A doença renal crônica (DRC) é considerada um problema de saúde pública em todo o mundo. Ela é definida pela lesão do parênquima renal (com ou sem diminuição da filtração glomerular) e/ou pela diminuição da função renal por um período de três meses ou mais. Quando a taxa de filtração glomerular (TFG) Prevalência de ansiedade e depressão e suas comorbidades em pacientes com doença renal crônica em hemodiálise e diálise peritonealPrevalence of anxiety and depression and its comorbidities in patients with chronic kidney disease on hemodialysis and peritoneal dialysis Introdução: Os pacientes com doença renal crônica (DRC) que realizam terapia renal substitutiva (TRS) estão sujeitos a maior prevalência de distúrbios de humor. Objetivo: O objetivo do presente estudo é comparar a prevalência de ansiedade e depressão nos pacientes que realizam hemodiálise (HD) e diálise peritoneal (DP), levando em conta comorbidades que podem contribuir para isso. Métodos: O estudo foi realizado em Ponta Grossa, PR, com pacientes portadores de DRC, utilizando os inventários de depressão e ansiedade de Beck (BDI e BAI) e a Escala Hospitalar de Ansiedade e Depressão (EHAD). Resultados: Foram estudados 155 pacientes, 128 no grupo em HD e 27 em DP. No primeiro, depressão foi encontrada em 22,6% dos pacientes no BDI e em 9,3% na EHAD, e ansiedade em 25,7% no BAI e em 11,7% na EHAD. No grupo em DP, 29,6% dos pacientes apresentaram depressão no BDI e 14,8% na EHAD, e ansiedade em 11,1% no BAI e em nenhum na EHAD. Conclusão: A realização de hemodiálise ou diálise peritoneal não influenciou na prevalência de ansiedade ou depressão nos pacientes com DRC. resumo Palavras-chave: ansiedade; depressão; diálise peritoneal; diálise renal; insuficiência renal crônica; unidades hospitalares de hemodiálise.Introduction: Patients with chronic kidney disease (CKD) who perform renal replacement therapy (RRT) are subject to a higher prevalence of mood disorders. Objective: The aim of this study is to compare the prevalence of anxiety and depression in patients on hemodialysis (HD) and peritoneal dialysis (PD), taking into account comorbidities that may contribute to this. Methods: The study was done in Ponta Grossa with CKD patients, using Beck Depression and Anxiety Inventory (BDI and BAI) and the Hospital Anxiety and Depression Scale (HADS). Results: We studied 155 patients, 128 in the HD group and 27 in PD. In the first, depression was found in 22.6% of patients in the BDI and 9.3% in HADS, and anxiety 25.7% in the BAI and 11.7% in the HADS. In the PD group, 29.6% of patients had depression in the BDI and 14.8% in HADS, and anxiety 11.1% in the BAI and none in HADS. Conclusion: The hemodialysis or peritoneal dialysis did not influence the prevalence of anxiety and depression in patients with CKD.
PURPOSE: To investigate the influence of using simvastatin on the peritoneal fibrosis induced in rats using peritoneal dialysis solution with glucoses 4.25%. METHODS: Prospective controlled study in 20 non-uremic Wistar rats. The animals received a peritoneal infusion of 10 ml/100 g of peritoneal dialysis solution glucose 4.25% on a daily basis. The animals were divided in two groups: experimental and control. The experimental group received simvastatin 4 mg/kg/d, by a gastric tube. The control group did not receive any drug. The follow-up was 21 and 49 days. At the end, one surgical procedure was performed to get histological samples of visceral and parietal peritoneum. The samples were analyzed using Hematoxylin Eosin and Sirius Red, to evaluate the severity of the fibrosis. RESULTS: The analysis showed that the intensity of the fibrosis, the peritoneal thickness and the cell number in experimental and control groups were not statistically significant different in experimental and control groups. CONCLUSION: The simvastatin do not decrease the intensity of fibrosis on the peritoneal membrane that happens on rats on peritoneal dialysis.
Background Cardiovascular disease (CVD) is the leading cause of death in patients with end-stage renal disease (ESRD). Elevated serum concentrations of myeloperoxidase (MPO) are associated with an increased risk of developing CVD. The objective of this study was to evaluate serum MPO levels, as well as other laboratory parameters, in individuals with ESRD, with and without CVD, undergoing hemodialysis. Methods 80 volunteers were admitted, divided into the following groups: control group (CON): 20 individuals without chronic kidney disease (CKD); ESRD group: 45 individuals with CKD stage V and ESRD/CVD group: 15 individuals with CKD stage V and with CVD. The following biomarkers were evaluated: MPO, High sensitivity C-reactive protein (hs-CRP) and α1-acid glycoprotein, following the manufacturer's guidelines in the package inserts. The data were processed through the statistical software SPSS 20.0®. Results The level of MPO for the CON group was 84 ng/mL (73–87 ng/mL), for the ESRD group 77 ng/mL (11–89 ng/mL) and for the ESRD/CVD group 21 ng/mL (8–47 ng/mL), with a significant statistical difference of the ESRD/CVD group from the CON and ESRD groups (p<0.001). For the parameters hs-CRP and α1-acid glycoprotein a statistical difference between the ESRD and ESRD/CVD groups from the CON group (p<0.0001) was observed, but not between the ESRD and ESRD/CVD groups. Conclusion It is suggested that further studies should be performed to define the potential role of MPO as a cardiovascular risk marker for patients with ESRD on hemodialysis.
Our findings indicate that captopril do not decrease the intensity of fibrosis on the peritoneal membrane that happens on rats on peritoneal dialysis.
Objective: The aim of this study was to relate the clinical profile with data on blood pressure (BP), intracranial pressure (ICP) and laboratory tests of a patient with Diabetes mellitus (DM) type 1 and chronic kidney disease (CKD) stage 5. Methodology: The research was carried out at the renal replacement therapy outpatient clinic of the Santa Casa de Misericórdia hospital, in Ponta Grossa-PR, previously approved by the ethics committee, under opinion nº 4,039,453. ICP monitoring and BP measurement were performed twice, on follow-up consultation days, in February and September 2020. In addition to the aforementioned parameters, a questionnaire on the patient's habits and demographic data was applied, and a consultation was carried out with the patient medical record for the collection of laboratory test data. Results: From February to September, the volunteer presented with persistent Systemic Arterial Hypertension (SAH) and hyperglycemia, and worsening of laboratory parameters. In February, the ICP morphology showed a significant change, suggesting intracranial hypertension, and the patient had a great impairment of visual acuity. In September, despite the worsening of the health condition, there was a significant improvement in vision and, also, an improvement in the ICP parameters, approaching normality. Between consultations, the diuretic administered by the patient was replaced. Conclusion: it is suggested that the visual impairment is due to intracranial hypertension and the improvement of both is related to the replacement of hydrochlorothiazide by furosemide, which occurred between consultations.
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