Hypophagia induced by glucocorticoid deficiency is associated with an increased activation of satiety-related responses

Uchoa ET, Sabino HA, Ruginsk SG, Antunes-Rodrigues J, Elias LL. Hypophagia induced by glucocorticoid deficiency is associated with an increased activation of satiety-related responses. J Appl Physiol 106: 596-604, 2009. First published November 20, 2008; doi: 10.1152/japplphysiol.90865.2008.-Glucocorticoids have major effects on food intake, demonstrated by the decrease of food intake following adrenalectomy. Satiety signals are relayed to the nucleus of the solitary tract (NTS), which has reciprocal projections with the arcuate nucleus (ARC) and paraventricular nucleus (PVN) of the hypothalamus. We evaluated the effects of glucocorticoids on the activation of hypothalamic and NTS neurons induced by food intake in rats subjected to adrenalectomy (ADX) or sham surgery 7 days before the experiments. One-half of ADX animals received corticosterone (ADX + B) in the drinking water (B: 25 mg/l). Fos/tyrosine hydroxylase (TH), Fos/corticotrophin-releasing factor (CRF) and Fos immunoreactivity were assessed in the NTS, PVN, and ARC, respectively. Food intake and body weight were reduced in the ADX group compared with sham and ADX + B groups. Fos and Fos/TH in the NTS, Fos, and Fos/CRF immunoreactive neurons in the PVN and Fos in the ARC were increased after refeeding, with higher number in the ADX group, compared with sham and ADX + B groups. CCK administration showed no hypophagic effect on ADX group despite a similar increase of Fos/TH immunoreactive neurons in the NTS compared with sham and ADX + B groups, suggesting that CCK alone cannot further increase the anorexigenic effect induced by glucocorticoid deficiency. The present data indicate that glucocorticoid withdrawal reduced food intake, which was associated with higher activation of ARC, CRF neurons of the PVN, and catecholaminergic neurons of the NTS. In the absence of glucocorticoids, satiety signals elicited during a meal lead to an augmented activation of brain stem and hypothalamic pathways.

Water deprivation increases Fos expression in hypothalamic corticotropin-releasing factor neurons induced by right atrial distension in awake rats

Atrial mechanoreceptors, sensitive to stretch, contribute in regulating heart rate and intravascular volume. The information from those receptors reaches the nucleus tractus solitarius and then the paraventricular nucleus (PVN), known to have a crucial role in the regulation of cardiovascular function. Neurons in the PVN synthesize CRF, AVP, and oxytocin (OT). Stimulation of atrial mechanoreceptors was performed in awake rats implanted with a balloon at the junction of the superior vena cava and right atrium. Plasma ACTH, AVP, and OT concentrations and Fos, CRF, AVP, and OT immunolabeling in the PVN were determined after balloon inflation in hydrated and water-deprived rats. The distension of the balloon increased the plasma ACTH concentrations, which were higher in water-deprived than in hydrated rats (P < 0.05). In addition, the distension in the water-deprived group decreased plasma AVP concentrations (P < 0.05), compared with the respective control group. The distension increased the number of Fos- and double-labeled Fos/CRF neurons in the parvocellular PVN, which was higher in the water-deprived than in the hydrated group (P < 0.01). There was no difference in the Fos expression in magnocellular PVN neurons after distension in hydrated and water-deprived groups, compared with respective controls. In conclusion, parvocellular CRF neurons showed an increase of Fos expression induced by stimulation of right atrial mechanoreceptors, suggesting that CRF participates in the cardiovascular reflex adjustments elicited by volume loading. Activation of CRF neurons in the PVN by cardiovascular reflex is affected by osmotic stimulation.

Adrenalectomy enhances endotoxemia-induced hypophagia: higher activation of corticotrophin-releasing-factor and proopiomelanocortin hypothalamic neurons

Inflammatory and infectious processes evoke neuroendocrine and behavioral changes known as acute-phase response that includes activation of the hypothalamo-pituitary-adrenal (HPA) axis and reduction of food intake. Besides its action as the most important ACTH secretagogue, corticotrophin-releasing factor (CRF), synthesized in the paraventricular nucleus (PVN), is also involved in the control of food intake. Alpha-melanocyte stimulating hormone (alpha-MSH) in the arcuate nucleus also plays a role in the energy homeostasis, possessing anorexigenic effects. To investigate the participation of neuropeptides involved in the regulation of food intake during endotoxemia, we administrated lipopolysaccharide (LPS) in sham-operated and adrenalectomized (ADX) male Wistar rats to evaluate food intake, hormone responses and Fos-CRF and Fos-alpha-MSH immunoreactivity in the PVN and arcuate nucleus, as well as CRF and POW mRNA expression in these hypothalamic nuclei. In sham-operated rats, treatment with LPS (100 mu g/kg) showed lower food intake, higher plasma ACTH and corticosterone levels, as well as an increase in Fos-CRF double labeled neurons and CRF mRNA expression in the PVN, with no changes in Fos-alpha-MSH immunoreactivity and POW mRNA expression in the arcuate nucleus, compared to saline treated rats. After LPS treatment, ADX rats showed further increase in plasma ACTH levels, marked decrease of food intake, higher Fos-CRF immunoreactive neurons in the PVN and CRF mRNA expression, as well as an increase in Fos-alpha-MSH immunoreactivity and POW mRNA expression in the arcuate nucleus, compared to sham-operated rats treated with LPS. In conclusion, the present data indicate that the marked hypophagia during endotoxemia following ADX is associated with an increased activation of CRF and POW neurons in the hypothalamus and an increased mRNA expression of these neuropeptides. (C) 2008 Elsevier Inc. All rights reserved.

Effect of stem cells seeded onto biomaterial on the progression of experimental chronic kidney disease

Different routes for the administration of bone marrow-derived cells (BMDC) have been proposed to treat the progression of chronic renal failure (CRF). We investigated whether (1) the use of bovine pericardium (BP) as a scaffold for cell therapy would retard the progression of CAF and (2) the efficacy of cell therapy differently impacts distinct degrees of CRF. We used 2/3 and 5/6 models of renal mass reduction to simulate different stages of chronicity. Treatments consisted of BP seeded with either mesenchymal or mononuclear cells implanted in the parenchyma of remnant kidney. Renal function and proteinuria were measured at days 45 and 90 after cell implantation. BMDC treatment reduced glomerulosclerosis, interstitial fibrosis and lymphocytic infiltration. Immunohistochemistry showed decreased macrophage accumulation, proliferative activity and the expression of fibronectin and alpha-smooth muscle-actin. Our results demonstrate: (1) biomaterial combined with BMDC did retard the progression of experimental CRF; (2) cellular therapy stabilized serum creatinine (sCr), improved creatinine clearance and 1/sCr slope when administered during the less severe stages of CRF; (3) treatment with combined therapy decreased glomerulosclerosis, fibrosis and the expression of fibrogenic molecules; and (4) biomaterials seeded with BMDC can be an alternative route of cellular therapy.

Glucocorticoid resistance in dialysis patients may impair the kidney allograft outcome

This study examines in vitro steroid sensitivity in chronic renal failure ( CRF) patients and its influence on the allograft outcome. We determined the inhibitory effect of dexamethasone ( DEX) on concanavalin A ( Con-A)-stimulated peripheral blood mononuclear cell ( PBMC) proliferation, and glucocorticoid receptor` ( GR) number of binding sites ( B-max) and affinity ( K-d) in 28 CRF patients and 40 normal healthy controls. Based on K-d values > 95th percentile from controls, patients were divided into two groups: glucocorticoid resistant ( n = 11) and glucocorticoid sensitive ( n = 17). Patients were followed during 18 months post-transplantation observing acute rejection episodes ( ARE), chronic allograft nephropathy ( CAN), allograft failure and death. The DEX concentration that caused 50% inhibition of Con-A-stimulated PBMC proliferation ( IC50) was higher in CRF than in healthy controls ( 2.2 x 10(-5) +/- 1.0 x 10(-5) versus 8.3 x 10(-6) +/- 4.2 x 10(-6) mol/ L, P = 0.02). Values of Kd ( 12.4 +/- 1.8 versus 7.2 +/- 0.9 nM) and Bmax ( 7.7 +/- 1.1 versus 4.1 +/- 0.3 fmol/ mg protein) were higher in CRF patients ( P = 0.02 and P = 0.001, respectively). There were higher incidences of ARE ( P = 0.02) and CAN ( P = 0.002) in the glucocorticoid-resistant group. Univariate and multivariate logistic regression showed that Kd was an independent predictor of ARE ( OR 8.8, P= 0.03) aswell as of CAN ( OR 16.5, P= 0.01). In conclusion, we observed glucocorticoid resistance in a subgroup of CRF patients undergoing dialysis, which led to a higher morbidity due to ARE and CAN in an 18-month follow-up period.

Immune-derived opioids and peripheral antinociception

1. Recent findings have suggested a significant involvement of the immune system in the control of pain. Immune cells contain opioid peptides that are released within inflamed tissue and act at opioid receptors on peripheral sensory nerve endings. It is also apparent that different types of lymphocytes contain P-endorphin, memory T cells containing more beta -endorphin than naive cells. 2. These findings highlight an integral link between immune cell migration and inflammatory pain, The present review highlights immune system involvement in the site-directed control of inflammatory pain. 3. Full-length mRNA transcripts for opioid precursor proteins are expressed in immune cells. Increased expression of pro-opiomelanocortin mRNA and beta -endorphin has been demonstrated in stimulated lymphocytes and lymphocytes from animals with inflammation. 4. Cytokines and corticotropin-releasing factor (CRF) release opioids from immune cells, Potent peripheral analgesia due to direct injection of CRF can be blocked by antagonists to CRF, antibodies to opioid peptides, antisense to CRF and opioid receptor-specific antagonists. The release of opioid peptides from lymphocytes is calcium dependent and opioid receptor specific. Furthermore, endogenous sources of opioid peptides produce potent analgesia when implanted into the spinal cord. 5. Activated immune cells migrate directly to inflamed tissue using cell adhesion molecules to adhere to the epithelial surface of the vasculature in inflamed tissue. Lymphocytes that have been activated can express opioid peptides, Memory type T cells that contain opioid peptides are present within inflamed tissue; naive cells are not present in inflamed tissue and do not contain opioid peptides, Inhibiting the migration of memory type T cells into inflamed tissue by blocking selectins results in reduced numbers of beta -endorphin containing cells, a reduced quantity of beta -endorphin in inflamed paws and reduced stress- and CRF-induced peripheral analgesia. 6. Immunosuppression is associated with increased pain in patients. Moreover, immunosuppression results in decreased lymphocyte numbers as well as decreased analgesia in animal models.

Development of a selective photoactivatable antagonist for corticotropin-releasing factor receptor, type 2 (CRF2)

A novel photoactivatable analog of antisauvagine-30 (aSvg-30), a specific antagonist for corticotropin-releasing factor (CRF) receptor, type 2 (CRF2), has been synthesized and characterized. The N-terminal amino-acid D-Phe in aSvg-30 [D-Phe11,His12] Svg((11-40)) was replaced by a phenyldiazirine, the 4-(1-azi-2,2,2-trifluoroethyl) benzoyl (ATB) residue. The photoactivatable aSvg-30 analog ATB-[ His12] Svg was tested for its ability to displace [I-125-Tyr0] oCRF or [I-125-Tyr0]Svg from membrane homogenates of human embryonic kidney (HEK) 293 cells stably transfected with cDNA coding for rat CRF receptor, type 1 ( rCRF(1)) or mouse CRF receptor, type 2beta (mCRF(2beta)). Furthermore, the ability of ATB- [His12] Svg((12-40)) to inhibit oCRF- or Svg-stimulated cAMP production of transfected HEK 293 cells expressing either rCRF(1) (HEK-rCRF(1) cells) or mCRF(2beta) (HEK-mCRF(2beta) cells) was determined. Unlike astressin and photo astressin, ATB- [His12]Svg((12-40)) showed high selective binding to mCRF(2beta) (K-i = 3.1 +/- 0.2 nM) but not the rCRF(1) receptor (K-i = 142. 5 +/- 22.3 nM) and decreased Svg-stimulated cAMP activity in mCRF(2beta)-expressing cells in a similar fashion as aSvg-30. A66-kDa protein was identified by SDS/PAGE, when the radioactively iodinated analog of ATB- [His12]Svg((12-40)) was covalently linked to mCRF(2beta) receptor. The specificity of the photoactivatable I-125-labeled CRF2beta antagonist was demonstrated with SDS/PAGE by the finding that this analog could be displaced from the receptor by antisauvagine-30, but not other unrelated peptides such as vasoactive intestinal peptide (VIP).

Influência da cirurgia abdominal na função pulmonar e capacidade de tosse

Introdução: A cirurgia abdominal acarreta grande risco de complicações pulmonares pós-operatórias. As alterações pós-cirúrgicas abdominais, reflectem-se na dinâmica ventilatória, de modo particular nos volumes e capacidades pulmonares, e na capacidade de tosse. Objectivos: Compreender qual a variação dos volumes e capacidades pulmonares e da capacidade de tosse antes e depois da cirurgia abdominal (estômago e cólon), e qual a correlação dessa variação com o nível de dor percepcionada. Desenho do estudo: Unicêntrico, prospectivo e observacional. Amostra: 10 indivíduos, propostos para cirurgia abdominal – estômago e cólon. Metodologia: Dois momentos de avaliação: um nas 24h préoperatórias em que se mediu a capacidade vital forçada (CVF) e o volume expirado máximo no primeiro segundo (VEMS1) com espirometria, e do pico de fluxo de tosse (PCF); e um segundo momento nas 24h pós-operatórias onde se repetiram as medições do primeiro momento com o acréscimo da avaliação da dor. Resultados: No pós-operatorio imediato há uma diminuição significativa da CVF de 44,30%±17,24 (p=0,005), do VEMS1 de 35,50%±28,47 (p=0,009) e do PCF de 38,97%±38,66 (p=0,012). Não se verificou nenhuma relação entre a dor percepcionada na realização das manobras de espirometria e tosse com diminuição a da CVF e do VEMS1 e do PCF respectivamente. O sexo apresentou uma relação significativa com a variação da CRF e do VEMS1 (p=0,046 e p=0,008 respectivamente). A frequência respiratória apresentou um aumento significativo no pós-operatório de 10±11,22 cpm (p=0,019). A saturação periférica de oxigénio apresentou uma diminuição significativa no pós-operatório de 3,52±2,47 (p=0,011) Conclusão: No estudo efectuado fica demonstrado o impacto negativo da cirurgia abdominal na dinâmica respiratória. A diminuição dos valores da CVF, do VEMS1 e do PCF podem contribuir de forma significativa para o aumento do risco de complicações respiratória pós-operatórias. No entanto seria importante a realização deste estudo com uma amostra maior.

Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern

Background and aim: Cardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern European Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents. Methods and Results: A cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumference and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had 1SD of this score. CRF was measured with the 20 m-Shuttle-Run- Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR Z 9.4; 95%CI:2.6e33.3) followed by the unfit ones with high adherence to the SEADiet (OR Z 6.6; 95% CI: 1.9e22.5) when compared to those who were fit and had higher adherence to SEADiet.

Espirometria estática e dinâmica em mulheres dos 60 aos 85 anos

Arquivos da Sociedade Portuguesa de Patologia Respiratória. 1992; 9(4): 175-180

Função dos músculos respiratórios em doentes com insuficiência cardíaca esquerda

Revista Portuguesa de Cardiologia, 2001; 20 (5):533-545

Opções de utilização sequencial de anti-retrovíricos em doentes com falência terapêutica em Angola

A infecção pelo VIH/SIDA constitui um dos principais problemas de saúde no Mundo e em África. A África Sub-sahariana detém actualmente 67% das infecções a nível global. Angola, localizada na sub-região central de África (OMS) tem uma prevalência actual média estimada em 2.4%, estando rodeada a Sul e Leste por países de prevalências mais elevadas. Em Angola, predomina o VIH-1. Os dados publicados sobre a epidemiologia molecular do VIH em Angola mostram uma grande diversidade de subtipos e formas recombinantes circulantes (CRF), recombinantes circulantes únicas (URF) e amostras não tipificadas. A motivação para o estudo presente foi o conhecimento ainda limitado sobre a infeção por VIH em Angola, desde a epidemiologia molecular às características clínicas, imunológicas, virológicas, resposta à terapêutica anti-retrovírica combinada (TARVc) e perfil de resistência do VIH à TARVc. Foi estudado um coorte de 300 doentes adultos, com infecção por VIH, de 15 de Junho de 2006 a 15 de Junho de 2010. Predomina o género feminino, 65% (194/300) e o grupo etário dos 25 aos 39 anos, 62% (186/300). A mediana de idades é 33 anos, residem em Luanda 98% (295/300), 94% são angolanos, sendo os estrangeiros de S. Tomé e RDC. A Classificação CDC de 1993 na linha de base mostrou um predomínio de doentes da categoria clínica C, 53% (160/300), com uma ou duas doenças definidoras; 34% (101/300) dos doentes eram da Categoria C3 do CDC e 49% (147/300) tinham linfócitos T CD4+ abaixo das 200 cel/l. A doença definidora mais frequente foi a Tuberculose, em 39% dos doentes (117/300). A mediana de linfócitos T CD4+ na linha de base foi de 195 cel/μl [1-1076]. Apenas 12,2% dos doentes (37/302) tinha T CD4+ de base superior a 500 células/l. Determinou-se a carga vírica na linha de base, em 213 dos doentes (71%), verificando-se que 46% destes doentes (97/213) tinham cargas virícas superiores a 100.000 cp/ml, 32% (69/213) entre 10001 e 100000, 21% (45/213) entre 400 e 10000, 0,9% (2/213) abaixo de 400 cp/ml. Iniciaram terapêutica anti-retrovírica no período de estudo 206 doentes (69%) com esquemas terapêuticos baseados em NNRTI, sendo 131 (64%) medicados com a associação d4t+3TC+ NVP. Ao fim de 4 anos, em Junho de 2010, havia 126 doentes monitorizados com contagem de linfócitos T CD4+ e CV, estando 62% dos doentes com CV indetectável (79/126). Os doentes em falência virológica corresponderam a 16% (20/126), 9% (11/126) tinham resultados discordantes (boa resposta imunológica mas carga viral detectável) e 13% (16/126) foram inconclusivos. Foi mudada a terapêutica para esquema de 2ª linha em 5 doentes, 4 dos 5 doentes com critérios de falência virológica e 1 sem critérios de falência virológica, por toxicidade ao EFV. Os doentes com critérios de falência imunológica ou virológica segundo a OMS e os doentes com dados inconclusivos foram seleccionados para testes genotípicos de resistência aos anti-retrovíricos (TR). Foram realizados TR e subtipagem em 37 doentes. Nos doentes que realizaram TR sob TARVc, as mutações de resistência mais frequentemente encontradas foram a M184V, em 16 doentes, a K103N em 12 doentes e a Y181C em 7 doentes. O subtipo C, foi o subtipo predominante em 30% (11/37) dos casos. Para avaliar a adesão à TARVc, foram estudados 63 doentes, faltosos a consultas ou demonstrado sinais de falência clínica, imunológica ou virológica. O método realizado foi o auto-relato por entrevista. Verificou-se uma adesão à TARVc de 100% em 33% (21/63), adesão entre 100% e 90% em 7% (4/63), de 50 a 90% em 7% (4/63) e inferior a 50% em 54% (34/63). Como factores de não-adesão, predominavam a mobilidade no emprego Opções de utilização sequencial de anti-retrovíricos em doentes com falência terapêutica em Angola X e factores familiares e sociais, apontados como razão para a falta às consultas que davam acesso aos medicamentos ARV. Fazendo corresponder os resultados dos testes de resistência realizados à adesão de todos os doentes entrevistados, verifica-se que o grupo de 34 doentes com menos de 50% de adesão, 19 realizaram TR e desses, 13 mostraram mutações de resistência, sendo 10 resistentes a 2 classes de ARV, NITR e NNITR, 2 a NNITR e 1 a NITR. Os restantes 6 doentes deste grupo eram aparentemente susceptíveis às 3 classes de ARV. Actualmente, estão em seguimento 58% dos doentes (176/300), 26 % (77/300) perderam-se no seguimento e 16% (47/300) faleceram. O estudo realizado salienta a fase tardia da chegada aos cuidados médicos; mostra a tuberculose como doença indicadora mais frequente e mostra que a maioria dos doentes foi medicada com D4T+3TC+NVP. Os critérios de sucesso terapêutico descem ao longo do estudo de 71% para 62%. Indica a necessidade de acções urgentes para acesso mais precoce aos cuidados de saúde e intervenção social para ultrapassar as limitações à adesão à TARVc e tornar esta mais eficaz. As opções de segunda linha já disponíveis são muito reduzidas (tenofovir, lopinavir potenciado com ritonavir e saquinavir), havendo necessidade de continuar estes estudos para uma avaliação mais profunda da eficácia destas terapêuticas.

Influence of cardiorespiratory fitness and parental lifestyle on adolescents' abdominal obesity

The aims of this study were (1) to analyse the influence of cardiorespiratory fitness (CRF) and parental overweight status (POS) and socioeconomic status (SES) on abdominal obesity. This study was comprised of 779 adolescents (12-18 years). Waist-height ratio (WHtR), 20 m shuttle-run test to ascertain CRF, POS according to World Health Organization recommendations and SES of parents using level of education were analysed. Using WHtR, the prevalence of abdominal obesity was 21.3% (23.5% girls and 17.9% boys; p = 0.062). Regardless of gender, participants who belonged to the WHtR risk group had significantly (p ≤ 0.05) lower CRF scores than the WHtR non-risk group; 84.4% of girls who belonged to the WHtR risk group had one or two overweight parents (p ≤ 0.05). Boys with low CRF (OR: 6.43; CI: 3.33-12.39) were more likely to belong to the WHtR risk group compared with their lean peers. Girls with low CRF (OR: 1.78; CI: 1.14-2.78) and with at least one overweight parent (OR: 2.50; CI: 1.07-5.85) or two overweight parents (OR: 4.90; CI: 2.08-11.54) were associated with the risk of abdominal obesity. This study highlights the influence of adolescents' family on abdominal obesity, especially in girls. Further, the data suggested that low CRF was a strong predictor of risk values of abdominal obesity in adolescence.

The relationship of cardiorespiratory fitness, birth weight and parental BMI on adolescents’ obesity status

The aims of this study were as follows: (1) to analyze differences in cardiorespiratory fitness (CRF), parents' body mass index (BMI) and birth weight (BW) between non-overweight (NOW) and overweight/obese (OV/OB) adolescents, and (2) to investigate the association of those variables with the risk of their biological offspring being OV/OB. This study comprised 788 adolescents (477 girls and 311 boys), aged between 12 and 18 years. CRF was predicted by maximal multistage 20-m shuttle-run test according to the procedures described in FITNESSGRAM. Children's BMI was classified according to the International Obesity Task Force. Adolescents' BW was assessed from each child's pediatric record at birth. Parents' OV/OB status was defined and classified according to the World Health Organization. Socioeconomic status was defined by parental education. The prevalence OV/OB was 21.4 and 5.3%, respectively, and there were no gender differences. The OV/OB adolescents (girls and boys) had significantly (PCRF scores and higher BW (PCRF (odds ratio (OR): 3.75; PCRF (OR: 2.66; PCRF and high BW were strong predictors of OV/OB in adolescence.

PREVALENCE OF INTESTINAL PARASITISM AND ASSOCIATED SYMPTOMATOLOGY AMONG HEMODIALYSIS PATIENTS

Intestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF), we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively). Blastocystis was the most common infection in the control group (41.9%), however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38). The most common symptoms in this group were flatulence (36.4%), asthenia (30.0%) and weight loss (30.0%). In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703). A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p < 0.05). Comparing symptomatic with asymptomatic, there was no association in either group between symptoms or the prevalence of parasitic infection, nor with the type of parasite or with multiple parasitic infections. Patients with chronic renal failure are frequent targets for renal transplantation, which as well as the inherent immunological impairment of the disease itself, results in immunosuppression by medication. For this reason, carriers of intestinal parasites with pathogenic potential can develop serious clinical complications influencing the success of transplantation. This fact, coupled with the high prevalence of intestinal parasites and the dissociation between symptoms and infection in CRF patients, suggests that the stool test should be incorporated in routine propedeutics. Furthermore, preventive measures for the acquisition of parasites through the fecal-oral contamination route should be introduced.