Navegando por Palavras-chave "Peritoneal dialysis"
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- ItemAcesso aberto (Open Access)Efeito da espironolactona na progressão da calcificação coronariana de pacientes com doença renal crônica em hemodiálise(Universidade Federal de São Paulo (UNIFESP), 2017-12-20) Gueiros, José Edevanilson de Barros [UNIFESP]; Carvalho, Aluizio Barbosa de [UNIFESP]; Souza, Alex Sandro Rolland de; http://lattes.cnpq.br/1855788987814153; http://lattes.cnpq.br/7909431111187945; http://lattes.cnpq.br/7638153138440210; Universidade Federal de São Paulo (UNIFESP)
- ItemAcesso aberto (Open Access)Efeito do uso da farinha de banana verde sobre toxinas urêmicas derivadas do metabolismo da microbiota intestinal em pacientes em diálise peritoneal(Universidade Federal de São Paulo (UNIFESP), 2020-06-24) Andrade, Laila Santos De [UNIFESP]; Valle, Lilian Cuppari [UNIFESP]; http://lattes.cnpq.br/3552074553183694; http://lattes.cnpq.br/2129284525097129; Universidade Federal de São PauloIntrodução: Vários metabólitos derivados do metabolismo microbiano compõem o metaboloma sérico dos mamíferos, tais como o indoxil sulfato (IS), p-cresil sulfato (pCS) e o ácido indol 3-acético (IAA). Na doença renal crônica (DRC), o acúmulo destes metabólitos tem sido associado à inflamação, doença cardiovascular e mortalidade por todas as causas. Nesse contexto, a fim de atenuar o acúmulo destes metabólitos, os prebióticos surgem como uma possível estratégia. Objetivos: Avaliar o efeito da farinha de banana verde (FBV- 48% de amido resistente) sobre os níveis séricos de IS, pCS, IAA, marcadores inflamatórios (IL-6, TNF-α, IL-10 e PCR), permeabilidade intestinal e sintomas gastrointestinais em indivíduos em programa de diálise peritoneal (DP). Metodologia: Trata-se de um ensaio clínico randomizado, controlado por placebo, duplo-cego, cruzado. Quarenta e três indivíduos em DP foram alocados para o grupo FBV (21 g/dia) ou placebo (amido de milho ceroso- 12 g/dia), por 4 semanas. Após a conclusão deste período, os participantes passaram por um período de washout de 4 semanas e na sequencia utilizaram o suplemento oposto. As concentrações de IS, pCS e IAA foram determinadas por cromatografia líquida de alta performance (HPLC); os níveis séricos de IL-6, TNF-α, IL-10 foram determinados pela tecnologia xMAP da Luminex®; a permeabilidade intestinal foi avaliada por meio da dosagem de endotoxinas no soro; os sintomas gastrointestinais por meio da Escala de Avaliação de Sintomas Gastrointestinais (GSRS) e a ingestão dietética por meio do registro alimentar de três dias alternados. Resultados: Dos 43 pacientes incluídos, 26 completaram o estudo [idade= 55±12 anos; homens- 53,8%; diabetes- 34,6%; diurese residual- 84,6%; tempo em diálise peritoneal= 16 (5-31) meses]. A FBV não promoveu mudanças nos níveis séricos de IS (p=0,70), pCS (p=0,70) e IAA (p=0,74). Uma redução no nível sérico de IS foi observada em um subgrupo de participantes que apresentaram uma ingestão diária de FBV mais próxima da dose proposta no protocolo de estudo [n=11; placebo: mediana 79,5 μmol/L (31-142) versus FBV: 62,5 μmol/L (31-133), p= 0,009]. Dentre os períodos do estudo, nenhuma diferença foi observada na ingestão alimentar habitual, na excreção urinária dos metabólitos estudados, assim como na remoção dos mesmos pelo processo dialítico. Nenhuma diferença foi encontrada nos demais parâmetros analisados. Conclusão: A FBV não afetou os níveis séricos de IS, pCS e IAA. Apenas no subgrupo de participantes que tiveram uma ingestão diária de FBV próxima da dose proposta no estudo foi observada redução no IS.
- ItemAcesso aberto (Open Access)Nutritional status and body composition after 6 months of patients switching from continuous ambulatorial peritoneal dialysis to automated peritoneal dialysis(Associação Brasileira de Divulgação Científica, 2008-12-01) Garcia-Lopes, Miriam Ghedini [UNIFESP]; Agliussi, Rosina Gabriela [UNIFESP]; Avesani, Carla Maria [UNIFESP]; Manfredi, Sílvia Regina [UNIFESP]; Bazanelli, Ana Paula [UNIFESP]; Kamimura, Maria Ayako [UNIFESP]; Draibe, Sergio Antonio [UNIFESP]; Cuppari, Lilian [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Our objective was to determine if automated peritoneal dialysis (APD) leads to changes in nutritional parameters of patients treated by continuous ambulatory peritoneal dialysis (CAPD). Twenty-six patients (15 males; 50.5 ± 14.3 years) were evaluated during CAPD while training for APD and after 3 and 6 months of APD. Body fat was assessed by the sum of skinfold thickness and the other body compartments were assessed by bioelectrical impedance. During the 6-month follow-up, 12 patients gained more than 1 kg (GW group), 8 patients lost more than 1 kg (LW group), and 6 patients maintained body weight (MW group). Except for length on dialysis that was longer for the LW group compared with the GW group, no other differences were found between the groups at baseline. After 6 months on APD, the LW group had a reduction in body fat (24.5 ± 7.7 vs 22.1 ± 7.3 kg; P = 0.01), body cell mass (22.6 ± 6.2 vs 21.6 ± 5.8 kg, P = 0.02) and phase angle (5.4 ± 0.9 vs 5.1 ± 0.8 degrees, P = 0.004). In the GW group, body fat (25 ± 7.6 vs 27.2 ± 7.6 kg, P = 0.001) and body cell mass (20.1 ± 3.9 vs 20.8 ± 4.0 kg, P = 0.05) were increased. In the present study, different patterns of change in body composition were found. The length of previous dialysis treatment seems to be the most important factor in determining these nutritional modifications.
- ItemSomente MetadadadosQuality of life in children on dialysis(Springer, 2012-10-01) Brunelli, Giovanna [UNIFESP]; Nogueira, Paulo Cesar Koch [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Diniz, Denise Helena de Madureira Pará [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)In recent years, the survival of patients with end stage renal disease (ESRD) has increased but few studies have assessed the quality of life in children on dialysis. the aim of the present cross-sectional study was to analyze the quality of life in this pediatric population and compare it with healthy controls using the Autoquestionnaire Qualit, de Vie Enfant Image.Thirty-three children on dialysis paired for gender, age, and social level with 33 healthy children.A significant difference was observed between the groups regarding the question on the practicing of sports. for this question, 29/33 healthy children reported to be very satisfied, while only 17/33 out of the ESRD group stated likewise. When asked about satisfaction of the children at the table with the family, 23/33 of the controls and 16/33 of the ESRD group reported to be very satisfied, showing a trend toward a significant difference (P = 0.059). No differences were observed for the remaining questions. We conclude that ESRD was linked to lower perception of quality of life in leisure aspects (sports) and a trend regarding functional issues (meal at the table).
- ItemAcesso aberto (Open Access)Repercussões cardiorrespiratórias da diálise peritoneal em crianças graves(Associação de Medicina Intensiva Brasileira - AMIB, 2008-03-01) Barcellos, Patrícia Gombai [UNIFESP]; Johnston, Cíntia [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Fonseca, Marcelo Cunio Machado [UNIFESP]; Santos, Jacqueline Evani dos [UNIFESP]; Bandini, Eliana [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica do Rio Grande do Sul; Hospital SantaCatarina; Pronto Socorro Infantil Sabará; Universidade de São Paulo (USP); Universidade Metodista de São PauloBACKGROUND AND OBJECTIVES: Peritoneal dialysis (PD) is frequently used to replace glomerular filtration and to control acid-base, electrolyte and fluid disturbances in critically ill children with acute renal failure. However, cardiorespiratory changes can happen during this procedure. The objective of this review is to describe the PD cardio-respiratory repercutions in the pediatric patient and the evidence level of the studies that approach these repercutions. METHODS: Bibliographic revision about PD cardio-respiratory repercutions in the pediatric patient. Medline, Ovid e Lilacs databases were searched for articles from 1990 to 2007 with the following key words in Portuguese, English and Spanish: diálise peritoneal, efeitos hemodinâmicos, complicações respiratórias, complicações cardíacas, Pediatria; peritoneal dialysis, hemodynamic effects, respiratory complications, cardiac complications, Pediatric; peritoneal diálisis, efecto hemodinámico, complicaciones respiratorias, complicaciones cardiacas, Pediatria. The retrieved articles were classified according to Cook et al. 1992. RESULTS: Thirteen articles were retrieved, 8 of them were about cardiorespiratory repercussions and five approached respiratory repercussions of PD. These studies evaluated 178 critically ill patients, from newborns to adolescents. Among the respiratory repercutions during PD the most frequent ones were decrease of the pulmonary compliance and arterial oxygen partial pressure and increase of airway resistance and carbon dioxide partial pressure; after the infusion of PD fluid the studies pointed out an increased arterial oxygen partial pressure/ inspired oxygen fraction relation and diminution of the alveolar-arterial difference and oxygenation index. Increase of the mean arterial pressure, pulmonary artery pressure, right and left atrial pressure and systemic vascular resistance and, reduction of the central venous pressure were the described cardio-circulatory repercutions during PD. CONCLUSIONS: Pulmonary volumes, gas exchange and cardio-circulatory alterations are the most frequent complications during and after PD in the pediatric patient. Therefore critically ill pediatric patients with acute renal failure needing PD should be monitored during and after this procedure to avoid clinical deterioration and to educate the multi-professional team.
- ItemSomente MetadadadosWaist circumference as a predictor of mortality in peritoneal dialysis patients: a follow-up study of 48 months(Cambridge Univ Press, 2017) Castro, Ana Catarina M. [UNIFESP]; Bazanelli, Ana Paula [UNIFESP]; Nerbass, Fabiana B.; Cuppari, Lilian [UNIFESP]; Kamimura, Maria A. [UNIFESP]Body-fat gain is a common finding among peritoneal dialysis (PD) patients, and the accumulation of adipose tissue occurs predominantly in the abdominal area. Waist circumference (WC) is a reliable marker of abdominal obesity and its association with worse outcomes has been demonstrated in non-dialysis and haemodialysis patients. We aimed at investigating whether WC measurements as well as the changes over time in WC were able to predict mortality in PD patients. This prospective study included 109 patients undergoing PD (57 % male, age 52 (sd 16) years, 32 % diabetics, 48 % BMI25 kg/m(2)). WC was measured at the umbilicus level (empty abdominal cavity), and values >88 cm for women and >102 cm for men were considered high. Nutritional status and laboratory parameters were also evaluated. WC was measured at baseline and after 6 months, and mortality was registered during a period of 48 months. High WC was observed in 55 % of women and in 23 % of men at baseline. After 6 months, 61 % of the patients showed an increased WC. At the end of the study, twenty-seven deaths were registered. A significant increase in WC was observed only in the non-survivor group. In the Cox regression analysis adjusting for sex, age, duration on dialysis, diabetes, BMI, serum albumin and C-reactive protein, high WC at baseline as well as the 6-month increase in WC were independently associated with mortality. This study demonstrated that a high WC and the increase over time in WC were both predictors of mortality in PD patients.