Burden of disease: prevalence and incidence of ESRD in Latin America.

Introduction: Chronic kidney disease (CKD) represents a major challenge for Latin America (LA), due to its epidemic proportions and high burden to the population affected and to public health systems.

Methods: Our methods have been reported previously: This paper shows the data for the last 10 years until 2010, from the Latin American Dialysis and Renal Transplantation Registry (RLADTR).

Results: 20 countries participated in the surveys, covering 99% of Latin America (LA).

Associations between global population health indicators and dialysis variables in the Monitoring Dialysis Outcomes (MONDO) consortium.

Background: The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified.

Aims: Gain a better understanding of the association between hemodialysis (HD)-related variables and general population global health indicators.

Impact of baseline health-related quality of life scores on survival of incident patients on peritoneal dialysis: a cohort study.

Introduction: In an attempt to decrease mortality in patients with end-stage renal disease, an increase in the lifetime of these patients without much focus on health-related quality of life (HRQOL) was pursued for a long period of time. However, lately, an improvement in the quality of this extended lifetime has focused on both the physical as well as the social and emotional aspects, as these parameters may be associated with clinical outcomes in end-stage renal disease patients.

Aim: To evaluate the impact of self-determined HRQOL at admission on survival of incident peritoneal dialysis (PD) patients.

N-acetylcysteine as a potential strategy to attenuate the oxidative stress induced by uremic serum in the vascular system.

Aims: Chronic kidney disease (CKD) progression is accompanied by systemic oxidative stress, which contributes to an increase in the risk of cardiovascular diseases (CVDs). N-acetylcysteine (NAC) is among the most studied antioxidants, but its therapeutic benefits in CKD-associated CVDs remain controversial. Here, we investigated whether NAC could inhibit the oxidative stress induced by uremia in vitro and in vivo.

Saliva urea nitrogen dipstick - a novel bedside diagnostic tool for acute kidney injury.

Background And Aims: Measurement of saliva urea nitrogen (SUN) may be valuable in the screening of kidney failure. Here we evaluate the diagnostic performance of SUN dipsticks in patients with acute kidney injury (AKI).

Material And Methods: We measured SUN and blood urea nitrogen (BUN) in hospitalized patients diagnosed with AKI based on Acute Kidney Injury Network (AKIN)-criteria.

Development of a formula for estimation of sodium intake from spot urine in people with chronic kidney disease.

Background/aims: High sodium intake is associated with adverse cardiovascular and renal outcomes in people with chronic kidney disease (CKD), and simple methods to facilitate assessment of sodium intake are required. The objective of this study was to develop a new formula to estimate 24-hour urinary sodium (24hUNa) excretion from urinary Na concentration measured on an early morning urine specimen (EM UNa).

Methods: Seventy participants from a prospective cohort of patients with CKD stage 3 in primary care, the Renal Risk in Derby (RRID) study, agreed to collect an additional EM UNa on the day after completing a 24-hour urine collection.

Systemic lupus erythematous and clinical outcomes in peritoneal dialysis.

Background: The prevalence of systemic lupus erythematous (SLE) patients requiring renal replacement therapy (RRT) is increasing but data on clinical outcomes are scarce. Interestingly, data on technique failure and peritoneal-dialysis (PD)-related infections are rarer, despite SLE patients being considered at high risk for infections. The aim of our study is to compare clinical outcomes of SLE patients on PD in a large PD cohort.

High sodium intake is associated with important risk factors in a large cohort of chronic kidney disease patients.

Background/objectives: An increased risk of mortality and cardiovascular disease (CVD) is observed in people with chronic kidney disease (CKD) even in early stages. Dietary sodium intake has been associated with important CVD and CKD progression risk factors such as hypertension and proteinuria in this population. We aimed to investigate the relationship between sodium intake and CVD or CKD progression risk factors in a large cohort of patients with CKD stage 3 recruited from primary care.

Impact of patient training patterns on peritonitis rates in a large national cohort study.

Background: Ideal training methods that could ensure best peritoneal dialysis (PD) outcome have not been defined in previous reports. The aim of the present study was to evaluate the impact of training characteristics on peritonitis rates in a large Brazilian cohort.

Methods: Incident patients with valid data on training recruited in the Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD II) from January 2008 to January 2011 were included.

Characterization of the BRAZPD II cohort and description of trends in peritoneal dialysis outcome across time periods.

Observational studies from different regions of the world provide valuable information in patient selection, clinical practice, and their relationship to patient and technique outcome. The present study is the first large cohort providing patient characteristics, clinical practice, patterns and their relationship to outcomes in Latin America. The objective of the present study was to characterize the cohort and to describe the main determinants of patient and technique survival, including trends over time of peritoneal dialysis (PD) initiation and treatment.

A Global Overview of the Impact of Peritoneal Dialysis First or Favored Policies: An Opinion.

Given the ever-increasing burden of end-stage renal disease (ESRD) in a global milieu of limited financial and health resources, interested parties continue to search for ways to optimize dialysis access. Government and payer initiatives to increase access to renal replacement therapies (RRTs), particularly peritoneal dialysis (PD) and hemodialysis (HD), may have meaningful impacts from clinical and health-economic perspectives; and despite similar clinical and humanistic outcomes between the two dialysis modalities, PD may be the more convenient and resource-conscious option. This review assessed country-specific PD-First/Favored policies and their associated background, implementation, and outcomes.

The quest for a better understanding of chronic kidney disease complications: an update on uremic toxins.

Chronic kidney disease is characterized by a progressive reduction of glomerular filtration rate and/or the appearance of proteinuria, and subsequently the progressive retention of organic waste compounds called uremic toxins (UT). Over the last decades, a large number of such compounds have been identified and their effects on organs and tissues, especially the cardiovascular system, has been demonstrated. In this review, we present the current classification of UT, as proposed by the EUTox Group, and the effects of some of the probably most important UTs, such as phosphate, FGF-23, PTH, AGEs, indoxyl sulfate and para-cresyl sulfate.

Uremic serum inhibits in vitro expression of chemokine SDF-1: impact of uremic toxicity on endothelial injury.

Introduction: Endothelial dysfunction is important in the pathogenesis of cardiovascular disease (CVD) related to chronic kidney disease (CKD). Stromal cell-derived factor-1 (SDF-1) is a chemokine which mobilizes endothelial progenitor cells (EPC) and together with interleukin-8 (IL-8) may be used as markers of tissue injury and repair.

Objective: This study investigated in vivo and in vitro the effect of uremic media on SDF-1 and IL-8 expression.

Demographic associations of high estimated sodium intake and frequency of consumption of high-sodium foods in people with chronic kidney disease stage 3 in England.

Objective: The objective of this study was to investigate sodium intake in a cohort of people with chronic kidney disease (CKD) Stage 3 in England to identify demographic characteristics of subgroups with high sodium intake and specific foods that contribute to excessive sodium intake.

Design And Methods: Study subjects (N = 1,729) included CKD patients from 32 general practices in the Renal Risk in Derby study. Patients had a glomerular filtration rate between 30 and 59 mL/min per 1.

The chronic kidney disease outcomes and practice patterns study Brazil (CKDopps-Brazil): design, data and methodology.

Introduction: The chronic kidney disease outcomes and practice patterns study (CKDopps) is an international observational, prospective, cohort study involving patients with chronic kidney disease (CKD) stages 3-5 [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, with a major focus upon care during the advanced CKD period (eGFR < 30 ml/min/1.73 m2)].

Evaluation of sub-clinical atherosclerosis and plasma levels of minimally modified LDL in patients with ankylosing spondylitis and its correlation with disease activity.

Introduction: Accelerated atherosclerosis has been shown in some autoimmune diseases, mainly in Systemic Lupus Erythematosus and Rheumatoid Arthritis. Although high prevalence of corticosteroids use may be a confounding factor due to their detrimental effects on several risk factors, systemic inflammation per se is supposed to play an important role in atherogenesis in these patients.

Methods: We have evaluated sub-clinical atherosclerosis and plasma levels of circulating electronegative LDL, which represents the fraction of LDL that is minimally modified, in patients with ankylosing spondylitis (AS).

Evaluation of the use of captopril on peritoneal fibrosis induced in rats by the use of glucose solution 4.25%.

Introduction: Chronic renal failure has alarming incidence all over the world in this century. Among the modalities of dialytic treatment, peritoneal dialysis has a major spot. This method of dialytic treatment may present complications, and among those is peritoneal fibrosis.

Novel predictors of peritonitis-related outcomes in the BRAZPD cohort.

Introduction: Peritonitis remains the main cause of peritoneal dialysis (PD) technique failure worldwide, despite significant reductions in infection rates observed over the past decades. Several studies have described risk factors for peritonitis, technique failure and mortality. However, there are scarce data regarding predictors of complications during and after a peritonitis episode.

Longitudinal changes in health-related quality of life scores in Brazilian incident peritoneal dialysis patients (BRAZPD): socio-economic status not a barrier.

Background And Objectives: A large proportion of the patients on peritoneal dialysis (PD) in Brazil have low levels of education and family income. The present study assessed whether education level and family income are associated with baseline and longitudinal changes in health-related quality of life (HRQOL) scores during the first year of PD therapy.

Methods: We evaluated 1624 incident patients from the Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD) at baseline, and 486 of them after 12 months.

Association among oral health parameters, periodontitis, and its treatment and mortality in patients undergoing hemodialysis.

Background: Chronic periodontitis (CP) is a continuous, reversible source of inflammation with a potential impact on mortality in patients undergoing hemodialysis (HD). This study investigates the impact of oral health indicators, CP, and its treatment on survival rates in a group of patients undergoing HD.

Methods: Clinically stable patients undergoing HD were referred for a dental examination.