15) ng/ml, p: n.s.). 21% of the sample had vitamin D deficiency, again without differences within genders. Vitamin D levels were lower in obese patients (28 (11) vs. 31 (12) ng/ml, p = 0.007). There were no differences in BMI in patients with vs. without vitamin D deficiency (31 (7) vs. 30 (11), p = 0.530). The presence of obesity was not associated with vitamin D deficiency (25% with obesity vs. 19% without obesity, p = 0.182). The levels of 25 (OH)D were positively correlated with age (r = .186, p < 00001) and HDL-cholesterol (r = 147, p = 0.003) and negatively correlated with eGFR-MDRD (r = - .186, p < 0.0001). The only independent determinants of serum 25(OH)D in multivariate analysis were HDL-cholesterol (beta = 0.125, 95% CI: 0.42- 0.208, p = 0.003) and eGFR-MDRD (beta = -0112, 95% CI: -0167 to -0057, p < 0.0001), while age and BMI were excluded from the final model. Conclusions: In our patients with EH, vitamin D deficiency was common but it was not associated with obesity. The levels of 25(OH) were lower in obese patients, although within a normal levels. We found no correlation between serum 25 (OH)D and BMI and the later was not associated with the serum 25 (OH)D concentration. Copyright
    No preview · Article · Jun 2015 · Journal of Hypertension
  • Article: PP.03.05
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Albuminuria has been linked more closely with blood pressure (BP) values in ambulatory blood pressure monitoring (ABPM) than with the BP in consultation. Our purpose was to analyse this association. Design and method: Observational, crossectional study in patients with EH. Albuminuria was calculated as the average of 2 determinations (turbidimetry). The office BP was determined as the average of 3 measurements and ABPM was performed with a SPACELAB monitor, mod. 90217. Results: We included a total of 1130 patients (50.3% male) with a mean age of 57 (14) years, 25% with type 2 DM. Office BP values were 147 (19)/81 (12) mm Hg and ABPM 133(15)/80 (10) mm Hg in the daytime and 121 (16)/70 (10) mm Hg in the night time. The mean values of albuminuria and eGFR-EPI-creatinine were 30 (121) mg/g creatinine and 84 (21) ml/min/1.73 m2, respectively. Albuminuria, adjusted for age and sex, was positively correlated with BMI (r = .075, p = 0.038), office SBP (r = .082, p = 0.024), office DBP (r = .073, p = 0.043), daytime SBP (r = .119, p = 0.001) and night time DBP (r = .094, p = 0.010) and negatively for eGFR-EPI-creatinine (r = -.104, p = 0.004). The ratio of night-time/day-time SBP and DBP was not correlated with albuminuria. There were no differences in albuminuria within patients classified as non-dipper vs. dipper neither for the SBP (32 vs. 27 mg./gr., respectively, p = 0.581) nor DBP (34 vs. 27 mg./ g., p = 0.386). In multivariate analysis the only independent determinants of albuminuria were daytime SBP (beta = 1.136, 95% CI .547-1.72, p < 0.0001) and BMI (beta = 1.80, 95% CI .082-3.52, p = 0.069). Conclusions: In our patients with EH, albuminuria was only associated, in addition to BMI, with the values of diurnal SBP in 24 h. Neither the night time BP values nor the pattern of nocturnal dipping showed this association. The 24-hour ABPM may well be a more effective tool than office BP for assessing this cardiovascular risk factor. Copyright
    No preview · Article · Jun 2015 · Journal of Hypertension
  • No preview · Article · Oct 2014 · AIDS (London, England)
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Background Non-linear methods have been applied to the analysis of biological signals. Complexity analysis of glucose time series may be a useful tool for the study of the initial phases of glucoregulatory dysfunction. Methods and Results This observational, cross-sectional study was performed in patients with essential hypertension. Glucose complexity was measured with detrended fluctuation analysis (DFA), and glucose variability was measured by the mean amplitudes of glycemic excursion (MAGE). We included 91 patients with a mean age of 59±10 years. We found significant correlations for the number of MS-defining criteria with DFA (r = 0.233, p = 0.026) and MAGE (r = 0.396, p< 0.0001). DFA differed significantly between patients who complied with MS and those who did not (1.44 vs. 1.39, p = 0.018). The MAGE (f = 5.3, p= 0.006), diastolic blood pressures (f = 4.1, p= 0.018) and HOMA indices (f= 4.2, p = 0.018) differed between the DFA tertiles. Multivariate analysis revealed that the only independent determinants of the DFA values were MAGE (beta coefficient = 0.002, CI 95%: 0.001-0.004, p = 0.001) and abdominal circumference (beta coefficient = 0.002, CI 95%: 0.000015- 0.004, p = 0.048). Conclusions In our population, DFA was associated with MS and a number of MS criteria. Complexity analysis seemed to be capable of detecting differences in variables that are arguably related to the risk of the development of type 2 diabetes.
    Full-text · Article · Sep 2014 · Journal of the American Society of Hypertension
  • [Show abstract] [Hide abstract] ABSTRACT: Objective To date few studies have examined whether ultrasonography can depict morphologic differences in painful and painless osteoarthritis (OA). This study describes and compares the clinical, radiographic and ultrasonographic findings of patients with both painful and painless proximal interphalgeal (PIP) and/or distal interphalgeal (DIP) OA. Methods Patients with PIP and/or DIP OA (ACR criteria) were prospectively recruited. The clinical rheumatologist chose up to 3 painful joints and up to 3 painless symmetric joints in each patient to define 2 cohorts of OA: symptomatic (SG) and asymptomatic (ASG). A conventional postero-anterior hand x ray was performed and read by one rheumatologist following the OARSI atlas, blinded to clinical and sonographic data. Ultrasound (US) was performed by an experienced rheumatologist, blinded to both clinical and radiographic data in joints previously selected by the clinical rheumatologist. US-pathology was assessed as present or absent as defined in previous reports: osteophytes, joint space narrowing, synovitis, intra-articular power doppler signal, intra-articular bony erosion, and visualization of cartilage. Radiographic and ultrasonographic intrareader reliability test was performed. Results A total of 50 joints in the SG and ASG were included from 20 right handed women aged 61.85 (46-73) years with PIP and DIP OA diagnosed 6.8 (1-17) years ago. 70% SG joints and ASG were right and left sided respectively. The SG showed significantly more osteophytes, synovitis and non-visualization of joint cartilage. Intrareader radiographic and ultrasonographic agreement was excellent. Conclusion This study demonstrates that painful PIP and/or DIP OA have more ultrasonographic structural changes and synovitis.
    No preview · Article · Sep 2014 · Reumatología Clínica
  • [Show abstract] [Hide abstract] ABSTRACT: To date few studies have examined whether ultrasonography can depict morphologic differences in painful and painless osteoarthritis (OA). This study describes and compares the clinical, radiographic and ultrasonographic findings of patients with both painful and painless proximal interphalgeal (PIP) and/or distal interphalgeal (DIP) OA. Patients with PIP and/or DIP OA (ACR criteria) were prospectively recruited. The clinical rheumatologist chose up to 3 painful joints and up to 3 painless symmetric joints in each patient to define 2 cohorts of OA: symptomatic (SG) and asymptomatic (ASG). A conventional postero-anterior hand x ray was performed and read by one rheumatologist following the OARSI atlas, blinded to clinical and sonographic data. Ultrasound (US) was performed by an experienced rheumatologist, blinded to both clinical and radiographic data in joints previously selected by the clinical rheumatologist. US-pathology was assessed as present or absent as defined in previous reports: osteophytes, joint space narrowing, synovitis, intra-articular power doppler signal, intra-articular bony erosion, and visualization of cartilage. Radiographic and ultrasonographic intrareader reliability test was performed. A total of 50 joints in the SG and ASG were included from 20 right handed women aged 61.85 (46-73) years with PIP and DIP OA diagnosed 6.8 (1-17) years ago. 70% SG joints and ASG were right and left sided respectively. The SG showed significantly more osteophytes, synovitis and non-visualization of joint cartilage. Intrareader radiographic and ultrasonographic agreement was excellent. This study demonstrates that painful PIP and/or DIP OA have more ultrasonographic structural changes and synovitis.
    No preview · Article · Apr 2014
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Background. We examine whether cystatin C, a surrogate marker of renal function, could identify patients with chronic kidney disease (CKD) with an increased risk of renal disease progression, death, or cardiovascular events. Methods. Data were obtained for 180 patients, with a diagnosis of chronic renal failure based on serum creatinine estimated glomerular filtration rate (eGFRcreat) <90 mL/min/1.73 m(2). This population was grouped in tertiles according to cystatin C and creatinine values at baseline. Cardiovascular events and overall mortality were estimated for each tertile. Predictors of overall mortality and for the development of renal disease progression were analyzed. Results. The median age was 75 years (interquartile range 69-82) and the median eGFRcreat 38 mL/min m(2) (interquartile range 33-49). Overall mortality was lower on the first and on the second tertiles of cystatin C than on the third one (HR = 0.060; 95% CI: 0.008-0.447 and HR = 0.094; 95% CI: 0.022-0.406, resp.). Deaths related to the creatinine tertiles followed the same pattern, but differences were not as large. Cardiovascular mortality was lower on the second than on the third cystatin C tertile (HR = 0.198; 95% CI: 0.040-0.987), but it did not show differences on the first and the second creatinine tertiles compared with the third one (HR = 0.126; 95% CI: 0.013-1.265 and HR = 0.403; 95% CI: 0.093-1.740). The only independent predictors of mortality during followup were baseline cystatin C (OR = 0.100; 95% CI: 0.021-0.463) and baseline uric acid (OR = 1.377; 95% CI: 1.070-1.773). Conclusion. Cystatin C may be an alternative to creatinine for detecting a high risk of death and cardiovascular events in a population with CKD.
    Full-text · Article · Feb 2014 · International Journal of Nephrology
  • No preview · Article · Jun 2010 · Journal of Hypertension
  • No preview · Article · Jun 2010 · Journal of Hypertension
  • [Show abstract] [Hide abstract] ABSTRACT: To describe the epidemiological characteristics and evolution of a cohort of HIV-infected patients in Madrid (Spain) over a period of 25 years. Longitudinal, prospective, cohort study of all patients diagnosed with HIV infection seen at the Hospital de Móstoles (1983-2008). Of the 2156 patients attended, 73% were men. In 68%, the route of infection was illicit drug use. There was a peak of new diagnoses in 1991 (188 patients) and a subsequent gradual decline. Sexual transmission increased over the time period studied, with a higher rise in heterosexual transmission. The percentage of immigrants with the infection also increased (more than 60% in the last 3 years). Sub-Saharan Africa remains the predominant region of origin of our immigrant patients. Over the period studied, 5% of patients were diagnosed during the acute infection, and 20% to 30% were diagnosed with AIDS within 1 year after detection of HIV infection. The estimated rate of new diagnoses of HIV infection in 2006 was 195 per million population (pmp), 269 pmp in men and 121 pmp in women. Many changes have occurred in the epidemiology of HIV infection in our area in the last 25 years. Routine serologic testing without waiting for warning signs would have an impact on early diagnosis and improving the prognosis of these patients.
    No preview · Article · Sep 2009 · Enfermedades Infecciosas y Microbiología Clínica
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Serum cystatin C has been associated with cardiovascular disease. We investigated whether cystatin C concentration is associated with the metabolic syndrome and with other cardiovascular risk factors in a hypertensive population. In this cross-sectional study, we prospectively included 611 essential hypertensive patients during a 12-month period. Cystatin C concentration was measured by nephelometry. The metabolic syndrome was present in 46% of the patients. Cystatin C was significantly higher in patients with the metabolic syndrome (0.94 +/- 0.27 mg/L) than in those without (0.87 +/- 0.23 mg/L) (P < .0001). Pearson partial correlation analysis showed a significant correlation between cystatin C and body mass index (r = 0.240; P = .001); waist circumference (r = 0.173; P = .012); microalbuminuria (r = 0.273; P < .0001); triglycerides (r = 0.138; P = .047); C-reactive protein (r = 0.190; P = .006); uric acid (r = 0.284; P < .0001); age (r = 0.409; P < .0001); and glomerular filtration rate (GFR) (r = -0.638; P < .0001). Multivariate analysis showed that GFR (B = -0.0061; 95% confidence interval [CI], -0.0073 to -0.0049; P < .0001), age (B = 0.0023; 95% CI, 0.0005-0.0041; P = .009), microalbuminuria (B = 0.0005; 95% CI, 0.0002-0.0007; P < .0001), uric acid (B = 0.0252; 95% CI, 0.0085-0.0418; P = .003), body mass index (B = 0.0051, 95% CI, 0.0012-0.0089; P = .011), and C-reactive protein (B = 0.0048; 95% CI, 0.0015-0.0082; P = .005) were independent determinants of cystatin C concentration. Measuring cystatin C concentration in hypertensive patients may be useful for evaluating their cardiovascular risk profile.
    Full-text · Article · May 2009 · Journal of the American Society of Hypertension
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: The optimal timing for initiation of highly active antiretroviral therapy (HAART) in patients with AIDS and tuberculosis (TB) is an unresolved question. To assess the effect of HAART on the survival of patients with TB, we designed this study. We selected all HIV patients included in the COMESEM cohort with TB diagnosis after 1996. Clinical and epidemiological data were registered. We compared patients who started HAART at the diagnosis of TB [simultaneous therapy (ST)] or not. Survival was assessed by Cox analysis. Among the 6934 HIV patients included in the cohort, 1217 patients had TB, 322 of them (26.5%) after 1996. At the time of TB diagnosis, 45% of them started HAART (ST). There were no differences between groups regarding basal characteristics, except for a lower viral load in ST patients. ST therapy was associated with improved survival (hazard ratio 0.38; 95% confidence interval 0.20 to 0.72, P = 0.003). By univariate analysis, survival was also associated with no endovenous drug use and a later year of TB diagnosis. After adjusting for other prognostic variables, by Cox multivariate analysis, ST remained robustly associated with improved survival (hazard ratio 0.37; 95% confidence interval 0.17 to 0.66, P = 0.001). Simultaneous HAART and TB treatment in HIV patients with TB is associated with improved survival.
    Full-text · Article · Feb 2009 · JAIDS Journal of Acquired Immune Deficiency Syndromes
  • No preview · Article · Jan 2009 · Journal of acquired immune deficiency syndromes
  • No preview · Conference Paper · Jun 2008
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: To evaluate the impact of immigration on tuberculosis (TB)-HIV co-infection in Spain in a prospective cohort of HIV patients. Among 7761 HIV patients, we evaluated 1284 with at least one episode of TB between 1987 and 2006. Variables were compared between immigrants and Spaniards. Incidence of TB decreased from 20 to five cases per 100 patient-years in 2006 (P<0.01) and was always higher in immigrants than in Spaniards. The proportion of immigrants increased, reaching almost 50% of both new cases of HIV and TB-HIV co-infection in 2006. In 34.4% of patients, TB and HIV infection were diagnosed within the same year; simultaneous diagnosis was more frequent in immigrants (83.3%vs. 16.7%, P<0.001). Mortality was associated independently with age [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.01-1.05], TB diagnosis before 1996 (HR 2.6, 95% CI 1.8-3.6), use of highly active antiretroviral treatment (HR 0.494, 95% CI 0.37-0.66) and CD4 cell count at TB diagnosis (HR 0.996, 95% CI 0.995-0.997). Immigrants have a major impact on the incidence of TB in HIV patients, slowing down the decreasing trend in Spain. Simultaneous diagnosis of the co-infection in immigrants reveals a need to intensify HIV case finding in immigrants in Spain.
    Full-text · Article · May 2008 · HIV Medicine
  • E Condés
    [Show abstract] [Hide abstract] ABSTRACT: Biostatistics has become an indispensable tool in all domains of the Health Sciences. Biostatistics is essential for ensuring valid decision making, and knowing the basic principles of biostatistics well will enable us to use this tool correctly. In this article, first biostatistics is defined and then its use and justification are discussed. The aim is to go through all of the steps that should be followed in the entire research process, beginning with specifying the objective of the study, approaching different study designs (cross-sectional, prospective and retrospective longitudinal, clinical trials) and the most commonly used statistical techniques in the Health Sciences, from descriptive statistics necessary to begin any study, to univariate analysis of both qualitative and quantitative variables, to the multivariate analyses most commonly used in our field.
    No preview · Article · Jan 2008 · Radiología
  • [Show abstract] [Hide abstract] ABSTRACT: Little is known about the global effects of HAART on the use of medical resources after the complete implementation of this therapy in Spain. This study was designed to determine the use of medical resources and the costs of health care for HIV-infected patients. All patients with HIV infection who came to our institution during the year 2002 were included in the study. We analyzed the global assistance data and pharmaceutical costs during the year. Costs were calculated based on a unitary cost for DRG and an officially assigned standard cost for outpatient clinic, visits to the day care unit and to the emergency room (ER), outpatient surgery, and total costs of pharmacy. The total cost for HIV-related health care assistance was euro739,048. The cost related to admissions was euro150,766.60; euro8631 per first visit and euro49,199.40 per successive visit; euro5085.10 per day care unit; euro14,920 per outpatient surgery; euro7655.70 per ER visit; and euro491,342.40 per antiretroviral treatment. A significant proportion of the total outpatient assistance was given by physicians other than HIV specialists, namely, 63% of the costs attributed to the first visit and 41% per successive visit. More than 50% of the costs of caring for HIV-infected patients are still attributed to antiretroviral therapy. Specialists other than infectious disease specialists provide a significant proportion of outpatient assistance. A method to control HIV costs is greatly needed.
    No preview · Article · Oct 2007 · European Journal of Internal Medicine
  • [Show abstract] [Hide abstract] ABSTRACT: Assessment of patient satisfaction with antiretroviral therapy is generating increasing interest in clinical practice, since the outcome is directly related with compliance with therapy and its effectiveness. Currently, there is no validated patient satisfaction questionnaire to evaluate this factor as related to control of the disease. An "ad hoc" questionnaire--Cuestionario Español de Satisfacción con el Tratamiento Antiretroviral (CESTA), Spanish Antiretroviral Treatment Satisfaction Questionnaire--was developed to evaluate satisfaction in patients switching to a simplified regimen. In a second phase, the questionnaire was validated in an observational study including 321 patients divided into two cohorts (patients switching to a simplified regimen and patients maintaining the same regimen). A total of 99% and 93% patients, respectively, completed the questionnaire at baseline and at the end-of-study visit. Cronbach's alpha coefficient for internal consistency and test-retest reliability were 0.82 and 0.69, respectively. Patients switching to a simplified regimen showed a statistically significant higher overall satisfaction score at the third-month visit than at baseline. The CESTA questionnaire is a valid instrument for use in clinical practice and provides valuable information on patient satisfaction with antiretroviral therapy.
    No preview · Article · Jan 2006 · Enfermedades Infecciosas y Microbiología Clínica