Navegando por Palavras-chave "kidney failure, chronic"
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- ItemSomente MetadadadosCalcifying panniculitis in a child after renal transplantation(Oxford Univ Press, 1997-01-01) Nogueira, Paulo Cesar Koch [UNIFESP]; Giuliani, C.; Rey, N.; Said, M. H.; Cochat, P.; HOP EDOUARD HERRIOT; UNIV LYON 1; Universidade Federal de São Paulo (UNIFESP); FAC ROCKEFELLER
- ItemAcesso aberto (Open Access)Espessura do músculo adutor do polegar como preditor da força de preensão manual nos pacientes em hemodiálise(Sociedade Brasileira de Nefrologia, 2013-09-01) Pereira, Raíssa Antunes [UNIFESP]; Caetano, Alex Lopes [UNIFESP]; Cuppari, Lilian [UNIFESP]; Kamimura, Maria Ayako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Recently, the adductor pollicis muscle thickness (APMT) has been suggested as a new nutritional marker in several population. OBJECTIVE: In view of the scarce data regarding the use of this marker in CKD patients, we aimed to evaluate APMT and its association with nutritional parameters in patients on hemodialysis. METHODS: We evaluated 73 hemodialysis patients (52.3 ± 17 years, without residual renal function). The APMT was assessed in the non vascular access arm by means of skinfold caliper. Body composition (bioelectrical impedance), handgrip strength (HGS, dynamometer), nutritional status (subjective global assessment), and laboratory parameters (creatinine, total protein and albumin) were also evaluated. RESULTS: Subjects with APMT values above the median were in greater proportion black/ brown, younger and had higher HGS. The APMT correlated positively with HGS, albumin and body cell mass (%), and negatively with age. In the linear regression analysis adjusted for sex, age and length on hemodialysis, APMT was independently associated with HGS. CONCLUSION: APMT was able to predict HGS in hemodialysis patients, suggesting APMT as a promising nutritional marker in this population.
- ItemAcesso aberto (Open Access)Estudo prospectivo de 2151 pacientes com doença renal crônica em tratamento conservador com abordagem multidisciplinar no Vale do Paraíba, SP(Sociedade Brasileira de Nefrologia, 2012-09-01) Luciano, Eduardo de Paiva; Luconi, Paulo Sérgio [UNIFESP]; Sesso, Ricardo de Castro Cintra [UNIFESP]; Melaragno, Claudio Santiago [UNIFESP]; Abreu, Patricia Ferreira [UNIFESP]; Reis, Sandra Ferreira Stanisck; Furtado, Rejane Maria Spindola; Ruivo, Gilson Fernandes; Centro Estadual para Tratamento de Doenças Renais do Vale do Paraíba; Universidade Federal de São Paulo (UNIFESP); Universidade de TaubatéINTRODUCTION: Chronic Kidney Disease (CKD) is common, severe and treatable. Its detection involves low cost tests. AIM: To evaluate the effect of a multidisciplinary (nephrologist, social worker, nurse, nutritionist, and psychologist) intervention comparing clinical and laboratory parameters in patients with CKD. METHODS: A prospective study with 2,151 patients attended at the State Center for Kidney Diseases of the Vale do Paraiba, São Paulo, from February 2008 to March 2011. The kidney function was measured using albuminuria and estimated glomerular filtration rate (eGRF) using the MDRD formula The clinical outcomes were the occurrence of cardiovascular disease (CAD), hospitalization episodes, need of renal replacement therapy (RRT) and death. RESULTS: Participants had a mean (range) age of 62 years (14-101), a mean follow-up of 546 days (90-1540) and the majority was in the stage 3 of CKD (59%). The most common primary diagnoses were hypertension (41.2%) and diabetes (32.4%). Mean blood pressure values at the beginning and at the end of treatment were 143 ± 26 mmHg x 87 ± 14 mmHg and 123 ± 16 mmHg x 79 ± 9 mmHg, respectively (p < 0.001); the eGRF decreased from 58.5 ± 31 ml/min. to 56.3 ± 23 ml/min (p < 0.01). Mean value of proteinuria decreased from 1.04 ± 1.44 g/day to 0.61 ± 1.12 g/day, p < 0.001, and the fasting glicemia decreased from 137 ± 73 mg/dl to 116 ± 42 mg/dl. One hundred and twenty-two patients (5.7%) had a CAD episode, the hospitalization rate was 6.6% (n = 143 patients), 7.3% patients died (n = 156), and 1.1% (n = 23) patients needed to start RRT. The risk of cardiovascular events, hospitalization, or death was inversely related to eGRF, and the rates of these events were low compared with the international literature. CONCLUSION: The multidisciplinary care with well defined targets is effective for the preservation of renal function and reduction in morbidity and mortality of CKD patients.
- ItemAcesso aberto (Open Access)Leitura rapida do KDIGO 2012: Diretrizes para avaliacao e manuseio da doenca renal cronica na pratica clinica(Sociedade Brasileira de Nefrologia, 2014-03-01) Mastroianni Kirsztajn, Gianna [UNIFESP]; Salgado Filho, Natalino; Draibe, Sergio Antonio [UNIFESP]; Netto, Marcus Vinicius de Padua; Thome, Fernando Saldanha; Souza, Edison; Bastos, Marcus Gomes; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Maranhao; Universidade Federal de Uberlandia; Universidade Federal do Rio Grande do Sul; Universidade do Estado do Rio de Janeiro; Universidade Federal do Rio de JaneiroThe authors of this fast reading present the data they have considered as more relevant in the KDIGO 2012 as concerned to evaluation and management of chronic kidney disease. The text does not correspond to their opinion, it is a brief presentation of guidelines that could be useful in clinical practice.
- ItemAcesso aberto (Open Access)Letramento em saúde: importância da avaliação em nefrologia(Sociedade Brasileira de Nefrologia, 2012-09-01) Santos, Luanda T. M.; Mansur, Henrique Novais; Paiva, Tatiane F. P. De Souza; Colugnati, Fernando Antonio Basile [UNIFESP]; Bastos, Marcus Gomes; UFJF; UCB; Universidade Federal de São Paulo (UNIFESP); UFJF Núcleo Interdisciplinar de Estudo, Pesquisa e Tratamento em Nefrologia; Fundação IMEPEN; UFJF Faculdade de Medicina Departamento de Clínica Médica; UFJF Programa de Saúde BrasileiraHealth literacy (HL) or basic reading and numeracy that allow an individual to function in the health care environment, is a relatively new topic, yet has increasingly been gaining interest over the past few years both in the research and policy agendas, particularly in the develop countries. Where studied, inadequate HL has been associated with poor health care quality and more cost. Yet many physicians do not recognize the problem or is not skilled enough to approach the subject with their patients. In this review, important aspects of HL, such as its epidemiology, associations with poor outcomes, assessment, determinants and interventions, particularly in nephrology, are discussed. Because it is common and associated to adverse clinical outcomes, inadequate HL should be incorporated into the list of assessments of patients with renal disease.