Acesso livre
Acesso livre

Nefrologia

M-A | Inibidores de SGLT2 estão associados com risco reduzido de hiperpotassemia em pessoas com diabetes tipo 2.

14 Abr, 2022 | 17:44h

Sodium-glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People with Type 2 diabetes: A Meta-analysis of Individual Participant Data from Randomized Controlled Trials – Circulation

Revisão | Menos é mais: deprescrição de medicamentos em idosos com doença renal.

14 Abr, 2022 | 17:41h

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Conteúdos relacionados:

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review.

AGA clinical practice update on de-prescribing of proton pump inhibitors.

Development of a metric to detect and decrease low-value prescribing in older adults.

Cluster Randomized Clinical Trial: An electronic decision support system for deprescribing in hospitalized older adults was safe and led to improvements in deprescribing but did not reduce adverse drug events.

Systematic Review: Quantifying anticholinergic burden and sedative load in older adults with polypharmacy.

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines.

Systematic review: Prescribing practices, patterns, and potential harms in patients receiving palliative care – “many patients receiving palliative care receive multiple medications closer to the time of death”.

A narrative review of evidence to guide deprescribing among older adults.

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens.

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt internationa

Eliminating Medication Overload: A National Action Plan

Deprescribing in Older Adults With Cardiovascular Disease – Journal of the American College of Cardiology

Position Statement: Reducing Inappropriate Medication Use & Polypharmacy (vários artigos e comentários sobre o tema)

Estudo randomizado por cluster | Uma intervenção multifacetada não reduziu as infecções de corrente sanguínea relacionadas a cateter em pacientes dialíticos.

14 Abr, 2022 | 17:38h

Multifaceted intervention to reduce haemodialysis catheter related bloodstream infections: REDUCCTION stepped wedge, cluster randomised trial – The BMJ

Visão geral dos critérios diagnósticos e epidemiologia da lesão renal aguda e da doença renal aguda em pacientes críticos.

14 Abr, 2022 | 16:30h

Overview of Diagnostic Criteria and Epidemiology of Acute Kidney Injury and Acute Kidney Disease in the Critically Ill Patient – Clinical Journal of the American Society of Nephrology

Intervenções para tratar infecções de corrente sanguínea relacionadas a cateter em pessoas sob hemodiálise de manutenção.

11 Abr, 2022 | 12:46h

Interventions for treating catheter‐related bloodstream infections in people receiving maintenance haemodialysis – Cochrane Library

Resumo: Interventions for treating catheter-related bloodstream infections in people receiving maintenance haemodialysis – Cochrane Library

Comentário de estudo | De volta ao BaSICS (estudo que comparou solução balanceada com solução salina a 0,9% em pacientes críticos).

11 Abr, 2022 | 12:43h

Back to BaSICS – Annals of Emergency Medicine

Estudos originais:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Conteúdos relacionados:

Perspective: The ongoing saga of normal saline vs. balanced fluids.

RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis – NEJM Evidence

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

Aplicações atuais e limitações das diretrizes europeias sobre medidas de pressão arterial: implicações para a prática clínica.

11 Abr, 2022 | 12:34h

Current applications and limitations of European guidelines on blood pressure measurement: implications for clinical practice – Internal and Emergency Medicine

Conteúdos relacionados:

Randomized Diagnostic Study: home blood pressure measurements correlate better with 24-h ambulatory monitoring measurements compared to clinic, and kiosk measurements.

Practice guidelines for office and out-of-office blood pressure measurement.

Study suggests a 30-second interval between automated office blood pressure measurements is as accurate and reliable as a 60-second interval.

USPSTF Statement recommends screening for hypertension in adults 18 years or older with office blood pressure measurement – diagnostic confirmation with blood pressure measurements outside of the clinical setting is advised before starting treatment

Study suggests that 7 days of home blood pressure monitoring is likely better than 24h ambulatory monitoring or 3 office measurements

Estudo randomizado | Eficácia de longo prazo e segurança da denervação renal na presença de medicamentos anti-hipertensivos.

8 Abr, 2022 | 21:47h

Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial – The Lancet (link para o resumo – $ para o texto completo)

Comentário: Three-year trial of SPYRAL HTN-ON MED shows blood pressure reductions – MedicalXpress

Conteúdos relacionados:

Systematic Review: Renal denervation may have a modest effect in improving 24h ambulatory blood pressure monitoring (reduction in SBP by 5.29 mmHg and DBP by 3.75 mmHg) but does not improve major cardiovascular outcomes and renal function.

M-A: Renal denervation for hypertension is associated with a modest reduction in ambulatory blood pressure control (3.61 mm Hg reduction in ambulatory systolic BP and 1.85 mm Hg reduction in ambulatory diastolic BP).

#ACC21 – RCT: Among patients with resistant hypertension, ultrasound renal denervation resulted in a modest improvement in systolic BP (–4.5 mm Hg) vs. sham procedure.

Meta-Analysis: Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients with Hypertension

 

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Estudo randomizado | Roxadustate oral vs. epoietina alfa no tratamento de anemia em pacientes sob diálise para doença renal crônica.

8 Abr, 2022 | 17:19h

Roxadustat Versus Epoetin Alfa for Treating Anemia in Patients with Chronic Kidney Disease on Dialysis: Results from the Randomized Phase 3 ROCKIES Study – Journal of the American Society of Nephrology

Conteúdos relacionados:

Randomized Trials: Evaluation of New Treatment for Anemia of Chronic Kidney

RCT: Efficacy and safety of Daprodustat (oral drug) for treating anemia of chronic kidney disease in incident dialysis patients.

RCT: In patients with chronic kidney diseases and anemia undergoing dialysis, Daprodustat (oral drug) was noninferior to darbepoetin alfa to increase hemoglobin levels and regarding cardiovascular outcomes.

RCT: In patients with chronic kidney diseases and anemia not undergoing dialysis, Daprodustat (oral drug) was noninferior to darbepoetin alfa in increasing hemoglobin levels and regarding cardiovascular outcomes.

Estudo randomizado | Eritropoietina não é benéfica para pacientes com lesão renal aguda.

8 Abr, 2022 | 17:02h

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial – BMC Nephrology

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