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Ítem WCN24-1762 Urgent cardiovascular cases in patients diagnosed with diabetes and de novo in a healthcare provider in magangué (BOL) between january 2021 and july 2023(International Society of Nephrology ISN, 2026) González-Torres, Henry Joseth; Baleta Plata, Waldys Alberto; Hernández Nieto, Bryan ; Agamez Díaz, Adriana Isabel; Domínguez-Vargas, Alex; Peña Vargas , William arturo; Aroca-Martinez, GustavoThe relationship between diabetes and cardiovascular risk has been extensively studied; the mortality associated with these two conditions remains a clinical and public health concern. The objetive was to assess cardiovascular emergencies in patients with pre-existing and newly diagnosed diabetes at a healthcare facility in Magangué, Bolívar, between January 2021 and July 2023.Ítem WCN24-1676 Results of a kidney transplant program at an clinic in the colombian caribbean region – 2019 to 2022(International Society of Nephrology ISN, 2026) González-Torres, Henry Joseth; Moran Marin, Leinad Yamile; Aroca-Martinez, Gustavo; Agamez Díaz, Adriana Isabel; Dominguez Vargas, Alex Alfredo; Cabarcas Barbosa, Omar de Jesus; Hernandez Agudelo, SandraKidney transplantation is an effective treatment option and, in many cases, the best option for patients with end-stage renal disease. However, it still faces significant challenges that need to be addressed to improve the quality of life and survival of transplant recipients. Therefore, follow-up programs for these renal patients are essential. Hence, the objective of this study was to evaluate the outcomes of a kidney transplant program in a clinic in the Colombian Caribbean Region between the years 2019 and 2022.Ítem WCN24-1355 Risk of dialysis according to the Kidney Failure Risk Equation (KFRE) in patients with chronic kidney disease enrolled in a nephroprotection program in la Guajira (Colombia) between 2021 and 2023(International Society of Nephrology ISN, 2026) González-Torres, Henry Joseth; Chacon Buendía, Ernesto Alfonso; Aroca-Martinez, Gustavo; Agamez Díaz, Adriana Isabel; Dominguez Vargas, Alex Alfredo; Cadena Bonfanti, Andrés ÁngeloChronic Kidney Disease (CKD) is a progressive, long-term condition characterized by a gradual and irreversible deterioration of renal function. In its early stages, it is a slow and silent process, leading to a decrease in the estimated glomerular filtration rate (eGFR), a measure of kidney function. Therefore, the objective was to monitor the risk profiles for requiring renal replacement therapy according to the Kidney Failure Risk Equation (KFRE) in patients with Chronic Kidney Disease enrolled in a nephroprotection program in La Guajira (CO) between the years 2021 and 2023.Ítem WCN24-1370 Incidence of acute kidney injury and the need for renal support therapy in the postoperative period of cardiovascular surgery(International Society of Nephrology ISN, 2026) González-Torres, Henry Joseth; Ospina Herrera, Daniel; Aroca-Martinez, Gustavo; Agamez Díaz, Adriana Isabel; Aguilera Caro, Sofia; Dominguez Vargas, Alex AlfredoMajor surgery is the second leading cause of Acute Kidney Injury (AKI), with cardiovascular surgery having the highest incidence. This is due to technical conditions like aortic clamping and extracorporeal circulation, which lead to systemic reactions including embolism formation, low cardiac output, prolonged hypotension, and contact-activated systemic inflammation. This study aimed to evaluate the incidence of AKI and the need for renal support therapy after cardiovascular surgery.Ítem WCN26-3469 Binutuzumab induces histologic remission and deep kidney parenchymal b-cell depletion in patients with lupus nephritis: exploratory analyses from the regency trial(International Society of Nephrology ISN, 2026) Rovin, Brad H.; Martins, Elsa; Austin, Cary D.; Raghu, Harini; Chan, Caleb; Chang, Patrick; Alberton, Valeria; Santiago, Mittermayer ; Aroca-Martinez, Gustavo; Alfaro, Jose; Furie, Richard A.; Larson, Christopher; Yoo, Bongin; Pendergraft, William F.; Malvar, AnaThe REGENCY trial (NCT04221477) demonstrated superiority of obinutuzumab (OBI) plus standard therapy (+ST) vs placebo (PBO) +ST in achieving complete renal response (CRR) at Week 76 (W76) in adults with active lupus nephritis (LN). It was postulated that OBI+ST would yield greater rates of histologic remission and kidney tissue-level B-cell depletion at W76 than PBO+ST, which would portend more favorable long-term kidney outcomes, such as reduced LN flare risk and preserved kidney function. These exploratory analyses aimed to evaluate histologic remission and kidney tissue-level B-cell depletion at W76 in patients treated with OBI+ST vs PBO+ST.Ítem WCN26-6530 Colombian registry of glomerular diseases (REGLOCOL)(International Society of Nephrology ISN, 2026) Aroca-Martinez, Gustavo; Figueroa-Millán, Christian; Daza, Jose Lucas; Cadena Bonfanti, Andres; Pérez-Jiménez, Valentina; Lasso-Latorre, Karen; Torres-Saltarín, Jaime; Puche-Carrascal, Eduardo; Ramírez, Roberto; Pérez Padilla, Rafael; Rodriguez, Liliana; Arcoa-Vidal, María; Fontalvo-Avila, Nicoll; Camargo-Rodriguez, Kanery; Vásquez-Obeso, EstebanGlomerular diseases are significant causes of chronic kidney disease (CKD) and are categorized as either primary or secondary. FSGS, IgA nephropathy, and membranous nephropathy are the most common primary forms, while lupus nephritis predominates among secondary causes. The REGLOCOL registry seeks to define their epidemiology and clinical profile in Colombia.Ítem WCN26-6812 Recurrent hypokalemia: the hidden footprint of an autoimmune distal renal tubular acidosis. Case report(International Society of Nephrology ISN, 2026) Ipia-Ordóñez, Nasly; Aroca-Martinez, Gustavo; Benavidez-Solarte, Mario; Madroñero-Muñoz, Simón; Solarte-Ordóñez, Danilo; Pérez-Jiménez, Valentina; Lasso-Latorre, KarenDistal renal tubular acidosis (dRTA) is an uncommon cause of hypokalemia and metabolic acidosis, especially among young adults. When associated with autoimmune diseases, it may represent the first manifestation of systemic involvement, as occurs in systemic lupus erythematosus (SLE) and Sjögren’s syndrome.Ítem WCN26-432 Relationship between social vulnerability and evolution of glomerular filtration rate in patients with polycystic kidney disease(International Society of Nephrology ISN, 2026) Arturo Dulce, Jaime; Guido Musso, Carlos; Aroca-Martinez, Gustavo; Alvarez Mora, Eveling LissethPolycystic kidney disease (PCD) is the main hereditary kidney disease worldwide (1). It is characterized by the progressive formation of multiple renal cysts, which increase renal volume and replace the functional parenchyma, hypertension also occurs (2). Over time, glomerular destruction impairs filtration, leading to chronic kidney disease and the need for renal replacement therapy in certain cases (3). In terms of pathophysiology, PKD is mainly associated with mutations in the PKD1 and PKD2 genes, with autosomal dominant inheritance predominating. However, there are cases without mutations in these genes, affecting other loci conditioning an earlier and more severe presentation of the disease (4). PKD is a multisystem pathology with extra-renal cystic and non-cystic manifestations. The former include brain, liver, and gastrointestinal cysts. Non-cystic manifestations include aortic and cerebral aneurysms, heart valve abnormalities, colonic diverticula, and abdominal hernias (5)(6). The most frequent clinical manifestations, related to pathophysiology, are back pain, hematuria, urinary tract infections and lithiasis (7). Globally, an estimated 12 million people suffer from ERP, with approximately 600,000 cases in the United States (8). In the European Union, prevalence ranges from 2.41 to 3.89 cases per 10,000 population, and about 91.1 cases per million people require replacement therapy due to PKD (9). In Colombia, information is limited; the former Social Security Institute reported a prevalence of 4.6% in patients with stage 4 chronic kidney disease (10). In the context of chronic kidney disease, social vulnerability acts as a determining factor that significantly increases the risk of clinical decompensation, delay in diagnosis, limited access to appropriate treatments and, consequently, a higher mortality rate (11). The objective of this study was to make a correlation between ERP and the social vulnerability score (SOVI).Ítem WCN26-436 De novo idiopathic nodular glomerulosclerosis in a kidney transplant patient(International Society of Nephrology ISN, 2026) Dulce, Jaime A.; Cabarcas, Omar; Niño, Lucia; Aroca-Martinez, GustavoChronic Kidney Disease is a condition characterized by a progressive and irreversible decrease in kidney function that can be caused by different etiologies, among which are primary or secondary glomerular diseases (1). Within renal replacement therapies; Transplantation is the modality that provides the greatest benefit in terms of quality of life and mortality. Renal graft survival can be affected not only by rejection and infections but also by relapse in the graft of a glomerular disease that affected the native kidney or otherwise, a de novo onset (2)(3). A study of 1505 transplant patients between 1988- 1997 with a diagnosis of confirmed glomerular disease documented that recurrence was the third most common cause of allograft loss at 10 years, after chronic rejection and death with a functioning allograft (4). It should be noted that live transplantation has better HLA compatibility and therefore greater graft survival, however increased rates of primary glomerulonephritis recurrence have been noted in this group of patients (5). Nodular glomerulonephritis is a histological lesion pattern characterized by the presence of hyaline deposits in the mesangial matrix with a nodule-like distribution; It also shows glomerular vascular involvement, and its usual clinical manifestation may be complete nephrotic syndrome or significant proteinuria. This type of injury is closely related mainly in patients with Diabetes Mellitus and smokers with a high rate of smoking activity. The de novo appearance of this type of lesion in the post-transplant period would constitute a primary form, whose presentation would be infrequent, corresponding to only 0.45% in the series published to date (6).Ítem WCN26-6802 The impact of active Lupus Nephritis on work productivity in patients from a Latin American Lupus Cohort(International Society of Nephrology ISN, 2026) Aroca-Martinez, Gustavo; Nieto, Romina; Quintana, Rosana; Pons-Estel, Guillermo; Pérez-Jiménez, Valentina; Pons-Este, BernardoIntroduction: The Latin American Group for the Study of Lupus (GLADEL) 2.0 is an observational prevalent and incident cohort of patients with systemic lupus erythematosus (SLE) in Latin-American countries. Here we evaluated the work productivity and activity impairment (WPAI) in patients with active lupus nephritis (LN) at cohort entry and 12 months after treatment initiation according to their renal response.Ítem WCN26-6861 Chronic kidney disease in vulnerable afro-descendant, indigenous, and agricultural communities in latin America(International Society of Nephrology ISN, 2026) Aroca-Martinez, Gustavo; Villavicencio, Elba; Vital, Socorro; Rizo, Lilia; Rodríguez, Carolina; Molina, Daniel; Rico, Jorge; Dina-Batlle, Eliana; Bermudez, Valmore; Depine, Santos; Cadena, Andres; Pérez-Jiménez, Valentina; Aroca, María-Paula; Kanery-Camargo, Nicoll-Fontalvo; Lodi, RubensChronic kidney disease (CKD) is a major global public health concern, affecting an estimated 13.4% of the world’s population (Lv & Zhang, 2019). Among afro-descendant, indigenous, and agricultural communities in Latin America, studies have identified a high prevalence of CKD, frequently undiagnosed and untreated (Correa-Rotter et al., 2014; Garza & Abascal Miguel, 2025; Ulasi et al., 2025). To effectively reduce the burden of CKD in these populations, it is essential to assess how the social determinants of health (SDOH) influence kidney health (Burgos-Calderón et al., 2021). The FRENEL study is an ongoing multicenter initiative, which to date has screened 4,876 participants from vulnerable agricultural, indigenous, and afrodescendant communities in Latin AmericaÍtem WCN26-8271 Social vulnerability and lupus nephritis clustering in Barranquilla, Colombia: integrating clinical registry data with a population vulnerability index(International Society of Nephrology ISN, 2026) Aroca, Maria-Paula; Aroca-Martinez, Gustavo; Depine, Santos; Camargo- Rodriguez, Kanery; Fontalvo Avila, Nicoll; Pérez-Jiménez, Valentina; Vasquez, Esteban; Cadena, Andres; Sarmiento, Joanny; Manjarres, Karen; Bermudez, ValmoreIntroduction: Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE), with its incidence and progression potentially influenced by structural socioeconomic inequalities. The Population Renal Health paradigm (Burgos-Calderón, Depine, and Aroca- Martínez, 2021) shifts from individual risk assessment to population and territorial vulnerability analysis by integrating social determinants of health (SDOH). To operationalize this approach, the Population Vulnerability Index (PVI) was developed as a quantitative geospatial tool that measures SDOH across the Colombian Caribbean region, enabling systematic comparison of territorial vulnerability. In parallel, the RENELUP registry collects and georeferences LN cases throughout Colombia. This study cross-references RENELUP data from the city of Barranquilla with PVI scores to examine how SDOH influence disease distribution patterns in this urban setting.Ítem Frequency and associated factors of herpes zoster infection in SLE patients from Latin America: data from the GLADEL 2.0 cohort(BMJ Group, 2026) Nieto, Romina; Hernández, Lucia; Scolnik, Marina; Maurelli, Laura; Gobbi, Carla; Saurit, Veronica ; Garcia, Lucila; Kisluk, Boris; Bertolaccini, Maria Constanza; Serna Gongora, Melissa Brenda; Gómez, Graciela N; Pisoni, Cecilia; Ralle, Ana Carolina ; Pirruccio, Paola; de Souza Barbosa, Vitalina; Gasparin, Andrese; Duarte, Angela; Alves Alvino, Laíssa Cristina; Borba, Eduardo F; Bonfá, Eloisa; Torres dos Reis Neto, Edgard; Bondi Peralta, Alexis; Massardo, Loreto; Aroca-Martinez, Gustavo; Iglesias Gamarra, Antonio; Cañas, Carlos A; Quintana López, Gerardo; Frederick Silvery, Leon; Maximiliano Martinez, Jose; Sánchez-Briones, Reyna; Pérez Cristóbal, Mario; Martín-Nares, Eduardo; Silveira, Luis H; García De La Torre, Ignacio; Ramírez Sánchez, Julio César; Esquivel-Valerio, Jorge Antonio; Losanto, Jhonatan; Vazquez, Marcos Aurelio; Alva Linares, Magaly; Ugarte-Gil, Manuel Francisco; Calvo-Quiroz, Armando; Polanco, Teresandris; Pizzarossa, Carina; Silveira, Gonzalo; Pons-Estel, Bernardo; Alarcon, Graciela S; Pons-Estel, GuillermoObjective The aim of this study was to assess the epidemiological and clinical characteristics of herpes zoster (HZ) and to identify the factors associated with its first episode in Latin American SLE patients. Methods GLADEL 2.0 (Grupo Latino Americano De Estudio del Lupus) is a multiethnic, Latin American observational cohort of SLE patients. Demographic, clinical, laboratory, treatment and disease activity/damage data were compared between patients with and without HZ; its prevalence was assessed at cohort entry, incidence rates of first and recurrent HZ infections were calculated based on person-years of follow-up. Logistic regression was used to identify factors associated with HZ events, while Cox regression was used to determine the variables associated with time to first event. Results Among 1083 SLE patients, the HZ cumulative incidence after its diagnosis was 11.5%, with a prevalence of 8.6% at cohort entry. During 5-year of follow-up, the incidence of HZ was 2.9% and 16.8% patients had recurrent episodes. Patients with HZ showed higher frequencies of alopecia, psychosis and seizures, along with higher disease activity, damage accrual, proteinuria and higher daily prednisone doses prior to the event. Multivariate analyses identified female sex, higher SLE Disease Activity Index 2000 (SLEDAI-2K) and higher daily prednisone dose as independent predictors of HZ occurrence. Older age at diagnosis, psychosis, disease activity and a higher daily prednisone dose were associated with a shorter time to HZ onset. Conclusion In the GLADEL 2.0 cohort, the high burden of HZ in SLE, together with its association with active disease, corticosteroid exposure and neuropsychiatric manifestations, underscores the need for proactive risk stratification in clinical practice.Ítem Renal Outcomes of GLP‑1 Receptor Agonists and Tirzepatide Across CKD Stages and Metabolic Phenotypes (Type 2 Diabetes and/or Overweight/ Obesity): A Scoping Review(Springer Nature, 2026) Rico‑Fontalvo, Jorge; Daza‑Arnedo, Rodrigo; Elbert, Alicia; Correa‑Rotter, Ricardo; Dina‑Batlle, Eliana; Lorca‑Herrera, Eduardo; Proença de Moraes, Thyago; Sánchez‑Polo, Vicente; Builes‑Montaño, Carlos E.Introduction: Diabetes mellitus is the leading global cause of chronic kidney disease (CKD) and end-stage renal disease. Although cardiovascular outcomes have improved substantially, renal risk remains high. Glucagon-like peptide 1 (GLP-1) receptor agonists and the dual GLP-1/GIP agonist tirzepatide have demonstrated potential cardiorenal benefits, but renal evidence has not been systematically mapped across CKD stages and metabolic phenotypes. This scoping review aimed to identify and describe clinical evidence on renal outcomes associated with GLP-1-based therapies in adults with type 2 diabetes and/or overweight/obesity, with or without CKD. Methods: Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines (protocol: OSF.IO/SZ87J), we searched PubMed, Embase, and CENTRAL from inception to October 2025. Eligible studies included phase 2–4 randomized controlled trials (RCTs), post hoc RCT analyses, and comparative observational studies reporting kidney outcomes. Data were charted using a structured extraction form with AI-assisted screening and manual validation. Risk of bias and certainty were appraised using RoB 2, ROBINS-I, and GRADE frameworks. Results: Of 607 records identified, 35 studies met inclusion criteria. Randomized evidence supports renal benefits for semaglutide, dulaglutide, and liraglutide, including reductions in composite kidney outcomes and slower eGFR decline. Tirzepatide demonstrated consistent albuminuria reductions and attenuation of eGFR decline compared with insulin glargine. Efpeglenatide, cotadutide, exenatide, and lixisenatide showed class-consistent antiproteinuric effects. Observational data extended findings to real-world and advanced CKD populations. Across agents, renal benefits were partly independent of glycemic and weight effects. Conclusion: GLP-1-based therapies demonstrate consistent renoprotective signals across CKD stages and metabolic phenotypes, particularly in type 2 diabetes. Evidence is strongest for semaglutide and dulaglutide, with emerging data for tirzepatide and other incretin-based agents. These findings provide a structured evidence map to inform future consensus and clinical decision-making.Ítem Apolipoprotein L1 (APOL1) and Nephropathy(Società Italiana di Nefrologia, 2026) Yael Szyferman, Alanis; Kleppe, Soledad; Cristiano, Fabrizio; Conde-Manotas, Juan C.; Cadena-Bonfanti, Andrés; Aroca-Martinez, Gustavo; Musso, Carlos G.Introduction. End-stage renal disease exhibits a disproportionate prevalence among Black individuals and older adults within the United States and worldwide. A significant genetic contributor to this disparity is the Apolipoprotein L1 (APOL1) gene, found exclusively in populations of African ancestry. Materials and Method. We aim to perform a narrative review regarding the current understanding of APOL1 and its complex role in kidney disease pathogenesis. Results. The G1 and G2 APOL1 risk alleles are strongly associated with an elevated risk for non-diabetic chronic kidney disease (CKD), including hypertensive nephropathy, focal segmental glomerulosclerosis, and HIV-associated nephropathy, in individuals who are homozygous or compound heterozygous for these variants. While 10-15% of African Americans carry two APOL1 risk alleles, approximately 80% remain disease-free, suggesting incomplete penetrance and the involvement of additional risk factors. In this condition, renal damage could be induced through different mechanisms such as altered cellular ion transport, mitochondrial dysfunction, and the requirement for additional stressors or “second hits”. Conclusion. The increased susceptibility to end-stage renal disease (ESRD) in individuals of African ancestry is influenced by variations in the APOL1 gene.Ítem Metabolic kidney disease: a new concept in the interaction between Obesity, Prediabetes, Diabetes and Liver Dysfunction(Società Italiana di Nefrologia, 2026) Rico Fontalvo, Jorge; Daza Arnedo, Rodrigo; Raad Sarabia, María; Jiménez, Javier; Montejo-Hernández, Juan; Rodríguez-Yánez, Tomas; José Soler, María; Sciarrone-Alibrandi, Maria Teresa; Fernando Rivera, RodolfoMetabolic abnormalities such as obesity, insulin resistance, prediabetes, type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD) increasingly contribute to chronic kidney disease (CKD). Although often treated as separate entities, these conditions share common mechanisms – including glomerular hyperfiltration, adipokine imbalance, chronic low-grade inflammation, endothelial dysfunction and lipid accumulation – that initiate and sustain renal injury long before classical CKD becomes clinically evident. The concept of Metabolic Kidney Disease (MKD) offers a unified framework that captures the continuum of renal involvement across the metabolic spectrum. Obesity- and prediabetes-related MKD frequently precede diabetic kidney disease, while MASLD – according to updated EASL-EASD-EASO guidelines – is a multisystem disorder with direct renal consequences. Mixed metabolic phenotypes further intensify metabolic stress, accelerating progression toward CKD. Recognising MKD has important clinical implications. Expanded screening strategies may identify early renal alterations in individuals with metabolic vulnerability who are not targeted by traditional CKD criteria. Integrating metabolic evaluation into nephrology practice may facilitate earlier, more holistic interventions and ultimately improve cardio-renal outcomes.Ítem Efficacy and safety of finerenone in diabetic kidney disease: Latin American experience from FINDKDLATAM trial(Baishideng Publishing Group Inc., 2026) Daza Arnedo, Rodrigo; Sánchez Polo, Vicente; Benavides Garcia , Jenniffer; Gutiérrez, Juan Felipe; Ramos Clason, Enrique; Domínguez, Daniel; Mera Rebutti, Giovany; Madrid Mancia, Carlos; Tabora López, Rene; Rocha Meza, Manuel; Tabora López, Dany; Muñoz Zambrano, James J; Lorca Herrera, Eduardo; Dina-Batlle, Eliana; Cieza Terrones, Michael; Proença de Moraes, Thyago; Rodriguez Yánez , Tomas; Osorio, Washington; Arellano Cabeza, Alyi; Rico-Fontalvo, JorgeBACKGROUND Patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) face high renal and cardiovascular risks. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, has demonstrated efficacy in reducing these risks in clinical trials. However, its real-world safety and effectiveness remain underexplored in local settings. AIM To evaluate the real-world safety and effectiveness of finerenone in patients with T2DM and CKD across seven Latin American countries. METHODS We conducted an observational, multicenter, retrospective cohort study based on real-world data in 347 patients with T2DM and CKD [urinary albumin-creatinine ratio (UACR) > 30 mg/g]. Patients received finerenone (10 mg or 20 mg daily), and clinical and laboratory parameters were evaluated at baseline and after six months of treatment. RESULTS At baseline, median values (interquartile range) were: Glycated hemoglobin A1c 7.6% (6.8%-8.1%); estimated glomerular filtration rate 39.0 mL/minute/1.73 m2 (30.0-50.0); UACR 345 mg/g (189-760); systolic blood pressure 143 mmHg (130-160); diastolic blood pressure 79 mmHg (70-82); and serum potassium 4.4 mmol/L (4.1-4.7). After six months, significant reductions were observed: Glycated hemoglobin A1c to 7.0% (6.5%-7.9%); UACR to 81 mg/g (28-167); systolic blood pressure to 130 mmHg (120-140); and diastolic blood pressure to 73 mmHg (70-80). Serum potassium increased to 4.7 mmol/L (4.3-5.0), while estimated glomerular filtration rate remained stable at 41.6 mL/minute/1.73 m2 (27.0-52.0). CONCLUSION In our cohort of patients with CKD associated with T2DM, finerenone proved to be an effective short-term therapy for reducing albuminuria, demonstrating very good tolerance and a low risk of hyperkalemiaÍtem Adecuación y necesidad de las terapias basadas en incretinas en la enfermedad renal crónica: consenso de expertos RAND/UCLA para América Latina(Sociedad Latinoamericana de Nefrología e Hipertensión, 2026) Rico-Fontalvo, Jorge; Rodrigo Daza-Arnedo; Eduardo Lorca-Herrera; Dina-Batlle, Eliana; Proenca de Moraes, Thyago; Elbert, Alicia; Builes-Montaño, Carlos E.; Correa-Rotter, Ricardo; Sánchez-Polo, VicenteAntecedentes: La evidencia que respalda a las terapias basadas en incretinas como modificadoras del riesgo renal continúa ampliándose; sin embargo, su aplicación clínica sigue siendo heterogénea entre distintos fármacos, fenotipos de enfermedad renal crónica (ERC) y sistemas de salud. En América Latina, la variabilidad en el acceso y la implementación acentúa la necesidad de una priorización guiada por fenotipos y de distinguir entre intervenciones que pueden considerarse razonables y aquellas que deben considerarse necesarias. Método: Se llevó a cabo un estudio formal de consenso de expertos utilizando el método RAND/UCLA de adecuación, reportado de acuerdo con los estándares RAND/UCLA y la guía ACCORD. Un panel multidisciplinario de expertos latinoamericanos (n = 9) evaluó la adecuación de cuatro terapias basadas en incretinas (dulaglutida, liraglutida, semaglutida y tirzepatida) en 18 escenarios clínicamente relevantes de ERC, utilizando una escala de 9 puntos en dos rondas independientes de calificación. Tras la primera ronda, se realizó una reunión presencial moderada para revisar las medianas y las distribuciones de las puntuaciones, así como para refinar la redacción de los escenarios. Las combinaciones escenario-terapia clasificadas como adecuadas tras la segunda ronda se evaluaron posteriormente en cuanto a necesidad en una tercera ronda independiente. El desacuerdo se evaluó mediante el rango interpercentílico y el rango interpercentílico ajustado por simetría, y las clasificaciones finales se establecieron según los criterios estándar RAND/UCLA. Resultados: En los 18 escenarios y las cuatro terapias evaluadas, las calificaciones de adecuación fueron más consistentemente favorables para la semaglutida y más selectivas para la tirzepatida, mientras que la dulaglutida y la liraglutida se clasificaron predominantemente como inciertas. Tras la discusión y la refinación de los escenarios, las calificaciones de la segunda ronda fueron más conservadoras y se resolvió todo el desacuerdo observado en la primera ronda. Dos escenarios orientados a la seguridad, antecedente de pancreatitis aguda y adultos mayores con fragilidad y pérdida de peso involuntaria, se clasificaron de manera uniforme como inapropiados para todas las terapias. La necesidad se estableció principalmente para la semaglutida en fenotipos cardiorrenales albuminúricos de mayor riesgo y para la tirzepatida, en escenarios seleccionados, particularmente cuando la obesidad coexistía con albuminuria persistente. En conjunto, la albuminuria, el riesgo residual a pesar de una terapia basal optimizada (bloqueo del sistema renina-angiotensina e inhibición del cotransportador sodio-glucosa tipo 2), el fenotipo metabólico y la comorbilidad cardiovascular emergieron como los principales determinantes del juicio experto. Conclusiones: En este consenso RAND/UCLA, la necesidad de terapias basadas en incretinas se concentró en fenotipos de ERC albuminúricos de alto riesgo, de forma más consistente para la semaglutida y de manera más limitada para la tirzepatida, mientras que la dulaglutida y la liraglutida se calificaron generalmente como inciertas. Estos hallazgos proporcionan un marco pragmático para apoyar la priorización terapéutica y la toma de decisiones compartida en América Latina, y ponen de relieve vacíos críticos de evidencia en la ERC avanzada, la enfermedad dependiente de diálisis y la ERC no diabética.Ítem Serum and urine electrolyte and nitrogenous waste product changes during the renal functional reserve test(Asociación Colombiana de Nefrología e Hipertensión Arterial, 2026) Musso, Carlos; Juarez, Rossina; González-Torres, Henry Joseth; Capotondo, Mercedes; Terrasa, Sergio; Aroca-Martinez, GustavoContext: Renal functional reserve (RFR) refers to the kidney’s capability to increase its basal glomerular filtration rate (GFR) by at least 20 % after an adequate stimulus, such as a protein overload. As far as we know, no studies have yet reported the behavior of electrolyte excretion during the renal functional reserve test. Material and methods: A prospective study to evaluate serum and urinary changes in electrolytes, nitrogenous waste products, glucose, protein, and albumin during the renal functional reserve test in healthy young adults, evaluating their cimetidine-aided creatinine clearance and renal functional reserve test (Hellerstein). Results: There was a statistically significant increase in glomerular filtration rate (positive renal functional reserve) and serum glucose, as well as a significant reduction in serum values of nitrogen derivatives and electrolytes in 46 healthy young adult volunteers during the renal functional reserve test. Regarding the urinary fractional excretion of these substances, significant increases were observed for nitrogenous waste products and electrolytes, except for phosphorus, glucose, protein, and albumin urinary excretion, which suffered no change. Conclusion: The renal functional reserve significantly modified not only glomerular filtration rate but also nitrogenous waste products and electrolyte serum levels, as well as their urinary fractional excretion values in healthy young adults (mean age: 35 years).Ítem Characterizing hypertension among recreational cyclists in Colombia: the Atlantico cyclists study(Elsevier, 2025) Hernandez Nieto, Bryan; Urina Jassir, Manuel; Mantilla Morron, Mirary; Charris Cogollo, Carolina Rosa; Mercado Marchena, Riguey; Urina Jassir, Daniela; Urina Triana, Manuel; Urina Triana, MiguelObjective: To describe the prevalence of hypertension and exercise-induced hypertension (EIH) among recreational cyclists in addition to their exercise habits and prior medical evaluations. Methods: A cross-sectional study was conducted among adult recreational cyclists from March to April 2024 in the Department of Atlántico, Colombia. Participants were selected via convenience sampling after cycling activities and data were collected with a structured survey (demographics, comorbidities, and exercise habits). Post-exercise blood pressure (BP; two measurements three minutes apart), heart rate, oxygen saturation, weight, height, and waist circumference were measured. EIH was defined as a systolic BP > 210 mmHg for men and > 190 mmHg for women. Data were summarized with descriptive statistics. Results: Three hundred and fifty-five individuals were included. Most were male (84.5 %) and older than 45 years of age (75.8 %). Hypertension was identified in 22 % of participants. Other risk factors included hypercholesterolemia (11.8 %), smoking (10.4 %), and hypertriglyceridemia (7.3 %). The mean post-exercise systolic BPs were 130.4 ± 55.6 mmHg and 122.6 ± 15.5 mmHg, and diastolic BPs were 77.2 ± 10.4 mmHg and 76.8 ± 10.7 mmHg (initial and three minutes later, respectively) and no participants fulfilled the criteria for EIH. Among the participants, 20.6 % underwent prior medical evaluation. Conclusions: Hypertension was a common baseline condition among recreational cyclists, but none was found to have EIH. Despite a high prevalence of cardiovascular risk factors, one-fifth of the participants had a medical evaluation before engaging in cycling activities. Our findings underscore the importance of encouraging routine health screenings in this population.