Banca de DEFESA: FLAVIO JOSE DUTRA DE MOURA
Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.STUDENT : FLAVIO JOSE DUTRA DE MOURA
DATE: 26/05/2023
TIME: 14:00
LOCAL: auditório da Pós-Graduação da Faculdade de Medicina
TITLE:
Keywords: Erithropoiesis. Metabolism markers. Ionic markers. Nutritional markers. Toxicity markers. Inflammatory markers
KEY WORDS:
Keywords: Erithropoiesis. Metabolism markers. Ionic markers. Nutritional markers. Toxicity markers. Inflammatory markers
PAGES: 84
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Clínica Médica
SPECIALTY: Nefrologia
SUMMARY:
Introduction: Chronic kidney disease (CKD) is characterized by low glomerular filtration rate, proteinuria, tissue damage in the kidneys and time of clinical manifestation. For the diagnosis, the anatomical/structural and functional criteria are considered, as well as the time of symptom manifestation. Once diagnosed, DRC patients are required to undergo renal replacement therapies such as hemodialysis (HD) and hemodiafiltration (HDF). HD removes low molecular weight molecules, while HDH purifies small and large molecules, favoring a reduction in oxidative stress, hospitalization, and mortality. Objectives: Considering all the benefits, this study evaluated the hematological, biochemical and immune parameters of individuals with CKD treated with HD and subsequently converted to DHT. Material and Methods: This was a descriptive and comparative cross-sectional study conducted with 25 individuals (66±10 years) treated with HD and subsequently converted to HDF (convenience sample). Hematological, biochemical and immune parameters were analyzed in blood samples (cells and serum) obtained from the individuals. Results: the etiology of CKD was type II DM (48%) and SAH (32%), the duration of HD was 4.7±4.9 years, the venous access was predominantly arteriovenous fistula (60%) and long-term catheter (36%). The dry weight (PS) of the subjects at the end of HD was 70.8±17.1 Kg, with ∆PS of 0.0±1.4 Kg. There was a negative correlation between HD time and ages. Cells and serum markers: HDF reduced serum levels of erythropoietin (EPO), glucose, Aspartate aminotransferase, ꞵ2-Microglobulin and EPO resistance index, increased alkaline phosphatase and C-reactive protein; HDF did not alter alanine aminotransferase, triglycerides, lipoproteins (low and high density), ions (HCO3-, Na+, K+, Mg2+, PO43-, Ca2+), vitamin D, albumin, ferritin, and parathormone. Furthermore, HDF increased hematocrit and hemoglobin (Hb) in diabetics, reduced Hb in hypertensives, and did not alter WBC, WBC, mean corpuscular volume, mean corpuscular hemoglobin, or red cell distribution amplitude in subjects with SAH or DM-II. Immunological markers: HDF normalized the phagocytic index in PMP or opsonin-mediated phagocytosis with 5 or 20 yeast/cell (C > HD < HDF), as well as normalized the stimulated corpuscular index (C > HD < HDF), but increased TNF and IL-4 production compared to HD. Furthermore, HDF normalized basal O2●- production, as well as, normalized its production in the absence of phagocytosis, but when compared to HD, HDF increased O2●- production, in the presence or absence of yeast ingestion. Conclusion: The set of results indicates that the HDF is safe, feasible and effective to improve the biochemical and inflammatory markers of individuals with CKD. Considering that this technique is little used in Brazil, being restricted to private organizations, it is suggested the continuity of studies to improve the technical parameters of HDF and thus promote greater visibility and acceptance of patients and the medicacommunity, aiming its future deployment in the single health system country.
BANKING MEMBERS:
Externo ao Programa - 1646005 - AMILCAR SABINO DAMAZO
Externo à Instituição - JOSÉ CARLOS DE ALMEIDA - SESDF
Externa ao Programa - 2201136 - MARIA ALICE DE VILHENA TOLEDO
Externa à Instituição - RENATA OLIVEIRA SOARES - FEPECS
Presidente - 3424061 - SELMA APARECIDA SOUZA KUCKELHAUS