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Research paper thumbnail of Índice De Gravidade Da Doença Renal, Indicadores Assistenciais e Mortalidade Em Pacientes Em Hemodiálise

Revista da Associação Médica Brasileira, 2005

RESUMO OBJETIVO. Verificar a associação das comorbidades, quantificadas por meio do índice de gra... more RESUMO OBJETIVO. Verificar a associação das comorbidades, quantificadas por meio do índice de gravidade da doença renal (IGDR), com os indicadores assistenciais Kt/V, hematócrito e albumina sérica, e com mortalidade. MÉTODOS. Quarenta pacientes renais crônicos em hemodiálise foram acompanhados por 12 meses e avaliados quanto a características sociodemográficas, tempo em diálise, presença de diabetes mellitus, indicadores assistenciais e comorbidades. A influência das comorbidades foi avaliada por meio do IGDR. RESULTADOS. O IGDR médio dos sobreviventes (85%) e óbitos (15%) foi 22±14,8 vs 44±12,4 (p<0,001) e entre pacientes diabéticos (29%) e não diabéticos (71%) de 40±15,1 vs 19±12,5 (p< 0,001). A correlação entre IGDR e albumina foi r=-0,475 (p<0,005). A maioria dos pacientes com albumina =3,6mg/l (82%) era composta de não diabéticos (p=0,021). Houve correlação do hematócrito com a albumina, sendo r = 0,544, (p<0,001). O Kt/V não teve associação com outras variáveis. A razão de chance de óbito para cada ponto do IGDR foi de 10% (p = 0,0093). CONCLUSÃO. O IGDR é um bom instrumento para avaliar comorbidade em pacientes em hemodiálise, sendo confiável para comparar grupos de pacientes e predizer mortalidade.

Research paper thumbnail of Protein/Creatinine Ratio in Random Urine Sample for Quantitation of Proteinuria Compared with 24 Hour Urine Collection in Patients with Pre-Eclampsia

Austin Journal of Reproductive Medicine & Infertility, Feb 26, 2019

Objective: To evaluate the diagnostic value of protein/creatinine (p/c) ratio in a single voided ... more Objective: To evaluate the diagnostic value of protein/creatinine (p/c) ratio in a single voided urine sample for quantitation compared to those of 24h urine sample in patient with pre-eclampsia. Patients and Methods: A prospective study was conducted in Basrah maternity and child hospital during the period from October 2013 to October 2014. The study involved 60 pregnant women with hypertension attending the antenatal clinic and admitted to obstetrics ward regardless the severity of the disease. The main measurement was estimation the urinary protein to urinary creatinine ratio by random direct measurement and a 24-hour urinary protein excretion. The data obtained was statically analyzed. Results: Out of 60 patients with gestational hypertension, 49 patients had significant proteinuria (>300 mg/day) and 11 patients had proteinuria less than (300 mg/day). Also, 17 out of 60 patients had p/c ratio <3 mg/dl and 43 patients had p/c ratio >3.5 mg/dl. The p/c ratio was able to correctly identify 42 out of 49 patients with significant proteinuria. It has been estimated that protein/creatinine ratio with sensitivity of 81.6%, specifity of 27.7% positive predictive value 93%, negative predictive value 70%, false positive rate 27.2%, false negative rate 18.3%. Conclusion: The study suggest that the p/c ratio in single voiding urine is highly accurate test (P<0.01) for discriminating between in significant proteinuria. This could be a reasonable alteration to the 24-hour collection for detection of significant proteinuria in hospitalized pregnant women with suspected preeclampsia.

Research paper thumbnail of Nephrotoxicity of cyclosporine: The role of platelet-activating factor and thromboxane

Lipids, 1991

Cyclosporine (CsA), an immunosuppressive agent, is potentially nephrotoxic. We had previously obs... more Cyclosporine (CsA), an immunosuppressive agent, is potentially nephrotoxic. We had previously observed that acute administration of CsA to Munich-Wistar rats induced a decrease in single nephron glomerular filtration rate, due to a decline in glomerular plasma flow, and in the glomerular ultrafiltration coefficient. Moreover, these alterations were prevented when an antagonist of plateletactivating factor (PAF) was administered. In the present study we examined whether the protective effect of the PAF blocker in CsA nephrotoxicity could have been mediated by thromboxane (TxA2). Our data show that the PAF effects were not mediated by TxA 2, since administration of dazmegrel, a thromboxane synthetase inhibitor, did not ameliorate the acute renal failure caused by CsA. Thus, PAF appears to be a direct mediator of acute CsA nephrotoxicity, while TxA 2 is not significantly involved in this process.

Research paper thumbnail of Índice De Gravidade Da Doença Renal, Indicadores Assistenciais e Mortalidade Em Pacientes Em Hemodiálise

Revista da Associação Médica Brasileira, 2005

RESUMO OBJETIVO. Verificar a associação das comorbidades, quantificadas por meio do índice de gra... more RESUMO OBJETIVO. Verificar a associação das comorbidades, quantificadas por meio do índice de gravidade da doença renal (IGDR), com os indicadores assistenciais Kt/V, hematócrito e albumina sérica, e com mortalidade. MÉTODOS. Quarenta pacientes renais crônicos em hemodiálise foram acompanhados por 12 meses e avaliados quanto a características sociodemográficas, tempo em diálise, presença de diabetes mellitus, indicadores assistenciais e comorbidades. A influência das comorbidades foi avaliada por meio do IGDR. RESULTADOS. O IGDR médio dos sobreviventes (85%) e óbitos (15%) foi 22±14,8 vs 44±12,4 (p<0,001) e entre pacientes diabéticos (29%) e não diabéticos (71%) de 40±15,1 vs 19±12,5 (p< 0,001). A correlação entre IGDR e albumina foi r=-0,475 (p<0,005). A maioria dos pacientes com albumina =3,6mg/l (82%) era composta de não diabéticos (p=0,021). Houve correlação do hematócrito com a albumina, sendo r = 0,544, (p<0,001). O Kt/V não teve associação com outras variáveis. A razão de chance de óbito para cada ponto do IGDR foi de 10% (p = 0,0093). CONCLUSÃO. O IGDR é um bom instrumento para avaliar comorbidade em pacientes em hemodiálise, sendo confiável para comparar grupos de pacientes e predizer mortalidade.

Research paper thumbnail of Protein/Creatinine Ratio in Random Urine Sample for Quantitation of Proteinuria Compared with 24 Hour Urine Collection in Patients with Pre-Eclampsia

Austin Journal of Reproductive Medicine & Infertility, Feb 26, 2019

Objective: To evaluate the diagnostic value of protein/creatinine (p/c) ratio in a single voided ... more Objective: To evaluate the diagnostic value of protein/creatinine (p/c) ratio in a single voided urine sample for quantitation compared to those of 24h urine sample in patient with pre-eclampsia. Patients and Methods: A prospective study was conducted in Basrah maternity and child hospital during the period from October 2013 to October 2014. The study involved 60 pregnant women with hypertension attending the antenatal clinic and admitted to obstetrics ward regardless the severity of the disease. The main measurement was estimation the urinary protein to urinary creatinine ratio by random direct measurement and a 24-hour urinary protein excretion. The data obtained was statically analyzed. Results: Out of 60 patients with gestational hypertension, 49 patients had significant proteinuria (>300 mg/day) and 11 patients had proteinuria less than (300 mg/day). Also, 17 out of 60 patients had p/c ratio <3 mg/dl and 43 patients had p/c ratio >3.5 mg/dl. The p/c ratio was able to correctly identify 42 out of 49 patients with significant proteinuria. It has been estimated that protein/creatinine ratio with sensitivity of 81.6%, specifity of 27.7% positive predictive value 93%, negative predictive value 70%, false positive rate 27.2%, false negative rate 18.3%. Conclusion: The study suggest that the p/c ratio in single voiding urine is highly accurate test (P<0.01) for discriminating between in significant proteinuria. This could be a reasonable alteration to the 24-hour collection for detection of significant proteinuria in hospitalized pregnant women with suspected preeclampsia.

Research paper thumbnail of Nephrotoxicity of cyclosporine: The role of platelet-activating factor and thromboxane

Lipids, 1991

Cyclosporine (CsA), an immunosuppressive agent, is potentially nephrotoxic. We had previously obs... more Cyclosporine (CsA), an immunosuppressive agent, is potentially nephrotoxic. We had previously observed that acute administration of CsA to Munich-Wistar rats induced a decrease in single nephron glomerular filtration rate, due to a decline in glomerular plasma flow, and in the glomerular ultrafiltration coefficient. Moreover, these alterations were prevented when an antagonist of plateletactivating factor (PAF) was administered. In the present study we examined whether the protective effect of the PAF blocker in CsA nephrotoxicity could have been mediated by thromboxane (TxA2). Our data show that the PAF effects were not mediated by TxA 2, since administration of dazmegrel, a thromboxane synthetase inhibitor, did not ameliorate the acute renal failure caused by CsA. Thus, PAF appears to be a direct mediator of acute CsA nephrotoxicity, while TxA 2 is not significantly involved in this process.