Publications by authors named "Pecoits-Filho R"
Background: Contrast-associated acute kidney injury (CA-AKI) is frequent in patients with chronic kidney disease who are submitted to cardiac endovascular procedures using iodinated contrast. In hemoadsorption, cartridges containing styrene-divinylbenzene sorbent resin are applied to remove substances from the blood through an extracorporeal circuit. Importantly, iodinated contrast is also removed via adsorption.
View Article and Find Full Text PDFBackground: We sought to comprehensively describe drug-related components associated with acute kidney injury (AKI) in patients with chronic kidney disease (CKD), describing the incidence of drug-related AKI, the proportion of preventable AKI, identified the various drugs potentially associated with it, explored the risk factors, and assessed the 1-year incidences of the recurrence of drug-related AKI, kidney failure, and death.
Methods: CKD-REIN is a French national prospective cohort of 3033 nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 ml/min/1.73 m²).
Background: People with kidney failure have a high risk of cardiovascular morbidity/death, including thromboembolic events. Factor XIa inhibitors are a new class of anticoagulants in development that may offer antithrombotic benefits with a lower risk of incremental bleeding events than traditional therapies. We investigated major adverse vascular events (MAVEs), a relevant composite outcome for testing novel antithrombotic agents, in a large cohort of patients on hemodialysis, to better understand the key requirements to adequately design a phase 3 trial.
View Article and Find Full Text PDFBackground: The associations between self-reported chronic kidney disease-associated pruritus (CKD-aP) and patient-reported outcomes (PROs) have been reported using various instruments to assess itch. Data collection via multiple CKD-aP instruments allows the evaluation of different domains and measurements of CKD-aP burden and may help tailor data capture for future research or clinical care.
Methods: An electronic PRO (ePRO) survey was distributed to European hemodialysis (HD) patients enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS) in 2021-23.
Introduction: Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.
Methods: DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m recorded 91-730 days apart.
Article Synopsis
- Blood pressure (BP) control is crucial for preventing complications in chronic kidney disease (CKD), yet many patients struggle to reach target levels; this study evaluates how antihypertensive prescriptions change over time in CKD patients.
- Conducted with 2,755 hypertensive CKD patients in France, the study tracked factors influencing prescription changes, such as patient demographics and healthcare provider interactions.
- Results showed that over five years, there was a high rate of changes in medication; poor adherence to medications increased the likelihood of needing additional drugs, while having a lower education level led to more frequent withdrawals of antihypertensive medications.
Introduction: While the economic and clinical burden of chronic diseases are well documented, their environmental impact remains poorly understood. We developed a framework to estimate the environmental impact of a disease care pathway using chronic kidney disease (CKD) as an example.
Methods: A life cycle assessment framework was developed for the CKD care pathway and validated by experts.
Our previous manuscript showed that thrombocytopenia predicts all-cause mortality in Chinese hemodialysis (HD) patients. Based on the role of platelets in coagulation, clot formation, and systemic inflammation, we speculate that high platelets increase risk of thrombo-embolic events, hence the mortality. However, research evidence is currently lacking.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the link between physical activity and outcomes in advanced chronic kidney disease (CKD) patients in Japan, focusing on those with eGFR < 45 ml/min.
- Results show that active patients in CKD stage G3b have a lower risk of renal decline, while physical activity is also associated with reduced mortality, particularly for non-diabetic patients across stages G3b to G5.
- Overall, the findings indicate that exercise can improve survival and renal health in advanced CKD, emphasizing its importance for both diabetic and non-diabetic patients, especially those in earlier stages.
Hypokalaemia in patients with type 2 diabetes and chronic kidney disease: the effect of finerenone - a FIDELITY analysis.
Eur Heart J Cardiovasc Pharmacother
October 2024
Article Synopsis
- Hypokalaemia, or low potassium levels, increases the risk of heart-related issues and death in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D).
- An analysis from the FIDELITY study showed that a significant percentage of patients experienced treatment-emergent hypokalaemia while on finerenone or placebo, with lower potassium levels correlating to higher cardiovascular risks.
- Finerenone was effective in lowering the incidence of hypokalaemia and also reduced the overall risk of cardiovascular events and arrhythmias, regardless of the initial potassium levels in patients.
Early peritoneal dialysis (PD)-related infection is a severe complication. This study investigated the relationship between patient-doctor contact (PDC) duration and early PD-related infection. In the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) Korea, incident dialysis patients receiving PD were divided into two groups based on PDC duration (< 15 min versus ≥ 15 min), which was defined as the duration a nephrologist typically spends with a patient receiving PD during each visit according to the facility practice pattern.
View Article and Find Full Text PDFRationale & Objective: Estimates of the incidence of hyperkalemia in patients with chronic kidney disease (CKD) vary widely. Our objective was to estimate hyperkalemia incidence in patients with CKD from routine clinical care, including by level of kidney damage or function and among important patient subgroups.
Study Design: Retrospective cohort study.
Article Synopsis
- Chronic kidney disease (CKD) significantly affects patients' emotional well-being and daily lives, with emotional responses like worry and shock reported at diagnosis.
- The study involved interviews with 105 CKD patients across four countries, revealing that disease severity correlates with increased impacts on mental health and daily functioning, particularly for those in advanced stages or on dialysis.
- The results highlight a need for better patient education and support, as many participants felt inadequately informed about their condition and sought additional information to manage their CKD experience.
Rationale & Objective: Recent evidence suggests people with nondialysis chronic kidney disease (ND-CKD) experience a substantial burden of symptoms, but informative large-scale studies have been scarce. We assessed the prevalence of symptoms and the association of overall symptom burden with quality of life in patients with moderate to severe CKD.
Study Design: Cross-sectional study.
Key Points: Hyperkalemia (HK) is associated with increased comorbidity burden in patients with CKD. Reducing serum potassium levels after HK episodes helps continuation of renin-angiotensin-aldosterone system inhibitor treatment. In Japan, HK treatment pathways are more heterogeneous and potassium binders are more commonly prescribed compared with the United Kingdom.
View Article and Find Full Text PDFBackground: Clinical practice guidelines for patients with chronic kidney disease (CKD) recommend regular monitoring and management of kidney function and CKD risk factors. However, the majority of patients with stage 3 CKD lack a diagnosis code, and data on the implementation of these recommendations in the real world are limited.
Aim: To assess the implementation of guideline-directed monitoring and management practices in the real world in patients with stage 3 CKD without a recorded diagnosis code.
Background: The use of diuretics in patients on haemodialysis (HD) is thought to maintain diuresis. However, this assumption and the optimal dose are based on little scientific evidence, and associations with clinical outcomes are unclear.
Methods: We reported international variations in diuretic use and loop diuretic dose across 27 759 HD patients with dialysis vintage <1 year in the Dialysis Outcomes and Practice Patterns Study phases 2-5 (2002-2015), a prospective cohort study.
Introduction: This analysis examined the baseline characteristics and clinical outcomes of patients with chronic kidney disease (CKD) and rapid or non-rapid estimated glomerular filtration rate (eGFR) decline, using retrospective data from DISCOVER CKD (ClinicalTrials.gov, NCT04034992).
Methods: Data (2008-2020) were extracted from UK Clinical Practice Research Datalink, US TriNetX, US Limited Claims and Electronic Health Record Dataset, and Japan Medical Data Vision.
Article Synopsis
- The study investigates how chronic kidney disease (CKD) affects sex differences in cardiovascular disease (CVD) risk, specifically distinguishing between atheromatous CVD (ACVD) and nonatheromatous CVD (NACVD).
- Utilizing data from a cohort of nearly 3,000 patients with moderate to severe CKD across France, the results indicate that women have a significantly lower rate of ACVD compared to men, but no significant difference in NACVD rates was found between the sexes.
- The findings highlight that as kidney function declines (measured by eGFR), the sex differences in ACVD risk diminish, whereas NACVD risk remains consistent across both sexes, suggesting gender impacts risk differently based on CVD