11 documents found, page 1 of 2
Principles of Antibiotic Adjustment in Renal Failure
Dias,Bruno Fraga; Santos,JosefinaABSTRACT The incidence and prevalence of patients with acute kidney injury and chronic kidney disease have increased significantly in recent years. Renal failure is associated with profound changes in the pharmacokinetics and pharmacodynamics of antibiotics. It is widely recognized that inadequate adjustment of antibiotics can lead to undertreatment and impair the patient’s clinical outcome. The difficulty of a...
Proteinase 3 (PR3)-Antineutrophil Cytoplasmic Antibody in a Patient with Minima...
Freitas,Joana; Sala,Inês; Oliveira,João; Campos,Andreia; Santos,Sofia; Santos,Josefina; Cabrita,AntónioABSTRACT Antineutrophil cytoplasmic antibodies (ANCA) are useful as markers for systemic vasculitis. PR3-ANCA antibodies have been also identified in association with chronic inflammatory and infectious conditions, other autoimmune diseases, malignancy, and certain drugs. The association of PR3 and minimal change disease (MCD) without vasculitis is not an expected finding. We report a case of MCD with PR3-ANCA ...
Association between severe chronic kidney disease defined by cystatin-c and cre...
Tavares,Joana; Santos,Josefina; Silva,Filipa; Oliveira,João; Malheiro,Jorge; Campos,Andreia; Cabrita,AntónioABSTRACT Introduction: Estimated glomerular filtration rate (eGFR) based on serum cystatin-C (sCys) seems as accurate as when based on serum creatinine (sCr), but sCys seems a better predictor of adverse outcomes. We aimed to study whether sCys could be a reliable tool for the prediction of adverse outcomes in elderly patients with severe chronic kidney disease (CKD). Methods: A group of 348 elderly patients wi...
Validation of a model to predict six-month mortality in incident elderly dialys...
Santos,Josefina; Oliveira,Pedro; Malheiro,Jorge; Campos,Andreia; Correia,Sofia; Cabrita,António; Lobato,Luísa; Fonseca,IsabelBackground and objectives: To evaluate RRT benefits and risks and to inform patients and their families about ESRD treatment options, we have developed a prognostic score to predict 6-month mortality in elderly ESRD patients initiating dialysis. Five independent predictors were identified and a point system was constructed: age 75 years or older (2 points), coronary artery disease (2 points), cerebrovascular di...
Diagnosis of monoclonal gammopathy of renal significance
Correia,Sofia O; Santos,Sofia; Martins,La Salete; Santos,JosefinaMonoclonal gammopathies are a heterogeneous group of disorders characterized by clonal proliferation of immunoglobulin produced by B-lymphocytes or plasma cell clone. The term monoclonal gammopathy of renal significance (MGRS) was introduced to distinguish monoclonal gammopathies that result in the development of kidney disease from those that are benign. Screening for monoclonal immunoglobulin and an appropria...
Acute tubulointersticial nephritis with uveitis: A report of two cases
Silva,Filipa; Correia,Sofia O; Castro,Ana; Moreira,Carla; Santos,Sofia; Malheiro,Jorge; Santos,Josefina; Martins,La Salete; Cabrita,AntónioTubulointersticial nephritis and uveitis syndrome is an idiopathic and rare cause of acute kidney injury that should not overlooked, because it usually requires specific therapeutic interventions. We report two distinct cases: a young and an elder female. Both cases presented with unspecific constitutional symptoms but had different onset of renal and ocular involvement. Both were treated with topical and syste...
Arterio-arterial graft - an option for hemodialysis patients with exhaustion of...
Castro,Ana; Almeida,Paulo; Silva,Filipa; Rego,Duarte; Tavares,Joana; Santos,Josefina; Silva,Fernanda; Queirós,José Alexandre; Cabrita,AntónioIntroduction: Vascular access (VA) for hemodialysis (HD) is the lifeline for End Stage Renal Disease (ESRD) patients. Long-term HD patients often have exhaustion of their venous patrimony for an autologous VA construction and, sometimes, even for a central venous catheter (CVC) placement. Case report: We describe the case of a 43-year-old woman with ESRD due to lupus nephritis, on maintenance HD since 2009. She...
ANCA-positive vasculitis: Clinical implications of ANCA types and titers
Domingues,Vital Manuel Da Silva; Machado,Bernardete; Santos,JosefinaSUMMARY Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease that can affect multiple organs, the kidney being one of the most affected. Apart from the diagnostics value of ANCA, they have also been advocated as biomarkers of the disease activity. Recently, the genetic changes found in polyangiitis associated with serine-protease proteinase 3 (PR3)-ANCA or mye...
Mesalazine induced tubulointersticial nephritis
Campos,Andreia; Santos,Sofia; Santos,Josefina; Malheiro,Jorge; Rodrigues,Anabela; Lobato,Luísa; Viscaíno,J. Ramón; Cabrita,AntónioInflammatory bowel disease and its various treatments may affect the kidney in several ways. Tubulointersticial nephritis is a rare but serious complication of longer-term mesalazine use. There are few cases reported in the literature. We report the first two cases of mesalazine-induced tubulointersticial nephritis, recently diagnosed in our department. The first one refers to a patient with ulcerous colitis an...
Use of equations for glomerular filtration rate estimation in the elderly
Malheiro,Jorge; Santos,JosefinaChronic kidney disease (CKD) has been increasingly diagnosed in the elderly, though its clinical significance is still matter of debate. Serum creatinine and cystatin C are the most used endogenous renal function markers. Several equations, usually adjusted for demographical variables, have been derived from them, in order to estimate glomerular filtration rate (eGFR). Serum creatinine levels are influenced by ...