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

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Presence of Cryptosporidium spp and other enteroparasites with pathogenic potential in hemodialysis patients: an open controlled study. 血液透析患者中隐孢子虫和其他具有致病性的肠道寄生虫的存在:一项开放对照研究。
IF 1.3
Yara Leite Adami, Nycole Abreu Gama, Flavia de Souza Cunha, Regina Helena Saramago Peralta, Jocemir Ronaldo Lugon
{"title":"Presence of Cryptosporidium spp and other enteroparasites with pathogenic potential in hemodialysis patients: an open controlled study.","authors":"Yara Leite Adami, Nycole Abreu Gama, Flavia de Souza Cunha, Regina Helena Saramago Peralta, Jocemir Ronaldo Lugon","doi":"10.1590/2175-8239-JBN-2024-0015en","DOIUrl":"10.1590/2175-8239-JBN-2024-0015en","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization (WHO) points out that infection by enteroparasites can affect ~3.5 billion people around the world. Hemodialysis (HD) patients may be more susceptible to infections by opportunistic pathogens due to impaired immune function. We evaluated enteroparasite infection in a sample of HD-patients from two dialysis centers and in a control group.</p><p><strong>Methods: </strong>Fecal samples were processed using the Hoffmann-Pons-Janner, Ritchie, Willis, and Rugai techniques. Patients with kidney failure from two dialysis centers undergoing HD for more than 3 months were included. The control group consisted of relatives of the patients without overt CKD. The TaqMan PCR and multiplex real-time PCR were carried out for detection of Cryptosporidium spp. and C. parvum and to differentiate the Entamoeba (E.) histolytica/E. dispar complex, respectively.</p><p><strong>Results: </strong>A total of 97 HD patients and 42 controls were enrolled in the study. Fifty (51.5%) fecal samples from the HD group were positive for enteroparasites, as were 26 (61.9%) from the control group (P = 0.260). S. stercoralis was the single helminth detected and was only present in HD-patients. Coproscopy detected seven positive samples for the E. histolytica/E. dispar complex, three from HD patients and four from controls: by PCR, all samples were positive for the non-pathogenic E. dispar. Safranin-stained fecal smear slides were all negative for Cryptosporidium spp. However, by PCR, amplification for Crypstosporidium spp. was seen in six samples, all from the HD patients. Two of the species were classified as C. hominis by PCR-RFLP.</p><p><strong>Conclusions: </strong>Enteroparasite infection as detected by traditional techniques were not more prevalent in HD patients, but S. stercoralis was only found in these patients. It is noteworthy that Cryptosporidium spp. infection, also affecting only HD patients, could only be detected by molecular biology techniques.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240015"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949131","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}
引用次数: 0
Onconephrology: a new frontier in medicine. 精神病学:医学的新前沿。
IF 1.3
Carolina Maria Pozzi, Juliana El Ghoz Leme
{"title":"Onconephrology: a new frontier in medicine.","authors":"Carolina Maria Pozzi, Juliana El Ghoz Leme","doi":"10.1590/2175-8239-JBN-2025-E004en","DOIUrl":"10.1590/2175-8239-JBN-2025-E004en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e2025E004"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573033","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}
引用次数: 0
Phosphate binder in dialysis: a cross-sectional study of patients' adherence and pill burden. 透析中的磷酸盐粘合剂:患者依从性和药丸负担的横断面研究。
IF 1.3
Brunelle Bruna Scavello Coelho Ferezin, Luiza Karla Ramos Pereira de Araújo, Carolina Marquez Lima, Hugo Abensur, Benedito Jorge Pereira, Maria Aparecida Dalboni, Rosa Maria Affonso Moyses, Rosilene Motta Elias
{"title":"Phosphate binder in dialysis: a cross-sectional study of patients' adherence and pill burden.","authors":"Brunelle Bruna Scavello Coelho Ferezin, Luiza Karla Ramos Pereira de Araújo, Carolina Marquez Lima, Hugo Abensur, Benedito Jorge Pereira, Maria Aparecida Dalboni, Rosa Maria Affonso Moyses, Rosilene Motta Elias","doi":"10.1590/2175-8239-JBN-2024-0075en","DOIUrl":"10.1590/2175-8239-JBN-2024-0075en","url":null,"abstract":"<p><strong>Introduction: </strong>Phosphate (P) binders are among the most common medications prescribed to control P levels in patients with chronic kidney disease on dialysis. There is still a paucity of data on adherence to P binders with no comparison between dialysis modalities.</p><p><strong>Methods: </strong>We accessed factors associated with P binder adherence among patients on dialysis in an academic hospital. Adherence was calculated as the ratio between the number of pills taken per day as reported and the prescribed number of pills. Patients were considered non-adherent if adherence was at least 20% less or 30% more than prescribed.</p><p><strong>Results: </strong>Patients (N = 137) were young, mostly women, and on dialysis for a median time of 53 months. Sevelamer and calcium carbonate were prescribed as P binders to 70.8% and 10.2% of patients, respectively, with no difference across dialysis modalities (p = 0.839). P correlated with the number of pills prescribed (r = 0.368, p = 0.001) and the number of pills taken per day (r = 0.275, p = 0.001). Hyperphosphatemia was found in 52 patients (36.4%). Adherence to Ca carbonate and sevelamer was 100% and 68.4%, respectively. Non-adherent patients were women, younger, with higher serum albumin and urea, and lower serum calcium. Logistic regression showed that female sex (HR 3.30, 95% CI: 1.39-7.84, p = 0.007) and hemodialysis vs. peritoneal dialysis (HR 4.55, 95%, CI: 1.26-16.39, p = 0.021) remained independently associated with a non-adherence behavior.</p><p><strong>Conclusions: </strong>The current study suggests that strategies to increase adherence should be implemented. Whether phosphate binder adherence is associated with better outcomes deserves further investigation.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240075"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005502","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}
引用次数: 0
Real-world cost-effectiveness analysis of thymoglobulin versus no induction therapy in kidney transplant recipients at low risk of graft loss. 在低移植损失风险的肾移植受者中,胸腺球蛋白与无诱导治疗的实际成本-效果分析。
IF 1.3
Adrieli Barros Bessa, Marina Pontello Cristelli, Claudia Rosso Felipe, Renato Demarchi Foresto, Marcelo Cunio Machado Fonseca, Jose Medina Pestana, Helio Tedesco-Silva
{"title":"Real-world cost-effectiveness analysis of thymoglobulin versus no induction therapy in kidney transplant recipients at low risk of graft loss.","authors":"Adrieli Barros Bessa, Marina Pontello Cristelli, Claudia Rosso Felipe, Renato Demarchi Foresto, Marcelo Cunio Machado Fonseca, Jose Medina Pestana, Helio Tedesco-Silva","doi":"10.1590/2175-8239-JBN-2024-0060en","DOIUrl":"10.1590/2175-8239-JBN-2024-0060en","url":null,"abstract":"<p><strong>Background: </strong>A new induction therapy strategy of a single 3 mg/kg dose of rabbit antithymocyte globulin (r-ATG) showed a lower incidence of acute rejection.</p><p><strong>Methods: </strong>The objective of this study was to use real-world data to determine the incremental cost-effectiveness ratio (ICER) of r-ATG induction for the prevention of acute rejection (AR) in the first year following kidney transplantation and for kidney graft survival over 1, 4, and 10 years of post-transplantation from the perspective of the national public healthcare system. A Markov state transition model was developed utilizing real-world data extracted from medical invoices from a single center. The study population consisted of adults at low immunological risk undergoing their initial transplantation and received kidneys from either living or deceased donors. The intervention of r-ATG induction was compared to no induction. The clinical outcomes considered for this analysis were acute rejection, cytomegalovirus infection/disease, death, graft loss, and retransplantation.</p><p><strong>Results: </strong>The cost-effectiveness analysis in the first year revealed that the r-ATG group was more cost-effective, with an ICER of US$ 399.96 per avoided AR episode, an effectiveness gain of 0.01 year in graft survival and a total incremental cost of US$ 147.50. The 4- and 10-year analyses revealed an effectiveness gain of 0.06 and 0.16 years in graft survival in the r-ATG induction group, and a total incremental cost of US$ -321.68 and US$ -2,440.62, respectively.</p><p><strong>Conclusion: </strong>The single 3 mg/kg dose of r-ATG is cost-effective in preventing acute rejection episodes and dominant in the long term of transplantation, conferring survival gain.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240060"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949134","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}
引用次数: 0
Renal long COVID-19: an ongoing debate requiring robust evidence. 肾长COVID-19:需要强有力证据的持续辩论。
IF 1.3
Heitor S Ribeiro, Emmanuel A Burdmann, Luis Yu
{"title":"Renal long COVID-19: an ongoing debate requiring robust evidence.","authors":"Heitor S Ribeiro, Emmanuel A Burdmann, Luis Yu","doi":"10.1590/2175-8239-JBN-2025-E001en","DOIUrl":"10.1590/2175-8239-JBN-2025-E001en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e2025E001"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515703","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}
引用次数: 0
Should a low-protein diet and ketoanalogue supplementation be part of the management of advanced chronic kidney disease? 低蛋白饮食和补充类酮应该成为晚期慢性肾病治疗的一部分吗?
IF 1.3
Yoko Narasaki, Hyung-Ah Jo, Connie M Rhee
{"title":"Should a low-protein diet and ketoanalogue supplementation be part of the management of advanced chronic kidney disease?","authors":"Yoko Narasaki, Hyung-Ah Jo, Connie M Rhee","doi":"10.1590/2175-8239-JBN-2024-0237en","DOIUrl":"10.1590/2175-8239-JBN-2024-0237en","url":null,"abstract":"<p><p>The vast majority of patients with advanced chronic kidney disease (CKD) who transition to end-stage kidney disease (ESKD) are treated with dialysis. Given that dialysis does not always have the intended effects of increasing longevity and/or improving health, particularly in those with high comorbidity burden and/or older age groups, there has been increasing emphasis on interventions that delay or avert the need for renal replacement therapy. Among the multi-disciplinary approaches used to reduce CKD progression, dietary interventions are a major cornerstone. Current guidelines support the role of a low-protein diet in patients with moderate to advanced CKD who are metabolically stable. In addition to dietary protein amount, there is evidence that dietary protein sources as well as nutrients in plant-based foods have an important impact on kidney health outcomes. Clinical practice guidelines, including the 2020 National Kidney Foundation and Academy of Nutrition and Dietetics Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in CKD, recommend a low protein diet for patients with moderate to advanced non-dialysis dependent (NDD)-CKD who are metabolically stable to reduce risk of ESKD and death. In addition to recommending lower protein intake, the recent 2024 Kidney Disease Improving Global Outcomes CKD Guidelines include a Practice Point advising that people with CKD eat more plant-based foods than animal-based foods. Increasing data also show that plant-based diets are associated with lower risk of progression of CKD and its complications including cardiovascular disease (cardio-kidney-metabolic syndrome), acid-base balance disorders, mineral bone disease, and dysglycemia.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240237"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604851","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}
引用次数: 0
Delving into the complexities of the interplay between acute kidney injury and diabetic kidney disease: A focus on glycemic control and outcomes. 深入探讨急性肾损伤与糖尿病肾病之间相互作用的复杂性:关注血糖控制和结果。
IF 1.3
Érika Bevilaqua Rangel
{"title":"Delving into the complexities of the interplay between acute kidney injury and diabetic kidney disease: A focus on glycemic control and outcomes.","authors":"Érika Bevilaqua Rangel","doi":"10.1590/2175-8239-JBN-2024-0074en","DOIUrl":"10.1590/2175-8239-JBN-2024-0074en","url":null,"abstract":"<p><p>Patients with diabetic kidney disease (DKD) face an elevated risk of experiencing acute kidney injury (AKI), exacerbating the progression of DKD. This article offers a comprehensive review of the literature and knowledge of the primary pathophysiologic mechanisms underlying kidney damage, as well as the biological implications of maladaptive kidney repair in the context of DKD complicated by AKI. Additionally, we examine in detail the findings of clinical trials evaluating the efficacy and safety of intensive insulin treatment for hyperglycemic patients in intensive care units, alongside the potential risks of hypoglycemia and mortality. Furthermore, through critical analysis of clinical trial results, opportunities for personalized safety-based approaches to mitigate side effects are identified. It is imperative to conduct randomized-controlled studies to assess the impact of intensive insulin treatment on diabetic patients with DKD, and to validate AKI biomarkers in this patient population. Such studies will help to tailor treatment strategies to improve patient outcomes and preserve kidney function.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240074"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828562","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}
引用次数: 0
Feasibility of the Hemomindful Program: a mindfulness-based program performed during hemodialysis. 血液心灵计划的可行性:在血液透析过程中实施的心灵计划。
IF 1.3
Angélica Nickel Adamoli, Bruno Nunes Razzera, Raphaele Nonnenmacher Colferai, Maitê Freitas Ranheiri, Wagner de Lara Machado, Ana Maria Pandolfo Feoli, Ana Regina Noto, Margareth da Silva Oliveira
{"title":"Feasibility of the Hemomindful Program: a mindfulness-based program performed during hemodialysis.","authors":"Angélica Nickel Adamoli, Bruno Nunes Razzera, Raphaele Nonnenmacher Colferai, Maitê Freitas Ranheiri, Wagner de Lara Machado, Ana Maria Pandolfo Feoli, Ana Regina Noto, Margareth da Silva Oliveira","doi":"10.1590/2175-8239-JBN-2024-0068en","DOIUrl":"10.1590/2175-8239-JBN-2024-0068en","url":null,"abstract":"<p><strong>Introduction: </strong>Recent evidence indicates that mindfulness-based programs (MBPs) improve overall well-being and the ability to cope with kidney failure and hemodialysis stressors. However, intradialytic MBPs are poorly investigated.</p><p><strong>Objective: </strong>The aim of this study was to describe the study protocol, evaluate the feasibility and perceived effects of the Hemomindful Program.</p><p><strong>Methods: </strong>The results presented are from a mixed-methods randomized controlled trial. Thirty-two adults with kidney failure were randomized into the Hemomindful Program, which consisting of 8 weekly individual sessions of 1 hour delivered at chairside during hemodialysis combined with the treatment as usual (TAU), or TAU alone. Feasibility was assessed based on retention of the study protocol, adherence to the Hemomindful Program, its safety, and participant satisfaction. Semi-structured interviews were conducted with participants in the intervention arm immediately following treatment. Data were analyzed using descriptive statistics and discursive textual analysis.</p><p><strong>Results: </strong>The overall rate of adherence to the study protocol was 84.38%. Among the participants in the Hemomindful Program (n = 16), 15 had four or more sessions (93.7%) and 12 completed the protocol (75%). Degree of importance attributed to the intervention was 8.58 (SD = 2.06) and intention to maintain the formal and informal mindfulness practices after the intervention was 6.67 (SD = 2.93) and 8.5 (SD = 2.31). The qualitative analysis indicated satisfaction with the perceived changes (greater awareness in daily activities, less reactivity, management of pain and discomfort) and the structure of the program.</p><p><strong>Conclusion: </strong>The Hemomindful Program showed positive indicators of feasibility, with good retention, acceptability and safety.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240068"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828564","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}
引用次数: 0
I Brazilian guideline on hypertension in dialysis of the Brazilian Society of Nephrology. 1巴西肾病学会透析高血压指南。
IF 1.3
Cibele Isaac Saad Rodrigues, Sebastião Rodrigues Ferreira-Filho, Ana Flávia de Souza Moura, Carlos Eduardo Poli-de-Figueiredo, Dirceu Reis da Silva, Fernanda Salomão Gorayeb Polacchini, Fernando Antônio de Almeida, Maria Eliete Pinheiro, Rodrigo Bezerra, Rogério Baumgratz de Paula, Aldo José Peixoto, Ana Elizabeth Prado Lima Figueiredo, Audes Diógenes Magalhães Feitosa, Carlos Alberto Machado, Celso Amodeo, Décio Mion Junior, Elizabeth Silaid Muxfeldt, Giovanio Vieira da Silva, José Andrade Moura-Neto, José Muniz Pazeli Júnior, Leda Daud Lotaif, Luciano F Drager, Luis Cuadrado Martín, Luiz Aparecido Bortolotto, Marcus Gomes Bastos, Marcus Vinícius Bolívar Malachias, Marcos Vinícius Paiva Cavalcanti Moreira, Maria Eugenia Fernandes Canziani, Roberto Dischinger Miranda, Roberto Jorge da Silva Franco, Roberto Pecoits Filho, Rogerio Andrade Mulinari, Rosilene Motta Elias, Weimar Kunz Sebba Barroso, Wilson Nadruz
{"title":"I Brazilian guideline on hypertension in dialysis of the Brazilian Society of Nephrology.","authors":"Cibele Isaac Saad Rodrigues, Sebastião Rodrigues Ferreira-Filho, Ana Flávia de Souza Moura, Carlos Eduardo Poli-de-Figueiredo, Dirceu Reis da Silva, Fernanda Salomão Gorayeb Polacchini, Fernando Antônio de Almeida, Maria Eliete Pinheiro, Rodrigo Bezerra, Rogério Baumgratz de Paula, Aldo José Peixoto, Ana Elizabeth Prado Lima Figueiredo, Audes Diógenes Magalhães Feitosa, Carlos Alberto Machado, Celso Amodeo, Décio Mion Junior, Elizabeth Silaid Muxfeldt, Giovanio Vieira da Silva, José Andrade Moura-Neto, José Muniz Pazeli Júnior, Leda Daud Lotaif, Luciano F Drager, Luis Cuadrado Martín, Luiz Aparecido Bortolotto, Marcus Gomes Bastos, Marcus Vinícius Bolívar Malachias, Marcos Vinícius Paiva Cavalcanti Moreira, Maria Eugenia Fernandes Canziani, Roberto Dischinger Miranda, Roberto Jorge da Silva Franco, Roberto Pecoits Filho, Rogerio Andrade Mulinari, Rosilene Motta Elias, Weimar Kunz Sebba Barroso, Wilson Nadruz","doi":"10.1590/2175-8239-JBN-2024-0033en","DOIUrl":"10.1590/2175-8239-JBN-2024-0033en","url":null,"abstract":"<p><p>Hypertension in dialysis patients (HTND) has a high prevalence, affecting at least 80% or more of patients, and its management in the nephrology practice is heterogeneous and often empirical. Knowing how to define, understand the pathophysiology, diagnose, monitor and treat with lifestyle changes, and adjust antihypertensive drugs to achieve the recommended blood pressure (BP) target - to reduce morbidity and mortality - requires specific knowl-edge and approaches within the contexts of hemodialysis (HD) and peritoneal dialysis (PD). This document is the first guideline of the Brazilian Society of Nephrology, developed by the departments of Hypertension and Dialysis. It aims to guide physicians who provide care in dialysis centers on how to manage patients with HTND, in a comprehensive and individualized manner, based on the critical appraisal of the best available scientific evidence. When such evidence is scarce or unavailable, the opinion of specialists should be recommended. The different topics covered include HTND definition (pre-HD BP ≥ 140/90 mmHg and post-HD BP ≥ 130/80 mmHg), epidemiology, and pathophysiology; diagnosis of HTND preferably with BP measurements outside the dialysis setting (BP ≥ 130/80 mmHg); complementary assessment; blood pressure targets; non-pharmacological treatment; use of the most appropriate antihypertensive medications; special situations; and complications of HTND, predominantly cardiovascular ones.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240033"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515701","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}
引用次数: 0
Potentially paraneoplastic glomerulopathies in a Brazilian cohort: a retrospective analysis. 巴西队列中潜在的副肿瘤肾小球病变:回顾性分析。
IF 1.3
Marcella Soares Laferreira, Gianna Mastroianni Kirsztajn
{"title":"Potentially paraneoplastic glomerulopathies in a Brazilian cohort: a retrospective analysis.","authors":"Marcella Soares Laferreira, Gianna Mastroianni Kirsztajn","doi":"10.1590/2175-8239-JBN-2024-0131en","DOIUrl":"10.1590/2175-8239-JBN-2024-0131en","url":null,"abstract":"<p><strong>Introduction: </strong>Glomerular diseases can be associated with solid or hematopoietic malignancies. The prevalence of these associations varies according to the studied glomerular disease. This study aimed to evaluate the frequency and type of neoplasms in patients with glomerular diseases as well as their clinical, laboratory, and histopathological features and the relationship with immunosuppressive therapy.</p><p><strong>Methods: </strong>This was a retrospective, descriptive, observational, longitudinal study that reviewed 4,820 medical records and included 95 patients with glomerular disease and neoplasms. Demographic, clinical, laboratory, and histologic data were collected.</p><p><strong>Results: </strong>The prevalence of neoplasms was 1.97% (95 patients; 81 [85.3%] malignant, 14 [14.7%] benign). Hematologic malignancies (35.8%) showed the highest prevalence, followed by colon, rectal, and gynecologic tumors. The glomerulopathy with the highest frequency was membranous glomerulopathy (MGN, 25 patients, 35.7%). The dose of the immunosuppressive agents among patients with neoplasms before or after immunosuppression was not statistically different. Neoplasm was diagnosed before glomerulopathy in 53% of patients. Among cases in which neoplasms were diagnosed after glomerulopathy, 43% were diagnosed in the first year of follow-up of the renal disease. The predominant syndrome at presentation was nephrotic syndrome. Progression to chronic kidney disease stage 5 at the end of follow-up occurred in 8.4% of the cases.</p><p><strong>Conclusions: </strong>Neoplasms manifested before or, less frequently, after the diagnosis of glomerular diseases. As neoplasms diagnosed after presentation of glomerulopathy often appeared early after this diagnosis, it is necessary to be aware of neoplasms during the first year of follow-up of glomerulopathies, especially in patients with nephrotic syndrome, and MGN.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240131"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059081","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}
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