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

{"title":"Gout prevalence and management strategies among patients with moderate to advanced chronic kidney disease.","authors":"Dhajanae Sylvertooth, Brian Bieber, Roberto Pecoits-Filho, Brad Marder, Brian LaMoreaux, Angelo Karaboyas","doi":"10.1590/2175-8239-JBN-2025-0282en","DOIUrl":"10.1590/2175-8239-JBN-2025-0282en","url":null,"abstract":"<p><strong>Introduction: </strong>Gout commonly coexists with chronic kidney disease (CKD), with prevalence increasing as kidney function declines. Despite its burden, data on monitoring and treatment practices in CKD are limited. This study describes the prevalence, characteristics, and management of gout in non-dialysis CKD patients.</p><p><strong>Methods: </strong>Cross-sectional data were analyzed from 3,524 stages 3a-5 CKD patients in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) in Brazil (n = 942) and the United States (n = 2,582) at enrollment (2013-2022). History of gout was extracted from medical records.</p><p><strong>Results: </strong>Gout prevalence was 18.7% overall-20.5% in the US and 13.9% in Brazil-higher in stages 4-5 vs. 3a-3b CKD. Allopurinol was most used (Brazil 75%; US 62%). Colchicine (13%) and febuxostat (8%) were reported in the US but rarely in Brazil. Uric acid was measured in 70% of Brazilian vs. 33% of US gout patients.</p><p><strong>Conclusions: </strong>Gout is common in CKD, with notable cross-country differences in monitoring and treatment.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e20250282"},"PeriodicalIF":1.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716840","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":"Declaration of Santo Domingo: commitment to improve education, regulations, public policies, and access to peritoneal dialysis in Latin America.","authors":"Gustavo L Moretta-Pedernera, Alfonso Ramos-Sánchez, Laura Cortés-Sanabria, Rosana Chaúd-Covarrubias, Guillermo Álvarez-Estévez, Mauricio Uribe, Vicente Sánchez-Polo, José Carolino Divino-Filho, Natalia M Wasmuth-Troche, Ledisbeth Batista-Buitrago, Marta Avellán-Boza, Rodrigo Orozco-Bass, Héctor Martínez-Eusebio, René Soto-Velásquez, María Marina Papaginovic-Leiva, Martín Gómez-Luján, Sandra Rodríguez-Manzano, José Manuel Rodríguez-Chagolla, Daniel Alejandro Molina-Comboni, Yanet Álvarez-González, Pedro Javier Dávila Crespo, Erwin Iván Campos, José A Moura-Neto, Magda Hinojosa, Lourdes Carolina Vásquez-Jiménez, Gloria G García-Villalobos, Gabriela González, Eliana Dina-Batle, José R Álvarez-Novoa","doi":"10.1590/2175-8239-JBN-2026-SA01en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2026-SA01en","url":null,"abstract":"<p><p>The Santo Domingo Declaration highlights the challenges and opportunities to improve education, regulations, public policies, and access to peritoneal dialysis (PD) in Latin America. It emphasizes the need to address structural inequalities in training and care, establishing minimum competency standards and strengthening health infrastructure. Inspired by initiatives such as the Standardised Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) and the European Specialty Examination in Nephrology (ESENeph), the declaration underlines the importance of harmonizing nephrologist training to promote standardised and internationally aligned competencies. Additionally, it outlines strategies to prioritize patients' quality of life, ensure accessibility and economic sustainability, and foster the implementation of satellite units and innovative technologies. Finally, it calls for intersectoral collaboration to ensure inclusive and equitable healthcare in the region.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e2026SA01"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690219","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: Innovation in daily hemodialysis: high-flux vs. hemodiafiltration.","authors":"","doi":"10.1590/2175-8239-JBN-2026-E003ener","DOIUrl":"10.1590/2175-8239-JBN-2026-E003ener","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/2175-8239-JBN-2026-E003en] [This corrects the article doi: 10.1590/2175-8239-JBN-2026-E003pt].</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e2026E003er"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771861","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":"IL-18 on the rise: tracking inflammatory drift in hemodialysis patients - a pilot study.","authors":"Jessyca Sousa de Brito, Hugo de Luca Corrêa, Thiago Santos Rosa, Aline Figueiredo, Carlos Eduardo H V P F Braga, Denise Mafra","doi":"10.1590/2175-8239-JBN-2025-0310en","DOIUrl":"10.1590/2175-8239-JBN-2025-0310en","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin-18 (IL-18) is a pro-inflammatory cytokine associated with inflammaging and cellular senescence in chronic kidney disease (CKD).</p><p><strong>Objective: </strong>To evaluate longitudinal changes in plasma IL-18 levels in incident hemodialysis (HD) patients.</p><p><strong>Methods: </strong>An observational longitudinal study was conducted, with blood and anthropometric data collected at baseline, 6, and 12 months. IL-18 was measured by ELISA, and biochemical parameters were measured using Bioclin® kits.</p><p><strong>Results: </strong>Twenty-four patients (61.4 ± 3.5 years) were enrolled; 10 and 5 completed the 6- and 12-month assessments, respectively. IL-18 levels increased significantly at 6 months (p = 0.04) and at 12 months (p = 0.01) versus baseline and correlated positively with creatinine (r = 0.893; p = 0.04) and urea (r = 0.823; p = 0.05).</p><p><strong>Conclusion: </strong>In this pilot study with incident HD patients, plasma IL-18 increased over one year of treatment and was associated with uremia-related markers.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e20250310"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574144","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":"Factors that preclude the conclusion of a kidney transplant protocol from a living donor.","authors":"Alfonso Rodríguez Ojeda, Raúl Edgar Santacruz Adi, Nelly Gonzalez Audiffred, Rogelio Iván Silva Rueda, Fabiola Pazos Pérez, Maria Inés Gil Arredondo, Javier Rivera Flores, Jorge Velez Silva, Adriana Flores Palacios, Juan Carlos H Hernández Rivera","doi":"10.1590/2175-8239-JBN-2024-0157en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2024-0157en","url":null,"abstract":"<p><strong>Introduction: </strong>A kidney transplant (KT) is a renal replacement therapy that offers greater survival and quality of life; however, it is not always successfully completed due to social, physical, medical, immunological factors, or lack of adherence.</p><p><strong>Methods: </strong>This retrospective, analytical, longitudinal study included patients in the KT protocol from a living donor between May 2021 and November 2022. Factors preventing completion were evaluated. Comparative analyses and cumulative incidence curves were used to assess time to protocol completion or discontinuation. The analysis was performed using IBM SPSS Statistics, version 26 (IBM Corp., USA).</p><p><strong>Results: </strong>Among 240 donor-recipient pairs, 116 (48.3%) successfully completed KT, whereas 124 (51.6%) did not. Reasons for non-completion included medical causes (59/124; 47.6%), immunological incompatibility (28/124; 22.6%), psychosocial factors (14/124; 11.3%), and other causes (23/124; 18.5%). The median time to protocol acceptance or discontinuation was 151 days (IQR 115-186). Among individuals who ultimately underwent KT, the median completion time was also 151 days (IQR 109-231).</p><p><strong>Conclusions: </strong>Medical conditions were the predominant barriers to completing living-donor KT protocols, followed by immunologic and psychosocial factors. Streamlining medical assessments, implementing early immunologic screening, and reinforcing psychosocial support may enhance protocol completion rates.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e20240157"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771898","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":"Anti-PLA2R antibodies: implications for therapeutic planning and the prediction of remission in membranous nephropathy.","authors":"Gianna Mastroianni-Kirsztajn, Michelle T Passos Riguetti, Juliana Mansur Siliano","doi":"10.1590/2175-8239-JBN-2026-E009en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2026-E009en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e2026E009"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771929","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":"Battle of the giants: KDIGO vs. Cochrane - who is the winner in the fight for blood pressure targets in chronic kidney disease?","authors":"Cibele Isaac Saad Rodrigues, Ana Flávia Moura, Rodrigo Bezerra","doi":"10.1590/2175-8239-JBN-2025-0335en","DOIUrl":"10.1590/2175-8239-JBN-2025-0335en","url":null,"abstract":"<p><p>Hypertension (HTN) in chronic kidney disease (CKD) is often regarded as the main villain. It represents the leading cause of dialysis-dependent CKD in Brazil and the second most common worldwide, yet it is also a frequent consequence of renal disorders that induce secondary HTN. In other words, HTN in CKD is a double-edged sword-causing disease progression when primary and aggravating existing injury when secondary, through multiple pathophysiological mechanisms. The most frequently cited blood pressure targets for CKD management in the current scientific literature come from two major authorities in evidence-based recommendations: the 2024 KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guidelines and the 2024 Cochrane Library systematic review and meta-analysis. This article aims to examine and compare the blood pressure targets proposed for CKD by these two leading institutions.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e20250335"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627571","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":"Effect of lifestyle modification and atorvastatin on dyslipidemia and endothelial dysfunction markers in children with steroid resistant nephrotic syndrome.","authors":"Vanshika Kakkar, Abhijeet Saha, Prajal Agrawal, Sunita Sharma, Anita Nagia, Prachi Singh, Harish K Pemde","doi":"10.1590/2175-8239-JBN-2025-0212en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2025-0212en","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent dyslipidemia in children with steroid resistant nephrotic syndrome (SRNS) causes endothelial dysfunction resulting in adverse cardiovascular outcomes.</p><p><strong>Methods: </strong>Thirty-four patients aged 4-18 years newly diagnosed with SRNS and no previous statin use were enrolled in this longitudinal observational study. Serum levels of total cholesterol, LDL cholesterol, and endothelial dysfunction markers (PSCK-9, E-selectin) were measured at baseline and after 12 weeks of lifestyle modifications in all patients, and atorvastatin was prescribed to those with LDL-cholesterol > 160 mg/dL. Primary outcome measure was change in plasma levels of total cholesterol, LDL cholesterol, PSCK-9, and E-selectin at 12 weeks. The secondary outcome was the correlation of PSCK-9 and E-selectin with lipid profile, blood pressure, BMI, serum albumin, and urine-protein creatinine ratio.</p><p><strong>Results: </strong>There was a significant decline in total cholesterol, LDL cholesterol, E-selectin, and PCSK-9 levels at 12 weeks of lifestyle modification and atorvastatin therapy. In a subgroup analysis between the statin group (n = 16) and the non-statin group (n = 18), both groups showed a significant decline in lipid profile parameters with a more pronounced decline in the statin subgroup. Endothelial dysfunction markers (E-selectin and PSCK-9) showed a declining trend in both subgroups, but the decline was not statistically significant in the statin group.</p><p><strong>Conclusion: </strong>Dietary and lifestyle modifications led to a decline in endothelial dysfunction markers and an improvement in lipid profile. Statins helped improve dyslipidemia but did not significantly improve endothelial dysfunction markers at 12 weeks.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"e20250212"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815585","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 paradoxes of the new Dietary Guidelines for Americans (2025-2030): a critical analysis.","authors":"Carla Maria Avesani, Lilian Cuppari","doi":"10.1590/2175-8239-JBN-2026-PO01en","DOIUrl":"10.1590/2175-8239-JBN-2026-PO01en","url":null,"abstract":"<p><p>In January 2026, the new Dietary Guidelines for Americans were released, generating substantial international debate. Unlike previous editions, these guidelines were not primarily based on the report of the Dietary Guidelines Advisory Committee but on an independent scientific review, a process that raised concerns regarding transparency and potential conflicts of interest. This article critically examines the main recommendations of the new Dietary Guidelines for Americans, with particular emphasis on their implications for metabolic, cardiovascular, and kidney health. While the guidelines appropriately emphasize the reduction of ultra-processed food consumption and the promotion of minimally processed foods, several inconsistencies with contemporary scientific evidence are identified. Key concerns include the use of an outdated inverted food pyramid, a strong emphasis on high-protein intake (1.2-1.6 g/kg/day) predominantly from animal sources, and an internal contradiction between recommended protein intake and limits on saturated fat consumption. The proposed dietary pattern may also inadequately support gut microbiota health due to relatively low recommendations for fruits, vegetables, and whole grains. These issues may also be relevant to nephrology, given the growing popularity of high-protein diets and their potential renal implications. Overall, while the guidelines contain positive elements, their scientific coherence and alignment with established evidence-based dietary patterns remain questionable, potentially limiting their effectiveness as a public health tool.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 2","pages":"2026PO01"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503903","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 Dialysis Survey 2024.","authors":"Fabiana Baggio Nerbass, Helbert do Nascimento Lima, Bruno Zawadzki, José A Moura-Neto, Jocemir Ronaldo Lugon, Ricardo Sesso","doi":"10.1590/2175-8239-JBN-2025-0112en","DOIUrl":"10.1590/2175-8239-JBN-2025-0112en","url":null,"abstract":"<p><strong>Introduction: </strong>The annual Brazilian Dialysis Survey (BDS) plays an important role in informing and shaping national health policies.</p><p><strong>Objective: </strong>To present the 2024 epidemiological findings from the BDS conducted by the Brazilian Society of Nephrology (BSN) and compare them with previous years.</p><p><strong>Methods: </strong>A survey was conducted among Brazilian chronic dialysis centers through voluntary participation, utilizing an online questionnaire to assess clinical and epidemiological characteristics of dialysis patients, as well as dialysis center attributes. For specific estimates of prevalence, incidence, and funding source, a nationally representative random sample of dialysis centers stratified by geographic region was selected (n = 258).</p><p><strong>Results: </strong>A total of 386 dialysis centers (42.7%) voluntarily responded to the online questionnaire, and 162 centers from the randomly selected centers provided data. On July 1st, 2024, the estimated number of dialysis patients was 172,585, with 52,944 new patients starting dialysis in 2024. The estimated prevalence and incidence rates per million population (pmp) were 812 and 249, respectively. Among prevalent patients, 87.3% were undergoing hemodialysis, 7.1% hemodiafiltration, and 5.6% peritoneal dialysis. Compared to the previous year, there was an increase in catheter use for hemodialysis vascular access, along with higher prevalence rates of anemia, hyperphosphatemia, hyper-kalemia, and low Kt/V. The estimated crude annual mortality rate was 16.5%.</p><p><strong>Conclusions: </strong>Data from a random sample of dialysis centers indicate a continued rise in the number and prevalence of chronic dialysis patients in Brazil. Worsening trends in permanent vascular access, dialysis adequacy, and metabolic control underscore the need for targeted improvements in patient care.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 1","pages":"e20250112"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226760","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}