RESUMO
We present the regional professional network to support the Renal Epidemiology Information Network (REIN) registry in maintaining high quality data production and information analyses in Ile-De-France region. The network is based on a long term partnership between the nephrologists and a regional methodology support unit. It integrates clinical research assistants for data quality control. We also present organizational methods on maintaining the registry and enhancing information analyses and automating analyses reports.
Assuntos
Sistema de Registros , Confiabilidade dos Dados , França , Serviços de InformaçãoAssuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Desoxicitidina/análogos & derivados , Rim/irrigação sanguínea , Rim/efeitos dos fármacos , Trombose/induzido quimicamente , Adulto , Idoso , Desoxicitidina/efeitos adversos , Feminino , Humanos , Incidência , Microcirculação/fisiopatologia , Estudos Retrospectivos , Síndrome , Trombose/diagnóstico , Trombose/fisiopatologia , GencitabinaAssuntos
Doxiciclina/uso terapêutico , Hemorragia Gastrointestinal/tratamento farmacológico , Adulto , Antibacterianos/uso terapêutico , Infecções por Bartonella/tratamento farmacológico , Feminino , Hemorragia Gastrointestinal/sangue , Hemorragia Gastrointestinal/microbiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Contagem de Plaquetas , Púrpura Trombocitopênica Trombótica/sangue , Púrpura Trombocitopênica Trombótica/tratamento farmacológico , Púrpura Trombocitopênica Trombótica/microbiologia , Transplante Homólogo/efeitos adversosRESUMO
BACKGROUND: Renal transplantation triggers an early bone loss that increases the subsequent risk of osteoporosis and fractures. Little is known about the long-term outcome of bone status and fracture prevalence several years after transplantation. Therefore, we conducted a cross-sectional evaluation of bone status to find out the frequency and predictors of osteoporotic fractures in late kidney graft patients. METHODS: Changes in spinal, hip, and total body bone mineral density were assessed using a DEXA Hologic QRD 1000 scanner, and fractures were quantified in all kidney graft patients presenting for routine evaluation with a minimal follow-up of 5 years after transplantation (with a mean follow-up 8.5+/-3.1 years). We measured biochemical markers of bone metabolism and collected clinical and dietary intake data. RESULTS: Fifty-nine renal graft recipients were enrolled in the study within 9 months. Osteoporosis, according to the World Health Organization definition, was observed in 31 patients (53% of the total population) and fractures occurred in 26 patients (44% of the total population and 51.6% of patients with osteoporosis). Femoral neck bone mineral density was positively correlated with patient's weight and cyclosporin current dosage. Steroid cumulative dosage correlated only to lumbar spine Z score. Dietary calcium, serum 25 hydroxyvitamin D, parathyroid hormone, and urinary N-telopeptides excretion were normal. CONCLUSIONS: These data emphasize the substantial prevalence of osteoporosis and fractures among very long-term kidney graft recipients. Therapeutic intervention in these patients is urgently needed.