nÃo hà / ABSTRACT Background - Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal abnormalities among patients with SCD. Methods - This is a cohort study with 26 SCD patients followed in a medical center in Fortaleza, CearÃ, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2), and after a 12h period of water and food deprivation. Fractional excretion of sodium (FENa), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH2O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Aquaporin-2 (AQP2) and renal outer medullary K+ channels (ROMK) were quantified through exosomes search in urine. Results - Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 5 SCD patients (19.2%), who presented urinary pH > 5.5 after CaCl2 test. Urinary osmolality was significantly lower in SCD patients (355Â60 vs. 818Â202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FENa was higher among SCD patients (0.75Â0.3 vs. 0.55Â0.2%, p=0.02). The TTKG was higher in SCD patients (5.5Â2.5 vs. 3.0Â1.5, p=0.001), and TcH2O was lower (0.22Â0.3 vs. 1.1Â0.3L/day, p=0.0001). The search for AQP2 did not show significant difference between SCD patients and control group (102Â6.0 vs. 100Â7.2%, p=0.874), as well as for ROMK (172Â38 vs. 100Â25%, p=0.207). Conclusions - SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water transport, evidencing the occurrence of distal tubular dysfunction. / RESUMO IntroduÃÃo - AlteraÃÃes renais representam uma das complicaÃÃes crÃnicas principais da doenÃa falciforme (DF). O objetivo deste estudo à investigar a ocorrÃncia de alteraÃÃes renais em pacientes com DF. MÃtodos - Foi realizado estudo de coorte com 26 pacientes com DF acompanhados em um ambulatÃrio de Fortaleza, CearÃ, Brasil. Testes de acidificaÃÃo e concentraÃÃo urinÃrias foram realizados usando cloreto de cÃlcio (CaCl2) e apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica. Foram calculados fraÃÃo de excreÃÃo de sÃdio (FENa), transporte transtubular de potÃssio (TTKG) e transporte de Ãgua livre de solutos (TcH2O). O grupo de pacientes com DF foi comparado com um grupo de 15 voluntÃrios sadios (grupo controle). Os transportadores aquaporina-2 (AQP2) e canal de K+ apical (ROMK) foram quantificados pela pesquisa de exossomas na urina. Resultados - A mÃdia de idade e a distribuiÃÃo de gÃnero foi similar entre os dois grupos. DÃficit de acidificaÃÃo urinÃria foi encontrada em 5 pacientes com DF (19,2%), que apresentaram pH urinÃrio > 5,5 apÃs o teste com CaCl2. A osmolaridade urinÃria foi significativamente menor entre os pacientes com DF (355Â60 vs. 818Â202mOsm/kg, p=0,0001, apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica). DÃficit de concentraÃÃo urinÃria foi encontrado em todos os casos de DF (100%). A FENa foi maior entre os pacientes com DF (0,75Â0,3 vs. 0,55Â0,2%, p=0,02). O TTKG tambÃm foi maior nos pacientes com DF (5,5Â2,5 vs. 3,0Â1,5, p=0,001), e o TcH2O foi menor (0,22Â0,3 vs. 1,1Â0,3L/dia, p=0,0001). A pesquisa de AQP2 nÃo mostrou diferenÃa significativa em relaÃÃo ao grupo controle (102Â6,0 vs. 100Â7,2%, p=0,874), bem como a do canal ROMK (172Â38 vs. 100Â25%, p=0,207). ConclusÃo - A DF à associada a importantes alteraÃÃes renais. As principais alteraÃÃes encontradas foram dÃficit de concentraÃÃo e acidificaÃÃo urinÃria. Foi ainda observado aumento no transporte

nÃo hà / IntroduÃÃo: A estenose da artÃria do enxerto renal (EAER), complicaÃÃo vascular mais comum pÃs-transplante (Tx) renal, pode levar à hipertensÃo resistente, piora da funÃÃo renal e atà perda do enxerto. Objetivos: Investigar a prevalÃncia e fatores associados à EAER. MÃtodos: Estudo caso-controle retrospectivo, em populaÃÃo de receptores de Tx realizados de janeiro de 2008 a marÃo de 2014, em um centro de referÃncia em Tx renal no nordeste do Brasil. Foram avaliados como fatores associados à EAER caracterÃsticas demogrÃficas e clÃnicas do receptor e doador, dados relacionados a cirurgia, dados laboratoriais e nÃmero de anti-hipertensivos. A anÃlise estatÃstica foi realizada atravÃs do programa SPSS 17.0, valores descritivos abaixo de 5% (p < 0,05) foram considerados estatisticamente significativos. Resultados: Foram avaliados 494 de 529 receptores, sendo 24 pacientes com EAER, prevalÃncia de 4,8%. MÃdia do tempo do diagnÃstico 89,9 dias pÃs-Tx. Fatores associados a EAER foram nÃmero de anti-hipertensivos &#8805; 2 e enxerto com duas ou mais artÃrias (p < 0,05). Houve reduÃÃo significativa na mÃdia da PAS (147,1  23,7 para 127,8  15,2mmHg, p=0,001) e da PAD (86,6  13,0 para 77,6  9,4mmHg, p=0,001) apÃs a correÃÃo da EAER, bem como na creatinina sÃrica (de 2,8  2,4 para 1,9  1,8mg/dL, p=0,04). ConclusÃo: A prevalÃncia de EAER mantem o padrÃo descrito na literatura e enxertos com duas ou mais artÃrias estÃo associados com EAER, bem como pacientes que utilizam maior nÃmero de anti-hipertensivos. A correÃÃo da EAER associou-se à melhora do controle pressÃrico e da funÃÃo renal. / Introduction: The transplant renal artery stenosis (TRAS) is the most common vascular complication post-kidney transplant (Tx) that can lead to resistant hypertension, impaired renal function and even loss of the graft. Objectives: To investigate the prevalence and factors associated with TRAS. Methods: A retrospective case-control study was carried out in a population of Tx recipients from January 2008 to March 2014 in a renal Tx reference center in northeastern Brazil. Demographic and clinical characteristics of the recipient and donor, data related to the surgery, laboratory data and number of antihypertensive drugs were assessed as factors associated with TRAS. Statistical analysis was performed using SPSS 17.0. Results: A total of 494 of 529 recipients were assessed, of which 24 had TRAS. The prevalence of TRAS was 4.8% (24 patients), of which 23 had a deceased donor. Twelve patients (50%) were males, mean age of 46.7  13.5 years (range 17-78 years). Mean time of diagnosis was 89.9 days post-Tx. The risk factors associated with TRAS were number of antihypertensive drugs &#8805; 2 (OR: 17.0; CI: 4.1 to 70.4, p = 0.001) and grafting with two or more arteries (OR 8.9, CI: 1.4 -56.6, p = 0.021). There was a significant reduction in mean SBP (147.1  23.7 to 127.8  15.2 mmHg, p = 0.001) and DBP (86.6  13.0 to 77.6  9.4 mmHg, p = 0.001) after TRAS repair, as well as in serum creatinine (2.8  2.4 to 1.9  1.8 mg / dL, p = 0.04). Conclusion: The prevalence of TRAS maintained the pattern described in the literature and grafts with two or more arteries are associated with TRAS, as well as patients that use a higher number of antihypertensive drugs. TRAS repair was associated with improved blood pressure control and renal function.

Orientador: Maria Almerinda Vieira Fernandes Ribeiro Alves / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-07-27T10:23:52Z (GMT). No. of bitstreams: 1 Beltrame_LuizPaulo_M.pdf: 5682775 bytes, checksum: 7814fb084f0c86a65c60b28361d06fc4 (MD5) Previous issue date: 2000 / Resumo: Avaliamos a microalbuminúria e a alfa-l microglobulina urinária em 104 doadores de sangue, descobertos serem portadores de hepatite C, na triagem sorológica a que foram submetidos no ato da doação. A microalbuminúria foi usada como marcador precoce de lesão glomerular renal, e a alfa-l microglobulina foi usada como marcado r de lesão tubular renal. Todos os indivíduos eram assintomáticos, apresentavam provas de funções hepática e renal normais, sedimento urinário normal, e ausência de macroproteinúria. Enquanto praticamente todos os indivíduos ( 98,1% ) apresentaram resultados nonnatS para a alfa-l microglobulina, encontramos microalbuminúria em 12 dos 104 doadores ( 11,5% ). Observamos associação (p < 0,01) entre a presença de microalbuminúria e o achado de crioglobulinas e fatores reumatóides no soro, detectados respectivamente em 26,4% e 17,5% dos pacientes do grupo estudado. A presença de fator reumatóide e crioglobulinas estiveram, por sua vez, associadas entre si, e com os níveis elevados de gama-glutamil-transferase e de gamaglobulinas séricas (p < 0,01); com níveis elevados de anticorpos contra o vírus da hepatite C, (relação DO/C maior ou igual a 3), e com a etnia (raça negra) (p < 0,05). Não observamos nos 104 doadores soro-positivos para hepatite C associação entre a presença de crioglobulinas e fatores reumatóides circulantes com elevação da alanina-amino-transferase, ou decréscimo das frações C3 e C4 do complemento sérico. Concluímos que em indivíduos portadores de hepatite C, mesmo com funções hepática e renal normais, a presença de microalbuminúria deveria ser avaliada quando houver crioglobulinas e/ou fatores reumatóides circulantes / Abstract: One hundred and four individuals found to be serurn-positive for hepatitis C during blood donation, were evaluated for microalbuminuria (for evaluation of glomerular proteinuria) and urinary alpha-1micro- globulin excretion (for evaluation of tubular proteinuria). All were asymptomatic and presented normal renal and hepatic function, normal urine sedimentation and absence of macroproteinuria. While practica1ly a1l (98.1 %) presented normallevels of alpha-1 microglobulin, we found microalbuminuria in 12 out of 104 patients (11.5%). We observed correlation between microalbuminuria and the presence of cryoglobulinemia and circulating rheumatoid factor (p<0.01). The presence of cryoglobulinemia and rheumatoid factor in these individuals were related.to elevated levels ofhepatitis C vírus antibodies (p<0.05), ethnic background (non-white) (p<0.05), elevated levels of gamma-globulin (p<0.01) and of gamma-glutamyl transferase (p<0.01). We found no relation between the presence of microalbuminuria and serurn levels of alanineaminotransferase, either with decreased in C3 and C4 fractions of the serurn complemento Therefore we concluded thàt even in asymptomatic iIÍdividuals with normal renal and hepatic functions, the presence of microalbuminuria should be evaluated when rheumatoid factor and/or cryoglobulinemia are present in serum, with the purpose of identify initial renal disease / Mestrado / Clinica Medica / Mestre em Clinica Medica

Orientador: Vera Maria Santoro Belangero / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-02T13:40:11Z (GMT). No. of bitstreams: 1 Prates_LilianeCury_M.pdf: 18017213 bytes, checksum: 39eb4c1143cd7ba63a0d4d601b7de1c1 (MD5) Previous issue date: 2001 / Resumo: Síndrome nefrótica (SN) é caracterizada por um conjunto de manifestações clínico-laboratoriais incluindo edema, proteinúria intensa, hipoproteinemia, hiperlipidemia e lipidúria. As anormalidades metabólicas que acompanham a SN são responsáveis por muito da morbidade e mortalidade desta condição. Considerando-se as dificuldades em estudos clínicos, vários modelos de SN experimental têm sido desenvolvidos, a maioria utilizando a Puromicina e a Adriamicina. A finalidade do presente estudo foi obter um modelo de SN de instalação aguda, utilizando-se infusão única endovenosa de Puromicina em ratos com unine&ectomia. Foram utilizados 64 ratos machos, Wistar, com 6 a 8 semanas de idade, peso médio de 230,8 gramas, divididos em 4 grupos: ... Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital / Abstract: Nephrotic syndrome is characterized by edema, increased proteinuria, hypoproteinemia, hyperlipidemia and lipidic factors. Metabolic changes following Nephrotic Syndrome (NS) cause a great ratio of deaths in this condition. Several models of experimental NS have been developed to clear many aspects that are difficult to understand inclinical studies. Among the ways to develop NS in laboratory animaIs, Puromycin and Adriamycin are the most used drugs. This present study shows a NS model using an unique perfusion of Puromycin intravenously in rats with unilateral nephrectomy. 64 male Wistar rats, 6 to 8 weeks old, with median weight of 220 grams were studied. They were divided into 4 groups: ... Note: The complete abstract is available with the full electronic digital thesis or dissertations / Mestrado / Pediatria / Mestre em Saude da Criança e do Adolescente

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Orientador : Edgard Ferro Collares / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-07-14T03:41:09Z (GMT). No. of bitstreams: 1 Belangero_VeraMariaSantoro_M.pdf: 1241447 bytes, checksum: 86e6d9c27d7dd96207fe3c26daaafd46 (MD5) Previous issue date: 1989 / Resumo: o papel do SRAA na formaçio do edema na Síndrome Nefrótica descompensada foi analisada atraves do emprego do captopril. Foram estudados 8 episódios de descompensaçao, em crIanças de 4 a 11 anos de idade, que estavam em franco desenvolvimento do edema, com dieta sem restrição de sódio ou água e sem diureticos ou corticoterapia, por pelo menos uma semana previa ao inicio do estudo. Nestes episódios foram analisados, entre outros parâmetros, a excreçio urinária de sódio em urina de 24 horas, o incremento diário de peso e o volume plasmático...Observação: O resumo, na integra, podera ser visualizado no texto completo da tese digital. / Abstract: The role of the Renin Angiotensin System (RAS) in the development of oedema in descompensated nephrotic syndrome was studied through the use of captopril. Eight episodes of descompensation were studied in children aged 4 te 12, who were develeping oedema, were on an unrestricted diet, and were taking no diuretics or cort:icoesteroids for at least a week before admission...Note: The complete abstract is available with the full electronic digital thesis or dissertations / Mestrado / Mestre em Medicina

Orientador: Nelson Rodrigues Netto Jr / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-15T11:01:46Z (GMT). No. of bitstreams: 1 Castilho_LisiasNogueira_M.pdf: 738620 bytes, checksum: 6220d91e82f2efbe770073c15a82c3b9 (MD5) Previous issue date: 1988 / Resumo: Descrevemos uma sistematização simplificada da técnica de nefrolitotomia anatrófica no tratamento de 9 pacientes potadores de 12 unidades renais com calculo coraliforme, com idade média de 40 anos e proporção mulher/homem de 3,5:1. As principais modificações introduzidas em relação à técnica original de Smith e Royce (1968) são: 1- A não utilização de injeção vascular de corantes para definir os limites entre os lobos anterior e posterior do rim. 2- Clampeamentode todo o pediculo renal. 3- Abertura de todos os infundíbulos caliciais, estenóticos ou não. 4- A não realização de calicoplastias e calicorrafias na tentativa de melhorar a drenagem intra-renal. 5- Revisão da hemostasia após o desclampeamento vascular com parenquima ainda aberto. 6- A não utilização de derivação urinária. O tempo médio de seguimento foi de 16 meses e os resultados obtidos quanto a tempo de cirurgia (média de 204min.), tempo de isquemia ( média de 61 min.), transfusão de sangue (2 unidades em 9 pacientes), complicações (22%), litíase residual (11 %), litiase recorrente (zero), mortalidade (zero) e internação pós-operatória (média de 7 dias) são semelhantes aos de outros autores que empregam a técnica original. / Abstract: We describe a simplified sistematization of the anatrophic neprolithotomy technique in the treatment of 9 patients with 12 renal units with staghorn calculus, with an average age of 40 years and woman/man ratio of 3,5:1. The main changes introduced in relation to the original Smith and Boyce technique (1968) are: 1- Non-utilization of vascular injection of dyes in order to determine the limits between anterior and posterior renal segments. 2- Clamping of the whole renal pedicle. 3- Opening of all the calyceal infundibulum, stenotic or not. 4- Non-realization of calycoplasties or calyorrhaphies as an attempt to improve the intra-renal drainage. 5- Review of hemostasis after the release of the vascular clamp, prior to renal closure. 6- Non-utilization of urinary derivation. The average time of follow-up was 16 months and the final results referring to the time of surgery (average 204 min.), ischemic period (average 61 min.), blood transfusion (2 units for 9 patients), complications (22%), residual lithiasis (11%), recurrent lithiasis (zero), mortality (zero) and post-operatory stay (average 7 days) are similar to the results of other authors who practice the original technique. / Mestrado / Mestre em Medicina

The immunosuppressive therapy still remains the only therapeutic strategy to control excessive immune activation following renal transplantation, but remain the problems related to excessive immunosuppression and in particular the toxicity due to high doses of immunosuppressive drugs such as calcineurin inhibitors. The present study has the aim of documenting, in a porcine animal model, the histological damage from calcineurin inhibitors using incremental doses of Tacrolimus, achieved in a limited amount of time, until it reaches toxic blood concentrations. We perform the study under different condition, like oral administration, intravenous infusion and with or without kidney transplant. It is noted that the damage is early, predominantly vascular and that affects different organs in addition to the kidneys. We also observe that the functional damage underestimates the structural damage. The search for non-invasive methods for the identification of biomarkers of nephrotoxicity and rejection, and to better characterize the inflammation status, led us to conduct analysis of the exosomal content, allowing us to observe the presence of serum cytokines which, although in low amounts, suggest a possible role of these in the inflammatory process mediated by exosomal vesicles. Finally, following the genetic SLA typing for the determination of the donors and the recipients, in an accessory project, we got a controlled and stable colony of pigs with SLA defined in homozygosis through the coupling of specific pathogen free pigs (SPF) for DQB-1 and SLA-1 genes.

L’insufficienza renale acuta(AKI) grave che richiede terapia sostitutiva, è una complicanza frequente nelle unità di terapia intensiva(UTI) e rappresenta un fattore di rischio indipendente di mortalità. Scopo dello studio é stato valutare prospetticamente, in pazienti “critici” sottoposti a terapie sostitutive renali continue(CRRT) per IRA post cardiochirurgia, la prevalenza ed il significato prognostico del recupero della funzione renale(RFR). Pazienti e Metodi:Pazienti(pz) con AKI dopo intervento di cardiochirurgia elettivo o in emergenza con disfunzione di due o più organi trattati con CRRT. Risultati:Dal 1996 al 2011, 266 pz (M 195,F 71, età 65.5±11.3aa) sono stati trattati con CRRT. Tipo di intervento: CABG(27.6%), dissecazione aortica(33%), sostituzione valvolare(21.1%), CABG+sostituzione valvolare(12.6%), altro(5.7%). Parametri all’inizio del trattamento: BUN 86.1±39.4, creatininemia(Cr) 3.96±1.86mg/dL, PAM 72.4±13.6mmHg, APACHE II score 30.7±6.1, SOFAscore 13.7±3. RIFLE: Risk (11%), Injury (31.4%), Failure (57.6%). AKI oligurica (72.2%), ventilazione meccanica (93.2%), inotropi (84.5%). La sopravvivenza a 30 gg ed alla dimissione è stata del 54.2% e del 37.1%. La sopravvivenza per stratificazione APACHE II: <24=85.1 e 66%, 25-29=63.5 e 48.1%, 30-34=51.8 e 31.8%, >34=31.6 e 17.7%. RFR ha consentito l’interruzione della CRRT nel 87.8% (86/98) dei survivors (Cr 1.4±0.6mg/dL) e nel 14.5% (24/166) dei nonsurvivors (Cr 2.2±0.9mg/dL) con un recupero totale del 41.4%. RFR è stato osservato nel 59.5% (44/74) dei pz non oligurici e nel 34.4% dei pz oligurici (66/192). La distribuzione dei pz sulla base dei tempi di RFR è stata:<8=38.2%, 8-14=20.9%, 15-21=11.8%, 22-28=10.9%, >28=18.2%. All’analisi multivariata, l’oliguria, l’età e il CV-SOFA a 7gg dall’inizio della CRRT si sono dimostrati fattori prognostici sfavorevoli su RFR(>21gg). RFR si associa ad una sopravvivenza elevata(78.2%). Conclusioni:RFR significativamente piu frequente nei pz non oligurici si associa ad una sopravvivenza alla dimissione piu elevata. La distribuzione dei pz in rapporto ad APACHE II e SOFAscore dimostra che la sopravvivenza e RFR sono strettamente legati alla gravità della patologia. / Severe AKI requiring RRT frequently occurs in ICU and represents an independent risk factor for mortality. The aim was to prospectively evaluate, in critically ill undergoing CRRT for AKI following heart surgery, prevalence and prognostic significance of renal function recovery (RFR). Patients and Methods: Patients (pts) with AKI following elective or emergent cardiac surgery with dysfunction of 2 or more organs treated with CRRT. Results: From 1996 to 2011, 266 pts (M 195, F 71, age 65.5±11.3) underwent CRRT. Type of surgery: CABG (27.6%), aortic dissection (33%), valvular surgery (21.1%), CABG+valvular surgery (12.6%), others (5.7%). CRRT starting parameters: BUN 86.1±39.4, creatinine (Cr) 3.96±1.86 mg/dL, MAP 72.4±13.6 mmHg, APACHE II 30.7±6.1, SOFA 13.7±3. RIFLE staging: Risk (11%), Injury (31.4%), Failure (57.6%). Oliguric AKI (72.2%), ventilation (93.2%), inotropics (84.5%). At 30 days and at hospital discharge, total survival was 54.2% and 37.1% (APACHE II score clusters survival: <24= 85.1 and 66%, 25-29= 63.5 and 48.1%, 30-34= 51.8 and 31.8%, >34= 31.6 and 17.7%). RFR allowed to stop CRRT in 87.8% (86/98) of survivors (Cr 1.4±0.6 mg/dL) and in 14.5% (24/166) of nonsurvivors (Cr 2.2±0.9mg/dL) with an overall recovery of 41.4%. RFR has been observed in 59.5% (44/74) of non oliguric pts and in 34.4% of oliguric pts (66/192). Distribution of pts according to the timing of RFR (days from CRRT start): <8 (38.2%), 8-14 (20.9%), 15-21 (11.8%), 22-28 (10.9%), >28 (18.2%). Logistic regression selected occurrence of oliguria, age, CV-SOFA at 7 days from CRRT start as a prognostic factors for delayed RFR (> 21 days).RFR was associated with a high survival rate (78.2%). Conclusions: RFR, more frequently observed in pts with nonoliguric AKI, was mostly associated with a favourable outcome. Patient distribution according to APACHE II and SOFA score revealed that survival and RFR are strictly related to the severity of illness.

Circulating Fibrocytes (CFs) are bone marrow-derived mesenchymal progenitor cells that express a similar pattern of surface markers related to leukocytes, hematopoietic progenitor cells and fibroblasts. CFs precursor display an ability to differentiate into fibroblasts and Myofibroblasts, as well as adipocytes. Fibrocytes have been shown to contribute to tissue fibrosis in the end-stage renal disease (ESRD), as well as in other fibrotic diseases, leading to fibrogenic process in other organs including lung, cardiac, gut and liver. This evidence has been confirmed by several experimental proofs in mice models of kidney injury. In the present study, we developed a protocol for the study of CFs, by using peripheral blood monocytes cells (PBMCs) samples collected from healthy human volunteers. Thanks to a flow cytometry method, in vitro culture assays and the gene expression assays, we are able to study and characterize this CFs population. Moreover, results confirmed that these approaches are reliable and reproducible for the investigation of the circulating fibrocytes population in whole blood samples. Our final aim is to confirm the presence of a correlation between the renal fibrosis progression, and the different circulating fibrocyte levels in Chronic Kidney Disease (CKD) patients. Thanks to a protocol study presented and accepted by the Ethic Committee we are continuing the study of CFs induction in a cohort of sixty patients affected by CKD, divided in three distinct groups for different glomerular filtration rate (GFR) levels, plus a control group of thirty healthy subjects. Ongoing experiments will determine whether circulating fibrocytes represent novel biomarkers for the study of CKD progression, in the early and late phases of this disease.