Made available in DSpace on 2015-04-14T13:35:58Z (GMT). No. of bitstreams: 1 458574.pdf: 1042465 bytes, checksum: a18a5566a2871bef1b665750abadef8e (MD5) Previous issue date: 2014-02-24 / OBJECTIVE: To evaluate blood pressure (BP), heart rate (HR), albuminuria (AL), and glomerular filtration rate (GFR) of patients undergoing ovarian stimulation to in vitro fertilization (IVF). METHODS: From March to September 2013 this quasi-experimental design analyzed the variation of baseline and after BP levels, HR, AL, and GFR from 75 subjects, before embryo transfer. Blood pressure was measured after a five minutes at rest. Glomerular filtration was estimated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Follicular growth was assessed using serial ultrasound scans. RESULTS: Median patient age was 36,89 years. Thirty-three (44%) women got pregnant, and 9 (12%) cycles were complicated by ovarian hyperstimulation. No statistically significant associations were found between systolic BP levels (P=0,945), diastolic BP levels (P=0,802), and GFR (P=0,301) before and after ovarian stimulation. However, this study found a statistically significant correlation of HR (P=0,012) and AL (P=0,002) with ovarian stimulation. There was no statistically significant difference in the modification of variables before and after stimulation between patients who got pregnant from those who did not pregnant, as well as the group who developed ovarian hyperstimulation compared with group that developed the expected number of follicles. Three patients developed acute kidney injury. CONCLUSION: Ovarian stimulation to IVF does not change the BP levels, and GFR of patients undergoing it. There is statistically significant increasing of HR and AL, but without clinical relevance. Pregnancy and ovarian hyperstimulation does not alter the pattern of the study variables. / OBJETIVO: Avaliar press?o arterial, frequ?ncia card?aca, albumin?ria e filtra??o glomerular estimada de pacientes submetidas ? estimula??o ovariana para fertiliza??o in vitro. MATERIAIS E M?TODO: De mar?o a setembro de 2013, este quase experimento intra-grupos analisou a varia??o da press?o arterial (PA), frequ?ncia card?aca (FC), albumin?ria (AL) e filtra??o glomerular estimada (FGE) basais e ap?s estimula??o ovariana de 75 pacientes para fertiliza??o in vitro (FIV), ainda antes da transfer?ncia embrion?ria. A PA foi verificada ap?s repouso de cinco minutos, em duas medidas, sendo registrada a segunda. A filtra??o glomerular foi estimada pela f?rmula CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). O crescimento folicular foi avaliado por ecografias transvaginais seriadas. RESULTADOS: a m?dia de idade foi 36,89 anos. Trinta e tr?s mulheres (44%) gestaram e 9 (12%) desenvolveram hiperestimula??o ovariana. N?o foi identificada diferen?a estatisticamente significativa entre os n?veis de PA sist?lica (P=0,945) e diast?lica (P=0,802) e da FGE (P=0,301) antes e ap?s a estimula??o, por?m houve diferen?a estat?stica no que concerne ? FC (P=0,012) e ? AL(P=0,002). N?o houve diferen?a estatisticamente significativa na modifica??o das vari?veis antes e ap?s a estimula??o entre gestantes e n?o gestantes, bem como em rela??o ao grupo que desenvolveu hiperestimula??o ovariana em rela??o ao grupo com estimula??o normal. Tr?s pacientes desenvolveram perda aguda de fun??o renal. CONCLUS?ES: Estimula??o ovariana n?o altera significativamente press?o arterial e FGE das pacientes submetidas ? fertiliza??o in vitro. A signific?ncia estat?stica do aumento no que concerne ? FC e ? AL n?o apresentou significado cl?nico. Gesta??o e hiperestimula??o ovariana n?o alteraram o padr?o das vari?veis do estudo.

Made available in DSpace on 2015-04-14T13:35:58Z (GMT). No. of bitstreams: 1 459896.pdf: 592846 bytes, checksum: 987bda46314bc6c01e598cce8d88d1d5 (MD5) Previous issue date: 2009-03-03 / Introduction: The most frequent adverse events during dialysis are hypotension (20% to 30%) and muscle cramps (5% to 10%), and the most often prescribed treatment to these adverse events is the use of variable sodium (VNa) profiling. Objectives: The aim of the current study was to compare the frequency of adverse events during hemodialysis (HD), interdialytic weight gain, and blood pressure before and after dialysis, with and without the use of VNa, as well as with the use of two variable sodium models: stepwise (VNass) and linear (VNal). Methods: a randomized, cross-over, prospective study that enrolled 22 patients in two groups: one to receive VNas for 12 HD sessions, and the other VNal, for a similar period after 12 sessions without VNa. After a wash-out period of 12 sessions, groups were crossed over. The following parameters were analyzed: adverse events, interdialytic weight gain, and blood pressure (BP) before and after dialysis. Results: Mean age was 61.2?15.2 years; 11 (50%) patients were male. The occurrence of adverse events was significantly different between the period without VNa (48.5%) and those with VNas and VNal (33.7% and 36%; p<0.001). There were no significant differences in BP or interdialytic weight gain among treatment modalities. Conclusion: The use of VNa was associated with a reduction in the number of adverse events. VNas resulted in less episodes of symptomatic hypotension; while VNal may be associated with reduced muscle cramps. VNa modeling is beneficial for selected patients, and should be individually prescribed. / Introdu??o: Os eventos adversos que ocorrem com mais freq??ncia no per?odo transdi?lise s?o hipotens?o (20% a 30%) e c?imbras (5% a 10%), e entre as condutas mais indicadas para o tratamento destas complica??es est? a utiliza??o de s?dio vari?vel (NaV). Objetivos: comparar a ocorr?ncia de eventos adversos em hemodi?lise (HD), o aumento de peso interdial?tico e a press?o arterial pr? e p?s-di?lise, sem e com a utiliza??o de NaV e comparar a ocorr?ncia de eventos adversos em HD com a utiliza??o de duas modalidades de s?dio vari?vel: step (NaVs) e linear (NaVl). M?todo: estudo prospectivo, randomizado e com cross-over que incluiu 22 pacientes para dois grupos: um para tratamento com NaVs durante 12 sess?es de HD e outro para tratamento com NaVl durante o mesmo per?odo, precedidos por 12 sess?es sem NaV. Ap?s per?odo de wash-out, ocorreu o cross-over entre os grupos. Analisaram-se: ocorr?ncia de eventos adversos, ganho de peso interdi?lise e press?o arterial (PA), antes e ap?s o procedimento. Resultados: a m?dia de idade foi de 61,2?15,2 anos e 11(50%) eram do sexo masculino. A ocorr?ncia de eventos adversos foi significativamente diferente entre os per?odos sem a utiliza??o de NaV (48,5%) e com a utiliza??o de NaVs e NaVl, (33,7% e 36%, respectivamente; p<0,001). N?o houve diferen?a significativa de PA entre qualquer das modalidades de tratamento usadas; o mesmo ocorreu com o ganho de peso interdial?tico. Conclus?es: a utiliza??o de NaV reduz a ocorr?ncia de eventos adversos em HD. H? menos hipotens?o sintom?tica com NaVs e tend?ncia para redu??o de c?imbras com o uso de NaVl.. NaV pode ser ben?fico para alguns pacientes e sua prescri??o deve ser individualizada.