ABSTRACT
Abstract The Department of Acute Kidney Injury (IRA) of the Brazilian Society of Nephrology prepared this document for the purpose of standardizing AKI terminology and dialysis modalities in the Portuguese language for Brazil. Several terms with similar meanings have been used in AKI and its dialysis modalities, causing confusion and disparities among patients, nephrologists, health institutions, private care companies, insurance companies and government entities. These disparities can impact medical care, hospital organization and care, as well as the funding and reimbursement of AKI-related procedures. Thus, consensual nomenclature and definitions were developed, including the definitions of AKI, acute kidney disease (AKD) and chronic kidney disease (CKD). Additionally, we addressed all dialysis modalities and extracorporeal procedures related to AKI, currently approved and available in the country. The Brazilian Society of Nephrology hopes that this Consensus can standardize the terminology and provide technical support to all involved in AKI care in Brazil.
Resumo O Departamento de Injúria Renal Aguda (IRA) da Sociedade Brasileira de Nefrologia elaborou o presente documento para fins de padronização da terminologia em IRA e modalidades dialíticas na língua portuguesa para o Brasil. Diversos termos com significados semelhantes têm sido empregados em IRA e suas modalidades dialíticas, causando confusão e disparidades entre pacientes, nefrologistas, instituições de saúde, empresas privadas de assistência, seguradoras e entidades governamentais. Essas disparidades podem impactar a assistência médica, a organização e o atendimento hospitalares, assim como o financiamento e reembolso dos procedimentos relacionados com a IRA. Assim, nomenclatura e definições consensuais foram elaboradas, incluindo-se as definições de IRA, doença renal aguda (DRA) e doença renal crônica (DRC). Adicionalmente, todas as modalidades dialíticas e os procedimentos extracorpóreos relacionados a IRA, atualmente aprovados e disponíveis no país, foram abordados. A Sociedade Brasileira de Nefrologia espera que este Consenso possa padronizar a nomenclatura e prover suporte técnico para todos os atores envolvidos na assistência à IRA no Brasil.
ABSTRACT
The Department of Acute Kidney Injury (IRA) of the Brazilian Society of Nephrology prepared this document for the purpose of standardizing AKI terminology and dialysis modalities in the Portuguese language for Brazil. Several terms with similar meanings have been used in AKI and its dialysis modalities, causing confusion and disparities among patients, nephrologists, health institutions, private care companies, insurance companies and government entities. These disparities can impact medical care, hospital organization and care, as well as the funding and reimbursement of AKI-related procedures. Thus, consensual nomenclature and definitions were developed, including the definitions of AKI, acute kidney disease (AKD) and chronic kidney disease (CKD). Additionally, we addressed all dialysis modalities and extracorporeal procedures related to AKI, currently approved and available in the country. The Brazilian Society of Nephrology hopes that this Consensus can standardize the terminology and provide technical support to all involved in AKI care in Brazil.
Subject(s)
Acute Kidney Injury , Nephrology , Acute Kidney Injury/diagnosis , Acute Kidney Injury/therapy , Humans , Reference Standards , Renal Dialysis , Renal Replacement TherapyABSTRACT
We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.
Subject(s)
Acute Kidney Injury/therapy , Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Renal Replacement Therapy/standards , Vascular Access Devices/standards , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Brazil/epidemiology , COVID-19 , Clinical Decision-Making , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Critical Care , Humans , Kidney/drug effects , Nephrology/standards , Occupational Diseases/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Recovery of Function , Renal Replacement Therapy/methods , Respiration, Artificial/adverse effects , SARS-CoV-2 , Societies, MedicalABSTRACT
ABSTRACT We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.
RESUMO Este documento foi desenvolvido para trazer informações pertinentes à prática nefrológica em relação ao conhecimento sobre o acometimento renal da COVID-19, conduta frente aos casos de injúria renal aguda e orientações práticas sobre a provisão do suporte dialítico.Como as informações sobre a COVID-19 evoluem a uma velocidade jamais vista na ciência médica, as orientações apresentadas, embora baseadas em evidências científicas recentes, referem-se ao momento presente. Essas orientaços poderão ser atualizadas à medida que dados publicados e outras informações relevantes venham a ser disponibilizadas.
Subject(s)
Humans , Pneumonia, Viral/epidemiology , Renal Replacement Therapy/standards , Coronavirus Infections/epidemiology , Acute Kidney Injury/therapy , Vascular Access Devices/standards , Betacoronavirus , Respiration, Artificial/adverse effects , Societies, Medical , Brazil/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/drug therapy , Recovery of Function , Critical Care , Acute Kidney Injury/etiology , Acute Kidney Injury/epidemiology , Clinical Decision-Making , SARS-CoV-2 , COVID-19 , Occupational Diseases/prevention & controlABSTRACT
O reconhecimento de que morbidade e mortalidade estão inversamente relacionadas à dose de diálise em pacientes com insuficiência renal crônica gerou significativas mudanças na prática clínica. Entre diversos fatores, a persistência da elevada mortalidade de pacientes com insuficiência renal aguda poderia estar relacionada ao recebimento de dose insuficiente de diálise.A adequação de diálise em insuficiência renal aguda envolve o método, início e dose de diálise. O início e o método de diálise ainda não estão claramente estabelecidos. Entretanto, dados recentes sugerem que a sobrevida de pacientes com insuficiência renal aguda está diretamente relacionada à dose de diálise recebida.
Subject(s)
Humans , Adult , Acute Kidney Injury , Dialysis/instrumentation , Dialysis/methods , MortalityABSTRACT
Com os objetivos de identificar fatores prognósticos de mortalidade e validar seis escores prognósticos foram avaliados 324 pacientes com insuficiência renal aguda. Os fatores prognósticos de mortalidade identificados foram: idade ≥65 anos, uréia ≥150 mg/dL, insuficiência renal de origem séptica e antecedente de hipertensão arterial. Creatinina ≥3,5 mg/dL, pressão arterial sistólica ≥100 mmHg e consciência normal foram fatores protetores de mortalidade. Ocorreu subestimação da mortalidade por todos os escores prognósticos estudados / In order to identify mortality risk factors and validate six prognostic models 324 patients with acute renal failure were evaluated. The identified mortality risk factors were: age ≥65 years, serum urea ≥150 mg/dL, renal failure of septic origin and history of hypertension. Serum creatinine ≥3.5 mg/dL, systolic blood pressure ≥100 mmHg and normal conscience were associated with protection in the multivariate model. All prognostic models underestimated the mortality rate. Validation of predictive mortality models outside of their original institution is essential and development of a specific severity score system in acute renal failure is still warranted...
