Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica
Ano de defesa: | 2021 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Nove de Julho
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Programa de Pós-Graduação: |
Programa de Mestrado em Medicina
|
Departamento: |
Saúde
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://bibliotecatede.uninove.br/handle/tede/2997 |
Resumo: | Introduction: Chronic Kidney Disease (CKD) is characterized by a progressive and irreversible loss of kidney function, with a consequent reduction in the production of erythropoietin, the hormone responsible for erythropoiesis. Therefore, loss of renal function can result in anemia and despite of treatment with the use of erythropoiesis stimulating agents (ESAs), some patients are hyporesponsive due to the state of micro inflammation caused by the accumulation of uremic toxins and hepcidin, a hormone that plays a central role in iron homeostasis. Hemodiafiltration (HDF) is a recent dialysis modality that, due to its higher convective rates, can purify a larger spectrum of molecules, reducing inflammation. Aims: To evaluate the serum concentration of hepcidin and inflammatory biomarkers by treatment with HDF in elderly patients with CKD. Material and methods: Thirty patients aged 65 to 94 years with CKD who were previously treated with conventional hemodialysis and started treatment with HDF were included. However, 19 patients completed the study and were evaluated at time zero and after 12 months of follow-up for hematimetric, biochemical, hepcidin and inflammatory cytokine parameters. Results: After 12 months of treatment, we observed a significant increase in hemoglobin, hematocrit, hepcidin, TNF-α, IL-10, β2-microglobulin and a decrease in C reactive protein (PCR). Discussion: The serum concentrations of hepcidin and β2-microglobulin were not reduced in follow-up in this elderly population of chronic kidney patients after 12 months with HDF treatment probably due to loss of residual renal function. The increase in hemoglobin and hematocrit levels observed may have been due to treatment withs ESAs (89%) and iron supplementation (74%), suggesting that there was no hyporesponsiveness or resistance to treatment in the patients of the present study. Conclusion: Hepcidin appeared to be more related as an iron biomarker regardless of the variations of inflammatory markers than associated with resistance to the use of ESAs. |
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Dalboni, Maria Aparecidahttp://lattes.cnpq.br/9818040147487320Dalboni, Maria Aparecidahttp://lattes.cnpq.br/9818040147487320Elias, Rosilene Mottahttp://lattes.cnpq.br/9742090948110017Custódio, Melani Ribeirohttp://lattes.cnpq.br/3390801574622152http://lattes.cnpq.br/9521707916398214Fanchini, Vanessa Corrêa2022-07-21T19:25:42Z2021-05-06Fanchini, Vanessa Corrêa. Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica. 2021. 56 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/2997Introduction: Chronic Kidney Disease (CKD) is characterized by a progressive and irreversible loss of kidney function, with a consequent reduction in the production of erythropoietin, the hormone responsible for erythropoiesis. Therefore, loss of renal function can result in anemia and despite of treatment with the use of erythropoiesis stimulating agents (ESAs), some patients are hyporesponsive due to the state of micro inflammation caused by the accumulation of uremic toxins and hepcidin, a hormone that plays a central role in iron homeostasis. Hemodiafiltration (HDF) is a recent dialysis modality that, due to its higher convective rates, can purify a larger spectrum of molecules, reducing inflammation. Aims: To evaluate the serum concentration of hepcidin and inflammatory biomarkers by treatment with HDF in elderly patients with CKD. Material and methods: Thirty patients aged 65 to 94 years with CKD who were previously treated with conventional hemodialysis and started treatment with HDF were included. However, 19 patients completed the study and were evaluated at time zero and after 12 months of follow-up for hematimetric, biochemical, hepcidin and inflammatory cytokine parameters. Results: After 12 months of treatment, we observed a significant increase in hemoglobin, hematocrit, hepcidin, TNF-α, IL-10, β2-microglobulin and a decrease in C reactive protein (PCR). Discussion: The serum concentrations of hepcidin and β2-microglobulin were not reduced in follow-up in this elderly population of chronic kidney patients after 12 months with HDF treatment probably due to loss of residual renal function. The increase in hemoglobin and hematocrit levels observed may have been due to treatment withs ESAs (89%) and iron supplementation (74%), suggesting that there was no hyporesponsiveness or resistance to treatment in the patients of the present study. Conclusion: Hepcidin appeared to be more related as an iron biomarker regardless of the variations of inflammatory markers than associated with resistance to the use of ESAs.Introdução: A Doença Renal Crônica (DRC) é caracterizada pela perda progressiva e irreversível da função renal, com consequente redução da produção de eritropoetina, hormônio responsável pela eritropoiese. Portanto, a perda da função renal pode resultar em anemia e apesar do tratamento com uso de agentes estimulantes de eritropoiese (AEEs) alguns pacientes são hiporresponsivos devido ao estado de micro inflamação causado pelo acúmulo de toxinas urêmicas e da hepcidina, hormônio que tem papel central na homeostase do ferro. A hemodiafiltração (HDF) é uma modalidade dialítica recente que por apresentar maiores taxas convectivas pode depurar maior espectro de moléculas reduzindo a inflamação. Objetivos: Avaliar a concentração sérica de hepcidina e biomarcadores inflamatórios pelo tratamento com HDF em pacientes idosos com DRC. Material e métodos: Foram incluídos 30 pacientes com idade entre 65 a 94 anos com DRC que previamente faziam tratamento com hemodiálise convencional e iniciaram o tratamento com HDF. Entretanto, 19 pacientes finalizaram o estudo e foram avaliados no tempo zero e após 12 meses de seguimento para os parâmetros hematimétricos, bioquímicos, hepcidina e citocinas inflamatórias. Resultados: Após 12 meses de tratamento observamos significante aumento da hemoglobina, hematócrito, hepcidina, TNF-α, IL-10 e β2-microglobulina e diminuição da proteína C reativa (PCR). Discussão: As concentrações séricas de hepcidina e β2-microglobulina não se apresentaram reduzidas no seguimento nesta população idosa de doentes renais crônicos após 12 meses de acompanhamento do tratamento com HDF provavelmente devido a perda da função renal residual. O aumento dos níveis de hemoglobina e hematócrito observados podem ter sido decorrentes do tratamento com AEEs (89%) e suplementação de ferro (74%), sugerindo que não houve hiporresponsividade ou resistência ao tratamento nos pacientes do presente estudo. Conclusão: A hepcidina pareceu estar mais relacionada como um biomarcador de ferro independentemente da variação dos marcadores inflamatórios do que associada à resistência ao uso de AEEs.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2022-07-21T19:25:42Z No. of bitstreams: 1 Vanessa Corrêa Fanchini.pdf: 1925167 bytes, checksum: 9f493348e83c689f748275fb0add308b (MD5)Made available in DSpace on 2022-07-21T19:25:42Z (GMT). No. of bitstreams: 1 Vanessa Corrêa Fanchini.pdf: 1925167 bytes, checksum: 9f493348e83c689f748275fb0add308b (MD5) Previous issue date: 2021-05-06application/pdfporUniversidade Nove de JulhoPrograma de Mestrado em MedicinaUNINOVEBrasilSaúdehepcidinainflamaçãoanemiahemodiafiltraçãodoença renal crônicahepcidininflammationanemiahemodiafiltrationchronic kidney diseaseCIENCIAS DA SAUDEAvaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônicaEvaluation of hemodiafiltration on hepcidin in elderly patients with chronic kidney diseaseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALVanessa Corrêa Fanchini.pdfVanessa Corrêa Fanchini.pdfapplication/pdf1925167http://localhost:8080/tede/bitstream/tede/2997/2/Vanessa+Corr%C3%AAa+Fanchini.pdf9f493348e83c689f748275fb0add308bMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/2997/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/29972022-07-21 16:25:42.169oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2022-07-21T19:25:42Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
dc.title.alternative.eng.fl_str_mv |
Evaluation of hemodiafiltration on hepcidin in elderly patients with chronic kidney disease |
title |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
spellingShingle |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica Fanchini, Vanessa Corrêa hepcidina inflamação anemia hemodiafiltração doença renal crônica hepcidin inflammation anemia hemodiafiltration chronic kidney disease CIENCIAS DA SAUDE |
title_short |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
title_full |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
title_fullStr |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
title_full_unstemmed |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
title_sort |
Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica |
author |
Fanchini, Vanessa Corrêa |
author_facet |
Fanchini, Vanessa Corrêa |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Dalboni, Maria Aparecida |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9818040147487320 |
dc.contributor.referee1.fl_str_mv |
Dalboni, Maria Aparecida |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/9818040147487320 |
dc.contributor.referee2.fl_str_mv |
Elias, Rosilene Motta |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9742090948110017 |
dc.contributor.referee3.fl_str_mv |
Custódio, Melani Ribeiro |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3390801574622152 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9521707916398214 |
dc.contributor.author.fl_str_mv |
Fanchini, Vanessa Corrêa |
contributor_str_mv |
Dalboni, Maria Aparecida Dalboni, Maria Aparecida Elias, Rosilene Motta Custódio, Melani Ribeiro |
dc.subject.por.fl_str_mv |
hepcidina inflamação anemia hemodiafiltração doença renal crônica |
topic |
hepcidina inflamação anemia hemodiafiltração doença renal crônica hepcidin inflammation anemia hemodiafiltration chronic kidney disease CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
hepcidin inflammation anemia hemodiafiltration chronic kidney disease |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Introduction: Chronic Kidney Disease (CKD) is characterized by a progressive and irreversible loss of kidney function, with a consequent reduction in the production of erythropoietin, the hormone responsible for erythropoiesis. Therefore, loss of renal function can result in anemia and despite of treatment with the use of erythropoiesis stimulating agents (ESAs), some patients are hyporesponsive due to the state of micro inflammation caused by the accumulation of uremic toxins and hepcidin, a hormone that plays a central role in iron homeostasis. Hemodiafiltration (HDF) is a recent dialysis modality that, due to its higher convective rates, can purify a larger spectrum of molecules, reducing inflammation. Aims: To evaluate the serum concentration of hepcidin and inflammatory biomarkers by treatment with HDF in elderly patients with CKD. Material and methods: Thirty patients aged 65 to 94 years with CKD who were previously treated with conventional hemodialysis and started treatment with HDF were included. However, 19 patients completed the study and were evaluated at time zero and after 12 months of follow-up for hematimetric, biochemical, hepcidin and inflammatory cytokine parameters. Results: After 12 months of treatment, we observed a significant increase in hemoglobin, hematocrit, hepcidin, TNF-α, IL-10, β2-microglobulin and a decrease in C reactive protein (PCR). Discussion: The serum concentrations of hepcidin and β2-microglobulin were not reduced in follow-up in this elderly population of chronic kidney patients after 12 months with HDF treatment probably due to loss of residual renal function. The increase in hemoglobin and hematocrit levels observed may have been due to treatment withs ESAs (89%) and iron supplementation (74%), suggesting that there was no hyporesponsiveness or resistance to treatment in the patients of the present study. Conclusion: Hepcidin appeared to be more related as an iron biomarker regardless of the variations of inflammatory markers than associated with resistance to the use of ESAs. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-05-06 |
dc.date.accessioned.fl_str_mv |
2022-07-21T19:25:42Z |
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Fanchini, Vanessa Corrêa. Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica. 2021. 56 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/2997 |
identifier_str_mv |
Fanchini, Vanessa Corrêa. Avaliação da hemodiafiltração sobre hepcidina em pacientes idosos com doença renal crônica. 2021. 56 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
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