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1.
Kidney Int ; 101(3): 432-440, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35190029

RESUMO

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Assuntos
Letramento em Saúde , Educação em Saúde , Pessoal de Saúde , Humanos , Rim , Estados Unidos
2.
Am J Nephrol ; 53(2-3): 87-95, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35287131

RESUMO

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Assuntos
Educação em Saúde , Letramento em Saúde , Humanos , Rim
3.
Nephrol Dial Transplant ; 37(4): 605-612, 2022 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-35142861

RESUMO

The high burden of kidney disease, global disparities in kidney care and poor outcomes of kidney failure bring a concomitant growing burden to those affected, their families, caregivers and the community at large. Health literacy is the degree to which people and organizations have or equitably enable individuals to have the ability to find, understand and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with healthcare providers communicating and educating effectively in a co-designed partnership with those with kidney disease. For kidney policymakers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of healthcare. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance people's and providers' education; the World Kidney Day declares 2022 as the year of 'Kidney Health for All' to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of healthcare providers and health policymakers. By engaging in and supporting kidney health-centered policymaking, community health planning and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Assuntos
Educação em Saúde , Letramento em Saúde , Cuidadores , Pessoal de Saúde , Humanos , Rim
4.
Clin Nephrol ; 97(4): 195-205, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35218334

RESUMO

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Assuntos
Educação em Saúde , Letramento em Saúde , Humanos , Rim
5.
Kidney Int ; 99(2): 278-284, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33509344

RESUMO

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.


Assuntos
Acessibilidade aos Serviços de Saúde , Insuficiência Renal Crônica , Diagnóstico Precoce , Promoção da Saúde , Humanos , Rim , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia
6.
Am J Nephrol ; 52(1): 1-7, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33662959

RESUMO

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.


Assuntos
Cuidadores/psicologia , Empoderamento , Participação do Paciente , Insuficiência Renal Crônica/psicologia , Humanos , Insuficiência Renal Crônica/terapia
7.
Transpl Int ; 34(3): 391-397, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33382133

RESUMO

Living with CKD is associated with hardships for patients and their care partners. Empowering patients and care partners may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of 'Living Well with Kidney Disease' in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness programme for kidney disease patients, the need for prevention should be reiterated. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals and policy makers, applicable to both developed and developing countries.


Assuntos
Cuidadores , Insuficiência Renal Crônica , Promoção da Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Rim
8.
Clin Nephrol ; 95(3): 115-122, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33527892

RESUMO

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.


Assuntos
Promoção da Saúde , Insuficiência Renal Crônica , Cuidadores , Família , Humanos , Participação do Paciente , Insuficiência Renal Crônica/prevenção & controle , Insuficiência Renal Crônica/terapia
9.
Clin Exp Nephrol ; 25(6): 567-573, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33721132

RESUMO

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy-makers, applicable to both developed and developing countries.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Rim/fisiopatologia , Participação do Paciente , Insuficiência Renal Crônica/terapia , Prestação Integrada de Cuidados de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Educação de Pacientes como Assunto , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/psicologia
10.
Blood Purif ; 50(1): 1-8, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32160626

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.


Assuntos
Acessibilidade aos Serviços de Saúde , Rim , Prevenção Primária , Diálise Renal , Insuficiência Renal Crônica , Prevenção Secundária , Humanos , Rim/patologia , Rim/fisiopatologia , Insuficiência Renal Crônica/patologia , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/prevenção & controle , Fatores de Risco
11.
J Ren Nutr ; 31(6): 554-559, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34749903

RESUMO

Living with chronic kidney disease is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of chronic kidney disease-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. World Kidney Day 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.


Assuntos
Cuidadores , Insuficiência Renal Crônica , Promoção da Saúde , Humanos , Rim , Participação do Paciente , Insuficiência Renal Crônica/terapia
12.
Am J Nephrol ; 51(4): 255-262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160623

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.


Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Programas de Rastreamento/organização & administração , Nefrologia/organização & administração , Serviços Preventivos de Saúde/organização & administração , Insuficiência Renal Crônica/prevenção & controle , Prestação Integrada de Cuidados de Saúde/organização & administração , Carga Global da Doença , Educação em Saúde/organização & administração , Política de Saúde , Humanos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco , Prevenção Secundária/organização & administração
13.
Pediatr Transplant ; 24(6): e13724, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32388917

RESUMO

Pediatric kidney transplantation is a multidisciplinary therapy that needs special consideration and experience. In this study, we aimed to present CUCH experience; over a 10-year period, as a specialized center of kidney transplantation in children. We studied 148 transplantations performed at a single center from 2009 to 2018. Pretransplant and follow-up data were collected and graft/patient survival rates were evaluated. A total of 48 patients developed at least one rejection episode during 688 patient-years of follow-up. Infections, recurrence of original disease, and malignancy were the most important encountered medical complications (20%, 2%, and 1.4%, respectively). One-year patient survival was 94.1%, while graft and patient survival was 91.9%. Graft/patient survival at 5, 7, and 9 years was 90%, 77%, and 58%, respectively. Infections were the main cause (69%) of mortality. Death with a functioning graft and CR were the main causes of graft loss (48% and 33%, respectively). Pediatric kidney transplantation in Egypt is still a challenging yet successful experience. Rejections and infections are the most frequent complications. Short-term outcomes surpass long-term ones and graft survival rates are similar to the international standard.


Assuntos
Transplante de Rim/métodos , Pediatria/métodos , Adolescente , Biópsia , Criança , Pré-Escolar , Egito/epidemiologia , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Terapia de Imunossupressão , Lactente , Estimativa de Kaplan-Meier , Falência Renal Crônica/cirurgia , Masculino , Período Perioperatório , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
14.
Pediatr Nephrol ; 35(10): 1801-1810, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32588223

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD are often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions-be it primary, secondary, or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, the management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase awareness of the importance of preventive measures throughout populations, professionals, and policy makers.


Assuntos
Carga Global da Doença , Implementação de Plano de Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Insuficiência Renal Crônica/terapia , Progressão da Doença , Política de Saúde , Acessibilidade aos Serviços de Saúde/normas , Humanos , Transplante de Rim/normas , Programas de Rastreamento/organização & administração , Programas de Rastreamento/normas , Diálise Renal/normas , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Prevenção Secundária/métodos , Prevenção Secundária/organização & administração
15.
Clin Nephrol ; 93(3): 111-122, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32017699

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals, and policy makers.


Assuntos
Acessibilidade aos Serviços de Saúde , Insuficiência Renal Crônica/prevenção & controle , Análise Custo-Benefício , Diagnóstico Precoce , Educação em Saúde , Humanos , Prevenção Primária , Insuficiência Renal Crônica/diagnóstico , Prevenção Secundária
16.
Int J Immunogenet ; 47(6): 494-500, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32881306

RESUMO

Given the uncertainty regarding the relationship between donor cells at microchimeric levels and its influence on graft function and clinical outcome, we explored the extent and importance of donor microchimerism in kidney transplantation. Twenty patients with chronic kidney disease who had received allografts from living donors were studied. We examined peripheral whole blood samples from the recipients one month after the transplant, applying mitochondrial DNA variant-specific polymerase chain reaction (PCR) to identify and quantify donor cells in relation to allograft function and survival during three years of follow-up. Higher quantities of donor-derived cell microchimerism in the peripheral blood correlated with better graft function in the early postoperative period at 1 month (R2  = .536, p = .001) and predicted improved graft function 1 year following the transplant (R2  = .430, p = .008). Furthermore, early post-transplant quantities of donor cell microchimerism were an important predictor of improved kidney function 3 years after transplantation (R2  = .397, p = .021). However, donor cell microchimerism failed to predict patient and graft survival after 3 years (odds ratio = 0.536, p = .860). Our findings suggest that donor cell microchimerism plays an immunoregulatory role in kidney transplantation and contributes to donor-specific immune hypo-responsiveness and graft acceptance.


Assuntos
Quimerismo , Transplante de Rim , Insuficiência Renal Crônica/cirurgia , Quimeras de Transplante , Adulto , Biomarcadores/metabolismo , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Masculino , Reação em Cadeia da Polimerase , Doadores de Tecidos , Adulto Jovem
17.
Am J Nephrol ; 49(3): 254-262, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30820003

RESUMO

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Assuntos
Injúria Renal Aguda/epidemiologia , Carga Global da Doença , Acessibilidade aos Serviços de Saúde/economia , Disparidades em Assistência à Saúde/economia , Insuficiência Renal Crônica/epidemiologia , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/economia , Injúria Renal Aguda/terapia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/economia , Insuficiência Renal Crônica/terapia , Cobertura Universal do Seguro de Saúde/tendências
18.
Pediatr Nephrol ; 34(4): 541-548, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30758679

RESUMO

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step toward achieving kidney health equity.


Assuntos
Países em Desenvolvimento , Saúde Global , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Nefropatias/terapia , Terapia de Substituição Renal , Efeitos Psicossociais da Doença , Países em Desenvolvimento/economia , Saúde Global/economia , Saúde Global/legislação & jurisprudência , Custos de Cuidados de Saúde , Equidade em Saúde , Política de Saúde , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/legislação & jurisprudência , Humanos , Nefropatias/diagnóstico , Nefropatias/economia , Nefropatias/epidemiologia , Formulação de Políticas , Terapia de Substituição Renal/economia , Fatores de Risco , Determinantes Sociais da Saúde , Cobertura Universal do Seguro de Saúde
19.
Clin Nephrol ; 91(3): 129-137, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30704553

RESUMO

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Assuntos
Injúria Renal Aguda/terapia , Equidade em Saúde , Disparidades em Assistência à Saúde , Insuficiência Renal Crônica/terapia , Injúria Renal Aguda/diagnóstico , Saúde Global , Disparidades nos Níveis de Saúde , Humanos , Insuficiência Renal Crônica/diagnóstico , Terapia de Substituição Renal
20.
Blood Purif ; 48(1): 32-39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30836351

RESUMO

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Assuntos
Efeitos Psicossociais da Doença , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Nefropatias/epidemiologia , Política de Saúde , Mão de Obra em Saúde , Humanos , Nefropatias/diagnóstico , Nefropatias/terapia , Assistência ao Paciente/economia , Assistência ao Paciente/métodos , Terapia de Substituição Renal , Fatores de Risco
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