Prevalence and predictors of nonadherence to hemodialysis.

BACKGROUND: The prevalence of nonadherence to dialysis (NAD) presents a wide variation, depending on the parameters used and demographic regions studied. This study aimed to assess the prevalence and predictors of NAD of patients with chronic kidney disease undergoing hemodialysis (HD). MATERIALS AND METHODS: This was a cross-sectional study with 255 adult patients receiving HD for >3 months. Skipping a session per month, shortening a session for at least 10 min, phosphorus >7.5 mg/dl, potassium >6.0 mmol/l and interdialytic weight gain (IDWG) >5.7% of body weight were indicative of NAD. The association of sociodemographic and clinical variables with NAD was assessed using logistic regression. RESULTS: Mean age was 50 ± 13.1 years, 62.7% were male, 85.5% were of African descent and 62% were married. The prevalence rates of NAD were: 49% of shortening sessions, 18% of hyperkalemia, 12% of hyperphosphatemia, 9% of IDWG >5.7% of dry weight and 8% of skipping HD. Independent predictors of NAD were: age ≤50 years, not being married, living alone, living in Salvador, attending dialysis without a companion, ethnic African descent, Kt/V <1.3 and residual diuresis <100 ml/day. CONCLUSION: NAD is frequent and distinct sociodemographic and clinical variables predict different parameters.

Risk factors for graft dysfunction in the late period of renal transplantation.

INTRODUCTION: Risk factors traditionally associated with kidney graft dysfunction after transplantation are delayed graft function, acute cellular rejection episodes, deceased donor organ source (particularly more than 50 years old), and HLA mismatch. Socioeconomic factors, such as income, education, and type of health insurance, have been reported in some studies. OBJECTIVE: To evaluate the risk factors traditionally associated with worse function of the transplanted kidney and the role of socioeconomic variables among our population. DESIGN OF STUDY: A cohort with 69 patients transplanted in the period 2003 to 2006 was assessed for predictors for a creatinine clearance estimated to be less than 60 mL/min or stage 3 or greater of renal dysfunction at 1 year of follow-up. CONCLUSION: Upon bivariate regression analysis, acute tubular necrosis [odds ratio (OR) 6.93 (1.9-24), P = .03], and bacterial infection [OR 4.13 (1.4-12), P < .01] were predictors of risk, which was also observed among transplants of kidneys from deceased donors [OR 2.67 (0.9-7.6), P = .07] or donors aged more than 49 years [OR 4.22 (0.9-18.1), P = .06]. Better education was a significant protective factor [OR 0.3 (0.1-0.9), P = .02]. Upon multivariate logistic regression analysis delayed graft function [OR 5.1 (1.3-20.5), P = .02] and severe bacterial infection [OR 3.9 (1.23-12.9), P = .02] were predictors; there was no association with socioeconomic factor.

[Analysis of scientific information published in Brazil in 5 years on Chagas disease, schistosomiasis, malaria, leishmaniasis and filariasis]. / Análisis de la información científica publicada en el Brasil en cinco años sobre la enfermedad de Chagas, esquistosomiasis, malaria, leishmaniasis y filariasis.

This paper offers a quantitative evaluation of the scientific information produced in Brazil on several endemic diseases: Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria and filariasis. The source of data was the Index Medicus Latino Americano (IMLA), and the published scientific information was analyzed in general and specifically, by type of disease and year of publication. The indexed production of articles on the material of the Latin American countries as a whole increased from 3,506 articles in 1978 to 5,528 in 1982 (for an increase of 52.7%), whereas that of Brazil alone rose from 1,781 to 2,531 (an increase of 42.1%) during the same period. The output of articles on endemic diseases totaled 703 papers (6.3% of the total indexed production). Of this total, 441 (62.7%) was on applied research and 262 (37.3%) were on basic research, and these proportions held relatively constant. Chagas' disease and schistosomiasis accounted for 75.2% of that total over the period considered. The production of papers on the diseases of interest grew 79.2%, at the same rate as that of all biomedical information published in Brazil over the period. An equilibrium was reached between the numbers of basic and applied papers. The analysis also identified the core of Brazilian periodicals that most frequently publish information on those endemics. It was also found that a large proportion of articles by Brazilian authors are published in journals of international circulation, and the foreign journals that publish papers by researchers in Brazil were identified.

Análisis de la información científica publicada en el Brasil en cinco años sobre la enfermedad de Chagas, esquistosomiasis, malaria, leishmaniasis y filariasis / Analysis of scientific information published in Brazil in 5 years on Chagas disease, schistosomiasis, malaria, leishmaniasis and filariasis

This paper offers a quantitative evaluation of the scientific information produced in Brazil on several endemic diseases: Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria and filariasis. The source of data was the Index Medicus Latino Americano (IMLA), and the published scientific information was analyzed in general and specifically, by type of disease and year of publication. The indexed production of articles on the material of the Latin American countries as a whole increased from 3,506 articles in 1978 to 5,528 in 1982 (for an increase of 52.7 per cent), whereas that of Brazil alone rose from 1,781 to 2,531 (an increase of 42.1 per cent) during the same period. The output of articles on endemic diseases totaled 703 papers (6.3 per cent of the total indexed production). Of this total, 441 (62.7 per cent) was on applied research and 262 (37.3 per cent) were on basic research, and these proportions held relatively constant. Chagas' disease and schistosomiasis accounted for 75.2 per cent of that total over the period considered. The production of papers on the diseases of interest grew 79.2 per cent, at the same rate as that of all biomedical information published in Brazil over the period. An equilibrium was reached between the numbers of basic and applied papers. The analysis also identified the core of Brazilian periodicals that most frequently publish information on those endemics. It was also found that a large proportion of articles by Brazilian authors are published in journals of international circulation, and the foreign journals that publish papers by researchers in Brazil were identified (Au)