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1.
Braz. j. infect. dis ; 24(1): 25-29, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089328

ABSTRACT

ABSTRACT Background: To analyze the effectiveness and the safety of Sofosbuvir-based regimens to treat patients with chronic hepatitis C virus (HCV) infection and chronic kidney disease (CKD). Methods: A retrospective, observational study in patients with chronic HCV infection and CKD treated with Sofosbuvir-based regimens was performed. Liver fibrosis, comorbidities, HCV genotype and sustained virological resposnse (SVR) at 12th week post-treatment were evaluated. Kidney function was accessed by serum creatinine and glomerular filtration rate (GFR). The assumed level of significance was 5 %. Results: Thirty-five patients were treated. The mean age was 52.1 ± 10.9 years, 19 (54.3 %) were women, 32 (91.4 %) were already kidney transplanted and 3 (8.6 %) were on hemodialysis. The SVR by intention to treat was 88.6 %. The mean GFR was 65.8 ± 28.6 and 63.7 ± 28.3 ml/min pre- and post-treatment respectively (p > 0.05). Treatment was interrupted in 1 (2.85 %) patient due to anemia and in 2 (5.7 %) due to loss of kidney function. Conclusion: Sofosbuvir-based regimens are effective to treat HCV in patients with CKD. In patients with mild CKD this type of therapy seems to be safe.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Renal Insufficiency, Chronic/physiopathology , Sofosbuvir/therapeutic use , Severity of Illness Index , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Kidney Transplantation , Treatment Outcome , Statistics, Nonparametric , Creatinine/blood , Renal Insufficiency, Chronic/therapy , Sustained Virologic Response , Glomerular Filtration Rate , Imidazoles/therapeutic use , Immunosuppressive Agents/therapeutic use
2.
Rev. méd. Chile ; 147(11): 1443-1448, nov. 2019.
Article in Spanish | LILACS | ID: biblio-1094174

ABSTRACT

Chronic kidney disease is associated with an increase in cardiovascular risk and mortality, and a decrease in the health-related quality of life. It is known that the physical capacity of patients with chronic kidney disease is lower than their healthy counterparts. It also decreases progressively after the start of hemodialysis, even leading to the loss of functional independence. There is a positive association between exercise and improvement of many targets in chronic kidney disease, especially in dialysis patients, such as cellular apoptosis, immune improvement and inflammation. In addition, several clinical studies and systematic reviews show an improvement in different clinical and laboratory variables and suggest a lower mortality, proving a reduction of health care economic costs. Exercise intervention in dialysis is safe. Although different guidelines promote exercise, it is necessary to work on its implementation on a large scale.


Subject(s)
Humans , Exercise/physiology , Renal Insufficiency, Chronic/therapy , Exercise Therapy , Quality of Life , Renal Dialysis , Evidence-Based Medicine , Renal Insufficiency, Chronic/physiopathology
3.
J. bras. nefrol ; 41(1): 124-130, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040238

ABSTRACT

Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used medications associated with nephrotoxicity, especially when used chronically. Factors such as advanced age and comorbidities, which in themselves already lead to a decrease in glomerular filtration rate, increase the risk of NSAID-related nephrotoxicity. The main mechanism of NSAID action is cyclooxygenase (COX) enzyme inhibition, interfering on arachidonic acid conversion into E2 prostaglandins E2, prostacyclins and thromboxanes. Within the kidneys, prostaglandins act as vasodilators, increasing renal perfusion. This vasodilatation is a counter regulation of mechanisms, such as the renin-angiotensin-aldosterone system works and that of the sympathetic nervous system, culminating with compensation to ensure adequate flow to the organ. NSAIDs inhibit this mechanism and can lead to acute kidney injury (AKI). High doses of NSAIDs have been implicated as causes of AKI, especially in the elderly. The main form of AKI by NSAIDs is hemodynamically mediated. The second form of NSAID-induced AKI is acute interstitial nephritis, which may manifest as nephrotic proteinuria. Long-term NSAID use can lead to chronic kidney disease (CKD). In patients without renal diseases, young and without comorbidities, NSAIDs are not greatly harmful. However, because of its dose-dependent effect, caution should be exercised in chronic use, since it increases the risk of developing nephrotoxicity.


Resumo Os anti-inflamatórios não esteroidais (AINEs) são medicamentos comumente utilizados, associados à nefrotoxicidade, sobretudo quando utilizados cronicamente. Fatores como idade avançada e comorbidades, que por si só já levam à diminuição da taxa de filtração glomerular, aumentam o risco de nefrotoxicidade dos AINEs. O principal mecanismo de ação dos AINEs é a inibição da enzima ciclooxigenase (COX), interferindo na conversão do ácido araquidônico em prostaglandinas E2, prostaciclinas e tromboxanos. Nos rins, as prostaglandinas atuam como vasodilatadoras, aumentando a perfusão renal. Essa vasodilatação atua como uma contrarregulação de mecanismos, como a atuação do sistema renina-angiotensina-aldosterona e do sistema nervoso simpático, culminando com uma compensação para assegurar o fluxo adequado ao órgão. O uso de AINEs inibe esse mecanismo, podendo causar lesão renal aguda (LRA). Altas doses de AINEs têm sido implicadas como causas de LRA, especialmente em idosos. A principal forma de LRA por AINEs é a hemodinamicamente mediada. A segunda forma de apresentação da LRA induzida por AINES é a nefrite intersticial aguda, que pode se manifestar com proteinúria nefrótica. O uso de AINEs em longo prazo pode ocasionar doença renal crônica (DRC). Nos pacientes sem doenças renais, jovens e sem comorbidades, os AINEs não apresentam grandes malefícios. Entretanto, por seu efeito dose-dependente, deve-se ter grande cautela no uso crônico, por aumentar risco de desenvolver nefrotoxicidade.


Subject(s)
Humans , Infant, Newborn , Aged , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cyclooxygenase Inhibitors/adverse effects , Renal Insufficiency, Chronic/chemically induced , Acute Kidney Injury/chemically induced , Nephritis, Interstitial/chemically induced , Prostaglandins E/metabolism , Proteinuria/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/metabolism , Risk Factors , Cyclooxygenase Inhibitors/metabolism , Renal Insufficiency, Chronic/physiopathology , Acute Kidney Injury/physiopathology , Nephritis, Interstitial/physiopathology
4.
Rev. bras. epidemiol ; 22(supl.2): E190010.SUPL.2, 2019. tab
Article in Portuguese | LILACS | ID: biblio-1042228

ABSTRACT

RESUMO: Objetivo: O presente estudo avaliou a função renal da população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde (PNS). Metodologia: Estudo descritivo realizado com os dados laboratoriais da PNS, coletados entre os anos de 2014 e 2015. Com base nos dados laboratoriais foram analisadas prevalências populacionais de creatinina sérica (CR) e estimativa da taxa de filtração glomerular (TFG), segundo variáveis sociodemográficas. Resultados: A amostra foi de 8.535 indivíduos com idade de 18 anos ou mais para o estudo da CR e de 7.457 indivíduos para o estudo de TFG. A prevalência TFG < 60 mL/min/1,73 m2 foi de 6,7% (IC95% 6,0 - 7,4), foi mais elevada em mulheres (8,2% IC95% 7,2 - 9,2) do que em homens (5,0% IC95% 4,2 - 6,0) p < 0,001 e em idosos ≥ 60 anos foi de 21,4%. Os valores de CR ≥ 1,3 mg/dL em homens foram 5,5% (IC95% 4,6 - 6,5) e em mulheres foram de CR ≥ 1,1 mg/dL, de 4,6% (IC95% 4,0- 5,4), sem diferença estatística significativa nos valores de CR entre sexo, p = 0,140. Conclusão: Resultados laboratoriais da PNS identificaram prevalências mais elevadas da doença renal crônica na população brasileira do que o estimado em estudos autorreferidos. ATFG < 60 mL/min/1,73 m2 é mais elevada em mulheres e atinge um quinto dos idosos. Esses exames podem ser úteis no propósito de identificar precocemente a doença e, dessa forma, prevenir a progressão da lesão renal e reduzir o risco de eventos cardiovasculares e de mortalidade.


ABSTRACT: Objective: To evaluate the renal function of the Brazilian adult population, according to laboratory criteria of the National Health Survey (Pesquisa Nacional de Saúde - PNS). Methodology: A descriptive study was carried out with laboratory data from the PNS, which was collected between the years 2014 and 2015. Population prevalence of the serum creatinine (CR) and estimated glomerular filtration rate (GFR) according to sociodemographic variables, were analyzed from the PNS laboratory data. Results: The sample consisted of 8,535 individuals aged 18 years old or older for the study of CR and 7,457 for the study of GFR. The GFR prevalence < 60 mL/min/1.73 m2 was 6.7% (95%CI 6.0 - 7.4), higher in women (8.2% 95%CI 7.2 - 9.2) than in men (5.0% 95%CI 4.2 - 6.0) p < 0.001, and in elderly > 60 years old it was 21.4%. For the values of CR ≥ 1.3 mg/dL in men were 5.5% (95%CI 4.6 - 6.5), and in women values of CR ≥ 1.1 mg/dL were 4.6% (95%CI 4.0 - 5.4), with no diference between the genders, p = 0.140. Conclusion: Results from the PNS laboratory identified a higher prevalence of chronic kidney disease in the Brazilian population than that estimated in self-reported studies, with higher GFR < 60 mL/min/1.73 m2 in women, and reaching one fifth of the elderly. These tests may be useful for the purpose of identifying the disease early on and thus preventing the progression of renal damage and reduce the risk of cardiovascular events and mortality.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Health Surveys/methods , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Health Surveys/statistics & numerical data , Sex Distribution , Age Distribution , Creatinine/blood , Glomerular Filtration Rate , Middle Aged
5.
J. pediatr. (Rio J.) ; 94(5): 525-531, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975998

ABSTRACT

Abstract Objective: To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. Methods: This was a multicenter prospective cohort in São Paulo, involving 209 children with CKD stages 3-4. The study outcome included: (a) death, (b) start of kidney replacement therapy, (c) eGFR decrease >50% during the followup. Thirteen risk factors were tested using univariate regression models, followed by multivariable Cox regression models. The terms of interaction between the variables showing significant association with the outcome were then introduced to the model. Results: After a median follow-up of 2.5 years (IQR = 1.4-3.0), the outcome occurred in 44 cases (21%): 22 started dialysis, 12 had >50% eGFR decrease, seven underwent transplantation, and three died. Advanced CKD stage at onset (HR = 2.16, CI = 1.14-4.09), nephrotic proteinuria (HR = 2.89, CI = 1.49-5.62), age (HR = 1.10, CI = 1.01-1.17), systolic blood pressure Z score (HR = 1.36, CI = 1.08-1.70), and anemia (HR = 2.60, CI = 1.41-4.77) were associated with the outcome. An interaction between anemia and nephrotic proteinuria at V1 (HR = 0.25, CI = 0.06-1.00) was detected. Conclusions: As the first CKD cohort in the southern hemisphere, this study supports the main factors reported in developed countries with regards to CKD progression, affirming the potential role of treatments to slow CKD evolution. The detected interaction suggests that anemia may be more deleterious for CKD progression in patients without proteinuria and should be further studied.


Resumo Objetivo: Identificar os fatores de risco para progressão da DRC em crianças do Brasil e avaliar as interações entre os fatores. Métodos: Coorte prospectiva multicêntrica em São Paulo, envolvendo 209 crianças com DRC em estágios 3-4. O desfecho do estudo incluiu: a) óbito, b) início da terapia de substituição renal, c) redução de > 50% na taxa estimada de filtração glomerular (eGFR) durante o acompanhamento. Foram testados 13 fatores de risco com o modelo de regressão univariada seguido do modelo de regressão multivariado de Cox. Os termos de interação entre as variáveis mostraram associação significativa e foram introduzidos ao modelo. Resultados: Após média de acompanhamento de 2,5 anos (IIQ = 1,4 a 3,0), 44 casos (21%) apresentaram desfecho: 22 iniciaram diálise, 12 apresentaram redução de > 50% na eGFR, sete foram submetidos a transplante e três morreram. Estágio avançado de DRC no acometimento (RR = 2,16, IC = 1,14-4,09), proteinúria nefrótica (RR = 2,89, IC = 1,49-5,62), idade (RR - 1,10, IC = 1,01-1,17), escore Z da pressão arterial sistólica (RR = 1,36, IC = 1,08-1,70) e anemia (RR = 2,60, IC - 1,41-4,77) foram associados ao resultado. Foi detectada interação entre anemia e proteinúria nefrótica na primeira visita (V1) (RR = 0,25, IC = 0,06-1,00). Conclusões: Como a primeira coorte de DRC no hemisfério sul, este estudo é concordante com os principais fatores relatados em países desenvolvidos com relação à progressão da DRC, afirmando o possível papel dos tratamentos para mostrar a evolução da DRC. A interação detectada sugere que a anemia pode ser mais nociva na progressão da DRC em pacientes sem proteinúria e deve ser ainda mais estudada.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Disease Progression , Renal Insufficiency, Chronic/physiopathology , Socioeconomic Factors , Prospective Studies , Risk Factors , Cohort Studies
6.
Ciênc. Saúde Colet ; 23(8): 2555-2564, Aug. 2018. tab
Article in Portuguese | LILACS | ID: biblio-952726

ABSTRACT

Resumo A doença renal crônica (DRC) é complexa, exigindo múltiplas abordagens em seu tratamento. O objetivo do presente estudo foi avaliar o impacto de um programa de intervenção nutricional sobre o estado nutricional e a qualidade de vida de idosos com DRC não dialítica. Foi realizada uma coorte prospectiva com 64 idosos, de ambos os sexos, com DRC estágio 3, atendidos em Unidade Básica de Saúde, em Diadema/SP. A intervenção nutricional consistiu em três encontros coletivos e um individual. O estado nutricional foi avaliado por antropometria, classificado pelo Índice de Massa Corporal (IMC) e o risco cardiovascular pela circunferência da cintura (CC). A qualidade de vida foi avaliada pelo WHOQOL-bref. Para as análises estatísticas, adotou-se nível de significância de 5%. A amostra apresentou idade média de 73,95 ± 7,84 anos, sendo a maioria do sexo feminino. Quanto ao estado nutricional, 21,9% apresentou baixo peso, 32,8% excesso de peso e 62,6% risco cardiovascular elevado ou muito elevado. O programa de intervenção proporcionou impacto positivo no estado nutricional, com redução do IMC e da CC, diminuindo o risco de desenvolvimento de doenças cardiovasculares e promoveu aumento da satisfação dos idosos em relação ao estado de saúde repercutindo na melhora da qualidade de vida.


Abstract Chronic kidney disease (CKD) is recognized as a complex disease that requires multiple approaches to its treatment. The aim of this study was to evaluate the impact of a nutritional intervention program on the nutritional status and quality of life of elderly pre-dialysis CKD patients. A prospective cohort study was carried out involving 64 elderly stage 3 CKD patients receiving treatment at a Primary Care Center in the Municipality of Diadema in the State of São Paulo, Brazil. The nutritional intervention consisted of one individual and three group meetings. Nutritional status was assessed using anthropometric variables and classified according to Body Mass Index (BMI). Cardiovascular risk was classified according to Waist Circumference (WC). Quality of life was assessed using the WHOQOL-BREF. The data was analyzed adopting a significance level of 5%. Mean age was 73.95 ± 7.84 years and the majority of the sample were women, had a low level of schooling, and low monthly income. With respect to nutritional status, 21.9% of the sample were underweight, 32.8% overweight, and 62.6% were at a high or very high risk of developing cardiovascular disease. The nutritional intervention program had a positive impact on nutritional status, leading to a decline in BMI and WC, reduction in risk of developing heart disease, increased satisfaction with current state of health, and improved quality of life.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Quality of Life , Nutritional Status , Renal Insufficiency, Chronic/physiopathology , Feeding Behavior , Thinness/epidemiology , Brazil/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Body Mass Index , Nutrition Assessment , Health Status , Prospective Studies , Risk Factors , Cohort Studies , Patient Satisfaction , Overweight/epidemiology , Waist Circumference , Income , Middle Aged
7.
J. bras. nefrol ; 40(1): 73-76, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-1040236

ABSTRACT

ABSTRACT Introduction: Secondary hyperoxalemia is a multifactorial disease that affects several organs and tissues in patients with native or transplanted kidneys. Plasma oxalate may increase during renal failure because it is cleared from the body by the kidneys. However, there is scarce evidence about the association between glomerular filtration rate and plasma oxalate, especially in the early stages of chronic kidney disease (CKD). Methods: A case series focuses on the description of variations in clinical presentation. A pilot study was conducted using a cross-sectional analysis with 72 subjects. The glomerular filtration rate (GFR) and plasma oxalate levels were measured for all patients. Results: Median (IQR) GFR was 70.50 [39.0; 91.0] mL/min/1.73 m2. Plasma oxalate was < 5.0 µmol/L in all patients with a GFR > 30 mL/min/1.73m2. Among the 14 patients with severe CKD (GFR < 30 mL/min/1.73 m2) only 4 patients showed a slightly increased plasma oxalate level (between 6 and 12 µmol/L). Conclusion: In non-primary hyperoxaluria, plasma oxalate concentration increases when GFR < 30mL/min/1.73 m2 and, in our opinion, values greater than 5 µmol/L with a GFR > 30 mL/min/1.73 m2 are suggestive of primary hyperoxaluria. Further studies are necessary to confirm plasma oxalate increase in patients with low GFR levels (< 30mL/min/1.73 m2).


RESUMO Introdução: A hiperoxalemia secundária é uma doença multifatorial que afeta vários órgãos e tecidos em pacientes com rins nativos ou transplantados. O oxalato plasmático pode aumentar durante a insuficiência renal porque é eliminado do corpo pelos rins. No entanto, há evidências escassas sobre a associação entre taxa de filtração glomerular e oxalato plasmático, especialmente nos estágios iniciais da doença renal crônica (DRC). Métodos: uma casuística centrada na descrição das variações na apresentação clínica. Foi realizado um estudo piloto a partir da análise transversal com 72 indivíduos. As taxas de filtração glomerular (TFG) e os níveis plasmáticos de oxalato foram medidos para todos os pacientes. Resultados: A TFG mediana (IIQ) foi de 70,50 [39,0; 91,0] mL/min/1,73 m2. O nível plasmático de oxalato foi < 5,0 µmol/L em todos os pacientes com TFG > 30 mL/min/1,73 m2. Entre os 14 pacientes com DRC grave (TFG < 30 mL/min/1,73 m2), apenas quatro apresentaram ligeiro aumento do nível plasmático de oxalato (entre 6 e 12 µmol/L). Conclusão: Na hiperoxalúria não primária, a concentração plasmática de oxalato aumenta quando TFG < 30 mL/min/1,73 m2 e, em nossa opinião, valores superiores a 5 µmol/L com TFG > 30 mL/min/1,73 m2 sugerem presença de hiperoxalúria primária. Estudos adicionais são necessários para confirmar o aumento do oxalato plasmático em pacientes com níveis baixos de TFG (< 30 mL/min/1,73 m2).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Oxalates/blood , Iohexol/metabolism , Chromatography, High Pressure Liquid , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/blood , Glomerular Filtration Rate , Pilot Projects
8.
Rev. bras. reumatol ; 57(6): 535-544, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-899472

ABSTRACT

Abstract Aim Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65 ± 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006) and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027) were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 ± 16 months. Conclusion Our study indicated that familial Mediterranean fever constituted a large proportion of cases and increased number of patients with idiopathic amyloid A amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in amyloid A amyloidosis.


Resumo Objetivo: A amiloidose AA é uma complicação rara de condições inflamatórias crônicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva à insuficiência renal e à morte. Estudaram-se as características clínicas e a sobrevida em pacientes com amiloidose AA. Métodos: Analisaram-se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biópsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados: A maior parte dos pacientes (55,6%) tinha proteinúria na faixa nefrótica no momento do diagnóstico. Os distúrbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressão arterial diastólica no grupo de desfecho bom e o nível de fósforo no grupo de desfecho ruim foram mais elevados. Os níveis séricos de creatinina aumentaram após o tratamento em ambos os grupos, enquanto a proteinúria diminuiu no grupo de desfecho bom. O aumento na creatinina sérica e a diminuição na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnóstico, 18,5% e 27,2% de todos os pacientes tinham doença renal crônica avançada (estágios 4 e 5, respectivamente). A duração média da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de diálise durante o período de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Níveis elevados de pressão arterial sistólica [taxas de risco (HR) 1,03, intervalo de confiança (IC) de 95%: 1 a 1,06, p = 0,036], creatinina sérica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excreção urinária de proteínas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doença renal terminal. A mediana da sobrevida de pacientes com comprometimento de órgãos foi de 50,3 ± 16 meses. Conclusão: O presente estudo indicou que a FFM constituiu uma grande proporção de casos e crescente quantidade de pacientes com amiloidose AA idiopática. Adicionalmente, observou-se que a sobrevida do paciente não foi afetada pelas diferentes causas etiológicas na amiloidose AA.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Young Adult , Familial Mediterranean Fever/mortality , Renal Insufficiency, Chronic/mortality , Amyloidosis/mortality , Familial Mediterranean Fever/complications , Proteinuria/urine , Proportional Hazards Models , Retrospective Studies , Renal Dialysis/statistics & numerical data , Outcome Assessment, Health Care/statistics & numerical data , Creatinine/blood , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/therapy , Kaplan-Meier Estimate , Amyloidosis/complications , Amyloidosis/physiopathology , Middle Aged
10.
Medisan ; 21(10)oct.2017. tab
Article in Spanish | LILACS | ID: biblio-995730

ABSTRACT

Introducción: El daño renal agudo producido por el empleo de medios de contraste es una complicación que a menudo se subestima desde el punto de vista clínico. En general, existen bajos índices de presunción y de diagnóstico y se asocia a intervenciones diagnósticas y terapéuticas, como la coronariografía percutánea. Objetivo: Evaluar los factores de riesgo relacionados con la aparición de nefropatía en pacientes que recibieron coronariografía percutánea.Métodos: Se realizó un estudio descriptivo y analítico de 37 pacientes que requirieron coronariografía percutánea en el Cardiocentro del Hospital Clínico-Quirúrgico Carlos J. Finlay de La Habana, desde octubre de 2009 hasta enero de 2010. Para ello se conformaron tres grupos de riesgo (bajo, mediano o alto) de acuerdo al número de factores presentes, y todos los integrantes fueron tratados con solución salina fisiológica a 1 mL/kg/h. Se determinó la existencia de daño renal agudo si se producía un incremento de la creatinina sérica de 25 por ciento o más a las 72 horas de practicado el procedimiento, en comparación con las cifras obtenidas inicialmente.Resultados: Se indujo la nefropatía solo en 4 pacientes (10,8 por ciento ), 3 de los cuales pertenecían al grupo de alto riesgo. No existió afectación alguna en los integrantes del grupo de bajo riesgo. Conclusiones: Los resultados de este estudio sugirieron la presencia de factores de riesgo que condicionan la aparición de una nefropatía luego del uso de la coronariografía percutánea, sobre todo si convergen dos o más de ellos en un mismo paciente.


Introduction: Acute renal damage provoked due to the use of contrast means is a complication that is often underestimated from the clinical point of view. In general, there are low rates of presumption and diagnosis and it is associated with diagnostic and therapeutic interventions, as the percutaneous coronariography. Objective: To evaluate risk factors related to the emergence of nephropathy in patients that received percutaneous coronariography. Methods: A descriptive and analytic study of 37 patients that required percutaneous coronariography was carried out in the Cardiology Center of Carlos J. Finlay Clinical-Surgical Hospital in Havana, from October, 2009 to January, 2010. Three risk groups (low, medium or high) were conformed for that purpose according to the number of present factors, and all the members were treated with physiologic saline solution to 1 mL/kg/h. The existence of acute renal damage was determined if a 25 percent increment or more of seric creatinin took place at 72 hours of having practiced the procedure, in comparison with the figures obtained initially. Results: Nephropathy was just induced in 4 patients (10.8 percent), 3 of which belonged to the high risk group. There was no affectation in the members of the low risk group. Conclusions: The results of this study suggested the presence of risk factors that condition the emergence of a nephropathy after using percutaneous coronariography, mainly if two or more converge in the same patient.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Coronary Angiography , Contrast Media/adverse effects , Renal Insufficiency, Chronic/physiopathology , Acute Kidney Injury/etiology , Epidemiology, Descriptive , Risk Factors
11.
Rev. cuba. med. mil ; 46(3): 256-265, jul.-set. 2017. tab
Article in Spanish | LILACS | ID: biblio-901225

ABSTRACT

Introducción: el diagnóstico histopatológico de necrosis tubular aguda, generalmente de causa isquémica o nefrotóxica, se encuentra muy relacionado con el desarrollo de insuficiencia renal aguda. Objetivo: analizar la presencia de diagnóstico histopatológico de necrosis tubular aguda en los egresados fallecidos autopsiados y explorar la relación con posibles factores favorecedores. Métodos: estudio retrospectivo, observacional de las autopsias en el Hospital Militar Central Dr. Luis Díaz Soto, en el período 1962 al 2015. Se estableció en ellas el diagnóstico histopatológico de necrosis tubular aguda y se analizó el comportamiento de variables demográficas, clínicas y anatomopatológicas. Resultados: se registraron 843 341 egresados, de ellos 25 213 fallecidos (índice de mortalidad 3,0), se realizaron 18 630 autopsias (índice autopsia 75,3 por ciento), en estas se estableció diagnóstico de necrosis tubular aguda en 6.264 (33,6 por ciento). Predominaron los pacientes masculinos y los mayores de 45 años de edad. El shock (22,3 por ciento), la bronconeumonía (16,3 por ciento), la aterosclerosis coronaria(18,5 por ciento) y el edema pulmonar (11,3 por ciento) constituyeron las principales causas directas de muerte. La aterosclerosis coronaria (18,5 por ciento) fue la principal causa básica de muerte. Conclusiones: se registró un incremento sostenido de egresos, de fallecidos y de autopsias practicadas, así como del diagnóstico histopatológico de necrosis tubular aguda. Predominaron los pacientes del sexo masculino y aquellos mayores de 45 años de edad. Las principales causas directas de muerte en estos fueron el shock, la bronconeumonía y el edema pulmonar. La aterosclerosis fue la principal causa básica de muerte(AU)


Introduction: The histopathological diagnosis of acute tubular necrosis, usually of ischemic or nephrotoxic cause, is closely related to the development of acute renal failure. Objective: To analyze the presence of histopathological diganosis of acute tubular necrosis in deceased autopsied and to explore the relationship with possible favoring factors. Method: Retrospective, observational study, with descriptive statistical study of the autopsies at the Central Military Hospital Dr. Luis Díaz Soto in the period from 1962 to 2015. The histopathological diagnosis of acute tubular necrosis was done and demographic, clinical and anatomopathological variables were analyzed. Results: 843 341 discharged from hospital were recorded, of which 25 213 died (mortality rate 3.0), 18 630 autopsies were performed (autopsy rate 75.3 percent). In these cases a diagnosis of acute tubular necrosis was done in 6 264 (33.6 percent). Male patients and those over 45 years of age predominated. Shock (22.3 percent), bronchopneumonia (16.3 percent), coronary atherosclerosis (18.5 percent) and pulmonary edema (11.3 percent) were the main direct causes of death. Coronary atherosclerosis (18.5 percent) was the main underlying cause of death. Conclusions: There was a sustained increase in discharged patients, deaths and autopsies, as well as the histopathological diagnosis of acute tubular necrosis. Male patients predominated and those older than 45 years of age. The main direct causes of death in these were shock, bronchopneumonia and pulmonary edema. Atherosclerosis was the leading cause of death(AU)


Subject(s)
Humans , Male , Middle Aged , Autopsy/methods , Coronary Artery Disease/mortality , Renal Insufficiency, Chronic/physiopathology , Kidney Tubular Necrosis, Acute/diagnosis , Shock/mortality , Retrospective Studies , Observational Study
12.
J. bras. nefrol ; 39(2): 186-195, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-893758

ABSTRACT

Abstract Patients with chronic kidney disease (CKD) are susceptible to the occurrence of ventricular arrhythmias. The leading cause of death in dialysis patients is cardiac arrhythmias. The pathophysiology of arrhythmias in this population is complex and seems to be related to structural cardiac abnormalities caused by CKD, associated with several triggers, such as water and electrolyte disorders, hormonal conditions, arrhythmogenic drugs, and the dialysis procedure itself. Little is known about the clinical outcomes in CKD patients with asymptomatic ventricular arrhythmias. The results of treatments with anti-arrhythmic drugs and invasive devices are controversial in these patients, according to the available literature. The aim of this study was to review this often-neglected topic, which is of special importance in the CKD population.


Resumo A população com doença renal crônica (DRC) está vulnerável à ocorrência de arritmias ventriculares. Os distúrbios do rítmo cardíaco constituem a principal causa de morte em pacientes dialíticos. A fisiopatologia das arritmias nesta população é complexa e parece relacionar-se às alterações da estrutura cardíaca causadas pela DRC, associadas a diversos gatilhos, tais como: distúrbios hidro-eletrolíticos e hormonais, uso de drogas arritmogênicas e aqueles relacionados ao próprio procedimento dialítico. Pouco se sabe sobre os desfechos clínicos dos pacientes com DRC portadores de arritmias ventriculares assintomáticas. O tratamento desta população com anti-arrítmicos e dispositivos invasivos tem resultados controversos na literatura. O objetivo desse trabalho foi revisar este tema muitas vezes negligenciado, mas de especial importância na população com DRC.


Subject(s)
Humans , Arrhythmias, Cardiac/etiology , Renal Insufficiency, Chronic/complications , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/therapy , Renal Insufficiency, Chronic/physiopathology
14.
Braz. j. med. biol. res ; 50(5): e6106, 2017. tab
Article in English | LILACS | ID: biblio-839292

ABSTRACT

Urinary biomarkers can predict the progression of chronic kidney disease (CKD). In this study, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG) were correlated with the stages of CKD, and the association of these biomarkers with CKD progression and adverse outcomes was determined. A total of 250 patients, including 111 on hemodialysis, were studied. Urinary KIM-1, NGAL, and NAG were measured at baseline. Patients not on dialysis at baseline who progressed to a worse CKD stage were compared with those who did not progress. The association of each biomarker and selected covariates with progression to more advanced stages of CKD, end-stage kidney disease, or death was evaluated by Poisson regression. NGAL was moderately correlated (rs=0.467, P<0.001) with the five stages of CKD; KIM-1 and NAG were also correlated, but weakly. Sixty-four patients (46%) progressed to a more advanced stage of CKD. Compared to non-progressors, those patients exhibited a trend to higher levels of KIM-1 (P=0.064) and NGAL (P=0.065). In patients not on dialysis at baseline, NGAL was independently associated with progression of CKD, ESKD, or death (RR=1.022 for 300 ng/mL intervals; CI=1.007-1.037, P=0.004). In patients on dialysis, for each 300-ng/mL increase in urinary NGAL, there was a 1.3% increase in the risk of death (P=0.039). In conclusion, urinary NGAL was associated with adverse renal outcomes and increased risk of death in this cohort. If baseline urinary KIM-1 and NGAL predict progression to worse stages of CKD is something yet to be explored.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Acetylglucosaminidase/urine , Hepatitis A Virus Cellular Receptor 1/analysis , Lipocalin-2/urine , Renal Insufficiency, Chronic/pathology , Renal Insufficiency, Chronic/urine , Age Factors , Analysis of Variance , Biomarkers/urine , Creatinine/blood , Creatinine/urine , Disease Progression , Glomerular Filtration Rate , Predictive Value of Tests , Reference Standards , Reference Values , Renal Dialysis , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/physiopathology , Reproducibility of Results , Risk Factors , Sex Factors , Statistics, Nonparametric
15.
Rev. Salusvita (Online) ; 36(1): 47-54, 2017.
Article in Portuguese | LILACS | ID: biblio-876018

ABSTRACT

Introdução: a Insuficiência renal crônica (IRC) é definida como uma condição fisiopatológica com perda progressiva e irreversível da função renal. A perda superior a 75% da taxa de filtração glomerular resulta em uma instabilidade hídrica e eletrolítica. Objetivo: avaliar a prevalência de casos de insuficiência renal crônica na cidade de Rio Verde-Goiás que foram atendidos pelo Serviço Médico de Atendimento de Urgência de Rio Verde, Goiás (SAMU/RV). Método: trata-se de um estudo epidemiológico, transversal e documental, realizado através de consulta ao banco de dados do SAMU/RV referente ao período 2014-2015. Resultado e Discussão: a prevalência de IRC foi de 41,20% em 2014 e 38,20% em 2015, em relação aos outros atendimentos realizados pelo SAMU/Rio Verde por queixas nefrológicas nessa mesma data. Conclusão: Os resultados indicaram alta prevalência de casos de atendimento de IRC pelo SAMU/RV no período de 2014-2015. (AU)


Introduction: Chronic renal failure (CRF) is defined as a pathophysiological condition with progressive and irreversible loss of renal function. Loss greater than 75% of the glomerular filtration rate results in water and electrolyte instability. Objective: In this way, the study sought to evaluate the prevalence of chronic renal failure in the city of Rio Verde-Goiás, which was attended by the Emergency Medical Service of Rio Verde, Goiás (SAMU/RV). Method: This is an epidemiological, cross-sectional and documentary study, carried out by consulting the SAMU/RV database for the period 2014-2015. Results and Discussion: the prevalence of CRI was 41.20% in 2014 and 38.20% in 2015, in relation to the other visits performed by SAMU/Rio Verde for nephrological complaints at the same date. Conclusion: The results indicated a high prevalence of cases of CKI care by the SAMU/RV in the period 2014-2015. (AU)


Subject(s)
Humans , Cross-Sectional Studies/methods , Emergency Medical Services/statistics & numerical data , Emergency Medicine , Renal Insufficiency/complications , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/epidemiology , Kidney Diseases/complications
17.
Int. j. cardiovasc. sci. (Impr.) ; 29(1): 13-18, jan.-fev.2016. tab
Article in Portuguese | LILACS | ID: lil-797107

ABSTRACT

Doenças cardiovasculares são frequentes no curso da insuficiência renal crônica, constituem importante causa de óbito, e causam 1/3 das hospitalizações de doentes dialíticos. Hiperparatireoidismo secundárioé o distúrbio metabólico mais comum na insuficiência renal, cuja fisiopatologia envolve alterações no equilíbriodo cálcio, fósforo, calcitriol e paratormônio. Objetivo: Avaliar a prevalência de alterações ecocardiográficas em pacientes renais crônicos com hiperparatireoidismo secundário, de acordo com níveis plasmáticos de paratormônio.Métodos: Estudo retrospectivo, realizado com base em dados registrados em prontuários entre 2005 e 2007,incluindo 52 indivíduos de ambos os sexos, com doença renal crônica em programa regular de diálise, estratificados com base nos níveis plasmáticos de paratormônio em três grupos: Grupo I ≤ 299pg/mL (n=10); Grupo II entre 300-499 pg/mL (n=21); e Grupo III ≥500 pg/mL (n=21). Foram avaliados os seguintes parâmetros ecocardiográficos: diâmetros da raiz da aorta, do átrio esquerdo e dos ventrículos; espessuras do septo e da parede posterior; fração de ejeção; e volumes diastólico e sistólico finais.Resultados: A análise comparativa dos achados ecocardiográficos nos três grupos revelou que a única variávelque apresentou significância estatística (p 0,009) foi a espessura diastólica da parede posterior. Conclusão: Doentes renais crônicos com hiperparatireoidismo secundário podem apresentar alteraçõesecocardiográficas, algumas das quais apresentam correlação com níveis circulantes de paratormônio....


Background: Cardiovascular diseases are frequent in the course of chronic kidney disease, are an important cause of death, and cause 1/3 of hospitalizations of patients on dialysis. Secondary hyperparathyroidism is the most common metabolic disorder in kidney failure. Its pathophysiology involves changes in the balance of calcium, phosphorus, calcitriol and parathyroid hormone. Objective: To assess the prevalence of echocardiographic abnormalities in chronic kidney disease patients with secondaryhyperparathyroidism, according to plasma levels of parathyroid hormone.Methods: Retrospective study conducted based on data recorded in medical records between 2005 and 2007, including 52 individuals of both sexes with chronic kidney disease on a regular dialysis program, stratified based on plasma levels of parathyroid hormoneinto three groups: Group I ≤ 299pg/mL (n=10); Group II between 300-499 pg/mL (n=21); and Group III ≥500 pg/mL (n=21).We evaluated the following echocardiographic parameters: aortic root diameter, left atrial and ventricular diameter; septal and posteriorwall thickness; ejection fraction; and end diastolic and systolic volumes. Results: The comparative analysis of the echocardiographic findings in the three groups revealed that the only variable presenting statistical significance (p 0.009) was diastolic posterior wall thickness. Conclusion: Patients with chronic kidney disease with secondary hyperparathyroidism may present echocardiographic changes, some of which correlate with circulating levels of parathyroid hormone...


Subject(s)
Humans , Male , Female , Middle Aged , Echocardiography/methods , Hyperparathyroidism, Secondary/complications , Hyperparathyroidism, Secondary/physiopathology , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/mortality , Patients , Chronic Disease , Calcium/analysis , Calcitriol/analysis , Renal Dialysis/methods , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnosis , Phosphorus/analysis , Prevalence , Retrospective Studies , Risk Factors , Kidney/physiopathology , Statistical Analysis
18.
Clinics ; 71(1): 22-27, Jan. 2016. tab, graf
Article in English | LILACS | ID: lil-771949

ABSTRACT

OBJECTIVES: To evaluate exercise tolerance and the reproducibility of the six-minute walk test in Brazilian children and adolescents with chronic kidney disease and to compare their functional exercise capacities with reference values for healthy children. METHODS: This cross-sectional study assessed the use of the six-minute walk test in children and adolescents aged 6-16 with stage V chronic kidney disease. For statistical analysis of exercise tolerance, including examinations of correlations and comparisons with reference values, the longest walked distances were considered. The reproducibility of the six-minute walk test was assessed using intraclass correlation coefficients. RESULTS: A total of 38 patients (14 females and 24 males) were evaluated, including 5 on peritoneal dialysis, 12 on hemodialysis and 21 who had undergone renal transplantation, with a median age of 11.2 years (6.5-16). The median walked distance was 538.5 meters (413-685) and the six-minute walk test was found to be reproducible. The walked distance was significantly correlated with age (r=0.66), weight (r=0.76), height (r=0.82), the height Z score (r=0.41), hemoglobin (r=0.46), hematocrit (r=0.47) and post-test systolic blood pressure (r=0.39). The chronic kidney disease patients predicted walked distance was 84.1% of the reference value according to age, 90.6% according to age-corrected height and 87.4% according to a predictive equation. CONCLUSIONS: The stage V chronic kidney disease patients had a significantly decreased functional exercise capacity, as measured by the six-minute walk test, compared with the healthy pediatric reference values. In addition, the six-minute walk test was shown to be well tolerated, reliable and applicable as a low-cost tool to monitor functional exercise capacity in patients with renal disease.


Subject(s)
Adolescent , Child , Female , Humans , Male , Exercise Test , Exercise Tolerance/physiology , Renal Insufficiency, Chronic/physiopathology , Walking/physiology , Brazil , Cross-Sectional Studies , Dyspnea/physiopathology , Healthy Volunteers/statistics & numerical data , Predictive Value of Tests , Reference Values , Reproducibility of Results , Time Factors
19.
Med. interna (Caracas) ; 32(3): 245-251, 2016. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1009380

ABSTRACT

Se trata de un estudio observacional, analítico y prospectivo cuyo objetivo es analizar la concentración de enzimas cardíacas en pacientes con enfermedad renal crónica en hemodiálisis sin evidencia clínica de cardiopatía isquémica aguda, hospitalizados en el Servicio de Medicina Interna del Hospital Universitario de Caracas, Venezuela durante el período 2014-2015. Métodos: Se tomó muestra de suero a 48 pacientes con enfermedad renal crónica en hemodiálisis sin evidencia de cardiopatía isquémica aguda, y se midieron las concentraciones de creatin quinasa (CK), creatin quinasa fracción MB (CK-MB) y Troponina I (Tn-I) antes y después de la diálisis. Resultados: la mediana de los valores obtenidos de CK fue 42 prediálisis y 38 postdiálisis (p = 0,434), CK-MB: 10 pre y postdiálisis (p = 0,629), con respecto a troponina I, la mediana fue 0,00 pre y postdiálisis (p = 0,586). Se obtuvo valores dentro de límites normales de CK en 91,1% pre y 93,3% postdiálisis, CKMB 93,3% prediálisis y postdiálisis y Troponina I en 97,67% pre y 95,35% postdiálisis. Conclusiones: no se evidenciaron cambios significativos en las concentraciones de CK, CK-MB y Troponina I tanto pre como postdiálisis, encontrándose dentro de la normalidad en más de 90% de los casos. No se encontró relación entre concentración Troponina I, CK y CK-MB según edad, sexo, factores de riesgo cardiovasculares (diabetes mellitus e hipertensión arterial) y tiempo de hemodiálisis. Cualquiera de las enzimas puede tener utilidad clínica, siendo de preferencia las más cardioespecíficas, individualizando cada caso según su clínica y sus valores basales de enzimas cardíacas(AU)


This is an observational, analytical prospective study aimed to analyze cardiac enzymes concentrations in chronic kidney disease patients in hemodialysis without evidence of acute coronary disease at Internal Medicine Service of Hospital Universitario de Caracas, Venezuela during 2014-2015. Methods: serum samples were taken in 46 patients' with chronic kidney disease in hemodialysis without evidence of acute coronary disease and creatin kinase (CK), creatin kinase fraction MB (CK-MB) and Troponin I (Tn-I) were measured before and after hemodialysis. Results: was 42 predialysis and 38 postdialysis (p = 0.434), CK-MB 10 predialysis and post-dialysis (p = 0.629) the median value of troponin I, was 0.00 before and after dialysis (p = 0.586). It was obtained values within normal range of CK in 91.1% and 93.3% pre and post-dialysis, CK-MB in 93.3% predialysis and postdialysis and Troponin I in 97.67% pre and 95.35 % postdialysis. Conclusions: No significant changes were found in concentrations of CK, CK-MB and Troponin I bothpre and post-dialysis, with normal values in over 90% of cases. No relationship between concentration of Troponin I, CK and CK-MB and age, sex, cardiovascular risk factors (diabetes and hypertension) or time in hemodialysis were found. Any of the enzymes may have clinical utility, being the cardiospecific ones preferably, individualizing each case based on clinical and baseline cardiac enzymes(AU)


Subject(s)
Humans , Male , Female , Troponin I , Coronary Disease/physiopathology , Enzymes , Renal Insufficiency, Chronic/physiopathology , Renal Dialysis , Internal Medicine
20.
Article in English | WPRIM | ID: wpr-48265

ABSTRACT

BACKGROUND: Estimated glomerular filtration rate (eGFR) is a widely used index of kidney function. Recently, new formulas such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations or the Lund-Malmö equation were introduced for assessing eGFR. We compared them with the Modification of Diet in Renal Disease (MDRD) Study equation in the Korean adult population. METHODS: The study population comprised 1,482 individuals (median age 51 [42-59] yr, 48.9% males) who received annual physical check-ups during the year 2014. Serum creatinine (Cr) and cystatin C (CysC) were measured. We conducted a retrospective analysis using five GFR estimating equations (MDRD Study, revised Lund-Malmö, and Cr and/or CysC-based CKD-EPI equations). Reduced GFR was defined as eGFR <60 mL/min/1.73 m2. RESULTS: For the GFR category distribution, large discrepancies were observed depending on the equation used; category G1 (≥90 mL/min/1.73 m2) ranged from 7.4-81.8%. Compared with the MDRD Study equation, the other four equations overestimated GFR, and CysC-based equations showed a greater difference (-31.3 for CKD-EPI(CysC) and -20.5 for CKD-EPI(Cr-CysC)). CysC-based equations decreased the prevalence of reduced GFR by one third (9.4% in the MDRD Study and 2.4% in CKD-EPI(CysC)). CONCLUSIONS: Our data shows that there are remarkable differences in eGFR assessment in the Korean population depending on the equation used, especially in normal or mildly decreased categories. Further prospective studies are necessary in various clinical settings.


Subject(s)
Adult , Aged , Algorithms , Creatinine/blood , Cystatin C/blood , Female , Glomerular Filtration Rate/physiology , Humans , Male , Middle Aged , Renal Insufficiency, Chronic/physiopathology , Retrospective Studies
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