Navegando por Palavras-chave "Kidney failure"
Agora exibindo 1 - 5 de 5
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosConstant Work-Rate Test to Assess the Effects of Intradialytic Aerobic Training in Mildly Impaired Patients With End-Stage Renal Disease: A Randomized Controlled Trial(Elsevier B.V., 2011-12-01) Reboredo, Maycon M.; Neder, J. Alberto [UNIFESP]; Pinheiro, Bruno V.; Henrique, Diane M.; Faria, Ruiter S.; Paula, Rogerio B.; Univ Fed Juiz de Fora; Fed Inst Educ Sci & Technol SE Minas Gerais; Universidade Federal de São Paulo (UNIFESP)Objective: To investigate if high-intensity constant work rate (CWR) would constitute a more appropriate testing strategy compared with incremental work rate (IWR) to assess the effectiveness of intradialytic aerobic training in patients with end-stage renal disease (ESRD).Design: Randomized controlled trial.Setting: Nephrology unit at the university hospital.Participants: Patients (N=28; 47.0 +/- 11.9y) under hemodialysis (4.4 +/- 4.3y) were randomly assigned to exercise and control groups.Intervention: Patients included in the exercise group underwent a moderate-intensity intradialytic aerobic training program 3 times per week for 12 weeks.Main Outcome Measures: Cardiopulmonary and perceptual responses were obtained during an IWR and a high-intensity CWR test to the limit of tolerance on a cycle ergometer.Results: Training-induced increases in peak oxygen uptake (Vo(2)peak) and time to exercise intolerance (Tlim). Mean improvement in Tlim (97.4%+/- 75.6%) was significantly higher than increases in Vo(2)peak (12%+/- 11.3%) (P<.01); in fact, while Tlim improved 50% to 200% in 9 of 12 patients, Vo(2)peak increases were typically in the 15% to 20% range. CWR test revealed lower metabolic, ventilatory, cardiovascular, and subjective stresses at isotime; in contrast, submaximal responses during the incremental work rate (at the gas exchange threshold) remained unaltered after training.Conclusions: A laboratory-based measure of endurance exercise capacity (high-intensity CWR test to Thin) was substantially more sensitive than oxygen uptake at the peak IWR test to unravel the physiologic benefits of an intradialytic aerobic training program in mildly impaired patients with ESRD.
- ItemAcesso aberto (Open Access)Estimated prevalence of childhood end-stage renal disease in the state of Sao Paulo(Assoc Medica Brasileira, 2011-07-01) Nogueira, Paulo Cesar Koch [UNIFESP]; Feltran, Luciana de Santis; Camargo, Maria Fernanda; Leão, Eliseth Ribeiro; Benninghoven, Jennifer Regina Corrêa da Silva; Gonçalves, Natália Zuanetti; Pereira, Luiz A.; Sesso, Ricardo de Castro Cintra [UNIFESP]; Hosp Samaritano Sao Paulo; Universidade Federal de São Paulo (UNIFESP); Fac Ciencias Med Santos UNILUS; Johns Hopkins Univ; Sistema Estadual TransplantesEstimated prevalence of childhood end-stage renal disease in the state of Sao PauloObjective: To estimate the prevalence of pediatric end-stage renal disease and evaluate demographics and renal disease characteristics in state of Sao Paulo over the year 2008. Methods: Observational, descriptive, and cross-sectional study based on a population sample with subjects < 18 years. The data collecting assumed three forms: 1. A questionnaire for dialysis units; 2. Search in the Transplant Center to determine the number and characteristics of patients who had been in a transplant waiting list over the study period; 3. Search in the database of patients registered at the Latin American Collaborative Registry of Pediatric Kidney Transplantation. Results: Data from 301 patients aged 9.0 +/- 5.8, including 140 girls (46.5%), resulting in an estimate prevalence of 23.4 cases per million age-related population (pmarp). The age group most frequently found was 10 to 15 years (32.2%), and urinary tract malformation was the most usual known etiology (24.9%). Most children underwent kidney transplantation (62.1%) and among subjects on dialysis, hemodialysis was predominant (71.2%). The Sistema Unico de Saude - Unified National Health System - (SUS) provided the financial support for treatments. Conclusion: The prevalence of 23.4 cases pmarp found by the authors is lower than that reported in Western world. We believe data were underestimated in the present study, as few dialysis units returned the completed questionnaire. This potential bias does not invalidate the exploratory character of results. Further mechanisms for retrospective and earlier data collecting on pediatric chronic renal disease (CRD) are needed so that the burden of this serious health condition can be appropriately sized up.
- ItemSomente MetadadadosLineage-Negative Bone Marrow Cells Protect Against Chronic Renal Failure(Alphamed Press, 2009-01-01) Alexandre, Cristianne Silva; Volpini, Rildo Aparecido; Shimizu, Maria Heloisa; Sanches, Talita Rojas; Semedo, Patricia [UNIFESP]; Di Jura, Vera Lucia; Camara, Niels Olsen [UNIFESP]; Seguro, Antonio Carlos; Andrade, Lucia; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Progressive renal failure continues to be a challenge. the use of bone marrow cells represents a means of meeting that challenge. We used lineage-negative (Lin(-)) cells to test the hypothesis that Lin(-) cell treatment decreases renal injury. Syngeneic Fischer 344 rats were divided into four groups: sham ( laparotomy only, untreated); Nx (five-sixth nephrectomy and untreated); NxLC1 (five-sixth nephrectomy and receiving 2 x 10(6) Lin(-) cells on postnephrectomy day 15); and NxLC3 (five-sixth nephrectomy and receiving 2 x 10(6) Lin(-) cells on postnephrectomy days 15, 30, and 45). On postoperative day 16, renal mRNA expression of interleukin (IL)-1 beta, tumor necrosis factor-alpha, and IL-6 was lower in NxLC rats than in Nx rats. On postnephrectomy day 60, NxLC rats presented less proteinuria, glomerulosclerosis, anemia, renal infiltration of immune cells, and protein expression of monocyte chemoattractant protein-1, as well as decreased interstitial area. Immunostaining for proliferating cell nuclear antigen showed that, in comparison with sham rats, Nx rats presented greater cell proliferation, whereas NxLC1 rats and NxLC3 rats presented less cell proliferation than did Nx rats. Protein expression of the cyclin-dependent kinase inhibitor p21 and of vascular endothelial growth factor increased after nephrectomy and decreased after Lin(-) cell treatment. On postnephrectomy day 120, renal function (inulin clearance) was significantly better in Lin(-) cell-treated rats than in untreated rats. Lin(-) cell treatment significantly improved survival. These data suggest that Lin(-) cell treatment protects against chronic renal failure. STEM CELLS 2009; 27: 682-692
- ItemAcesso aberto (Open Access)O Transplante renal sob a ótica de crianças portadoras de insuficiência renal crônica em tratamento dialítico: estudo de caso(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2005-09-01) Setz, Vanessa Grespan [UNIFESP]; Pereira, Sônia Regina [UNIFESP]; Naganuma, Masuco [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: To understand implications of the chronic disease for the child and his/her family it must be consider that the chronic disease can not be cured and that this cure may turn into a dangerous myth, involving the child s development process. AIM: To understand the meaning that renal transplantation has for those children in dyalitic treatment and to know their expectations regarding this treatment. METHOD: This is a qualitative study using as an investigation method a Case Study and the Mayeroff s philosophical referential. The techniques used to collect data were semi-structured interviews and the subject was the Design-Story. 15 children who gave their consent to take part of this research, with ages ranging from 6 to 16 years were interviewed and submitted to a dialytic and hemodialytic treatment. RESULTS: Four categories emerged from the semi-structured questions and after using the content analysis technique according to categories: building the knowledge on transplantation; searching to understand the wait for transplant; creating expectation on the transition; being in contact with frustration. Based on the design-story we had a category: unveiling feelings by means of the draw. In this study, we will show the results regarding the semi-structures questions emerged from the individual s speech. CONCLUSION: This study allowed us to understand that children realize the renal transplant as the only possibility to have their lives back to normal.
- ItemAcesso aberto (Open Access)Variação dos níveis de hemoglobina de pacientes em hemodiálise tratados com eritropoetina: uma experiência brasileira(Associação Médica Brasileira, 2010-01-01) Ammirati, Adriano Luiz [UNIFESP]; Watanabe, Renato [UNIFESP]; Aoqui, Cristiane [UNIFESP]; Draibe, Sergio Antonio [UNIFESP]; Carvalho, Aluizio Barbosa de [UNIFESP]; Abensur, Hugo; Drumond, Soraia Stael; Moreira, João; Bevilacqua, José Luis; Silva, Anita Cm; Tatsch, Fernando; Canziani, Maria Eugênia Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Instituto de Nefrologia e Diálise; Instituto de Hemodiálise de Sorocaba; Roche BrazilOBJECTIVE: Correction of anemia using epoetin decreases morbidity and increases survival and quality of life in end-stage renal disease. Maintaining hemoglobin levels within the range proposed by guidelines has become a major challenge, with hemoglobin cycling affecting more than 90% of patients undergoing hemodialysis. The variability of hemoglobin levels over time was assessed in our patients. METHODS: Data were retrospectively collected on 249 patients undergoing hemodialysis over a 3-year period at seven centers in Brazil. Hemoglobin was measured at least monthly, and target levels were those between 10.5 g/dL and 12.5 g/dL. Patients were grouped into six categories of variability consistently low (<10.5g/dL), consistently target range (10.5 to 12.5 g/dL), consistently high (>12.5g/dL), low amplitude fluctuation with low hemoglobin levels, low amplitude fluctuation with high hemoglobin levels and high amplitude fluctuation. None of the patients maintained stable hemoglobin levels for the entire 36-month period. RESULTS: The mean monthly proportion of patients that had hemoglobin levels within the target range was 50% (range, 42% to 61%). Mean levels above the target (30%) were more frequent than those below it (20%). During 6, 12, and 36 months, proportions of patients with consistently low levels of hemoglobin decreased from 3.6% to 0%, from 31.7% to 2.8% for those with consistently high, from 7.6% to 0% for those with low amplitude fluctuation with low hemoglobin levels and from 41.3% to 8.3% for those with low amplitude fluctuation with high hemoglobin levels. However, the proportions of patients with high amplitude fluctuation increased from 21.5% to 88.9%. CONCLUSION: Maintaining hemoglobin levels within the target range is difficult, especially for longer periods of time. Missing the target seems more often due to levels above it, but high-amplitude fluctuations eventually occur in the majority of patients.