Jornal Brasileiro de Nefrologia Journal Impact Factor & Information

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ISSN 2175-8239

Publications in this journal

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    ABSTRACT: Introdução O Ministério da Saúde do Peru não tem um programa nacional de hemodiálise e os hospitais que oferecem este tipo de tratamento têm problemas de cobertura que pode resultar em aumento da mortalidade. Avaliou-se a mortalidade da população incidente em hemodiálise em um hospital de Lima. Métodos Análise da população acima de 18 anos que iniciou o tratamento entre 01 de janeiro de 2012 e 31 de Dezembro de 2013, com data de corte final do acompanhamento em 31 de março de 2014. Foi realizada regressão logística bivariada e multivariada dos fatores associados com a mortalidade e foram usadas as curvas de Kaplan-Meier para determinar a probabilidade de sobrevivência durante o acompanhamento. Resultados Foram incluídos 235 pacientes para estudo, com idade média de 56,4 ± 15,8 anos). A mediana de acompanhamento foi 0,6 meses (IQR 0,3 a 1,5). A pesquisa mostra que 50% dos pacientes abandonaram o tratamento durante o estudo por falta de vagas ou recursos econômicos. No final do terceiro mês a mortalidade foi 37,7% (IC 95% 29,3 a 48,5) e 49,5% (IC 95% 38,8 a 61,4) ao sétimo mês. A mortalidade foi menor quando o paciente tinha mais de seis meses com diagnóstico de insuficiência renal crônica (OR = 0,39 [IC 95% 0,12-1,27]) e quando o paciente ingressava à diálise programada (OR = 0,28 [IC 95% 0,01 a 2,28]). Conclusões Metade dos pacientes foram à óbito no sétimo mês de seguimento. Ter ingressado com diálise programada e ter mais tempo de diagnóstico foi associado à menor mortalidade.
    Jornal Brasileiro de Nefrologia 11/2014;
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1 Suppl 1):15-8. DOI:10.5935/0101-2800.2014S005
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1 Suppl 1):13-4. DOI:10.5935/0101-2800.2014S004
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1 Suppl 1):9-12. DOI:10.5935/0101-2800.2014S003
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    ABSTRACT: Introduction: Increased carotid intima-media thickness (IMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events in general population. The prognostic value of IMT in patients with early-stage chronic kidney disease (CKD) has not been clearly established. Objective: We aimed to evaluate the association between IMT and cardiovascular (CV) events and mortality in CKD patients. Methods: A cohort of CKD patients in stage 2-4 was evaluated the occurrence of CV events and death in a 24 months follow-up. Laboratory data, carotid ultrasound and coronary computed tomography were performed at baseline. Results: A total of 117 patients (57 ± 11 years-old, 61% male) were evaluated. Mean glomerular filtration rate (eGFR) was 36 ± 17 mL/min, 96% of patients had hypertension, 23% diabetes and 27% were obese. Coronary calcification was found in 48% of the patients, with higher prevalence among CKD stage 4 (p = 0.02). The median value of IMT was 0.6 mm (0.4-0.7 mm). When compared to patients with IMT ≤ 0.6 mm, those with IMT > 0.6 mm were older (p = 0.001), had higher prevalence of male (p = 0.001) and had lower eGFR (p = 0.01). These patients also had higher prevalence of coronary calcification (p = 0.001). During the follow-up, there were no differences in the occurrence of cardiovascular events and deaths between the two groups. Conclusion: IMT in early-stage CKD patients was related to coronary calcification, but not with the occurrence of cardiovascular events or death.
    Jornal Brasileiro de Nefrologia 03/2014; 36(1):35-41. DOI:10.5935/0101-2800.20140007
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    ABSTRACT: In this review, phenomena involved in fluid and solute exchange through the peritoneal membrane, both in the physiologic and in the peritoneal dialysis settings, are explained. For that purpose, mathematical models developed for the study of molecule transport through the membrane, such as the "Pore Model" and the "Distributive Model" are used. Scientific accomplishments in the field are described and areas that require additional research are also cited. Knowledge about the physiologic mechanisms involved in this renal replacement therapy modality, concerning events directly related to the peritoneal membrane itself, is synthesized in this manuscript.
    Jornal Brasileiro de Nefrologia 03/2014; 36(1):74-9. DOI:10.5935/0101-2800.20140013
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    ABSTRACT: Introduction: The relationship between urinary tract infections and primary vesicoureteral reflux may lead to permanent renal damage. In the literature an increasing number of spontaneous cure of vesicoureteral reflux in children and the significant decrease in surgical therapy has been observed. Objective: To study the evolution of primary vesicoureteral reflux associated with recurring urinary tract infections settings in patients of the Pediatric Nephrology department of our institution, evaluating cases in which cure was achieved through conservative therapy only and those in which surgical intervention was required. Methods: We analyzed records and collected data refers to parameters: sex, age upon the diagnosis of primary urinary infection, age upon diagnosis of vesicoureteral reflux, number of urinary tract infections, vesicoureteral reflux grade; renal function, renal scaring, other malformation of urinary tract, and surgical or conservative intervention. Statistical analysis was descriptive and conducted with the SPSS program. Results: Within the subgroup of patients with grade IV and V, 63.6% of the cases evolved to surgical intervention and 36.4% to conservative intervention. In those with grades I, II, and III, 38.5% evolved to surgical treatment against 61.5% for conservative approach. Among those with bilateral vesicoureteral reflux, 72.7% had to undergo surgical intervention. No relationship was observed between the vesicoureteral reflux grade and the presence of renal scaring. Conclusion: Patients with low grade vesicoureteral reflux and recurring urinary tract infections tend to experience spontaneous reflux resolution with good renal evolution in the long term in a way that surgical intervention becomes limited to high grade reflux or when followed by other clinical issues.
    Jornal Brasileiro de Nefrologia 03/2014; 36(1):10-7. DOI:10.5935/0101-2800.20140004
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    ABSTRACT: Lipoprotein glomerulopathy (LPG) is a rare autosomal recessive glomerulopathy associated with the deposition of lipoprotein thrombi in the capillary lumina due to apoE gene mutations. Abnormal plasma lipoprotein profile and marked increase in serum apoliprotein E (apoE) are characteristic clinical data. The compromised patients can present nephrotic syndrome, hematuria, and progressive renal failure. Herein, the authors present the first described case of LPG in a Brazilian male patient, 11 years, who presented with a steroid-resistant nephrotic syndrome. Renal function was normal. Kidney biopsy showed markedly enlarged glomerulus, with dilated capillary loops and weak eosinophilic lipoprotein thrombi in the capillary lumina. Interstitium, tubules, arteries, and veins showed normal histologic aspect. Genotypic study for the apoE gene showed the presence of the alleles E3 and E4. The diagnosis of LPG was then performed. The patient received lipid-lowering treatment. After 2 years of follow-up, renal function is gradually decreasing, with persisting heavy proteinuria, despite a marked decrease in serum cholesterol and triglycerides levels.
    Jornal Brasileiro de Nefrologia 03/2014; 36(1):93-5. DOI:10.5935/0101-2800.20140015
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    ABSTRACT: During the last decade, several major breakthroughs have led to the identification of human podocyte membrane antigens. Experimental involving antipodocyte antibodies in human membranous nephropathy (MN) have opened a new line of thinking about this disease, relating as an autoimmune kidney disease. In this setting, the M-type phospholipase A2 receptor (PLA2R) was identified as the first major antigen target in human primary MN. Studies have demonstrated anti-PLA2R antibodies against PLA2R ranging from 70 to 89% in patients with MN, but not in those with secondary MN. It has been suggested that the serum level of anti-PLA2R could be used for the diagnosis of idiopathic MN and for the monitoring of response to treatment. However, the coexistence of autoantibodies suggests a complex pathogenic pathway that involves different podocyte targets. New experimental models are needed to elucidate the appearance time and the role of each anti-podocyte antibody in MN development and progression.
    Jornal Brasileiro de Nefrologia 03/2014; 36(1):59-62. DOI:10.5935/0101-2800.20140011
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1):6-7. DOI:10.5935/0101-2800.20140002
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1 Suppl 1):32-5. DOI:10.5935/0101-2800.2014S010
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1 Suppl 1):36-45. DOI:10.5935/0101-2800.2014S011
  • Jornal Brasileiro de Nefrologia 03/2014; 36(1):8-9. DOI:10.5935/0101-2800.20140003