Introduction: Chronic kidney disease - mineral and bone disorders (CKD-MBD) are common in dialysis patients. Definition of targets for calcium (Ca), phosphorus (P), parathormone (iPTH), and alkaline phosphatase (ALP) and their treatment... more
Introduction: Chronic kidney disease - mineral and bone disorders (CKD-MBD) are common in dialysis patients. Definition of targets for calcium (Ca), phosphorus (P), parathormone (iPTH), and alkaline phosphatase (ALP) and their treatment recommendations, are provided by international guidelines. There are few studies analyzing CKD-MBD in peritoneal dialysis (PD) patients and the impact of guidelines on mineral metabolism control. The aim of our study was to describe the prevalence of biomarkers for CKD-MBD in a large cohort of PD patients in Brazil. Methods: Data from the nation-wide prospective observational cohort BRAZPD II was used. Incident patients were followed between December 2004 and January 2011. According to KDOQI recommendations, reference ranges for total Ca were 8.4 to 9.5 mg/dL, for P, 3.5 to 5.5 mg/dL, for iPTH, 150-300 pg/mL, and for ALP, 120 U/L. Results: Mean age was 59.8 ± 16 years, 48% were male, and 43% had diabetes. In the beginning, Ca was 8.9 ± 0.9 mg/dL, and...
Introduction: The protein-energy malnutrition is found in a large proportion in dialysis patients. The malnutrition-inflammation score (MIS) seems to be the most appropriate integrated method for assessing the nutritional status or... more
Introduction: The protein-energy malnutrition is found in a large proportion in dialysis patients. The malnutrition-inflammation score (MIS) seems to be the most appropriate integrated method for assessing the nutritional status or nutritional risk of these patients. The aim of the study is to evaluate the MIS, in the diagnostic accuracy for the assessment of malnutrition, and its correlation with the survival time of patients in hemodialysis (HD). Methods: Study carried out in HD units in the city of Curitiba, Brazil, from January 2013 to December 2015. Clinical, laboratory and anthropometric data were evaluated. The data comparison between patients was made according to the t-test and the chi-square. The Kaplan-Meier curve was constructed to assess the influence of MIS on patient survival and log rank tests were used to verify the equality of survival distributions in these groups. Results: 113 HD patients were evaluated, 74% male. From the multivariable proportional hazards model...
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Research Interests: Heart Failure, Humans, Female, Male, Follow-up studies, and 13 moreRisk factors, Aged, Middle Aged, Myocardial Infarction, Adult, Diabetes complications, Retrospective Studies, Sudden Cardiac Death, Left ventricular hypertrophy, Risk Factors, Renal Dialysis, Case Control Studies, and Cardiovascular medicine and haematology
Research Interests:
Research Interests: Immune response, Atherosclerosis, Kidney diseases, Chronic kidney disease, Inflammation, and 24 moreCardiovascular disease, Antioxidants, Clinical Practice, Complication, Humans, Mice, Vasculitis, Chronic Disease, Animals, Vascular endothelium, Anti-inflammatory agents, Clinical Sciences, Immune system, Degeneration, Tumor necrosis factor-alpha, Periodontitis, Cardiovascular Diseases, Chronic Inflammation, Cardiomyopathies, Vascular Calcification, Angiotensin Converting Enzyme Inhibitors, Renal Dialysis, Interleukin, and Clinical Trials as Topic
Chronic kidney disease (CKD) compromises the health and routine of the patient. On the fifth stage of CKD, the patient becomes eligible to start renal replacement therapy: hemodialysis (HD), peritoneal dialysis (PD) or kidney... more
Chronic kidney disease (CKD) compromises the health and routine of the patient. On the fifth stage of CKD, the patient becomes eligible to start renal replacement therapy: hemodialysis (HD), peritoneal dialysis (PD) or kidney transplantation. The type of CKD treatment is essential to improving quality of life of the patient. To compare the quality of life of CKD stage 5 patients who perform HD and home PD. Cross-sectional study with data collection, by convenience, through the application of socioeconomic and KDQOL SF-36 questionnaires in HD and PD patients of the Pro-Renal Foundation and satellite clinics in Curitiba-PR. The sample was 338 patients, 222 HD and 116 PD. Average age: 54.4 years for HD group (± 15.28) and 58.00 for the DP group (± 13.99). The variables: work status (p < 0.05), encouragement by dialysis staff (p < 0.01) and patient satisfaction (p < 0.001) were in favor of DP; while physical functioning (p < 0.05) and emotional function (p < 0.01) were to HD. Objectively, PD was more favorable regarding quality of life, for the large number of items with significant results when compared to HD. However, the two variables of greatest significance found in HD (physical functioning and emotional functioning) ended up having a much greater impact on well-being and daily-life of the patient in the environment external to the clinic than those who were higher in DP, making HD the most favorable for patient quality of life.
Although renal dysfunction is a known risk factor for cardiovascular disease (CVD), there are few experimental studies investigating the cardiovascular consequences of this condition. To analyze the impact of the induction of renal... more
Although renal dysfunction is a known risk factor for cardiovascular disease (CVD), there are few experimental studies investigating the cardiovascular consequences of this condition. To analyze the impact of the induction of renal dysfunction on biomarkers of cardiovascular risk and on the histology of subepicardial vessels. This experimental study involved thirty Wistar male rats, which were divided into two groups. One (chronic kidney disease - CKD group) underwent renal ablation, and the other (SHAM group) was submitted to kidney manipulation only. Both groups were followed up for eight weeks. During follow-up, serum levels of urea, phosphorus and TNF-α were measured. Heart tissue was processed for histological analysis. The CKD group had increased levels of urea and phosphorus, in comparison with the SHAM group. The levels of TNF-α were increased in the CKD group and undetectable in the SHAM group (p < 0.05). Thickness of the middle layer of the subepicardial vessels of the ...
Research Interests:
Research Interests: Inflammation, Vitamin D, Cardiovascular disease, Humans, Left Ventricular Assist Device, and 20 moreFemale, Hemodialysis, Male, Systemic inflammation, Medical Physiology, Risk factors, Parathyroid Hormone, Clinical Sciences, Aged, Middle Aged, Adult, Myocardium, Cardiovascular Risk Factor, Biological markers, Risk Factors, Ventricular Remodeling, Vitamin D Deficiency, Left Ventricle, Renal Dialysis, and Serum albumin
Research Interests: Chronic kidney disease, Inflammation, Humans, Periodontal Disease, End Stage Renal Disease, and 11 moreAnimals, Medical Physiology, Clinical Sciences, Immune system, ENDOTOXEMIA, Gastrointestinal Tract, Chronic Inflammation, Vascular Calcification, Chronic Kidney Failure, Vascular Access, and Inflammatory response
Research Interests: Nutrition and Dietetics, Inflammation, Vitamin D, Vitamins, Calcium, and 21 morePhosphorus, Prospective studies, Humans, Female, Hemodialysis, Male, Dietary Supplements, Parathyroid Hormone, Alkaline phosphatase, Clinical Sciences, Aged, Middle Aged, C reactive protein, Myocardium, Renal Nutrition, Biological markers, Hyperparathyroidism, Vitamin D Deficiency, Renal Dialysis, Interleukin, and Serum albumin
Research Interests: Immune response, Atherosclerosis, Kidney diseases, Chronic kidney disease, Inflammation, and 24 moreCardiovascular disease, Antioxidants, Clinical Practice, Complication, Humans, Mice, Vasculitis, Chronic Disease, Animals, Vascular endothelium, Anti-inflammatory agents, Clinical Sciences, Immune system, Degeneration, Tumor necrosis factor-alpha, Periodontitis, Cardiovascular Diseases, Chronic Inflammation, Cardiomyopathies, Vascular Calcification, Angiotensin Converting Enzyme Inhibitors, Renal Dialysis, Interleukin, and Clinical Trials as Topic
Research Interests: Chronic kidney disease, Inflammation, Treatment Outcome, Polyamines, Prospective studies, and 17 moreHumans, Female, Hemodialysis, Male, Systemic inflammation, Follow-up studies, Clinical Sciences, Chelating agent, Middle Aged, C reactive protein, Immune system, ENDOTOXEMIA, Calcium Carbonate, Chelating Agents, Endotoxins, Renal Dialysis, and Inflammatory response
From the immunologic viewpoint, chronic kidney disease (CKD) is characterized by disorders of both the innate and adaptive systems, generating a complex and still not fully understood immune dysfunction. Markers of a chronically activated... more
From the immunologic viewpoint, chronic kidney disease (CKD) is characterized by disorders of both the innate and adaptive systems, generating a complex and still not fully understood immune dysfunction. Markers of a chronically activated immune system are closely linked to several complications of CKD and represent powerful predictors for mortality in the CKD population. On the other hand, CKD patients respond poorly to vaccination and to challenges such as bacterial infection. Interestingly, the main causes of death in patients with CKD are cardiovascular and infectious diseases, both being pathologic processes closely linked to immune function. Therefore, accelerated tissue degeneration (as a consequence of chronic inflammation) and increased rate of sepsis (because of a poorly orchestrated immune response) represent the most important targets for interventions aiming to reduce mortality in CKD patients. Understanding the mechanisms behind the immune dysfunction that is peculiar ...