{"title":"A realistic human model to teach physicians how to diagnose ascites using point-of-care ultrasound.","authors":"Marcus G Bastos","doi":"10.1590/2175-8239-JBN-2023-0034en","DOIUrl":"10.1590/2175-8239-JBN-2023-0034en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"502"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877116","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}
Aislander Junio da Silva, Ana Cristina Dos Santos Lopes, Ana Paula Lucas Mota, Ana Cristina Simões E Silva, Luci Maria Sant'Ana Dusse, Patrícia Nessralla Alpoim
{"title":"Pediatric chronic kidney disease: blood cell count indexes as inflammation markers.","authors":"Aislander Junio da Silva, Ana Cristina Dos Santos Lopes, Ana Paula Lucas Mota, Ana Cristina Simões E Silva, Luci Maria Sant'Ana Dusse, Patrícia Nessralla Alpoim","doi":"10.1590/2175-8239-JBN-2022-0190en","DOIUrl":"10.1590/2175-8239-JBN-2022-0190en","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes.</p><p><strong>Aim: </strong>To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII).</p><p><strong>Methods: </strong>We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group.</p><p><strong>Results: </strong>Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two.</p><p><strong>Conclusion: </strong>The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"458-469"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209384","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}
Fabiana Baggio Nerbass, Helbert do Nascimento Lima, Jocemir Ronaldo Lugon, Ricardo Sesso
{"title":"Hemodialysis in Brazil: differences across geographic regions regarding demographics, laboratory parameters and drug prescription.","authors":"Fabiana Baggio Nerbass, Helbert do Nascimento Lima, Jocemir Ronaldo Lugon, Ricardo Sesso","doi":"10.1590/2175-8239-JBN-2022-0169en","DOIUrl":"10.1590/2175-8239-JBN-2022-0169en","url":null,"abstract":"<p><strong>Introduction: </strong>Brazil has a vast territory divided into five geographic regions with important differences in sociodemographic indices. We aimed to present and compare socio-demographic characteristics, biochemical results, and drug prescription of patients on chronic hemodialysis (HD) treatment in the five geographic regions.</p><p><strong>Methods: </strong>We evaluated data from the Brazilian Dialysis Registry of all adult patients undergoing chronic HD in 2021. Variables included sociodemographic characteristics, serum levels of phosphate, calcium, and albumin, hemoglobin, urea reduction rate, and prescription of phosphate binders, erythropoietin, and intravenous iron. Data from the North and Northeast regions were combined into one group.</p><p><strong>Results: </strong>A total of 13,792 patients (57.9 ± 16.0 years old, 58.5% male, median HD vintage of 31 (11-66) months) from 73 dialysis centers were analyzed. Regional distribution was 59.5% in the Southeast; 21.7% in the South; 5.9% in the Midwest; and 12.9% in the North/Northeast. Sociodemographic features, biochemical results, and medication prescriptions differed across regions. The prevalence of elderly patients was lower in the Midwest and North/Northeast. The South region had the highest prevalence of hyperphosphatemia (41.2%) and urea reduction rate <65% (24.8%), while anemia and hypoalbuminemia were more prevalent in the Southeast, 32.7% and 11.6%, respectively.</p><p><strong>Conclusion: </strong>We found differences in socio-demographics, clinical features, and drug prescriptions across Brazilian geographic regions. Some findings reflect the socio-demographic diversity of the country, while others deserve further elucidation.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"410-416"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795817","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":"Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru.","authors":"Percy Herrera-Añazco, Moisés Apolaya Segura, Jessica Bravo-Zúñiga, Juan Lluncor Vásquez, Alvaro Taype-Rondán","doi":"10.1590/2175-8239-JBN-2022-0149en","DOIUrl":"10.1590/2175-8239-JBN-2022-0149en","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population.</p><p><strong>Objective: </strong>To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru).</p><p><strong>Methods: </strong>This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex.</p><p><strong>Results: </strong>An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high.</p><p><strong>Conclusion: </strong>HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"440-448"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823892","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}
Pedro Lisboa-Gonçalves, Adriana Santos, Teresa Pina-Vaz
{"title":"A silent presentation of massive staghorn calculi.","authors":"Pedro Lisboa-Gonçalves, Adriana Santos, Teresa Pina-Vaz","doi":"10.1590/2175-8239-JBN-2023-0072en","DOIUrl":"10.1590/2175-8239-JBN-2023-0072en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"495-496"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71481548","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":"mTOR inhibitors are the first-choice therapy for renal angiomyolipomas secondary to tuberous sclerosis.","authors":"Aline Grosskopf Monich, Mariana Faucz Munhoz da Cunha, Fellype Carvalho Barreto","doi":"10.1590/2175-8239-JBN-2023-0077en","DOIUrl":"10.1590/2175-8239-JBN-2023-0077en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"503-505"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877118","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}
Ayman Abd El-Hameed, Mohammed Fouad Ahmed, Ali Omar Ahmed Ehmemeed, Ahmad Mokhtar, Walid Ahmed Ragab Abdelhamid
{"title":"Assessment of humoral immune response to different COVID-19 vaccines in patients undergoing maintenance hemodialysis.","authors":"Ayman Abd El-Hameed, Mohammed Fouad Ahmed, Ali Omar Ahmed Ehmemeed, Ahmad Mokhtar, Walid Ahmed Ragab Abdelhamid","doi":"10.1590/2175-8239-JBN-2022-0184en","DOIUrl":"10.1590/2175-8239-JBN-2022-0184en","url":null,"abstract":"<p><strong>Introduction: </strong>The immune response to different Coronavirus Disease 2019 (COVID-19) vaccines is under-investigated in end-stage kidney disease (ESKD) patients, especially in the Middle East and North Africa. We carried out this research to estimate the effectiveness of COVID-19 immunization in ESKD patients on regular hemodialysis (HD).</p><p><strong>Methods: </strong>In this prospective observational study, we enrolled 60 ESKD patients on regular HD who had completed COVID-19 vaccination and 30 vaccinated healthy participants. Serum levels of severe acute respiratory syndrome coronavirus 2 immunoglobulin G (SARS-COV2 IgG) were quantified 1 month after completing the vaccination schedule, and all participants were followed up from October 2021 to March 2022. The vaccines used in the study were from Pfizer-BioNTech, AstraZeneca, and Sinopharm.</p><p><strong>Results: </strong>The median level of SARS-COV2 IgG was lower in HD patients than in healthy participants (p < 0.001). Regarding the type of COVID-19 vaccination, there was no statistical difference in SARS-COV2 IgG levels among HD patients. During the observation period, none of the HD patients had COVID-19.</p><p><strong>Conclusion: </strong>COVID-19 vaccination appeared to be protective in HD patients for 6 months and the side effects of vaccines were tolerable.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"417-423"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972377","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":"The importance of investigating frailty in chronic kidney disease.","authors":"Adriano Luiz Ammirati","doi":"10.1590/2175-8239-JBN-2023-E017en","DOIUrl":"10.1590/2175-8239-JBN-2023-E017en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"389-390"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71481552","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}
Marina Ribeiro de Oliveira Santos, Marcus Faria Lasmar, Evaldo Nascimento, Raquel Aparecida Fabreti-Oliveira
{"title":"Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients.","authors":"Marina Ribeiro de Oliveira Santos, Marcus Faria Lasmar, Evaldo Nascimento, Raquel Aparecida Fabreti-Oliveira","doi":"10.1590/2175-8239-JBN-2022-0150en","DOIUrl":"10.1590/2175-8239-JBN-2022-0150en","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of nutritional status on clinical outcome, graft survival (GS) and mortality risk in kidney transplant patients (KTP).</p><p><strong>Methods: </strong>In this retrospective cohort study including 451 KTP, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The patients were stratified into 3 groups according to the final score: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. The patients were monitored after transplantation at least 1 to 10 years.</p><p><strong>Results: </strong>Stratifying the 451 patients based on the pretransplant risk score, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p = 0.012). The incidence of infection in the patients from G3 was higher than patients from G1 and G2 (p = 0.030). G3 recipients showed worse GS than G1 patients (p = 0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996).</p><p><strong>Conclusions: </strong>KTP with higher malnutrition risk score were associated with worse outcomes and GS. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for kidney transplant.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"470-479"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826960","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}
Miguel Moyses Neto, Anderson Marliere Navarro, Marcio Dantas
{"title":"Malnutrition before kidney transplantation: how to assess it and what is the impact?","authors":"Miguel Moyses Neto, Anderson Marliere Navarro, Marcio Dantas","doi":"10.1590/2175-8239-JBN-2023-E014en","DOIUrl":"10.1590/2175-8239-JBN-2023-E014en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":" ","pages":"391-392"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71481550","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}