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Kidney Function and 24-Hour Proteinuria in Patients with Fabry Disease during 36 Months of Agalsidase Alfa Enzyme Replacement Therapy: A Brazilian Experience

THOFEHRN, Scheila; NETTO, Cristina; CECCHIN, Claudia; BURIN, Maira; MATTE, Ursula; BRUSTOLIN, Silvia; NUNES, Ane Claudia Fernandes; COELHO, Janice; TSAO, Marylin; JARDIM, Laura; GIUGLIANI, Roberto; BARROS, Elvino Jose Guardao
Fonte: TAYLOR & FRANCIS INC Publicador: TAYLOR & FRANCIS INC
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.1%
Background. Prior to the introduction of enzyme replacement therapy (ERT), management of Fabry disease (FD) consisted of symptomatic and palliative measures. ERT has been available for several years using recombinant human agalsidase alfa, an analogue of alpha-galactosidase A (GALA). However, the limitations of ERT in improving kidney function have not been established. This study evaluates the safety and therapeutic effect of agalsidase alfa replacement in terms of kidney function and reduction in 24-hour proteinuria. Methods. During the period between January 1, 2002, and August 1, 2005, nine Fabry patients (7 male, 2 female) were treated according to protocol, receiving 0.2 mg/kg agalsidase alfa IV every two weeks. Kidney function was evaluated by measuring the glomerular filtration rate (GFR) using chromium ethylene diamine tetra-acetate clearance ((51)Cr-EDTA mL/min/1.73 m(2)) at baseline, 12, 24, and 36 months. 24-hour proteinuria was measured at baseline, 3, 6, 12, 18, 24, and 36 months of ERT. Kidney disease was classified according to National Kidney Foundation Disease Outcome Quality Initiative (NKF/DOQI) Advisory Board criteria, which define stage I chronic kidney disease (CKD) as GFR >= 90mL/min/1.73 m(2), stage II as 60-89 mL/min/1.73m(2)...

O significado da hemodiálise para o paciente renal-crônico: a busca por uma melhor qualidade de vida; The meaning of hemodialysis for the chronic renal patient:the searh for the quality of life.

Lima, Antonio Fernandes Costa
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 28/07/2000 PT
Relevância na Pesquisa
45.88%
Este estudo qualitativo busca compreender o significado da hemodiálise e o impacto desta modalidade terapêutica, na qualidade de vida de pacientes do serviço de hemodiálise do Hospital Universitário da Universidade de São Paulo. A coleta de dados foi realizada por meio de entrevistas utilizando-se como referencial metodológico a história oral de vida. Os dados foram apresentados na forma de narrativa e analisados à luz do referencial da trajetória da doença crônica proposta por BURY. Nos seus relatos, vários depoentes afirmam que a hemodiálise representa um tratamento que lhes possibilita o bem estar físico e o prolongamento da vida. No entanto, evidencia-se a existência de vários sentimentos relacionados à irreversibilidade da doença renal e à obrigatoriedade de submissão ao tratamento. Percebe-se que a hemodiálise passa a ter diferentes significados para cada depoente. Cada um deles revela a sua dificuldade em lidar com as restrições, que afetam e influenciam a sua qualidade de vida, com a qual articulam expectativas diversificadas em relação ao transplante renal. Depositam sua esperanças na crença em um ser superior e na realização do transplante renal. Para alguns dos depoentes, a vivência da doença e do tratamento propiciou uma trajetória de vida. ; This qualitative study aimed to understand the meaning of hemodialysis and the impact of this therapeutic mode of treatment in quality of life of patients affected by chronical kidney disease of the Hemodialysis unity of the University Hospital at the University of São Paulo . Data collection was carried out through interview...

Alterações vasculares em pacientes com doença renal crônica com hiperparatiroidismo secundário; Vascular changes in chronic renal disease patients with secondary hyperparathyroidism

Hong, Valéria Aparecida da Costa
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/09/2008 PT
Relevância na Pesquisa
45.89%
Fundamentos: Hiperparatiroidismo secundário (HPT2), hiperfosfatemia e produto cálcio x fósforo elevado são associados com doença cardiovascular (DCV) em pacientes com doença renal crônica (DRC). Um papel mais direto exercido pelo PTH neste contexto é controvertido. O objetivo deste estudo foi avaliar como o PTH, cálcio, fósforo e produto cálcio x fósforo interagem para influenciar a função e estrutura vascular de pacientes com DRC com níveis diferentes de PTH e graus diversos de HPT2. Mais especificamente, nós procuramos verificar se o efeito do PTH sobre o sistema vascular ocorre via alterações nos níveis de cálcio e fósforo ou do estresse oxidativo. Métodos: A reatividade vascular das artérias musculares e as características morfofuncionais das artérias de condução foram determinadas em 31 pacientes com DRC tratados por hemodiálise (46 ± 13 anos de idade, 65% do sexo masculino, 48% caucasóides, 52% afro-brasileiros, em tratamento por hemodiálise por 67 meses, PTH 541 ± 389 [mediana 472, intervalo 81 1437], Ca 10,3 ± 1,0, P 6,0 ± 1,5, Ca x P 62 ± 15) e em 22 controles normais. O diâmetro da artéria braquial foi determinado por ultra-sonografia vascular de alta resolução em condições basais...

Status férrico e algumas funções do estresse oxidativo de fagócitos em idosos anêmicos ou não, portadores de doenças inflamatórias crônicas; Iron status and some phagocytes oxidative stress functions in the elderly with or without anemia, carriers of inflammation chronic diseases.

Paino, Iêda Maria Martinez
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 27/11/2008 PT
Relevância na Pesquisa
55.8%
Introdução. A Anemia das Doenças Crônicas (ADC) é uma desordem comum em idosos, freqüentemente multifatorial, e exacerbada por citocinas pró-inflamatórias. Nesta população, o diagnóstico de anemia por deficiência de ferro (ADF) é difícil utilizando-se os testes laboratoriais convencionais, devido à prevalência destes estados crônicos. Espécies reativas de oxigênio (ERO) são produzidas por fagócitos durante o burst oxidativo em defesa do hospedeiro, mas são também implicadas como agentes deletérios em um grande número de desordens inflamatórias. Objetivos. Verificar a eficiência do receptor de transferrina sérico (sTfR) e índice sTfR-log ferritina (sTfR-F) no diagnóstico da ADF e ADC; determinar os efeitos das anemias e de estados inflamatórios crônicos sem anemia no burst oxidativo, fagocitose, produção de óxido nítrico (NO) por monócitos, e produção de ácido hipocloroso (HOCl) por neutrófilos. Métodos. Participaram do estudo cinqüenta e três indivíduos (42 mulheres e 11 homens) idosos recrutados do departamento de Cardio-Geriatria da Rede Pública de Saúde de Ribeirão Preto-SP. A proteína C reativa (PCR), utilizada como marcador inflamatório foi analisada pela metodologia ultra-sensível. O status férrico foi estabelecido pelos níveis do sTfR (enzimaimunoensaio...

Fatores associados à doença renal crônica em pacientes internados em um hospital universitário na cidade de São Paulo; Factors associated with chronic kidney disease among hospitalized patients in a university hospital in the city of São Paulo

Pinho, Natália Alencar de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 14/06/2013 PT
Relevância na Pesquisa
46.21%
Introdução: a doença renal crônica constitui importante problema de saúde pública mundial. Contudo, pouco se sabe sobre suas características em nosso meio. Objetivo: identificar os fatores associados à doença renal crônica em pacientes internados em um hospital universitário. Método: foram selecionados, aleatoriamente, 386 pacientes que constituíram dois grupos: com e sem doença renal crônica. A doença renal crônica foi definida pela presença de diagnóstico médico ou antecedente pessoal. Os dados foram obtidos do prontuário do paciente. Foram comparados os grupos com e sem doença renal crônica e os hipertensos com e sem doença renal crônica, mediante as variáveis de estudo. Estimou-se a taxa de filtração glomerular (eTFG) dos pacientes sem doença renal a partir das equações Modification of Diet in Renal Disease abreviada (MDRD4) e Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Verificou-se a associação da eTFG <90 mL/min/1,73m², pela MDRD4, com dados biossociais e comorbidades. O nível de significância foi de p<0,05. Resultados: a amostra foi 50,5% homens, 64,4% brancos, 50,7% com companheiro e idade de 58,2±18,6 anos. Os pacientes com doença renal crônica se distinguiram daqueles sem a doença (p<0...

Ocorrência de cálculo renal e/ou ureteral em gatos com doença renal crônica atendidos no Hospital Veterinário da Universidade de São Paulo; Nephrolithiasis and/or ureterolithiasis occurrence in cats with chronic kidney disease attended at the Veterinary Hospital of the University of São Paulo

Pimenta, Marcela Malvini
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 10/07/2013 PT
Relevância na Pesquisa
55.93%
Mais do que uma realidade na clínica de felinos, os cálculos renais em gatos tornaram-se motivo de grande preocupação para a especialidade. Em contraste aos cálculos de estruvita encontrados frequentemente na vesícula urinária, os cálculos de oxalato de cálcio (CaOx), localizados em rins e ou ureteres passaram a compor um novo perfil da urolitíase. Foi realizado um estudo clínico transversal com 96 gatos com o objetivo de determinar a ocorrência de cálculos de origem renal (nefrolitíase e ureterolitíase) em gatos portadores de DRC e uma possível associação entre essas duas doenças. Destes pacientes, 24 foram excluídos por não atenderem os critérios necessários para classificação entre os grupos. Assim, 72 gatos portadores de DRC foram divididos em dois grupos, DRC com evidências de nefrolitíase e ou ureterolitíase (n=47), e DRC sem evidências de nefrolitíase e ou ureterolitíase (n=25). Os grupos mostraram homogeneidade em relação à classificação da DRC segundo os estágios propostos pela IRIS - International Renal Interest Society (p= 0,5613), como também em relação à idade (p=0,274). Contudo, os gatos classificados no estágio II da DRC foram os mais representados em ambos os grupos. Apesar disso...

Anemia, insuficiência cardíaca e manejo clínico baseado em evidências

Pereira, Camila Alves; Roscani, Meliza Goi; Zanati, Silméia Garcia; Matsubara, Beatriz Bojikian
Fonte: Sociedade Brasileira de Cardiologia (SBC) Publicador: Sociedade Brasileira de Cardiologia (SBC)
Tipo: Artigo de Revista Científica Formato: 87-92
POR
Relevância na Pesquisa
45.88%
Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with heart failure (HF). Its clinical relevance, as well as its pathophysiology and the clinical management of these patients are important subjects in the specialized literature. In the present review, we describe the current concepts on the pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for iron supplementation. Also, we make a critical analysis of the major studies showing evidences on the benefits of this supplementation. The four main components of anemia are addressed: chronic disease, dilutional, renal and malabsorption. In patients with HF, the diagnostic criteria are the same as those used in the general population: serum ferritin levels lower than 30 mcg/L in patients without kidney diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with transferring saturation lower than 20% in patients with chronic kidney diseases. Finally, the therapeutic possibilities for anemia in this specific patient population are discussed.; A anemia é uma comorbidade prevalente e marcadora de pior prognóstico em pacientes com insuficiência cardíaca (IC). Sua relevância clínica, bem como a fisiopatologia e abordagem terapêutica nesses pacientes são temas de destaque na literatura especializada. Nessa revisão são descritos os conceitos atuais sobre a fisiopatologia da anemia na IC...

The long-term outcome after acute kidney injury: a narrative review

Pôncio, Luana; Balbi, Andre Luis; Rocha, Érica Pires da; Dias, Dayana Bitencourt; Ponce, Daniela
Fonte: Sociedade Brasileira de Nefrologia Publicador: Sociedade Brasileira de Nefrologia
Tipo: Artigo de Revista Científica Formato: 115-120
ENG
Relevância na Pesquisa
45.76%
This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients.; Esta revisão tem como objetivo focar o prognóstico em longo prazo de pacientes após episódio de lesão renal aguda (LRA). Pacientes sobreviventes à LRA apresentam maior mortalidade tardia quando comparados com aqueles internados sem LRA. Estudos recentes mostram mortalidade em logo prazo após LRA entre 15 e 74% e, de modo geral...

A Soft Computing Approach to Kidney Diseases Evaluation

Neves, José; Martins, M. Rosário; Vilhena, João; Neves, João; Gomes, Sabino; Abelha, António; Machado, José; Vicente, Henrique
Fonte: Springer, New York Publicador: Springer, New York
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.1%
Kidney renal failure means that one’s kidney have unexpectedly stopped functioning, i.e., once chronic disease is exposed, the presence or degree of kidney dysfunction and its progression must be assessed, and the underlying syndrome has to be diagnosed. Although the patient’s history and physical examination may denote good practice, some key information has to be obtained from valuation of the glomerular filtration rate, and the analysis of serum biomarkers. Indeed, chronic kidney sickness depicts anomalous kidney function and/or its makeup, i.e., there is evidence that treatment may avoid or delay its progression, either by reducing and prevent the development of some associated complications, namely hypertension, obesity, diabetes mellitus, and cardiovascular complications. Acute kidney injury appears abruptly, with a rapid deterioration of the renal function, but is often reversible if it is recognized early and treated promptly. In both situations, i.e., acute kidney injury and chronic kidney disease, an early intervention can significantly improve the prognosis. The assessment of these pathologies is therefore mandatory, although it is hard to do it with traditional methodologies and existing tools for problem solving. Hence...

Targeting the Hepcidin-Ferroportin Axis to Develop New Treatment Strategies for Anemia of Chronic Disease and Anemia of Inflammation

Sun, Chia Chi; Vaja, Valentina; Babitt, Jodie L.; Lin, Herbert Y.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.83%
Anemia of Chronic Disease (ACD) or Anemia of Inflammation (AI) is prevalent in patients with chronic infection, autoimmune disease, cancer and chronic kidney disease. ACD is associated with poor prognosis and lower quality of life. Management of ACD using intravenous iron and erythropoiesis stimulating agents (ESAs) are ineffective for some patients and are not without adverse effects, driving the need for new alternative therapies. Recent advances in our understanding of the molecular mechanisms of iron regulation reveal that increased hepcidin, the iron regulatory hormone, is a key factor in the development of ACD. In this review, we will summarize the role of hepcidin in iron homeostasis, its contribution to the pathophysiology of ACD, and novel strategies that modulate hepcidin and its target ferroportin for the treatment of ACD.

TLR-2/TLR-4 TREM-1 Signaling Pathway Is Dispensable in Inflammatory Myeloid Cells during Sterile Kidney Injury

Campanholle, Gabriela; Mittelsteadt, Kristen; Nakagawa, Shunsaku; Kobayashi, Akio; Lin, Shuei-Liong; Gharib, Sina A.; Heinecke, Jay W.; Hamerman, Jessica A.; Altemeier, William A.; Duffield, Jeremy S.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.07%
Inflammatory macrophages are abundant in kidney disease, stimulating repair, or driving chronic inflammation and fibrosis. Damage associated molecules (DAMPs), released from injured cells engage pattern recognition receptors (PRRs) on macrophages, contributing to activation. Understanding mechanisms of macrophage activation during kidney injury may lead to strategies to alleviate chronic disease. We identified Triggering-Receptor-in-Myeloid-cells (TREM)-1, a regulator of TLR signaling, as highly upregulated in kidney inflammatory macrophages and tested the roles of these receptors in macrophage activation and kidney disease. Kidney DAMPs activated macrophages in vitro, independently of TREM-1, but partially dependent on TLR-2/−4, MyD88. In two models of progressive interstitial kidney disease, TREM-1 blockade had no impact on disease or macrophage activation in vivo, but TLR-2/−4, or MyD88 deficiency was anti-inflammatory and anti-fibrotic. When MyD88 was mutated only in the myeloid lineage, however, there was no bearing on macrophage activation or disease progression. Instead, TLR-2/−4 or MyD88 deficiency reduced activation of mesenchyme lineage cells resulting in reduced inflammation and fibrosis, indicating that these pathways play dominant roles in activation of myofibroblasts but not macrophages. To conclude...

Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases

Bonilla-Chacin, Maria Eugenia; Vásquez, Luis T. Marcano
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
45.89%
Non-communicable diseases (NCDs) are the main cause of death and disability in Central America. However, communicable diseases and maternal and child conditions remain important causes of death and disability as well as injuries. With the aging of the population and improvements in the control of infectious diseases, the share of NCDs in the total burden of disease is likely to increase. However, in Central America these diseases cause death at a much younger age than in higher-income countries. It is critical to prevent and control NCDs, both for their impact on health, as well as the economy. When not controlled, they can cause costly hospitalizations and large productivity losses due to absenteeism, disability and premature deaths. Finally, they can impoverish households hit by out-of-pocket payments for health services and drugs. A large share of NCDs can be prevented since they result from exposure to health risk factors such as unhealthy diets, physical inactivity, tobacco use, and the harmful use of alcohol. Central Americans have very high caloric diets that are rich in sodium and refined sugars...

The kidney is resistant to chronic hypoglycaemia in late-gestation fetal sheep

Boyce, A.; Gibson, K.; Wintour, E.; Koukoulas, I.; Gatford, K.; Owens, J.; Lumbers, E.
Fonte: Natl Research Council Canada Publicador: Natl Research Council Canada
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
45.85%
We imposed a sustained reduction in glucose supply to late-gestation fetal sheep to see whether the reduction in glucose and insulin levels affected renal growth, renin expression and synthesis, and renal function. Maternal glucose concentrations were lowered to 1.7–1.9 mmol/L for 12–13 days by i.v. insulin infusion (n = 9, 121 days gestation, term = 150 days). Control ewes (n = 7) received vehicle. Maternal and fetal glucose concentrations were 40% and 31% lower than in controls (p < 0.001), respectively. Fetal plasma insulin levels fell 36% ± 7% by day 7 (p < 0.05); IGF-I levels were unchanged. Arterial PO2 and pH increased and PCO2 fell (p < 0.05). Renal function was largely unaffected. Longitudinal growth was 28% slower and spleen weights were 36% smaller (p < 0.05); body and kidney weights were not affected. Renal renin levels and renin, angiotensinogen, and angiotensin receptor mRNA levels were similar to those of controls. Plasma renin levels increased from 2.1 ± 0.6 to 7.6 ± 2.8 ng angiotensin I·mL–1·h–1 (p = 0.01). Thus reductions in fetal glucose and insulin levels in late gestation that were sufficient to retard skeletal growth had no effect on kidney growth or function or the renal renin–angiotensin system...

Facilitators and barriers to the implementation of primary health care interventions for Aboriginal and Torres Strait Islander people with chronic diseases: a systematic review protocol

Davy, C.; Aromataris, E.; Gibson, O.; Brown, A.
Fonte: Joanna Briggs Institute Publicador: Joanna Briggs Institute
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
55.93%
The specific purpose of this review is to systematically examine the scientific literature in order to examine factors that facilitate and/or inhibit the implementation of interventions aimed at improving primary health care provided to Indigenous patients with chronic disease. More specifically, to fully encompass the factors of interest, the questions asked by this review are: • What attitudes, beliefs, expectations, understandings, perceptions, experiences and knowledge of Indigenous communities support (facilitators) or inhibit (barriers) the implementation of interventions aimed at improving chronic disease care for Indigenous people within the primary health care setting? • What attitudes, beliefs, expectations, understandings, perceptions, experiences and knowledge of health care providers support (facilitators) or inhibit (barriers) the implementation of interventions aimed at improving chronic disease care for Indigenous people within the primary health care setting? • What attitudes, beliefs, expectations, understandings, perceptions, experiences and knowledge of policy and decision makers support (facilitators) or inhibit (barriers) the implementation of interventions aimed at improving chronic disease care for Indigenous people within the primary health care setting? INCLUSION CRITERIA TYPES OF PARTICIPANTS This review will consider studies that have included Indigenous people of any age receiving treatment for chronic disease (cardiovascular disease...

Economics of Chronic Diseases Protocol: Cost-effectiveness modelling and the future burden of non-communicable disease in Europe

Divajeva, D.; Marsh, T.; Logstrup, S.; Kestens, M.; Vemer, P.; Kriaucioniene, V.; Peresson, S.; O’Kelly, S.; Rito, A.; Webber, L.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 16/05/2014 ENG
Relevância na Pesquisa
45.92%
Background: The majority of chronic disease is caused by risk factors which are mostly preventable. Effective interventions to reduce these risks are known and proven to be applicable to a variety of settings. Chronic disease is generally developed long before the fatal outcome, meaning that a lot of people spend a number of years in poor health. Effective prevention measures can prolong lives of individuals and significantly improve their quality of life. However, the methods to measure cost-effectiveness are a subject to much debate. The Economics of Chronic Diseases project aims to establish the best possible methods of measuring cost-effectiveness as well as develop micro-simulation models apt at projecting future burden of chronic diseases, their costs and potential savings after implementation of cost-effective interventions. Method: This research project will involve eight European countries: Bulgaria, Finland, Greece, Lithuania, The Netherlands, Poland, Portugal and the United Kingdom (UK). A literature review will be conducted to identify scientific articles which critically review the methods of cost-effectiveness. Contact will be made health economists to inform and enrich this review. This evidence will be used as a springboard for discussion at a meeting with key European stakeholders and experts with the aim of reaching a consensus on recommendations for cost-effectiveness methodology. Epidemiological data for coronary heart disease...

Cause for concern in the use of non-steroidal anti-inflammatory medications in the community - a population-based study

Adams, R.; Appleton, S.; Gill, T.; Taylor, A.; Wilson, D.; Hill, C.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
46.07%
Background: Non-steroidal anti-inflammatory (NSAID) medications are a common cause of reported adverse drug side-effects. This study describes the prevalence of non-steroidal anti-inflammatory (NSAID) use (other than low-dose aspirin) and the presence of co-existing relative contraindications to NSAID use and chronic conditions in a representative population sample. Methods: Data were analysed from 3,206 adults attending first follow-up of the North West Adelaide Health Study (NWAHS) in 2004 - 2006, a longitudinal representative population study. Medications were brought into study clinic visits by participants. Clinical assessment included measured blood pressure, kidney function, serum cholesterol, blood glucose. Questionnaires assessed demographics, lifestyle risk factors, physician-diagnosed chronic conditions. Data were weighted to census measures by region, age group, gender, and probability of selection in the household, to provide population representative estimates. Pearson's Chi-square tests determined significant differences in proportions. Multiple logistic regression was used to examine associations of socio-demographic characteristics with use of NSAIDs. Results: Of 3,175 participants, 357 (11.2%), and 16% of those aged > 55 years...

A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester

Humphreys, J.; Harvey, G.; Coleiro, M.; Butler, B.; Barclay, A.; Gwozdziewicz, M.; O'Donoghue, D.; Hegarty, J.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
45.92%
PROBLEM: Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. DESIGN: A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. SETTING: 19 general practices from four primary care trusts within Greater Manchester. KEY MEASURES FOR IMPROVEMENT: Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. STRATEGIES FOR CHANGE: The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. EFFECTS OF CHANGE: At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. LESSONS LEARNT: Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices...

Effectiveness, cost effectiveness, acceptability and implementation barriers/facilitators of chronic kidney disease management programs and models of care for Aboriginal and Torres Strait Islander Australians: a mixed methods systematic review protocol

Reilly, R.; Evans, K.; Gomersall, J.; Gorham, G.; Warren, S.; O'Shea, R.; Peters, M.; Brown, A.; Cass, A.
Fonte: The Joanna Briggs Institute Publicador: The Joanna Briggs Institute
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
46.05%
Review objectives and questions: The objective of this mixed methods review is to synthesize quantitative, economic and qualitative evidence on chronic kidney disease management programs and models delivered to Aboriginal and Torres Strait Islander Australians. Studies with Indigenous participants from New Zealand and Canada will also be considered because similar persistent patterns of health inequities have arisen in these countries as a result of a shared colonial history, despite vast differences in timing and location. Also, there are geographic and demographic similarities, such as remoteness from health services and poor engagement due to differing language, culture and concepts of health and illness from the dominant culture. These socio-demographic circumstances are associated with higher burdens of chronic disease and poorer health outcomes. The intention of this systematic review is to inform chronic kidney disease program design, practice and service delivery to Aboriginal and Torres Strait Islander populations in Australia. The questions to be addressed in the review are: 1. What is the effectiveness of programs/models in relation to outcomes, including, though not limited to, the management of “indicators to target” such as blood pressure control...

Religião e espiritualidade: experiência de famílias de crianças com Insuficiência Renal Crônica; Religion and spirituality: the experience of families of children with Chronic Renal Failure; Religiosidad y espiritualidad: la experiencia de familias de niños con Insuficiencia Renal Crónica

PAULA, Érica Simpionato de; NASCIMENTO, Lucila Castanheira; ROCHA, Semiramis Melani Melo
Fonte: Associação Brasileira de Enfermagem Publicador: Associação Brasileira de Enfermagem
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
55.81%
OBJETIVO: Descrever as manifestações de religiosidade e espiritualidade de famílias de crianças com Insuficiência Renal Crônica em diálise peritoneal. MÉTODO: Trata-se de uma pesquisa qualitativa, com a característica de estudo de caso com múltiplos sujeitos. A análise de conteúdo adotada foi a de significados, optando-se pelo tipo temático, tendo como referência a promoção de saúde em enfermagem familiar. RESULTADOS: Participaram do estudo quatro famílias, totalizando quatorze participantes. A religião e a espiritualidade se apresentam como recursos importantes para os familiares no enfrentamento da doença crônica, principalmente diante de prognósticos ameaçadores. CONCLUSÃO: Destacamos a importância de compreender a religião e a espiritualidade da família no processo de adoecimento, para o enfermeiro atuar na promoção da saúde.; OBJECTIVE: To describe the manifestations of religiosity and spirituality in families of children with Chronic Kidney Failure undergoing peritoneal dialysis. METHODS: This qualitative research is a case study with multiple subjects. Meaningful content analysis was adopted, using the thematic type, in the framework of family nursing in health promotion. RESULTS: Four families participated in the study...

A soft computing approach to kidney diseases evaluation

Neves, José; Martins, M. R.; Vilhena, João; Neves, João C. P.; Gomes, Sabino; Abelha, António; Machado, José Manuel; Vicente, Henrique
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2015 ENG
Relevância na Pesquisa
46.1%
Kidney renal failure means that one’s kidney have unexpectedly stopped functioning, i.e., once chronic disease is exposed, the presence or degree of kidney dysfunction and its progression must be assessed, and the underlying syndrome has to be diagnosed. Although the patient’s history and physical examination may denote good practice, some key information has to be obtained from valuation of the glomerular filtration rate, and the analysis of serum biomarkers. Indeed, chronic kidney sickness depicts anomalous kidney function and/or its makeup, i.e., there is evidence that treatment may avoid or delay its progression, either by reducing and prevent the development of some associated complications, namely hypertension, obesity, diabetes mellitus, and cardiovascular complications. Acute kidney injury appears abruptly, with a rapid deterioration of the renal function, but is often reversible if it is recognized early and treated promptly. In both situations, i.e., acute kidney injury and chronic kidney disease, an early intervention can significantly improve the prognosis.The assessment of these pathologies is therefore mandatory, although it is hard to do it with traditional methodologies and existing tools for problem solving. Hence...