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      Risco cardiovascular e estilo de vida em pacientes com doença renal crônica Translated title: Cardiovascular risk and lifestyle in patients with chronic kidney disease

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          Abstract

          Objetivo correlacionar fatores de risco cardiovascular de pacientes com doença renal com níveis pressóricos elevados. Métodos estudo transversal realizado com 150 pacientes em hemodiálise. Foram utilizados dois formulários, um referente aos fatores socioeconômicos e outro ao estilo de vida. Resultados a amostra foi composta predominantemente por pacientes do sexo masculino, idade acima de 52 anos, casados e não exercendo atividade laboral. Dos fatores de risco cardiovascular, os níveis pressóricos foram os mais alterados, onde 78,0% estavam com pressão arterial sistólica acima dos valores ideais. Foi encontrada associação estatisticamente significativa entre pressão arterial e idade (p=0,024) e entre pressão arterial e capacidade de lidar com o estresse (p=0,015). Conclusão por meio deste estudo, pôde-se verificar que a significância estatística entre as variáveis indica que a pressão arterial sistólica elevada, a idade e a capacidade em lidar com o estresse favorecem os fatores de risco cardiovascular em pacientes com doença renal crônica.

          Translated abstract

          Objective to correlate cardiovascular risk factors of patients with kidney disease with elevated blood pressure levels. Methods this is a cross-sectional study with 150 patients on hemodialysis. Two forms were used, one referring to socioeconomic factors and the other to lifestyle. Results the sample consisted predominantly of male patients, aged over 52 years old, married and not working. Blood pressure levels were the most affected of the cardiovascular risk factors, where 78.0% had systolic blood pressure above ideal values. A statistically significant association was found between blood pressure and age (p=0.024) and between blood pressure and ability to deal with stress (p=0.015). Conclusion through this study, it was verified that the statistical significance between the variables indicates that high systolic blood pressure, age and ability to deal with stress favor cardiovascular risk factors in patients with chronic kidney disease.

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          Brazilian Chronic Dialysis Survey 2016

          Abstract Introduction: National chronic dialysis data are important for the treatment planning. Objective: To report data of the annual survey of the Brazilian Society of Nephrology about chronic kidney disease patients on dialysis in July 2016. Methods: A survey based on data of dialysis centers from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis centers. Results: 309 (41%) of the dialysis units in the country answered the questionnaire. In July 2016, the total estimated number of patients on dialysis was 122,825. The estimated prevalence and incidence rates of chronic maintenance dialysis were 596 (range: 344 in the North region and 700 in the Southeast) and 193 patients per million of population (pmp), respectively. The annual incidence rate of patients with diabetic nephropathy was 79 pmp. The annual gross mortality rate was 18.2%. For prevalent patients, 92% were on hemodialysis and 8% on peritoneal dialysis, and 29,268 (24%) were on a waiting list of renal transplant. A venous catheter was the vascular access for 20.5% of the hemodialysis patients. The prevalence rates of positive serology for hepatitis B and C showed a tendency to reduce from 2013 (1.4% and 4.2%, respectively) to 2016 (0.7% and 3.7%, respectively). Conclusion: The absolute number and the prevalence and incidence rates of patients on dialysis continue to rise steadily; the gross mortality rate remained stable. Regional inequities are evident in these rates.
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            Protein-Bound Uremic Toxins: New Culprits of Cardiovascular Events in Chronic Kidney Disease Patients

            Chronic kidney disease (CKD) has been considered a major risk factor for cardiovascular diseases. Although great advances have recently been made in the pathophysiology and treatment of cardiovascular diseases, CKD remains a major global health problem. Moreover, the occurrence rates of cardiovascular events among CKD patients increase even in cases in which patients undergo hemodialysis, and the mechanisms underlying the so-called “cardiorenal syndrome” are not clearly understood. Recently, small-molecule uremic toxins have been associated with cardiovascular mortality in CKD and/or dialysis patients. These toxins range from small uncharged solutes to large protein-bound structures. In this review, we focused on protein-bound uremic toxins, such as indoxyl sulfate and p-cresyl sulfate, which are poorly removed by current dialysis techniques. Several studies have demonstrated that protein-bound uremic toxins, especially indoxyl sulfate, induce vascular inflammation, endothelial dysfunction, and vascular calcification, which may explain the relatively poor prognosis of CKD and dialysis patients. The aim of this review is to provide novel insights into the effects of indoxyl sulfate and p-cresyl sulfate on the pathogenesis of atherosclerosis.
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              Prevalence of Cardiovascular Risk Factors in Hemodialysis Patients - The CORDIAL Study

              Background There are scarce epidemiological data on cardiovascular risk profile of chronic hemodialysis patients in Brazil. Objective The CORDIAL study was designed to evaluate cardiovascular risk factors and follow up a hemodialysis population in a Brazilian metropolitan city. Methods All patients undergoing regular hemodialysis for chronic renal failure in all fifteen nephrology centers of Porto Alegre were considered for inclusion in the baseline phase of the CORDIAL study. Clinical, laboratory and demographic data were obtained in medical records and in structured individual interviews performed in all patients by trained researchers. Results A total of 1215 patients were included (97.3% of all hemodialysis patients in the city of Porto Alegre). Their average age was 58.3 years old, 59.5% were male and 62.8% were white. The prevalence of cardiovascular risk factors observed was 87.5% for hypertension, 84.7% for dyslipidemia, 73.1% for sedentary lifestyle, 53.7% for tobacco use, and 35.8% for diabetes. In a multivariate adjusted analysis, we found that sedentary lifestyle (p = 0.032, PR 1.08 - 95%CI: 1.01-1.15), dyslipidemia (p = 0.019, PR 1.08 - 95%CI: 1.01-1.14), and obesity (p < 0.001, PR 1.96 - 95%CI: 1.45-2.63) were more frequent in women; and hypertension (p = 0.018, PR 1.06 - 95%CI: 1.01-1.11) and tobacco use (p = 0.006, PR 2.7 - 95%CI: 1.79-4.17) were more often found among patients under 65 years old. Sedentary lifestyle was independently associated with time in dialysis less than 12 months (p < 0.001, PR 1.23 - 95% CI: 1.14-1.33). Conclusion Hemodialysis patients in this southern metropolitan Brazilian city have a high prevalence of cardiovascular risk factors resembling many northern countries.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rene
                Revista da Rede de Enfermagem do Nordeste
                Rev. Rene
                Universidade Federal do Ceará (Fortaleza, CE, Brazil )
                1517-3852
                2175-6783
                December 2018
                : 19
                : 0
                : e32550
                Affiliations
                [1] Picos Piauí orgnameUniversidade Federal do Piauí Brazil
                Article
                S1517-38522018000100341
                10.15253/2175-6783.20181932550
                103d71d5-871c-41d3-b8e2-0ea1cdee0703

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 24 May 2018
                : 27 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos Originais

                Fatores de Risco,Cardiovascular Diseases,Doenças Cardiovasculares,Life Style,Risk Factors,Estilo de Vida

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