Multidisciplinary treatment for patients with chronic kidney disease in pre-dialysis minimizes costs: a four-year retrospective cohort analysis
CONCLUSION: A pre-dialysis care program may reduce by R$ 33,023.12 ± 1,676.80 (US$ 8,508.26 ± 432.02) the average cost for each year of DT avoided, which is sufficient to cover the program's operation, minimizing cost. These results signal to public health policy makers the real possibility of achieving significant cost reduction in the medium term for CKD care (4 years), to a program that disbursed R$ 24 billion (US$ 6.8 billion) for DT in Brazil between 2009 and 2018.PMID:33843942 | DOI:10.1590/2175-8239-JBN-2020-0226 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - April 12, 2021 Category: Urology & Nephrology Authors: Celso Souza de Moraes J únior Nat ália Maria da Silva Fernandes Fernando Ant ônio Basile Colugnati Source Type: research

Living well with kidney disease by patient and care-partner empowerment: kidney health for everyone everywhere
J Bras Nefrol. 2021 Apr 12:S0101-28002021005030301. doi: 10.1590/2175-8239-JBN-2020-0241. Online ahead of print.ABSTRACTLiving with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee h...
Source: Jornal Brasileiro de Nefrologia - April 12, 2021 Category: Urology & Nephrology Authors: Kamyar Kalantar-Zadeh Philip Kam-Tao Li Ekamol Tantisattamo Latha Kumaraswami Vassilios Liakopoulos Siu-Fai Lui Ifeoma Ulasi Sharon Andreoli Alessandro Balducci Sophie Dupuis Tess Harris Anne Hradsky Richard Knight Sajay Kumar Maggie Ng Alice Poidevin Gam Source Type: research

Donor-derived TB after kidney transplantation: a case report
CONCLUSION: TB is an important differential diagnosis for infectious complications in patients after solid-organ transplantation, especially in endemic regions. Its initial clinical presentation can be unspecific and it should be suspected in the presence of fever or formation of fluid collections. The suspicion of TB is the key to early diagnosis and satisfactory outcomes in post-transplant TB.PMID:33836038 | DOI:10.1590/2175-8239-JBN-2020-0117 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Luiz Roberto de Sousa Ulisses Helen Souto Siqueira Cardoso Inara Cre ão Costa Alves Isabela Novais Medeiros Camilla Garcia de Oliveira Tiago Martins de Almeida Fab íola Fernandes Dos Santos Castro Claudia Neto Gon çalves Neves da Silva Laura Viana de L Source Type: research

COVID-19 and chronic kidney disease: a comprehensive review
J Bras Nefrol. 2021 Apr 9:S0101-28002021005032301. doi: 10.1590/2175-8239-JBN-2020-0203. Online ahead of print.ABSTRACTKidney impairment in hospitalized patients with SARS-CoV-2 infection is associated with increased in-hospital mortality and worse clinical evolution, raising concerns towards patients with chronic kidney disease (CKD). From a pathophysiological perspective, COVID-19 is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha), causing systemic inflammation and hypercoagulability, and multiple organ dysfunction syndrome. Emerging data postulate that CKD under conservative treatment or r...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Inah Maria D Pecly Rafael B Azevedo Elizabeth S Muxfeldt Bruna G Botelho Gabriela G Albuquerque Pedro Henrique P Diniz Rodrigo Silva Cibele I S Rodrigues Source Type: research

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease
J Bras Nefrol. 2021 Apr 9:S0101-28002021005031302. doi: 10.1590/2175-8239-JBN-2020-0210. Online ahead of print.ABSTRACTThis nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Cristina Martins Simone L Saeki Marcelo Mazza do Nascimento Fernando M Lucas J únior Ana Maria Vavruk Christiane L Meireles Sandra Justino Denise Mafra Estela Iraci Rabito Maria Eliana Madalozzo Schieferdecker Let ícia Fuganti Campos Denise P J van Aanh Source Type: research

Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?
J Bras Nefrol. 2021 Apr 9:S0101-28002021005033301. doi: 10.1590/21758239-JBN-2020-0273. Online ahead of print.ABSTRACTIn the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. The HCO dialyzer is applied in septic patients with acute kidney in...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Thiago Reis Siddiq Anwar Francisco de Assis da Rocha Neves Claudio Ronco Source Type: research

Donor-derived TB after kidney transplantation: a case report
CONCLUSION: TB is an important differential diagnosis for infectious complications in patients after solid-organ transplantation, especially in endemic regions. Its initial clinical presentation can be unspecific and it should be suspected in the presence of fever or formation of fluid collections. The suspicion of TB is the key to early diagnosis and satisfactory outcomes in post-transplant TB.PMID:33836038 | DOI:10.1590/2175-8239-JBN-2020-0117 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Luiz Roberto de Sousa Ulisses Helen Souto Siqueira Cardoso Inara Cre ão Costa Alves Isabela Novais Medeiros Camilla Garcia de Oliveira Tiago Martins de Almeida Fab íola Fernandes Dos Santos Castro Claudia Neto Gon çalves Neves da Silva Laura Viana de L Source Type: research

COVID-19 and chronic kidney disease: a comprehensive review
J Bras Nefrol. 2021 Apr 9:S0101-28002021005032301. doi: 10.1590/2175-8239-JBN-2020-0203. Online ahead of print.ABSTRACTKidney impairment in hospitalized patients with SARS-CoV-2 infection is associated with increased in-hospital mortality and worse clinical evolution, raising concerns towards patients with chronic kidney disease (CKD). From a pathophysiological perspective, COVID-19 is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha), causing systemic inflammation and hypercoagulability, and multiple organ dysfunction syndrome. Emerging data postulate that CKD under conservative treatment or r...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Inah Maria D Pecly Rafael B Azevedo Elizabeth S Muxfeldt Bruna G Botelho Gabriela G Albuquerque Pedro Henrique P Diniz Rodrigo Silva Cibele I S Rodrigues Source Type: research

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease
J Bras Nefrol. 2021 Apr 9:S0101-28002021005031302. doi: 10.1590/2175-8239-JBN-2020-0210. Online ahead of print.ABSTRACTThis nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Cristina Martins Simone L Saeki Marcelo Mazza do Nascimento Fernando M Lucas J únior Ana Maria Vavruk Christiane L Meireles Sandra Justino Denise Mafra Estela Iraci Rabito Maria Eliana Madalozzo Schieferdecker Let ícia Fuganti Campos Denise P J van Aanh Source Type: research

Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?
J Bras Nefrol. 2021 Apr 9:S0101-28002021005033301. doi: 10.1590/21758239-JBN-2020-0273. Online ahead of print.ABSTRACTIn the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. The HCO dialyzer is applied in septic patients with acute kidney in...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Thiago Reis Siddiq Anwar Francisco de Assis da Rocha Neves Claudio Ronco Source Type: research

Donor-derived TB after kidney transplantation: a case report
CONCLUSION: TB is an important differential diagnosis for infectious complications in patients after solid-organ transplantation, especially in endemic regions. Its initial clinical presentation can be unspecific and it should be suspected in the presence of fever or formation of fluid collections. The suspicion of TB is the key to early diagnosis and satisfactory outcomes in post-transplant TB.PMID:33836038 | DOI:10.1590/2175-8239-JBN-2020-0117 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Luiz Roberto de Sousa Ulisses Helen Souto Siqueira Cardoso Inara Cre ão Costa Alves Isabela Novais Medeiros Camilla Garcia de Oliveira Tiago Martins de Almeida Fab íola Fernandes Dos Santos Castro Claudia Neto Gon çalves Neves da Silva Laura Viana de L Source Type: research

COVID-19 and chronic kidney disease: a comprehensive review
J Bras Nefrol. 2021 Apr 9:S0101-28002021005032301. doi: 10.1590/2175-8239-JBN-2020-0203. Online ahead of print.ABSTRACTKidney impairment in hospitalized patients with SARS-CoV-2 infection is associated with increased in-hospital mortality and worse clinical evolution, raising concerns towards patients with chronic kidney disease (CKD). From a pathophysiological perspective, COVID-19 is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha), causing systemic inflammation and hypercoagulability, and multiple organ dysfunction syndrome. Emerging data postulate that CKD under conservative treatment or r...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Inah Maria D Pecly Rafael B Azevedo Elizabeth S Muxfeldt Bruna G Botelho Gabriela G Albuquerque Pedro Henrique P Diniz Rodrigo Silva Cibele I S Rodrigues Source Type: research

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease
J Bras Nefrol. 2021 Apr 9:S0101-28002021005031302. doi: 10.1590/2175-8239-JBN-2020-0210. Online ahead of print.ABSTRACTThis nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Cristina Martins Simone L Saeki Marcelo Mazza do Nascimento Fernando M Lucas J únior Ana Maria Vavruk Christiane L Meireles Sandra Justino Denise Mafra Estela Iraci Rabito Maria Eliana Madalozzo Schieferdecker Let ícia Fuganti Campos Denise P J van Aanh Source Type: research

Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?
J Bras Nefrol. 2021 Apr 9:S0101-28002021005033301. doi: 10.1590/21758239-JBN-2020-0273. Online ahead of print.ABSTRACTIn the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. The HCO dialyzer is applied in septic patients with acute kidney in...
Source: Jornal Brasileiro de Nefrologia - April 9, 2021 Category: Urology & Nephrology Authors: Thiago Reis Siddiq Anwar Francisco de Assis da Rocha Neves Claudio Ronco Source Type: research

COVID-19 quarantine in chronic kidney disease patients: A focus on sarcopenia traits
J Bras Nefrol. 2021 Mar 22:S0101-28002021005028301. doi: 10.1590/2175-8239-JBN-2020-0201. Online ahead of print.NO ABSTRACTPMID:33770152 | DOI:10.1590/2175-8239-JBN-2020-0201 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - March 26, 2021 Category: Urology & Nephrology Authors: Heitor Siqueira Ribeiro Kenneth R Wilund Ricardo Moreno Lima Source Type: research

Emphysematous pyelonephritis caused by C. glabrata
We describe a case of EPN caused by C. glabrata, sensitive to fluconazole in a young, hypertensive woman with undiagnosed diabetes mellitus (DM), with renal dysfunction upon admission; her abdominal CT scan found a volumetric increase in the left kidney, signs of gas collections and perirenal blurring. Despite the antimicrobial therapy instituted, due to clinical refractoriness, a double J catheter and subsequent total nephrectomy were indicated, with good postoperative evolution. Her uroculture showed C. glabrata sensitive to fluconazole, and the pathology study showed tubular atrophy and intense interstitial inflammatory...
Source: Jornal Brasileiro de Nefrologia - March 24, 2021 Category: Urology & Nephrology Authors: Eduardo Augusto Schutz Ana Paula Zabott Rubia Bethania Biela Boaretto Gisele Toyama Carlos Floriano de Morais Juliana Gerhardt Moroni Carla Sakuma de Oliveira Source Type: research

Interleukin-8 is increased in chronic kidney disease in children, but not related to cardiovascular disease
In this study, we aimed to detect the cytokine that is involved in the early stage of chronic kidney disease and associated with cardiovascular disease.METHODS: We included 50 patients who were diagnosed with predialytic chronic kidney disease and 30 healthy pediatric patients in Ege University Medical Faculty Pediatric Clinic, İzmir/Turkey. Interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-13 (IL-13), and transforming grow factor-β1 (TGF-β1) levels (pg/mL) were measured by ELISA. Carotid-femoral pulse wave velocity (PWV), augmentation index (Aix), carotid intima media thickness (cIMT), and left ventricu...
Source: Jornal Brasileiro de Nefrologia - March 12, 2021 Category: Urology & Nephrology Authors: Se çil Conkar Tunçay Eser Do ğan G ülden Hakverdi Zulal Ülger Tutar Sevgi Mir Source Type: research

Acute kidney injury associated with rhabdomyolysis in a patient with COVID-19
J Bras Nefrol. 2021 Mar 5:S0101-28002021005025301. doi: 10.1590/2175-8239-JBN-2020-0170. Online ahead of print.ABSTRACTRhabdomyolysis is defined as the breakdown of skeletal muscle leading to the release of muscle contents into the extracellular fluid. Patients with rhabdomyolysis can be asymptomatic or have myalgia symptoms, weakness, myoglobinuria with dark urine, significant electrolyte imbalance, and acute kidney injury. Here we describe a case on acute kidney injury associated to rhabdomyolysis in a patient with COVID-19.PMID:33704346 | DOI:10.1590/2175-8239-JBN-2020-0170 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - March 11, 2021 Category: Urology & Nephrology Authors: Viviane Schmitt Jahnke Jos é Antonio Tesser Poloni Carla Andretta Moreira Neves Camila Peter Claudia Elizabeth Thompson Liane Nanci Rotta Source Type: research

Epidemiological profile of acute kidney injury in critically ill patients admitted to intensive care units: A Prospective Brazilian Cohort
DISCUSSION: Patients with AKI had higher mortality rates when compared to those without AKI. Likewise, among patients with AKI, higher disease stages were associated with higher death occurrences. AKI incidence (21.3%) and mortality (25.7%) in our study is in line with the largest meta-analysis ever conducted, in which incidence and mortality of 21.6 and 23.9% were observed, respectively. These findings confirm the importance of establishing the KDIGO guideline for the definition and management of AKI in Brazilian ICUs.PMID:33704347 | DOI:10.1590/2175-8239-JBN-2020-0191 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - March 11, 2021 Category: Urology & Nephrology Authors: Ant ônio José Inda-Filho Heitor Siqueira Ribeiro Edilene Almeida Vieira Aparecido Pimentel Ferreira Source Type: research

An analysis of chronic kidney disease as a prognostic factor in pediatric cases of COVID-19
J Bras Nefrol. 2021 Mar 5:S0101-28002021005025303. doi: 10.1590/2175-8239-JBN-2020-0208. Online ahead of print.ABSTRACTAdvanced age is a risk factor for severe infection by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Children, however, often present with milder manifestations of Coronavirus Disease 2019 (COVID-19). Associations have been found between COVID-19 and multisystem inflammatory syndrome in children (MIS-C). Patients with the latter condition present more severe involvement. Adults with comorbidities such as chronic kidney disease (CKD) are more severely affected. This narrative review aimed to look in...
Source: Jornal Brasileiro de Nefrologia - March 11, 2021 Category: Urology & Nephrology Authors: B árbara Caroline Dias Faria Luiz Gustavo Guimar ães Sacramento Carolina Sant' Anna Filipin Aniel Feitosa da Cruz Sarah Naomi Nagata Ana Cristina Sim ões E Silva Source Type: research

Kidneys also "speak Portuguese"
J Bras Nefrol. 2021 Mar 5:S0101-28002021005026302. doi: 10.1590/2175-8239-JBN-2020-0264. Online ahead of print.NO ABSTRACTPMID:33704349 | DOI:10.1590/2175-8239-JBN-2020-0264 (Source: Jornal Brasileiro de Nefrologia)
Source: Jornal Brasileiro de Nefrologia - March 11, 2021 Category: Urology & Nephrology Authors: Iara da Silva Santos Maria J úlia Correia Lima Nepomuceno Araújo Vanda Jorgetti Rosilene Motta Elias Jordi Bover Source Type: research

Hyperuricemia and chronic kidney disease: to treat or not to treat
J Bras Nefrol. 2021 Mar 5:S0101-28002021005026301. doi: 10.1590/2175-8239-JBN-2020-U002. Online ahead of print.ABSTRACTHyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and...
Source: Jornal Brasileiro de Nefrologia - March 11, 2021 Category: Urology & Nephrology Authors: Federica Piani Fumihiko Sasai Petter Bjornstad Claudio Borghi Ashio Yoshimura Laura G Sanchez-Lozada Carlos Roncal-Jimenez Gabriela E Garcia Ana Andres Hernando Gabriel Cara Fuentes Bernardo Rodriguez-Iturbe Miguel A Lanaspa Richard J Johnson Source Type: research

Is the Fistula First Approach still valid?
Discussion points are: (1) the questionable survival benefit of AVFs over AVGs, if one takes into account the high rates of primary AVF failure; (2) the potential benefits of using AVGs for greater primary success; and (3) the questionable benefit of AVFs over AVGs in patients with shorter survival, such as the elderly. The high rate of primary failure and maturation procedures leads to prolonged use of catheters, and it is one of the weaknesses of the fistula first strategy. AVGs proved to be better than AVFs as a second access after the failure of a first AVF, and in patients with non-ideal vessels, with greater primary ...
Source: Jornal Brasileiro de Nefrologia - March 8, 2021 Category: Urology & Nephrology Authors: Ricardo Portiolli Franco Source Type: research

Dialysis-related thrombocytopenia: a case report
J Bras Nefrol. 2021 Feb 26:S0101-28002021005022301. doi: 10.1590/2175-8239-JBN-2020-0109. Online ahead of print.ABSTRACTThrombocytopenia is frequently observed in hemodialysis patients, and its correct investigation and control remain a challenge. It is estimated that during the hemodialysis session there is a drop of up to 15% in the platelet count, with recovery after the end of treatment. This reduction in platelets is due to platelet adhesion and complement activation, regardless of the membrane material. Several studies with platelet surface markers demonstrate increased platelet activation and aggregation secondary t...
Source: Jornal Brasileiro de Nefrologia - March 3, 2021 Category: Urology & Nephrology Authors: Irene Faria Duayer Maria J úlia Correia Lima Nepomuceno Araújo Camila Hitomi Nihei Maria Alice Fernandes Barcelos Osni Braga Zita Maria Leme Britto Rosilene Mota Elias Source Type: research