Sousa, LM; Marques-Vieira, C; Severino, S; Pozo Rosado, JL; José, HM
Objetivo: verificar las propiedades psicométricas del Índice de bien-estar personal (IBP) en personas con enfermedad renal crónica en programa de hemodiálisis.
Método: Se trata de un estudio metodológico. La muestra aleatoria es constituida por 171 personas con Enfermedad Renal Crónica (ERC) sometida a hemodiálisis en dos clínicas en la región de Lisboa, Portugal. La recogida de datos fue realizada entre mayo y junio de 2015. Se evaluaron las propiedades psicométricas: validad (constructo, predictiva convergente, y discriminativa), confiabilidad por medio de la consistencia interna (α de Cronbach) y estabilidad (Coeficiente de Correlación de Spearman-Brown y Coeficiente de Correlación Intraclasse (CCI)).
Campos, P; Ortiz, A; Soto, K
Kidney diseases in human immunodeficiency virus (HIV)-infected patients are often misdiagnosed. Despite reductions in morbidity and mortality owing to widespread use of highly effective combination antiretroviral therapy (cART), acute kidney injury (AKI) and chronic kidney disease (CKD) are still more common in these patients than in the general population, and are associated with poor health outcomes. HIV-associated nephropathy and HIV immune complex kidney diseases are the more recognizable HIV-related kidney diseases. However, a broad spectrum of kidney disorders related or not directly related with HIV infection can be observed, including cART-induced AKI, CKD, proximal tubular dysfunction, crystalluria and urolithiasis, among...
The definition of a good glycemic control in patients with diabetes mellitus on hemodialysis is far from settled. In the general population, hemoglobin A1c is highly correlated with the average glycemia of the last 8-12 weeks. However, in hemodialysis patients, the correlation of hbA1c with glycemia is weaker as it also reflects changes in hemoglobin characteristics and red blood cells half-life. As expected, studies show that the association between HbA1c and outcomes in these patients differ from the general population. Therefore, the value of HbA1c in the treatment of hemodialysis patients has been questioned. Guidelines are generally cautious in their...
Coelho, S; Rodrigues, A
Almost half the patients on peritoneal dialysis are diabetic and glycemic control is essential to improve both patient and technique survival. Hemoglobin A1c (HbA1c) is widely used in the general population for diabetes diagnosis and monitoring as it highly correlates with blood glucose levels and outcomes. Its use has been extrapolated to the peritoneal dialysis population, despite HbA1c being commonly underestimated. In renal failure patients, HbA1c is influenced by variables affecting not only glycemia but also hemoglobin and the time of interaction between the two. Importantly, the impact of these variables differs in peritoneal dialysis compared to non-dialysis chronic kidney...
Cunha, L; Marcelino, G; Amaral, M; Alves, J
Introduction: Recent studies suggest that magnesium deficiency may play a role in inflammation. In diabetes
and cardio-vascular diseases, conditions with a component of chronic inflammation, C–reactive protein levels
are higher and associated with low serum magnesium. The objective of this study is to evaluate serum magnesium
levels in patients with systemic lupus erythematosus and its potential association with inflammation
and renal manifestations. Methods: All patients with systemic lupus erythematosus followed in a Systemic
Immune Diseases Unit, from January 2012 until January 2014, were included in this cross sectional analysis.
Patients with infection, neoplasia, liver failure and chronic kidney disease (stage > 3) were excluded. Clinical
Normal human metabolism leads to the daily production of large amounts of volatile and non-volatile
acids. The maintenance of the pH within physiological limits is a demanding task in which several mechanisms
are involved. The most immediate answer comes from several physiological buffers that quickly neutralize
pH deviations caused by the addition of strong acids or bases to the body. Bicarbonate/carbonic acid is the
most important buffer pair of the extracellular milieu, but is chemically inefficient and depends on the continuous
activity of the lung and kidney. Other physiological buffers have higher efficacy and are very important
in the intracellular environment and renal tubules. The capacity...
Domingos, F; Serra, A
Kidney stones and metabolic syndrome (MetS) are common conditions in industrialized countries. There is growing evidence of associations between kidney stone disease and MetS or some of its components. The link between uric acid stones and MetS is well understood, but the link with calcium oxalate (CaOx) stones, the most common kidney stone composition, is more complex, and MetS is frequently overlooked as a risk factor for calcium nephrolithiasis. The physiopathological mechanisms of kidney stone disease in MetS are reviewed in this article. Uric acid stones are a consequence of the excessively acidic urine that results from insulin resistance. The...
Coelho, S; Ortiz, F; Gelpir, R; Koskinen, P; Porta, N; Bestard, O; Melilli, E; Taco, O; Torras, J; Honkanen, E; Grinyó, J; Cruzado, J
Kidney allograft interstitial fibrosis and tubular atrophy (IF/TA) is associated with a poorer renal function and outcome. In the current clinical practice, an early diagnosis can only be provided by invasive tests. We aimed to investigate the association of sterile leukocyturia with Banff criteria histological findings in kidney allograft protocol biopsies. We studied 348 allograft biopsies from two different European countries performed at 8.5 + 3.5 months after transplantation. In these cases, the presence of sterile leukocyturia (Leuc+, n = 70) or no leukocyturia (Leuc-, n = 278) was analyzed and related to Banff elementary lesions. Only IF/TA was significantly...
Fidalgo, P; Ahmed, M; Myer, S; Lien, D; Weinkauf, J; Kapasi, A; Cardoso, F; Jackson, K; Bagshaw, S
Acute kidney injury (AKI) is a common occurrence after lung transplantation (LTx). Whether transient AKI or early recovery is associated with improved outcome is uncertain. Our aim was to describe the incidence, factors, and outcomes associated with transient AKI after LTx.
MATERIALS AND METHODS:
We performed a retrospective cohort study of all adult recipients of LTx at the University of Alberta between 1990 and 2011. Our primary outcome transient AKI was defined as return of serum creatinine below Kidney Disease-Improving Global Outcome AKI stage I within 7days after LTx. Secondary outcomes included occurrence of postoperative complications, mortality, and long-term kidney function.
Correia, P; Domingos, F
Gomes, A; Germano, A; Sousa, M; Rocha, R; Marinho, R; Campos, P; Fragoso, M; Pignatelli, N; Nunes, V
Introdução: O mapeamento vascular por ecografia e doppler é crucial no planeamento de um acesso vascular para hemodiálise.
O objectivo deste estudo é avaliar quais das variáveis anatómicas e hemodinâmicas arteriais e venosas, medidas por
ecografia e Doppler, se associam a permeabilidade global aos 12 meses nos acessos vasculares proximais.
Material e Métodos: Estudo observacional, analítico, longitudinal, com colheita retrospetiva de dados. Foram incluídos os
doentes admitidos no nosso hospital entre Janeiro de 2011 e Junho de 2013 para a criação de acesso vascular proximal para
hemodiálise como primeiro acesso, com mapeamento vascular por ecografia e doppler. Foram comparados os doentes com
permeabilidade de acesso aos...
Rodrigues, B; Natário, A; Vizinho, R; Jorge C, C; Weigert, A; Martinho, A; Toscano, C; Marques, T; Machado, D
Fungal infections are a rare but important cause of morbidity and mortality in kidney transplantation. Fungal contamination of the kidney preservation fluid may, sometimes, be the cause of these infections. However, the clinical consequences of fungal contamination of this fluid are not completely understood and literature on this topic is controversial. The purpose of this study was to determine the incidence of preservation fluid contamination by fungi and its clinical consequences.
From June 2010 to September 2011, a prospective cohort analysis was conducted at our center, enrolling all patients who received a renal allograft and whose perfusion fluid was analyzed for...
Coelho, S; Carrilho, P; Inchaustegui, L
A diabetes é uma patologia com uma prevalência crescente, que condiciona um importante impacto
negativo na morbilidade e mortalidade dos doentes, sendo a principal causa de doença renal crónica ter-
minal. O tratamento da diabetes no doente com doença renal crónica implica desafios adicionais nomea-
damente em relação à definição dos alvos glicémicos e da terapêutica utilizada para os atingir. Os autores
fazem uma revisão sobre o estado da arte da utilização dos agentes hipoglicimiantes na diabetes tipo 2
na perspectiva do profissional de saúde responsável por doentes com doença renal crónica.