This study was conducted using machine learning models to identify patient non-invasive information for cardiovascular complications prediction in peritoneal dialysis patients. Nowadays is well known that cardiovascular diseases are the key to mortality in patients undergoing peritoneal dialysis as the risk of cardiovascular disease increases with the progression of renal failure. Primary aim is to establish variables most associated with cardiovascular complications. To achieve this goal four different machine learning techniques were used. We found that the best classification algorithm was a Generalized Linear Model, which achieved AUC values above 96% using a small subset of the original variables following a feature selection approach. Our approach allows us to increase the interpretability of the combinations of traditional factors, advanced chronic kidney disease factors and peritoneal dialysis factors all related with cardiovascular risk profile. The final model is based primarily in the traditional factors.

Percutaneous vascular access can be used temporarily (temporary central venous catheters) or permanently (tunneled central venous catheters) [1]. Although percutaneous vascular access is considered inferior to native vascular access due to its shorter half-life and its more frequent complications, the use of percutaneous accesses has increased signifi cantly in recent years. This is due to the fact that the renal patient has more cardiovascular complications, more morbidities and more advanced age, in addition to the waiting time until the AVF maturation which in some patients needs more time due to associated comorbidities such as diabetes mellitus, peripheral arteriopathy, smoking, obesity, advanced age and suboptimal vascular anatomy; even reaching the primary failure of the native access created. In addition to this the easy access to its placement and the immediacy of its use for hemodialysis, has allowed the abuse of its use as vascular access [2,3]. According to the published results of some studies, the use of central venous catheters has increased in many countries, with the percentage of patients dialyzing through tunneled catheters as high as 27.7% in Sweden, 35% in Belgium and 49.1% in Canada [3,4]. The ideal site for the placement of permanent catheters is the right jugular vein, but in some cases it is impossible to

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Background: Atypical hemolytic-uremic syndrome is caused by a thrombotic microangiopathy and manifests itself with hemolytic anemia, thrombocytopenia, and organ ischemia. Its etiology is a mutation affecting the genes encoding for proteins of the complement system. Early treatment with eculizumab (8.6 months from the moment of presentation), a humanized monoclonal antibody against complement, is shown to be effective in controlling symptoms and reversing organ damage. We present a patient with a mutation not previously described in the literature. Late treatment with eculizumab resulted in a good therapeutic response, eliminating the need for peritoneal dialysis. Case Presentation: A 34-year-old woman showed symptoms and laboratory findings consistent with atypical hemolytic-uremic syndrome. Genetic analysis revealed an unusual mutation of the complement regulatory gene not seen previously. Due to unavailability of eculizumab at the time of presentation, conventional treatment was started with poor response. Late initiation of eculizumab resulted in discontinuation of peritoneal dialysis and yielded a good and sustained clinical response. Conclusions: This case shows that eculizumab treatment for patients with atypical hemolytic-uremic syndrome, even when initiated many months after beginning on dialysis, might offer substantial benefits and improve the patients’ quality of life.