Performance of creatinine-based equations for estimating glomerular filtration rate compared to endogenous creatinine clearance / Desempenho das equações baseadas em creatinina para estimativa da taxa de filtração glomerular comparadas à depuração da creatinina endógena

Abstract Introduction: The guidelines recommend estimating the glomerular filtration rate using serum creatinine-based equations as a predictor of kidney disease, preferably adjusted for local population groups. Methods: Cross-sectional study that evaluated the performance of four equations used for estimating GFR compared to endogenous creatinine clearance (ClCr) in 1,281 participants. Modification of Diet equations in Renal Disease Study Group (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI with adjustment for local population (CKD-EPI local) and Full Age Spectrum (FAS) in comparison with endogenous creatinine clearance (ClCr). We used the Quantile Regression to calculate the median bias, interquartile range (IQR), Bland-Altman agreement analysis and 30% margin of error (P30). Results: The mean age of participants was 52.5 ± 16.5 years with 466 women (38%), median ClCr[IQR] of 92.0 [58.0; 122.0] mL/min/1.73 m2, with 320 (25%) participants presenting ClCr < 60 mL/min/1.73 m2. The performance of the local CKD-EPI and FAS equations were superior to MDRD and CKD-EPI in relation to variability (0.92 [0.89; 0.94]) and P30 (90.5% [88.7; 92, 0]). In the group with ClCr < 60 mL/min/1.73 m2, the local CKD-EPI and FAS equations showed less variability than the CKD-EPI and MDRD (0.90 [0.86; 0.98] and 1.05 [0.97; 1.09] vs. 0.63 [0.61; 0.68] and 0.65 [0.62; 0.70], P < 0.01) and best P30 (85.5) % [81.0; 90.0], 88.0% [84.0; 92.0] vs. 52.0% (46.0; 58.0) and 53.0% [47.0; 58 .5], P < 0.01). Conclusion: Local CKD-EPI and FAS equations performed better than CKD-EPI and MDRD when compared to ClCr.

Resumo Introdução: As diretrizes recomendam a estimativa da taxa de filtração glomerular pelo uso de equações baseadas em creatinina sérica como preditor de doença renal, preferencialmente ajustadas para grupos populacionais locais. Métodos: Estudo transversal que avaliou o desempenho de quatro equações para estimativa da TFG em comparação com a depuração de creatinina endógena (DCE) em 1.281 participantes. Foram avaliadas as equações Modification of Diet in Renal Disease Study Group (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI com ajuste para a população local (CKD-EPI local) e Full Age Spectrum (FAS) em comparação com a depuração de creatinina endógena (DCE). Utilizamos a Regressão Quantílica para cálculo do viés mediano, intervalo interquartil (IQR), análise de concordância de Bland-Altman e margem de erro de 30% (P30). Resultados: A idade média dos participantes era de 52,5 ± 16,5 anos com 466 mulheres (38%), mediana da DCE [IQR] de 92,0 [58,0; 122,0] mL/min/1,73 m2, com 320 (25%) participantes apresentando DCE < 60 mL/min/1,73 m2. A performance das equações CKD-EPI local e FAS foram superiores às MDRD e CKD-EPI em relação à variabilidade (0,92 [0,89; 0,94]) e P30 (90,5% [88,7; 92,0]). No grupo com DCE < 60 mL/min/1,73 m2, as equações CKD-EPI local e FAS apresentaram menor variabilidade que as CKD-EPI e MDRD (0,90 [0,86; 0,98] e 1,05 [0,97; 1,09] vs. 0,63 [0,61; 0,68] e 0,65 [0,62; 0,70], P < 0,01) e melhores P30 (85,5% [81,0; 90,0], 88,0% [84,0; 92,0] vs. 52,0% (46,0; 58,0) e 53,0% [47,0; 58,5], P < 0,01). Conclusão: As equações CKD-EPI local e FAS tiveram desempenho superior às CKD-EPI e MDRD, quando comparadas a DCE.

Performance of creatinine-based equations for estimating glomerular filtration rate compared to endogenous creatinine clearance.

INTRODUCTION: The guidelines recommend estimating the glomerular filtration rate using serum creatinine-based equations as a predictor of kidney disease, preferably adjusted for local population groups. METHODS: Cross-sectional study that evaluated the performance of four equations used for estimating GFR compared to endogenous creatinine clearance (ClCr) in 1,281 participants. Modification of Diet equations in Renal Disease Study Group (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI with adjustment for local population (CKD-EPI local) and Full Age Spectrum (FAS) in comparison with endogenous creatinine clearance (ClCr). We used the Quantile Regression to calculate the median bias, interquartile range (IQR), Bland-Altman agreement analysis and 30% margin of error (P30). RESULTS: The mean age of participants was 52.5 ± 16.5 years with 466 women (38%), median ClCr[IQR] of 92.0 [58.0; 122.0] mL/min/1.73 m2, with 320 (25%) participants presenting ClCr < 60 mL/min/1.73 m2. The performance of the local CKD-EPI and FAS equations were superior to MDRD and CKD-EPI in relation to variability (0.92 [0.89; 0.94]) and P30 (90.5% [88.7; 92, 0]). In the group with ClCr < 60 mL/min/1.73 m2, the local CKD-EPI and FAS equations showed less variability than the CKD-EPI and MDRD (0.90 [0.86; 0.98] and 1.05 [0.97; 1.09] vs. 0.63 [0.61; 0.68] and 0.65 [0.62; 0.70], P < 0.01) and best P30 (85.5) % [81.0; 90.0], 88.0% [84.0; 92.0] vs. 52.0% (46.0; 58.0) and 53.0% [47.0; 58 .5], P < 0.01). CONCLUSION: Local CKD-EPI and FAS equations performed better than CKD-EPI and MDRD when compared to ClCr.

Biomining of iron-containing nanoparticles from coal tailings.

Sulfur minerals originating from coal mining represent an important environmental problem. Turning these wastes into value-added by-products can be an interesting alternative. Biotransformation of coal tailings into iron-containing nanoparticles using Rhodococcus erythropolis ATCC 4277 free cells was studied. The influence of culture conditions (stirring rate, biomass concentration, and coal tailings ratio) in the particle size was investigated using a 23 full factorial design. Statistical analysis revealed that higher concentrations of biomass produced larger sized particles. Conversely, a more intense stirring rate of the culture medium and a higher coal tailings ratio (% w/w) led to the synthesis of smaller particles. Thus, the culture conditions that produced smaller particles (< 50 nm) were 0.5 abs of normalized biomass concentration, 150 rpm of stirring rate, and 2.5% w/w of coal tailings ratio. Composition analyses showed that the biosynthesized nanoparticles are formed by iron sulfate. Conversion ratio of the coal tailings into iron-containing nanoparticles reached 19%. The proposed biosynthesis process, using R. erythropolis ATCC 4277 free cells, seems to be a new and environmentally friendly alternative for sulfur minerals reuse.

Effect of Temperature, Precursor Type and Dripping Time on the Crystallite Size of Nano ZnO Obtained by One-Pot Synthesis: 2k Full Factorial Design Analysis.

The aim of this work was to determine the effect of temperature, precursor and dripping time on the crystallite size of ZnO nanoparticles synthesized by controlled precipitation according a 2k full factorial design. ZnCl2, Zn(NO3)2 and NaOH were used as precursors. After synthesis, the nano crystalline powder was characterized by XRD (Cu Kα), UV-Vis, and HR-TEM. The nano ZnO particles presented a crystallite size between 210 and 260 Å (HR-TEM and XRD). The results show that the crystallite size depends on the type of precursor and temperature of synthesis, but not on the dripping time.

Reimplante intencional: opção de tratamento para dentes fraturados verticalmente / Intentional replantation: treatment option to vertically fractured teeth

O objetivo do presente trabalho é a descrição de um caso clínico no qual no foi realizado um reimplante intencional após radicular vertical de um dente tratado endodonticamente. Este procedimento consiste na exodontia para corrigir algum defeito ou iatrogenia, seguido da reimplantação imediata do elemento dental com o intuito de criar condições para que ocorra o reparo de um processo inflamatório crônico. Baseado em uma proservação clínico-radiográfica de cinco anos e após revisão de literatura, este artigo demonstra que o reimplante intencional é uma alternativa de tratamento para dentes com fraturas radiculares verticais.

A percepção dos portadores da fluorose dentária, no Município de Cocal do Sul, 12 anos após o diagnóstico / Perception of dental fluorosis twelve years after diagnosis in the city of Cocal do Sul, Santa Catarina - Brazil

A fluorose dentária, caracterizada por apresentar manchas brancas e ou marrons nos elementos dentais acometeu a população de Cocal do Sul - SC em 1985, atingindo 92 por cento dos escolares em vários graus (índice de Dean). O presente trabalho teve como objetivo avaliar a forma com que as alterações dentais influenciam na vida dos adolescentes e adultos afetados pela fluorose em Cocal do Sul em 1985. Para isto foi elaborado um questionário que foi respondido pelos adolescentes da comunidade. Obteve-se como resultado, que a fluorose, assim como qualquer outra forma de doença ou trauma que afeta a estética do indivíduo, teve uma pequena influência na vida social dos entrevistados, minimizada pelo tratamento que foi realizado na grande parcela da população afetada