Publicações - 2009

Cost Benefits of Peritoneal Dialysis in Specific Groups of Patients

Rodrigues A.

Division of Nephrology, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal.

Contrib Nephrol. 2009;163:285-291. Epub 2009 Jun 3.

The cost benefit of peritoneal dialysis (PD) is reflected in generally lower expenditure than in-center hemodialysis while clinical advantages of home therapy are guaranteed. PD offers similar patient survival in comparison with hemodialysis, and opportunities of better adequacy, beyond Kt/V, including continuous removal of uremic toxins, residual renal function protection, nutritional intraperitoneal support, and life satisfaction. Advances on the modality including the use of icodextrine, automated PD, low-glucose degradation products, new solutions and individualized schedules promise to improve the prognosis of risk patients under dialysis such as diabetics and patients with congestive heart failure, the elderly, the fast transporters or the anuric. Patients deserve an individualized prescription taking into account their lifestyle and therapy options in an integrated care plan. PD after renal transplantation failure is an emerging group of PD patients with need for specific protocols, while PD in the acute setting can also be considered in specific situations. Copyright © 2009 S. Karger AG, Basel.

PMID: 19494627 [PubMed - as supplied by publisher] 

How to Persuade Peritoneal Dialysis - Skeptical Hemodialysis Fans

Rodrigues A.

Division of Nephrology, Hospital de Santo António, Porto, Portugal.

Contrib Nephrol. 2009;163:237-242. Epub 2009 Jun 3.

Already from its early decades, peritoneal dialysis (PD) has proved to be effi cient and able to confer similar or better chronic patient survival in comparison with hemodialysis (HD). More recent years allowed many PD therapy advances with further outcomes improvement: mortality, hospitalizations and clinical complications all have been reduced across patient's vintages. Adequacy parameters of PD also compare advantageously with the erroneously named 'high-efficiency' HD which is now facing the limitations of intermittent procedures, frailty of KT/V as measure of adequacy, importance of sustained fluid removal and time of dialysis. Adequacy should also include life satisfaction and PD also compares favorably as a home therapy. The best approach, also the most intelligent and cost-effective, would be not to underestimate a different therapy, but discover how complementary it can be for success of long term patient treatment. Copyright © 2009 S. Karger AG, Basel.

PMID: 19494619 [PubMed - as supplied by publisher]

Importance of Residual Renal Function and Peritoneal Dialysis in Anuric Patients

Carvalho MJ, Rodrigues A.

Division of Nephrology, Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal.

Contrib Nephrol. 2009;163:155-160. Epub 2009 Jun 3.

Residual renal function (RRF) impacts on patient survival and quality of life of dialysis patients. Its longer preservation is a major advantage of peritoneal dialysis (PD) and should be also a target of adequacy, beyond Kt/V. Anuric patients no longer benefit from such PD advantage, depending only on dialysis schedule to achieve adequate small solute and volume control. This challenge can be successfully dealt with by using automated PD, icodextrine, low-glucose degradation products and individualized PD profiles. There is evidence that PD advances allow nowadays satisfactory patient survival while keeping the benefi ts of home dialysis and preserving vascular network. An integrated care plan should consider both medical indications and patient preference aiming for the longer total patient survival, even if transfer to HD might be later needed as part of individualized renal replacement strategy. Copyright © 2009 S. Karger AG, Basel.

PMID: 19494609 [PubMed - as supplied by publisher]

Peritoneal dialysis in anuric patients: old problems and new perspectives

Rodrigues AS.

Nephrology Department, Hospital Geral Santo Antonio, Porto, Portugal.

Perit Dial Int. 2009 Feb;29 Suppl 2:S233-5. Review.

Anuric patients are often excluded from peritoneal dialysis (PD) because of the fear that PD is inadequate to treat this higher-risk group of patients. However, advances in PD knowledge and technique allow better and adjusted treatments. There is now clinical evidence that anuric patients can be successfully treated with PD, while new solutions promise to mitigate some limitations of automated PD, such as sodium and fluid removal and preservation of membrane function.

PMID: 19270225 [PubMed - indexed for MEDLINE]

A meta-analysis of the relative doses of erythropoiesis-stimulating agents in patients undergoing dialysis

Xavier Bonafont1, Andreas Bock2, Dave Carter3, Reinhard Brunkhorst4, Fernando Carrera5, Michael Iskedjian6, Bart Molemans3, Bastian Dehmel7 and Sean Robbins7

1 Department of Pharmacy, University Hospital Germans Trias i Pujol, Badalona, Spain, 2 Kantonsspital Aarau, Aarau, Switzerland, 3 Amgen Ltd, Uxbridge, UK, 4 Klinikum Hannover-Oststadt, Hannover, Germany, 5 Eurodial, Dialysis Unit, Leiria, Portugal, 6 PharmIdeas, Research & Consulting Inc, Oakville, Ontario, Canada and 7 Amgen Europe GmbH, Zug, Switzerland

NDT Plus (2009) 2: 347–353

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Femoral bone mineral density reflects histologically determined cortical bone volume in hemodialysis patients

T. Adragao & J. Herberth & M.-C. Monier-Faugere & A. J. Branscum & A. Ferreira & J. M. Frazao & H. H. Malluche

Osteoporos Int (2009) DOI 10.1007/s00198-009-0988-9

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Inferring Disease Mechanisms from Epidemiological Data in Chronic Kidney Disease: Calcium and Phosphorus Metabolism

Ana Pires a Teresa Adragão b Maria João Pais b José Vinhas c Hugo Gil Ferreira d

Departments of Nephrology, a Fernando da Fonseca Hospital, b Santa Cruz Hospital, c São Bernardo Hospital, and d Centro de Biotecnologia e Química Fina, REQUIMTE, FCT, New University of Lisbon, Lisbon, Portugal

Nephron Clin Pract 2009;112:c137–c147

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A plain X-ray vascular calcification score is associated with arterial stiffness and mortality in dialysis patients

Teresa Adragão1, Ana Pires1, Rita Birne1, Jose Dias Curto2, Carlos Lucas1, Margarida Gonçalves1 and Acácio Pita Negrão1

1 Nefroclínica-Estoril, Diaverum, Estoril and 2 ISCTE, Business School, Lisbon, Portugal

Nephrol Dial Transplant (2009) 24: 997–1002

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Low Bone Volume - A Risk Factor for Coronary Calcifications in Hemodialysis Patients

Teresa Adragao,* Johann Herberth,† Marie-Claude Monier-Faugere,† Adam J. Branscum,‡ Anibal Ferreira,§ Joao M. Frazao,II Jose Dias Curto,¶ and Hartmut H. Malluche†.

*Nephrology Department, Santa Cruz Hospital, Lisbon, Portugal; †Division of Nephrology, Bone, and Mineral Metabolism and ‡Department of Biostatistics, Statistics, and Epidemiology, University of Kentucky, Lexington, Kentucky; §Nephrology Department, Curry Cabral Hospital, Lisbon, Portugal; II Nephrology Department, Hospital de S. João, Medical School and Nephrology Research and Development Unit, University of Porto, Porto, Portugal; and ¶ISCTE, Business School, Lisbon, Portugal

Clin J Am Soc Nephrol 4: 450–455, 2009.

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Evaluation of vascular calcifications in CKD patients

Teresa Adragão.

Nephrology Department, Santa Cruz Hospital, Carnaxide - Portugal

The International Journal of Artificial Organs / Vol. 32 / no. 2, 2009 / pp. 81-86

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Intercurrent events and comorbid conditions influence hemoglobin level variability in dialysis patients

A.L.M. DeFrancisco1, I.C. Macdougall2, F. Carrera3 et al.

1 Hospital Universitario Valdecilla, Servicio de Nefrologia, Santander, Spain, 2 Department of Renal Medicine, King’s College Hospital, London, UK, 3 Eurodial, Dialysis Unit, Leiria, Portugal,

Clinical Nephrology, Vol. 71 – No. 4/2009 (397-404)

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Use of darbepoetin alfa in the treatment of anaemia of chronic kidney disease: clinical and pharmacoeconomic considerations

Fernando Carrera¹ and Michel Burnier²

Dialysis Unit, Eurodial, Euromedic, Leiria, Portugal and ² University Hospital of Lausanne, Lausanne, Switzerland

NDT Plus (2009) 2 [Suppl 1]: i9–i17

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PATROCINADORES (Com base no apoio dado às actividades da SPN nos últimos 5 anos)