SummaryBackground and objectives Anemia and inflammation are prevalent in diabetic patients with chronic kidney disease (CKD). The role of endogenous erythropoietin (EPO) in the pathophysiology of anemia in chronic diseases and its relationship to clinical outcomes remain uncertain. In this cohort study, we aimed to identify factors associated with endogenous EPO levels and investigate their relation to all-cause mortality. Results Patients (median age, 67 years; 52% men; median duration of diabetes, 10 years; median estimated GFR, 49 ml/min per 1.73 m 2 ) were followed for up to 7.0 years. Forty-one patients died. Elevated EPO levels were independently associated with elevated C-reactive protein, low ferritin, and hypertension, in a multivariate model that also included age, cardiovascular disease, kidney function, albumin, cholesterol, and hemoglobin. Higher EPO levels were independently predictive for mortality, as were age, low levels of albumin, and cardiovascular disease.
ConclusionsIn diabetic patients with CKD, elevated endogenous EPO levels were predictive for mortality and were related mainly to markers of inflammation, independent of kidney function, and despite low hemoglobin levels. Understanding the phenomenon of EPO resistance and iron dysregulation caused by inflammation is crucial for effective and safe treatment of anemia in patients with CKD.
ResumoEste artigo apresenta o quadro teórico, a conceção e a avaliação dos resultados do projeto internacional Strong de investigação prática no que à implementação de estratégias de prevenção da violência nas escolas diz respeito através da promoção da resiliência.Após a apresentação breve dos resultados quantitativos e qualitativos, serão realçados os fatores de sucesso de uma estratégia de prevenção.
Palavras-chaveResiliência; Promoção da resiliência; Prevenção da violên-cia; Desenvolvimento escolar; Investigação prática.
AbstractThe following article presents the theoretical back-
Mots-clésRésilience; Promotion de la résilience; Prévention de la violence; Rendement scolaire; Recherche opérationnelle.
ResumenEn este artículo se presenta el marco teórico, el diseño y la evaluación de los resultados del proyecto internacional de investigación práctica Strong de la implementación de estrategias para prevenir la violencia en las escuelas mediante la promoción de la resiliencia.Después de la breve presentación de los resultados cuantitativos y cualitativos se destacarán los factores de éxito de una estrategia de prevención.
Palabras claveResiliencia; Promoción de la resiliencia; Prevención de la violencia; Rendimiento escolar; Investigación práctica.
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