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205 results on '"D'Avila, Domingos"'

1. Mayo Clinic Consensus Report on Membranous Nephropathy: Proposal for a Novel Classification

Author

Sethi, Sanjeev, Beck, Laurence H., Jr., Glassock, Richard J., Haas, Mark, De Vriese, An S., Caza, Tiffany N., Hoxha, Elion, Lambeau, Gérard, Tomas, Nicola M., Madden, Benjamin, Debiec, Hanna, D’Agati, Vivette D., Alexander, Mariam P., Amer, Hatem, Appel, Gerald B., Barbour, Sean J., Caravaca-Fontan, Fernando, Cattran, Daniel C., Casal Moura, Marta, D’Avila, Domingos O., Eick, Renato G., Garovic, Vesna D., Greene, Eddie L., Herrera Hernandez, Loren P., Jennette, J. Charles, Lieske, John C., Markowitz, Glen S., Nath, Karl A., Nasr, Samih H., Nast, Cynthia C., Pani, Antonello, Praga, Manuel, Remuzzi, Giuseppe, Rennke, Helmut G., Ruggenenti, Piero, Roccatello, Dario, Soler, Maria Jose, Specks, Ulrich, Stahl, Rolf A.K., Singh, Raman Deep, Theis, Jason D., Velosa, Jorge A., Wetzels, Jack F.M., Winearls, Christopher G., Yandian, Federico, Zand, Ladan, Ronco, Pierre, and Fervenza, Fernando C.

Published
2023
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2. Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Author

Perkovic, Vlado, Mahaffey, Kenneth W., Agarwal, Rajiv, Bakris, George, Brenner, Barry M., Cannon, Christopher P., Charytan, David M., de Zeeuw, Dick, Greene, Tom, Jardine, Meg J., Heerspink, Hiddo J.L., Levin, Adeera, Meininger, Gary, Neal, Bruce, Pollock, Carol, Wheeler, David C., Zhang, Hong, Zinman, Bernard, Jardine, Meg, Li, Nicole, Kolesnyk, Inna, Aizenberg, Diego, Pecoits-Filho, Roberto, Cherney, David, Obrador, Gregorio, Chertow, Glenn, Chang, Tara, Hawley, Carmel, Ji, Linong, Wada, Takashi, Jha, Vivekanand, Lim, Soo Kun, Lim-Abrahan, Mary Anne, Santos, Florence, Chae, Dong-Wan, Hwang, Shang-Jyh, Vazelov, Evgueniy, Rychlík, Ivan, Hadjadj, Samy, Krane, Vera, Rosivall, László, De Nicola, Luca, Dreval, Alexander, Nowicki, Michał, Schiller, Adalbert, Distiller, Larry, Górriz, Jose L., Kolesnyk, Mykola, David, Wheeler, C., Guerrero, Rodolfo Andres Ahuad, Albisu, Juan Pablo, Alvarisqueta, Andres, Bartolacci, Ines, Berli, Mario Alberto, Bordonava, Anselmo, Calella, Pedro, Cantero, Maria Cecilia, Cartasegna, Luis Rodolfo, Cercos, Esteban, Coloma, Gabriela Cecilia, Colombo, Hugo, Commendatore, Victor, Cuadrado, Jesus, Cuneo, Carlos Alberto, Cusumano, Ana Maria, Douthat, Walter Guillermo, Dran, Ricardo Dario, Farias, Eduardo, Fernandez, Maria Florencia, Finkelstein, Hernan, Fragale, Guillermo, Fretes, Jose Osvaldo, Garcia, Nestor Horacio, Gastaldi, Anibal, Gelersztein, Elizabeth, Glenny, Jorge Archibaldo, Gonzalez, Joaquin Pablo, Colaso, Patricia del Carmen Gonzalez, Goycoa, Claudia, Greloni, Gustavo Cristian, Guinsburg, Adrian, Hermida, Sonia, Juncos, Luis Isaias, Klyver, Maria Isabel, Kraft, Florencia, Krynski, Fernando, Lanchiotti, Paulina Virginia, Leon de la Fuente, Ricardo Alfonso, Marchetta, Nora, Mele, Pablo, Nicolai, Silvia, Novoa, Pablo Antonio, Orio, Silvia Ines, Otreras, Fabian, Oviedo, Alejandra, Raffaele, Pablo, Resk, Jorge Hector, Rista, Lucas, Papini, Nelson Rodriguez, Sala, Jorgelina, Santos, Juan Carlos, Schiavi, Lilia Beatriz, Sessa, Horacio, Casabella, Tomas Smith, Ulla, Maria Rosa, Valdez, Maria, Vallejos, Augusto, Villarino, Adriana, Visco, Virginia Esther, Wassermann, Alfredo, Zaidman, Cesar Javier, Cheung, Ngai Wah, Droste, Carolyn, Fraser, Ian, Johnson, David, Mah, Peak Mann, Nicholls, Kathy, Packham, David, Proietto, Joseph, Roberts, Anthony, Roger, Simon, Tsang, Venessa, Raduan, Roberto Abrão, Costa, Fernando Augusto Alves da, Amodeo, Celso, Turatti, Luiz Alberto Andreotti, Bregman, Rachel, Sanches, Fernanda Cristina Camelo, Canani, Luis Henrique, Chacra, Antônio Roberto, Borges, João Lindolfo Cunha, Vêncio, Sérgio Alberto Cunha, Franco, Roberto Jorge da Silva, d’Avila, Domingos, Portes, Evandro de Souza, de Souza, Pedro, Deboni, Luciane Mônica, Fraige Filho, Fadlo, Neto, Bruno Geloneze, Gomes, Marcus, Kohara, Suely Keiko, Keitel, Elizete, Saraiva, Jose Francisco Kerr, Lisboa, Hugo Roberto Kurtz, Contieri, Fabiana Loss de Carvalho, Milagres, Rosângela, Junior, Renan Montenegro, de Brito, Claudia Moreira, Hissa, Miguel Nasser, Sabbag, Ângela Regina Nazario, Noronha, Irene, Panarotto, Daniel, Filho, Roberto Pecoits, Pereira, Márcio Antônio, Saporito, Wladmir, Scotton, Antonio Scafuto, Schuch, Tiago, de Almeida, Roberto Simões, Ramos, Cássio Slompo, Felício, João Soares, Thomé, Fernando, Hachmann, Jean Carlo Tibes, Yamada, Sérgio, Hayashida, Cesar Yoiti, Petry, Tarissa Beatrice Zanata, Zanella, Maria Teresa, Andreeva, Viktoria, Angelova, Angelina, Dimitrov, Stefan, Genadieva, Veselka, Genova-Hristova, Gabriela, Hristozov, Kiril, Kamenov, Zdravko, Koundurdjiev, Atanas, Lozanov, Lachezar, Margaritov, Viktor, Nonchev, Boyan, Rangelov, Rangel, Shinkov, Alexander, Temelkova, Margarita, Velichkova, Ekaterina, Yakov, Andrian, Aggarwal, Naresh, Aronson, Ronnie, Bajaj, Harpreet, Chouinard, Guy, Conway, James, Cournoyer, Serge, DaRoza, Gerald, De Serres, Sacha, Dubé, François, Goldenberg, Ronald, Gupta, Anil, Gupta, Milan, Henein, Sam, Khandwala, Hasnain, Leiter, Lawrence, Madore, François, McMahon, Alan, Muirhead, Norman, Pichette, Vincent, Rabasa-Lhoret, Remi, Steele, Andrew, Tangri, Navdeep, Torshizi, Ali, Woo, Vincent, Zalunardo, Nadia, Montenegro, María Alicia Fernández, Gonzalo Godoy Jorquera, Juan, Fariña, Marcelo Medina, Gajardo, Victor Saavedra, Vejar, Margarita, Chen, Nan, Chen, Qinkai, Gan, Shenglian, Kong, Yaozhong, Li, Detian, Li, Wenge, Li, Xuemei, Lin, Hongli, Liu, Jian, Lu, Weiping, Mao, Hong, Ren, Yan, Song, Weihong, Sun, Jiao, Sun, Lin, Tu, Ping, Wang, Guixia, Yang, Jinkui, Yin, Aiping, Yu, Xueqing, Zhao, Minghui, Zheng, Hongguang, Mendoza, Jose Luis Accini, Arcos, Edgar, Avendano, Jorge, Diaz Ruiz, Jorge Ernesto Andres, Ortiz, Luis Hernando Garcia, Gonzalez, Alexander, Triana, Eric Hernandez, Higuera, Juan Diego, Malaver, Natalia, de Salazar, Dora Inés Molina, Rosero, Ricardo, Alexandra Terront Lozano, Monica, Cometa, Luis Valderrama, Valenzuela, Alex, Vargas Alonso, Ruben Dario, Villegas, Ivan, Yupanqui, Hernan, Bartaskova, Dagmar, Barton, Petr, Belobradkova, Jana, Dohnalova, Lenka, Drasnar, Tomas, Ferkl, Richard, Halciakova, Katarina, Klokocnikova, Vera, Kovar, Richard, Lastuvka, Jiri, Lukac, Martin, Pesickova, Satu, Peterka, Karel, Pumprla, Jiri, Rychlik, Ivan, Saudek, Frantisek, Tesar, Vladimir, Valis, Martin, Weiner, Pavel, Zemek, Stanislav, Alamartine, Eric, Borot, Sophie, Cariou, Bertrand, Dussol, Bertrand, Fauvel, Jean-Pierre, Gourdy, Pierre, Klein, Alexandre, Le Meur, Yannick, Penfornis, Alfred, Roussel, Ronan, Saulnier, Pierre-Jean, Thervet, Eric, Zaoui, Philippe, Burst, Volker, Faghih, Markus, Faulmann, Grit, Haller, Hermann, Jerwan-Keim, Reinhold, Maxeiner, Stephan, Paschen, Björn, Plassmann, Georg, Rose, Ludger, Gonzalez Orellana, Ronaldo Arturo, Haase, Franklin Paul, Moreira Diaz, Juan Pablo, Ramirez Roca, Luis Alberto, Sánchez Arenales, Jose Antonio, Sanchez Polo, José Vicente, Juarez, Erick Turcios, Csecsei, Gyongyi, Csiky, Botond, Danos, Peter, Deak, Laszlo, Dudas, Mihaly, Harcsa, Eleonora, Keltai, Katalin, Keresztesi, Sandor, Kiss, Krisztian, Konyves, Laszlo, Major, Lajos, Mileder, Margit, Molnar, Marta, Mucsi, Janos, Oroszlan, Tamas, Ory, Ivan, Paragh, Gyorgy, Peterfai, Eva, Petro, Gizella, Revesz, Katalin, Takacs, Robert, Vangel, Sandor, Vasas, Szilard, Zsom, Marianna, Abraham, Oomman, Bhushan, Raju Sree, Deepak, Dewan, Edwin, Fernando M., Gopalakrishnan, Natarajan, Gracious, Noble, Hansraj, Alva, Jain, Dinesh, Keshavamurthy, C.B., Khullar, Dinesh, Manisha, Sahay, Peringat, Jayameena, Prasad, Narayan, Satyanarayana, Rao K., Sreedhar, Reddy, Sreelatha, Melemadathil, Sudhakar, Bhimavarapu, Chandra Vyasam, Ramesh, Bonadonna, Riccardo, Castellino, Pietro, Ceriello, Antonio, Chiovato, Luca, De Cosmo, Salvatore, Derosa, Giuseppe, Di Carlo, Alberto, Di Cianni, Graziano, Frascà, Giovanni, Fuiano, Giorgio, Gambaro, Giovanni, Garibotto, Giacomo, Giorda, Carlo, Malberti, Fabio, Mandreoli, Marcora, Mannucci, Edoardo, Orsi, Emanuela, Piatti, Piermarco, Santoro, Domenico, Sasso, Ferdinando Carlo, Serviddio, Gaetano, Stella, Andrea, Trevisan, Roberto, Veronelli, Anna Maria, Zanoli, Luca, Akiyama, Hitoshi, Aoki, Hiromi, Asano, Akimichi, Iitsuka, Tadashi, Kajiyama, Shizuo, Kashine, Susumu, Kawada, Toshio, Kodera, Takamoto, Kono, Hiroshi, Koyama, Kazunori, Kumeda, Yasuro, Miyauchi, Shozo, Mizuyama, Kazuyuki, Niiya, Tetsuji, Oishi, Hiroko, Ota, Satoshi, Sakakibara, Terue, Takai, Masahiko, Tomonaga, Osamu, Tsujimoto, Mitsuru, Wakasugi, Masakiyo, Wakida, Yasushi, Watanabe, Takayuki, Yamada, Masayo, Yanagida, Kazuhiro, Yanase, Toshihiko, Yumita, Wataru, Gaupsiene, Egle, Kozloviene, Dalia, Navickas, Antanas, Urbanaviciene, Egle, Abdul Ghani, Rohana, Kadir, Khalid Abdul, Ali, Norsiah, Che Yusof, Mohd Daud, Gan, Chye Lee, Ismail, Mastura, Kong, Wei Yen, Lam, Swee Win, Lee, Li Yuan, Loh, Chek Loong, Manocha, Anita Bhajan, Ng, Kee Sing, Ahmad, Nik Nur Fatnoon Nik, Ratnasingam, Vanassa, Shudim, Saiful Shahrizal Bin, Vengadasalam, Paranthaman, Abraira Munoz, Luis David, Salazar, Melchor Alpizar, Cruz, Juan Baas, Soto, Mario Burgos, Ramos, Jose Chevaile, Wong, Alfredo Chew, Correa Rotter, Jose Ricardo, Escalante, Tonatiu Diaz, Enriquez Sosa, Favio Edmundo, Lozano, Fernando Flores, Flota Cervera, Luis Fernando, Baron, Paul Frenk, Ballesteros, Cecilia Garcia, Gomez Rangel, Jose David, Herrera Jimenez, Luis Enrique, Irizar Santana, Sergio Saul, Flores, Fernando Jimenez, Molina, Hugo Laviada, Luna Ceballos, Rosa Isela, del Campo Blanco, Belia Martin, Franco, Guadalupe Morales, Moreno Loza, Oscar Tarsicio, Rocha, Cynthia Mustieles, Vera, Gregorio Obrador, Castellanos, Ricardo Orozco, Calcaneo, Juan Peralta, Reyes Rosano, Miguel Angel, Pattzi, Hiromi Rodriguez, Guzman, Juan Rosas, Rucker Joerg, Isabel Erika, Saavedra Sanchez, Sandra Berenice, Sanchez Mijangos, Jose Hector, Sanson, Pablo Serrano, Tamayo y Orozco, Juan Alfredo, Chavez, Eloisa Tellez, Cepeda, Alejandro Valdes, Carrillo, Luis Venegas, Mesa, Juan Villagordoa, Escobedo, Rolando Zamarripa, Baker, John, Noonan, Paul, Scott, Russell, Walker, Robert, Watson, Edward, Williams, Michael, Young, Simon, Abejuela, Zaynab, Agra, Jeimeen, Aquitania, Grace, Caringal, Clodoaido, Comia, Rhea Severina, Santos, Lalaine Delos, Gomez, Olivert, Jimeno, Cecilia, Tan, Gerry, Tolentino, Marsha, Yao, Christy, Yap, Yvette Ethel, Lallaine Ygpuara, Ma. Dovie, Bijata-Bronisz, Renata, Hotlos, Lucyna, Januszewicz, Andrzej, Kaczmarek, Barbara, Kaminska, Anna, Lazuka, Lech, Madej, Andrzej, Mazur, Stanislaw, Mlodawska-Choluj, Dorota, Nowicki, Michal, Orlowska-Kowalik, Grazyna, Popenda, Grazyna, Rewerska, Barbara, Sowinski, Dariusz, Angelescu, Liliana Monica, Anghel, Veronica, Avram, Rodica-Ioana, Busegeanu, Mihaela-Magdalena, Cif, Adriana, Cosma, Dana, Crisan, Carmen, Demian, Luiza Despina, Ferariu, Ioana Emilia, Halmagyi, Ildiko, Hancu, Nicolae, Munteanu, Mircea, Negru, Doru, Onaca, Adriana Gabriela, Petrica, Ligia, Popa, Amorin Remus, Ranetti, Aurelian-Emil, Serafinceanu, Cristian, Toarba, Cristina, Agafyina, Alina, Barbarash, Olga, Barysheva, Olga, Chizhov, Daniil, Dobronravov, Vladimir, Glinkina, Irina, Grineva, Elena, Khirmanov, Vladimir, Kolmakova, Elena, Koroleva, Tatiana, Kvitkova, Liudmila, Marasaev, Viacheslav, Mkrtumyan, Ashot, Morugova, Tatiana, Nagibovich, Galina, Nagibovich, Oleg, Nedogoda, Sergei, Osipova, Irina, Raskina, Tatiana, Samoylova, Yulia, Sazonova, Olga, Shamkhalova, Minara, Shutemova, Elena, Shwartz, Yuriy, Uriasyev, Oleg, Vorobyev, Sergey, Zateyshchikova, Anna, Zateyshshikov, Dmitry, Zykova, Tatyana, Antic, Slobodan, Djordjevic, Miodrag, Kendereski, Aleksandra, Lalic, Katarina, Lalic, Nebojsa, Popovic-Radinovic, Vesna, Babikova, Jana, Benusova, Olga, Buganova, Ingrid, Culak, Jan, Dzupina, Andrej, Dzuponova, Jana, Fulop, Peter, Ilavska, Adriana, Martinka, Emil, Ochodnicka, Zuzana, Pella, Daniel, Smatanova, Iveta, Ahmed, Fayzal, Badat, Aysha, Breedt, Johannes, Distiller, Lawrence, Govender, Vimladhevi, Govender, Ravendran, Joshi, Mukesh, Jurgens, Jaco, Latiff, Gulam, Lombard, Landman, Mookadam, Mohamed, Ngcakani, Nomangesi, Nortje, Hendrik, Oosthuizen, Helena, Pillay-Ramaya, Larisha, Prozesky, Hans, Reddy, Jeevren, Rheeder, Paul, Seeber, Mary, Cho, Young Min, Jeong, In-Kyung, Kim, Sin Gon, Kim, Yeong Hoon, Kwon, Hyuk-Sang, Kwon, Min Jeong, Lee, Byung-Wan, Lee, JungEun, Lee, Moon-Kyu, Nam, Moon-Suk, Oh, Kook-Hwan, Park, Cheol- Young, Park, Sun-Hee, Yoon, Kun Ho, Garcia, Pere Alvarez, Mercadal, Luis Asmarats, Barrios, Clara, Castro, Fernando Cereto, Guldris, Secundino Cigarran, Lopez, Marta Dominguez, Egido de los Rios, Jesus, Fresnedo, Gema Fernandez, Serrano, Antonio Galan, Garcia, Isabel, Gonzalez Martinez, Francisco Javier, Jodar Gimeno, Jose Esteban, Mendoza, Manuel Lopez, Marin, Tamara Malek, Portillo, Cristobal Morales, Munar Vila, Maria Antonia, Torres, Manuel Muñoz, Iglesias, Javier Nieto, Perez, Jonay Pantoja, Vera, Merce Perez, Portoles Perez, Jose M., Quesada Simón, María Angustias, Canonge, Rafael Simo, Gonzalez, Alfonso Soto, Riera, Manel Terns, Tinahones Madueno, Francisco Jose, Plaza, Mercedes Velo, Chang, Chwen-Tzuei, Chuang, Lee-Ming, Hsia, Te-Lin, Hsieh, Chang-Hsun, Lin, Chih-Ching, Lu, Yung- Chuan, Sheu, Wayne H-H, Barna, Olga, Bilyk, Svitlana D., Botsyurko, Volodymyr, Dudar, Iryna, Fushtey, Ivan, Godlevska, Olga, Golovchenko, Oleksandr, Gyrina, Olga, Kazmirchuk, Anatoliy, Komisarenko, Iuliia, Korzh, Oleksii, Kravchun, Nonna, Legun, Oleg, Mankovskyy, Borys, Martynyuk, Liliya, Mostovoy, Yuriy, Pashkovska, Nataliia, Pererva, Larysa, Pertseva, Tetyana, Samoylov, Oleksandr, Smirnov, Ivan, Svyshchenko, Yevgeniya, Tomashkevych, Halyna, Topchii, Ivan, Tryshchuk, Nadiya, Tseluyko, Vira, Vizir, Vadym, Vlasenko, Maryna, Zlova, Tetiana, Zub, Liliia, Abusnana, Salah, Railey, Mohamed, Abouglila, Kamal, Ainsworth, Paul, Ali, Zishan, Arutchelvam, Vijayaraman, Barnard, Maria, Bellary, Srikanth, Davies, Emyr, Davies, Mark, Davies, Simon, Dawson, Alison, El Kossi, Mohsen, English, Patrick, Fraser, Donald, Gnudi, Luigi, Gunstone, Anthony, Hall, Timothy, Hanif, Wasim, Jackson, Alan, Johnson, Andrew, Joseph, Franklin, Krishnan, Singhan, Kumwenda, Mick, MacDougall, Iain, Nixon, Paul, O'Hare, Joseph, Philip, Sam, Ramtoola, Shenaz, Saxena, Manish, Sennik, Davesh, Simon, Godwin, Singh, Baldev, Stephens, Jeffrey, Strzelecka, Anna, Symonds, Rehan, Turner, Wayne, Wahba, Mona, Wakeling, John, Wheeler, David, Winocour, Peter, Abdallah, Joseph, Abdullah, Raied, Abramowitz, Matthew, Acosta, Idalia, Aiello, Joseph, Akright, Laura, Akyea-Djamson, Ayim, Alappan, Rajendran, Alicic, Radica, Al-Karadsheh, Amer, Allison, Dale Crawford, Arauz-Pacheco, Carlos, Arfeen, Shahabul, Arif, Ahmed, Arvind, Moogali, Atray, Naveen, Awad, Ahmed, Barnhill, Peggy, Barranco, Elizabeth, Barrera, Carlos, Beacom, Matthew, Behara, Venkata, Belo, Diogo, Bentley-Lewis, Rhonda, Berenguer, Ramon, Bermudez, Lidia, Bernardo, Marializa, Biscoveanu, Mihaela, Bowman-Stroud, Cynthia, Brandon, Donald, Brusco, Osvaldo, Busch, Robert, Canaan, Yamil, Chilito, Alicia, Christensen, Tom, Christiano, Cynthia, Christofides, Elena, Chuateco, Caroucel, Cohen, Kenneth, Cohen, Robert, Cohen-Stein, Debbie, Cook, Charles, Coyne, Daniel, Daboul, Nizar, Darwish, Riad, Daswani, Adarsh, Deck, Kenneth, Desouza, Cyrus, Dev, Devasmita, Dhillon, Monika, Dua, Sohan, Eder, Frank, Elosegui, Ana Maria, El-Shahawy, Mohamed, Ervin, John, Esquenazi, Alberto, Evans, John, Fishbane, Steven, Frias, Juan, Galindo-Ramos, Eugenia, Galphin, Claude, Ghazi, Adline, Gonzalez, Enrique, Gorson, David, Gowda, Anupama, Greco, Barbara, Grubb, Stephen, Gulati, Rakesh, Hammoud, Jamal, Handelsman, Stuart, Hartman, Israel, Hershon, Kenneth, Hiser, Daniel, Hon, George, Jacob, Radu, Jaime, Maria, Jamal, Aamir, Kaupke, Charles, Keightley, Gerald, Kern, Elizabeth, Khanna, Rakhi, Khitan, Zeid, Kim, Sun, Kopyt, Nelson, Kovesdy, Csaba, Krishna, Gopal, Kropp, Jeffrey (Jay), Kumar, Amrendra, Kumar, Jayant, Kumar, Neil, Kusnir, Jorge, Lane, Wendy, Lawrence, Mary, Lehrner, Lawrence, Lentz, John, Levinson, Dennis, Lewis, Derek, Liss, Kenneth, Maddux, Andreas, Maheshwari, Hiralal, Mandayam, Sreedhar, Marar, Isam, Mehta, Bhasker, Middleton, John, Mordujovich, Jorge, Moreda, Ramon, Moustafa, Moustafa, Trenche, Samuel Mujica, Narayanan, Mohanram, Narvarte, Javier, Nassar, Tareq, Newman, George, Nichol, Brian, Nicol, Philip, Nisnisan, Josier, Nossuli, A. Kaldun, Obialo, Chamberlain, Olelewe, Sarah, Oliver, Michael, O'Shaughnessy, Andrew, Padron, John, Pankhaniya, Rohit, Parker, Reginald, Patel, Devesh, Patel, Gnyandev, Patel, Nina, Pavon, Humberto, Perez, Armando, Perez, Carlos, Perlman, Alan, Pettis, Karlton, Pharr, Walter, Phillips, Andrea, Purighalla, Raman, Quesada-Suarez, Luis, Ranjan, Rajiv, Rastogi, Sanjeev, Reddy, Jakkidi, Rendell, Marc, Rich, Lisa, Robinson, Michael, Rodriguez, Hector, Rosas, Sylvia, Saba, Fadi, Sankaram, Rallabhandi, Sarin, Ravi, Schreiman, Robert, Scott, David, Sekkarie, Mohamed, Sensenbrenner, John, Shakeel, Muhammad, Shanik, Michael, Shaw, Sylvia, Smith, Stephen, Solomon, Richard, Sprague, Amy, Spry, Leslie, Suchinda, Pusadee, Sultan, Senan, Surampudi, Prasanth, Sussman, Sherry, Tan, Anjanette, Terrelonge, Antonio, Thompson, Michael, Trespalacios, Fernando, Trippe, Bruce, Trueba, Pilar, Twahirwa, Marcel, Updegrove, John, Van Buren, Peter, Vannorsdall, Mark, Varghese, Freemu, Velasquez-Mieyer, Pedro, Ventrapragada, Sailaja, Vukotic, Goga, Wadud, Khurram, Warren, Mark, Watson, Henry, Watts, Ronald, Weiner, Daniel, Welker, James, Welsh, Jean, Williams, Shelley, Zaniewski-Singh, Michelle, Yi, Tae Won, Smyth, Brendan, Di Tanna, Gian Luca, Arnott, Clare, Cardoza, Kathryn, and Kang, Amy

Published
2023
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4. Mayo Clinic consensus report on membranous nephropathy: proposal for a novel classification

Author

Sethi, Sanjeev, primary, Beck, Laurence H., additional, Glassock, Richard J., additional, Haas, Mark, additional, De Vriese, An S., additional, Caza, Tiffany N., additional, Hoxha, Elion, additional, Lambeau, Gérard, additional, Tomas, Nicola M., additional, Madden, Benjamin, additional, Debiec, Hanna, additional, D’Agati, Vivette D., additional, Alexander, Mariam P., additional, Amer, Hatem, additional, Appel, Gerald B., additional, Barbour, Sean J., additional, Caravaca-Fontan, Fernando, additional, Cattran, Daniel C., additional, Casal Moura, Marta, additional, D’Avila, Domingos O., additional, Eick, Renato G., additional, Garovic, Vesna D., additional, Greene, Eddie L., additional, Herrera Hernandez, Loren P., additional, Jennette, J. Charles, additional, Lieske, John C., additional, Markowitz, Glen S., additional, Nath, Karl A., additional, Nasr, Samih H., additional, Nast, Cynthia C., additional, Pani, Antonello, additional, Praga, Manuel, additional, Remuzzi, Giuseppe, additional, Rennke, Helmut G., additional, Ruggenenti, Piero, additional, Roccatello, Dario, additional, Soler, Maria Jose, additional, Specks, Ulrich, additional, Stahl, Rolf A.K., additional, Singh, Raman Deep, additional, Theis, Jason D., additional, Velosa, Jorge A., additional, Wetzels, Jack F.M., additional, Winearls, Christopher G., additional, Yandian, Federico, additional, Zand, Ladan, additional, Ronco, Pierre, additional, and Fervenza, Fernando C., additional

Published
2023
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5. Tropical Infectious Diseases and the Kidney

Author

De Francesco Daher, Elizabeth, da Silva Junior, Geraldo Bezerra, Barros, Elvino, d’Avila, Domingos O., Fervenza, Fernando C., editor, Lin, Julie, editor, Sethi, Sanjeev, editor, and Singh, Ajay K., editor

Published
2014
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6. Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease

Author

Zhou, Zien, primary, Jardine, Meg J., additional, Li, Qiang, additional, Neuen, Brendon L., additional, Cannon, Christopher P., additional, de Zeeuw, Dick, additional, Edwards, Robert, additional, Levin, Adeera, additional, Mahaffey, Kenneth W., additional, Perkovic, Vlado, additional, Neal, Bruce, additional, Lindley, Richard I., additional, Ahuad Guerrero, Rodolfo Andres, additional, Aizenberg, Diego, additional, Albisu, Juan Pablo, additional, Alvarisqueta, Andres, additional, Bartolacci, Ines, additional, Berli, Mario Alberto, additional, Bordonava, Anselmo, additional, Calella, Pedro, additional, Cantero, Maria Cecilia, additional, Cartasegna, Luis Rodolfo, additional, Cercos, Esteban, additional, Coloma, Gabriela Cecilia, additional, Colombo, Hugo, additional, Commendatore, Victor, additional, Cuadrado, Jesus, additional, Cuneo, Carlos Alberto, additional, Cusumano, Ana Maria, additional, Douthat, Walter Guillermo, additional, Dran, Ricardo Dario, additional, Farias, Eduardo, additional, Fernandez, Maria Florencia, additional, Finkelstein, Hernan, additional, Fragale, Guillermo, additional, Fretes, Jose Osvaldo, additional, Garcia, Nestor Horacio, additional, Gastaldi, Anibal, additional, Gelersztein, Elizabeth, additional, Glenny, Jorge Archibaldo, additional, Gonzalez, Joaquin Pablo, additional, del Carmen Gonzalez Colaso, Patricia, additional, Goycoa, Claudia, additional, Greloni, Gustavo Cristian, additional, Guinsburg, Adrian, additional, Hermida, Sonia, additional, Juncos, Luis Isaias, additional, Klyver, Maria Isabel, additional, Kraft, Florencia, additional, Krynski, Fernando, additional, Lanchiotti, Paulina Virginia, additional, Leon de la Fuente, Ricardo Alfonso, additional, Marchetta, Nora, additional, Mele, Pablo, additional, Nicolai, Silvia, additional, Novoa, Pablo Antonio, additional, Orio, Silvia Ines, additional, Otreras, Fabian, additional, Oviedo, Alejandra, additional, Raffaele, Pablo, additional, Resk, Jorge Hector, additional, Rista, 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Published
2021
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7. Prevention of illicit drug use from the users’ perspective

Author

Carla Aparecida Arena Ventura, Paulo Sérgio Ferreira, Stefany Guimarães de Avila Domingos, Iracema da Silva Frazão, Samira Janis Eugênio, and Bruna Sordi Carrara

Subjects
Medical education, Government, Perspective (graphical), Qualitative property, SAÚDE PÚBLICA, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Illicit drug, 030212 general & internal medicine, Psychology, Psychosocial, 030217 neurology & neurosurgery, Qualitative research
Abstract

This research described the perspective of illicit drug users regarding illicit drug use prevention initiatives. The study used a convergent parallel mixed methods design, combining quantitative and qualitative methods. In the quantitative component of the study, 111 subjects from a psychosocial care centre (CAPS-AD). The qualitative data were collected through semi-structured interviews with 11 subjects who were selected from among the participants and who declared themselves to be personally affected as being or having been illicit drugs users. From the perspective of drug users, the results pointed out different prevention initiatives and the institutions that should be responsible for them. For preventive actions to be successful, they must be intersectoral and involve government, community and families.

Published
2021

12. Perspectives About Treatment Services From People Who Use Illicit Drugs

Author

Sireesha J Bobbili, Bruna Sordi Carrara, Stefany Guimarães de Avila Domingos, Paulo Sérgio Ferreira, Samira Janis Eugênio, and Carla Aparecida Arena Ventura

Subjects
Adult, Male, Mental Health Services, medicine.medical_specialty, Substance-Related Disorders, Fundamental rights, Psychiatric Nursing, Drug Users, 03 medical and health sciences, Drug treatment, 0302 clinical medicine, Inner city, Surveys and Questionnaires, mental disorders, Illicit drug, Medicine, Humans, General Nursing, 030504 nursing, business.industry, Illicit Drugs, Treatment options, Mental health, 030227 psychiatry, Hospitalization, Family medicine, Female, Pshychiatric Mental Health, 0305 other medical science, business, Psychosocial, Brazil
Abstract

The objective of the current study was to describe the perspectives of people who use illicit drugs regarding the availability and effectiveness of drug treatment services. A total of 111 participants with illicit drug use experience were recruited from an inner city community in São Paulo, Brazil. Treatment services were considered to be essential and necessary by the majority of participants, whereas general hospitals and mental health services were considered to be the most highly available treatment options for illicit drug use. Participants also indicated that treatment led to positive changes in their lives, highlighting the importance of drug treatment services for promoting the rights and responsibilities of people who use illicit drugs. Results support the need for services that value and respect the fundamental rights of people who use illicit drugs. [ Journal of Psychosocial Nursing and Mental Health Services, 58 (4), 28–37.]

Published
2019

19. DRUG USE AND KNOWLEDGE OF ITS CONSEQUENCES AMONG NURSING STUDENTS

Author

Ana Carolina Guidorizzi Zanetti, Jacqueline de Souza, Stefany Guimarães de Avila Domingos, Luciane Sá de Andrade, Letícia Yamawaka de Almeida, and Keyla Ponciano Ornella

Subjects
Drug, 030504 nursing, Uso indevido de drogas, media_common.quotation_subject, Conhecimento, Enfermagem, Nursing, Drug abuse, 03 medical and health sciences, Estudiantes, Knowledge, 0302 clinical medicine, Álcool, Conocimiento, Enfermería, 030212 general & internal medicine, Alcohol, Students, 0305 other medical science, Psychology, Estudantes, General Nursing, media_common
Abstract

RESUMO Objetivo: analisar o padrão de consumo de substâncias psicoativas e o conhecimento das consequências do uso de álcool, maconha e cocaína de estudantes de graduação em enfermagem no primeiro e no último ano do curso. Método: estudo descritivo, transversal, com 141 graduandos de enfermagem de uma universidade pública do interior do Estado de São Paulo. Para coleta dos dados foram utilizados o Questionário para Triagem do Uso de Álcool, Tabaco e outras Substâncias e um questionário sobre o conhecimento das consequências do uso de álcool, maconha e cocaína. Para análise, foram aplicados o teste Exato de Fisher, o Qui-quadrado de Pearson e o Teste t de Student. Resultados: o álcool e a maconha foram as substâncias mais consumidas pelos estudantes. Quanto às consequências do uso de álcool, maconha e cocaína, a maioria alcançou mais de 50% de acertos, considerado um bom conhecimento, sendo que 86,5% obtiveram mais da metade de acertos em relação ao álcool, 68,8% para a maconha e 76,6% para a cocaína. Quanto à média dos escores sobre o conhecimento de tais consequências entre os alunos ingressantes e aqueles do último ano, encontrou-se diferença estatisticamente significativa para o álcool (p=0,026) e a cocaína (p

Published
2018

20. Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Author

Heerspink, Hiddo J L, primary, Parving, Hans-Henrik, additional, Andress, Dennis L, additional, Bakris, George, additional, Correa-Rotter, Ricardo, additional, Hou, Fan-Fan, additional, Kitzman, Dalane W, additional, Kohan, Donald, additional, Makino, Hirofumi, additional, McMurray, John J V, additional, Melnick, Joel Z, additional, Miller, Michael G, additional, Pergola, Pablo E, additional, Perkovic, Vlado, additional, Tobe, Sheldon, additional, Yi, Tingting, additional, Wigderson, Melissa, additional, de Zeeuw, Dick, additional, Elbert, Alicia, additional, Vallejos, Augusto, additional, Alvarisqueta, Andres, additional, Maffei, Laura, additional, Juncos, Luis, additional, de Arteaga, Javier, additional, Greloni, Gustavo, additional, Farias, Eduardo, additional, Zucchini, Alfredo, additional, Vogel, Daniel, additional, Cusumano, Ana, additional, Santos, Juan, additional, Fraenkel, Margaret, additional, Gallagher, Martin, additional, Davis, Tim, additional, Acharya, Shamasunder, additional, Cooke, Duncan, additional, Suranyi, Michael, additional, Roger, Simon, additional, Toussaint, Nigel, additional, Pollock, Carol, additional, Chan, Doris, additional, Stranks, Stephen, additional, MacIsaac, Richard, additional, Endre, Zoltan, additional, Schmidt, Alice, additional, Prager, Rudolf, additional, Mayer, Gert, additional, Warling, Xavier, additional, Jadoul, Michel, additional, Hougardy, Jean, additional, Vercammen, Chris, additional, Van Vlem, Bruno, additional, Gillard, Pieter, additional, Costa e Forti, Adriana, additional, Borges, Joao Lindolfo, additional, Santos Canani, Luis, additional, Eliaschewitz, Freddy, additional, Leite, Silmara, additional, Fraige Filho, Fadlo, additional, Paschoalin, Raphael, additional, Moura Neto, Jose Andrade, additional, Deboni, Luciane, additional, de Lourdes Noronha, Irene, additional, Cercato, Cintia, additional, Prompt, Carlos Alberto, additional, Zanella, Maria, additional, Rassi, Nelson, additional, D'Avila, Domingos, additional, Milagres, Rosangela, additional, Felicio, Joao, additional, Pecoits Filho, Roberto, additional, Riella, Miguel Carlos, additional, Salles, Joao, additional, Keitel, Elizete, additional, Draibe, Sergio, additional, Amodeo, Celso, additional, Youmbissi, Joseph, additional, Roy, Louise, additional, Cournoyer, Serge, additional, Jolly, Shivinder, additional, Pichette, Vincent, additional, Nesrallah, Gihad, additional, Bajaj, Harpreet Singh, additional, Khandwala, Hasnain, additional, Aronson, Ronnie, additional, Goluch, Richard, additional, Tam, Paul, additional, Rabbat, Christian, additional, Bailey, Gordon, additional, Chow, Stephen, additional, Castillo, Alvaro, additional, Danin Vargas, Alfredo, additional, Gonzalez, Fernando, additional, Munoz, Rodrigo, additional, Gutierrez, Vicente, additional, Godoy, Gonzalo, additional, Zhao, Hongwen, additional, Liu, Zhangsuo, additional, Zhao, Minghui, additional, Guo, Xiaohui, additional, Su, Benli, additional, Fu, Shuxia, additional, Xu, Yan, additional, Yang, Jinkui, additional, Shi, Bingyin, additional, Xiao, Guanqing, additional, Shi, Wei, additional, Hao, Chuanming, additional, Xing, Changying, additional, Hou, Fanfan, additional, Luo, Qun, additional, Li, Yuxiu, additional, Ji, Linong, additional, Zuo, Li, additional, Wang, Song, additional, Ni, Zhaohui, additional, Ding, Guohua, additional, Chen, Nan, additional, Zhao, Jiajun, additional, Jia, Weiping, additional, Yu, Shengqiang, additional, Weng, Jian, additional, Xu, Gang, additional, Fu, Ping, additional, Sun, Shiren, additional, Liu, Bicheng, additional, Ding, Xiaoqiang, additional, Rychlik, Ivan, additional, Oplustilova, Alexandra, additional, Bartaskova, Dagmar, additional, Honova, Vaclava, additional, Chmelickova, Hana, additional, Petr, Martin, additional, Bucek, Petr, additional, Tesar, Vladimir, additional, Zahumensky, Emil, additional, Povlsen, Johan, additional, Egstrup, Kenneth, additional, Oczachowska-Kulik, Anna, additional, Rossing, Peter, additional, Lahtela, Jorma, additional, Strand, Jorma, additional, Kantola, Ilkka, additional, Petit, Catherine, additional, Combe, Christian, additional, Zaoui, Philippe, additional, Esnault, Vincent, additional, Urena Torres, Pablo, additional, Halimi, Jean-Michel, additional, Dussol, Bertrand, additional, Bieler, Tasso, additional, Budde, Klemens, additional, Dellanna, Frank, additional, Segiet, Thomas, additional, Kosch, Christine, additional, Schmidt-Guertler, Hans, additional, Schenkenberger, Isabelle, additional, Vielhauer, Volker, additional, Pistrosch, Frank, additional, Alscher, Mark, additional, Hasslacher, Christoph, additional, Hugo, Christian, additional, Muehlfeld, Anja, additional, Wanner, Christoph, additional, Passadakis, Ploumis, additional, Apostolou, Theofanis, additional, Tentolouris, Nikolaos, additional, Stefanidis, Ioannis, additional, Mavromatidis, Konstantinos, additional, Liakopoulos, Vasilios, additional, Goumenos, Dimitrios, additional, Siamopoulos, Konstantinos, additional, Yeung, Vincent, additional, Ozaki, Risa, additional, Fung, Samuel, additional, Tan, Kathryn, additional, Tang, Sydney, additional, Lui, Sing Leung, additional, Cheung, Siu Fai, additional, Sreenan, Seamus, additional, Eustace, Joseph, additional, O'Shea, Donal, additional, Lavin, Peter, additional, Stack, Austin, additional, Yagil, Yoram, additional, Wainstein, Julio, additional, Knobler, Hilla, additional, Cohen, Josef, additional, Kenis, Irina, additional, Daoud, Deeb, additional, Bar-Dayan, Yosefa, additional, Frajewicki, Victor, additional, Adawi, Faiad, additional, Gesualdo, Loreto, additional, Santoro, Domenico, additional, Marino, Francesco, additional, Galfre, Andrea, additional, Brunati, Chiara, additional, Ruggenenti, Piero, additional, Rombola, Giuseppe, additional, Pugliese, Giuseppe, additional, Ravera, Maura, additional, Malberti, Fabio, additional, Pontoriero, Giuseppe, additional, Rampino, Teresa, additional, De Cosmo, Salvatore, additional, Esposito, Ciro, additional, Nappi, Felice, additional, Abaterusso, Cataldo, additional, Conte, Giuseppe, additional, Panichi, Vincenzo, additional, Lauro, Davide, additional, Capasso, Giovambattista, additional, Russo, Domenico, additional, Anzai, Jiichi, additional, Naka, Motoji, additional, Ato, Keita, additional, Tsujimoto, Tetsuro, additional, Nimura, Toshinori, additional, Nakashima, Eitaro, additional, Takeda, Tetsuro, additional, Fujii, Shinya, additional, Kobayashi, Kunihisa, additional, Iwaoka, Hideaki, additional, Nagayama, Koji, additional, Harada, Hiroyuki, additional, Maeda, Hajime, additional, Kishimoto, Rui, additional, Iitsuka, Tadashi, additional, Itabashi, Naoki, additional, Furuya, Ryuichi, additional, Maeda, Yoshitaka, additional, Yamada, Daishiro, additional, Sasaki, Nobuhiro, additional, Sasaki, Hiromitsu, additional, Ueda, Shinichiro, additional, Kashihara, Naoki, additional, Watanabe, Shuichi, additional, Nakamura, Takehiro, additional, Kanai, Hidetoshi, additional, Makita, Yuichiro, additional, Ono, Keiko, additional, Iehara, Noriyuki, additional, Goto, Daisuke, additional, Kosuge, Keiichiro, additional, Tsuchida, Kenichi, additional, Sato, Toshiaki, additional, Sekikawa, Takashi, additional, Okamoto, Hideki, additional, Tanaka, Tsuyoshi, additional, Ikeda, Naoko, additional, Tadika, Takenobu, additional, Mukasa, Koji, additional, Osonoi, Takeshi, additional, Hirano, Fuminori, additional, Nishimura, Motonobu, additional, Yambe, Yuko, additional, Tanaka, Yukio, additional, Ujihara, Makoto, additional, Sakai, Takashi, additional, Imura, Mitsuo, additional, Umayahara, Yutaka, additional, Makino, Shinya, additional, Nakazawa, Jun, additional, Yamaguchi, Yukinari, additional, Kashine, Susumu, additional, Miyaoka, Hiroaki, additional, Suzuki, Katsunori, additional, Inoue, Toshihiko, additional, Nagai, Sou, additional, Sato, Nobuyuki, additional, Yamamoto, Masahiro, additional, Taya, Noriyasu, additional, Fujita, Akira, additional, Matsutani, Akira, additional, Shibagaki, Yugo, additional, Sato, Yuichi, additional, Yamauchi, Akira, additional, Tsutsui, Masahiro, additional, Ishiko, Tamayo, additional, Kaneko, Shizuka, additional, Azuma, Nobuyuki, additional, Matsuda, Hirofumi, additional, Hashiguchi, Yasuhiro, additional, Onishi, Yukiko, additional, Tokui, Mikiya, additional, Matsuhisa, Munehide, additional, Kiyosue, Arihiro, additional, Shinoda, Junji, additional, Ishikawa, Kazuo, additional, Ahmad, Ghazali, additional, Vijayasingham, Shalini, additional, Aziz, Nor Azizah, additional, Hussein, Zanariah, additional, Fung, Yin Khet, additional, Hassan, Wan Hasnul Halimi Wan, additional, Wong, Hin Seng, additional, Goh, Bak Leong, additional, Ali, Norhaliza Mohd, additional, Merican, Nor Shaffinaz Yusuf Azmi, additional, Vaithilingam, Indralingam, additional, Nik Ahmad, Nik Nur Fatnoon, additional, Adam, Noor, additional, Sukor, Norlela, additional, Vengadasalam, V Paranthaman P, additional, Abdul Kadir, Khalid, additional, Mohamed, Mafauzy, additional, Renoirte Lopez, Karina, additional, Leguizamo-Dimas, Aniceto, additional, Chew Wong, Alfredo, additional, Chevaile-Ramos, Jose, additional, Gonzalez Gonzalez, Jose, additional, Rico Hernandez, Raul, additional, Nino-Cruz, Jose, additional, Sauque Reyna, Leobardo, additional, Gonzalez-Galvez, Guillermo, additional, Madero Rovalo, Magdalena, additional, Bochicchio-Ricardelli, Tomasso, additional, Aldrete, Jorge, additional, Carranza-Madrigal, Jaime, additional, Vogt, Liffert, additional, Smak Gregoor, Peter, additional, Barendregt, JNM, additional, Luik, Peter, additional, Gansevoort, Ronald, additional, Laverman, Gozewijn, additional, Pilmore, Helen, additional, Lunt, Helen, additional, Baker, John, additional, Miller, Steven, additional, Rabindranath, Kannaiyan, additional, Zapata-Rincon, Luis, additional, Vargas-Gonzales, Rolando, additional, Calderon Ticona, Jorge, additional, Dextre Espinoza, Augusto, additional, Burga Nunez, Jose, additional, Zea-Nunez, Carlos Antonio, additional, Herrada Orue, Benjamin, additional, Medina-Santander, Boris, additional, Delgado-Butron, Cesar, additional, Farfan-Aspilcueta, Julio, additional, Mazur, Stanislaw, additional, Necki, Miroslaw, additional, Wruk, Michal, additional, Klodawska, Katarzyna, additional, Popenda, Grazyna, additional, Skokowska, Ewa, additional, Arciszewska, Malgorzata, additional, Wiecek, Andrzej, additional, Ciechanowski, Kazimierz, additional, Nowicki, Michal, additional, Birne, Rita, additional, Cabrita, Antonio, additional, Ramos, Aura, additional, Antunes Ferreira, Manuel Anibal, additional, Matta Fontanet, Evelyn, additional, Alcantara-Gonzalez, Altagracia Aurora, additional, Comulada-Rivera, Angel, additional, Galindo Ramos, Eugenia, additional, Cangiano, Jose, additional, Quesada-Suarez, Luis, additional, Calderon Ortiz, Ricardo, additional, Vazquez-Tanus, Jose, additional, Burgos-Calderon, Rafael, additional, Rosado, Carlos, additional, Hancu, Nicolae, additional, Pintilei, Ella, additional, Mistodie, Cristina, additional, Bako, Gabriel, additional, Ionutiu, Lavinia, additional, Petrica, Ligia, additional, Timar, Romulus, additional, Tuta, Liliana, additional, Duma, Livia, additional, Tutescu, Adriana, additional, Ivanova, Svetlana, additional, Essaian, Ashot, additional, Zrazhevskiy, Konstantin, additional, Tomilina, Natalia, additional, Smolyarchuk, Elena, additional, Kuzin, Anatoly, additional, Lantseva, Olga, additional, Karpova, Irina, additional, Shamkhalova, Minara, additional, Liberanskaya, Natalia, additional, Yavdosyuk, Andrey, additional, Shvarts, Yuri, additional, Bardymova, Tatiana, additional, Blagoveshchenskaya, Olga, additional, Solovev, Oleg, additional, Rechkova, Elena, additional, Pikalova, Natalia, additional, Pavlova, Maria, additional, Kolmakova, Elena, additional, Sayfutdinov, Rustam, additional, Villevalde, Svetlana, additional, Koziolova, Natalya, additional, Martynenko, Vladimir, additional, Marasaev, Vyacheslav, additional, Maksudova, Adelya, additional, Sigitova, Olga, additional, Mordovin, Viktor, additional, Klimontov, Vadim, additional, Samoylova, Yulia, additional, Karonova, Tatiana, additional, Yeoh, Lee Ying, additional, Teo, Boon Wee, additional, Foo, Marjorie Wai Yin, additional, Liew, Adrian, additional, Tkac, Ivan, additional, Oroszova, Aniko, additional, Fekete, Jozef, additional, Rosenberger, Jaroslav, additional, Obetkova, Ida, additional, Fulopova, Alla, additional, Kolesarova, Eva, additional, Raslova, Katarina, additional, Smolko, Peter, additional, Oksa, Adrian, additional, Distiller, Larry, additional, Trokis, Julien, additional, Adams, Luthando, additional, Makan, Hemant, additional, Ramlachan, Padaruth, additional, Mitha, Essack, additional, Coetzee, Kathleen, additional, Punt, Zelda, additional, Bhorat, Qasim, additional, Naiker, Puvenesvari, additional, Ellis, Graham, additional, Van Zyl, Louis, additional, Lee, Kwan Woo, additional, Kim, Min Seon, additional, Yoo, Soon-Jib, additional, Yoon, Kun Ho, additional, Cho, Yong-Wook, additional, Park, Tae-Sun, additional, Kim, Sang Yong, additional, Choi, Moon-Gi, additional, Oh, Tae Keun, additional, Lee, Kang-Wook, additional, Shon, Ho Sang, additional, Suh, Sung Hwan, additional, Kim, Byung-Joon, additional, Doo-Man, Kim, additional, Yi, Joo Hark, additional, Lee, Sang Ah, additional, Cho, Ho Chan, additional, Kim, Sin-Gon, additional, Cha, Dae-Ryong, additional, Seo, Ji A, additional, Choi, Kyung Mook, additional, Woo, Jeong-Taek, additional, Ahn, Kyu Jeung, additional, Lee, Jae Hyuk, additional, Kim, In-Joo, additional, Lee, Moon-Kyu, additional, Jang, Hak Chul, additional, Park, Kyong-Soo, additional, Kim, Beom Seok, additional, Mok, Ji Oh, additional, Shin, Mijung, additional, Yoon, Sun Ae, additional, Nam-Goong, Il-Seong, additional, Chung, Choon Hee, additional, Yu, Tae Yang, additional, Lee, Hyoung Woo, additional, Soto Gonzalez, Alfonso, additional, Almirall, Jaume, additional, Egido, Jesus, additional, Calero Gonzalez, Francesca, additional, Fernandez Fresnedo, Gema, additional, Valera Cortes, Ildefonso, additional, Praga Terente, Manuel, additional, Garcia Mendez, Isabel, additional, Navarro Gonzalez, Juan, additional, Herrero Calvo, Jose, additional, Cigarran Guldris, Secundino, additional, Prieto Velasco, Mario, additional, Minguela Pesquera, Jose Ignacio, additional, Galan, Antonio, additional, Pascual, Julio, additional, Marques Vidas, Maria, additional, Martins Munoz, Judith, additional, Rodriguez-Perez, Jose, additional, Castro-Alonso, Cristina, additional, Bonet Sol, Josep, additional, Seron, Daniel, additional, Fernandez Giraldez, Elvira, additional, Arrieta Lezama, Javier, additional, Montero, Nuria, additional, Hernandez-Jaras, Julio, additional, Santamaria Olmo, Rafael, additional, Molas Coten, Jose Ramon, additional, Hellberg, Olof, additional, Fellstrom, Bengt, additional, Bock, Andreas, additional, Pei, Dee, additional, Lin, Ching-Ling, additional, Tien, Kai-Jen, additional, Chen, Ching-Chu, additional, Huang, Chien-Ning, additional, Jiang, Ju-Ying, additional, Wu, Du-An, additional, Chu, Chih-Hsun, additional, Tseng, Shih-Ting, additional, Chen, Jung-Fu, additional, Bau, Cho-Tsan, additional, Sheu, Wayne, additional, Wu, Mai-Szu, additional, Sari, Ramazan, additional, Sezer, Siren, additional, Yildiz, Alaattin, additional, Satman, Ilhan, additional, Kalender, Betul, additional, Mankovskyy, Borys, additional, Fushtey, Ivan, additional, Stanislavchuk, Mykola, additional, Kolenyk, Mykola, additional, Dudar, Iryna, additional, Zolotaikina, Viktoriia, additional, Abrahamovych, Orest, additional, Kostynenko, Tetyana, additional, Petrosyan, Olena, additional, Kuskalo, Petro, additional, Galushchak, Olga, additional, Legun, Oleg, additional, Topchii, Ivan, additional, Martynyuk, Liliya, additional, Stryzhak, Vasyl, additional, Panina, Svitlana, additional, Tkach, Sergii, additional, Korpachev, Vadym, additional, Maxwell, Peter, additional, Gnudi, Luigi, additional, Kon, Sui Phin, additional, Tindall, Hilary, additional, Kalra, Phillip, additional, Mark, Patrick, additional, Patel, Dipesh, additional, El-Shahawy, Mohamed, additional, Bai, Liqun, additional, Nica, Romanita, additional, Lien, Yeong-Hau, additional, Menefee, Judson, additional, Busch, Robert, additional, Miller, Alan, additional, Ahmed, Azazuddin, additional, Arif, Ahmed, additional, Lee, Joseph, additional, Desai, Sachin, additional, Bansal, Shweta, additional, Bentsianov, Marie, additional, Belledonne, Mario, additional, Jere, Charles, additional, Gaona, Raul, additional, Greenwood, Gregory, additional, Brusco, Osvaldo, additional, Boiskin, Mark, additional, Belo, Diogo, additional, Minasian, Raffi, additional, Atray, Naveen, additional, Lawrence, Mary, additional, Taliercio, John, additional, Pergola, Pablo, additional, Scott, David, additional, Alvarez, German, additional, Marder, Bradley, additional, Powell, Thomas, additional, Bakdash, Wa'el, additional, Stoica, George, additional, McFadden, Christopher, additional, Rendell, Marc, additional, Wise, Jonathan, additional, Jones, Audrey, additional, Jardula, Michael, additional, Madu, Ivy-Joan, additional, Varghese, Freemu, additional, Tulloch, Brian, additional, Ahmed, Ziauddin, additional, Hames, Melanie, additional, Nazeer, Imran, additional, Shahid, Newman, additional, John, Rekha, additional, Montero, Manuel, additional, Fitz-Patrick, David, additional, Phillips, Lawrence, additional, Guasch, Antonio, additional, Christofides, Elena, additional, Gundroo, Aijaz, additional, Amin, Mohammad, additional, Bowman-Stroud, Cynthia, additional, Link, Michael, additional, Mulloy, Laura, additional, Nammour, Michael, additional, Lalwani, Tarik, additional, Hanson, Lenita, additional, Whaley-Connell, Adam, additional, Herman, Lee, additional, Chatha, Rupi, additional, Osama, Sayed, additional, Liss, Kenneth, additional, Kayali, Zeid, additional, Bhargava, Anuj, additional, Israel, Ezra, additional, Peguero-Rivera, Alfredo, additional, Fang, Michael, additional, Slover, Judith, additional, Barengolts, Elena, additional, Flores, Jose, additional, Muoneke, Rosemary, additional, Savin, Virginia, additional, Awua-Larbi, Stella, additional, Levine, Andrew, additional, Newman, George, additional, Golestaneh, Laden, additional, Bohm, Guillermo, additional, Reisin, Efrain, additional, Cruz, Lucita, additional, Weiss, Robert, additional, Zieve, Franklin, additional, Horwitz, Edward, additional, Chuang, Peale, additional, Mersey, James, additional, Manley, John, additional, Graf, Ronald, additional, Bedros, Fadi, additional, Joshi, Sudhir, additional, Frias, Juan, additional, Assefi, Ali, additional, O'Shaughnessy, Andrew, additional, Brantley, Roman, additional, Minga, Todd, additional, Tietjen, David, additional, Kantor, Samuel, additional, Jamal, Aamir, additional, Guadiz, Ramon, additional, Hershon, Kenneth, additional, Bressler, Peter, additional, Kopyt, Nelson, additional, Cathcart, Harold, additional, Bloom, Scott, additional, Reichel, Ronald, additional, Nakhle, Samer, additional, Dulude, Emily, additional, Tarkan, Joshua, additional, Baker, Penelope, additional, Zeig, Steven, additional, Moya Hechevarria, Jaynier, additional, Ropero-Cartier, Armando, additional, De la Calle, Gilda, additional, Doshi, Ankur, additional, Saba, Fadi, additional, Sligh, Teresa, additional, Shaw, Sylvia, additional, Kumar, Jayant, additional, Szerlip, Harold, additional, Bayliss, George, additional, Perlman, Alan, additional, Sakhrani, Lakhi, additional, Gouge, Steven, additional, Argoud, Georges, additional, Acosta, Idalia, additional, Elder, John, additional, Joshi, Sucharit, additional, Sensenbrenner, John, additional, Vicks, Steven, additional, Mangoo-Karim, Roberto, additional, Galphin, Claude, additional, Leon-Forero, Carlos, additional, Gilbert, John, additional, Brown, Eric, additional, Ijaz, Adeel, additional, Butt, Salman, additional, Markell, Mariana, additional, Arauz-Pacheco, Carlos, additional, Sloan, Lance, additional, Alvarado, Odilon, additional, Jabbour, Serge, additional, Simon, Eric, additional, Rastogi, Anjay, additional, James, Sam, additional, Hall, Karen, additional, Melish, John, additional, Dixon, Brad, additional, Adolphe, Allen, additional, Kovesdy, Csaba, additional, Beddhu, Srinivasan, additional, Solomon, Richard, additional, Fernando, Ronald, additional, Levin, Ellis, additional, Thakar, Charuhas, additional, Robey, Brooks, additional, Goldfarb, David, additional, Fried, Linda, additional, Maddukuri, Geetha, additional, Thomson, Stephen, additional, Annand, Andrew, additional, Kronfli, Saeed, additional, Kalirao, Paramjit, additional, Schmidt, Rebecca, additional, Dahl, Neera, additional, Blumenthal, Samuel, additional, Weinstein, Debra, additional, Ostergaard, Ove, additional, Weinstein, Talia, additional, Ono, Yasuhiro, additional, Yalcin, Murat, additional, and Karim, Shahana, additional

Published
2019
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22. Comparação entre duas técnicas de higienização das mãos em pacientes de diálise peritoneal

Author

Siqueira,Soraia Lemos, Figueiredo,Ana Elizabeth, Figueiredo,Carlos Eduardo Poli de, and D'Avila,Domingos Otávio

Subjects
etanol, diálise peritoneal, higiene da pele, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, insuficiência renal crônica
Abstract

INTRODUÇÃO: A higienização das mãos é um importante procedimento para a prevenção de infecções relacionadas à diálise peritoneal. OBJETIVO: Comparar a eficácia de duas técnicas de higienização das mãos na redução do número de unidades formadoras de colônia em pacientes em programa de diálise peritoneal. MATERIAIS E MÉTODO: Ensaio Clínico controlado. Trinta indivíduos submetidos a três coletas da flora microbiológica das mãos, em três momentos distintos: antes e após higienização das mãos com água e sabão glicerinado; após aplicação de álcool-gel etílico glicerinado a 70%. Culturas obtidas da superfície dos dedos das mãos, diretamente em placas de Agar Sangue de Carneiro. RESULTADOS: O crescimento médio nas culturas foi 31, 30 e 12 unidades formadoras de colônia antes da higienização, após a lavagem com água e sabão glicerinado e após a fricção com álcool gel, respectivamente (p < 0, 001). Staphyloccocus epidermidis ou Estafilococo coagulase-negativo foi o germe predominante, presente em 93,7% das placas. CONCLUSÃO: A higienização com álcool gel produziu maior redução no número de unidades formadoras de colônia.

Published
2012

24. Effect of standard and neutral-pH peritoneal dialysis solutions upon fibroblasts proliferation

Author

Poitevin, André Antunes, Viezzer, Christian, Machado, Denise Cantarelli, Costa, Bartira Ercilia Pinheiro da, Figueiredo, Ana Elizabeth, d'Avila, Domingos, and Poli-de-Figueiredo, Carlos Eduardo

Subjects
cell culture techniques, fibroblastos, teste de materiais, peritoneal dialysis, técnicas de cultura de células, fibroblasts, diálise peritoneal, materials testing
Abstract

Introduction: Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations. Objective: To compare in vitro mouse fibroblast NIH-3T3 cell viability after exposition to a neutral pH dialysis solution in comparison to cells exposed to a standard solution. Methods: Experimental study to compare the effects of a conventional standard or a neutral-pH, low-glucose degradation products peritoneal dialysis solution on the viability of exposed fibroblasts in cell culture. Both solutions were tested in all the commercially available glucose concentrations. Cell viability was evaluated with tetrazolium salt colorimetric assay. Results: Fibroblast viability was significantly superior in the neutral pH solution in comparison to control, in all three glucose concentrations (Optical density in nm-means ± SD: 1.5% 0.295 ± 0.047 vs. 0.372 ± 0.042, p < 0.001; 2.3% 0.270 ± 0.036 vs. 0.337 ± 0.051, p < 0.001; 4.25% 0.284 ± 0.037 vs. 0.332 ± 0.032, p < 0.001; control vs. neutral pH respectively, Student t Test). There was no significant difference in cell viability between the three concentrations of glucose when standard solution was used (ANOVA p = 0.218), although cell viability was higher after exposition to neutral pH peritoneal dialysis fluid at 1.5% in comparison to 2.3 and 4.25% glucose concentrations (ANOVA p = 0.008: Bonferroni 1.5% vs. 2.3% p = 0.033, 1.5% vs. 4.25% p = 0.014, 2.3% vs. 4.25% p = 1.00). Conclusion: Cell viability was better in neutral pH dialysis solution, especially in the lower glucose concentration. A more physiological pH and lower glucose degradation products may be responsible for such results. Introdução: A exposição contínua da membrana peritoneal a soluções convencionais de diálise é um importante fator de risco para induzir alterações estruturais e funcionais. Objetivo: Comparar a viabilidade in vitro dos fibroblastos NIH-3T3 de camundongo após exposição à solução de diálise com pH neutro com células expostas à solução padrão. Métodos: Estudo experimental; ambas as soluções foram testadas em todas as concentrações de glicose comercialmente disponíveis. A viabilidade celular foi avaliada por ensaio colorimétrico de sal tetrazólio. Resultados: A viabilidade de fibroblastos foi melhor na solução de pH neutro em relação ao controle nas três concentrações de glicose (densidade óptica em nm-médias ± DP: 1,5% 0,295 ± 0,047 vs. 0,372 ± 0,042, p < 0,001; 2,3% 0,270 ± 0,036 vs. 0,337 ± 0,051, p < 0,001; 4,25% 0,284 ± 0,037 vs. 0,332 ± 0,032, p < 0,001; controle vs. pH neutro respectivamente, teste t de Student). Não houve diferença significativa na viabilidade celular entre as três concentrações de glicose quando solução padrão foi utilizada (ANOVA p = 0,218), embora a viabilidade celular tenha sido superior após exposição aos fluidos de diálise peritoneal neutros, pH 1,5% em comparação com 2,3 e 4,25% de concentrações de glicose (ANOVA p = 0,008: Bonferroni 1,5% vs. 2,3% p = 0,033, 1,5% vs. 4,25% p = 0,014, 2,3% vs. 4,25% p = 1,0). Conclusão: A viabilidade celular foi melhor em solução neutra de pH de diálise, especialmente nas menores concentrações de glicose. O pH fisiológico e com menos produtos de degradação de glicose podem ser responsáveis por estes resultados.

Published
2014

26. Composição corporal, depressão, qualidade de vida e mortalidade em hemodiálise

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Chronic kidney disease is a progressive condition, with no healing prospect, yet extended upholding under adequate monitoring and treatment. Approximately 100,000 patients currently undergo dialysis therapy - ninety percent on hemodialysis. Mortality ratio varies between 15 to 20%, being cardiovascular events mainly responsible. Among mental ailments thwarting kidney disease patients, depression is the most frequently associated co-morbidity, and linked to increased mortality and morbidity rates. In patients undergoing hemodialysis, malnourishment may relate with depressive symptoms, besides inflammation and cardiovascular diseases. Life style changes induced by end-stage renal disease impose a number of limitations that end up affecting the quality of life. Protein depletion is commonly observed in patients submitted to hemodialysis, and is associated with higher mortality. Strangely enough, it may be accompanied by weight gain and central fat accumulation. The role of adipocytokines in chronic kidney disease has recently drawn attention: association of serum chemerin to metabolic syndrome indicators, inflammation and obesity has been suggested. The aim of this study was to longitudinally evaluate nutritional status, presence of depressive symptoms, quality of life and mortality of hemodialysis patients, in a cohort study at the São Lucas Hospital /PUCRS, Porto Alegre, Brazil. Stable patients, undergoing hemodialysis for at least three months, were enrolled and evaluated at twelve month-intervals, thereafter. Participants were assessed for: depressive symptoms using the Beck Depression Inventory and for quality of life perception by the WHOQOL-bref questionnaire. Anthropometric data: weight, height, waist circumference; blood collection: for biochemical determinations, high-sensitivity C-reactive protein, chemerin; body composition analysis by direct segmental multi frequency bioimpedance, were obtained at a mid week dialysis session. One hundred and five participa, A doença renal crônica é uma doença progressiva, que não contempla expectativa de cura, mas o prolongamento da cronicidade, com acompanhamento e tratamento adequados. Quase 100. 000 pacientes são submetidos a tratamento dialítico, 90% em hemodiálise. A taxa de mortalidade bruta varia entre 15 a 20%, sendo eventos cardiovasculares os principais responsáveis. Dentre os problemas mentais que acometem pacientes com doença renal, depressão é a comorbidade mais frequente, associada a aumento das taxas de morbimortalidade. Desnutrição pode se relacionar com sintomas de depressão, assim como inflamação e doença cardiovascular, em pacientes tratados por hemodiálise. As mudanças de estilo de vida induzidas pela doença renal crônica terminal causam inúmeras limitações que afetam a qualidade de vida. Depleção proteica em pacientes submetidos a hemodiálise é frequentemente observada, e se associa com elevada mortalidade. Curiosamente, pode se acompanhar por excesso de peso e acúmulo de gordura central. O papel das adipocitocinas na doença renal crônica tem despertado interesse: associação de quemerina sérica com indicadores de síndrome metabólica, inflamação e obesidade foram sugeridas.O objetivo do presente estudo é correlacionar estado nutricional, sintomas de depressão, qualidade de vida e mortalidade em hemodiálise. Foi realizado estudo prospectivo de coorte com pacientes em hemodiálise no Hospital São Lucas/PUCRS, Porto Alegre, Brasil. Os pacientes estavam há três ou mais meses em hemodiálise, clinicamente estáveis. A cada doze meses, pacientes incluídos no estudo foram reavaliados para: sintomas de depressão – por questionário Beck de depressão; percepção da qualidade de vida – pelo questionário WHOQOL-bref; medidas antropométricas – peso, altura, circunferência da cintura; coleta de sangue - para dosagens de parâmetros bioquímicos, proteína C-reativa e quemerina; análise da composição corporal – por bioimpedância segmentar de multi-frequências. Foram incluídos 105 pacient

Published
2015

27. Evaluación de programa de enseñanza-aprendizaje sobre metabolismo de calcio y fósforo para pacientes en hemodiálisis

Author

Araujo, Lílian Peres Righetto de, Figueiredo, Ana Elizabeth Prado Lima, and d'Avila, Domingos Otavio Lorenzoni

Subjects
Calcio, Health education, Patients, Educação em saúde, Cálcio, Fósforo, Calcium, Phosphorus, Pacientes, Educación en salud, Diálise renal, Renal dialysis, Diálisis renal
Abstract

Estudo de corte avaliando efeitos de programa de ensino-aprendizagem sobre o metabolismo e controle de níveis séricos de cálcio (Ca), fósforo (PO4), paratormônio (PTH), produto Ca x PO4, em 33 pacientes estáveis em HD, randomizados para dois grupos: Controle (n=17) e Intervenção (n=16). O grupo Controle recebeu informação sobre acesso vascular: a Intervenção sobre metabolismo de Ca, PO4 e PTH. Mudanças de conhecimento avaliadas por testes pré e pós-classe; adesão à terapia por dosagens laboratoriais seriadas. Não houve mudança significativa de conhecimento em qualquer grupo [Intervenção: 8/17 vs. 14/17 pacientes competentes no pré e pós-teste, respectivamente (P

Published
2010

28. Hemodialysis patients: inflammatory status and lean body mass

Author

Barros, Annerose, Oliboni Sussela, Alex, Felix, Raisa, Silveira Lucas, Luiza, O. d'Avila, Domingos, Barros, Annerose, Oliboni Sussela, Alex, Felix, Raisa, Silveira Lucas, Luiza, and O. d'Avila, Domingos

Abstract

AIMS: To investigate the relationship of the inflammatory status with the lean body mass in hemodialysis patients. METHODS: A cross-sectional observational study included patients on hemodialysis for at least three months. The body composition analysis was performed by segmental multi-frequency bioimpedance (InBody 520®). The nutritional status associated with inflammation was evaluated using the instrument that computes the Malnutrition-Inflammation Score. RESULTS: The sample included 59 subjects, 30 were female. The mean age was 58.7 ± 14.4 years, the median time on dialysis was 24 (9-49) months, the mean estimated dry weight was 67.0 ± 14.7 kg and mean lean body mass was 29.7 ± 5.5 kg. The median serum level of ultrasensitive C-reactive protein was 8.6 (3.9 to 18.0) mg / L and above the normal limit (equal or less than 5.0 mg / L), suggesting the presence of inflammation. The malnutrition-inflammation score had a median of 4 (2-6). There was a significant correlation between the score malnutrition-inflammation and age (rs = 0.350, p less than 0.01) and with time on dialysis: (rs = 0.320, p less than 0.05). Inflammation assessed by the level of ultrasensitive C-reactive protein was significantly associated with lean body mass (rs = - 0.283, p less than 0.05). CONCLUSIONS: The increased time on dialysis and increased age were associated with poorer nutritional status. In this population, apparently the lower lean body mass the higher level of ultrasensitive C-reactive protein, suggesting a possible association between inflammation and lean body mass in these patients.

Published
2014

32. Medida da espessura médio-intimal da artéria carótida de crianças e adolescentes transplantados renais: um estudo controlado

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Background : Young adults with end-stage renal disease present increased risk of early cardiovascular morbidity and mortality. A kidney transplant is the treatment of choice to improve the kidney function, although it does not alter that risk. Carotid artery intima-media thickness (CIMT) seems to be an early predictor of cardiovascular risk. The aim of this study was to examine CIMT in young kidney transplant patients. Methods : Individuals aged 5 to 21 years were enrolled: 27 who had undergone a kidney transplant (Transplant group), and 25 without kidney disease (Control group). Anthropometric, family, clinical and laboratory variables, and time on dialysis (for Transplant group) were collected. Systolic and diastolic blood pressure and abdominal circumference were measured. Automated ultrasonography measured CIMT. Descriptive statistics was used to compare groups and search for associations. Results : A majority of patients was male, with mean age 12. 3 ± 4. 7 years. Systolic blood pressure, hematocrit, creatinine, eGFR, serum albumin and insulin levels significantly differed between groups. Yet no significant difference in CIMT between Transplant and Control groups (0. 46 ± 0. 04 vs. 0. 45 ± 0. 03, respectively; p = 0. 304) was detected. Univariate analysis was unable to show any association with known risk factors. Conclusion : No difference in CIMT between groups was established using a new ultrasound measuring device., Introdução : Adultos jovens com doença renal crônica apresentam risco aumentado de morbimortalidade cardiovascular. Transplante renal pode restaurar a função renal, mas o seguimento de crianças com transplante renal mostra que a principal causa de morte é a doença cardiovascular. A EMIAC tem sido considerada um bom preditor de doença aterosclerótica, permitindo que alterações da parede vascular associadas a aumento do risco cardiovascular possam ser precocemente detectadas. O objetivo deste estudo foi examinar e comparar a EMIAC de indivíduos normais com a de pacientes que receberam um transplante renal e verificar associações com fatores de risco conhecidos em crianças e adolescentes transplantados renais.Método : Participaram da pesquisa pacientes entre 5 e 21 anos de idade. História familiar de doença cardiovascular, variáveis antropométricas, clínicas e laboratoriais foram coletadas. O tempo em diálise foi mensurado. A pressão arterial sistólica e diastólica, bem como a circunferência abdominal foi medida em cada participante. Hematócrito, creatinina, glicemia, lipídios e frações, produto cálcio x fósforo, albumina, insulina e fibrinogênio séricos foram determinados. Ultrassonografia de alta resolução mediu a EMIAC. Estatística descritiva foi empregada para comparar grupos. Análise de regressão linear foi usada para verificar correlações. Resultados : Vinte e sete crianças com transplantes renais e vinte e cinco crianças saudáveis participaram do estudo. A maioria dos pacientes pertencia ao sexo masculino. Os grupos diferiram quanto à pressão arterial sistólica, à creatinina sérica, ao clearance de creatinina, ao hematócrito, à albumina sérica e ao nível de insulinemia. Não houve diferença significativa entre as medidas da EIMAc entre os grupos Transplantados e Controles (0,46 ± 0,03 vs. 0,45 ± 0,03). Em análise univariada, a EMIAC não se associou aos percentis da pressão arterial sistólica e diastólica, IMC, creatinina ou produto cálcio/fósforo. Conclusão : A E

Published
2013

33. Pacientes em hemodiálise ambulatorial: protocolo de administração e monitoramento de níveis séricos de vancomicina

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Background: The current study aims to test and a vancomycin protocol based on the initial hemodialysis patients’ weight and to describe drug peak and through serum levels. Methods: A study enrolling 16 ESRD adult patients cohort undergoing hemodialysis received a uniform vancomycin administration schedule: 20 mg/kg initial dose, infused during the last dialysis hour; blood sample collection 30 minutes post-dialysis and, subsequently, before every dialysis session. Additionally, a fixed schedule to adjust every new dose was used. Anthropometric, clinical and laboratory variables were collected. Descriptive statistics was used; Spearman correlation coefficient was used to verify associations. Results: No significant correlation between vancomycin peak serum level and trough levels and the initial dose, nor any trough level and the following doses were uncovered. However, total serum protein strong and positively correlated with the initial Vancomycin dose and the first trough serum level (rs = 0. 608, P = 0. 016 and rs= 0. 641; P = 0. 010, respectively). Initial dose positively correlated with albumin too (rs= 0. 572, P = 0. 02). A strong correlation between the first and second trough levels was also found (rs = 0. 608; P = 0. 021).Conclusion: As applied, the vancomycin administration protocol was ineffective in reaching and maintaining therapeutic peak and trough levels. It is possible that a significant loss of vancomycin free-fraction by dialysis accounted for such a finding. Correlation of vancomycin serum levels between total serum proteins should be further investigated., Objetivo Descrever os níveis séricos de vancomicina em amostras coletadas nos vales em pacientes em hemodiálise, a partir de um protocolo de administração deste antimicrobiano com dose inicial de 20mg/kg seguida de 10mg/kg e ajustes nas doses subsequentes, conforme a faixa de vancocinemia obtida e correlacionar com parâmetros fisiológicos para verificar possíveis associações.Métodos Estudo de coorte onde foram incluídos pacientes em hemodiálise ambulatorial, com idade igual ou superior a 18 anos que realizaram tratamento com vancomicina, empírico ou com germe isolado. O medicamento foi administrado por infusão intravenosa numa concentração de 10mg/mL na última hora da sessão de hemodiálise. O protocolo proposto baseia-se em doses administradas a cada sessão de diálise, realizadas três vezes na semana, considerando o peso do paciente, uma dose inicial e define ajustes de dose a cada vancocinemia, com o objetivo de mantê-la nos níveis terapêuticos estabelecidos de 10 a 20mg/L. Resultados: Não houve correlação significativa entre as concentrações de vancomicina sérica no pico e vales com as doses definidas pelo protocolo. Entretanto, o primeiro vale e as proteínas plasmáticas apresentaram forte correlação positiva (rs = 0. 608, P = 0. 01), além da dose inicial também se correlacionar positivamente com as proteínas plasmáticas e albumina (rs = 0. 641, P = 0. 01 e rs= 0. 572, P = 0. 02). Os níveis séricos de vancomicina entre o primeiro e o segundo vales apresentam forte correlação positiva (rs = 0. 608, P = 0. 02) e o volume de distribuição apresenta forte correlação inversa ao valor de pico de vancomicina (rs = - 0. 990; P < 0. 001).Conclusão Embora o estudo não tenha sido capaz de determinar um protocolo, identificamos uma variabilidade muito grande entre os resultados de vancocinemia. Doses mesmo ajustadas pelo peso seco do paciente e níveis séricos de vancomicina não foram suficientes para manter os níveis terapêuticos de vancomicina. É possível que haja perda signi

Published
2013

35. Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Author

Yi, Tae Won, Smyth, Brendan, Di Tanna, Gian Luca, Arnott, Clare, Cardoza, Kathryn, Kang, Amy, Pollock, Carol, Agarwal, Rajiv, Bakris, George, Charytan, David M., de Zeeuw, Dick, Heerspink, Hiddo J.L., Neal, Bruce, Wheeler, David C., Cannon, Christopher P., Zhang, Hong, Zinman, Bernard, Perkovic, Vlado, Levin, Adeera, Mahaffey, Kenneth W., Jardine, Meg, Perkovic, Vlado, Mahaffey, Kenneth W., Agarwal, Rajiv, Bakris, George, Brenner, Barry M., Cannon, Christopher P., Charytan, David M., de Zeeuw, Dick, Greene, Tom, Jardine, Meg J., Heerspink, Hiddo J.L., Levin, Adeera, Meininger, Gary, Neal, Bruce, Pollock, Carol, Wheeler, David C., Zhang, Hong, Zinman, Bernard, Jardine, Meg, Heerspink, Hiddo J.L., Charytan, David M., Li, Nicole, Kolesnyk, Inna, Aizenberg, Diego, Pecoits-Filho, Roberto, Levin, Adeera, Cherney, David, Obrador, Gregorio, Chertow, Glenn, Chang, Tara, Hawley, Carmel, Ji, Linong, Zhang, Hong, Wada, Takashi, Jha, Vivekanand, Lim, Soo Kun, Lim-Abrahan, Mary Anne, Santos, Florence, Chae, Dong-Wan, Hwang, Shang-Jyh, Vazelov, Evgueniy, Rychlík, Ivan, Hadjadj, Samy, Krane, Vera, Rosivall, László, De Nicola, Luca, Dreval, Alexander, Nowicki, Michał, Schiller, Adalbert, Distiller, Larry, Górriz, Jose L., Kolesnyk, Mykola, David, Wheeler, C., Guerrero, Rodolfo Andres Ahuad, Aizenberg, Diego, Albisu, Juan Pablo, Alvarisqueta, Andres, Bartolacci, Ines, Berli, Mario Alberto, Bordonava, Anselmo, Calella, Pedro, Cantero, Maria Cecilia, Cartasegna, Luis Rodolfo, Cercos, Esteban, Coloma, Gabriela Cecilia, Colombo, Hugo, Commendatore, Victor, Cuadrado, Jesus, Cuneo, Carlos Alberto, Cusumano, Ana Maria, Douthat, Walter Guillermo, Dran, Ricardo Dario, Farias, Eduardo, Fernandez, Maria Florencia, Finkelstein, Hernan, Fragale, Guillermo, Fretes, Jose Osvaldo, Garcia, Nestor Horacio, Gastaldi, Anibal, Gelersztein, Elizabeth, Glenny, Jorge Archibaldo, Gonzalez, Joaquin Pablo, Colaso, Patricia del Carmen Gonzalez, Goycoa, Claudia, Greloni, Gustavo Cristian, Guinsburg, Adrian, Hermida, Sonia, Juncos, Luis Isaias, Klyver, Maria Isabel, Kraft, Florencia, Krynski, Fernando, Lanchiotti, Paulina Virginia, Leon de la Fuente, Ricardo Alfonso, Marchetta, Nora, Mele, Pablo, Nicolai, Silvia, Novoa, Pablo Antonio, Orio, Silvia Ines, Otreras, Fabian, Oviedo, Alejandra, Raffaele, Pablo, Resk, Jorge Hector, Rista, Lucas, Papini, Nelson Rodriguez, Sala, Jorgelina, Santos, Juan Carlos, Schiavi, Lilia Beatriz, Sessa, Horacio, Casabella, Tomas Smith, Ulla, Maria Rosa, Valdez, Maria, Vallejos, Augusto, Villarino, Adriana, Visco, Virginia Esther, Wassermann, Alfredo, Zaidman, Cesar Javier, Cheung, Ngai Wah, Droste, Carolyn, Fraser, Ian, Johnson, David, Mah, Peak Mann, Nicholls, Kathy, Packham, David, Proietto, Joseph, Roberts, Anthony, Roger, Simon, Tsang, Venessa, Raduan, Roberto Abrão, Costa, Fernando Augusto Alves da, Amodeo, Celso, Turatti, Luiz Alberto Andreotti, Bregman, Rachel, Sanches, Fernanda Cristina Camelo, Canani, Luis Henrique, Chacra, Antônio Roberto, Borges, João Lindolfo Cunha, Vêncio, Sérgio Alberto Cunha, Franco, Roberto Jorge da Silva, d’Avila, Domingos, Portes, Evandro de Souza, de Souza, Pedro, Deboni, Luciane Mônica, Fraige Filho, Fadlo, Neto, Bruno Geloneze, Gomes, Marcus, Kohara, Suely Keiko, Keitel, Elizete, Saraiva, Jose Francisco Kerr, Lisboa, Hugo Roberto Kurtz, Contieri, Fabiana Loss de Carvalho, Milagres, Rosângela, Junior, Renan Montenegro, de Brito, Claudia Moreira, Hissa, Miguel Nasser, Sabbag, Ângela Regina Nazario, Noronha, Irene, Panarotto, Daniel, Filho, Roberto Pecoits, Pereira, Márcio Antônio, Saporito, Wladmir, Scotton, Antonio Scafuto, Schuch, Tiago, de Almeida, Roberto Simões, Ramos, Cássio Slompo, Felício, João Soares, Thomé, Fernando, Hachmann, Jean Carlo Tibes, Yamada, Sérgio, Hayashida, Cesar Yoiti, Petry, Tarissa Beatrice Zanata, Zanella, Maria Teresa, Andreeva, Viktoria, Angelova, Angelina, Dimitrov, Stefan, Genadieva, Veselka, Genova-Hristova, Gabriela, Hristozov, Kiril, Kamenov, Zdravko, Koundurdjiev, Atanas, Lozanov, Lachezar, Margaritov, Viktor, Nonchev, Boyan, Rangelov, Rangel, Shinkov, Alexander, Temelkova, Margarita, Velichkova, Ekaterina, Yakov, Andrian, Aggarwal, Naresh, Aronson, Ronnie, Bajaj, Harpreet, Cherney, David, Chouinard, Guy, Conway, James, Cournoyer, Serge, DaRoza, Gerald, De Serres, Sacha, Dubé, François, Goldenberg, Ronald, Gupta, Anil, Gupta, Milan, Henein, Sam, Khandwala, Hasnain, Leiter, Lawrence, Levin, Adeera, Madore, François, McMahon, Alan, Muirhead, Norman, Pichette, Vincent, Rabasa-Lhoret, Remi, Steele, Andrew, Tangri, Navdeep, Torshizi, Ali, Woo, Vincent, Zalunardo, Nadia, Montenegro, María Alicia Fernández, Gonzalo Godoy Jorquera, Juan, Fariña, Marcelo Medina, Gajardo, Victor Saavedra, Vejar, Margarita, Chen, Nan, Chen, Qinkai, Gan, Shenglian, Kong, Yaozhong, Li, Detian, Li, Wenge, Li, Xuemei, Lin, Hongli, Liu, Jian, Lu, Weiping, Mao, Hong, Ren, Yan, Song, Weihong, Sun, Jiao, Sun, Lin, Tu, Ping, Wang, Guixia, Yang, Jinkui, Yin, Aiping, Yu, Xueqing, Zhao, Minghui, Zheng, Hongguang, Mendoza, Jose Luis Accini, Arcos, Edgar, Avendano, Jorge, Diaz Ruiz, Jorge Ernesto Andres, Ortiz, Luis Hernando Garcia, Gonzalez, Alexander, Triana, Eric Hernandez, Higuera, Juan Diego, Malaver, Natalia, de Salazar, Dora Inés Molina, Rosero, Ricardo, Alexandra Terront Lozano, Monica, Cometa, Luis Valderrama, Valenzuela, Alex, Vargas Alonso, Ruben Dario, Villegas, Ivan, Yupanqui, Hernan, Bartaskova, Dagmar, Barton, Petr, Belobradkova, Jana, Dohnalova, Lenka, Drasnar, Tomas, Ferkl, Richard, Halciakova, Katarina, Klokocnikova, Vera, Kovar, Richard, Lastuvka, Jiri, Lukac, Martin, Pesickova, Satu, Peterka, Karel, Pumprla, Jiri, Rychlik, Ivan, Saudek, Frantisek, Tesar, Vladimir, Valis, Martin, Weiner, Pavel, Zemek, Stanislav, Alamartine, Eric, Borot, Sophie, Cariou, Bertrand, Dussol, Bertrand, Fauvel, Jean-Pierre, Gourdy, Pierre, Klein, Alexandre, Le Meur, Yannick, Penfornis, Alfred, Roussel, Ronan, Saulnier, Pierre-Jean, Thervet, Eric, Zaoui, Philippe, Burst, Volker, Faghih, Markus, Faulmann, Grit, Haller, Hermann, Jerwan-Keim, Reinhold, Maxeiner, Stephan, Paschen, Björn, Plassmann, Georg, Rose, Ludger, Gonzalez Orellana, Ronaldo Arturo, Haase, Franklin Paul, Moreira Diaz, Juan Pablo, Ramirez Roca, Luis Alberto, Sánchez Arenales, Jose Antonio, Sanchez Polo, José Vicente, Juarez, Erick Turcios, Csecsei, Gyongyi, Csiky, Botond, Danos, Peter, Deak, Laszlo, Dudas, Mihaly, Harcsa, Eleonora, Keltai, Katalin, Keresztesi, Sandor, Kiss, Krisztian, Konyves, Laszlo, Major, Lajos, Mileder, Margit, Molnar, Marta, Mucsi, Janos, Oroszlan, Tamas, Ory, Ivan, Paragh, Gyorgy, Peterfai, Eva, Petro, Gizella, Revesz, Katalin, Takacs, Robert, Vangel, Sandor, Vasas, Szilard, Zsom, Marianna, Abraham, Oomman, Bhushan, Raju Sree, Deepak, Dewan, Edwin, Fernando M., Gopalakrishnan, Natarajan, Gracious, Noble, Hansraj, Alva, Jain, Dinesh, Keshavamurthy, C.B., Khullar, Dinesh, Manisha, Sahay, Peringat, Jayameena, Prasad, Narayan, Satyanarayana, Rao K., Sreedhar, Reddy, Sreelatha, Melemadathil, Sudhakar, Bhimavarapu, Chandra Vyasam, Ramesh, Bonadonna, Riccardo, Castellino, Pietro, Ceriello, Antonio, Chiovato, Luca, De Cosmo, Salvatore, De Nicola, Luca, Derosa, Giuseppe, Di Carlo, Alberto, Di Cianni, Graziano, Frascà, Giovanni, Fuiano, Giorgio, Gambaro, Giovanni, Garibotto, Giacomo, Giorda, Carlo, Malberti, Fabio, Mandreoli, Marcora, Mannucci, Edoardo, Orsi, Emanuela, Piatti, Piermarco, Santoro, Domenico, Sasso, Ferdinando Carlo, Serviddio, Gaetano, Stella, Andrea, Trevisan, Roberto, Veronelli, Anna Maria, Zanoli, Luca, Akiyama, Hitoshi, Aoki, Hiromi, Asano, Akimichi, Iitsuka, Tadashi, Kajiyama, Shizuo, Kashine, Susumu, Kawada, Toshio, Kodera, Takamoto, Kono, Hiroshi, Koyama, Kazunori, Kumeda, Yasuro, Miyauchi, Shozo, Mizuyama, Kazuyuki, Niiya, Tetsuji, Oishi, Hiroko, Ota, Satoshi, Sakakibara, Terue, Takai, Masahiko, Tomonaga, Osamu, Tsujimoto, Mitsuru, Wada, Takashi, Wakasugi, Masakiyo, Wakida, Yasushi, Watanabe, Takayuki, Yamada, Masayo, Yanagida, Kazuhiro, Yanase, Toshihiko, Yumita, Wataru, Gaupsiene, Egle, Kozloviene, Dalia, Navickas, Antanas, Urbanaviciene, Egle, Abdul Ghani, Rohana, Kadir, Khalid Abdul, Ali, Norsiah, Che Yusof, Mohd Daud, Gan, Chye Lee, Ismail, Mastura, Kong, Wei Yen, Lam, Swee Win, Lee, Li Yuan, Lim, Soo Kun, Loh, Chek Loong, Manocha, Anita Bhajan, Ng, Kee Sing, Ahmad, Nik Nur Fatnoon Nik, Ratnasingam, Vanassa, Shudim, Saiful Shahrizal Bin, Vengadasalam, Paranthaman, Abraira Munoz, Luis David, Salazar, Melchor Alpizar, Cruz, Juan Baas, Soto, Mario Burgos, Ramos, Jose Chevaile, Wong, Alfredo Chew, Correa Rotter, Jose Ricardo, Escalante, Tonatiu Diaz, Enriquez Sosa, Favio Edmundo, Lozano, Fernando Flores, Flota Cervera, Luis Fernando, Baron, Paul Frenk, Ballesteros, Cecilia Garcia, Gomez Rangel, Jose David, Herrera Jimenez, Luis Enrique, Irizar Santana, Sergio Saul, Flores, Fernando Jimenez, Molina, Hugo Laviada, Luna Ceballos, Rosa Isela, del Campo Blanco, Belia Martin, Franco, Guadalupe Morales, Moreno Loza, Oscar Tarsicio, Rocha, Cynthia Mustieles, Vera, Gregorio Obrador, Castellanos, Ricardo Orozco, Calcaneo, Juan Peralta, Reyes Rosano, Miguel Angel, Pattzi, Hiromi Rodriguez, Guzman, Juan Rosas, Rucker Joerg, Isabel Erika, Saavedra Sanchez, Sandra Berenice, Sanchez Mijangos, Jose Hector, Sanson, Pablo Serrano, Tamayo y Orozco, Juan Alfredo, Chavez, Eloisa Tellez, Cepeda, Alejandro Valdes, Carrillo, Luis Venegas, Mesa, Juan Villagordoa, Escobedo, Rolando Zamarripa, Baker, John, Noonan, Paul, Scott, Russell, Walker, Robert, Watson, Edward, Williams, Michael, Young, Simon, Abejuela, Zaynab, Agra, Jeimeen, Aquitania, Grace, Caringal, Clodoaido, Comia, Rhea Severina, Santos, Lalaine Delos, Gomez, Olivert, Jimeno, Cecilia, Santos, Florence, Tan, Gerry, Tolentino, Marsha, Yao, Christy, Yap, Yvette Ethel, Lallaine Ygpuara, Ma. Dovie, Bijata-Bronisz, Renata, Hotlos, Lucyna, Januszewicz, Andrzej, Kaczmarek, Barbara, Kaminska, Anna, Lazuka, Lech, Madej, Andrzej, Mazur, Stanislaw, Mlodawska-Choluj, Dorota, Nowicki, Michal, Orlowska-Kowalik, Grazyna, Popenda, Grazyna, Rewerska, Barbara, Sowinski, Dariusz, Angelescu, Liliana Monica, Anghel, Veronica, Avram, Rodica-Ioana, Busegeanu, Mihaela-Magdalena, Cif, Adriana, Cosma, Dana, Crisan, Carmen, Demian, Luiza Despina, Ferariu, Ioana Emilia, Halmagyi, Ildiko, Hancu, Nicolae, Munteanu, Mircea, Negru, Doru, Onaca, Adriana Gabriela, Petrica, Ligia, Popa, Amorin Remus, Ranetti, Aurelian-Emil, Serafinceanu, Cristian, Toarba, Cristina, Agafyina, Alina, Barbarash, Olga, Barysheva, Olga, Chizhov, Daniil, Dobronravov, Vladimir, Dreval, Alexander, Glinkina, Irina, Grineva, Elena, Khirmanov, Vladimir, Kolmakova, Elena, Koroleva, Tatiana, Kvitkova, Liudmila, Marasaev, Viacheslav, Mkrtumyan, Ashot, Morugova, Tatiana, Nagibovich, Galina, Nagibovich, Oleg, Nedogoda, Sergei, Osipova, Irina, Raskina, Tatiana, Samoylova, Yulia, Sazonova, Olga, Shamkhalova, Minara, Shutemova, Elena, Shwartz, Yuriy, Uriasyev, Oleg, Vorobyev, Sergey, Zateyshchikova, Anna, Zateyshshikov, Dmitry, Zykova, Tatyana, Antic, Slobodan, Djordjevic, Miodrag, Kendereski, Aleksandra, Lalic, Katarina, Lalic, Nebojsa, Popovic-Radinovic, Vesna, Babikova, Jana, Benusova, Olga, Buganova, Ingrid, Culak, Jan, Dzupina, Andrej, Dzuponova, Jana, Fulop, Peter, Ilavska, Adriana, Martinka, Emil, Ochodnicka, Zuzana, Pella, Daniel, Smatanova, Iveta, Ahmed, Fayzal, Badat, Aysha, Breedt, Johannes, Distiller, Lawrence, Govender, Vimladhevi, Govender, Ravendran, Joshi, Mukesh, Jurgens, Jaco, Latiff, Gulam, Lombard, Landman, Mookadam, Mohamed, Ngcakani, Nomangesi, Nortje, Hendrik, Oosthuizen, Helena, Pillay-Ramaya, Larisha, Prozesky, Hans, Reddy, Jeevren, Rheeder, Paul, Seeber, Mary, Chae, Dong-Wan, Cho, Young Min, Jeong, In-Kyung, Kim, Sin Gon, Kim, Yeong Hoon, Kwon, Hyuk-Sang, Kwon, Min Jeong, Lee, Byung-Wan, Lee, JungEun, Lee, Moon-Kyu, Nam, Moon-Suk, Oh, Kook-Hwan, Park, Cheol- Young, Park, Sun-Hee, Yoon, Kun Ho, Garcia, Pere Alvarez, Mercadal, Luis Asmarats, Barrios, Clara, Castro, Fernando Cereto, Guldris, Secundino Cigarran, Lopez, Marta Dominguez, Egido de los Rios, Jesus, Fresnedo, Gema Fernandez, Serrano, Antonio Galan, Garcia, Isabel, Gonzalez Martinez, Francisco Javier, Jodar Gimeno, Jose Esteban, Mendoza, Manuel Lopez, Marin, Tamara Malek, Portillo, Cristobal Morales, Munar Vila, Maria Antonia, Torres, Manuel Muñoz, Iglesias, Javier Nieto, Perez, Jonay Pantoja, Vera, Merce Perez, Portoles Perez, Jose M., Quesada Simón, María Angustias, Canonge, Rafael Simo, Gonzalez, Alfonso Soto, Riera, Manel Terns, Tinahones Madueno, Francisco Jose, Plaza, Mercedes Velo, Chang, Chwen-Tzuei, Chuang, Lee-Ming, Hsia, Te-Lin, Hsieh, Chang-Hsun, Hwang, Shang-Jyh, Lin, Chih-Ching, Lu, Yung- Chuan, Sheu, Wayne H-H, Barna, Olga, Bilyk, Svitlana D., Botsyurko, Volodymyr, Dudar, Iryna, Fushtey, Ivan, Godlevska, Olga, Golovchenko, Oleksandr, Gyrina, Olga, Kazmirchuk, Anatoliy, Kolesnyk, Mykola, Komisarenko, Iuliia, Korzh, Oleksii, Kravchun, Nonna, Legun, Oleg, Mankovskyy, Borys, Martynyuk, Liliya, Mostovoy, Yuriy, Pashkovska, Nataliia, Pererva, Larysa, Pertseva, Tetyana, Samoylov, Oleksandr, Smirnov, Ivan, Svyshchenko, Yevgeniya, Tomashkevych, Halyna, Topchii, Ivan, Tryshchuk, Nadiya, Tseluyko, Vira, Vizir, Vadym, Vlasenko, Maryna, Zlova, Tetiana, Zub, Liliia, Abusnana, Salah, Railey, Mohamed, Abouglila, Kamal, Ainsworth, Paul, Ali, Zishan, Arutchelvam, Vijayaraman, Barnard, Maria, Bellary, Srikanth, Davies, Emyr, Davies, Mark, Davies, Simon, Dawson, Alison, El Kossi, Mohsen, English, Patrick, Fraser, Donald, Gnudi, Luigi, Gunstone, Anthony, Hall, Timothy, Hanif, Wasim, Jackson, Alan, Johnson, Andrew, Joseph, Franklin, Krishnan, Singhan, Kumwenda, Mick, MacDougall, Iain, Nixon, Paul, O'Hare, Joseph, Philip, Sam, Ramtoola, Shenaz, Saxena, Manish, Sennik, Davesh, Simon, Godwin, Singh, Baldev, Stephens, Jeffrey, Strzelecka, Anna, Symonds, Rehan, Turner, Wayne, Wahba, Mona, Wakeling, John, Wheeler, David, Winocour, Peter, Abdallah, Joseph, Abdullah, Raied, Abramowitz, Matthew, Acosta, Idalia, Aiello, Joseph, Akright, Laura, Akyea-Djamson, Ayim, Alappan, Rajendran, Alicic, Radica, Al-Karadsheh, Amer, Allison, Dale Crawford, Arauz-Pacheco, Carlos, Arfeen, Shahabul, Arif, Ahmed, Arvind, Moogali, Atray, Naveen, Awad, Ahmed, Bakris, George, Barnhill, Peggy, Barranco, Elizabeth, Barrera, Carlos, Beacom, Matthew, Behara, Venkata, Belo, Diogo, Bentley-Lewis, Rhonda, Berenguer, Ramon, Bermudez, Lidia, Bernardo, Marializa, Biscoveanu, Mihaela, Bowman-Stroud, Cynthia, Brandon, Donald, Brusco, Osvaldo, Busch, Robert, Canaan, Yamil, Chilito, Alicia, Christensen, Tom, Christiano, Cynthia, Christofides, Elena, Chuateco, Caroucel, Cohen, Kenneth, Cohen, Robert, Cohen-Stein, Debbie, Cook, Charles, Coyne, Daniel, Daboul, Nizar, Darwish, Riad, Daswani, Adarsh, Deck, Kenneth, Desouza, Cyrus, Dev, Devasmita, Dhillon, Monika, Dua, Sohan, Eder, Frank, Elosegui, Ana Maria, El-Shahawy, Mohamed, Ervin, John, Esquenazi, Alberto, Evans, John, Fishbane, Steven, Frias, Juan, Galindo-Ramos, Eugenia, Galphin, Claude, Ghazi, Adline, Gonzalez, Enrique, Gorson, David, Gowda, Anupama, Greco, Barbara, Grubb, Stephen, Gulati, Rakesh, Hammoud, Jamal, Handelsman, Stuart, Hartman, Israel, Hershon, Kenneth, Hiser, Daniel, Hon, George, Jacob, Radu, Jaime, Maria, Jamal, Aamir, Kaupke, Charles, Keightley, Gerald, Kern, Elizabeth, Khanna, Rakhi, Khitan, Zeid, Kim, Sun, Kopyt, Nelson, Kovesdy, Csaba, Krishna, Gopal, Kropp, Jeffrey (Jay), Kumar, Amrendra, Kumar, Jayant, Kumar, Neil, Kusnir, Jorge, Lane, Wendy, Lawrence, Mary, Lehrner, Lawrence, Lentz, John, Levinson, Dennis, Lewis, Derek, Liss, Kenneth, Maddux, Andreas, Maheshwari, Hiralal, Mandayam, Sreedhar, Marar, Isam, Mehta, Bhasker, Middleton, John, Mordujovich, Jorge, Moreda, Ramon, Moustafa, Moustafa, Trenche, Samuel Mujica, Narayanan, Mohanram, Narvarte, Javier, Nassar, Tareq, Newman, George, Nichol, Brian, Nicol, Philip, Nisnisan, Josier, Nossuli, A. Kaldun, Obialo, Chamberlain, Olelewe, Sarah, Oliver, Michael, O'Shaughnessy, Andrew, Padron, John, Pankhaniya, Rohit, Parker, Reginald, Patel, Devesh, Patel, Gnyandev, Patel, Nina, Pavon, Humberto, Perez, Armando, Perez, Carlos, Perlman, Alan, Pettis, Karlton, Pharr, Walter, Phillips, Andrea, Purighalla, Raman, Quesada-Suarez, Luis, Ranjan, Rajiv, Rastogi, Sanjeev, Reddy, Jakkidi, Rendell, Marc, Rich, Lisa, Robinson, Michael, Rodriguez, Hector, Rosas, Sylvia, Saba, Fadi, Sankaram, Rallabhandi, Sarin, Ravi, Schreiman, Robert, Scott, David, Sekkarie, Mohamed, Sensenbrenner, John, Shakeel, Muhammad, Shanik, Michael, Shaw, Sylvia, Smith, Stephen, Solomon, Richard, Sprague, Amy, Spry, Leslie, Suchinda, Pusadee, Sultan, Senan, Surampudi, Prasanth, Sussman, Sherry, Tan, Anjanette, Terrelonge, Antonio, Thompson, Michael, Trespalacios, Fernando, Trippe, Bruce, Trueba, Pilar, Twahirwa, Marcel, Updegrove, John, Van Buren, Peter, Vannorsdall, Mark, Varghese, Freemu, Velasquez-Mieyer, Pedro, Ventrapragada, Sailaja, Vukotic, Goga, Wadud, Khurram, Warren, Mark, Watson, Henry, Watts, Ronald, Weiner, Daniel, Welker, James, Welsh, Jean, Williams, Shelley, and Zaniewski-Singh, Michelle

Abstract

It is unclear whether the effect of canagliflozin on adverse kidney and cardiovascular events in those with diabetic kidney disease varies by age and sex. We assessed the effects of canagliflozin among age group categories and between sexes in the Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study.

Published
2023
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36. Relação do volume de ultrafiltração e sobrevida em pacientes incidentes em diálise peritoneal

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introduction: Peritoneal dialysis ultrafiltration failure is a functional abnormality associated with increased risk of death and technique failure. Daily ultrafiltration volume early on therapy may predict patient and technique survival. Objective: to determine the relationship between to presence of risk factors, daily ultrafiltration volume, patient and technique survival. Patients and Method: Data were extracted from the observational, multicenter, BRAZPD cohort study. From a population of 2419 suitable patients, 977 incident patients were selected. At the three-month therapy interval, demographic, clinical and technical variables were appraised and daily ultrafiltration volume was analyzed by quartiles (1st: ≤ 700 ml; 2nd: > 700 ml up to ≤ 1100 ml; 3rd: > 1100 ml up to < 1600 ml; 4th: ≥ 1600 ml), as were its changes at the sixth and twelfth follow-up months. Two outcomes were considered : death and technique failure, which were analyzed till the 30th therapy month. Comparison between groups, correlations, patient and technique uni and multivariate survival analyses, using Kaplan-Meier technique and Cox regression analysis, were performed. Results: Age (HR=1. 038; 95% CI: 1. 027-1. 049; P<0. 01), diabetes (HR=1. 416; 95% CI: 1. 043-1. 922; P=0. 03) and number of co-morbidities (HR=2. 687; 95% CI: 1. 336-5. 407; P<0,01) were directly associated with increased patient mortality. The 4th ultrafiltration quartile related with higher patient and technique survival (P=0. 02 and P=0. 10, respectively); peritonitis had a strong negative effect upon therapy maintenance (HR=3. 459; 95% CI: 2. 218-5. 394; P<0. 01). Conclusion: young, non-diabetic patients had increased chance for survival. High ultrafiltration volumes promoted patient and technique survival. Peritonitis significantly reduced the likelihood of technical success., Introdução: A falha de ultrafiltração na diálise peritoneal é uma anormalidade funcional associada a risco aumentado para morte e para falha técnica. O volume diário de ultrafiltração, aos três meses de terapia, pode ser fator de risco e preditor precoce para sobrevida de paciente e técnica. Objetivo: determinar a relação entre a presença de fatores de risco, volume diário ultrafiltrado e sobrevida de paciente e terapia. Pacientes e Método: estudo de coorte baseado em dados do estudo BRAZPD, multicêntrico, observacional. Foram incluídos 977 pacientes incidentes, dentre 2419 elegíveis. Aos três meses de terapia analisaram-se variáveis demográficas, clínicas e técnicas. O volume diário de ultrafiltração foi analisado por quartis, (1º quartil: ≤ 700 ml; 2º quartil: > 700 ml e ≤ 1100 ml; 3º quartil: > 1100 ml e < 1600 ml; 4º quartil: ≥ 1600 ml, assim como sua variação aos seis e doze meses de seguimento. Dois desfechos foram contemplados: morte e falha técnica, analisados até 30 meses de terapia. Comparações entre grupos, correlações bem como análise univariada de sobrevida - de paciente e técnica - foi feita pela técnica de Kaplan-Meier e multivariada por regressão de Cox. Resultados: idade (HR=1,038; IC 95%: 1,027-1,049; P<0,001), Diabetes Mellitus (HR=1,416; IC 95%: 1,043-1,922; P<0,026) e número de comorbidades (HR=2,687; IC 95% -1,336-5,407; P<0,01) foram diretamente associados com mortalidade aumentada do paciente. O quarto quartil de ultrafiltração associou-se a maior sobrevida do paciente e da técnica (P=0,02 e P=0,10, respectivamente); a ocorrência de peritonite teve impacto negativo para manutenção da terapia (HR=3,459; IC 95%: 2,218-5,394; P<0,01). Conclusão: pacientes jovens, sem diabetes tiveram maior chance de sobrevida. Ter alto volume de ultrafiltração foi favorável à sobrevida de pacientes e da técnica. A ocorrência de peritonite reduziu significativamente a chance de sucesso da técnica.

Published
2012

37. Monitoramento terapêutico do ácido micofenólico: validação de método e análise de interação com omeprazol

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Renal transplantation has been deemed the best treatment for patients with end stage renal disease. Mycophenolic acid is an immunosuppressant widely used in transplantation, acting as a potent, selective, non-competitive and reversible inhibitor of inosine monophosphate-dehydrogenase enzyme. Currently, two compounds are available: mycophenolate mofetil and mycophenolate sodium, both presenting with high rate of gastrointestinal complications. In clinical practice, patients are routinely prescribed with fixed doses, which can lead to drug exposure differences as great as 10 times. Therapeutic monitoring of Mycophenolic acid appears as a helping tool, useful for adjusting doses, individualizing therapy and promoting better understanding of drug interactions on the pharmacokinetics of Mycophenolic acid. Omeprazole is a widely prescribed drugs for transplanted patient, either as prophylaxis of gastric disorders or peptic ulcers therapy. However, literature data have hinted at a possible omeprazole interaction on Mycophenolic acid pharmacokinetics, by raising gastric pH and reducing its gastric absorption. The aim of the current study was to evaluate Mycophenolic acid levels in patients using mycophenolate mofetil or mycophenolate sodium with and without co-administration of omeprazole. The method for therapeutic drug monitoring of Mycophenolic acid seemed consistent with previously established validation parameters. There was no statistical difference in Mycophenolic acid levels of patients using either mycophenolate mofetil or mycophenolate sodium, with or without concomitant omeprazole; yet Mycophenolic acid plasma levels presented lower variance when omeprazole was concomitantly used, in both groups., O transplante renal constitui-se no tratamento de escolha para pacientes com insuficiência renal crônica terminal. O ácido micofenólico é um imunossupressor muito empregado no transplante, que age como um potente, seletivo, não competitivo e reversível inibidor da enzima inosina-monofosfato desidrogenase. Atualmente, dois compostos estão disponíveis: o micofenolato de mofetila e o micofenolato sódico, ambos apresentando elevado índice de complicações gastrointestinais. Na prática clínica, os pacientes são rotineiramente prescritos com doses fixas padrão, o que pode levar a uma diferença de pelo menos 10 vezes na exposição à droga.O monitoramento terapêutico do ácido micofenólico surge como uma ferramenta de apoio clínico, auxiliando no ajuste de doses, na individualização da terapia, e promovendo maior entendimento quanto a interações medicamentosas na farmacocinética do ácido micofenólico. O omeprazol é um dos fármacos muito prescritos para pacientes transplantados, seja na profilaxia de distúrbios gástricos, seja no tratamento de úlceras pépticas. Entretanto, dados da literatura vêem apontando uma possível interação do omeprazol na farmacocinética do ácido micofenólico, por elevar o pH gástrico e diminuir sua absorção. Assim, o objetivo desse trabalho foi realizar a validação de método para monitoramento terapêutico do ácido micofenólico e realizar uma análise dos efeitos da coadministração de omeprazol nos níveis plasmáticos do ácido micofenólico em grupos de pacientes em uso de micofenolato mofetila ou micofenolato sódico. O método laboratorial desenvolvido e validado para monitoramento terapêutico do ácido micofenólico apresentou-se condizente com os parâmetros de validação descritos na literatura. A análise dos níveis de ácido micofenólico, quando co-administrado ou não omeprazol em pacientes em uso de micofenolato mofetila ou micofenolato sódico, não demonstrou diferença estatística, mas se observou que tanto o grupo micofenolato mofetila quanto o micofenolat

Published
2012

38. Comparação entre duas técnicas de higienização das mãos em pacientes de diálise peritoneal

Author

D'Avila, Domingos Otávio Lorenzoni, Figueiredo, Ana Elizabeth Prado Lima, D'Avila, Domingos Otávio Lorenzoni, and Figueiredo, Ana Elizabeth Prado Lima

Abstract

INTRODUÇÃO: A higienização das mãos é um importante procedimento para a prevenção de infecções relacionadas a diálise peritoneal. OBJETIVO: comparar a eficácia de duas técnicas de higienização das mãos, na redução do número de unidades formadoras de colônia em pacientes em programa de diálise peritoneal. MATERIAIS E MÉTODO: Estudo observacional, transversal. Vinte e dois indivíduos submetidos a duas coletas da flora microbiológica das mãos, em dois momentos distintos: após higienização das mãos com água e sabão não antimicrobiano seguida de fricção com álcool etílico 70%, apresentação gel; após aplicação de álcool etílico 70%, apresentação gel. Culturas obtidas da superfície dos dedos das mãos, diretamente em placas de Agar Sangue de Carneiro. RESULTADOS: A comparação entre grupos mostrou uma diferença significativa (p<0,01), nas unidades formadoras de colônia nas mãos direitas e mãos esquerdas, a média 59,6±43,1 do grupo água e sabão não antimicrobiano; mostrou-se mais elevada que no grupo álcool etílico 70%, apresentação gel (31,8±39,9). Esta diferença é caracterizada pela presença de colônias de Staphyloccocus coagulasenegativa, sendo que este foi o germe prevalente nas culturas. CONCLUSÃO: A higienização com álcool etílico 70%, apresentação gel produziu maior redução no número de unidades formadoras de colônia., Hand hygiene is an important procedure in preventing peritoneal dialysis-related infections. OBJECTIVE: To compare the effectiveness of two distinct techniques for hand hygiene in reducing the number of colony-forming units in patients on peritoneal dialysis. PATIENTS AND METHOD: Observational study. Twenty-two patients underwent two collections of microbiological flora from the hands in two different instances: after hand washing with non-antimicrobial soap and water followed by rubbing with 70% ethyl alcohol, gel presentation, after application of 70% ethyl alcohol, presentation gel. Cultures were obtained by applying the fingers surface directly on agar-blood plates. RESULTS: The comparison between groups showed a significant difference (p <0.01) in colony-forming units in the right hands and left hands, mean 59.6 ± 43.1 in the group not antimicrobial soap and water, proved higher than in group 70% ethyl alcohol, presentation gel (31.8 ± 39.9). This difference is characterized by the presence of colonies of Staphylococcus coagulase-negative, and this was predominant in the seed crops. CONCLUSION: Hand rubbing with gel-alcohol was more effective in reducing the number of colonies recovered than the other methods.

Published
2012

39. Nefropatia induzida por contraste e uso concomitante de medicamentos em tomografia computadorizada

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introdução: O termo nefropatia induzida por contraste é amplamente utilizado para se referir a uma redução da função renal após administração de contraste radiológico. É definida pelo aumento absoluto na concentração de creatinina sérica de, pelo menos, 0,5 mg/dL ou por aumento relativo de, no mínimo, 25% do valor de base em 48 a 72 horas após a infusão, na ausência de causa alternativa.Objetivo: Avaliar a associação entre nefropatia induzida por contraste e o uso concomitante de medicamentos e/ou fatores de risco, em pacientes submetidos a Tomografia Computadorizada.Materiais e métodos: Coorte com 400 pacientes que realizaram exame tomográfico com contraste iodado. As variáveis analisadas foram: sexo, idade, diabetes mellitus, hipertensão arterial sistêmica, insuficiência cardíaca congestiva, acidente vascular encefálico, obesidade, perda de função renal, medicamentos em uso (metformina, ácido acetilsalicílico, inibidores da enzima conversora da angiotensina, anti-inflamatórios não esteróides, betabloqueadores) e uso de medidas preventivas. Dosou-se creatinina sérica antes e 48 horas após o exame para avaliar a presença de nefropatia do contraste. A presença de fatores de risco foi avaliada em pacientes que desenvolveram ou não nefropatia.Resultados: A incidência de nefropatia induzida por contraste, usando ambos os critérios, foi de 20,6% (28/136) em pacientes que utilizaram medicação e de 12,9% (34/264) nos que não utilizaram (p=0,061). Por aumento percentual, a incidência foi de 19,9% e de 12,9%, respectivamente (p=0,091), e, por aumento absoluto, foi de 8,8% e 1,1%, respectivamente (p<0,001). Na análise bivariada, foram significativamente associados a creatinina 48 horas após o exame: sexo masculino, idosos, obesos, pacientes com insuficiência cardíaca congestiva, diabetes, insuficiência renal, hipertensão, sem uso de medidas preventivas, acido acetilsalicílico, inibidores da enzima conversora da angiotensina e betabloqueador. Em modelo multivariado, permanecer, Introduction: Contrast-induced nephropathy is a widely used expression referring to a decrease in renal function after contrast administration. It has been characterized as an absolute increase in serum creatinine concentration of at least 0. 5 mg/dL or an of at least 25% increase, from baseline, 48 to 72 hours after intravenous contrast infusion, in the absence of another cause.Objective: To evaluate the association between contrast-induced nephropathy and the concomitant use of drugs or risk factors, in patients undergoing computerized tomography.Materials and methods: A cohort of 400 patients undergoing computerized tomography with iodine contrast. Evaluated variables were: gender, age, co-morbidities (diabetes, hypertension, congestive heart failure, stroke, obesity and renal failure), use of medication (metformin, acetilsalysilic acid, angiotensin-converting enzyme inhibitors, nonsteroidal anti-inflammatory, betablockers) and use of preventive measures. Serum creatinine was measured before, and 48 hours after contrast infusion. Current definitions were used throughout to characterize contrast-induced nephropathy occurrence. Risk factors were evaluated by a multivariate linear regression model.Results: Contrast-induced nephropathy incidence was 20. 6% (28/136) in patient using drugs and 12. 9% (34/264) in patient not using (p=0. 061). It was 19. 9% and 12. 9% (p=0. 091), respectively, by the percent increase criterion. Yet, by the absolute creatinine level increase, the incidence was 8. 8% and 1. 1% (p≤0. 001), respectively. Factors significantly associated with increased post-infusion creatinine levels were: male gender, old age, obesity, congestive heart failure, diabetes, decreased renal function, hypertension, no preventive measures, acetilsalysilic acid, angiotensinconverting enzyme inhibitors and betablockers use. Presence of congestive heart failure, reduced kidney function and diabetes remained positively associated in a multivariate regression model, wh

Published
2011

40. Associação entre estado nutricional, depressão e qualidade de vida de pacientes em hemodiálise

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introdução: A hemodiálise (HD) tem significativo impacto físico, psicológico e social para os pacientes. A redução da qualidade de vida (QV) depende de vários fatores, como desnutrição, depressão e distúrbios metabólicos. Objetivo: Este estudo teve como objetivo avaliar o estado nutricional, a QV, sintomas depressivos e determinar as possíveis relações com outros fatores de risco para mau prognóstico, em pacientes estáveis em HD. Métodos: Estudo transversal, em único centro de diálise, envolvendo 59 pacientes em HD. Foram avaliados dados laboratoriais, QV e sintomas depressivos, além do estado nutricional e composição corporal – pelo método direto de impedância bioelétrica segmentar multi-frequência (DSM-BIA). Os pacientes foram classificados pela DSM-BIA como desnutridos, padrão, sobrepeso ou obesos. As diferenças entre os grupos foram avaliadas por ANOVA. Resultados: Sete pacientes são desnutridos, 19 padrão, 19 com sobrepeso e 14 obesos. Os níveis de triglicerídeos foram significativamente diferentes entre os grupos [1,06 (0,98-1,98), 1,47 (1,16-1,67), 2,53 (1,17-3,13), 2,12 (1,41-2,95) mmol/L, respectivamente; p=0,026] e Kt/V entre desnutridos, sobrepeso e obesos (1,49±0,14; 1,23±0,19; 1,19±0,22; p=0,015 e p=0,006, respectivamente). Sintomas depressivos, QV, nível de inflamação ou níveis de fosfato não foram diferentes entre os grupos. Creatinina, albumina e fosfato, se correlacionaram fortemente, bem como percentagem de gordura corporal (PGC), índice de massa corporal (IMC) e circunferência da cintura (CC) [r=0,859; (p<0,001) e r=0,716 (p<0,001), respectivamente].Sintomas depressivos e domínios físico e psicológico da QV também se correlacionaram fortemente [rs= -0,501 (p<0,001); rs= -0,597 (p<0,001), respectivamente]. Conclusões: A maior parte dos pacientes tem sobrepeso e obesidade. As medidas de IMC, PGC e CC, apesar de diferentes, forma relacionadas. Inflamação foi altamente prevalente. Marcadores de sintomas depressivos e QV não foram diferentes entre os g, Background: Hemodialysis therapy (HD) significantly impacts on patients physical, psychological and social performances. This reduced quality of life (QOL) depends on several factors, such as malnutrition, depression and metabolic derangements. Objective: This study aimed at evaluating the nutritional status, QOL, depressive symptoms and determining possible relationships with other risk factors for poor outcome, in stable HD patients. Design: A single-center, cross-sectional study that enrolled 59 adult patients on HD. Laboratory data, QOL and depressive symptoms evaluation, besides nutritional status and body composition - direct segmental multifrequency bioimpedance analysis (DSM-BIA) - determinations were performed. Patients were classified as underfat, standard, overfat or obese by DSM-BIA. Group differences were evaluated by one way ANOVA. Results: Seven patients were underfat, 19 each standard or overfat and 14 obese. Triglycerides levels significantly differed among all groups [1. 06 (0. 98-1. 98), 1. 47 (1. 16-1. 67), 2. 53 (1. 17-3. 13), 2. 12 (1. 41-2. 95) mmol/L, respectively; P=0. 026] and Kt/V between underfat and overfat or obese (1. 49±0. 14; 1. 23±0. 19; 1. 19±0. 22; P=0. 015 and P=0. 006, respectively). Depressive symptoms, QOL, levels of inflammation or phosphate levels did not diverge among classes. Creatinine, albumin and phosphate strongly correlated, as well as percent body fat (PBF), body mass index (BMI) and waist circumference (WC) [r=0. 859; (P<0. 001) and r=0. 716 (P<0. 001), respectively].Depressive symptoms and physical and psychological QOL domains also strongly correlated [rs= -0. 501 (P<0. 001); rs= -0. 597 (P<0. 001), respectively]. Conclusions: A majority of patients was overfat and obese. BMI, PBF and WC measured different, yet related parameters. Inflammation was highly prevalent. Markers of depressive symptoms and QOL did not differ among nutritional groups.

Published
2010

41. Ocorrência de eventos adversos em hemodiálise sem e com a utilização de duas modalidades de sódio variável: estudo randomizado e com cross-over

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introduction: The most frequent adverse events during dialysis are hypotension (20% to 30%) and muscle cramps (5% to 10%), and the most often prescribed treatment to these adverse events is the use of variable sodium (VNa) profiling. Objectives: The aim of the current study was to compare the frequency of adverse events during hemodialysis (HD), interdialytic weight gain, and blood pressure before and after dialysis, with and without the use of VNa, as well as with the use of two variable sodium models: stepwise (VNass) and linear (VNal).Methods: a randomized, cross-over, prospective study that enrolled 22 patients in two groups: one to receive VNas for 12 HD sessions, and the other VNal, for a similar period after 12 sessions without VNa. After a wash-out period of 12 sessions, groups were crossed over. The following parameters were analyzed: adverse events, interdialytic weight gain, and blood pressure (BP) before and after dialysis. Results: Mean age was 61. 2±15. 2 years; 11 (50%) patients were male. The occurrence of adverse events was significantly different between the period without VNa (48. 5%) and those with VNas and VNal (33. 7% and 36%; p<0. 001). There were no significant differences in BP or interdialytic weight gain among treatment modalities. Conclusion: The use of VNa was associated with a reduction in the number of adverse events. VNas resulted in less episodes of symptomatic hypotension; while VNal may be associated with reduced muscle cramps. VNa modeling is beneficial for selected patients, and should be individually prescribed., Introdução: Os eventos adversos que ocorrem com mais freqüência no período transdiálise são hipotensão (20% a 30%) e câimbras (5% a 10%), e entre as condutas mais indicadas para o tratamento destas complicações está a utilização de sódio variável (NaV).Objetivos: comparar a ocorrência de eventos adversos em hemodiálise (HD), o aumento de peso interdialítico e a pressão arterial pré e pós-diálise, sem e com a utilização de NaV e comparar a ocorrência de eventos adversos em HD com a utilização de duas modalidades de sódio variável: step (NaVs) e linear (NaVl).Método: estudo prospectivo, randomizado e com cross-over que incluiu 22 pacientes para dois grupos: um para tratamento com NaVs durante 12 sessões de HD e outro para tratamento com NaVl durante o mesmo período, precedidos por 12 sessões sem NaV. Após período de wash-out, ocorreu o cross-over entre os grupos. Analisaram-se: ocorrência de eventos adversos, ganho de peso interdiálise e pressão arterial (PA), antes e após o procedimento. Resultados: a média de idade foi de 61,2±15,2 anos e 11(50%) eram do sexo masculino. A ocorrência de eventos adversos foi significativamente diferente entre os períodos sem a utilização de NaV (48,5%) e com a utilização de NaVs e NaVl, (33,7% e 36%, respectivamente; p<0,001). Não houve diferença significativa de PA entre qualquer das modalidades de tratamento usadas; o mesmo ocorreu com o ganho de peso interdialítico. Conclusões: a utilização de NaV reduz a ocorrência de eventos adversos em HD. Há menos hipotensão sintomática com NaVs e tendência para redução de câimbras com o uso de NaVl. NaV pode ser benéfico para alguns pacientes e sua prescrição deve ser individualizada.

Published
2009

42. Caracterização do paciente em terapia renal substituitiva quanto à motivação para mudança de práticas alimentares

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introdução: O melhor resultado no tratamento para pacientes com doença renal crônica terminal (DRCT) em hemodiálise (HD) exige disciplina, que inclui adesão à medicação, à dieta e restrição da ingestão de líquidos. Este estudo transversal testou pacientes em HD pelo instrumento URICA para avaliar sua prontidão para mudança de práticas alimentares. Método: Estudo observacional transversal e descritivo que incluiu 100 pacientes estáveis em HD crônica, em dois centros de HD ambulatorial. Foram avaliados pela escala URICA e por ficha de registro com dados demográficos e bioquímicos. Resultados: O valor médio do URICA (6. 3±1. 6) mostrou que a maioria dos pacientes (85%) estava no estágio inicial (pré-contemplação) de prontidão. Houve correlação fraca do instrumento apenas com o ganho de peso entre HD e com o nível de fósforo sérico. Conclusão: Pacientes em HD parecem não estar preparados para mudanças de seu comportamento alimentar. O nível educacional não altera o grau de prontidão para mudança. Disciplina no controle da dieta e nível de prontidão podem estar associados. Estudo prospectivo é necessário para elucidar aspectos do problema., Introduction: The success of the treatment of patients with chronic end stage renal disease receiving hemodialysis depends on self-discipline, adherence to medication and diet, and restrictions to liquid intake. This cross-sectional study applied the University of Rhode Island Change Assessment (URICA) scale to patients receiving HD to evaluate their readiness to change eating behaviors. Method: This descriptive observational cross-sectional study included 100 patients on chronic HD at two outpatient HD services. Patients were evaluated using the University of Rhode Island Change Assessment (URICA) scale, and patient demographic and biochemical data were retrieved from medical charts. Results: Mean URICA score (6. 3±1. 6) showed that most patients (85%) were in the initial readiness stage (precontemplation). There was a weak correlation of scale scores only with interdialytic weight gain and serum phosphorus levels. Conclusion: Patients on HD did not seem to be prepared for changes in their eating behaviors. Level of education did not affect the degree of readiness to change. Self-discipline to control diet and level of readiness to change may be associated, and prospective studies should be conducted to further evaluate it.

Published
2009

43. Avaliação de um programa de ensino-aprendizagem sobre o metabolismo de cálcio e fósforo para pacientes em hemodiálise

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Introduction - Patients on chronic hemodialysis have difficulty to adequately follow drug therapy and dietary restrictions aimed at maintaining adequate phosphorus serum levels. Such behavior has been associated with progressive bone disease and multiple bone fractures. The current study aimed at evaluating the effect of an educational program on the metabolism of calcium (Ca), phosphorus (PO4), parathormone (PTH), Ca x PO4 product, as well as on the measures to keep them under control. Methods – A cohort study that enrolled 33 stable hemodialysis patients at Hospital São Lucas da PUCRS and Hospital Moinhos de Vento, randomized to two groups: Control (n=17) and Intervention (n=16), during a three-month period,. The Control group received information on vascular access care and the Intervention group on calcium, phosphorus and PTH metabolism. Knowledge changes regarding the presented themes were assessed by pre and post-class tests. Treatment compliance was assessed by serial laboratory Ca, PO4 and PTH measurements. Results – No statistically significant knowledge changes were observed in any group. In the Intervention group 8/17 patients were competent at the pre, compared to 11/17 at the pos-test (P>0. 001); in the Control group 11/16 patients were competent, compared to 13/17 at the post-test (P>0. 001). A significant decrease in PO4 levels and Ca x PO4 product between time zero and time 1 occurred in both groups, and also in Control group between time 1 and time 2.Conclusion – At the end of this short-timed educational program, no apparent knowledge or behavioral change occurred in any group. It is possible that to be effective educational programs aimed at dialysis patients should be continuously applied., Introdução: Pacientes em hemodiálise crônica têm dificuldade em manter níveis séricos adequados de fósforo (PO4), possivelmente por não aderirem às medidas terapêuticas recomendadas, ou não observarem as restrições dietéticas sugeridas. Tal comportamento associa-se a doença óssea progressiva e a múltiplas fraturas, em médio e longo prazo. O presente trabalho tem como objetivo avaliar os efeitos de um programa de ensino-aprendizagem sobre metabolismo e importância dos níveis séricos de cálcio (Ca), PO4, paratormônio (PTH), produto Ca x PO4, bem como sobre medidas para mantê-los controlados, de duração limitada. Métodos: Estudo de coorte, com duração de três meses, que incluiu 33 pacientes em hemodiálise crônica no Hospital São Lucas da PUCRS e no Hospital Moinhos de Vento, randomizados em dois grupos: Controle (n=17) e Intervenção (n=16). O grupo Controle recebeu informação sobre acesso vascular e o grupo Intervenção sobre metabolismo de Ca, PO4 e PTH. A mudança de conhecimento sobre os assuntos apresentados foi avaliada por testes pré e pós-programa e a adesão às medidas propostas por dosagens laboratoriais periódicas de Ca, PO4 e PTH. Resultados: Não houve mudança de conhecimento estatisticamente significante em qualquer dos grupos - no grupo Intervenção, 8/17 pacientes eram competentes no pré-teste e 14/17 no pós-teste (P<0. 001); no grupo Controle, 11/16 eram competentes, passando a 13/16 (P<0. 001). Na avaliação das mudanças de comportamento relacionadas com adesão à dieta e uso de quelantes de PO4, houve redução significativa do nível de PO4 e do produto Ca x PO4 entre o tempo 0 e o tempo 1, em ambos os grupos (P<0. 001 e P<0. 001). Ocorreu redução significativa dos mesmos marcadores, no grupo Controle, entre o tempo 1 e o tempo 2, também. Conclusão: Ao término do programa não ocorreu diferença significativa de conhecimento ou de comportamento. Para serem efetivos, programas de ensinoaprendizagem com pacientes renais crônicos devem ter caráter contínuo.

Published
2008

44. Qualidade de vida e sexualidade de mulheres em diálise

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Background: Patients in end-stage renal disease (ESRD) undergoing dialysis present reduced quality of life (QOL) and impaired sexual function. Previous studies have mostly addressed male sexual dysfunction. Scant information on ESRD female patient’s sexuality is available. The current study evaluated QOL and sexual function of female patients with and without ESRD on chronic dialysis. Patients and Method: A cross-sectional controlled study that applied a general and the WHOQOL-bref© questionnaires to assess demographic, marital and sexual conditions, and QOL to 86 healthy women aged 18 or more years (Group 1), and to 38 female ESRD patients undergoing dialysis for no less than two months (Group 2). To further evaluate sexual function, participants were stratified by age (W 60 or > 60). Anthropometrical and clinical data were also collected. The effects of several explanatory variables upon QOL components were estimated. Results: QOL was lower in Group 2 - overall, and on physical and environment domains. To undergo dialysis and poor education negatively affected the QOL. In Group 1, 62 (72%) individuals had a stable marital relationship, and 58 (67%) were sexually active, while in Group 2, 22 (58%) and 7 (18%), respectively (P<0. 001). No patient older than 60 was sexually active. Age, having a stable relationship, or being sexually active had no effect on the QOL. Conclusion: Patients with ESRD on dialysis experienced a lower QOL, and were significantly more sexually dysfunctional than comparable healthy women. Yet, decline in sexual function had no effect upon the QOL., Introdução: Pacientes com insuficiência renal crônica (IRC) em tratamento dialítico apresentam redução da qualidade de vida (QV) e da função sexual. Vários estudos prévios avaliaram indivíduos do sexo masculino. Poucos dados sobre a função sexual de mulheres sob tratamento dialítico estão disponíveis. O presente estudo avaliou a qualidade de vida e o funcionamento sexual de pacientes do sexo feminino hígidas e com IRC, em diálise. Pacientes e Método: Estudo transversal, controlado, em que foram aplicados dois questionários - um genérico, com o qual foram coletados dados demográficos, sobre idade, escolaridade, estado marital e condições sexuais, e o de QV da Organização Mundial da Saúde (WHOQOL-bref ©) - a 86 mulheres com idade superior a 18 anos, alfabetizadas, sem doença renal (Grupo 1), e a 38 pacientes femininas, em diálise crônica há pelo menos 2 meses (Grupo 2). Para análise adicional, as participantes foram divididas por idade (≤ 60 ou > 60). Dados antropométricos e clínicos também foram coletados. Estatística descritiva, teste chi-quadrado (ou teste exato de Fisher), teste t de Student e análise de regressão linear multivariada foram utilizados. Resultados: A QV foi menor no Grupo 2, em geral, e nos domínios físico e meio-ambiente. Estar em diálise e ter menor nível educacional afetaram negativamente a QV. No Grupo 1, 62 (72%) participantes tinham relação marital estável, e 58 (67%) tinham vida sexual ativa (VSA). No Grupo 2, 22 (58%) pacientes tinham relação estável, mas apenas 7 (18%; P<0,001) tinham VSA. Nenhuma paciente com mais de 60 anos estava sexualmente ativa. A QV não foi influenciada pela idade, pela estabilidade da relação ou pela presença de VSA. Conclusão: Os resultados sugerem que pacientes do sexo feminino em diálise apresentam menor QV e redução da função sexual comparativamente a mulheres saudáveis. Entretanto, o declínio da atividade sexual não afetou a QV.

Published
2006

45. Velocidade de transporte peritoneal e níveis séricos de glicose e insulina de pacientes em diálise peritoneal

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Objetivo: Observar as variações de glicemia e insulinemia induzidas pela exposição da cavidade peritoneal à solução de glicose, durante teste de equilíbrio peritoneal (PET), e buscar relação com a velocidade de transporte peritoneal de pequenos solutos. Pacientes e Método: Estudo transversal, observacional, com 34 pacientes prevalentes em diálise peritoneal, submetidos a PET modificado (uso de glicose a 4,25%). Glicemia e insulinemia foram seqüencialmente determinadas sete vezes (em zero, 15, 30, 60 120, 180 e 240 minutos) ao longo do teste e índice de resistência a insulina (IR-HOMA) foi calculado. Categorias de transporte peritoneal foram definidas, na amostra, por quartís da razão dialisado/soro das concentrações de creatinina após 240 minutos de exposição do peritônio ao líquido (D4/PCr). Variáveis demográficas e clínicas foram computadas e possíveis correlações entre variáveis e categorias de transporte peritoneal foram testadas. Resultados: Não houve diferença para o IR-HOMA ou para medidas de glicemia e de insulinemia, entre as categorias de transporte peritoneal. Houve correlação direta entre os incrementos iniciais da glicemia, bem como a variação máxima de insulinemia e a variável D4/PCr – uma medida de velocidade de transporte de solutos pelo peritônio. O IR-HOMA relacionou-se diretamente com o índice de massa corporal. Conclusão: Os incrementos iniciais de glicemia e o pico máximo de insulinemia estão associados à velocidade de transporte peritoneal de pequenos solutos medida pelo PET. O significado destes achados sobre o prognóstico de pacientes com alto transporte deve ser mais bem avaliado., Objective: To observe the variations in serum glucose and insulin levels induced by the peritoneal exposition to glucose solution during a peritoneal equilibration test (PET), and to relate the findings with the solutes peritoneal transport rate. Patients and Method: A cross-sectional, observational, study using a modified PET procedure (4,25% glucose solution) that enrolled 34 prevalent peritoneal dialysis patients. Glucose and insulin serum levels were sequentially determined (at zero, 15, 30, 60, 120, 180, and 240 minutes) along the procedure, and an insulin resistance index (IR-HOMA) was computed. Categories of peritoneal transport were separated by quartiles of the dialisate/serum creatinine rate after 240 minutes of peritoneal exposition to the infused fluid (D4/PCr). Demographic and clinical variables were examined, and possible correlations among variables and categories of peritoneal transport were tested. Results: No difference for IR-HOMA, glucose and insulin levels was demonstrated among peritoneal transport categories. A direct correlation between the early glucose, and insulin peak increment and D4/PCr was evidenced. IR-HOMA was associated with the body mass index. Conclusion: Early glucose and insulin peak increment were associated with the solutes transport rate, as measured by the PET. The meaning of the findings on the outcome of patients with high peritoneal transport rate must be further evaluated.

Published
2006

47. Óxido nítrico e função peritoneal de pacientes em diálise peritoneal

Author

D'Avila, Domingos Otávio Lorenzoni and D'Avila, Domingos Otávio Lorenzoni

Abstract

Objetivo: O presente trabalho tem como objetivo avaliar os metabólitos do óxido níitrico (NO) no soro e no peritônio, e a função endotelial de pacientes em diálise peritoneal em diferentes categorias de transporte peritoneal, avaliados pelo teste de equilíbrio peritoneal. Método: Estudo transversal, em pacientes estáveis em DP. Quartis da razão dialisado/plasma (D/P) de creatinina, após 4 horas de permanência do líquido na cavidade, foram usados para classificar o transporte peritoneal em: baixo, baixomédio, alto-médio e alto. Os metabólitos do NO foram medidos por quimioluminescência (n=41), e a função endotelial avaliada através da dilatação mediada por fluxo da artéria braquial (n=31). Resultados: Os metabólitos do NO no soro, dialisado de 24 horas e de 4 horas não foram diferentes entre as categorias. A razão de NO no dialisado de 4 horas/soro (D/P de NO) também não foi diferente (p=0,096), mas houve tendência de aumento do baixo para o alto transportador. A mediana (intervalo interquartil) da dilatação mediada por fluxo não foi diferente entre os grupos. Houve correlação entre NO no soro e dialisado de 4 horas (r=0,891, p<0,001). A D/P de NO foi inversamente correlacionada com o transporte peritoneal de glicose (r=-0,579, p<0,001), e com a ultrafiltração (r=-0,422, p<0,001), e diretamente correlacionada com a D/P de creatinina (r=0,533, p<0,001). Conclusão: Os resultados sugerem que os níveis de NO refletem permeabilidade perioneal. Os metabólitos do NO não são um marcador da produção peritoneal de NO, em pacientes sem peritonite. A prescrição de diálise peritoneal não é dependente da função endotelial., Objective: The aim of this study was to evaluate serum and dialysate nitric oxide (NO), and endothelial function in peritoneal dialysis patients in different peritoneal equilibration test (PET) categories. Methods: Cross-sectional study, in stable PD patients free of peritonitis for at least one month. Quartiles of the 4-h dialysate/plasma (D/P) ratio creatinine were used to classify the peritoneal membrane transport as low, low average, high average and high. NO metabolites were measured by chemiluminescence (n=41), and endothelial function was evaluated by arterial flow-mediated dilation (n=31). Results: Serum, 4-h and 24-h dialysate NO were not different among the PET categories. The 4-h dialysate/serum NO ratio (D/PNO) was also not different (p=0,096), but the data suggested the presence of a trend, increasing from low toward high peritoneal transport. Additionally, median (interquartile range) flowmediated dilation was not different between groups. There was correlation between 4-h dialysate and serum NO (r=0. 891, p<0. 001). D/PNO was negatively correlated with glucose transport (r=-0. 579, p<0. 001) and ultrafiltration (r=-0. 422, p<0. 001), and positively correlated with the D/P creatinine ratio (r=0. 533, p<0. 001). Conclusion: NO levels appear to reflect peritoneal permeability only. The dialysate NO level is not a sensible marker for local production of NO, in peritonitis-free patients. Peritoneal dialysis prescription is not dependent upon endothelial function.

Published
2004

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