Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28.481
Filtrar
1.
Rev Bras Epidemiol ; 23: e200101, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33027436

RESUMO

OBJECTIVE: To identify the prevalence of glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 in Brazil and the associated factors. METHODS: This is a cross-sectional household-based epidemiological survey. Data were collected from the National Health Survey (PNS), conducted in 2013, by carrying out creatinine blood test and GFR calculation (n = 7,457). The groups of explanatory variables were: sociodemographic characteristics, lifestyles, chronic diseases, anthropometry, and health assessment. The prevalence of GFR < 60 mL/min/1.73 m2 and the respective 95% confidence intervals were estimated using the Poisson regression to calculate the crude and adjusted prevalence ratio (PR and adjPR) by age, sex, education level, and region. RESULTS: The prevalence of GFR < 60 mL/min/1.73 m2 was 6.48% (95%CI 5.88 - 7.09). After the adjustment, the following aspects remained associated: women (PR = 1.40; 95%CI 1.16 - 1.68), age of 45-59 years (adjPR = 7.27; 95%CI 3.8 - 14.1), 60 years or older (adjPR = 33.55; 95%CI 17.8 - 63.4), obesity (PR = 1.32 (95%CI 1.1 - 1.7), diabetes (PR = 1.44; 95%CI 1.2 - 1.8), poor/very poor self-rated health (PR = 1.50; 95%CI 1.2 - 1.9); and the lowest adjPR was found for the Northeast and Southeast regions, among smokers with high salt intake. CONCLUSION: GFR < 60 mL/min/1.73 m2 was higher in women, increased with age, in addition to being associated with obesity, diabetes, and poor self-rated health. Knowing the prevalence of chronic kidney disease through biochemical tests and risk and protective factors are paramount to support public health policies.


Assuntos
Insuficiência Renal Crônica/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
2.
Arch Pathol Lab Med ; 144(10): 1199-1203, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002152

RESUMO

CONTEXT.­: The burden of chronic kidney disease in Indigenous Australians is 7.3 times higher than that of non-Indigenous Australians. If chronic kidney disease is detected early and managed, deterioration in kidney function can be reduced. Urine albumin to creatinine ratio is a key marker of early renal damage. OBJECTIVE.­: To report on 16 years of analytic quality of urine albumin to creatinine ratio testing on Siemens DCA devices enrolled in the national Quality Assurance for Aboriginal and Torres Strait Islander Medical Services point-of-care testing program. DESIGN.­: Quality Assurance for Aboriginal and Torres Strait Islander Medical Services participants are required to test 2 quality assurance samples each month across two 6-monthly testing cycles per year. Participants also test 2 quality control samples monthly. RESULTS.­: The percentage of urine albumin, creatinine, and albumin to creatinine ratio results for quality assurance point-of-care testing that were within assigned allowable limits of performance averaged 96.9%, 95.9%, and 97.5%, respectively. The percentage acceptable quality control results for urine albumin and creatinine averaged 93.5% and 86.8%. The median imprecision for urine albumin, creatinine, and albumin to creatinine ratio quality assurance testing averaged 5.5%, 4.1%, and 3.3%, respectively, and the median within-site imprecision for quality control testing averaged 5.4%, 4.3%, and 5.7%, respectively, for the low sample and 4.0%, 4.1%, and 4.5%, respectively, for the high sample. CONCLUSIONS.­: For 16 years the DCA system has proven to be reliable and robust and operators at Aboriginal medical services have demonstrated they are able to conduct point-of-care testing for urine albumin to creatinine ratio that consistently meets analytic performance standards.


Assuntos
Albuminúria/urina , Creatinina/urina , Testes Imediatos , Insuficiência Renal Crônica/diagnóstico , Austrália , Humanos , Grupo com Ancestrais Oceânicos , Garantia da Qualidade dos Cuidados de Saúde , Controle de Qualidade , Insuficiência Renal Crônica/urina , Urinálise
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2752-2755, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018576

RESUMO

Intervention in the early stages of cardiovascular and kidney diseases is proven to be more effective in preventing disease progression. Large artery stiffness measurement can be a potential early predictor of future risks. The purpose of the study reported in this work was to demonstrate the feasibility of our ARTSENS® Pen device as a high-throughput vascular screening tool for risk assessment. The study was performed during a medical camp conducted for awareness and early-stage detection of kidney diseases. Screening procedures included biosample tests and blood pressure measurements. Alongside, various clinically relevant measures of the arterial stiffness were evaluated using the ARTSENS® Pen, by measuring vessel wall dynamics via our proprietary image-free ultrasound algorithms. Stiffness measurement from the left common carotid artery on 85 participants could be completed within 4 hours, employing two units of ARTSENS® Pen; this also includes time taken for all the procedures enlisted in the study protocol. The associations of carotid stiffness indices with age-, gender-, and risk factor-dependent variations were established.


Assuntos
Insuficiência Renal Crônica , Rigidez Vascular , Diagnóstico Precoce , Humanos , Insuficiência Renal Crônica/diagnóstico , Processamento de Sinais Assistido por Computador , Ultrassonografia
4.
Medicine (Baltimore) ; 99(40): e22334, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019409

RESUMO

This study aims to establish a diagnostic model of coronary heart disease (CHD) for diabetic foot (DF) patients.The clinical data of 489 hospitalized patients with DF were retrospectively analyzed in this case-control study. The patients were divided into the CHD group (DF with CHD, n = 212) and the control group (DF without CHD, n = 277). Univariate analysis was performed to screen for CHD-related risk factors, and multivariate logistic regression analysis was conducted to determine significant CHD risk factors. Scores were assigned according to the ratio of risk factors (OR) to establish a diagnostic model of CHD for patients with DF. The area under the ROC curve was used to test the application value of the diagnostic model.The logistic regression analysis showed that the risk factors for CHD in DF patients were age, duration of diabetes, toe-brachial index, hyperuricemia, and chronic renal insufficiency. The area under the ROC curve of the diagnostic model was 0.798 (0.759-0.837), the diagnostic point of CHD was 6 points, the diagnostic sensitivity was 69.3%, and the specificity was 76.5%.The established model has good diagnostic value and provides the basis for preliminary screening for CHD in patients with DF.


Assuntos
Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Pé Diabético/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , Estudos de Casos e Controles , Feminino , Humanos , Hiperuricemia/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Insuficiência Renal Crônica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
12.
Zhonghua Yi Xue Za Zhi ; 100(38): 2997-3000, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33086450

RESUMO

Objective: To investigate the efficacy of sodium zirconium cyclosilicate on emergency correction of hyperkalemia in chronic kidney disease patients. Methods: Patients with chronic kidney disease who were admitted to the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from May to June 2020 were selected. Those who had hyperkalemia and took sodium zirconium cyclosilicate powder were finally included. The patient's clinical data and laboratory results were collected. Results: A total of 24 results were included from 21 patients. The age of patients was (48.9±13.5) years old. Fourteen patients were male, and 7 patients were female. After 2 hours of administration, the venous potassium level decreased from (5.85±0.52) mmol/L to (5.15±0.43) mmol/L (P<0.001, n=21), with an average decline of (0.71±0.43) mmol/L. Meanwhile, the arterial potassium level decreased from (5.50±0.40) mmol/L to (4.88±0.33) mmol/L (P<0.001, n=10), with an average decline of (0.62±0.29) mmol/L. Based on the initial venous potassium level, the patients were further divided into three groups. The average potassium decrease in<5.5 mmol/L group (4 patients), 5.5-<6.0 mmol/L group (11 patients) and ≥6.0 mmol/L group (6 patients) was (0.46±0.26) mmol/L, (0.62±0.38) mmol/L and (1.04±0.45) mmol/L, respectively. There was statistically significant difference of potassium reduction among the three groups (P=0.045). Moreover, the extent of potassium reduction was positively correlated with baseline venous potassium level (r=0.603, P=0.004, n=21). The study did not reveal any treatment-related adverse event. Conclusion: Sodium zirconium cyclosilicate powder can rapidly and effectively reduce the serum potassium level in chronic kidney disease patients with hyperkalemia.


Assuntos
Hiperpotassemia , Insuficiência Renal Crônica , Adulto , Feminino , Humanos , Hiperpotassemia/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Potássio , Insuficiência Renal Crônica/complicações , Silicatos/uso terapêutico
14.
Medicine (Baltimore) ; 99(40): e21533, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019383

RESUMO

RATIONALE: Midodrine is widely used in the treatment of hypotensive states, there have been no reports of myoclonus associated with midodrine use in hypotension with chronic kidney disease. PATIENT CONCERNS: We report a 58-year-old female patient with chronic kidney disease (CKD) presenting with involuntary tremor 2 h after taking midodrine, which became more frequent after 6 h. Brain CT and neurological examination did not yield findings of note. Blood chemistry showed serum albumin of 3.1 g/L, ALT of 19 U/L, AST of 22 U/L, SCr of 273.9 µmol/L, K of 2.94 mmol/L, Ca of 1.63 mmol/L, and Mg of 0.46 mmol/L. Her BP was maintained at 83-110/56-75 mmHg. Her urine volume was 600-1000 mL/d, and her heart rate was within a range of 90-100 beats/min. DIAGNOSIS: Chronic kidney disease (CKD), hypotension, metabolic acidosis, hypocalcemia, hypokalemia, and hypomagnesemia. INTERVENTIONS: Midodrine treatment was stopped and the patient was treated with intravascular rehydration and furosemide. Myoclonus ceased one day after midodrine withdrawal. LESSONS: Oral midodrine is widely used in the treatment of orthostatic hypotension, recurrent reflex syncope and dialysis-associated hypotension and the adverse effects are mostly mild. However, clinicians should be alert for midodrine-induced myoclonus, especially in patients with CKD.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Hipotensão/tratamento farmacológico , Midodrina/efeitos adversos , Mioclonia/induzido quimicamente , Administração Oral , Agonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Feminino , Humanos , Hipotensão/etiologia , Pessoa de Meia-Idade , Midodrina/administração & dosagem , Insuficiência Renal Crônica/complicações
15.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026201

RESUMO

Coronavirus disease 2019 is an infectious respiratory syndrome caused by the virus called SARS-CoV-2, belonging to the family of coronaviruses. The first ever cases were detected during the 2019-2020 pandemic. Coronaviruses can cause a common cold or more serious diseases such as Middle Eastern Respiratory Syndromes (MERS) and Severe Acute Respiratory Syndrome (SARS). They can cause respiratory, lung and gastrointestinal infections with a mild to severe course, sometimes causing the death of the infected person. This new strain has no previous identifiers and its epidemic potential is strongly associated with the absence of immune response/reactivity and immunological memory in the world population, which has never been in contact with this strain before. Most at risk are the elderly, people with pre-existing diseases and/or immunodepressed, dialyzed and transplanted patients, pregnant women, people with debilitating chronic diseases. They are advised to avoid contacts with other people, unless strictly necessary, and to stay away from crowded places, also observing scrupulously the recommendations of the Istituto Superiore di Sanità. In this article we detail the recommendations that must be followed by the nursing care staff when dealing with chronic kidney disease patients in dialysis or with kidney transplant patients. We delve into the procedures that are absolutely essential in this context: social distancing of at least one meter, use of PPI, proper dressing and undressing procedures, frequent hand washing and use of gloves, and finally the increase of dedicated and appropriately trained health personnel on ward.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Transplante de Rim/enfermagem , Pandemias , Pneumonia Viral/enfermagem , Guias de Prática Clínica como Assunto , Diálise Renal/enfermagem , Insuficiência Renal Crônica/enfermagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Desinfecção , Desinfecção das Mãos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Resíduos de Serviços de Saúde , Processo de Enfermagem/normas , Registros de Enfermagem , Pandemias/prevenção & controle , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/cirurgia , Insuficiência Renal Crônica/terapia , Precauções Universais
16.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(8): 935-940, 2020 Aug 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33053535

RESUMO

OBJECTIVES: To understand the prevalence and risk factors for chronic kidney disease (CKD) among freshmen from a university in Hunan Province in 2018. METHODS: A cross-sectional survey was conducted on 1 685 freshmen from a university in Hunan Province in 2018. Height, weight, body mass index (BMI), blood pressure, creatinine, uric acid, fasting blood glucose, triglyceride, total cholesterol, blood urea nitrogen, and other laboratory indicators were measured. The risk factors of hematuria, proteinuria, and CKD were analyzed by logistic regression. RESULTS: Among the 1 685 students, the detection rates of proteinuria, hematuria, and renal dysfunction were 2.14%, 6.65%, and 0.95%, respectively. The prevalence of CKD was 10.86%, mainly at stage 1 and 2. The awareness rate in the patients was 6.56%. The detection rate of proteinuria was not significantly correlated with gender, and the detection rate of hematuria and renal dysfunction was higher in women than in men, and the prevalence of CKD was higher in women than in men. Independent risk factors associated with CKD were hypertension and diabetes. CONCLUSIONS: In 2018, the prevalence of CKD among freshmen in this university is roughly the same as the national level. CKD patients and people with hypertension and diabetes should be checked regularly, and early intervention should be performed to delay the occurrence and development of the disease.


Assuntos
Insuficiência Renal Crônica , Universidades , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco
17.
Brasília, D.F.; OPAS; 2020-10-01. (OPAS/BRA/NMH/NV/COVID-19/20-0017).
em Português | PAHO-IRIS | ID: phr2-52788

RESUMO

Aborda os riscos enfrentados por pessoas com doença renal crônica no contexto do COVID-19 e os passos que podem tomar para reduzi-los. O documento faz parte de uma série de notas descritivas que tratam de diferentes doenças não transmissíveis em relação ao COVID-19 por meio de perguntas e respostas. São dirigidas a um público em geral e, em particular, a pessoas com doenças não transmissíveis, com o objetivo de fornecer informações e mensagens claras sobre os riscos associados ao COVID-19 e à gestão da situação de saúde.


Assuntos
Infecções por Coronavirus , Coronavirus , Pandemias , Insuficiência Renal Crônica , Fatores de Risco
18.
Ther Umsch ; 77(8): 401-405, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054652

RESUMO

Incidental finding of a high creatinine Abstract. In up to 10 % of patient visiting their General Practitioner and having blood tests an elevated creatinine or reduced kidney function are detected incidentally by the often automatically reported estimation of glomerular filtration rate (eGFR) by a creatinine-based formula. The most important step in this situation is to evaluate whether reduced kidney function is due to chronic kidney disease or whether the patient presents with an acute kidney injury (AKI). Early detection of AKI is crucial as any delay in accurate therapy can lead to further decline of kidney function and elevated mortality. In addition, intrinsic kidney diseases, which are less common should not be missed because early access to specialised management is crucial. Clinical history including history of medication, context of consultation, clinical evaluation and additional laboratory values will help to provide a first suspicion diagnosis. Further investigations (abdominal sonography, urinary sediment, proteinuria) will help to confirm the diagnosis. In any case of absence of an obvious cause of AKI, young patient, threatening severe renal insufficiency with rapid progression of kidney failure or suspicious laboratory abnormalities, the patient should be referred without any delay to a nephrologist for further evaluation and management.


Assuntos
Lesão Renal Aguda , Insuficiência Renal Crônica , Lesão Renal Aguda/diagnóstico , Creatinina , Taxa de Filtração Glomerular , Humanos , Achados Incidentais
19.
Wiad Lek ; 73(8): 1723-1725, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055341

RESUMO

OBJECTIVE: The aim: To study the status of pro- and anticoagulant components of hemostasis in patients with stage VD CKD depending on residual renal function. PATIENTS AND METHODS: Materials and methods: 88 patients with stage VD CKD were studied, 16 of them had preserved residual renal function (RRF). Hemostatic parameters - soluble fibrin, D-dimer and protein C - were determined in the patients. RESULTS: Results: Significant increase in soluble fibrin and fibrinogen levels along with depressive reaction of D-dimer and protein C were found in patients with stage VD CKD having lost RRF. Preserved RRF in those patients had positive influence on hemostatic profile, decreasing the degree of hypercoagulation. CONCLUSION: Conclusions: 1. In long term dialysis patients with stage VD CKD and lost RRF, significantly increased levels in soluble fibrin and fibrinogen along with decreased D-dimer concentration were found, being a key factor in the development of thrombotic complications. 2. There was significant decrease in protein C activity in patients with lost RRF. 3. Preserved RRF in patients with stage VD CKD had positive influence on hemostatic profile.


Assuntos
Anticoagulantes , Insuficiência Renal Crônica , Anticoagulantes/uso terapêutico , Hemostasia , Humanos , Proteína C , Diálise Renal , Insuficiência Renal Crônica/complicações
20.
Enferm. nefrol ; 23(3): 244-251, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193707

RESUMO

La prevalencia de malnutrición en paciente con Enfermedad Renal Crónica es elevada, aumentando en pacientes con infección por SARS-CoV-2. La relación existente entre inflamación y nutrición es conocida en la enfermedad renal, por lo que la presencia previa de cuadros de malnutrición empeora el pronóstico de la infección. El objetivo del presente artículo es la creación de recomendaciones dietéticas específicas para pacientes con enfermedad renal crónica e infección o post-infección por SARS-CoV-2, adaptadas al estadio de enfermedad y a la etapa del proceso de infección. El abordaje nutricional comienza por la valoración del estado nutricional, para lo que se recomiendan minimizar el contacto físico mediante la utilización de los criterios Global Leadership Initiative on Malnutrition (GLIM), y el cuestionario rápido de sarcopenia (SARC-F). Las recomendaciones dietéticas deben considerar el estadio de enfermedad renal crónica, la etapa de infección por SARS-CoV-2 y las complicaciones surgidas que comprometan la ingesta oral, entre las más comunes se encuentran: anorexia, ageusia, disfagia y diarrea. En el presente documento se han elaborado tablas de raciones de ingestas diarias adaptadas a las diferentes situaciones. En aquellos pacientes que no cubran los requerimientos nutricionales se recomienda comenzar con la suplementación nutricional de manera precoz, considerando las consecuencias de la infección descrita. Debido al elevado riesgo de malnutrición en pacientes con enfermedad renal cónica e infección por SARS-CoV-2, se recomienda la adaptación de la valoración del estado nutricional y su tratamiento, así como realizar una monitorización tras la fase de infección activa


The prevalence of malnutrition in patients with Chronic Kidney Disease is high, increasing in patients with SARS-CoV-2 infection. The relationship between inflammation and nutrition in kidney disease is known, so the previous presence of malnutrition conditions worsens the prognosis of infection. The objective of this article is the creation of specific dietary recommendations for patients with chronic kidney disease and infection or post-infection by the SARS-CoV-2 virus, adapted to the stage of the disease and the stage of the infection process. The nutritional approach begins with the assessment of nutritional status, recommending minimizing physical contact through the use of the Global Leadership Initiative on Malnutrition (GLIM) criteria and the rapid sarcopenia questionnaire (SARC-F). The dietary recommendations should consider the stage of chronic kidney disease, the stage of infection by SARS-CoV-2 and the complications arising that compromise oral intake, among the most common are: anorexia, ageusia, dysphagia and diarrhea. In this document, tables of daily intakes have been prepared adapted to different situations. In those patients who do not meet the nutritional requirements, it is recommended to start with an early nutritional supplementation, considering the consequences of the infection described. Due to the high risk of malnutrition in patients with chronic kidney disease and SARS-CoV-2 infection, it is recommended to adapt the assessment of nutritional status and treatment, as well as to carry out monitoring after the active infection phase


Assuntos
Humanos , Infecções por Coronavirus/dietoterapia , Insuficiência Renal Crônica/dietoterapia , Desnutrição/dietoterapia , Diálise Renal/estatística & dados numéricos , Infecções por Coronavirus/complicações , Insuficiência Renal Crônica/complicações , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , Pandemias/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA