Nephrology

Team

Presentation

Introduction

Bellvitge University Hospital is the centre with the highest renal transplant activity in Spain and one of the main promoters of home dialysis techniques in Catalonia.

The Nephrology Service of Bellvitge University Hospital is a reference centre for nephrological care in part of the Barcelona Health Region (Alt Penedès, Garraf, Anoia, Baix Llobregat and Hospitalet de Llobregat). This task is carried out in collaboration with the nephrology care units of Igualada and the Moisès Broggi Hospital, the Garraf Health Consortium and the haemodialysis centres of Hospitalet (Fresenius Medical Care and Diaverum Servicios Renales), Sant Boi (Fresenius Medical Care) and Martorell (BBraun). In addition, the Service is a reference for renal transplants in the health regions of Terres de l'Ebre and Camp de Tarragona, which depend on the Joan XXIII Hospital in Tarragona for nephrological care.

We work along with primary care for the prevention, early detection and treatment of patients at risk of progression of chronic kidney disease. We coordinate with all the nephrology teams in our area in order to offer the best treatment option for each patient, from living donor kidney transplantation to conservative treatment. We consider the patient as the main actor in decision-making and responsible for self-care. To facilitate this, we develop innovative tools based on virtual reality and telemedicine.

Team

Head of Service

Head of Nursing Area

Head of Section - Clinical Nephrology

Head of Section - Renal Trasplant Unit (RTU)

Director of the Dialysis and Interventional Nephrology Programme

Specialist Doctors

Nurse Managers

Advanced Practice Nurses - Kidney Transplantation

Advanced Practice Nurse - Advanced Chronic Kidney Disease

Home Dialysis Programme Nurses

Relevant aspects

Study and evaluation of the kidney transplant candidate
Post-surgery control of the kidney transplant patient Reference centre of the National Health System (CSUR) for crossed kidney transplant.
Kidney transplant from deceased donor Kidney transplant from asystole donor
Kidney preservation techniques, normothermic perfusion and pulsatile hypothermic perfusion machine
Kidney transplantation from living donor ABO incompatible kidney transplantation
High complexity kidney transplantation
Desensitisation techniques for hyperimmunised patients: plasmapheresis and immunoadsorption (non-specific and specific)
Kidney transplantation from asystole donor and HLA-sensitised patient
Treatment of acute cellular and humoral rejection
Diagnostic and protocol kidney biopsy

Nursing consultation on kidney replacement therapy techniques (transplant, peritoneal dialysis, haemodialysis)
Information on renal replacement therapy techniques using virtual reality
Conservative treatment of patients with advanced chronic kidney disease
Haemodialysis vascular access unit (FAVBELL)
Haemodialysis unit for chronic patients. Online haemodiafiltration
Peritoneal dialysis programme
Home haemodialysis programme
Home dialysis patient monitoring by telemedicine
Treatment of heart failure with peritoneal ultrafiltration
Treatment of acute kidney failure with continuous therapies in critically ill patients.
Plasmapheresis Immunoadsorption Haemoperfusion
Diagnostic and interventional nephrology: kidney biopsy (transplanted and native kidney)
Ultrasound study: POCUS, VExUS, ultrasound of vascular access
Placement of echo-guided dialysis catheters

Diagnosis and treatment of primary and systemic autoimmune nephropathies
Diabetic nephropathy consultation
Chronic kidney disease consultation
Hereditary nephropathies and rare diseases
Consultation of kidney failure in oncology patients
Diagnosis and treatment of acute kidney failure
Diagnostic kidney biopsy Arterial hypertension consultation: refractory and secondary hypertension 24-hour blood pressure recording (MAPA)
Vascular elasticity study (Pulse Wave Velocity)

Research

Lines of research

Biomarkers and personalised medicine in kidney transplantation
Autoimmunity and renal disease
Mechanisms of kidney damage and regeneration
Pharmacogenomics and pharmacokinetics for the optimisation of immunosuppressive therapy
Atheromatosis and chronic kidney disease
New technologies to optimise chronic kidney disease monitoring and treatment
Clinical trials in kidney transplantation, diabetic nephropathy, chronic kidney disease, dialysis, glomerular and systemic diseases

Research groups

Main Publications

Couceiro C, Rama I, Comas J, et al. Effect of kidney replacement therapy modality after first kidney graft failure on second kidney transplantation outcomes. Clin Kidney J. 2022; 15(11):2046-2055
Favà A. Donadeu L, Jouve T, et al A comprehensive assessment of long-term SARS-CoV-2-specific adaptive immune memory in convalescent COVID-19 Solid Organ Transplant recipients. Kidney Int. 2022;101(5):1027-1038
Montero, N.; Moreso, F.; Cruzado, J.M.. 2021. HIV-positive deceased donor-to-HIV-positive recipient kidney transplantation: the HOPE must go on. Am J Transplant. 2021; 21-5, pp.1683-1684.
Fontova, P.; Colom, H.; Rigo-Bonnin, R.; et al. Influence of the Circadian timing System on tacrolimus pharmacokinetics after kidney transplantation Frontiers in Pharmacol 2021; 12, pp.636048
Favà, A.; Donadeu, L.; Sabé, N.; et al . 2021. SARS-CoV-2-specific serological and funcional T-cell immune responses during acute and early COVID-19 convalescence in solid organ transplantation patients. Am J Transplant 2021; 21-8, pp.2749-2761.
Favà A, Cucchiari D, Montero N, et al. Clinical characteristics and risk factors for severe COVID-19 in hospitalized kidney transplant recipients: A multicentric cohort study. Am J Transplant. 2020;20(11):3030-3041
Montero N, Quero M, Arcos E, et al. Effects of body weight variation in obese kidney recipients: a retrospective cohort study. Clin Kidney J. 2019;13(6):1068-1076.
Manonelles A, Guiteras R, Melilli E, et al. The Presence of Urinary Renal Progenitor Cells in Stable Kidney Transplant Recipients Anticipates Allograft Deterioration. Front Physiol. 2018 Oct 10;9:1412

Education

MIR TRAINING IN NEPHROLOGY

Teaching tutors: Edoardo Melilli and Xavier Fulladosa Oliveras.

4-year training programme, accreditation of 2 residents per year. The programme includes an initial short rotation in the Nephrology Department, followed by a period of training in other specialities of the Hospital in order to achieve solid core competencies as an internist. From the second year onwards, the resident joins the Nephrology service, first in the dialysis and interventional nephrology unit and then in hospitalisation, renal transplant unit and clinical nephrology, including outpatient consultation. During the last year of residency, there is the possibility of a 3-month external rotation in international centres of excellence.

We also host nephrology residents from other national and international centres who wish to extend their training in our department.