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

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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-2024-0092en","DOIUrl":"10.1590/2175-8239-JBN-2024-0092en","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":"e20240092"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287602","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":"Underscoring the challenges in the training of kidney transplant surgeons.","authors":"Renato Demarchi Foresto, Lúcio Requião-Moura","doi":"10.1590/2175-8239-JBN-2024-E011en","DOIUrl":"10.1590/2175-8239-JBN-2024-E011en","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":"e2024E011"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620668","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":"Chronic kidney disease stages and changes in ambulatory blood pressure monitoring: letter to the editor.","authors":"Hineptch Daungsupawong, Viroj Wiwanitkit","doi":"10.1590/2175-8239-JBN-2024-0128en","DOIUrl":"10.1590/2175-8239-JBN-2024-0128en","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":"e20240128"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406386","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":"Association between chronic kidney disease stages and changes in ambulatory blood pressure monitoring parameters.","authors":"André Murad Nagahama, Vanessa Dos Santos Silva, Vanessa Burgugi Banin, Roberto Jorge da Silva Franco, Pasqual Barretti, Silmeia Garcia Zanati Bazan, Luis Cuadrado Martin","doi":"10.1590/2175-8239-JBN-2024-0128rpen","DOIUrl":"10.1590/2175-8239-JBN-2024-0128rpen","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":"e20220128rp"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568928","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}