Clinical Nephrology Unit. Hospital 12 de Octubre
Avda. de Córdoba, s/n. 28041 Madrid
Principal Investigator: Manuel Praga
Project Staff: Enrique Morales Ruiz, Eduardo Gutierrez Martinez, Paula Jara Caro Espada, Cristina Rabasco Ruiz, Jorge Enrique Rojas Rivera.
The Clinical Nephrology Unit, lead by the Head of Division (Manuel Praga) has centered many of its investigations in the field of renal disease progression and the therapeutic measures to halt it. Of remarkable importance in this way are the group publications focused on antiproteinuric treatments (drugs blocking the renin-angiotensin-aldosterone system), that are nowadays obligated treatment in renal diseases and in whose clinical application our group provided pioneering publications that achieved a high impact. The study of renal diseases associated to obesity has been another field in which our Group has performed relevant and widely recognized clinical investigations, as well as in the study of clinical characteristics and treatment of interstitial renal diseases.
The Clinical Nephrology Unit has developed also, along the last decades, a continuous work in the clinical care, teaching and investigation of glomerular diseases. Many national and abroad investigators have chosen our Center to improve and obtain a deeper knowledge in the field of glomerulonephritis. The publications of our Group centered in glomerular diseases are numerous, deserving special mention the performance of prospective randomized trials that achieved a remarkable diffusion and clinical relevance: good examples are the demonstration of the efficacy of ACEI to prevent the progression of IgA nephropathy and the efficacy of tacrolimus in the treatment of membranous nephropathy. These treatments are currently recognized by Clinical Guidelines on the basis of our results and publications. Also worthy of mention is the Group collaboration in the performance of many of the highest worldwide impact therapeutic and Clinical Guidelines, such as the KDIGO Guidelines.
In recent years, the Clinical Nephrology Unit has focused many of its investigations on renal diseases mediated by the Complement system. Complement activity is a central pathogenic mediator in practically all the glomerular diseases, both primary and secondary. Therefore, the implications of complement dysregulation in the progression of some of the most common glomerular disorders, such as IgA nephropathy and membranous nephropathy, have focused our interest. Through the Grupo Español para el Estudio de las Enfermedades Glomerulares (GLOSEN), of whom Dr Manuel Praga is the central coordinator, large series of patients suffering these diseases have been collected to study the influence of Complement activation on their progression. The recently described C3 glomerulopathy is also one of the main objectives of the Unit in order to characterize its clinical findings, to evaluate the best therapeutic alternatives and to deepen on its pathogenic mechanisms. Finally, the recent discovery and availability of drugs that block the Complement system have revolutionized the therapeutic expectations for the care of renal diseases such as Hemolytic Uremic Syndrome. The Clinical Nephrology Unit has actively collaborated in the performance of consensus documents and therapeutic investigations in order to better define the indications and the clinical use of these new treatments.