Perfil do sono de pacientes em hemodiálise: um estudo transversal no Distrito Federal

Objetivo: Avaliar o perfil do sono de pacientes em hemodiálise (HD). Métodos: Estudo transversal com pacientes em hemodiálise de duas clínicas no Distrito Federal, Brasil. Durante a sessão de HD houve a aplicações dos questionários de Índice de Qualidade de Sono de Pittsburgh e Escala de Sonolência de Epworth. Resultados: Foram incluídos 65 pacientes (56,9% homens e 61,4 ± 16,4 anos). Os resultados demonstraram qualidade do sono irregular em 57,6% da amostra. A presença de sonolência diurna excessiva compreendeu 34,6% dos pacientes. Conclusão: Nossos achados mostram um perfil do sono prejudicado em pacientes em HD, evidenciando um preocupante cenário, que pode ser avaliado e identificado com facilidade por meio de instrumentos de rastreio

Global Prevalence of Osteoporosis in Chronic Kidney Disease: Protocol for a Systematic Review

Abnormalities in mineral metabolism, soft tissue calcifications, and bone health are common in people with chronic kidney disease (CKD). In this scenario, osteoporosis is a highly prevalent skeletal disorder characterized by reduced bone strength predisposing patients to adverse health outcomes. We will summarize the evidence of the prevalence of osteoporosis in adults with CKD. Methods: We will perform a comprehensive literature search using MEDLINE, EMBASE, Web of Science, CINAHL, and LILACS databases, without date or language restrictions from inception until January 2021. We will include cross-sectional, case–control, or cohort studies that report prevalence data of osteoporosis in adults aged ≥18 years with CKD in stages 3a–5, including those receiving kidney replacement therapies. We will exclude conference abstracts and experimental studies. The primary outcome will be the prevalence of osteoporosis according to the World Health Organization criteria (T-score ≤ −2.5). Two independent reviewers will screen title and abstract, full-text review, critical appraisal of the quality of studies, risk of bias, heterogeneity, and data extraction. The quality of the included studies will be assessed with the Joanna Briggs Institute (JBI) appraisal checklist. The overall prevalence of the studies will be synthesized using random-effects meta-analysis. This systematic review will be reported according to the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE) and the JBI methodological guidance for systematic reviews of observational epidemiological studies. The qualitative and quantitative results will be synthesized and presented in tables, figures or graphs

Design and methodology of the SARCopenia trajectories and associations with adverse clinical outcomes in patients on HemoDialysis: the SARC-HD study

Abstract Background Sarcopenia has been associated with adverse outcomes in patients with chronic kidney disease (CKD), particularly in those undergoing hemodialysis (HD). However, the trajectories across sarcopenia stages, their determinants, and associations with adverse clinical outcomes have yet to be comprehensively examined. Methods The SARC-HD is a multicenter, observational prospective cohort study designed to comprehensively investigate sarcopenia in patients on HD. Eligibility criteria include adult patients undergoing HD for ≥ 3 months. The primary objective is to investigate the trajectories of sarcopenia stages and their potential determinants. Secondary objectives include evaluating the association between sarcopenia and adverse clinical outcomes (i.e., falls, hospitalization, and mortality). Sarcopenia risk will be assessed by the SARC-F and SARC-CalF questionnaire. Sarcopenia traits (i.e., low muscle strength, low muscle mass, and low physical performance) will be defined according to the revised European Working Group on Sarcopenia in Older People and will be assessed at baseline and after 12 follow-up months. Patients will be followed-up at 3 monthly intervals for adverse clinical outcomes during 24 months. Discussion Collectively, we expect to provide relevant clinical findings for healthcare professionals from nephrology on the association between sarcopenia screening tools (i.e., SARC-F and SARC-CalF) with objective sarcopenia measurements, as well as to investigate predictors of trajectories across sarcopenia stages, and the impact of sarcopenia on adverse clinical outcomes. Hence, our ambition is that the data acquired from SARC-HD study will provide novel and valuable evidence to support an adequate screening and management of sarcopenia in patients on HD

Intradialytic isometric handgrip exercise does not cause hemodynamic instability: A randomized, cross‐over , pilot study

Hemodialysis (HD) patients experience hemodynamic instability and intradialytic exercise seems to attenuate it. This study aimed to verify the acute hemodynamic response to different intradialytic handgrip exercise intensities in HD patients. In a randomized, cross-over, experimental pilot study, eight patients completed two experimental sessions and one control in random order: (a) regular HD; (b) low-intensity isometric handgrip exercise; and (c) moderate-intensity isometric handgrip exercise. BP and heart rate variability were recorded immediately before and every 15 minutes. Isometric handgrip exercise protocols, regardless of the intensity, did not lead to significant changes in hemodynamic stability, nor when compared to the control condition (P > .05). The systolic BP and double product significantly increased immediately after the moderate-intensity protocol (122.0 ± 15.9 vs 131.3 ± 19.8, P < .05; 9094.7 ± 1705.7 vs 9783.0 ± 1947.9, P < .05, respectively) but returned to the pre-exercise values 10 minutes later. We conclude that intradialytic isometric handgrip exercise does not induce hemodynamic instability at low and moderate intensities.info:eu-repo/semantics/publishedVersio