Is it safe to delay testosterone replacement therapy in pandemic times?
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - September 21, 2020 Category: General Medicine Source Type: research

Ipse Dixit
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - September 21, 2020 Category: General Medicine Source Type: research

Drug-induced nephrotoxicity
SUMMARY Acute kidney injury is a very common diagnosis, present in up to 60% of critical patients, and its third main cause is drug toxicity. Nephrotoxicity can be defined as any renal injury caused directly or indirectly by medications, with acute renal failure, tubulopathies, and glomerulopathies as common clinical presentations. Some examples of drugs commonly associated with the acute reduction of glomerular filtration rate are anti-inflammatories, antibiotics, such as vancomycin and aminoglycosides, and chemotherapeutic agents, such as cisplatin and methotrexate. Cases of tubulopathy are very common with amphotericin ...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

HIV-related nephropathy: new aspects of an old paradigm
SUMMARY The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretrovira...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Acute kidney injury
SUMMARY A healthy diet is an essential requirement to promote and preserve health, even in the presence of diseases, such as chronic kidney disease (CKD). In this review, nutritional therapy for CKD will be addressed considering not only the main nutrients such as protein, phosphorus, potassium, and sodium, which require adjustments as a result of changes that accompany the reduction of renal functions, but also the benefits of adopting dietary patterns associated with better outcomes for both preventing and treating CKD. We will also emphasize that these aspects should also be combined with a process of giving new meaning...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Diet in Chronic Kidney Disease: an integrated approach to nutritional therapy
SUMMARY A healthy diet is an essential requirement to promote and preserve health, even in the presence of diseases, such as chronic kidney disease (CKD). In this review, nutritional therapy for CKD will be addressed considering not only the main nutrients such as protein, phosphorus, potassium, and sodium, which require adjustments as a result of changes that accompany the reduction of renal functions, but also the benefits of adopting dietary patterns associated with better outcomes for both preventing and treating CKD. We will also emphasize that these aspects should also be combined with a process of giving new meaning...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Anemia in chronic kidney disease
CONCLUSIONS: Cellular therapy with MSCs is very promising and should be part of the treatment of AKI patients in combination with other approaches already available, helping to accelerate recovery and/or slow the progression to chronic kidney disease. Randomized, multicentre controlled studies are needed to develop robust protocols that validate population-based cell therapy with MSCs. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Mesenchymal stem cell therapy in acute kidney injury (AKI): review and perspectives
CONCLUSIONS: Cellular therapy with MSCs is very promising and should be part of the treatment of AKI patients in combination with other approaches already available, helping to accelerate recovery and/or slow the progression to chronic kidney disease. Randomized, multicentre controlled studies are needed to develop robust protocols that validate population-based cell therapy with MSCs. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Peritoneal Dialysis
SUMMARY Peritoneal dialysis (PD) is a renal replacement therapy based on infusing a sterile solution into the peritoneal cavity through a catheter and provides for the removal of solutes and water using the peritoneal membrane as the exchange surface. This solution, which is in close contact with the capillaries in the peritoneum, allows diffusion solute transport and osmotic ultrafiltration water loss since it is hyperosmolar to plasma due to the addition of osmotic agents (most commonly glucose). Infusion and drainage of the solution into the peritoneal cavity can be performed in two ways: manually (continuous ambulatory...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Hyperkalemia in chronic kidney disease
SUMMARY Hyperkalemia is a frequent finding in patients with chronic kidney disease (CKD). This increase in serum potassium levels is associated with decreased renal ion excretion, as well as the use of medications to reduce the progression of CKD or to control associated diseases such as diabetes mellitus and heart failure. Hyperkalemia increases the risk of cardiac arrhythmia episodes and sudden death. Thus, the control of potassium elevation is essential for reducing the mortality rate in this population. Initially, the management of hyperkalemia includes orientation of low potassium diets and monitoring of patients' adh...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Acute kidney injury in cancer patients
SUMMARY The increasing prevalence of neoplasias is associated with new clinical challenges, one of which is acute kidney injury (AKI). In addition to possibly constituting a clinical emergency, kidney failure significantly interferes with the choice and continuation of antineoplastic therapy, with prognostic implications in cancer patients. Some types of neoplasia are more susceptible to AKI, such as multiple myeloma and renal carcinoma. In cancer patients, AKI can be divided into pre-renal, renal (intrinsic), and post-renal. Conventional platinum-based chemotherapy and new targeted therapy agents against cancer are exampl...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

SGLT-2 inhibitors in diabetes: a focus on renoprotection
SUMMARY Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Fabry disease: genetics, pathology, and treatment
SUMMARY Fabry disease (FD) is a recessive monogenic inheritance disease linked to chromosome X, secondary to mutations in the GLA gene. Its prevalence is estimated between 1:8,454 and 1:117,000 among males and is probably underdiagnosed. Mutations in the GLA gene lead to the progressive accumulation of globotriaosylceramide (Gb3). Gb3 accumulates in lysosomes of different types of cells of the heart, kidneys, skin, eyes, central nervous system, and gastrointestinal system, and may lead to different clinical scenarios. The onset of symptoms occurs during childhood, with acroparesthesia, heat intolerance, and gastrointestina...
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Chronic Kidney Disease
The objectives of the conservative treatment for chronic kidney disease are to slow down the progression of kidney dysfunction, treat complications (anemia, bone diseases, cardiovascular diseases), vaccination for hepatitis B, and preparation for kidney replacement therapy. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research

Novel treatment options for chronic kidney disease complications
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - January 13, 2020 Category: General Medicine Source Type: research