scholarly journals VANTAGENS E DESVANTAGENS NA UTILIZAÇÃO DO QUESTIONÁRIO SCORED PARA TRIAGEM DE DOENÇA RENAL CRÔNICA EM PACIENTES NA ATENÇÃO BÁSICA: UMA REVISÃO DE LITERATURA

2021 ◽  
Author(s):  
Giovanna Benichel Bilancieri ◽  
Gabriela Beck Dos Santos ◽  
Letícia Umetsu Yaginuma ◽  
Eliazar Da Silva Santos Júnior ◽  
Eliane Cardozo Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Renal Diseases

Introdução: A doença renal crônica (DRC) é um grave problema de saúde pública, com alta prevalência, de 3 a 6 milhões de brasileiros, e mortalidade, de 15,7 por 100 mil ao ano. O rastreamento precoce em pacientes com comorbidades que predispõem à DRC, é infrequente no sistema único de saúde, resultando no diagnóstico tardio e prejuízos ao paciente. Pretendendo rastrear a DRC em fase inicial, foi elaborado o questionário SCORED, do inglês Screening for Occult Renal Disease. Constituído por 11 perguntas referentes a dados demográficos e clínicos, com pontuação de 0 a 12, sendo considerado paciente de alto risco para desenvolvimento de DRC aqueles com pontuação maior ou igual a 4. Objetivo: O presente estudo busca levantar as vantagens e desvantagens da utilização do questionário SCORED em pacientes da atenção primária à saúde. Materiais e métodos: Revisão baseada em artigos publicados no período de 2007 a 2021, nas plataformas LILACS e PubMed, a partir dos termos “Screening for Occult Renal Diseases” (15 e 5 artigos, respectivamente) e “SCORED and chronic kidney disease” (10 e 8 artigos, respectivamente). Posteriormente, foram excluídos os artigos incoerentes com o tema proposto e selecionados 9 trabalhos para a composição da revisão de literatura. Resultados: O método SCORED proporciona benefícios ao paciente, melhorando a qualidade de vida, acesso facilitado a medicamentos de alto custo e redução da mortalidade. A fácil aplicabilidade em contextos de assistência à saúde, meios de comunicação e a autoaplicação, somado ao baixo-custo, podem auxiliar a reduzir os gastos com tratamentos e terapia renal substitutiva. Todavia, o SCORED limita os fatores envolvidos na gênese da DRC, e considera o histórico médico autorrelatado, gerando alta sensibilidade e baixa especificidade. Ademais, necessita de confirmação por dosagem de creatinina sérica e taxa de filtração glomerular, que em idosos pode ser reduzida, devido ao declínio fisiológico. Conclusão: O questionário auxilia no diagnóstico precoce de DRC, sendo de fácil aplicação e custos baixos. Apesar disso, deve-se realizar o atendimento médico completo e exames complementares. Portanto, deve-se conscientizar que esse método de triagem carece de rastreio de outros quadros, como a doença renal policística autossômica dominante e glomerulonefrite.

scholarly journals Seropositivity for Antibodies to DRS-G, a Virulence Factor from Streptococcus dysgalactiae subsp. equisimilis, Is an Independent Risk Factor for Poststreptococcus Glomerulonephritis and Chronic Kidney Disease in Mumbai, India

2015 ◽  
Vol 22 (8) ◽  
pp. 938-942 ◽  
Author(s):  
Gouri P. Hule ◽  
Mohan G. Karmarkar ◽  
Ainslie Cameron ◽  
Niwrutti Hase ◽  
Uday Khopkar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Renal Disease ◽  
Renal Diseases ◽  
Enzyme Linked Immunosorbent Assay ◽  
Streptococcus Dysgalactiae ◽  
Poststreptococcal Glomerulonephritis ◽  
Content Type ◽  
Esrd Patients

ABSTRACTThe disease spectrum caused byStreptococcus dysgalactiaesubsp.equisimilisresembles that ofS. pyogenes(group A streptococcus [GAS]). These two bacterial species are closely related and possess many common virulence characteristics. While some GAS strains express virulence factors called streptococcal inhibitor of complement (SIC) and distantly related to SIC (DRS), someS. dysgalactiaesubsp.equisimilisisolates express an orthologue of DRS, which is referred to as DRS-G. We reported previously that seropositivity for either anti-SIC or anti-DRS antibodies (Abs) is associated with poststreptococcal glomerulonephritis (PSGN). However, only seropositivity for anti-SIC Abs is associated with chronic kidney disease (CKD). We now extend the study to test whether seropositivity for anti-DRS-G Abs is also associated with these renal diseases. Stored serum samples collected for our previous study were tested by an enzyme-linked immunosorbent assay (ELISA) for Abs to DRS-G. The samples represented sera from 100 CKD adult patients, 70 adult end-stage renal disease (ESRD) patients, 25 PSGN pediatric patients, and corresponding age-matched control subjects. The proportion of PSGN, CKD, and ESRD patients who showed seroreaction to anti-DRS-G Abs was significantly higher than that of the corresponding age-matched controls, who in general exhibited seropositivity rates commensurate with the isolation rate ofdrsG-positiveS. dysgalactiaesubsp.equisimilisin the community during this study period. Since higher rates of seropositivity for anti-DRS-G Abs in the renal disease categories are resultant of previous infections with DRS-G-positiveS. dysgalactiaesubsp.equisimilisstrains, we conclude the seropositivity is an additional risk factor for these renal diseases. In this regard, anti-DRS-G Abs have attributes similar to those of the anti-SIC Abs.

scholarly journals Connexin 43: a New Therapeutic Target Against Chronic Kidney Disease

2018 ◽  
Vol 49 (3) ◽  
pp. 998-1009 ◽  
Author(s):  
Niki Prakoura ◽  
Panagiotis Kavvadas ◽  
Christos E.  Chadjichristos
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Animal Models ◽  
Renal Disease ◽  
Connexin 43 ◽  
Molecular Mechanisms ◽  
De Novo ◽  
Kidney Diseases ◽  
In Vivo Studies ◽  
Renal Diseases

Chronic kidney disease is an incurable to date pathology with a continuously growing incidence that contributes to the increase of the number of deaths worldwide. With currently no efficient prognostic or therapeutic options being available, the only possibility for treatment of end-stage renal disease is renal replacement therapy through dialysis or transplantation. Understanding the molecular mechanisms participating in the progression of renal diseases and uncovering the pathways implicated will permit the identification of novel and more efficient targets of therapy. Connexin43 was recently identified as a novel player in the development of chronic kidney disease. It was found de novo expressed and/or differentially localized in various renal cell populations during progression of renal disease, indicating an abnormal connexin signaling, both in patients and animal models. Subsequent in vivo studies demonstrated that connexin43 is involved in mediating inflammatory and fibrotic processes contributing to renal damage. Genetic, pharmaco-genetic or peptide-based inhibition of connexin43 in animal models and cell culture systems was successful in preventing the progression of the pathology and preserving the cell phenotypes. This review will summarize the recent advances on connexin43 in the field of kidney diseases and discuss the potential of future connexin43-based therapies against chronic kidney disease.

scholarly journals Deprivation and kidney disease—a predictor of poor outcomes

2019 ◽  
Vol 13 (2) ◽  
pp. 128-132
Author(s):  
Greg D Guthrie ◽  
Samira Bell
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Injury ◽  
Renal Diseases ◽  
Confounding Factors ◽  
Growing Body ◽  
Poor Outcomes

Abstract There is a growing body of evidence for the role of deprivation in a broad spectrum of diseases including renal disease. Deprivation has been demonstrated to be associated with poorer outcomes across a range of renal diseases including acute kidney injury (AKI), chronic kidney disease and transplantation. In this issue of Clinical Kidney Journal, Hounkpatin et al. describe the association of socioeconomic deprivation with incidence, mortality and resolution of AKI in a large UK cohort. Investigating deprivation as a factor influencing either incidence or outcome of disease is challenging due to variations in measures of deprivation used and other confounding factors that may be contributing to the observed differences. In this editorial, we review the current literature examining the role of deprivation in renal disease.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

scholarly journals Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 326
Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Root Canal ◽  
Dialysis Patients ◽  
Root Canal Therapy ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

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