scholarly journals Divergences in antihypertensive therapy in special situations in nephrology

2008 ◽  
Vol 126 (1) ◽  
pp. 34-40
Author(s):  
Marcelo Montebello Lemos ◽  
Alessandra Coelho Pedrosa ◽  
Alze Pereira Tavares ◽  
Miguel Ângelo Góes ◽  
Sérgio Antônio Draibe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Antihypertensive Therapy ◽  
Ace Inhibitors ◽  
Antihypertensive Agents ◽  
Sao Paulo ◽  
Diabetic Patients ◽  
São Paulo ◽  
Multiple Choice Questions ◽  
First Line

CONTEXT AND OBJECTIVE: The choice of an antihypertensive drug is based on several criteria and specific situations give rise to doubt and controversy. The aim here was to evaluate physicians’ approaches towards treatment with antihypertensive agents in specific situations. DESIGN AND SETTING: Cross-sectional study, at Universidade Federal de São Paulo, São Paulo. METHODS: A questionnaire was applied during a nephrology meeting to evaluate individual approaches towards each hypothetical clinical situation. The questionnaire consisted of five multiple-choice questions (clinical cases) concerning controversial aspects of antihypertensive therapy. RESULTS: A total of 165 questionnaires were analyzed. Most participants were nephrologists (93.2%). There was a preference for angiotensin-converting enzyme (ACE) inhibitors in at least two of the cases. Only 57.2% of the physicians were correct in choosing beta-blockers as the first-line drugs for patients with ischemic coronary disease. Moreover, 66.2% chose ACE inhibitors as the first-line drugs for patients with chronic kidney disease and proteinuria. About 5% of the physicians did not follow the current recommendations for the use of ACE inhibitors in diabetic patients with microalbuminuria. The most controversial question concerned the first-line drug for advanced chronic kidney disease. Most physicians were correct in choosing calcium channel blockers and avoiding ACE inhibitors in renovascular hypertension in the case of a patient with a single functioning kidney. CONCLUSIONS: Most physicians adopted the correct approach, but some had an alternative strategy for the same situations that was not based on evidence.

scholarly journals Chronic kidney disease - determinants of progression and cardiovascular risk. PROGREDIR cohort study: design and methods

2017 ◽  
Vol 135 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Maria Alice Muniz Domingos ◽  
Alessandra Carvalho Goulart ◽  
Paulo Andrade Lotufo ◽  
Isabela Judith Martins Benseñor ◽  
Silvia Maria de Oliveira Titan
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Calcium Score ◽  
Tolerance Test ◽  
Sao Paulo ◽  
Public Health Issue ◽  
Oral Glucose ◽  
São Paulo ◽  
Mortality And Morbidity

ABSTRACT CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) has become an important public health issue. The socioeconomic burden of renal replacement therapy (RRT) is very high, as is CKD-related cardiovascular mortality and morbidity. Preventive and therapeutic measures only have modest impact and more research is needed. Few cohort studies have been conducted on populations with CKD. Our aim was to establish a cohort that would include more advanced forms of CKD (stages 3 and 4). Data collection was focused on renal and cardiovascular parameters. DESIGN AND SETTING: Prospective cohort study; São Paulo, Brazil. METHODS: Recruitment took place in Hospital das Clínicas, São Paulo, from March 2012 to December 2013. Data relating to medical history, food-frequency questionnaire, anthropometry, laboratory work-up, calcium score, echocardiography, carotid intimal-medial thickness, pulse-wave velocity, retinography and heart rate variability were collected. A biobank including serum, plasma, post-oral glucose tolerance test serum and plasma, urine (morning and 24-hour urine) and DNA was established. RESULTS: 454 participants (60% men and 50% diabetics) of mean age 68 years were enrolled. Their mean estimated glomerular filtration rate-CKD Epidemiology Collaboration was 38 ml/min/1.73 m2. Follow-up is ongoing and the main outcomes are the start of RRT, cardiovascular events and death. CONCLUSIONS: The PROGREDIR cohort is a promising prospective study that will allow better understanding of CKD determinants and validation of candidate biomarkers for the risks of CKD progression and mortality.

scholarly journals Confirming high prevalence of human herpesvirus 8 infection in chronic kidney disease patients in Sao Paulo, Brazil

2008 ◽  
Vol 2 (1) ◽  
pp. 93-94 ◽  
Author(s):  
M. C. Magri ◽  
M. E. F. Canziani ◽  
S. A. Draibe ◽  
E. Santos-Fortuna ◽  
A. C. de-Araujo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Human Herpesvirus ◽  
Sao Paulo ◽  
Human Herpesvirus 8 ◽  
São Paulo ◽  
Herpesvirus 8 ◽  
High Prevalence

scholarly journals Análise dos exames de perfil renal realizados no Hospital Universitário Ana Bezerra no período 2017 – 2018

2019 ◽  
Vol 8 (6) ◽  
Author(s):  
Alana Karoline Penha do Nascimento ◽  
Brenda Lavínia Calixto dos Santos ◽  
Abrahão Alves de Oliveira Filho ◽  
Heloisa Mara Batista Fernandes de Oliveira
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rio De Janeiro ◽  
Sao Paulo ◽  
São Paulo ◽  
De Se ◽  
Prevalence Of Anemia

Com o aumento da expectativa de vida dos brasileiros, houve também o crescimento da incidência de doenças crônicas degenerativas, como as alterações renais, que estão afetando cada vez mais a população como um todo, envolvendo o risco de desenvolver a insuficiência renal crônica e/ou aguda. Com isso é necessário à realização de exames laboratoriais rotineiros, a fim de se diagnosticar precocemente tais distúrbios, sendo necessária a solicitação dos marcadores laboratoriais. O propósito deste trabalho foi descrever o padrão de exames solicitados para a avaliação do perfil renal de pacientes atendidos no Hospital Universitário Ana Bezerra. A metodologia adotada trata-se de um estudo epidemiológico delineado como retrospectivo documental, em que foi analisado o quantitativo dos exames solicitados para a avaliação do perfil renal no banco de dados do Laboratório de Análises Clínicas do Hospital Universitário Ana Bezerra do período de junho de 2017 a junho de 2018. Diante da pesquisa realizada foi possível evidenciar que foram solicitados 31.159 exames para avaliar o perfil renal, sendo a creatinina o exame mais solicitado para os pacientes atendidos no Hospital Universitário Ana Bezerra.Descritores: Rim; Testes de Função Renal; Creatinina.ReferênciasBrasil. Ministério da Saúde. Indicadores e Dados Básicos: Brasil - 2009 IDB-2009 Brasília: Ministério da Saúde. Disponível em: http://tabnet.datasus.gov/. Acesso em 11 Agosto 2018.Begman R. Avaliação de pacientes com doença renal crônica em tratamento especializado por equipe multidisciplinar. J Bras Nefrol. 2006;28(3 Supl 2):33-5.Godinho TM, Lyra TG, Braga OS, Queiroz RA, Alves JA, Kraychete AC et al. Perfil do paciente que inicia hemodiálise de manutenção em Hospital Público de Salvador, Bahia. J Bras Nefrol. 2006;28(2):96-103.Zawada ET. Inicio da diálise. In: Daugiardas JT, Blake PG, Ing T. Manual de Diálise. 3. ed. Rio de Janeiro: Guanabara Koogan; 2003. p.4-11.Kohagura K, Tomiyama N, Kinjo K, Takishita S, Iseki K. Prevalence of anemia according to stage of chronic kidney disease in a large screening cohort of Japanese. Clin Exp Nephrol. 2009;13(6):614-20.Guyton AC, Hall JE, Guyton AC. Tratado de fisiologia médica. Elsevier Brasil; 2006.Azevedo AC, Gómez JFB, Lugon JR, Graciano ML. Detecção de disfunção renal através da dosagem de creatinina em amostra de gota de sangue seca no papel filtro. J Bras Nefrol. 2016;38(1):15-21.Silva Junior, Matos SMA. Padrões alimentares e doença renal crônica. In: Cruz J, Cruz HMM, Kirsztajn GM, Oliveira RB, Barros RT (eds). Atualidades em Nefrologia. 14.ed. São Paulo: Sarvier; 2016.Tizatto LAP, Machado RAF. Exames diagnósticos e tratamento de urolitíase: uma revisão da literatura. Thêma et Scientia. 2016;6(1):212-29.Telles C, Boita ERF. Importância da terapia nutricional com ênfase no cálcio, fósforo e potássio no tratamento da doença renal crônica. Perspectiva Erechim. 2015;39(145):143-54.Bottini PV, Afaz SH, Silveira S, Garlipp CR. Utilização da relação albumina/creatinina no diagnóstico de microalbuminúria. J Bras Patol  Med Lab. 2005;41(2):99-103.

Stentul JJ ureteral - care este optiunea mai buna? New Considerations Regarding Chronic Kidney Disease, Cardiovascular Disease and Dyslipidemia in Diabetic Patients

2018 ◽  
Vol 69 (8) ◽  
pp. 2064-2066
Author(s):  
Mircea Munteanu ◽  
Adrian Apostol ◽  
Viviana Ivan
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Total Cholesterol Level ◽  
Vascular Complications ◽  
Hdl Cholesterol ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Artery Disease

The aim of the present study is to investigate the prevalance of chronic kidney disease (CKD), of cardiovascular disease (CVD) and dyslipidemia in patients with diabetes mellitus (DM). We conducted a prospective, controlled study involving 420 diabetic patients (120 T1DM, 300 T2DM) and investigate the following aspects: the presence of vascular complications (stroke, coronary artery disease, peripheral artery disease), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), kidney function (glomerular filtration rate, albuminuria), blood pressure, HbA1C. The results that in diabetic patients with CKD there is an increased prevalence of CVD and of dislipidemia. Also we noticed a negative correlation between total cholesterol level and decease in eGFR in all patients, with or without CKD.

scholarly journals Guidelines adherence in the prevention and management of chronic kidney disease in patients with diabetes mellitus on the background of recent European recommendations – a registry-based analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Bramlage ◽  
Stefanie Lanzinger ◽  
Sascha R. Tittel ◽  
Eva Hess ◽  
Simon Fahrner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Analysis Data ◽  
Disease Diagnosis ◽  
Diabetic Patients ◽  
European Society Of Cardiology

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

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