Urinary Albumin Excretion and Glomerular Filtration Rate ... - JASN

Urinary Albumin Excretion and Glomerular Filtration Rate across the Spectrum of Glucose Abnormalities in Essential Hypertension ´ ngel Brito,§ Josep Redon,* Francisco Morales-Olivas,† Alberto Galgo,‡ Miguel A 储 ¶ Javier Mediavilla, Rafael Marıń, Pilar Rodrı´guez,** Salvador Tranche,†† Jose´ Vicente Lozano,‡‡ Claudia Filozof;§§ and the MAGAL Group *Internal Medicine Service, Hospital Clıńico, and †Department of Pharmacology, University of Valencia, Valencia, ‡ Centro de Salud Espronceda and §Endocrinology, Hospital Puerta de Hierro, Madrid, 储Centro de Salud Pampliega, Burgos, ¶Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, **Fingoi Health CareCentre, Lugo, †† El Cristo Health Centre, Oviedo, ‡‡Centro de Salud Serrerıá 2, Valencia, and §§Scientific Department, Cardiovascular Section, Bristol-Myers-Squibb, Madrid, Spain The objective of this study was to assess the relationship between urinary albumin excretion (UAE) and GF across the spectrum of the glucose metabolism abnormalities in a large population of patients with hypertension. The Microaluminuria en Pacientes con Glucemia Basal Alterada (MAGAL) is a multicenter, cross-sectional study that was carried out by 1723 primary care physicians. A total of 6227 patients with essential hypertension (in three groups: [1] normal fasting glucose 100 to 126 mg/dl, and [3] type 2 diabetes) were analyzed in this substudy. GFR was estimated by using the Modification of Diet in Renal Disease (MDRD) abbreviated equation. A single first-morning urine albumin/creatinine ratio was measured using Bayer reagent strip Microalbustix, a semiquantitative method. Abnormal UAE was defined as an albumin/creatinine ratio >3.4 mg/mmol (equivalent to >30 mg/g). The prevalence of abnormal UAE, >3.4 mg/mmol, increased across the spectrum of glucose abnormalities: 39.7, 46.2, 48.6, and 65.6% for normoglycemic, low-range, and high-range impaired fasting glucose and diabetes, respectively. UAE was positively related to SBP (P ⴝ 0.003) and inversely to GFR (P < 0.001). Renal insufficiency (GFR 3.4 mg/mmol (odds ratio 1.86; 95% confidence interval 1.60 to 2.17) and diabetes (odds ratio 1.62; 95% confidence interval 1.29 to 2.04). There is a close relationship between abnormal UAE and renal insufficiency in essential hypertension. This is more marked in patients with diabetes and moderate in patients with high-range impaired fasting glucose. J Am Soc Nephrol 17: S236 –S245, 2006. doi: 10.1681/ASN.2006080920

A

n increase in urinary albumin excretion (UAE) even to a small extent, microalbuminuria, has become a marker for cardiovascular and renal disease. Initially tested in diabetes, its prognostic value in hypertensive patients without diabetes and in subgroups of the general population has been well established during the past few years (1–11). In both patients with diabetes and without diabetes, elevated SBP and glucose levels are the main factors related to development of increased UAE. One of the largest epidemiologic studies, the Australian Diabetes Obesity and Lifestyle Study (AusDiab) (12), clearly showed the interaction of both factors in the prevalence of microalbuminuria. The relationship between UAE and estimated GFR, however, has received less attention even though GFR, like UAE, is a predictor of cardiovascular risk. Widespread use of formulas to calculate GFR has enabled the

Address correspondence to: Dr. Josep Redon, Hypertension Clinic, Internal Medicine, Hospital Clinico, University of Valencia, 46010 Valencia, Spain. Phone: ⫹34-963862647; Fax: ⫹34-963862647; E-mail: [email protected] Copyright © 2006 by the American Society of Nephrology

influence of renal function in cardiovascular risk to be assessed. Therefore, alterations in renal function have emerged as a predictive marker for cardiovascular disease, and it has been reflected as such in the guidelines for clinical management (13,14). Several studies have shown calculated GFR to be a risk indicator for general mortality and cardiovascular death after myocardial infarction (15–20) and also for mortality associated with heart failure (21). Likewise, a large health registry has revealed a gradual relationship between estimated GFR and the risk for death, cardiovascular events, and hospitalization, independent of other risk factors (22). Microalbuminuria and renal insufficiency frequently run in parallel (23). Both of them are influenced by BP and glucose levels. Whereas BP is the major determinant of microalbuminuria, glucose level is the major determinant of renal insufficiency (23). Despite the frequent cluster of microalbuminuria and low GFR, the potential interaction between UAE and GFR is not well understood even though it can provide useful clinical information. Therefore, the objective of the present study was to analyze the relationship between UAE and GFR across ISSN: 1046-6673/1712-0236

J Am Soc Nephrol 17: S236 –S245, 2006

the spectrum of the glucose metabolism abnormalities in a large population of patients with hypertension. Combining both glucose abnormalities and hypertension, we included a population that was prone to developing microalbuminuria and renal insufficiency, which enabled us to assess their potential interactions

Materials and Methods This study was a post hoc analysis from the Microaluminuria en Pacientes con Glucemia Basal Alterada (MAGAL) study, the design of which is described elsewhere in this journal. In brief, it is a multicenter, cross-sectional, observational study that was carried out by 1723 primary care physicians all over Spain. Each physician consecutively enrolled six patients with essential hypertension and age ⬎18 and ⱕ80 yr divided into three categories according to carbohydrate metabolism: (1) Normal fasting glucose (NFG): fasting plasma glucose ⬍100 mg/dl; (2) impaired fasting glucose (IFG): fasting plasma glucose ⱖ100 and ⬍126 mg/dl; and (3) type 2 diabetes. Hypertension was defined as a previous diagnosis of hypertension and/or receiving antihypertensive medication. Exclusion criteria were type 1 diabetes, pregnancy or breast-feeding, urinary tract infection, pyuria, hematuria, fever, and having done strenuous physical exercise during the 24 h before UAE determination. The study was approved by the Ethics and Clinical Trials Committee of the Hospital Central de Asturias. Informed consent of the patient was obtained in all cases.

Study Protocol Demographic and clinical data were obtained for each patient. Physical examination that included weight, height, body mass index (BMI), and SBP and diastolic BP (DBP) measurements was carried out on the visit day. Sitting SBP and DBP were measured according to the Spanish Hypertension Society guidelines (24), after 5 min of rest and with the cuff fitted to the perimeter of the arm. Three readings were taken, and the mean value of the last two was accepted as valid. Serum glucose levels, creatinine levels, and the lipid profile were determined in blood samples that were obtained after at least 8 h of fasting. Glucose status was stratified as NFG, IFG, and diabetes, as described previously. In addition, patients with IFG were subdivided into two groups, those with fasting glucose of between 100 and 109.9 mg/dl (low-range IFG) and the remainder between 110 and 125.9 mg/dl (high-range IFG), based on the current and the former criteria for IFG. GFR was estimated as ml/min per 1.73 m2 according to the abbreviated Modification of Diet in Renal Disease (MDRD) study equation (16), which includes serum creatinine level, age, and gender. Race was not applicable in our study because all of the patients were white. Patients were stratified according to the GFR categories of the Kidney Disease Outcomes Quality Initiative guidelines (25). A single first-morning urine albumin/creatinine ratio was measured using Bayer reagent strip Microalbustix (Leverkusen, Germany), a semiquantitative method. Abnormal UAE was defined as an albumin/ creatinine ratio ⱖ3.4 mg/mmol (equivalent to ⱖ30 mg/g). According to the manufacturer, the Bayer Microalbustix test has a sensitivity of 90% and a specificity of 88% for the albumin/creatinine ratio. As defined in the protocol, urine samples with creatinine concentrations of ⱕ10 mg/dl were ruled out because they were considered too diluted.

Statistical Analyses The variables are presented as frequency (95% confidence interval [CI]), mean (SD), or median (25th to 75th percentiles) according to the distribution of the variable. ANOVA was used for comparisons among groups. The association between qualitative variables was evaluated

Relationship between GFR and UAE

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using the ␹2 or Fisher exact test, depending on the application conditions. All hypothesis contrasts rejected the null hypothesis with an ␣ error ⬍0.05. The relationship between GFR and UAE was assessed by Pearson correlation coefficients and multiple regression analysis. Factors that were related to abnormal GFR were assessed by using a multiple logistic regression model. The odds ratio (OR) of these variables, together with their CI and level of significance, were reported. The analysis was carried out using SAS for Windows (version 9.1; SAS Institute, Cary, NC).

Results General Characteristics of the Study Population This post hoc analysis was performed in 6227 patients: 1138 (18%) in the NFG group, 2491 (40%) in the IFG group (591 [9%] in the low-range IFG, 1900 [31%] in the high-range IFG), and 2598 (41%) in the diabetes group. The characteristics of the patients as grouped by the glucose categories are shown in Table 1. Age increased progressively from NFG to diabetes and gender was equally distributed among the four groups. SBP increased significantly from the normal carbohydrate metabolism group to the diabetes group. A BP ⬍140/90 mmHg was observed in 41.4% of the patients with NFG and in 36.9% of those with IFG. In the patients with diabetes, BP was controlled (⬍130/80 mmHg) in 11.5% of cases. BMI was higher in patients with abnormalities in glucose values as compared with normoglycemic patients. A progressive increment in fasting plasma glucose, by definition, and in triglycerides was observed from the NFG to the diabetes groups. HDL cholesterol, however, followed an inverse association.

UAE The prevalence of abnormal UAE (ⱖ3.4 mg/mmol) was 54.5%, which increased across the spectrum of glucose abnormalities (39.7, 46.2, 48.6, and 65.6% for normoglycemic, lowrange IFG, high-range IFG, and diabetes, respectively). In a multiple regression analysis, UAE was positively related to the SBP (P ⫽ 0.003) and inversely to the GFR (P ⬍ 0.001). In normoalbuminuric patients, GFR values did not differ among the glucose categories: 76.7, 76.8, 75.9, and 74.6 ml/min per 1.73 m2 for NFG, low-range and high-range IFG, and diabetes, respectively. In contrast, in those with abnormal UAE, GFR was significantly lower in the diabetes group (67.9 ml/min per 1.73 m2) as compared with the other two groups (74.7, 74.4, and 74.3 ml/min per 1.73 m2; P ⬍ 0.01 for each comparison).

GFR Most of the patients had a GFR between 60 and 90 ml/min per 1.73 m2 (3623 [58.2%]). Renal insufficiency (GFR ⬍60 ml/min per 1.73 m2) was present in 1361 (21.8%) of the patients, but only 298 (4.8%) patients had a GFR ⱕ45 ml/min. The main characteristics of the patients in the various GFR categories are shown in Table 2. Patients with the lowest GFR more frequently were older and women and had diabetes. Although the selection criteria established a misbalanced number of study patients (more patients selected by inclusion criteria in the IFG group), the trend association between the glucose category and the GFR spectrum can be observed. The proportion of normoglycemic patients decreases

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Table 1. General characteristics of the study population grouped by glucose metabolism statusa Glucose Status Characteristic

Age (yr) Male gender (%) BMI (kg/m2) Fasting glucose (mg/dl) Total cholesterol (mg/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglycerides (mg/dl) Creatinine (mg/dl) UAE (mg/mmol creatinine) UAE (mg/mmol creatinine) ⬍3.4 (%) ⱖ3.4 (%) BP (mmHg) SBP DBP eGFR (ml/min per 1.73 m2) ⬎90 (%) 60 to 90 (%) 60 to 45 (%) ⱕ45 (%)

NFG (n ⫽ 1128)

Low-Range IFG (n ⫽ 591)

High-Range IFG (n ⫽ 1902)

Diabetes (n ⫽ 2598)

61.7 ⫾ 10.7 48.6 28.3 ⫾ 4.1 92.1 ⫾ 8.4 211.6 ⫾ 34.6 54.7 ⫾ 12.9 133.5 ⫾ 31.7 133.5 ⫾ 54.0 0.94 ⫾ 0.2 8.7 ⫾ 18.9

63.5 ⫾ 9.8 46.5 30.5 ⫾ 4.9 105.3 ⫾ 2.9 211.0 ⫾ 34.2 54.4 ⫾ 12.9 131.2 ⫾ 31.0 140.4 ⫾ 61.2 0.98 ⫾ 0.2 7.6 ⫾ 15.0

62.8 ⫾ 10.1 51.3 29.9 ⫾ 4.5 117.3 ⫾ 4.3 214.4 ⫾ 34.5 52.7 ⫾ 13.4 133.6 ⫾ 30.3 151.0 ⫾ 63.8 0.96 ⫾ 0.2 8.5 ⫾ 16.2

64.9 ⫾ 9.0 50.4 30.2 ⫾ 4.6 151.9 ⫾ 36.1 209.3 ⫾ 37.6 51.0 ⫾ 12.6 128.2 ⫾ 32.5 162.5 ⫾ 66.2 1.03 ⫾ 0.3 13.5 ⫾ 27.6

60.3 39.7

53.8 46.2

53.4 48.6

34.4 65.6

139.3 ⫾ 14.7 82.1 ⫾ 8.6

139.7 ⫾ 13.5 81.7 ⫾ 8.6

141.4 ⫾ 13.0 83.3 ⫾ 8.4

141.9 ⫾ 14.1 81.6 ⫾ 8.6

23.4 18.6 12.7 10.4

8.9 10.2 8.4 8.7

35.5 31.5 27.1 16.8

32.4 40.2 51.8 64.1

P

⬍0.0001 0.1542 0.0050 ⬍0.0001 0.0002 0.0025 0.0383 0.0001 ⬍0.0001 ⬍0.0001 ⬍0.0001

0.0122 0.7404 ⬍0.0001

a BMI, body mass index; DBP, diastolic BP; eGFR, estimated GFR; IFG, impaired fasting glucose; NFG, normal fasting glucose; SBP, systolic BP; UAE, urinary albumin excretion.

from those with GFR ⬎90 ml/min per 1.73 m2 to those with ⱕ45 ml/min per 1.73 m2; a similar trend is found for patients with IFG. In contrast, the proportion of diabetes increases as the GFR declines. For each GFR category, UAE values increase as well as the percentage of patients with abnormal UAE, although the increment is steeper for the diabetes group as compared with the other glucose categories (Table 3). The factors that were related to GFR ⱕ60 ml/min per 1.73 m2 were analyzed in a multiple logistic regression analysis. Abnormal UAE, presence of glucose abnormalities, and uncontrolled BP were related independently to the low GFR. UAE ⱖ3.4 mg/mmol increased the risk by 87% (OR 1.87; 95% CI 1.61 to 2.17), IFG and diabetes by 30% (OR 1.30; 95% CI 1.05 to 1.62), and BP ⱖ140/90 mmHg or ⱖ130/80 if diabetes by 23% (OR 1.23; 95% CI 1.04 to 1.45). When each of the glucose status categories was included separately in the model, abnormal UAE and diabetes were the only significant determinants of renal insufficiency. An elevated UAE (ⱖ3.4 mg/mmol) increased the risk by 86% (OR 1.86; 95% CI 1.60 to 2.17) and diabetes by 62% (OR 1.62; 95% CI 1.29 to 2.04).

Discussion In this large cohort of hypertensive patients from primary care, the proportion of patients with abnormal UAE was 54.5%, and 21.8% had renal insufficiency. This study shows a clear association between UAE and frequency of renal insufficiency

with a higher prevalence among those with higher UAE. Urinary albumin excretion was inversely related to GFR, and an abnormal UAE increases the risk for renal insufficiency (GFR ⱕ60 ml/min per 1.73 m2) by 89%. This association between abnormal UAE and renal insufficiency was more evident in patients with diabetes as compared with those with NFG and IFG. Likewise, for each GFR category, UAE values increased as well as the percentage of patients with abnormal UAE, although the values were higher for the diabetes group as compared with patients with NFG and those with IFG. Figures for patients with IFG, both low range and high range, were between those of NFG and diabetes. In this study, the prevalence of abnormal UAE was greater than that observed in other cross-sectional surveys (26). This probably is due to the method used for measuring UAE and the characteristics of the study population. It has been reported that a single UAE assessment may increase by at least one fifth the prevalence of abnormal UAE (27). Selecting patients with both hypertension and glucose disorders also increases the prevalence, because high BP and glucose values are among the most important causes of UAE elevation (28). In addition, mean age and BMI in our study population was higher than in other surveys, two factors that also have been associated with abnormal UAE. The prevalence of renal insufficiency was 21.8%, although it might be slightly overestimated as a result of the use of the



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Table 2. General characteristics of the study population grouped by eGFR eGFR (ml/min per 1.73 m2) Characteristic

⬎90 (n ⫽ 1243)

关90 to 60 (n ⫽ 3623)

关60 to 45 (n ⫽ 1063)

ⱕ45 (n ⫽ 298)

P

Age (yr) Male gender (%) BMI (kg/m2) Fasting glucose (mg/dl) Total cholesterol (mg/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglycerides (mg/dl) Creatinine (mg/dl) UAE (mg/mmol creatinine) UAE (mg/mmol creatinine) ⬍3.4 (%) ⱖ3.4 (%) BP (mmHg) SBP DBP Glucose status normal (%) low-range IFG (%) high-range IFG (%) diabetes (%)

57.2 ⫾ 8.8 81.3 29.6 ⫾ 4.4 129.7 ⫾ 30.7 210.8 ⫾ 36.4 52.4 ⫾ 12.6 130.6 ⫾ 31.3 150.2 ⫾ 63.8 0.80 ⫾ 0.1 9.8 ⫾ 21.5

64.3 ⫾ 9.7 47.9 29.8 ⫾ 4.6 132.2 ⫾ 31.7 210.8 ⫾ 35.2 52.9 ⫾ 12.9 130.7 ⫾ 31.2 148.1 ⫾ 62.5 0.95 ⫾ 0.2 9.7 ⫾ 20.4

67.4 ⫾ 8.1 26.1 30.1 ⫾ 4.5 136.6 ⫾ 32.0 212.4 ⫾ 36.1 51.8 ⫾ 13.4 131.8 ⫾ 31.9 158.7 ⫾ 65.2 1.17 ⫾ 0.2 12.6 ⫾ 25.3

68.0 ⫾ 8.0 29.2 29.9 ⫾ 4.7 143.3 ⫾ 37.7 217.6 ⫾ 40.0 51.3 ⫾ 13.2 136.1 ⫾ 36.8 175.1 ⫾ 69.9 1.63 ⫾ 0.3 17.4 ⫾ 31.2

⬍0.0001 ⬍0.0001 0.1158 ⬍0.0001 0.0123 0.0528 0.0482 ⬍0.0001 ⬍0.0001 0.0070 ⬍0.0001

49.6 50.4

49.6 50.4

37.2 62.8

18.5 81.5

140.8 ⫾ 12.9 83.5 ⫾ 8.2

140.7 ⫾ 13.8 81.9 ⫾ 8.5

142.2 ⫾ 13.9 81.7 ⫾ 8.8

144.4 ⫾ 16.0 82.4 ⫾ 9.4

23.3 20.1 24.3 32.4

18.6 18.4 22.8 40.2

12.7 15.5 30.0 51.8

10.4 10.5 15.5 64.1

0.0004 0.00026 ⬍0.0001

Table 3. UAE and prevalence of abnormal UAE (⬎3.4 mg/mmol) grouped by glucose status and eGFR eGFR (ml/min per 1.73 m2) Glucose Status

⬎90 (n ⫽ 1243)

UAE (mg/mmol creatinine)a normal 2.3 low-range IFG 2.3 high-range IFG 3.2 diabetes 3.4 UAE (mg/mmol creatinine) ⱖ3.4 normal low-range IFG high-range IFG diabetes a

关90 to 60 (n ⫽ 3623)

关60 to 45 (n ⫽ 1063)

ⱕ45 (n ⫽ 298)

P

⬍0.0001 (1.1 (1.7 (1.7 (1.7

to to to to

5.6) 6.8) 6.8) 6.8)

2.3 2.3 2.3 4.5

(1.1 (1.7 (1.7 (1.7

37.4 46.5 50.0 58.4

to to to to

38.2 42.2 44.1 61.8

6.8) 4.5) 6.8) 9.1)

2.3 3.4 3.4 6.8

(1.7 (1.7 (1.7 (2.3

to to to to

41.9 53.3 58.0 71.6

6.8) 7.6) 8.5) 9.1)

4.5 5.0 6.8 8.5

(1.7 (2.3 (3.4 (4.5

to to to to

8.5) 13.3) 18.2) 18.2)

⬍0.0001

62.1 70.8 77.5 87.4

Data are median (25th to 75th percentiles).

MDRD equation to calculate GFR (29). Several studies have examined the difference between this method and the corresponding gold standard: derived GFR calculated by isotopic techniques (30 –32). In the range of normal values, with true GFR ⬎60 ml/min, the GFR may be underestimated by up to 28% when the formula is applied. As true glomerular filtration decreases, the differences become smaller, reaching an underestimation of 6% when the true GFR is ⬍30 ml/min (31). The factors that were associated with a worsening in renal

function behaved as expected. The mean age was greater among patients with lower GFR values, and the prevalence of diabetes was higher as compared with the other groups. Not only diabetes but also a previous stage, such as the IFG, increased the risk for renal insufficiency. Likewise, uncontrolled hypertension was associated with low GFR. There were no differences, however, in the degree of obesity, with mean values ⬎29 kg/m2 in all of the groups. Patients with the lowest GFR more frequently were older and

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women and had diabetes. Although increased age and the presence of diabetes have been widely accepted as conditions that are associated with renal insufficiency, the high rate in women is less recognized, but it is in agreement with previous surveys of renal insufficiency using the MDRD equation. Differences between genders in the prevalence of GFR ⬍60 ml/min are noteworthy, with a higher prevalence in women as compared with men. This also has been observed in other large-scale studies (32–34). The differences in the prevalence of GFR ⬍60 ml/min between genders increases across the age range: The older the higher (33). This contradicts that more men than women receive treatment for ESRD, and it seems that the higher prevalence of renal failure in women results from the excessive dominance of age and gender in the equation. The relationship between GFR and UAE was analyzed. Lower GFR was observed in patients with abnormal UAE, mainly in patients with diabetes. Likewise, as the GFR declined, the UAE values, as well as the prevalence of abnormal UAE, increased, and both shared common causative factors: High BP and abnormal glucose. Despite that this is a cross-sectional study, it seems that the presence of UAE increases the risk for renal function worsening, as has been demonstrated in a follow-up study (35). In patients who are prone to developing an increment in UAE, the impact over time of both BP values and abnormal glucose lead to a faster GFR decline than in those who maintain normal values of UAE. Another factor that may contribute to the association between abnormal UAE and low GFR is that during antihypertensive treatment and for a given BP, UAE values in patients with renal insufficiency resist reduction. The main strengths of the present study lies in the large number of patients analyzed in the cross-sectional survey and a large representation of the glucose metabolism status categories. However, its limitations are that the sample size is not population based and that selection bias by the participating physicians cannot be completely ruled out. This, however, does not invalidate the main goal of the study, which was to examine the relationship between GFR and UAE in various glucose conditions. Another limitation of the study was that creatinine measurement was not calibrated with reference standards by all of the participating physicians. Finally, an unresolved question is whether the poorer prognosis for cardiovascular outcomes that are associated with UAE and GFR overlaps or is additive. Only prospective studies can help us to resolve this key issue.

Conclusion There is a close relationship between abnormal UAE and renal insufficiency in patients with essential hypertension. This was more marked in patients with diabetes and was moderate in patients in the highest IFG range The clinical relevance of this relationship needs to be established in terms of temporal trend, treatment changes, and impact on risk.

Acknowledgments This study was supported by a Grant from Bristol-Myers Squibb. The following investigators participated in the MAGAL Study:


Abarca Bujan Benjamıń, Abordan Chanat Ruchdi Omar, Acosta Meńdez Juan M., Acosta Socorro Antonio, Adelantado Pozuelo Esther, Afonso Navarro Carmen, Agote Cuesta Gabriel, Aguado Mori Ana Cristina, Agudo Codujoń Beatriz, Aguilar Huertas Eva, Aguilera Zu´ lamo bizarreta Eulalia, Aguilo´ Furio´ Sara, Aguirre Minãna Teresa, A ´ ngel, Albert Cunãt Vicente, Albors Domıńguez Anı´bal, Alba Dıáz A Valls Alberto, Alegret Crespi Santiago, Alegria Alonso Ramoń, Alfaro Alonso Guillermo, Alfaya Carrera Juan Jose, Allut Vidal Germań, Almela Tejedo Teresa, Alonso Atienza Ma Del Carmen, Alonso Del Pino Elena, Alonso Dıáz-Marta Manuel, Alonso Fernandez Lola, Alonso Matia Rafael, Alonso Quintanilla Carmelo, Alonso Patricio, Altarriba Cano Ma Luisa, Altuna Zuriarrain Manuel, Alvarado Tato ´ lvarez Blanco Antonio, A ´ lvarez De Monrego Carina, Antonio M., A ´ lvarez Fernandez Hortensia, A ´ lvarez Garcıá Antonio, A ´ lvarez GuisaA ´ lvarez Mejorada Enrique, A ´ lvarez Sanchez Ignacio, sola Fernando, A ´ lvarez Taboas Jorge, A ´ lvarez Valero Jesu´s, A ´ lvarez Vicente Juan A Carlos, Alvear Garcıá Martin Jorge, Amhed Loufty Kheder, Amigo Nuń˜ez Ma Elena, Amurrio Olartua Juan Ma, Andre´s Pauls Inmaculada, Andre´s Mayor Ma Jose´, Andre´s Santos Esther, Andreu Amoros Juan Luis, Angel Cavada Miguel, Angora Mazuecos Francisco, Anguiano Calvo Jose´, Angulo Gonzalez Javier, Angulo Vallejo Ester, Angulo Yuste Enrique, Antolin Llinares, Asuncioń, Anton Ortega Javier, Antoń Castello´ Jose´ Luis, Antoń Garcıá Francisco, An˜el Rodrı´guez Rosa, Aramburu Aramburu Pedro, Arancegi Marticorena Izaskun, Arayo Sola Inmaculada, Arbesu´ Prieto Jose´, Arde´vol Gonza´lez Ro´mulo, Arenas Mosqueda Juliań, Arias Go´mez Ma Jesus, Arias Salgado-Robsy Ana Marıá, Ariza Hernańdez Andre´s, Arlandis Puig Antonio, Arnal Sanchez Jose, Aroca Sanz Ma Luisa, Arocas Pe´rez Ricardo, Arribas Aguirregavirıá F. Javier, Arrieta Ma Jesu´s, Arrondo Beguiristain Ma ´ ngeles, Arroyo Azpa Concepcioń, Arteaga Herrera Domingo, Arteche A ´ ngel, Artigues Llull Isabel, Arujo Marisol, Arza Legorburu Miguel A Arteaga Alicia, Ascanio Leoń Beleń, Asenjo Cabrera Irene, Asenjo Martin Amparo, Asensi Penãrrocha Isabel, Atienza Gaona Jose Juan, Atxotegi Loizate Laura, Auza Jose´ Javier, Avile´s Martıńez Francisco Javier, Ayala Munõz Francisco, Ayensa Esparza Javier, Aznar Ladroń De Guevara Ma Jose, Azorıń Sanz Francisco Javier, Baamonde Mosquera Leopoldo, Badiola Elu Jose Luis, Badosa Sanuy Ana, Baeza Romero Manuel, Baixarias Tibau Joaquim, Bajo Garcia Juliań, Balaguer Montesinos Francisco, Balanzategi Garmendia Inmaculada, Ballester Berenguer Jose´ Vicente, Ballester Dıáz Trinidad Margarita, Ballester Orti Javier, Banõń Garcıá Raquel, Banõs Martıńez Ma Soledad, Banõs Merino Isabel, Ban˜ Gago Ma Jesu´s, Barbeito Zaldua Edurne, Barcelo´ Bartolome´, Barges Ponce Vicente, Barras Galań Domingo, Barreiro Mourentans Carlos, Barrera Pe´rez Manuel, Barrera Torres Vicente, Barruso Bares Carlos, Bartolome´ Resano Javier, Bartolome´ Resano Rafael, Baudet Dejean Chantal, Beaus Alonso Jose´ Luis, Becerra Becerra Alberto, Belayos Jimeńez Enrique, Belenguer Ma´rquez J.Maria, Belenguer Prieto Rafael, Belles Calvo Amadeo, Belmonte Santamarıá Julia Elena, Beltrań Juana Jose, Benavides Fernańdez Encarnacioń, Benedicto Acebo Rosa, Benedito Garcıá Esther, Bengoa Goiri Ainhoa, Bengoetxea Zorrilla Juan, Benı´tez Ortiz Juan Pedro, Benı´tez Rivero Javier, Benito De La Cruz Jose´-Luis, Benlloch Guillem Jose´ Blas, Berciano Ma´rquez Eduardo, Bermejo Enjuto Carmen, Bermejo Garcia Begon˜, Bermejo Guilleń Gonzalo, Bernad Guerrero Amparo, Bernal Soto Jose Antonio, Bernat Gil Luis Marcial, Besada Gesta Ricardo, Bethencourt Marante Jorge, Bijedick Snejada, Bilbao Armas Inãki, Blanco Aparicio Javier, Blanco Arias Ana, Blanco Perdigoń Luis, Blanco Ramos Cristina, Blanco Rodrı´guez Rubeń, Bocos Ruiz Jose´ Ignacio, Bolinches Gandia Juan Jose, Bonet Garcia Jorge, Bordallo Huidobro Juan Ramoń, Bordas Ignacio, Borges Mesa Ofelia, Borrachero Carmen, Borras Palle Carlos, Botella Gregori Ana, Bouzas Formoso Fernando, Bravo Bricien Ma Luz, Bravo Valverde Antonio, Brime Secades Jose´ Manuel, Brito Brito Elisenda,

J Am Soc Nephrol 17: S236 –S245, 2006 Brito Ma Jesu´s, Buendıá Romero Alejandro, Bueno Lozano Mercedes, Buitrago Vera Carmen, Burgui Eslava Antonio, Busselo Lete Luis Miguel, Bustamante Caso Maria Luisa, Caamanõ Mata Juan, Cabal Garcia Alberto, Cabaleiro Ubeira Dolores, Caballero Millan Pilar, Caballero Montanary Leońides, Cabanes Martıń Teodorico, Cabanilla ´ ngel, Cal Martıńez Pablo, Calatayud CarValenzuela Antonio, Cacho A a reres M Del Carmen, Calatayud Climent Enrique, Calatayud Climent Enrique, Caldeiro Jimeńez Jose´ Ma, Calderoń Alva Juan, Calduch Herrera Lourdes, Calero Gonzalez Cloria, Callado Ramoń Mariano, Calleja ´ ngeles, Calvillo Navarro A ´ ngel, Calvinõ Carballo Delgado Ma A Ramoń, Calvo Hornillos Mercedes, Calvo Quintela Laura, Calzada Gil Manuel, Camarena Rodrı´guez Jose´ Ma, Campos Martos Ignacio, Candau Marcos Rafael, Candela Maetzu Macarena, Caneda Carmen, Ca´ ngel, Cano Aparicio Pere, neiro Lo´pez Ana Maria, Caniego Monreal A Cano Espıń Agustina, Cantera Valls Nieves, Canãs Gonzalez Juan, Capdevila Falguera Dolors, Carballal Martıńez Angelines, Carballo Albarate Jose Luis, Carballo Garcia Jose Juan, Carcas Sansuan Jose´ Luis, Carcedo Sua´rez Virgilio, Ca´rdenas Joyanes Ma Dolores, Cardona Rossello Federico, Carmona Segado Jose Manuel, Carrasco Go´mez Consolacioń, Carrasco Herrera Jesu´s, Carrasco Pineda Marcos, Carretero Ramos Raquel, Carretero Salvador Olegario, Carrillo Lourdes, Carrio Garcia Guillermo, Carrioń Valero Lucinio, Carvajal Trujillo Nicomedes, Casal Ardines Eliecer, Casal Osorio Antonio, Casal Redondo Fernando, ´ lvarez Rosa Ma, Cascan Martıń Jose Ma, Casanova Carlos, Casanueva A Castanõ Gonza´lez Mercedes, Castell Victoria, Castello Esteve Luis, Castillejo Orozco Ana E, Castresana Arrate Ma Victoria, Castro Blanco Isabel, Catalań Macia´ Jose´, Catoń Valde´s Manuel, Cavero Clerencia Elena, Cazador Romero Pilar, Cebreiro Navalon Antonio, Cebrian Montolio Francisco, Cebrian Picazos Adolfo, Cejudo Serrano Rosa, Celades Moliner Pilar, Cenoz Osinaga Juan Carlos, Cerdan Oliver Miguel, Cereceda Pecilla Ricardo, Cervantes Chaves Alfredo, Cervera Moscardo Jose B, Chumilla Checa Celia, Cifuentes Go´mez Pedro, Cirapozu Mendivil Juan, Cobo Domıńguez Concepcioń, Cobo Rodrigo Ammonia, Codesido Blanco Teresa, Colomer Escuder Teresa, Colomer Lloret Mireya, Colomina Sarrio´ Pilar, Comas Samper Jose Manuel, Concheiro Coello Gonzalo, Contrera Enrique, Contreras Torres Juan A, Copeiro Del Villar Martıńez Ana, Corell Dolz Jose´, Coronado Reyes Pedro, Corralez Hava Joaquin, Correa Armero Rosario, Corte´s Oliva Anna, Cortilla Santamaria Albert, Cozar Hernandez Antonio, Crespo Basterra Javier, Crespo Gargallo Antonio, Crespo Jimenez Floreal, Crespo Martıńez Francisco, Crespo Rodrı´guez Rufina, Criado Gonzalez Luis, Cristobal Torras Joan, Cruz Villegas Inmaculada, Cubas Cubells ´ lvarez Francisco, Carmen, Cuende Chamorro Maria Jesu´s, Cuerpo A Cueto Bulnes Ignacio, Cumplido Pe´rez Antonio, Damas Manuel, Dapena Baroń Cristina, Davila Brun Carlos, De Diego Sierra David, De Felipe Medina Ricardo, De Frutos Marcos Concha, De La Fuente Fernańdez Teodoro, De La Fuente Marinõ Rosa, De La Torre Edo Jorge, De La Vega Cuya´s Arturo, De La Villa De Diego Ricardo, De Miguel Villamediana Begonã, De Simoń Gutie´rrez Rau´l, Debon Belda Manuel, ´ lamo Alonso Alberto, Del Alba Carballo Dehesa Terreros Jose´, Del A Maria Rosa, Del Amo Rodrı´guez Concha, Del Amo Carmen, Del Campo Aguado Concepcion, Del Carmen Elcuaz Juliań, Del Castillo Martıńez Ma Jose´, Del Jesu´s Clemente Amelia, Del Rivero Llano Enrique, Dela´s Go´mez Enrique, Delfin Va´zquez Marta, Delgado Dominguez Benito, Diaz Bernabe´ Jose´ Ramoń, Diaz Fernandez Ma Del Carmen, Diaz Gomez Juan Manuel, Diaz Millań Almudena, Diaz Olea Emilia, Diaz Roger Teresa, Dıáz Andre´s Ma Luisa, Dıáz Eraso Montserrat, Dıáz Jimeńez Jesu´s, Dıáz Luis Carmen, Dieguez Estevez Agapito, Diez Blanco Felipe, Diez Garcia Manuel, Diez Ruiz Ana, Dıéz Cantalapiedra Eladio, Dıéz Cantarero Adolfo, Dimas Nun˜ez Fernando, Divison Garrote Juan Antonio, Doíaz Ruisanchez Enrique, Domingo Platero Concepcion, Domingo Sancho Cesar, Dominguez Gonzalez


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Jesus, Domıńguez Deben Daniel, Domıńguez Pe´rez Juan A., Dosantos Hernandez Javier, Echeverria Arruabarrena Juan, Eguinoa Villanueva Jose´ Luis, Eiris Cambre M.Jesu´s, Ekek Jannura Miguel, El Kak Chaaban Raffat, Eliche Vilchez Juliań, Elorriaga Campos Angel, Elorriaga Urquijo Eguzkin˜e, Elorza Olabegoya Itziar, Elvira Perez Eladio, Encinoso Sańchez Candelaria, Enrriquez De Terry Alfonso, Epaizabal Mujika Xabier, Erdozain Corpas Juan Pedro, Erlanz Abad Arturo, Escobar Moreno Cesar, Espinosa Barrientos Lourdes, Estarriol Jimeńez Carlos, Esteban Gaitero Juan Pedro, Esteban Marquez Juan Jose´, Estebanez Auxina Alberto, Esteve Fuster Vicente, Este´vez Ardit Anabel, Este´vez Gonza´lez Pablo, Etxeberria Uribesalgo Carmelo, Etxevarria Etxevaria Juan Ignacio, Etxezarreta Crespo Ramon, Ezpeleta Albuixech Leonardo, Farouk Hendi Malas Mohamer, Farreres Pı´ Concepcio´, Faus Mascarell Emilia, Fenoll Pascual Federico, Fenoy Soriano Angel, Fernańdez Benitez Carlos, Fernandez Cabello Ma Luisa, Fernandez Canãdas Enrique, Fernandez Fernandez Carmen, Fernandez Fernandez Leandro, Fernandez Fernandez Luis, Fernandez Gomez Jose, Fernandez ´ ngel, Fernańdez Lo´pez Jose´ Manuel, Fernandez MarHernandez Jose A tinez Angel, Fernandez Martinez Juncal, Fernandez Moyano Fernando, Fernandez Peleteiro Jose Manuel, Fernandez Seoane Antonio, Fernandez Silva Ma Jesus, Fernandez Villaverde Jose Maria, Fernandez Yebra Esther, Fernańdez Arienza Jose´, Fernańdez Barrial Manuel, Fernańdez Canãveras Ma Isabel, Fernańdez Escalada Eugenio, Fernańdez Garcia Elisa, Fernańdez Garcia Jose Maria, Fernańdez Gonza´lez Angeles, Fer´ ngeles, Fernańnańdez Gonza´lez Manuel, Fernańdez Gutie´rrez Maria A dez Mourinõ Ma Jesu´s, Fernańdez Prieto Dulce, Fernańdez Roces Ramonita, Fernańdez Rodriguez Jose´ Antonio, Fernańdez Sańchez Carlos, Fernańdez Simoń Felisa, Ferrandiz Miquel Joaquin, Ferrandiz Miquel Joaquin, Ferreiro Alonso Pablo, Ferreiro Guri Jose Antonio, Ferrer Bascunãna Pedro, Ferrer Tomas Ramon, Fiallega Otero Rafael, Flores Hernandez Miguel Angel, Flores Holguera Antonio, Flo´rez Garcia Jose´, Florit Anglada Antonio, Font Servera Jose, Forcada Lozano Eugenio, Formento Tirado Aurelio, Fraga Cabado Jose´, Fraga Carballo Carmen, Fraga Gonzalez Camila, Franco Martinez Generosa, Fransi Galiana Amparo, Frasquet Todolı´ Concha, Fuentes Fernandez Fernando, Fu´ ngeles, entes Vigil Jose´, Fuster Bellido Toma´s, Gabriel Escribano Ma A Gacto Fernandez Socorro, Gadea Vicente Pilar, Gaga Garcia Alfredo, Gago Fernańdez Carlos, Gainza De Los Rios Luis, Gaisań Tome´ Carmen, Galań Velasco Jose´ Antonio, Galarreta Calvo Javier, Galarza Amorrortu Ana, Galdamez Nun˜ez Ana Ma, Galindo Tobal Francisca, Gallardo Alonso Fernando, Gallego Berciano Pilar, Gallego Garcia Carmen, Gallo Trebol Fernando, Gallo Jaime, Gamarra Ortiz Javier, Gamero Perez Florencio, Gandia Moya Carmen, Garay Orte Jon, Garayoa Arraiza Javier, Garcia Andre´s Luis Enrique, Garcia Blas Miguel, Garcia Cabarcos Juan Antonio, Garcia Campo Urbano, Garcia Cantos Elena, Garcia Castellanos Natividad, Garcia Cuadros Marta, Garcia De Francisco Ana, Garcia Exposito Esmeralda, Garcia Falide Nieves, Garcia Gallego Francisco, Garcia Gonzalez Carmen, Garcia Lombardero Jose Maria, Garcia Machado Ma Luisa, Garcia Martinez Jose Joaquıń, Garcia Molinos Juan R, Garcia Nadal Ignacio, Garcia Ortiz Jose Pablo, Garcia Ortiz Luis, Garcia Ortiz Teresa, Garcia Panero Maria Luisa, ´ ngeles, Garcia Perez Rafael, Garcia Pe´rez Fina, Garcia Pindado Ma A Garcia Prades Pascuala, Garcia Ramoń Elpidio, Garcia Romanos Fernando, Garcia Sanchez Dolores, Garcia Sanchez Sofia, Garcia Serrano Angel, Garcia Sierra Alberto, Garcia Suarez Victor Ignacio, Garcia Valverde Concepcion, Garcia Velasco Guillermo, Garcia Velasco Pilar, Garcıá Palacios Carmen, Garcıá Vilamea Jose´ Carlos, Garcia-Reyes Ramos Mercedes, Gardoki Elorriaga Jose A., Garicano Lasa Critina, Garrido Marcos Cecilio, Garrote Florencio Timotea, Garrote Gutierrez Luis, Gascon Boto Fatima, Gasso Jimeńez Jose´ Manuel, Gazquez Inmaculada, Genoves Esplugues Andres Vicente, Gerpe Rodriguez Oscar, Gijon Conde Teresa, Gil Correa Leopoldo, Gil Gil Cecilio, Gil

S242


Munõz Julio, Gil Prats Pedro, Gil Tocados Guadalupe, Gil Velez Jaime, Gili Juan, Gimeńez Gonza´lez Manuel, Gobierno Hernańdez Jesu´s, Godoy Garcıá Isidro, Goenaga Badiola Eugenia, Goikoetxea Arrillaga Alejandro, Golpe Dıáz Marcos, Gomez Abellas Enrique, Gomez Aguinaga Juan Manuel, Gomez Albadalejo Eduardo, Gomez Criado Maria Soledad, Gomez Dacal Maria Dolores, Gomez Galvez Cayetano, Gomez Garcia Beatriz, Gomez Queipo Belen, Gomez Rodriguez Adela, Gomez ´ ngel, Gomez Sal Esther, Gomez Vazquez Jose Luis, Saez Miguel A Gomez Sonsoles, Go´mez Del Rıó Marıá Zulema, Go´mez Marcos Man´ ngel, Go´mez Marıń Elisa, Gonzalez Aller Manuel, Gonza´lez uel A Acunã Eduardo, Gonzalez Alvarez Antonio, Gonzalez Candela Rosa, Gonzalez Espadas Ricardo, Gonzalez Gordillo Soledad, Gonzalez Hernańdez Luis, Gonzalez Loureiro Patricia, Gonzalez Lujan Jose´ Luis, Gonzalez Marcos Juanjo, Gonzalez Martin Carmen Teresa, Gonzalez Perez Carmen, Gonzalez Perez Ma Jesu´s, Gonzalez Ramos Elena, Gonzalez Reza Emilio, Gonzalez Rodriguez Manuel, Gonzalez Vicente Angel, Gonza´lez Aguado Jose´ Manuel, Gonza´lez Casado Ignacio, Gonza´lez Delgado Federico, Gonza´lez Fernańdez Maximino, Gonza´lez Gago Jose´ Antonio, Gonza´lez Garcia Angel, Gonza´lez Garcia Carmen, Gonza´lez Hernańdez Jose´ A., Gonza´lez Martin Angela, Gonza´lez Martin Carmen Teresa, Gonza´lez Meńdez Magdalena, Gonza´lez Pozueco Yolanda, Gonza´lez Rodriguez Emilio, Gonzalez-Vals Gonzalez Ma Jose, Gonzalo Ines, Gorostiza Ormaetxea Javier, Gorrocategui Erenõ Jesus, Granado Sanchez Francisco Jose´, Granja Garrań Yolanda, Gregori Pellicer Juan-Ignasi, Guerrero Espejo Ma Carmen, Guija Villa Eduardo, Guillard Marie Martine, Guillen Hernandez Gaspar Elias, Guillot Valls Alfonso, Guinot Martinez Enrique, Gutierrez Angulo Marisa, Gutierrez Espinosa de los Montero Juan Antonio, Gutierrez Marin Francisco, ´ ngel, Haya Guaita Gutierrez Moreno Jose Abel, Gutierrez Miguel A Amparo, Hermosa Hernan Juan Carlos, Hernaiz Valero Susana, Hernandez Inãrra Gabriel, Hernandez Manzano Carmen, Hernandez Martin Francisco Javier, Hernandez Mayle Colette, Hernańdez Gutie´rrez Juana Isabel, Hernańdez Ollero Ma Dolores, Hernańdez Perlines Ma Vicenta, Hernando Mendivil Itziar, Hernando Zapatero Carlos, Hernani Bengoa Marta, Herraiz Rodriguez Ramoń, Herrera Pelaez Antonio, Herrera Valladolid Carmen, Herrero Ballestar Jose Vte, Herrerozorriqueta Ma Jesu´s, Hervias Saiz Francisco Jose´, Hevia Rodriguez Eduardo, Hidalgo Herrera Manuel, Homar Isern Bernardino, Hortal Gutierrez Felicidad, Iban˜ez Bernabeu Vicente, Iban˜ez Gomez Patricia, Ibarra Corbilloń Angel, Ibeas Cristina, Iglesias Clemente Jose´ M., Iglesias Perez Eugenia, Iglesias Retamar Rafael, Igual Fraile Dimas, Ilizarri Ollauri Miren, Indurain Ordunã Santos, In˜igo Espinosa Pedro A., Isidro Ortega Joan, Iturralde Iriso Jesus, Iturri Gaztelu Ana, Iznaola Sanchez Pedro Juan, Izquierdo Lopez Enrique, Izquierdo Sanz Jose Ramoń, Izquierdo Yan˜ez Ma Jose´, Jalon Monzon Mercedes, Jamil Ala Ramzi, Jesu´s Casado Maria, Jimenez Perez Ramon, Jimeńez Franco Julio, Jimeńez Paredes Javier, Jimeńez Redondo Jose´ Ramoń, Jorge Bravo Maria Teresa, Jorge Rodriguez Fco.Jose, Jorques Navarro Juan Daniel, Jover Barber Juan Manuel, Juan Armas Julia, Juanes De La Penã Adriań, Jurado Toro Alberto, Labrador Gonzalez Alberto, Labrador Esther, Lado Llerena Angel, Lado Lopez Manuel, Laencina Lo´pez Salvador, Lafuente Gutie´rrez Jose Luis, Laguna Isabel, Lalanza Lasheras Juan Jose, Lamelas Garcia Jose A., Landin Vicunã Concha, Laporta Crespo Felix, Lara Moles Jesu´s, Larrinaga Kortabitarte Aitor, Lasarte Calderay Jose E., Lasheras Fernańdez Yolanda, Lazaro Rivera Mariano, Lazo Naudin Victor, Leal Correa Bartolme, Lebrero Sańchez Encarnacioń, Ledo Cabaleiro Jose´ Marıá, Letona Antia Lurdes, Linãres Stolle Manuel, Lite Dıáz Annabel, Lizarribar Sans Marta, Llario Sanjuań Miguel, Llido Vicedo Ricardo, Llinares Moreno Vicente, Lliteras Fleixas Gabriel, Llorens Edo Fernando, Llorente Martin Carmen, Lloscos Llavador German, Llull Sarralde Micaela, Lobato Delgado Luis Alberto, Lobato Fernańdez Manuel, Lobera Serrano Pedro, Loizaga Horno Juan, Lom-

J Am Soc Nephrol 17: S236 –S245, 2006 billo De Onãte Margarita, Lopez Abietar Ma Isabel, Lopez Abril Juan, Lopez Aisa Blanca, Lopez Andrino Juan Carlos, Lopez Bazo Pedro, Lopez Cambeses Pilar, Lopez Cambeses Rosario, Lo´pez Castan˜eda Elvia, Lopez Castro Antonio Jose´, Lopez De Coca Fernandez-Valencia Enrique, Lopez De La Calle Fernando, Lopez De La Fuente Elena, Lopez Diaz Jesus, Lopez Hernandez Antonio, Lopez Leza Simon, Lopez Lopez Francisco, Lopez Martinez Mario, Lopez Moreno Ma Del Carmen, Lopez Munõz Felix, Lopez Rodriguez Isidro, Lopez Rodriguez Jesus, Lopez Serrano Beatriz, Lopez Vazquez Luis Miguel, Lo´pez Crespo Yolanda, Lo´pez De La Fuente F. Javier, Lo´pez Galindo Pedro Luis, Lo´pez Munõz Manuel, Lo´pez Ortiz Franciso, Lo´pez Ruiz Teresa, Lopez Perez Jose Manuel, Lopez-Cozar Fernandez Carmen, Lo´pez Carmen, Lorente Lopez Enrique, Lorente Mayor Juan, Lorenzo Lorenzo Jesus Francisco, Lorenzo Salido Francisco, Lozano Chilet Inmaculada, Lucas Sańchez Roque, Lucero Avinã Jose´ Luis, Luengo Aguëro Jesus, Luis Ruiz Cristina, Luna Estevez Sergio, Luna Estevez Sergio, Luque Jimenez Miguel, Madero Ambrojo Emilio, Maduenõ Caro Antonio J., Maestre Amat Luis, Maestre Amat Luis, Maestro Castellblanque Esperanza, Maffiotte Carrillo Nicola´s, Mampel Almela Josep, Manzano Martinez Antonio, Marchena Consejero Manuel, Marco Macian Ma Dolores, Marcos Bailon Jesus, Marcos Fernandez Fco.Jose, Marcos Olea Javier Luis, Marcos Rodriguez Angel, Margeli Ana, Mari Solivellas Bartolome, Marin Castanõ David, Marıń Andre´s Fernando, Marıń Valero Jose´, Marque´s Calvo Inmaculada, Martel Martel Alberto, Martin Alfaro Maria Luisa, Martin Gomez Madel Carmen, Martin Martin Pedro, Martin Sanchez Jose, Martıń Burillo Teresa, Martıń Garcıá Lourdes, Martıń Garito Enrique, Martıń Martıńez Enrique, Martıń Millana Juan Carlos, Martıń Moros Jose´ Ma, Martıń Portal Alejandro, Martıń Serrano Fernando, Martıń Soledad Jose´ A, Martincano Jose Luis, Martinez Andueza Camino, Martinez Ausin Ma Carmen, Martinez Barrios Jesus, Martinez Bes Ma Jose´, Martinez Cabrera Ana, Martinez Carrasco Jose Luis, Martinez Castellanos Mar, Martinez Correcher Francisca, Martinez Eizagirre Jose Manuel, Martinez Fernandez Montserrat, Martinez Galvan Luis Alfonso, Martinez Garcia Candido, Martinez Garcia Eladio, Martinez Gonzalez Esteban, Martinez Gonza´lez Mercedes, Martinez Hermosilla Alicia, Martinez Jativa Teresa, Martinez Lahuerta Juan Jose´, Martinez Linuesa Remedios, Martinez Martinez Jose Ma, Martinez Montero Juan Alberto, Martinez Nun˜ez Elisa, Martinez Orozco Marino, Martinez Quess Dulce, Martinez Quilez Javier, Martinez Ramos Fco, Martinez Sanchez Luis, Martinez Vidal Angel, Martinez Vindel Juan Carlos, Martıńez Guerola Carmen, Martıńez Pardo Inmaculada, Martıńez Pardo Rafael, Martıńez Quintas Marıá Jose´, Martıńez Vazquez Constantino, Martn Martin Araceli, Martorell Adsuara Vicente, Martos Calzado Jose´, Martos Garcia Emilio, Mateo Cabrejas Jesu´s Javier, Mateos Mateos Jesu´s, Mateos Perez Mar, Matilla Alvarez Carmen, Maya Teresa, Mazquiarań Mendia Martıń, Medina Castanõ Antonio, Medina Cuenca Pedro, Medina Engler Berta, Medrano Gonzalez Maite, Megias Boils Araceli, Mejıás Gonza´lez Santiago, Mejuto Bernabe´ Francisco J., Mellizo Moya Angel, Mena Garcia Juan, Mena Sastre Francisco Javier, Mencıá De Castro Gaspar, Mencıá Herreras Jose´ Ma, Mendez Gomez Begonã, Mendez Martinez Carmen, Mendez San Pedro Tomas, Mend´ ngeles, Mendiguren Navascues Arantxa, Mendinueta ieta Ruiz Ma A Fernandez Carmen, Menedez Tamargo Jose Manuel, Meneńdez Piquero Manuel, Mengual Moll, Vicente, Merino Munõz Marta, Mesa Pedrero Carlos, Mesquida Jerońima, Mestre Llugany Joan, Mialdea Lozano Maria Jose´, Milian Beser Susana, Minchero Arroyo Alberto, Minguez Villar Jose´ Carlos, Minguijon Barea Concha, Mininõ Couto Gerardo, Minuesa Cortijo Francisco Javier, Miquel Mira Ma Jose, Mira Castejoń Luis Alfredo, Miranda Ruiz Francisco, Modrego Navarro Angel, Molina Contreras Moises, Monfort Saez Rogelio, Monraba Capella Miquel, Monsalve Terroń Manuel, Montagud Moncho Miguel, Montan˜es Rustullet Carlos, Montero Luengo Juan, Montero Luque Javier,


Mora Breso´ Concha, Mora Dıáz Juan De Dios, Mora Garcia Cristina, Morales Abad Manuel A., Morales Colas Ma Luz, Moranco Sengariz Ma ´ ngeles, Moreno De Mingo Javier, Moreno Gonzalez Antonia, Moreno A Marıń Germań, Moreno Minguez Vicente, Moreno Moreno Ana, Moreno Moreno Jose Manuel, Moreno Beatriz, Moreno Esther, Moro Jimenez Juliań, Moro Torija Pilar, Moron Alejandre Angela, Morrell Rosario, Mosquera Martıńez Juan, Mourinõ Paz Amelia, Moya Cantarell Ma Victoria, Moya Santana Rafael, Mulet Sart Monserrat, Munar Mateu Juana Ana, Mun˜iz Fontainãs Manuel, Mun˜iz Villa Candelas, Munõz Conde Carmen, Munõz Hernańdez Jose´ Gabriel, Munõz Mora Francisco Javier, Munõz Rodriguez Pepe, Mur Martı´ Teresa, Muriel Velasco Ana, Muruais Gonzalez Jesus, Napal Anaut Ma Olga, Naranjo Carrioń Emilio Diego, Natal Gonza´lez Fernando, Navarro Martinez Victoria, Navarro Moreno Carlos, Navarro Soler Javier, Navarro Tarin Ricardo, Navarro Tarin Vicente, Navarro Valero Diego, Navarro Villena Manuel, Navascues Beltran German, Navaz Tejeiro Julio, Navaza Dafonte Ana Maria, Nevado Munõz Rafael, Nicolau Pellicer Carmen, Niell Crespi Miguel, Nieto Hortal Pepe, Nogue´s Loboń Aurora, Novoa Rodriguez Belen, Nuń˜ez Jorge Carlos, Ocanã Cazalilla Carmelo, Ogallas Raya Fuensanta, Ojea Amoedo Enrique, Olea Carrasco Miriam, Olid Valle Antonio, Olina Iparragirre Anuska, Olivar Castrilloń Carmen, Olivares Escribano Quintin, Olivera Canãdas Guadalupe, Olivera Ramos Ana G., Olmos Diaz Francisco, Ontanõn Bort Juan Jose, Ordon˜ez Picoń Roberto, Orgaz Gallego Pilar, Ormad Sebastian Javier, Orribo Rodrı´guez Severiana, Orrunõ Albizu Luis, Ortega De La Torre Llanos, ´ ngel Felipe, Ortega Motilla Natividad, Ortega Rıós FranOrtega Dıáz A cisco Javier, Ortin Arronis Jose´ Manuel, Ortiz Forcada Josefina, Ortueta Ruiz De Arbulu Jesus, Otaduy Bengoa Santiago, Otero Arias Fernando, Otero Cotoń Jose´, Otero Lopez Jose Manuel, Otxoa Iban˜ez Inãki, Oujo Pujales Juan, Pablos Herrero Eva, Paches Porcar Ma Dolores, Padin Montoto Fernando, Padron Chao Antonio, Padroń Pe´rez Marcos, Palacio Monedero Carmen, Palacios Claramunt Juan Andres, Palacios Del Cerro Antonio, Palacios Gonzalez Eleazar, Pallare´s Hernańdez Maria Pilar, Palma Lafuente Javier, Palomares Fernańdez Sixto, Palomo Del Arco Jesu´s, Panero Juan Vicente, Pappalardo Ordinãna Eric, Pappalardo Ordinãna Eric, Pardo Diaz Beatriz, Paredes Martinez Ma Luz, Paredes Urraca Toma´s, Parra Rodriguez Francisco, Parralejo Cano Francisco, Parrilla Rubio Margarita, Pascual Gil Octavio, Pascual Gonza´lez Oscar, Pascual Seara Benito, Pastor Benavent Carmen, Pastor Oliver Jose´ Francisco, Pastor Pastor Juan, Pastrana Gonzalez Victoria, Paya Perez Jose´ Antonio, Payań Godoy Josefa, Pazos Lopez Jose´, Pedraz Garcıá Ma Isabel, Peiro Morant Juan, Pellit Ramil Jose Ignacio, Penades Vaya Vicente, Pensado Pousa Jose´ Francisco, Penã Forcada Carmen, Penãs Merino Antonio, Perales Bolado Javier, Peralta Mun´ ngeles, Perera Pe´rez Carmen G., guıá Lucıá, Pereira Aparicio Ma A Perez Alemany Antonio, Perez Algar Ma Jose´, Perez Alonso Manuel, Perez Bermudez Aurelio, Perez Domingo Elena, Perez Gallego Francisco, Perez Garcia Catalina, Perez Llamas Miguel, Perez Perez Jose Luis, Perez Urraza Gotzone, Perez Vera Juan Antonio, Pe´rez Martıń Ma Del Puerto, Pe´rez Palmes M. Paz, Pe´rez Sańchez Jose´ Carlos, Pe´rez Vicente Antonio, Perez De Lis Fernandez Jesus, Perez De Olaguer Clavell Juan Jose, Perez-Blanco Fernańdez Antonio, Perez-Romero Martinez Jaime, Pericas Garcia Bartolome, Pericas Garcia Julio, Peris Velarde Jose´ Manuel, Peset Aleixandre Asuncioń, Picazo Moreno Eduardo, Pilar Claramonte Juan M, Pitarch Marco Florentina, Pla´ Vaya Rafael, Pleguezuelos Martinez Manuel, Ponce Buj Begonã, Poncela Costas Elvira, Ponzola Sanchez Jose´ Manuel, Porcel Llado Miquel, Porritt Lueiro Begonã, Portela Anton Jose, Porto Iglesias Jesus, Portus Vinyeta Teresa, Pousa Estevez Lorenzo, Poveda Grau Vicente, Pozo Teruel Amparo, Pradas Gonzalez Carmen, Pradela Leonardo Juan, Prados Cano Dolores, Prados Del Pino Javier, Prats Villagrasa M° Jose, ´ ngeles, Prieto Ferrer Prieto Albino Luis, Prieto Carnicer Maria De Los A


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Nuria, Prieto Gonzalez Laureano, Prieto Seva Alvaro Jose´, Prieto Carmen, Prol Ranã Manuel, Puchalt Ana Maria, Pucholt Bergara Juan, Puente Galań Oscar, Puente Martinez Antonio, Puente Perez Pablo, Quevedo Rivera Julia, Quiles Anõn Fernando, Quindimil Vazquez Jose Antonio, Quiros Alvarez Jesu´s, Raga Asins Martin, Raga Casasus Jose´ Vicente, Ralla Pablo Jordi, Rama Ferro Jesu´s, Ramia Mulet Jose Luis, Ramirez Aparicio Antonio, Ramı´rez Perez Carlos, Ramos Aleixades Adolfo, Ramos Hernańdez Santiago, Ramos Rodriguez Manuel, Ramos Rafael, Razoń Angulo Emilio, Real. Balaguer Vicente, Reboso Reyes Cristina, Recio Ribote Lourdes, Reguillo Diaz Joaquina, Remoń Soriano Agustina, Renteria Goirigolzarri Jon, Repiso Moreno Manuel, Requena Solera Juan, Retis Vazquez Julio, Retuerta Garcıá Ma Dolores, Revert Algarra Adoracion, Revert Algarra Adoracioń, Rey Suarez Salvador, Ribelles Cebrian Julio, Ribes Vicedo Juana, Ricart Cortes Jose Vicente, Ridaura Martı´ Amparo, Riera Calvo Andre´s, Rios Gomez Prados, Rios Rey Teresa, Ripoll Sanchez Jaime, Rivero Macristo, Robres Oliete Mariano, Roca Baeza Ramon, Roca Bosch Jose Luis, Roca Martinez Amparo, ´ ngel, Roche Del Toro Marciela, Rodilla Alonso Roca Verdu´ Antonio A Angel, Rodriguez Bacardit Neus, Rodriguez Fernandez Benito, Rodriguez Fernandez Concepcion, Rodriguez Gallego Concepcion, Rodriguez Garcia Amor, Rodriguez Ledo Pilar, Rodriguez Lopez Elisa, Rodriguez Lopez Isabel, Rodriguez Morua Javier, Rodriguez Ortiz De Zarate Ma Luisa, Rodriguez Perez Jose Carlos, Rodriguez Quintela Jesus, Rodriguez Romo Antonio, Rodriguez Soriano Ma Jose, Rodriguez Tebar Fabiola, Rodriguez Vivar Antonio, Rodrı´guez Alvarez Jesu´s, Rodrı´guez Bartolome´ Emilio, Rodrı´guez Franco Mercedes, Rodrı´guez Gallego Concepcioń, Rodrı´guez Pe´rez Ana Denis, Rodrı´guez Portillo Fernando, Rodrı´guez Relucio Angela, Roig Valdivieso Monserrat, Rojo Calderoń Aranzazu, Roldań Sanchez Pilar, Romero Conde Antonio, Romero Corroto Carmen, Romero De Lama Concepcion, Romero Garcia Cesar, Romero Mera Fernando, Ros Dominguez Jose, Rosell Cruchaga Luis, Rovira Penã Blanca, Rubert Escrig Carmina, Rubiera Alvarez Carlos, Rubio Arribas Victor, Rubio Beltran De Guevara Jesus, Rubio Fernandez Jose Fe´lix, Rubio Gonzalez Manuela, Rubio Guerrero Manuel, Rubio Ruiz Jose´ Ma, Rubio Villar Montserrat, Rubio Teresa, Ruiz Aguilar Gloria, Ruiz Chamorro Manuel, Ruiz Lopez Jesus, Ruiz Pastor Luis, Ruiz Quintero Manuel, Ruiz Quintero Manuel, Ruiz Ramos Rosa, Ruiz Roig Joaquina, Ruiz Ruiz Ana Marıá, Ruiz Vicente Juliań, Ruiz Margarita, Ruz Franzi Ignacio, Saavedra Mijań Juan, Saenz GarciaBaquero Isabel, Saez Azucena, Saéz Sifre Salvador, Saguïllo Gonzalez Pedro, Said Heluani Mohamed, Salanova Penãlva Alejandro, Salas Gonza´lez Toma´s, Salas Herrera Fernando, Salas Hospital Jose Carlos, Salcedo Peris Teresa, Salguero Chavez Emilio, Salguero Emilio, Salvador Hernandez Juan, Salvador Herrero Luis, Salvatierra Palacio Ma Luisa, San Andre´s Hernańdez Inmaculada, San Juan Perez Begonã, Sanchez Calso Antonio, Sanchez De Enciso Miguel, Sanchez Escudero Alfonso, Sanchez Flores Marife´, Sanchez Garcia Jorge, Sanchez Jimenez Vicente, Sanchez Lozano Sandra, Sanchez Miralles Manuel, Sanchez Ortiz Pilar, Sanchez Peral Beatriz, Sanchez Ruiz Martino, Sanchez Santos Natividad, Sańchez Blanco Juan, Sańchez Carrasco Marisol, Sańchez Garcıá M. Isabel, Sańchez Go´mez Ma Henar, Sańchez Lopez Eugenio, Sańchez Molla Manuel, Sańchez Pardo Garcıá Jesu´s, SańchezVillares Rodrı´guez Ma Teresa, Sanchidrian Velayos Ismael, Sandua Sada Jose´ Manuel, Saneleuterio Brines Rafael, Sangronid Uribarri Marisol, Sanmartin Fernandez Dolores, Sanso Rubert Pascual Patricia, Santacoloma Campos Idoia, Santana Fernańdez Juan A., Santos Altozano Carlos, Santos Bartolome´ Antonio, Santos Benito Begonã, Sanz Arribas Jose´, Sanz Gonza´lez Francisco, Seara Ma Luz, Sebastian Aparicio Ma Paz, Sebastian Milian Elena, Sedano Garcia Jose I., Segador Parra Jose, Serrano Cumplido Adalberto, Serrano Guerra-Librero Javier, Serrano Mallagray Luis, Serrano Vaverde Leticia, Sidro Bou Luisa Fda, Sieiro Prada Eudaldo, Siles Luna Maria Teresa, Siles Pozo Carmen, Simarro

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Rueda Marta, Sipan Sarrion Yolanda, Sirumal Hassamal Enrique, Sobrino Sorinas Eugenio, Soengas Vazquez Jose Antonio, Soler Carbo´ Montse, Soler David Vicente, Soler Lopez Tomas, Solera Albero Juan, ´ lvarez SOriano FUentes Segundo, Sorlı´ Guerola Jose´ Vicente, Sosa A Cesar, Soto Figueiras Manuel, Soto Trigueros Juan De Dios, Suarez Alen Jose´, Suarez Fernańdez Alejandro, Suarez Morań Ramoń, Sua´rez Castro Nicanor, Suero Palancar Jose´, Tardıó Lo´pez Manuel, Tarrıó Tobar Manuel, Tejeda Serrano Ma Isabel, Tellado Rosello Jose L, Terron Ruiz Maria Jesu´s, Testillano Perez Enrique, Thalamas Atienza Aitor, Tienza Villalobos Marisa, Tirado Moliner Jose Ma, Toldos Villegas Gregorio, Tolosana Almale Jose´ Marıá, Tomas Marin Carolina, Tomas Pruneda Pedro, Torcal Potente Ana, Toribio Espino Espino J.Manuel, Tormo Quiles Facundo, Tormos Felip Amparo, Torre Expo´sito Juan Simoń, Torrero Atienza Araceli, Torres Hernandez Candelaria, Torres Vazquez Bernardo, Tranche Iparraguirre Salvador, Trujillo Pe´rez Isabel, Turegano Albarran Miguel, Unanue Aurrekoetxea Juan Toma´s, Unceta Aramburu Fernando, Urbe Castelruiz Patxi, Urdangarin Tolosa Elena, Uribeetxeberria Garcia Lourdes, Usoz Otal Ramon, Valero Barcelo´ Carmen, Valero Valero Rosana, Valero Valero Rosana, Valhondo Elias Juan Antonio, Valle Garcia Nicanor, Valledor Puente Juan, Valle´s Romero Nuria, Valls Roca Francisco, Valverde Leis Jesus, Valverde Lizundia Anton, Vaquer Perez Jose´ Vicente, Vara Gonza´lez Luis Alberto, Varela Rotger Cirıáco, Vargas Negrıń Francisco, Vargas Concha, Vargas Rafael, Vazquez Garcia Manuel, Vazquez Ortega Ma Dolores, Vazquez Ramos Elena, Velasco Escobar Pablo, Velasco Gemio Joaquin, Vendrell Torres Federico, Ventura Garcia Silvestre, Ventura Rodriguez Silvestre, Verdial Varela Jose Antonio, Vergara Ruiz Miguel, Vicente Diaz Juan Ignacio, Vicente Hernańdez Javier, Vicioso Pedro, Vidal Mesa Claudio, Vidal Pardo Jose´, Vidal Planelles Francisca, Viejo Menendez Carmen, Vila Hernandez Luis, Vila Miro´ Ramon, Viladomiu Pascual Montserrat, Vilaplana Bernabeu Carlos, Villa Pe´rez Ma Jesu´s, Villalobos Martı¨n Juan Carlos, Villanueva Gomez Isabel, Villanueva Horn Luis, Villanueva Zarate Juan Ramoń, Villar Guerrero Domingo, Villaro´ Gabarro´ Merce`, Villasevil Hernandez Raul, Villora Fernandez Angel, Villoria Echegaray Juan Manuel, Villuela Gonza´lez Fernando, Vilumbrales Llorente Roberto, Viota Esperanza, Viqueira Perez Bernardo, Zanon Gonzalez Emilio, Zaragoza Moreno Ampara, Zardoya Zardoya Milagros, Zubiria Sopena Carlos.

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