Ankle-brachial index: a simple way to predict mortality among patients on hemodialysis--a prospective study.

Background: Ankle-brachial index (ABI) can access peripheral artery disease and predict mortality in prevalent patients on hemodialysis. However, ABI has not yet been tested in incident patients, who present significant mortality. Typically, ABI is measured by Doppler, which is not always available, limiting its use in most patients.

Bioelectrical impedance analysis and skinfold thickness sum in assessing body fat mass of renal dialysis patients.

Objective: In chronic renal failure patients under hemodialysis (HD) treatment, the availability of simple, safe, and effective tools to assess body composition enables evaluation of body composition accurately, in spite of changes in body fluids that occur in dialysis therapy, thus contributing to planning and monitoring of nutritional treatment. We evaluated the performance of bioelectrical impedance analysis (BIA) and the skinfold thickness sum (SKF) to assess fat mass (FM) in chronic renal failure patients before (BHD) and after (AHD) HD, using air displacement plethysmography (ADP) as the standard method.

Design: This single-center cross-sectional trial involved comparing the FM of 60 HD patients estimated BHD and AHD by BIA (multifrequential; 29 women, 31 men) and by SKF with those estimated by the reference method, ADP.

When is the best moment to assess the ankle brachial index: pre- or post-hemodialysis?

Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD.

Obstetric outcome in pregnant women on long-term dialysis: a case series.

Background: Although still uncommon, pregnancy frequency in women on maintenance hemodialysis therapy has increased in the past 20 years. Most published reports suggest that intensified hemodialysis regimens result in better pregnancy outcomes. The small number of patients investigated in all reported series is the main limitation of the available studies.

Insertion of tunneled hemodialysis catheters without fluoroscopy.

Background: The tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists.

Methods: We performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter.

Effects of bone remodelling on calcium mass transfer during haemodialysis.

Background: During haemodialysis, calcium balance can affect, or be affected by, mineral metabolism. However, when dialysate calcium concentration (d[Ca]) is chosen or kinetic models are employed to calculate calcium balance, bone remodelling is rarely considered. In this study, we examined whether bone remodelling affects calcium mass transfer during haemodialysis.

Obstructive sleep apnea in patients on conventional and short daily hemodialysis.

Obstructive sleep apnea (OSA) is common among patients on maintenance hemodialysis. However, the factors associated with the origin of OSA as well as the cardiovascular consequences in this population are not completely understood. We evaluated, by standard overnight polysomnography, 24-hour ambulatory blood pressure (BP) monitoring and echocardiography in 30 patients (14 males, age 34 +/- 11 years, BMI 23.

End-stage renal disease and its treatment in Latin America in the twenty-first century.

The Latin American Society of Nephrology and Arterial Hypertension's Dialysis and Transplant Registry was chartered in 1991. It collects information on ESRD and its treatment in 20 countries of the region. The prevalence of patients on renal replacement therapy (RRT) increased from 129 pmp in 1992 to 447 pmp in 2004; in 2004, 56% of the patients were on hemodialysis, 23% on peritoneal dialysis, and 21% had a functioning kidney graft.

End-stage renal failure and national resources: the Brazilian experience.

Brazil is the fifth largest and the fifth most populous nation in the world. Its economy rivals Mexico as the strongest in Latin America and ranks among the 15 largest economies in the world. Despite these achievements, a substantial fraction of the Brazilian population still lives in poverty, and many still have limited access to medical assistance.

Paulista Registry of glomerulonephritis: 5-year data report.

Background: The Paulista Registry of Glomerulopathies was created in May 1999 and comprises several centres of São Paulo, the most populous Brazilian State, that concentrates people from all regions of the country who look for health care.

Methods: This report includes data from 2086 patients from Brazil submitted to renal biopsy due to the presumed diagnosis of glomerular diseases, registered prospectively since May 1999 until January 2005. Data were collected by the integrants of the 11 centres involved, utilizing a standardized questionnaire.

Positive acute-phase inflammatory markers in different stages of chronic kidney disease.

Background: An elevated serum level of acute-phase inflammatory markers is associated with an increased risk of cardiovascular disease. We hypothesized that elevated acute-phase inflammatory markers are directly associated with the different stages of chronic kidney disease (CKD).

Methods: We evaluated the relationship between serum levels of high-sensitivity C-reactive protein (hsCRP) and alpha1-acid glycoprotein (alpha1-AGP), as well as the renal function in 224 adult patients with CKD (mean age 56.

End-stage renal disease in Brazil: epidemiology, prevention, and treatment.

Brazil is one of the largest and most populous nations in the world, ranking among the 5 largest economies in the Americas and among the 15 largest economies in the world. However, Brazil is still plagued by social problems such as the persistence of poverty and immense deficiencies in its health system. Currently, there are approximately 390 patients on chronic renal replacement therapy (RRT) per million population, about one third the US prevalence, which suggests that end-stage renal disease is either underdiagnosed or undertreated.

Plasma and dialysate IL-6 and VEGF concentrations are associated with high peritoneal solute transport rate.

Background: It has been speculated that increased levels of circulating or intraperitoneal pro-inflammatory cytokines such as interleukin 6, and pro-angiogenic vascular endothelial growth factor (VEGF) may contribute to high peritoneal small-solute transport rate (PSTR) in continuous ambulatory peritoneal dialysis (CAPD) patients. In this study we evaluated possible relationships between plasma and dialysate IL-6 and VEGF levels and PSTR.

Methods: Forty CAPD patients (mean age+/-SD of 58+/-14 years) with no apparent inflammation process or disease, who had been on CAPD for 19+/-15 months (range 3-56 months) were included in the study.