Efeitos da sobrecarga calórica em ratos machos submetidos ou não a restrição protéica in útero

Pós-graduação em Biologia Geral e Aplicada - IBB

Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

Predictors of Beta-Blocker Intolerance and Mortality in Patients After Acute Coronary Syndrome

Purpose: To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).Methods: This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university. Statistics: the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05) in PATIENTS.Results: BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).Conclusions: After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.

Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Dog with hydronephrosis due to abdominal trauma

Hydronephrosis is a condition that results from complete or partial obstruction of the urinary flow. This paper reports the case of a two-year-old, mixed-breed dog diagnosed with hydronephrosis of the left kidney six months after being kicked in the thoraco-abdominal region. The diagnosis was based on radiographic and ultrasonographic examinations. Percutaneous antegrade pyelography was also performed and allowed the visualization of opacification of the left kidney, which confirmed the diagnosis. Because the exams indicated that the patient had normal renal function, nephrectomy was performed. The patient remained in good health during the postoperative period and in subsequent evaluations. (C) 2013 PVJ. All rights reserved

Evaluation of the Antihypertensive Properties of Yellow Passion Fruit Pulp (Passiflora edulis Sims f. flavicarpa Deg.) in Spontaneously Hypertensive Rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Predictive Usefulness of Urinary Biomarkers for the Identification of Cyclosporine A-Induced Nephrotoxicity in a Rat Model

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estresse oxidativo, alterações metabólicas e renais decorrentes da elevada ingestão de sacarose: efeito protetor da N-acetilcisteína (NAC)

Oxidative stress is related with physiopathology of diabetes mellitus type II and with its secondary complications, such as diabetic nephropathy. Thus, the purpose of this study was to examine the effects of n-acetylcysteine NAC, an antioxidant from Allium cepa, on oxidative stress, morphometrical and nutritional parameters and basal metabolism and energetic substrate utilization, serum glucose and oral glucose tolerance test (OGTT), and renal function of high-sucrose intake rats. Animals were initially divided into three groups. Rats in the control group (C; n=10) were given free access to a standard chow and water; (S; n=10) group received standard chow and 30% sucrose in its drinking water; (SN; n=5) group received standard chow and 2g/L NAC and 30% sucrose in its drinking water. After 25 days of treatments, rats were submitted to indirect calorimetry in fasted and feed states. After 30 days of treatments, rats from C and S groups were divided into four groups of five rats each. The (CC) and (SS) groups were given an intra-gastric dose 0,6mL saline (0,9%NaCl) and the (CNAC) and (SNAC) groups were treated with a intra-gastric dose of 0,6mL NAC (160g/day), and then everybody received a intra-gastric dose of glucose solution (20%) for the OGTT. Animals of S and SN groups have higher liquid consumption and lower food consumption than C group. Calorimetric analyses confirm that despite of the final body weight had not statistical difference among groups, S group have lower resting metabolic rate when compared to C and SN animals. Besides, S group has higher respiratory quotient, higher carbohydrate oxidation and lower lipid oxidation, both in fasted and feed states, than C and SN groups, evidencing the beneficial effect of NAC. Fasting plasma glucose is increased in SS and SNAC animals when compared to CC and CNAC, however SN group has glicemic level at 30 min before OGTT decreased when ...(Complete abstract click electronic access below)

Exames laboratoriais importantes no diagnóstico da Piometra canina

Canine Pyometra is a uterine disease that occurs in sexually mature bitches, with higher incidence in nulliparous and animals over 4 years and is characterized by presenting an accumulation of pus in the uterine lumen, usually occurring in diestrus. Laboratory tests are important tools for the detection of metabolic abnormalities associated with sepsis and renal function, which are serious consequences of pyometra. In blood the main findings are normochromic non-regenerative anemia, presence of dehydration, and sometimes thrombocytopenia. The WBC count may be normal but most often occurs a neutrophilic leukocytosis with a left shift, monocytosis and the presence of toxic neutrophils. In less than 1 / 3 of the animals the presence of azotemia is present and a density lower than 1035 is detected in the urine of almost 90% of bitches which may be in normal range at the onset of the desease. Urinary protein loss is rare but the protein may be elevated in the reagent strip due to urinary contamination by uterine secretion. The increase of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and creatine kinase (CK) may be present, indicating disorders in the liver. Currently, additional laboratory tests are being studied for the diagnosis of pyometra and its prognosis, such as the measurement of C-reactive protein and fibrinogen for monitoring the recovery of the inflammatory process and the urine electrophoresis to characterize the origin of proteinuria in these animals . The aim of this work is to review the literature on the main laboratory tests that aid the diagnosis of Pyometra

O papel do NGAL urinário como preditor diagnóstico e prognóstico da lesão aguda associada a sepse em pacientes admitidos na emergência clínica

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

The long-term outcome after acute kidney injury: a narrative review

This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients.

Avaliação clínica, laboratorial e anatopatológica do sistema urinário de ovinos confinados com e sem suplementação de cloreto de amônio

Pós-graduação em Medicina Veterinária - FMVZ

Fetal kidney programming by severe food restriction: effects on structure, hormonal receptor expression and urinary sodium excretion in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Lycopene supplementation reduces TNF-alpha via RAGE in the kidney of obese rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alterações ultrassonográficas renais e vesicais de ovinos confinados e suplementados com cloreto de amônio

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)