Navegando por Palavras-chave "ARF"

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    The role of growth factors on renal tubular cells submitted to hypoxia and deprived of glucose
    (Marcel Dekker Inc, 2003-01-01) Durao, M. D.; Razvickas, C. V.; Goncalves, EAP; Okano, I. R.; Camargo, SMR; Monte, JCM; Santos, OFP dos; Universidade Federal de São Paulo (UNIFESP)
    Background. in acute renal failure (ARF) renal tubular cell death and detachment can be induced by necrotic and apoptotic mechanisms. Several studies have demonstrated some benefits of the use of growth factors in experimental models of ARF. Methods. MDCK cells were cultured in a glucose-free medium for 24 h and were submitted to hypoxia (pO(2) around 35 mmHg) for additional 24 h. To evaluate the possible protective role of growth factors, EGF, IGF-I or HGF were added to the medium (20 ng mL). LDH release, viability (acridine orange and ethidium bromide dyes) and quantification of apoptotic cells (Hoechst 33342 dye fluorescence) were determined. Results. in the injury group, an increase on LDH release (60% vs. 3%) and on number of apoptotic cells (22% vs. 0.2%) which was associated with a reduced cell viability (61% vs. 94%) when compared with controls. Only HGF, not EGF or IGF-I, was able to protect cells from injury. HGF caused a significant reduction on LDH release (30%) and on number of apoptotic cells (5%), with an increase on viability cellular (79%). Conclusions. HGF decreases cell death on MDCK cells after hypoxic-induced injury, probably acting in both necrotic and apoptotic mechanisms.
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    Timing of renal replacement therapy initiation in acute renal failure: A meta-analysis
    (Elsevier B.V., 2008-08-01) Seabra, Victor F.; Balk, Ethan M.; Liangos, Orfeas; Sosa, Marie Anne; Cendoroglo, Miguel [UNIFESP]; Jaber, Bertrand L.; Caritas St Elizabeths Med Ctr; Universidade de São Paulo (USP); Tufts Med Ctr; Universidade Federal de São Paulo (UNIFESP)
    Background: Some studies have suggested that early institution of renal replacement therapy (RRT) might be associated with improved outcomes in patients with acute renal failure (ARF).Study Design: A systematic review and meta-analysis of randomized controlled trials and cohort comparative studies to assess the effect of early RRT on mortality in patients with ARF.Setting & Population: Hospitalized adult patients with ARF.Selection Criteria for Studies: We searched several databases for studies that compared the effect of early and late RRT initiation on mortality in patients with ARF We included studies of various designs.Intervention: Early RRT as defined in the individual studies.Outcomes: the primary outcome measure was the effect of early RRT on mortality stratified by study design. the pooled risk ratio (RR) for mortality was compiled using a random-effects model. Heterogeneity was evaluated by means of subgroup analysis and meta-regression.Results: We identified 23 studies (5 randomized or quasi-randomized controlled trials, 1 prospective and 16 retrospective comparative cohort studies, and 1 single-arm study with a historic control group). By using meta-analysis of randomized trials, early RRT was associated with a nonsignificant 36% mortality risk reduction (RR, 0.64; 95% confidence interval, 0.40 to 1.05; P = 0.08). Conversely, in cohort studies, early RRT was associated with a statistically significant 28% mortality risk reduction (RR, 0.72; 95% confidence interval, 0.64 to 0.82; P < 0.001). the overall test for heterogeneity among cohort studies was significant (P = 0.005). Meta-regression yielded no significant associations; however, early dialysis therapy was associated more strongly with lower mortality in smaller studies (n < 100) by means of subgroup analysis.Limitations: Paucity of randomized controlled trials, use of variable definitions of early RRT, and publication bias preclude definitive conclusions.Conclusion: This hypothesis-generating meta-analysis suggests that early initiation of RRT in patients with ARF might be associated with improved survival, calling for an adequately powered randomized controlled trial to address this question.