Publications by authors named "Jose A Moura-Neto"

Article Synopsis
  • GLP-1 receptor agonists (GLP-1 RAs) may reduce major kidney events and all-cause mortality in patients with type 2 diabetes and chronic kidney disease (CKD).
  • A systematic review included 10 studies involving over 18,000 patients, showing significant benefits with GLP-1 RAs compared to placebo.
  • There were no significant differences in cardiovascular events or mortality, indicating more research may be needed in those areas.
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Introduction: Visual Abstract is a visual summary of the most relevant information from a scientific article, presented as an infographic. Despite the growing use of Visual Abstracts by journals around the world, studies evaluating their components to guide their development remain scarce.

Objective: The primary objective of this study is to identify the aesthetic perceptions of Visual Abstracts components by physicians and medical students.

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Women with chronic kidney disease are less likely to become pregnant and are more susceptible to pregnancy complications when compared to patients with normal kidney function. As a result, these are considered high-risk pregnancies, both maternal and fetal. Over the years, there has been an increase in the incidence of pregnancies in dialysis patients, and an improvement in maternal and fetal outcomes.

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Background And Objectives: The efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) may depend on renal function, and this raises theoretical concern over its effects on cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).

Methods: This systematic review and updated meta-analysis of randomized controlled trials (RCTs) compared cardiovascular outcomes of patients with T2DM and CKD treated with SGLT2i to placebo. PubMed, Embase, and Cochrane were systematically searched.

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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.

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Purpose: Brazil has one of the world's highest numbers of patients on hemodialysis (HD). Most dialysis centers are private and perform HD for patients with private and public health insurance. We compared 1-year survival between patients initiating chronic HD with public and private health insurance.

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Introduction: The Brazilian Dialysis Survey (BDS) is an annual national survey about patients on chronic dialysis that contributes to health policies.

Objective: To report the 2022 epidemiological data from the BDS of the Brazilian Society of Nephrology (BSN).

Methods: A survey was carried out in Brazilian chronic dialysis centers using an online questionnaire that included clinical and epidemiological aspects of patients on chronic dialysis, dialysis therapy data, and dialysis center characteristics.

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Background: Anemia is a common finding among patients with advanced chronic kidney disease, especially those on dialysis. The recent introduction of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) has raised some concerns about the cardiovascular and thrombotic complications of this class of drugs.

Objectives: This meta-analysis aimed to assess the safety of HIF-PHIs in patients with end-stage kidney disease (ESKD) versus standard therapy with erythropoiesis-stimulating agents (ESAs).

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Acute kidney injury (AKI) and electrolyte disorders are important complications of hospitalized coronavirus disease 2019 (COVID-19) patients. AKI is thought to occur due to multiple pathophysiological mechanisms, such as multiple organ dysfunction (mainly cardiac and respiratory), direct viral entry in the renal tubules, and cytokine release syndrome. AKI is present in approximately one in every ten hospitalized COVID-19 patients.

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Among renal replacement therapies, preemptive kidney transplantation (PKT) presents the best clinical, social, and economic results. However, it is still infrequently chosen as first therapy for patients with irreversible kidney failure. Initiatives in different parts of the world were developed to identify the reasons why PKT is still not widely used and to facilitate the access of patients with end-stage kidney disease to the advantages associated with it.

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Article Synopsis
  • COVID-19 poses significant risks to patients on renal replacement therapy, as those with kidney disease face severe complications if infected.
  • Several medical guidelines have emerged to help manage this vulnerable population, focusing on prevention and safety in dialysis settings.
  • The article reviews key strategies for screening and protecting healthcare workers and dialysis patients, along with emergency responses to outbreaks and management of complications, including special considerations for children with kidney disease.
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Infection by the hepatitis C virus is more prevalent in patients on dialysis than in the general population in Brazil, and has been associated with worse outcomes. Current therapy for hepatitis C is highly effective, safe, and widely available in Brazil, with coverage provided to dialysis patients with chronic kidney disease, which makes the elimination of hepatitis C a viable target. The Brazilian Society of Nephrology, the Brazilian Society of Hepatology, and the Brazilian Liver Institute developed the "Brazilian Registry for the Elimination of Hepatitis C in Dialysis Units".

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Article Synopsis
  • Hypertension affects about 36 million Brazilians, with 10%-20% of those diagnosed having resistant hypertension, which can lead to serious health complications.
  • A study in a specialized clinic found that 31.7% of 104 patients had resistant hypertension; this group was predominantly female and had higher instances of diabetes and dyslipidemia.
  • The study suggests that the higher prevalence of resistant hypertension may be linked to the demographic makeup of the population, especially the significant percentage of black and brown patients.
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Purpose Of Review: In this narrative review, we describe general aspects, histological alterations, treatment, and implications of Fabry disease (FD) nephropathy. This information should be used to guide physicians and patients in a shared decision-making process.

Source Of Information: Original peer-reviewed articles, review articles, and opinion pieces were identified from PubMed and Google Scholar databases.

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The attractiveness of a career in nephrology has diminished over the past decades, leading to global concerns about the future of the specialty's workforce. The reasons physicians choose (and do not choose) a career in the field must be identified in order to boost recruitment of new nephrologists. In this article, a multilevel strategy is proposed to deal with the declining interest in the specialty: (1) increasing contact and providing early exposure to nephrology; (2) promoting mentoring and role models in medical schools; (3) improving the experience of trainees and medical students; (4) incorporating procedural skills and combined fellowship training with critical care in nephrology; (5) facilitating exchanges between trainees and young and senior nephrologists; (6) adopting an active approach to identify reasons for dissatisfaction, reduce burnout, and encourage a suitable work-life balance among nephrologists; (7) increasing remuneration; and (8) incentivizing advances in the field.

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Chloroquine and hydroxychloroquine have shown promising preliminary results and have been discussed as therapeutic options for patients with Covid-19. Despite the lack of robust evidence demonstrating the benefits and justifying the use of one of these drugs, the final decision is the responsibility of the attending physician and should be individualized and shared, whenever possible. This position statement recommends dosage adjustment for these drugs in the context of renal impairment.

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Introduction: The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic.

Methods: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed.

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Considering the new coronavirus epidemic (Covid-19), the Brazilian Society of Nephrology, represented by the Peritoneal Steering Committee, in agreement with the and the Dialysis Department, developed a series of recommendations for good clinical practices for peritoneal dialysis (PD) clinics, to be considered during the period of the Covid-19 epidemic. We aim to minimize the disease spread, protecting patients and staff, and ensuring the quality of the treatment provided and adequate follow-up for PD patients. The recommendations suggested at this moment must be adapted to each clinic's reality and the conditions of the structural and human resources, dependent on the adequate financial provision of the public health system for its full implementation.

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Dialysis units are environments potentially prone to the spread of Covid-19. Patients cannot suspend treatment, and they often have comorbidities, which assigns them a higher risk and worse prognosis. The Brazilian Society of Nephrology prepared this document of good practices, whose technical recommendations deal with general measures that can be implemented to reduce the risk of transmission and prevent the spread of the disease in the unit.

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These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted.

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