Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica

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dc.audience.educationlevelMestrado
dc.contributor.advisorKaneko, Maria Ayako Kamimura [UNIFESP]
dc.contributor.advisor-coSilva Júnior, Antonio Carlos Cordeiro
dc.contributor.advisor-coLatteshttp://lattes.cnpq.br/5874601346158886pt_BR
dc.contributor.advisorLatteshttp://lattes.cnpq.br/3356377676492451pt_BR
dc.contributor.authorBichels, Andre Valente [UNIFESP]
dc.contributor.authorLatteshttp://lattes.cnpq.br/7254976533483796
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)pt
dc.coverage.spatialSão Paulopt_BR
dc.date.accessioned2021-01-19T16:33:50Z
dc.date.available2021-01-19T16:33:50Z
dc.date.issued2019-05-30
dc.description.abstractBackground: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the loss of skeletal muscle mass. Muscle mass is a key element for evaluation of nutritional disturbances, and low muscle mass is associated with increased morbidity and mortality. An accurate method for muscle mass evaluation that is not subject to errors caused by perturbations in the uremic milieu remains a challenge for the nephrology community. Methods: This is a prospective observational cohort study. We evaluated 223 non-dialyzed CKD patients [60.3±10.6 years; 64% men; 50% diabetics; glomerular filtration rate (GFR) 27.3±16.3 ml/min/1.73m2]. Muscle mass was measured by computed tomography at the third lumbar vertebra region (CTMM-L3) using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data and comorbidities were evaluated, and mortality was followed-up for 4 years. Results: During the study period 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower GFR, hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P=0.017), and in Cox-regression analysis [crude hazard ratio, HR, 1.87 (95% confidence interval, CI, 1.11-3.16)], also when adjusting for potential confounders [HR 1.83 (CI 1.02-3.30)]. Conclusions: Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in non-dialyzed CKD patients.en
dc.description.abstractpt_BR
dc.description.sourceDados abertos - Sucupira - Teses e dissertações (2019)
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)pt
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)pt_BR
dc.description.sponsorshipFundação Oswaldo Ramospt
dc.identifierhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7878075pt_BR
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/59587
dc.language.isopor
dc.publisherUniversidade Federal de São Paulo (UNIFESP)
dc.rightsAcesso abertopt_BR
dc.subjectMuscle massen
dc.subjectComputed tomographyen
dc.subjectMortalityen
dc.subjectChronic kidney diseaseen
dc.subjectBody compositionen
dc.subjectMassa muscularpt_BR
dc.subjectTomografia computadorizadapt_BR
dc.subjectComposição corporalpt_BR
dc.subjectDoença renal crônicapt_BR
dc.subjectMortalidadept_BR
dc.titleAvaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônicapt_BR
dc.title.alternativeEvaluation of muscle mass measured by abdominal computed tomography as surrogate for mortality in nondialysis chronic kidney disease patientsen
dc.typeDissertação de mestrado
unifesp.campusSão Paulo, Escola Paulista de Medicinapt_BR
unifesp.graduateProgramNutriçãopt_BR
unifesp.knowledgeAreaNutriçãopt_BR
unifesp.researchAreaNutrição em Especialidades Clínicaspt_BR
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