Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2016-09-09T13:24:18Z No. of bitstreams: 2 Dissertação - Ramon Ramos Filho - 2002.pdf: 1651595 bytes, checksum: da2b2e148f79fbda613d8593834b9e91 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-09T15:25:27Z (GMT) No. of bitstreams: 2 Dissertação - Ramon Ramos Filho - 2002.pdf: 1651595 bytes, checksum: da2b2e148f79fbda613d8593834b9e91 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-09-09T15:25:27Z (GMT). No. of bitstreams: 2 Dissertação - Ramon Ramos Filho - 2002.pdf: 1651595 bytes, checksum: da2b2e148f79fbda613d8593834b9e91 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2002-08-29 / Patients with renal failure are at high risk of acquiring viral hepatitis thought blood transfusion, kidney transplant and nosocomial transmission. High prevalence of hepatitis C (HCV) and G (HGV) have been observed among these patients. To assess the prevalence of infection by these viruses in a dialysis unit, 123 patients in Goiânia- Goias were interviewed and blood colleted. They were tested for the presence of antibodies to HCV (anti-HCV) and RNA-HCV, and to detect RNA-HGV. RNA viral positive samples were genotyped. An overall prevalence of 37.4% and 14.6% for hepatitis C and G viruses were found respectively. Patients in hemodyalisis (41.8% and 15.3%) and renal transplanted subjects (33.3% and 16.7%), had higher rates of positivity for the virus C and G when compared to patients in peritoneal dialysis (7.7%). Genotype 1 (54.8%) and 3 (45.2%) of HCV were the most frequently found, and the subtypes 1a and 3a were prevalent. Regarding HGV genotypes 1 (17%), 2 (72%) and 3 (11%) were found, with predominance of subtype 2b. A co-infection by C and G viruses of 3.2% was observed. History of blood transfusions, the duration of end-stage renal disease and co-infection with hepatitis B were risk factors associated with infection by virus C. The patients infected with HGV reported blood transfusion, treatment with a non graduated dentist and sexually transmitted disease as risk factors, beside most of them had been in hemodyalisis. Our data showed a high prevalence for HCV infection in this population, in spite of the screening for blood products and the adoption of universal precautions in dialysis units, and also a high prevalence of HGV in this population was observed. / Os pacientes portadores de insuficiência renal crônica em terapia renal substitutiva apresentam um risco elevado de adquirirem as hepatites virais através de transfusão sangüínea, transplante de órgãos ou ainda pela transmissão horizontal em unidades de hemodiálise. Prevalências altas para as infecções pelos vírus das hepatites C (HCV) e G (HGV) têm sido observadas nos pacientes renais crônicos. Para determinar a prevalência destas infecções em um serviço de terapia renal substitutiva em Goiânia-GO, 123 pacientes foram entrevistados e amostras sangüíneas coletadas, sendo testadas para detecção de anticorpos para o HCV (anti-HCV) e do RNA-HCV. Com relação ao vírus da hepatite G, foi realizada a pesquisa do RNA-HGV. As amostras que apresentaram o RNA viral foram genotipadas. Prevalências globais de 37,4% e 14,6% para as infecções pelos vírus das hepatites C e G foram encontradas, respectivamente. Os pacientes que realizaram hemodiálise (41,8% e 15,3%) e os transplantados renais (33,3% e 16,7%) apresentaram maiores taxas de soropositividade para os vírus C e G em relação às encontradas em pacientes em diálise peritoneal (7,7%). Os genótipos 1 (54,8%) e 3 (45,2%) do HCV foram os mais freqüentemente encontrados, sendo os subtipos 1a e 3a os mais prevalentes. Em relação ao HGV, os genótipos 1 (17%), 2 (72%) e 3 (11%) foram identificados, havendo dominância do subtipo 2b. Uma taxa de 3,2% foi verificada para co-infecção pelos vírus das hepatites C e G. Tempo de tratamento e sorologia positiva para a hepatite B mostraram-se como fatores de risco para a infecção pelo vírus C. Os pacientes soropositivos para o RNA-HGV relataram transfusão sangüínea prévia, historia de tratamento odontológico com dentista prático e de doença sexualmente transmissível, além da maioria ter realizado hemodiálise. Os resultados do presente estudo mostraram que ainda é alta a prevalência para o HCV nesta população, apesar da triagem dos derivados sangüíneos e do aumento do controle de infecção nos ambientes de terapia dialitica, bem como é elevada a prevalência do HGV neste grupo.

A nefropatia induzida por adriamicina (ADR) em ratos é um dos modelos experimentais mais utilizados para o estudo desenvolvimento da doença renal progressiva. Uma dose única deste quimioterápico induz a proteinúria progressiva e irreversível que progride para glomeruloesclerose segmental e focal, com fusão dos processos podais e lesões tubulointersticiais. A lesão das células endoteliais glomerulares precede as alterações dos podócitos na nefropatia induzida pela ADR. A atividade física regular melhora as funções cardíacas e renais em pacientes e animais com doença renal progressiva e pode reduzir ou retardar a progressão da lesão renal. Este estudo avaliou o efeito do treinamento físico prévio na evolução da lesão renal induzida por ADR e a sua relação com o processo inflamatório, a função endotelial e angiogênese. Ratos Wistar submetidos ou não ao treinamento físico receberam ADR (2,5 mg/kg, e.v) ou solução salina fisiológica (SAL). Amostras de sangue e urina foram coletadas 60 dias após as injeções para avaliação da função renal e os rins removidos para estudos histológicos, imuno-histoquímicos, Western blot e de ELISA. Amostras de urina de 24 h, obtidas 7, 30 e 60 dias após a administração de ADR ou SAL, foram utilizadas para avaliação da albuminúria. Os ratos tratados com ADR apresentaram albuminúria progressiva, elevação dos níveis plasmáticos de creatinina e queda da taxa de filtração glomerular (TFG), lesão de podócitos, expansão da área mesangial, alargamento da área intersticial relativa no córtex renal, infiltração de macrófagos, aumento dos níveis de interleucina (IL)-1?, elevação dos níveis urinários do fator de transformação do crescimento ? (TGF-?) e dos níveis urinários de proteína quimiotática de monócitos 1 (MCP-1), diminuição de marcação de aminopeptidase P (marcador de células endoteliais) nos glomérulos e perda de capilares peritubulares corticais, que estavam associados com reduções das expressões do fator de crescimento endotelial vascular (VEGF) e da óxido nítrico sintase endotelial (eNOS) no córtex renal desses animais. Estas alterações foram menos intensas nos ratos que realizaram treinamento físico prévio ao tratamento com ADR. Em conclusão, o pré-condicionamento físico reduziu as lesões renais induzidas pela ADR. Este efeito esteve associado com as reduções do processo inflamatório, das lesões endoteliais e das alterações de fatores relacionados com o processo de angiogênese (VEGF e eNOS) no córtex renal. / Adriamycin (ADR)-induced nephropathy is one of the most experimental models of progressive kidney disease in rats. A single dose of this drug induces progressive and irreversible proteinuria that progresses to focal segmental glomerulosclerosis and tubulointerstitial lesions. The lesion of glomerular endothelial cells precedes the podocyte damage in nephropathy induced by ADR. Regular physical activity improves cardiac and renal functions in patients and animals with progressive renal disease and may reduce or delay the progress of impaired renal function. This study evaluated the effect of previous physical training in renal damage induced by ADR and the role of inflammation, endothelial lesions and angiogenesis in this process. Male Wistar rats submitted or not to previous physical training received ADR (2.5 mg/kg, i.v.) or physiological saline (SAL). Urine and plasma samples were collect 60 days after the injection in order to evaluated the renal function. The kidneys were removed for histological, immunohistochemical, Western blot and ELISA analysis. Twenty-four-hour urine samples were collected to dose albuminuria 7, 30 and 60 days after ADR or SAL injection. ADR-treated rats presented progressive albuminuria, increases in plasma creatinine levels, decreasing glomerular filtration rate (GFR), podocyte damage, mesangial expansion, enlargement of the tubular interstitial relative area of renal cortex, macrophage infiltration, higher interleukin (IL)- 1? levels in renal tissue, urinary transforming growth factor ? (TGF-?) and urinary monocyte chemoattractant protein (MCP)-1, reduction of aminopeptidase P (endothelial cell marker) in the glomeruli and cortical peritubular capillary number. Those were associated with reduction in vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) expressions in renal cortex. Those alterations were less intense in the animals undergone previous exercise training. In conclusion, physical training prior to ADR injection reduced the renal damage induced by this drug. This effect was related with the reduction of the inflammatory process, endothelial lesions and with the decrease in alterations of factors related to the process of angiogenesis (VEGF and eNOS) in renal cortex.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-02-03T11:32:27Z No. of bitstreams: 1 fabianerossidossantos.pdf: 1207169 bytes, checksum: 239998bfa9068a9b4676999c0ad12433 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-03T12:06:14Z (GMT) No. of bitstreams: 1 fabianerossidossantos.pdf: 1207169 bytes, checksum: 239998bfa9068a9b4676999c0ad12433 (MD5) / Made available in DSpace on 2017-02-03T12:06:14Z (GMT). No. of bitstreams: 1 fabianerossidossantos.pdf: 1207169 bytes, checksum: 239998bfa9068a9b4676999c0ad12433 (MD5) Previous issue date: 2007-09-13 / O impacto do diagnóstico da Doença Renal Crônica pode trazer perdas que vão além da função renal. A evolução da doença pode trazer significativas mudanças na qualidade de vida de pacientes renais crônicos, envolvendo alterações corporais, sociais e psíquicas. Grande parte dos programas de atendimento a pacientes com Doença Renal Crônica são focados em pacientes já em terapia renal substitutiva. Porém, o acompanhamento precoce destes pacientes, ainda em tratamento conservador, pode proporcionar aos profissionais de saúde intervenções que busquem retardar a entrada destes em diálise, bem como reforçar uma maior adesão ao tratamento. A abordagem de pacientes em tratamento conservador através de equipes interdisciplinares torna-se fundamental, uma vez que se destina a uma abordagem global desta população, e pode ter como conseqüência uma melhora da qualidade de vida destes pacientes. O presente estudo avaliou os efeitos da abordagem interdisciplinar na qualidade de vida de pacientes com Doença Renal Crônica em tratamento conservador. Através da avaliação da qualidade de vida pelo instrumento SF-36 e de parâmetros bioquímicos, foi realizada comparação entre um grupo de pacientes acompanhados por equipe interdisciplinar e um grupo que recebeu apenas acompanhamento médico tradicional, observando-se o impacto do acompanhamento interdisciplinar nas possíveis melhoras de aspectos físicos, sociais e emocionais. Pacientes acompanhados por equipe interdisciplinar apresentaram melhora da qualidade de vida nos domínios capacidade funcional, aspectos físicos, estado geral de saúde, vitalidade e aspectos emocionais. O grupo que recebeu acompanhamento médico tradicional não apresentou melhora da qualidade de vida em nenhum dos parâmetros. Pacientes acompanhados por equipe interdisciplinar também apresentaram mudança estatisticamente significante da anemia, cálcio e redução de peso, o que não foi observado no grupo controle. / The impact of chronic renal disease may involve losses well beyond renal function. Body, social, and psychic changes, brought about by disease evolution, may significantly impair the quality of life. A sizeable proportion of programs targeting chronic renal disease patients prioritize those on renal substitutive therapies. If these patients are followed at an earlier stage, while still on conservative treatment, health providers may implement interventions to delay dialytic therapy and enhance compliance. A global interdisciplinary approach to the care of patients on conservative treatment is fundamental, as it may lead to a better quality of life. This study assessed the effects on the quality of life of an interdisciplinary approach to the care of chronic renal disease patients on conservative treatment. Through SF-36assessed quality of life and determination of biochemical parameters, a group of patients followed by an interdisciplinary team was compared with a group receiving traditional medical care. The interdisciplinary approach was possibly accountable for the improvements in the physical, social, and emotional features. Patients followed by the interdisciplinary team had better quality of life as refers to functional capacity, physical features, general health, vitality, and emotional features. The group on traditional medical care did not present any improvement of the quality of life as refers to these parameters. Patients on interdisciplinary care also had statistically significant favorable changes in their anemia, calcium levels, and weight loss, findings not seen in the control group.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-09-20T11:23:05Z No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-10-01T19:27:18Z (GMT) No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) / Made available in DSpace on 2018-10-01T19:27:18Z (GMT). No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) Previous issue date: 2018-07-31 / Introdução: Metade dos pacientes com insuficiência cardíaca (IC) apresentam disfunção diastólica (DD) e fração de ejeção preservada do ventrículo esquerdo (FEpVE). A hipertrofia ventricular esquerda (HVE) é a anormalidade cardíaca em pacientes com doença renal crônica (DRC). O diagnóstico por imagem da DD é tradicionalmente realizado com a ecocardiografia transtorácica (ETT), sendo o volume do átrio esquerdo indexado (IVAE) um dos principais componentes no algoritmo da avaliação da DD. A metodologia do speckle tracking através do strain longitudinal global do ventrículo esquerdo (SLGVE) e o strain atrial esquerdo (SAE), possibilitam quantificar a contratilidade miocárdica e a avaliação instantânea da função do átrio esquerdo, respectivamente. Objetivo: Avaliar, em pacientes com DRC estágios 3B a 5 (em tratamento conservador) e FEpVE, o uso do SAE na identificação da disfunção diastólica indeterminada pelo IVAE. Métodos: Estudo de caso controle que avaliou pacientes com DRC estágios 3B a 5, em tratamento conservador, e que apresentavam fração de ejeção normal através da ecocardiografia transtorácico (ETT). Os pacientes foram divididos em dois grupos, com e sem HVE. A disfunção diastólica (DD), baseado em recomendações recentes da ASE, 2016, foi avaliada inicialmente pela ETT e, posteriormente, através do SAE (valor normal de referência >23%) pelo método speckle tracking. Adicionalmente, também se avaliou o strain longitudinal global do ventrículo esquerdo (SLGVE). O diagnóstico da DRC seguiu os critérios do KDIGO de 2012. Resultados: No total, foram avaliados 114 pacientes (57 em cada grupo), com idade média de 66,3±8,65, sendo 52,7% do sexo feminino, 94% hipertensos e 46% diabéticos. A média da taxa de filtração glomerular (em mL/min/1,73 m2) nos pacientes com e sem HVE foi de 32,6±11,9 e 40,4±13,9, respectivamente. A presença da DD no grupo com HVE (24,6%) foi maior do que no grupo sem HVE. Entre os 29 pacientes com HVE e DD indeterminada pelo IVAE, o SAE reduzido foi observado em 10 casos, aumentando o percentual de DD para 42%. No grupo sem HVE e DD indeterminada (18 casos), o SEA reduzido foi observado em quatro pacientes, aumentando para 21% o DD. A relação E/e´ no ânulo mitral lateral não apresentou alteração significativa entre os grupos (10,75±3,3; 10,14±3,8; p>0,05 Conclusão: Em pacientes com DRC não dialítica, o uso do SAE potencialmente aumenta a identificação de casos indeterminados de DD. / Introduction: Half of patients with heart failure (HF) have diastolic dysfunction (DD) and preserved left ventricular ejection fraction (LVEF). Left ventricular hypertrophy (LVH) is the cardiac abnormality in patients with chronic kidney disease (CKD). DD imaging has traditionally been performed with transthoracic echocardiography (TTE), with indexed left atrium volume (VTE) being one of the main components in the DD assessment algorithm. The methodology of speckle tracking through left ventricular global longitudinal strain (SLGVE) and left atrial strain (SAE), allows quantification of myocardial contractility and the instantaneous evaluation of left atrial function, respectively. Objective: To evaluate the use of SAE in the identification of undetermined diastolic dysfunction by VTE in patients with CKD stages 3B to 5 (in conservative treatment) and FEpVE. Methods: A control case study that evaluated patients with CKD stages 3B to 5, in conservative treatment, and who presented normal ejection fraction through transthoracic echocardiography (ETT). Patients were divided into two groups, with and without LVH. Diastolic dysfunction (DD), based on recent ASE recommendations, 2016, was initially evaluated by ETT and, later, by the SAE (reference normal value> 23%) by the speckle tracking method. In addition, the overall longitudinal strain of the left ventricle (SLGLE) was also evaluated. Results: A total of 114 patients (57 in each group) were evaluated, with a mean age of 66.3 ± 8.65, of which 52.7% were female, 94 % hypertensive and 46% diabetic. The mean glomerular filtration rate (in mL / min / 1.73 m2) in patients with and without LVH was 32.6 ± 11.9 and 40.4 ± 13.9, respectively. The presence of DD in the group with LVH (24.6%) was higher than in the group without LVH. Among the 29 patients with LVH and DD undetermined by IVAE, reduced SAE was observed in 10 cases, increasing the percentage of DD to 42%. In the group without undetermined LVH and DD (18 cases), the reduced SEA was observed in four patients, increasing the DD to 21%. Conclusion: In patients with non-dialytic CKD, the use of E / e 'in the lateral mitral annulus did not present significant alteration between the groups (10.75 ± 3.3; 10.14 ± 3.8; p> 0.05 of SAE potentially increases the identification of indeterminate cases of DD.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Acute and Chronic renal diseases have a high morbidity and mortality. There is a good deal of interest in MSC-based approaches for the treatment of Kidney injury, thanks to positive preclinical results and the strong clinical need for novel therapies to treat Acute Kidney Injury. Several routes of administration have been tested and have shown a better response when applied arterially. The main goal of this study was to describe and to compare the use of Fogarty thru-lumen embolectomy catheter with angiographic catheter by using conventional radiology as a guide. We used seven healthy dogs to measure the diameter of the aorta caudal to the renal arteries and right and left femoral and renal arteries. It was assessed the number of attempts for the placement of the introducer, number of radiographic studies to carry out nefrography with both cathethers. In five out of seven animals it was possible to place of the introducer tube 6F. Regarding the number of radiographic films used, the technique with the angiographic catheter needed more than the Fogarty when accessed both arteries, but there is no significant difference when compared to the Fogarty with access to only one renal artery. There was hematoma formation in three animals. The access of the renal artery for drug delivery and cell therapy is possible using both Fogarty thru-lumen embolectomy catheter and angiographic catheter by conventional radiology as a guide, however, we considered the Fogarty catheter easier to be applied, since only one procedure can be performed to access both renal arteries, thus making it less expensive and faster to run. If access to only one renal artery is require, the angiographic catheter would be recommended, since cell therapy would be administered more selectively in the target kidney. / A insuficiência renal aguda e crônica são doenças com altos índices de morbidade e mortalidade. O interesse na utilização de células tronco mesenquimais após um insulto renal tem sido crescente, devido ao indício de efeitos positivos em estudos pré-clínicos e a necessidade de novas terapias para tratar lesão renal aguda. Diversas vias de administração já foram testadas, sendo observado que a aplicação na artéria renal é a via de escolha pela sua melhora mais significativa na função renal. Diante disso o objetivo desse estudo foi descrever e comparar a utilização do cateter Fogarty de embolectomia duplo lúmen com o cateter angiográfico utilizando radiologia convencional. Utilizaram-se sete cães hígidos nos quais foram avaliados os diâmetros da aorta caudal às artérias renais e das artérias femorais e renais direita e esquerda. Quantificou-se o número de tentativas para colocação do introdutor e de estudos radiográficos para a realização de nefrografia com ambos cateteres. Em cinco dos sete animais foi possível a realização do acesso vascular pela artéria renal. Quanto ao número de estudos radiográficos, a técnica com o cateter angiográfico precisou de maior número do que o Fogarty quando se acessou ambas artérias, no entanto não houve diferença significativa quando comparou-se o Fogarty com o acesso de apenas uma artéria renal. Houve a formação de hematoma em três animais. O acesso da artéria renal para administração de fármacos e terapia celular é possível utilizando-se tanto o cateter Fogarty duplo lúmen quanto o Angiográfico por meio de radiologia convencional como guia, no entanto, considerou-se o cateter Fogarty o cateter de escolha, visto que em apenas um procedimento consegue-se realizar o acesso de ambas artérias renais, tornando-se dessa forma menos dispendioso e mais rápido de ser executado. Caso seja necessário o acesso de apenas uma artéria renal, sugere-se a utilização do cateter angiográfico, uma vez que a terapia celular seria administrada mais seletivamente no rim alvo.

End stage renal disease (ESRD) patients have an excess cardiovascular risk, above that predicted by traditional risk factor models. Despite the advances in both Cardiovascular disease (CVD) management and renal replacement therapy (RRT), there still is a major burden of cardiovascular mortality and morbidity in the chronic kidney disease (CKD) population. Declining renal function itself represents a continuum of cardiovascular risk and in those individuals who survive to reach ESRD, the risk of suffering a cardiac event is uncomfortably and unacceptably high. Pro-thrombotic status may contribute to this increased risk. Global thrombotic status assessment, including measurement of occlusion time (OT) the time taken to form an occlusive platelet rich thrombus and thrombolytic status (time taken to lyse such thrombus) as assessed by measuring Lysis Time (LT), may identify vulnerable patients. The aim of this study was to assess overall thrombotic status in ESRD and relate this to cardiovascular and peripheral thrombotic risk. Small sub studies were also planned to establish the effect of RRT modality on the thrombotic status.

Nous avons montré que malgré d'importantes améliorations survenues depuis 2001, la maladie rénale chronique reste fréquente et fortement sous-estimée chez les patients diabétiques de type 2, du fait du dosage insuffisant d'albuminurie. Nous avons également montré qu'au stade tardif, près d'un tiers des patients (30%), en particulier diabétiques de type 2 (32%), démarrent le traitement de suppléance en urgence, et que l'augmentation de l'incidence de l'insuffisance rénale chronique terminale en France, est exclusivement attribuée à la part liée au diabète type 2. Ces résultats suggèrent que davantage d'efforts de sensibilisation des patients diabétiques de type 2 et des médecins pour (i) améliorer le dépistage, (ii) renforcer le contrôle de la pression artérielle et la réduction de l'albuminurie pathologique, (iii) et une meilleure préparation des patients à la dialyse. Bien qu'il soit connu que les patients diabétiques de type 2, en particulier âgés, soient moins souvent inscrits sur la liste d'attente de greffe rénale par rapport aux patients non diabétiques, il apparaît in fine à l'issue de ce travail, qu'une fois inscrit, ce n'est pas le diabète en lui-même qui constitue un facteur de risque élevé de décès ou de retrait de liste et d'échecs post-greffe rénale, mais plutôt l'impact des comorbidités cardiovasculaires préexistantes et d'une longue durée de dialyse. Accélérer l'accès à la greffe rénale aux patients, non pas exclusivement diabétiques de type 2, mais plutôt atteints de comorbidités cardiovasculaires, en les priorisant, leur octroieraient un bénéfice certain de survie en terme de réduction du risque d'échecs en liste d'attente et post-greffe rénale. / We have shown that chronic kidney disease (CKD) is frequently seen in patients with type 2 diabetes and is likely to be underestimated because albuminuria screening remains inadequate, despite significant improvements since 2001. We also showed that at of end stage renal disease, almost a third of patients (30%), especially those with type 2 diabetes (32%), starting dialysis or kidney transplantation (KTx) on an emergency basis. The skyrocketing incidence of ESRD observed in France, especially in elderly patients, is exclusively due to an actual increase in that related to type 2 diabetes. These findings suggest that further efforts are needed to raise patients with type 2 and doctor awareness on the issue of (i) CKD screening, (ii) blood pressure and elevated albuminuria control and (iii) predialysis care. Although patients with type 2 diabetes, especially elderly, were less likely to be wait-listed for KTx than their counterparts without diabetes, ultimately, once registered, type 2 diabetes per se was not associated with death or delisting after adjustment for other factors, and death or kidney failure after KTx. Pre-existing cardiovascular comorbidities, regardless of their link to diabetes, and a long-term dialysis appear to be the major predictors of death or delisting. Improving access to KTx, not only to patients with type 2 diabetes, but also with cardiovascular comorbidities, by giving them some priorities, would enhance survival benefit by reducing the risk of failures on waiting list and after KTx.

Thesis title: Kinesiophobia in patients on renal dialysis therapy - questionnaire study. The aims of the thesis: To characterise the term kinesiophobia and to evaluate the dependence of the measure of fear of movement on sociodemographic and clinical variables with the use of the Tampa Scale for Kinesiophobia questionnaire (TSK-CZ) in a group of respondents on renal dialysis therapy and a group of healthy respondents. Methods: To determine the dependence of the measure of kinesiophobia on selected variables, the TSK-CZ questionnaire was used in Fresenius Medical Care dialysis centres across towns in the Czech Republic. The reference group of individuals with no renal disease - healthy respondents - was addressed by means of the Survio.cz website. The research comprised a group of respondents on renal dialysis therapy (n = 135) and a group of healthy respondents (n = 135). The collected data was processed using statistical methods - descriptive statistics and data analysis (t-test, Chi-squared test, ANOVA, Spearman's correlation coefficient). After that, the data was transferred to tables and charts and was evaluated. Results: On the basis of the TSK-CZ questionnaire, a significant difference in the measure of fear of movement was found between the respondents on renal dialysis and the healthy ones...

The objective of the study is to analyze the factors associated with the severity of pruritus in patients with terminal chronic kidney disease undergoing hemodialysis. The methodology used is based on a cross-sectional study in patients receiving hemodialysis at the Centro Nacional de Salud Renal. Severe pruritus was defined as a score on the visual analogue scale greater than or equal to 7, and the strength of association with the possible risk factors was assessed by calculating prevalence ratios. Regarding the results, 264 patients were included, 59.9% were male, with a mean time on hemodialysis of 10.26 ± 7.14 years. 75% experienced pruritus, of this group, 1 in 3 presented severe pruritus. Hyperphosphatemia and the use of antihistamines were associated with a higher prevalence of severe pruritus (RP 1.71, 95% CI 1.09-267 and RP 2.39, 95% CI 1.51-3.75, respectively). The positive serology for Hepatitis C Virus was described as a protective factor for presenting severe pruritus (RP 0.55, 95% CI 0.33 - 0.89). In conclusion, severe uremic pruritus is a frequent problem in patients with chronic terminal kidney disease who have hyperphosphatemia and treatment with antihistamines independently of the time they have been on hemodialysis. / Revisión por pares

No description available.