Laura Rosales, MD, MPH

Director, Research Medical Education & Information

Laura Rosales

Laura obtained her MD degree from the Central University in Quito, Ecuador, and a master’s degree in public health from Columbia University, New York. She was a research fellow for Beth Israel Medical Center in partnership with RRI and was the Research Associate Lab Director at RRI for several years. Laura is an accomplished scientist with ample experience in clinical research for more than 16 years and has authored and co-authored numerous publications in peer-reviewed journals. Laura has collaborated actively with prestigious institutions and scientists from the University of California at Davis; Medical University of Graz, Austria; Maastricht University Hospital, Netherlands; and the Instituto Nacional de Cardiologia Ignacio Chavez from Mexico City, Mexico.

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Recent Articles by Laura Rosales, MD, MPH

  • Hemodialysis international. International Symposium on Home Hemodialysis
    June 12, 2023
    Interactions between intradialytic central venous oxygen saturation, relative blood volume, and all-cause mortality in maintenance hemodialysis patients
    Priscila Preciado, Laura Rosales Merlo, Hanjie Zhang, Jeroen P Kooman, Frank M van der Sande, Peter Kotanko
    DISCUSSIONConcurrent combined monitoring of intradialytic ScvO2 and RBV change may provide additional insights into a patient's circulatory status. Patients with low ScvO2 and small changes in RBV may represent a specifically vulnerable group of patients at particularly high risk for adverse outcomes, possibly related to poor cardiac reserve and fluid overload.INTRODUCTIONIn maintenance hemodialysis (HD) patients, low central venous oxygen saturation (ScvO2 ) and small decline in relative blood volume (RBV) have been associated with adverse outcomes. Here we explore the joint association between ScvO2 and RBV change in relation to all-cause mortality.FINDINGSBaseline comprised 5231 dialysis sessions in 216 patients. The median RBV change was -5.5% and median ScvO2 was 58.8%. During follow-up, 44 patients (20.4%) died. In the adjusted model, all-cause mortality was highest in patients with ScvO2 below median and RBV change above median (HR 6.32; 95% confidence interval [CI] 1.37-29.06), followed by patients with ScvO2 below median and RBV change below median (HR 5.04; 95% CI 1.14-22.35), and ScvO2 above median and RBV change above median (HR 4.52; 95% CI 0.95-21.36).METHODSWe conducted a retrospective study in maintenance HD patients with central venous catheters as vascular access. During a 6-month baseline period, Crit-Line (Fresenius Medical Care, Waltham, MA) was used to measure continuously intradialytic ScvO2 and hematocrit-based RBV. We defined four groups per median change of RBV and median ScvO2 . Patients with ScvO2 above median and RBV change below median were defined as reference. Follow-up period was 3 years. We constructed Cox proportional hazards model with adjustment for age, diabetes, and dialysis vintage to assess the association between ScvO2 and RBV and all-cause mortality during follow-up.

More than ever, scientific research at RRI has been/is the right response to uncertainty.

Laura Rosales, MD, MPH
Director, Research Medical Education & Information