Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia最新文献

{"title":"Cardiovascular-kidney-metabolic Syndrome: a current and urgent concept.","authors":"Andrea Pio de Abreu, Luciano Ferreira Drager, Madson Queiroz Almeida, Luiz Aparecido Bortolotto, Heno Ferreira Lopes","doi":"10.1590/2175-8239-JBN-2024-0277en","DOIUrl":"10.1590/2175-8239-JBN-2024-0277en","url":null,"abstract":"<p><p>The concept of cardiovascular-kidney-metabolic health is based on the idea of a multifaceted interaction among several cardiovascular, renal, and meta-bolic factors. Alterations in this complex interaction have a significant impact on morbidity and mortality. The ramifications of poor cardiovascular-kidney-metabolic health are far-reaching, with a notable clinical impact. A considerable proportion of the population is affected by precarious cardiovascular, renal, and metabolic health, and indivi-duals with adverse social determinants of health endure an even greater burden. To this end, it is essential to develop an approach that incorporates metabolic staging and prioritizes lifelong prevention. Equally imperative is integrating the social determinants of health into care models for Cardiovascular-kidney-metabolic syndrome, facilitating patient-centered interdisciplinary care. The American Heart Association (AHA) provides guidelines on the definition, staging, paradigms, and holistic approaches to the management of patients with this syndrome. Furthermore, it offers a comprehensive framework for effectively and equitably improving the cardiovascular, kidney, and metabolic health of the population.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240277"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C3 glomerulonephritis associated with monoclonal gammopathy of renal significance: a diagnostic and therapeutic challenge.","authors":"Bárbara Beirão, Mariana Freitas, Natália Silva, Patrícia Ferraz, Catarina Prata, Teresa Morgado","doi":"10.1590/2175-8239-JBN-2024-0106en","DOIUrl":"10.1590/2175-8239-JBN-2024-0106en","url":null,"abstract":"<p><p>C3 glomerulopathy represents a heterogeneous group of glomerulopathies characterized by hyperactivity of the alternative complement pathway. Although the pathophysiology is incompletely understood, an association between this disease and monoclonal gammopathies is increasingly recognized, especially in older individuals. There is still some uncertainty regarding the best treatment for patients with monoclonal gammopathy-associated C3 glomerulopathy. However, recent evidence suggests that myeloma-targeted therapies are associated with improved renal outcomes compared with conservative or conventional immunosuppressive therapies. This case report describes the clinical course and long-term follow-up of a patient with monoclonal gammopathy-associated C3 glomerulonephritis treated with myeloma-targeted therapy.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240106"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional counseling tailored to the patient's learning type and its impact on interdialytic weight gain in chronic hemodialysis patients.","authors":"Naiane Rodrigues de Almeida, Caio Pellizzari, Cynthia Leinig, Fabiana Nerbass, Thyago Proença de Moraes","doi":"10.1590/2175-8239-JBN-2023-0205en","DOIUrl":"10.1590/2175-8239-JBN-2023-0205en","url":null,"abstract":"<p><strong>Introduction: </strong>Interdialytic weight gain (IDWG) is a risk factor for cardiovascular complications and mortality in hemodialysis (HD) patients. Sodium and fluid intake are important modifiable risk factors for these outcomes, and the role of the nutritionist as educator is essential in this process. However, patient adherence is often low, representing a significant challenge. Recent recommendations suggest personalizing the education process, but there is limited data on how to effectively carry out this adaptation. The present study aimed to assess the effectiveness of a personalized nutritional intervention based on learning style using the VARK tool with the goal of reducing IDWG in HD patients.</p><p><strong>Objective: </strong>This was a randomized crossover clinical trial. Patients in the intervention group received individualized nutritional guidance based on their learning style, as determined by the VARK questionnaire. The control group received standard guidance without any personalization or educational materials.</p><p><strong>Results: </strong>A total of 21 chronic HD patients participated in the study. On average, the baseline IDWG in the population was 2.61 ± 1.08 liters, and we did not observe any significant pattern of change in either IDWG (p = 0.55) or systolic blood pressure (p = 0.44) over the study period.</p><p><strong>Conclusion: </strong>Tailored nutritional counseling based on the patient's learning style did not lead to an improvement in IDWG in our population.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20230205"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Long-term kidney outcomes in children after allogeneic hematopoietic stem cell transplantation assessed with estimated glomerular filtration rate equations, creatinine levels, and cystatin C levels.","authors":"","doi":"10.1590/2175-8239-JBN-2021-0231eren","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2021-0231eren","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/2175-8239-JBN-2021-0231en] [This corrects the article doi: 10.1590/2175-8239-JBN-2021-0231pt].</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20210231er"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary hyperparathyroidism in patients on dialysis therapy in 2025.","authors":"Tilman B Drüeke","doi":"10.1590/2175-8239-JBN-2025-E006en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2025-E006en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e2025E006"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New trends in AA amyloidosis with renal involvement: a single-center experience.","authors":"Nídia Marques, Catarina Oliveira-Silva, Ana Pinho, Ana Teresa Nunes, Susana Sampaio, Ana Oliveira, Isabel Tavares","doi":"10.1590/2175-8239-JBN-2024-0127en","DOIUrl":"10.1590/2175-8239-JBN-2024-0127en","url":null,"abstract":"<p><strong>Introduction: </strong>In the northwest of Portugal, AA amyloidosis was reported as the most frequent amyloid nephropathy, but it is unclear if the disease's incidence and outcomes have changed. The authors studied the changing epidemiology, aetiologies, and outcomes of patients with renal AA amyloidosis over the last 40 years.</p><p><strong>Methods: </strong>This is a retrospective single-center cohort study involving patients with renal biopsy-proven AA amyloidosis diagnosed in the northwest of Portugal between 1978 and 2019. The patients were grouped into 14-year cohorts based on the year of diagnosis (CA 1978-1991; CB 1992-2005; CC 2006-2019), and clinical course and outcomes were analyzed.</p><p><strong>Results: </strong>Sixty-nine AA amyloidosis patients were included. The incidence of the disease remained stable in CA (64%) and CB (62.7%) as opposed to the significant decrease in the most recent cohort (44%, p = 0.027). The mean age at presentation increased by ten years from CA to CC. Overall, infections were the leading cause of death, with a significant rise over time (9.1% in CA to 76.9% at CC, p = 0.002). There were no significant global and renal survival differences between the three cohorts. However, the CC patients died at an older age (61.4 years) than the CA (52.3 years).</p><p><strong>Conclusion: </strong>The incidence of AA amyloidosis has been declining over the last 40 years. In contrast, the age at presentation of amyloid nephropathy has been increasing. Global and renal outcomes did not improve, but the average life expectancy increased, suggesting progress in general management and supportive care of renal and underlying pathology.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240127"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for diagnosis and treatment of Atypical Hemolytic Uremic Syndrome (aHUS): an expert consensus statement from the Rare Diseases Committee of the Brazilian Society of Nephrology (COMDORA-SBN).","authors":"Maria Helena Vaisbich, Luis Gustavo Modelli de Andrade, Maria Izabel Neves de Holanda Barbosa, Maria Cristina Ribeiro de Castro, Silvana Maria Carvalho Miranda, Carlos Eduardo Poli-de-Figueiredo, Stanley de Almeida Araujo, Miguel Ernandes Neto, Maria Goretti Moreira Guimarães Penido, Roberta Mendes Lima Sobral, Oreste Ferra Neto, Precil Diego Miranda de Menezes Neves, Cassiano Augusto Braga da Silva, Fellype Carvalho Barreto, Igor Gouveia Pietrobom, Lilian Monteiro Pereira Palma","doi":"10.1590/2175-8239-JBN-2024-0087en","DOIUrl":"10.1590/2175-8239-JBN-2024-0087en","url":null,"abstract":"<p><p>Atypical hemolytic uremic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA) caused by the dysregulation of the alternative complement pathway. The diagnosis of TMA is made clinically by the triad: microangiopathic hemolytic anemia, thrombocytopenia, and organ damage (mainly acute kidney injury). The heterogeneity of clinical manifestation and the lack of a gold standard diagnostic test makes the precise diagnosis of aHUS a challenging process that may impact patient management. Until one decade ago, there was no specific treatment for aHUS and patients were submitted to plasma therapy (plasma exchange and/or plasma infusion) and/or liver transplantation, procedures that are not free of serious complications and that do not address the underlying pathophysiology of the disease. Since 2011, an anti-C5 complement monoclonal antibody has been approved by the Food and Drug Administration (FDA) for aHUS patients beginning a new era in treatment. Clinical trials on new complement inhibitors may also add to the treatment portfolio in the future. The Brazilian population is a mixed race with a unique genetic and clinical profile. This consensus aims to offer recommendations for the diagnosis and treatment of patients with aHUS in this population based on expert experience, data from the aHUS Brazilian Registry and literature review. The GRADE system was used to classify the quality of the evidence.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240087"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and satisfaction regarding an intradialytic virtual reality exercise program in Brazil.","authors":"Marcelly Oliveira Pinton, Bruno Valle Pinheiro, Fabrício Sciammarella Barros, Daniele Thomé Silva, Ana Paula de Lima Souza Dias, Maria Clara de Lima Assis, Emanuele Poliana Lawall Gravina, Leda Marília Fonseca Lucinda, Eva Segura Orti, Maycon Moura Reboredo","doi":"10.1590/2175-8239-JBN-2024-0133en","DOIUrl":"10.1590/2175-8239-JBN-2024-0133en","url":null,"abstract":"<p><strong>Introduction: </strong>Virtual reality (VR) has been used as an effective tool for improving patient adherence to intradialytic exercise programs. This study evaluated the perception and satisfaction of patients and healthcare professionals regarding an intradialytic VR exercise program.</p><p><strong>Methods: </strong>The VR protocol included lower limb resistance and endurance training. Patients' perception and satisfaction, as well as the perception of healthcare professionals, were assessed using questionnaires.</p><p><strong>Results: </strong>Of the 27 patients who participated in the exercise program, most evaluated the experience as very good and easy to perform. Of the 24 patients who completed the program, most described the experience as beneficial. Most of the healthcare professionals reported that the protocol did not affect their work routine.</p><p><strong>Conclusion: </strong>The intradialytic VR exercise program was well accepted by patients and healthcare professionals.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240133"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Guidelines on evaluation and clinical management of Nephrolithiasis: Brazilian Society of Nephrology.","authors":"Mauricio de Carvalho, Ana Cristina Carvalho de Matos, Daniel Rinaldi Dos Santos, Daniela Veit Barreto, Fellype Carvalho Barreto, Fernanda Guedes Rodrigues, Igor Gouveia Pietrobom, Lucas Gobetti da Luz, Natasha Silva Constancio, Samirah Abreu Gomes, Ita Pfeferman Heilberg","doi":"10.1590/2175-8239-JBN-2024-0189en","DOIUrl":"10.1590/2175-8239-JBN-2024-0189en","url":null,"abstract":"<p><p>The prevalence of nephrolithiasis has been increasing in recent years, affecting appro-ximately 10% and 15% of the population. Kidney stone disease is associated with syste-mic comorbidities such as cardiovascular dis-ease, diabetes mellitus, and obesity. The first Nephrolithiasis Guideline by the Brazilian Society of Nephrology was published in 2002, and since then, the accumulation of new clinical studies and guidelines has justified a review of the subject. This updated document, prepared by the Nephrolithiasis Committee of the Brazilian Society of Nephrology, reflects the advances in the management of patients with kidney stones. The guideline aims to provide recommendations for the diagnosis, prevention, and treatment of nephrolithiasis, based on the best available evidence. Topics covered include clinical evaluation, laboratory and imaging tests, as well as dietary and pharmacological interventions, and follow-up strategies.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240189"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Estimated glomerular filtration rate in clinical practice: consensus positioning of the Brazilian Society of Nephrology (SBN) and Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML).","authors":"","doi":"10.1590/2175-8239-JBN-2023-0193eren","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2023-0193eren","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/2175-8239-JBN-2023-0193en] [This corrects the article doi: 10.1590/2175-8239-JBN-2023-0193pt].</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20230193er"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}