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

{"title":"Assessment of hyperparathyroidism secondary to CKD beyond laboratory tests: the important validation of the Parathyroid Assessment of Symptom (PAS) questionnaire for Portuguese language (Brazil).","authors":"Fellype Carvalho Barreto, Cássia Gomes da Silveira Santos","doi":"10.1590/2175-8239-JBN-2024-E009en","DOIUrl":"10.1590/2175-8239-JBN-2024-E009en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e2024E009"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716297","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":"Pregnancy in patients with chronic kidney disease undergoing dialysis.","authors":"Fernanda Salomão Gorayeb-Polacchini, Ana Flavia Moura, Claudio Luders, José Andrade Moura Neto, Juliana El Ghoz Leme, Dirceu Reis da Silva","doi":"10.1590/2175-8239-JBN-2024-0067en","DOIUrl":"10.1590/2175-8239-JBN-2024-0067en","url":null,"abstract":"<p><p>Women with chronic kidney disease are less likely to become pregnant and are more susceptible to pregnancy complications when compared to patients with normal kidney function. As a result, these are considered high-risk pregnancies, both maternal and fetal. Over the years, there has been an increase in the incidence of pregnancies in dialysis patients, and an improvement in maternal and fetal outcomes. It is believed that the optimization of obstetric and neonatal care, the adjustment of dialysis treatment (particularly the increase in the number of hours and weekly frequency of dialysis sessions), and the use of erythropoiesis-stimulating agents have provided better metabolic, volume, blood pressure, electrolyte, and anemia control. This review article aims to analyze pregnancy outcomes in chronic kidney disease patients undergoing dialysis and to review nephrological medical management in this scenario. Due to the growing interest in the subject, clinical recommendations for care practice have become more consistent in both drug and dialysis management, aspects that are addressed in this review.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20240067"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604544","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 prenatal corticosteroids on the maturation of renal tubules in preterm infants.","authors":"Jenny Ponce, Javier Cieza, Reyner Loza, Cristian León, Claudia Nuñez-Mochizaki","doi":"10.1590/2175-8239-JBN-2023-0035en","DOIUrl":"10.1590/2175-8239-JBN-2023-0035en","url":null,"abstract":"<p><strong>Introduction: </strong>The benefit of prenatal steroids in fetal lung maturation is well established, but their effect on the kidney has not been studied in detail in humans. Animal models have shown an increase in the expression of Na+/H+ exchangers, Na+-K+-ATPase pumps and aquaporin-1. This study aims to assess the effect of prenatal steroids on the maturation of renal tubules in preterms.</p><p><strong>Methods: </strong>21 preterms born between 24 and 34 weeks were included. Participants were divided into two groups according to their exposure to prenatal steroids. The maturation of tubular function was evaluated through the change of the fractional excretion of Na+, K+ and beta 2-microglobulin, the transtubular gradient of K+, urine pH, and osmolality.</p><p><strong>Results: </strong>The mean age was 30.57 ± 1.8 weeks and the mean weight was 1415 ± 267.8 grams. Baseline differences were not observed, except for a significant difference in the change in urinary excretion of beta 2-microglobulin (Group 1: 1 980 ± 9 075 ng/mL and Group 2: -7 274 ± 10 006 ng/mL, p = 0.04).</p><p><strong>Conclusions: </strong>Prenatal steroids showed no statistically significant difference on renal tubule maturation in preterms.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20230035"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11593545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716301","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":"Urinoma as a complication of cervical cancer.","authors":"Janio de Paula Santos, Rangel de Sousa Costa, Diogo Goulart Corrêa","doi":"10.1590/2175-8239-JBN-2024-0113en","DOIUrl":"10.1590/2175-8239-JBN-2024-0113en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20240113"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287605","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":"Exercise prescriptions for patients on hemodialysis in Brazil: a scoping review.","authors":"Heitor S Ribeiro, Francini P Andrade, Diogo V Leal, Juliana S Oliveira, Kenneth R Wilund, Maycon M Reboredo, João L Viana","doi":"10.1590/2175-8239-JBN-2024-0049en","DOIUrl":"10.1590/2175-8239-JBN-2024-0049en","url":null,"abstract":"<p><strong>Introduction: </strong>Exercise is being incorporated into the treatment of patients on hemodialysis; however, little is known about the major characteristics of these interventions.</p><p><strong>Objective: </strong>To describe the exercise protocols prescribed for hemodialysis patients in Brazil.</p><p><strong>Methods: </strong>A scoping review was conducted following JBI and Prisma-ScR guidelines. Searches were carried out in Medline, Embase and three other databases until May 2024. Other sources (websites, books and guidelines) were also investigated. Evidence from patients on hemodialysis describing exercise protocols in all settings and designs in Brazil was included.</p><p><strong>Results: </strong>Forty-five pieces of evidence were found, resulting in 54 exercise protocols from 16 Brazilian states. Strength exercises (33.3%), followed by aerobic exercises (22.2%), were the most prescribed, mainly to be performed during dialysis (85.2%). The most prevalent professionals supervising the programs were physiotherapists and exercise physiologists (37.0% and 18.5%, respectively). All protocols implemented the principles of type and frequency training, while progression was adopted in only 53.7%. The main prescription was three times per week (88.9%). Exercise intensity was predominantly determined by subjective methods (33.3%).</p><p><strong>Conclusion: </strong>Aerobic and strength exercises during dialysis were the most commonly prescribed modalities in Brazil, with the majority of programs being properly supervised by qualified professionals. However, existing protocols have not employed systematic progression throughout the intervention, which would be appropriate for providing better physiological responses and adaptations.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20240049"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287604","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":"Translation into Portuguese (Brazil), cultural adaptation and validation of Parathyroid Assessment of Symptoms (PAS) in patients with chronic kidney disease and hyperparathyroidism.","authors":"Rafael Costa E Campos, Rayssa Ruszkowski do Amaral, Marta Ribeiro Hentschke, Marcelo Garcia Toneto, Carlos Eduardo Poli-de-Figueiredo","doi":"10.1590/2175-8239-JBN-2022-0059en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2022-0059en","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is related to high morbidity and mortality and loss of quality of life. Likewise, hyperparathyroidism is associated to progressive loss of renal function, with increased phosphate and decrease calcium levels, which induce the secretion of parathyroid hormone.</p><p><strong>Objectives: </strong>To translate into Portuguese (Brazil), culturally adapt and validate the questionnaire Parathyroid Symptoms Assessment (PAS), following reliability and validity criteria in patients with chronic kidney disease and hyperparathyroidism.</p><p><strong>Methods: </strong>Methodological and cross-sectional study, carried out at São Lucas Hospital/PUCRS, Porto Alegre, Brazil. The PAS questionnaire validation process followed protocols from previous studies. After translating into Portuguese, it was applied to 100 patients with secondary (SHPT) and tertiary or persistent (THPT) hyperparathyroidism. For PAS validation data, patients responded to the Short Form Health 36 (SF-36) questionnaire. Reliability criteria were evaluated using intraclass correlation coefficient (ICC) and Cronbach's alpha (α-C). Validity was assessed by Spearman's correlation coefficient between PAS and SF-36 values.</p><p><strong>Results: </strong>Participant's mean age was 55.6 ± 15.6 years, 61% was male, and 68% was diagnosed with SHPT. Among 100 patients, 53% performed a PAS retest (ICC = 0.83). The internal reliability by α-C was 0.86. Negative correlations were observed between PAS questions and SF-36 physical and mental domains, which ranged from 0.3 to 0.7.</p><p><strong>Conclusion: </strong>The Brazilian version of the PAS questionnaire was found to be valid and reliable. The PAS questionnaire can be used to evaluate quality of life in Brazilian patients with hyperparathyroidism who speak Portuguese.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20220059"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465890","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 urinary tract infection on the outcome of the allograft in patients with kidney transplantation.","authors":"Rahul Sai Gangula, Mahesh Eshwarappa, R Rajashekar, Hamsa Reddy, Pooja Prakash Prabhu, Gireesh M Siddaiah, Gurudev Konana Chennabasappa, Lia Sara Anish, Yousuff Mohammad","doi":"10.1590/2175-8239-JBN-2024-0002en","DOIUrl":"10.1590/2175-8239-JBN-2024-0002en","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are the second most common cause of graft dysfunction, accounting for significant morbidity, and are associated with poor graft and patient survival. This study aimed to assess the association between post-renal transplant UTI and graft outcomes.</p><p><strong>Methods: </strong>We examined the effect of UTIs on graft outcomes in patients who underwent renal transplantation surgery between January 2010 and December 2022. The study population included 349 renal transplantations, of which 74 experienced 140 UTI events. Based on the number of UTI episodes, patients were categorized into three groups.</p><p><strong>Results: </strong>Of the 349 recipients, 275 (74.4%) had no UTI, 47 (18.8%) had non-recurrent UTIs (NR-UTIs), and 27 (6.8%) had recurrent UTIs (R-UTIs). Kaplan-Meier survival analysis showed that post-KT UTI status was a significant factor in graft survival, death-censored graft survival, and patient survival after a follow up of 5 years (log rank, P < 0.001). R-UTIs were associated with very poor graft survival and patient survival when compared with no UTI after a follow up of 5 years (hazard ratio [HR], 1.506; 95% confidence interval [CI], 1.233-1.840; P < 0.001 & HR, 1.529; 95% CI, 1.227-1.905; P = 0.001). R-UTIs were more likely to be associated with multi-drug resistant Gram-negative organisms (Klebsiella pneumonia or Escherichia coli) with resistance to nitrofurantoin (RR, 2.753; 95% CI, 1.257-6.032; P = 0.01) and carbapenem (RR, 2.064; 95% CI, 0.988-4.314; P = 0.05).</p><p><strong>Conclusion: </strong>Compared to no UTI, R-UTIs were associated to worse graft and patient outcomes after a follow-up of 5 years, whereas NR-UTIs were associated with poor graft and patient outcomes in the long term.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20240002"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287603","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":"Fenofibrate attenuates renal lipotoxicity in uninephrectomized mice with high-fat diet-induced obesity.","authors":"Barbara Bruna Abreu Castro, Petrus Ferreira Reno, Bianca Fatima Pereira, Kaique Arriel, Fabiana Bastos Bonato, Fernando Antonio Basile Colugnati, Marcos Antonio Cenedeze, Niels Olsen Saraiva-Camara, Helady Sanders-Pinheiro","doi":"10.1590/2175-8239-JBN-2023-0148en","DOIUrl":"10.1590/2175-8239-JBN-2023-0148en","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to investigate the role of fenofibrate, a peroxisome proliferator-activated receptor-α agonist, in obesity-induced kidney damage (lipotoxicity) in mice with uninephrectomy.</p><p><strong>Methods: </strong>C57BL/6 mice underwent uninephrectomy and sham surgeries and were fed normocaloric or high-fat diets. After 10 weeks, obese mice were administered 0.02% fenofibrate for 10 weeks. Kidney function and morphology were evaluated, as well as levels of inflammatory and fibrotic mediators and lipid metabolism markers.</p><p><strong>Results: </strong>High-fat diet-fed mice developed characteristic obesity and hyperlipidemia, with subsequent renal lipid accumulation and damage, including mesangial expansion, interstitial fibrosis, inflammation, and proteinuria. These changes were greater in obese uninephrectomy mice than in obese sham mice. Fenofibrate treatment prevented hyperlipidemia and glomerular lesions, lowered lipid accumulation, ameliorated renal dysfunction, and attenuated inflammation and renal fibrosis. Furthermore, fenofibrate treatment downregulated renal tissue expression of plasminogen activator inhibitor-1, monocyte chemoattractant protein-1, and local expression of fibroblast growth factor-21.</p><p><strong>Conclusion: </strong>Peroxisome proliferator-activated receptor-α activation by fenofibrate, with subsequent lipolysis, attenuated glomerular and tubulointerstitial lesions induced by renal lipotoxicity, thus protecting the kidneys of uninephrectomy mice from obesity-induced lesions. The study findings suggest a pathway in the pharmacological action of fenofibrate, providing insight into the mechanisms involved in kidney damage caused by obesity in kidney donors.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20230148"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465888","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":"Just a consequence of hunger or a sign of chronic kidney disease in children? The dilemma of growth failure in countries with regional disparities.","authors":"Marcelo de Sousa Tavares","doi":"10.1590/2175-8239-JBN-2024-E010en","DOIUrl":"10.1590/2175-8239-JBN-2024-E010en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e2024E010"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716303","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":"SGLT2 inhibitors and NLRP3 inflammasome: potential target in diabetic kidney disease.","authors":"Paulo André Bispo Machado Júnior, André Lass, Bruna Isadora Pilger, Raphaella Fornazari, Thyago Proença de Moraes, Ricardo Aurino Pinho","doi":"10.1590/2175-8239-JBN-2023-0187en","DOIUrl":"10.1590/2175-8239-JBN-2023-0187en","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) worldwide. The pathogenesis of DKD is influenced by functional, histopathological, and immune mechanisms, including NLRP3 inflammasome activity and oxidative stress. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown metabolic benefits and the ability to slow the progression of DKD in several clinical studies over the years. Recent studies suggest that the antidiabetic activity also extends to inhibition of the inflammatory response, including modulation of the NLRP3 inflammasome, reduction of pro-inflammatory markers and reduction of oxidative stress. Here we review the efficacy of SGLT2i in the treatment of CKD and discuss the role of the inflammatory response in the development of DKD, including its relationship to the NLRP3 inflammasome and oxidative stress.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20230187"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465889","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}