Key Performance Indicators of Secondary Health Care in Chronic Kidney Disease: Experience in Public and Private Services in the State of São Paulo, Brazil.

The objective of this study was to evaluate quality indicators of secondary health care in chronic kidney disease (CKD). This retrospective longitudinal study was conducted in an outpatient medical nephrology clinic of the Brazilian Unified Health System (UHS) and a multidisciplinary outpatient clinic of a private health plan (PHP). The inclusion criteria were age ≥ 18 years, ≥ 3 medical appointments, and follow-up time ≥ 6 months.

The role of podocyte injury in the pathogenesis of Fabry disease nephropathy.

Renal involvement is one of the most severe morbidities of Fabry disease (FD), a multisystemic lysosomal storage disease with an X-linked inheritance pattern. It results from pathogenic variants in the GLA gene (Xq22.2), which encodes the production of alpha-galactosidase A (α-Gal), responsible for glycosphingolipid metabolism.

Safety and feasibility of transcranial direct current stimulation in end-stage renal disease patients undergoing hemodialysis: an exploratory study.

Introduction: Patients with end-stage renal disease often face a challenging routine of hemodialysis, dietary restrictions, and multiple medications, which can affect their hemodynamic function. Home-based, safe, and nonpharmacological approaches such as transcranial direct current stimulation (tDCS) should be combined with conventional treatment.

Objective: To assess the safety and feasibility of tDCS on blood pressure and heart rate in patients with end-stage renal disease undergoing hemodialysis.

Laboratory-based surveillance of chronic kidney disease in people with private health coverage in Brazil.

Background: Although approximately 25% of Brazilians have private health coverage (PHC), studies on the surveillance of chronic kidney disease (CKD) in this population are scarce. The objective of this study was to estimate the prevalence of CKD in individuals under two PHC regimes in Brazil, who total 8,335,724 beneficiaries.

Methods: Outpatient serum creatinine and proteinuria results of individuals from all five regions of Brazil, ≥ 18 years of age, and performed between 10/01/2021 and 10/31/2022, were analyzed through the own laboratory network database.

Estimated glomerular filtration rate in clinical practice: Consensus positioning of the Brazilian Society of Nephrology (SBN) and Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML).

Chronic kidney disease (CKD) represents one of today's main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease - Epidemiology) is the most recommended one.

Understanding of the role of serum creatinine in a subset of the Brazilian population.

Introduction: Chronic kidney disease is usually asymptomatic, and its diagnosis depends on laboratory tests, with emphasis on serum creatinine and proteinuria.

Objective: To assess knowledge on the role of serum creatinine as a biomarker of kidney function in a sample of the Brazilian population.

Method: Cross-sectional observational study conducted in São Paulo (SP, Brazil), in which a random adult population was interviewed.

ACE2, ACE, DPPIV, PREP and CAT L enzymatic activities in COVID-19: imbalance of ACE2/ACE ratio and potential RAAS dysregulation in severe cases.

Objective And Design: Circulating enzymatic activity and RAAS regulation in severe cases of COVID-19 remains unclear, therefore we measured the serum activity of several proteases as potential targets to control the SARS-CoV-2 infection.

Material Or Subjects: 152 patients with COVID-19-like symptoms were grouped according to the severity of symptoms (COVID-19 negative, mild, moderate and severe).

Methods: Serum samples of COVID-19 patients and controls were subjected to biochemical analysis and enzymatic assays of ACE2, ACE, DPPIV, PREP and CAT L.

Onychomycosis in immunocompromised population: Phenotypic and molecular identification.

Unlabelled: Onychomycosis is common among immunosuppressed individuals. Renal transplant recipients (RTR) and lupus nephritis (LN) patients are submitted to corticosteroid and other immunosuppressive therapy; and diabetes mellitus (DM) patients are intrinsically immunocompromised.

Objectives: The aim of this study was to characterise and identify fungal infections on the nails (feet and hands) in immunocompromised patients.

A Cross-Sectional Study on the Prevalence and Risk Stratification of Chronic Kidney Disease in Cardiological Patients in São Paulo, Brazil.

Chronic kidney disease (CKD) provides a worse prognosis for patients with heart disease. In Latin America, studies that analyzed the prevalence and risk stratification of CKD in this population are scarce. We aimed to evaluate CKD prevalence and risk categories in patients of a public referral cardiology hospital in São Paulo, Brazil.

Supply/demand ratio for medical consultations, diagnostic tests and chronic kidney disease monitoring in the Brazilian National Health System: a descriptive study, state of São Paulo, Brazil, 2019.

Objective: To determine the supply/demand ratio for procedures related to diagnosis and treatment for chronic kidney disease in the Brazilian National Health System (SUS), in the state of São Paulo, Brazil, 2019.

Methods: This was a descriptive study, using data from the SUS outpatient and hospital information systems. The numbers of medical consultations, diagnostic and chronic kidney disease monitoring tests, performed in the period, were compared with the demand estimation, obtained through ministerial guidelines.

Transcranial Direct Current Stimulation (tDCS): Pain Management in End-Stage Renal Disease - Report of an Early Randomized Controlled Trial.

Context: Chronic pain in end-stage renal disease (ESRD) is an increasingly neglected clinical problem affecting more than 60% of patients. Long-term chronic pain could be associated with brain imbalance in circuits of pain matrix and is associated with poor quality of life (QoL) and mood disturbance.

Objectives: The aim of this study was evaluating the effects of transcranial direct current stimulation (tDCS) on pain, QoL, depression, anxiety and affectivity in ESRD patients undergoing hemodialysis (HD).

The first appointment with a nephrologist: Brazilian patients' demographic and kidney function characteristics. A retrospective study.

Background: The number of nephrologists has risen slowly, compared with the prevalence of chronic kidney disease (CKD) in Brazil. Data on patients referred to nephrology outpatient clinics remains scarce.

Objective: To determine the demographic and kidney function characteristics of patients at their first appointment with a nephrologist.

Quality indicators for primary health care in chronic kidney disease in the public service of a city in the State of São Paulo, Brazil.

Complications of chronic kidney disease (CKD) can be avoided when promptly diagnosed and treated. The objective was to describe quality indicators of CKD detection and health care in the primary care public service of a city in the State of São Paulo, Brazil. This retrospective study analyzed charts of patients who attended primary care in the public service between November 2019 and February 2020.

Inflammation and kidney involvement in human viral diseases caused by SARS-CoV-2, HIV, HCV and HBV.

Inflammation is closely related to renal diseases. This is particularly true for renal diseases caused by infections as in viral diseases. In this review, we highlight the inflammatory mechanisms that underlie kidney dysfunction in SARS-CoV-2, human immunodeficiency (HIV), hepatitis C (HCV), and hepatitis B (HBV) infections.

Face Mask Use During the COVID-19 Outbreak: How Did Educated Brazilians Behave?

Purpose: To describe Brazilians' behavior regarding face mask use and health literacy during the COVID-19 pandemic before and after the Ministry of Health of Brazil formal recommendation.

Design: Cross-sectional surveys using a web-based questionnaire. Participants were recruited via snowball techniques.

Eculizumab interruption in atypical hemolytic uremic syndrome due to shortage: analysis of a Brazilian cohort.

Background: The risk of eculizumab therapy discontinuation in patients with atypical hemolytic uremic syndrome (aHUS) is unclear. The main objective of this study was to analyze the risk of aHUS relapse after eculizumab interruption due to drug shortage in Brazil.

Methods: We screened all the registered dialysis centers in Brazil (n = 800), willing to participate in the aHUS Brazilian shortage cohort, through electronic mail and formal invitation by the Brazilian Society of Nephrology.

Knowledge of medical students on organ donation.

Objective: To analyze the spontaneous knowledge of medical students about organ donation.

Methods: 518 students of a medical school in Sao Paulo city, from the first-year to internship, answered an objective questionnaire applied through electronic media to assess their spontaneous theoretical knowledge and organ donation awareness.

Results: Organs that can be donated after brain death, such as the cornea, kidneys, heart, liver, and lung were mentioned by the students.

Point-of-care ultrasonography in nephrology: a cross-sectional national survey among Brazilian nephrologists.

Introduction: Point-of-care ultrasonography (US) (POCUS) has been used in several specialties, particularly in medical emergency. Despite the confirmation of its numerous benefits, the use of POCUS is still timid in nephrology. In the present study, we aim to investigate the use of POCUS by Brazilian nephrologists.

Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus.

Introduction: Infectious complications are common in systemic lupus erythematosus. Although uncommon, central nervous system infections do occur and have significant lethality, with several etiological agents.

Methods: We report on the case of a 29-year-old woman recently diagnosed with systemic lupus erythematosus with hematological, cutaneous, serous and renal manifestations (class IV lupus nephritis), who underwent corticosteroid pulse therapy and mycophenolate induction therapy.

Recurrence of FSGS after Kidney Transplantation in Adults.

Background And Objectives: FSGS recurrence after kidney transplantation is a major risk factor for graft loss. However, the natural history, clinical predictors, and response to treatment remain unclear because of small sample sizes and poor generalizability of single-center studies, and disease misclassification in registry-based studies. We therefore aimed to determine the incidence, predictors, and treatment response of recurrent FSGS in a large cohort of kidney transplant recipients.

HIV-related nephropathy: new aspects of an old paradigm.

The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretroviral drugs, chronic diseases associated with increased survival, or glomerular disease associated to HIV.