Navegando por Palavras-chave "nondialysis patients"

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    Effect of rosuvastatin and sevelamer on the progression of coronary artery calcification in chronic kidney disease: a pilot study
    (Dustri-verlag Dr Karl Feistle, 2013-07-01) Lemos, Marcelo M. [UNIFESP]; Watanabe, Renato [UNIFESP]; Carvalho, Aluizio B. [UNIFESP]; Jancikic, Alessandra D. B. [UNIFESP]; Sanches, Fabiana M. R. [UNIFESP]; Christofalo, Dejaldo M. [UNIFESP]; Draibe, Sergio A. [UNIFESP]; Canziani, Maria Eugenia F. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Coronary artery calcification (CAC) is highly prevalent among chronic kidney disease (CKD) patients and its strong association with mortality has been recognized early in the course of CKD. the aim of the present study was to test the effect of rosuvastatin and sevelamer hydrochloride on the progression of CAC in nondialyzed CKD patients. Methods: An open-label, randomized and controlled pilot study was conducted including 117 CKD patients (62% men, 56.9 +/- 11.2 years, eGFR 36 +/- 16.5 ml/min) Patients were randomly assigned to rosuvastatin (n = 38; 10 mg/day), to sevelamer hydrochloride (n = 38; 2,400 mg/day) and to control (n = 41) groups. CAC (by multislice computed tomography) and biochemical analyses were performed at baseline and after 24 months. Results: At baseline, CAC was observed in 55%, 58% and 61% of patients in the rosuvastatin, sevelamer hydrochloride and control groups, respectively (p = 0.87). Calcium score at baseline as well as its absolute and relative changes during 24 months were similar among the groups. Low density lipoprotein cholesterol (LDL-c) was higher and decreased significantly in the rosuvastatin group (p < 0.01). the analysis adjusting for LDL-c showed that the drug regimens were not associated with the progression of CAC (drug effect p = 0.85; time-effect p < 0.001; interaction p = 0.76). Conclusions: Treatment with rosuvastatin and sevelamer hydrochloride may not delay the progression of CAC in non-dialysis dependent CKD patients.
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    Severe hypovitaminosis D in chronic kidney disease: association with blood pressure and coronary artery calcification
    (Nature Publishing Group, 2013-05-01) Pillar, Roberta [UNIFESP]; Lopes, Miriam Ghedini G. [UNIFESP]; Rocha, Lillian Andrade [UNIFESP]; Cuppari, Lilian [UNIFESP]; Carvalho, Aluizio B. [UNIFESP]; Draibe, Sergio A. [UNIFESP]; Canziani, Maria Eugenia F. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Hypovitaminosis D occurs early in the course of chronic kidney disease (CKD), and its association with cardiovascular morbidity and mortality is well known. in this study, we aimed to evaluate whether the degree of hypovitaminosis D may differently affect blood pressure (BP) and coronary artery calcification (CAC) in nondialyzed CKD patients. This study included 80 CKD patients with a creatinine clearance between 15 and 60 ml/min/1.73 m(2) and serum 25 hydroxivitamin D [25(OH)D] level <30 ng/ml. Patients underwent 24-h ambulatory BP monitoring, evaluation of CAC (multi-slice computed tomography), and laboratory evaluation. Two groups, based on the degree of hypovitaminosis D, were defined according to the median 25(OH) D value. Patients with severe hypovitaminosis D [25(OH)D <17.2 ng/ml; S-group) exhibited a higher systolic BP at all time periods (24-h, nighttime, daytime) when compared to patients with mild hypovitaminosis D [25(OH)D >17.2 ng/ml; M-group]. No differences were found between the S and M-group in terms of diastolic BP and the presence of coronary calcification. in the multiple linear regression analysis, severe hypovitaminosis D was a predictor of 24-h, daytime and nighttime BP after controlling for a number of confounders. the severity of hypovitaminosis D was associated with increased BP in nondialyzed CKD patients. the degree of hypovitaminosis D was not related to CAC, which was equally elevated in both the severe and mild hypovitaminosis D groups.