Author
Gregorio T. Obrador
Other affiliations: Tufts University, Analytical Services, Tufts Medical Center
Bio: Gregorio T. Obrador is an academic researcher from Panamerican University. The author has contributed to research in topics: Kidney disease & Dialysis. The author has an hindex of 37, co-authored 78 publications receiving 11385 citations. Previous affiliations of Gregorio T. Obrador include Tufts University & Analytical Services.
Topics: Kidney disease, Dialysis, Anemia, Nephrology, Population
Papers published on a yearly basis
Papers
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University of Southern California1, United States Department of Veterans Affairs2, University of California, San Francisco3, Washington University in St. Louis4, Children's Memorial Hospital5, University of Kentucky6, Saint Louis University7, Mayo Clinic8, Indiana University – Purdue University Indianapolis9, University of California, Los Angeles10, University of Virginia11
2,609 citations
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Hennepin County Medical Center1, Heidelberg University2, Westmead Hospital3, Children's Hospital at Westmead4, Lund University5, University of Minnesota6, Boston Children's Hospital7, University of Chicago8, Dalhousie University9, Paris Descartes University10, University of Washington11, Panamerican University12, University of California, San Francisco13, National Kidney Foundation14, Tufts Medical Center15
TL;DR: The guideline makes recommendations for immunosuppression and graft monitoring, as well as prevention and treatment of infection, cardiovascular disease, malignancy, and other complications that are common in kidney transplant recipients, including hematological and bone disorders.
1,908 citations
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Tufts University1, Wake Forest University2, Oregon Health & Science University3, Indiana University4, Albany College of Pharmacy and Health Sciences5, Rush University Medical Center6, Vanderbilt University7, East Carolina University8, University of Illinois at Chicago9, Beaumont Hospital10, Johns Hopkins University11, Cleveland Clinic12, University of Wisconsin-Madison13, University of Texas at Austin14, University of Pittsburgh15, Virginia Commonwealth University16, Texas Tech University Health Sciences Center17, National Institutes of Health18, University of Virginia19
TL;DR: The purpose of the Executive Summary is to provide a "stand-alone" summary of the background, scope, methods, and key recommendations, as well as the complete text of the guideline statements.
1,145 citations
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British Heart Foundation1, Memorial University of Newfoundland2, University of California, Berkeley3, University of Pennsylvania4, University of Bern5, University of Picardie Jules Verne6, Yale University7, North Shore-LIJ Health System8, Semel Institute for Neuroscience and Human Behavior9, University of Cambridge10, Seattle Children's11, Panamerican University12, Innsbruck Medical University13
TL;DR: The 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for Anemia in Chronic Kidney disease aims to provide guidance on diagnosis, evaluation, management and treatment for all CKD patients at risk of or with anemia.
766 citations
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01 Jan 2012
TL;DR: The use of ESAs and other agents to treat anemia in CKD and methods for Guideline Development suggest that red cell transfusion is a viable treatment option.
Abstract: 282 Summary of Recommendation Statements 283 Chapter 1: Diagnosis and evaluation of anemia in CKD 288 Chapter 2: Use of iron to treat anemia in CKD 292 Chapter 3: Use of ESAs and other agents to treat anemia in CKD 299 Chapter 4: Red cell transfusion to treat anemia in CKD 311 Methods for Guideline Development 317 Biographic and Disclosure Information 324
712 citations
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TL;DR: The role of vitamin D in skeletal and nonskeletal health is considered and strategies for the prevention and treatment ofitamin D deficiency are suggested.
Abstract: Once foods in the United States were fortified with vitamin D, rickets appeared to have been conquered, and many considered major health problems from vitamin D deficiency resolved. But vitamin D deficiency is common. This review considers the role of vitamin D in skeletal and nonskeletal health and suggests strategies for the prevention and treatment of vitamin D deficiency.
11,849 citations
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TL;DR: In the early 1990s, the National Kidney Foundation (K/DOQI) developed a set of clinical practice guidelines to define chronic kidney disease and to classify stages in the progression of kidney disease.
10,265 citations
01 Feb 2015
TL;DR: In this article, the authors describe the integrative analysis of 111 reference human epigenomes generated as part of the NIH Roadmap Epigenomics Consortium, profiled for histone modification patterns, DNA accessibility, DNA methylation and RNA expression.
Abstract: The reference human genome sequence set the stage for studies of genetic variation and its association with human disease, but epigenomic studies lack a similar reference. To address this need, the NIH Roadmap Epigenomics Consortium generated the largest collection so far of human epigenomes for primary cells and tissues. Here we describe the integrative analysis of 111 reference human epigenomes generated as part of the programme, profiled for histone modification patterns, DNA accessibility, DNA methylation and RNA expression. We establish global maps of regulatory elements, define regulatory modules of coordinated activity, and their likely activators and repressors. We show that disease- and trait-associated genetic variants are enriched in tissue-specific epigenomic marks, revealing biologically relevant cell types for diverse human traits, and providing a resource for interpreting the molecular basis of human disease. Our results demonstrate the central role of epigenomic information for understanding gene regulation, cellular differentiation and human disease.
4,409 citations
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TL;DR: The goal is to disseminate the simple definition and five-stage classification system of Chronic kidney disease, to summarize the major recommendations on early detection of chronic kidney disease in adults, and to consider some of the issues associated with these recommendations.
Abstract: Chronic kidney disease is a worldwide public health problem with an increasing incidence and prevalence, poor outcomes, and high cost. Outcomes of chronic kidney disease include not only kidney failure but also complications of decreased kidney function and cardiovascular disease. Current evidence suggests that some of these adverse outcomes can be prevented or delayed by early detection and treatment. Unfortunately, chronic kidney disease is underdiagnosed and undertreated, in part as a result of lack of agreement on a definition and classification of its stages of progression. Recent clinical practice guidelines by the National Kidney Foundation 1) define chronic kidney disease and classify its stages, regardless of underlying cause, 2) evaluate laboratory measurements for the clinical assessment of kidney disease, 3) associate the level of kidney function with complications of chronic kidney disease, and 4) stratify the risk for loss of kidney function and development of cardiovascular disease. The guidelines were developed by using an approach based on the procedure outlined by the Agency for Healthcare Research and Quality. This paper presents the definition and five-stage classification system of chronic kidney disease and summarizes the major recommendations on early detection in adults. Recommendations include identifying persons at increased risk (those with diabetes, those with hypertension, those with a family history of chronic kidney disease, those older than 60 years of age, or those with U.S. racial or ethnic minority status), detecting kidney damage by measuring the albumin-creatinine ratio in untimed ("spot") urine specimens, and estimating the glomerular filtration rate from serum creatinine measurements by using prediction equations. Because of the high prevalence of early stages of chronic kidney disease in the general population (approximately 11% of adults), this information is particularly important for general internists and specialists.
4,363 citations
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TL;DR: There was a high prevalence of CVD in CKD and that mortality due to CVD was 10 to 30 times higher in dialysis patients than in the general population, and the task force recommended that patients with CKD be considered in the “highest risk group” for subsequent CVD events.
Abstract: Chronic kidney disease1 (CKD) is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. The number of individuals with kidney failure treated by dialysis and transplantation exceeded 320 000 in 1998 and is expected to surpass 650 000 by 2010.1,2 There is an even higher prevalence of earlier stages of CKD (Table 1).1,3 Kidney failure requiring treatment with dialysis or transplantation is the most visible outcome of CKD. However, cardiovascular disease (CVD) is also frequently associated with CKD, which is important because individuals with CKD are more likely to die of CVD than to develop kidney failure,4 CVD in CKD is treatable and potentially preventable, and CKD appears to be a risk factor for CVD. In 1998, the National Kidney Foundation (NKF) Task Force on Cardiovascular Disease in Chronic Renal Disease issued a report emphasizing the high risk of CVD in CKD.5 This report showed that there was a high prevalence of CVD in CKD and that mortality due to CVD was 10 to 30 times higher in dialysis patients than in the general population (Figure 1 and Table 2).6–18 The task force recommended that patients with CKD be considered in the “highest risk group” for subsequent CVD events and that treatment recommendations based on CVD risk stratification should take into account the highest-risk status of patients with CKD.
View this table:
TABLE 1. Stages of CKD
Figure 1. Cardiovascular mortality defined by death due to arrhythmias, cardiomyopathy, cardiac arrest, myocardial infarction, atherosclerotic heart disease, and pulmonary edema in general population (GP; National Center for Health Statistics [NCHS] multiple cause of mortality data files International Classification of Diseases, 9th Revision [ICD 9] codes 402, 404, 410 to 414, and …
4,037 citations