ROSILENE MOTTA ELIAS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina
72 resultados
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- Water removal from the legs does explain hypotension in short daily hemodialysis(2014) BALES, A. M.; BATTAINI, L. C.; NARDOTTO, L. L.; HUMEL, R. S.; SILVA, B. C.; MOYSES, R. M. A.; CASTRO, M. C. M.; ELIAS, R. M.
- Restless legs syndrome in patients on hemodialysis: Polysomnography findings(2019) BAMBINI, Beatriz B. M.; MOYSES, Rosa M. A.; BATISTA, Luci C. D.; COELHO, Brunelle B. S. S.; TUFIK, Sergio; ELIAS, Rosilene M.; COELHO, Fernando M.Introduction: Restless legs syndrome (RLS) is a highly prevalent sleep movement disorder usually accompanied by periodic limb movements of sleep (PLMS). The incidence of RLS and PLMS in patients with end-stage renal disease (ESRD) on dialysis is much higher. Clinically, RLS and PLMS can co-occur. We hypothesized that patients with ESRD on dialysis would have a distinct presentation of RLS, with a higher prevalence of PLMS. Methods: We examined clinical, demographic, biochemical, and polysomnographic characteristics of RLS in patients on dialysis matched to control subjects with normal renal function based on age, sex, body mass index, and frequency of apneas and hypopneas per hour of sleep, defined by the apnea and hypopnea index (AHI), in a proportion of 3:1. Patients with ESRD were on hemodialysis three times per week. Polysomnography was performed overnight in the sleep laboratory. Findings: Patients on dialysis compared to control subjects had a lower amount of N3 sleep (77.6 +/- 39.9 minutes vs. 94.8 +/- 33.7 minutes, p = 0.037) and REM sleep (55.6 +/- 27.5 minutes vs. 74.1 +/- 28.4 minutes, p = 0.006), regardless of the presence of RLS. Among the patients on dialysis, those with RLS had higher PLMS. In the control group, patients with RLS had a lower ferritin level, which was not observed in the dialysis group. There was a significant interaction between PLMS and ESRD (p = 0.001), with a higher prevalence of PLMS in patients with ESRD on dialysis in a model adjusted for AHI, sex, arousals, and age. Factors that were associated with PLMS were RLS (p = 0.003), ESRD (p = 0.0001), and AHI (p = 0.041), with an adjusted R-2 of 0.321. Conclusion: RLS in patients with ESRD on dialysis is independently associated with PLMS, regardless of the severity of sleep apnea, arousals, and age.
bookPart Doença renal crônica(2022) SILVA, Bruno Caldin da; ABENSUR, Hugo; ELIAS, Rosilene Motta- A critical appraisal of chronic kidney disease mineral and bone disorders clinical practice guidelines using the AGREE II instrument(2017) SEKERCIOGLU, Nigar; AL-KHALIFAH, Reem; EWUSIE, Joycelyne Efua; ELIAS, Rosilene M.; THABANE, Lehana; BUSSE, Jason W.; AKHTAR-DANESH, Noori; IORIO, Alfonso; ISAYAMA, Tetsuya; MARTINEZ, Juan Pablo Diaz; FLOREZ, Ivan D.; GUYATT, Gordon H.Patients with chronic kidney disease mineral and bone disorders (CKD-MBD) suffer high rates of morbidity and mortality, in particular related to bone and cardiovascular outcomes. The management of CKD-MBD remains challenging. The objective of this systematic survey is to critically appraise clinical practice guidelines (CPGs) addressing CKD-MBD. Data sources included MEDLINE, EMBASE, the National Guideline Clearinghouse, Guideline International Network and Turning Research into Practice up to May 2016. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility and subsequently appraised the guidelines using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE). Sixteen CPGs published from 2003 to 2015 addressing the diagnosis and management of CKD-MBD in adult patients (11 English, two Spanish, one Italian, one Portuguese and one Slovak) proved eligible. The National Institute for Health and Care Excellence guideline performed best with respect to AGREE II criteria; only three other CPGs warranted high scores on all domains. All other guidelines received scores of under 60% on one or more domains. Major discrepancies in recommendations were not, however, present, and we found no association between quality of CPGs which was not associated with resulting recommendations. Most guidelines assessing CKD-MBD suffer from serious shortcomings using AGREE criteria although limitations with respect to AGREE criteria do not necessarily lead to inappropriate recommendations.
- The unexpected presence of iron in bone biopsies of hemodialysis patients(2018) CUSTODIO, Melani R.; ELIAS, Rosilene M.; VELASQUEZ, Wagner D.; REIS, Luciene M. dos; OLIVEIRA, Ivone B.; MOYSES, Rosa M. A.; CARVALHO, Aluizio B.; JORGETTI, VandaPurpose Bone biopsy defines classical diseases that constitute the renal osteodystrophy. There is a recent concern regarding other histological findings that are not appreciated by using the turnover, mineralization, and volume (TMV) classification. Iron (Fe) overload has been considered a new challenge and the real significance of the presence of this metal in bones is not completely elucidated. Therefore, the main goal of the current study was to not only to identify bone Fe, but also correlate its presence with demographic, and biochemical characteristics. Methods This is a cross-sectional analysis of bone biopsies performed in 604 patients on dialysis from 2010 to 2014 in a tertiary academic Hospital. Results Histomorphometric findings revealed the presence of Fe in 29.1%. Fe was associated with higher levels of serum ferritin and serum calcium. No TMV status was related to Fe bone overload. Conclusion Our study has highlighted that the presence of Fe in one-third of bone samples has unknown clinical significance. The lack of other contemporary bone biopsy study reporting Fe prevents us from comparison. The findings presented here should be specifically addressed in a future research and will require attention prior to implementation of any clinical guideline. If any proposed treatment, however, would change the bone Fe-related morbidity is undetermined.
- Furosemide Increases the Risk of Hyperparathyroidism in Chronic Kidney Disease(2016) VASCO, Raquel F. V.; MOYSES, Rosa M. A.; ZATZ, Roberto; ELIAS, Rosilene M.Background: Diuretics are widely used in patients with chronic kidney disease (CKD). While thiazide-like diuretics limit urinary calcium excretion, loop diuretics (LD) promote calcium wasting, which might facilitate the development of secondary hyperparathyroidism (HPT2). We sought to investigate, in CKD patients not on dialysis, the influence of either hydrochlorothiazide (Hydro) or furosemide (Furo) on circulating parathyroid hormone (PTH) and whether such actions are determined by the effects of these compounds on calcium excretion. Methods: Electronic charts of all nephrology outpatients (CKD stages 2-5) who were given Hydro or Furo were included. We assessed estimated glomerular filtration rate (eGFR), biochemical parameters and 24-hour calcium excretion. Hyperparathyroidism was defined as PTH > 65 pg/ml. Results: Out of 275 patients, 108 (29%) were taking Hydro and 167 (61%) Furo. Patients on Hydro were younger, mostly female and had higher eGFR. The median 24-hour urinary calcium excretion in the overall cohort was 41 (22, 76), being lower in Furo than in Hydro patients (37 (16, 68) vs. 47 (26, 88) mg/24 h, respectively, p = 0.016). Logistic regression showed that, after adjustment for eGFR, calcium excretion rate was found not to increase the risk ratio for HPT2, where as Furo was a strong predictor of HPT2. Conclusion: Furo increased the risk of HPT2 among CKD patients compared to Hydro. This effect was independent of eGFR or calcium excretion. The use of LD in CKD, currently preferred in advanced stages, should be reappraised. (C) 2016 S. Karger AG, Basel
- Predialysis serum phosphate levels according to hemodialysis shift: Circadian rhythm matters(2021) DARIO, Ketili Alice; DALBONI, Maria Aparecida; SILVA, Bruno C. da; MARTINS, Carolina Steller Wagner; ARAUJO, Luiza Karla R. P. de; ELIAS, Rosilene M.; MOYSES, Rosa M. A.
- Higher Serum Phosphate-Another Undesirable Effect of Smoking?(2018) SANTOS, Geuza Dutra dos; DALBONI, Maria Aparecida; ELIAS, Rosilene Motta; MOYSES, Rosa Maria Affonso
bookPart O idoso em diálise: Particularidades, cuidados e prognóstico(2015) ÁLVARES, Valeria Regina de Cristo; ELIAS, Rosilene MottabookPart Tratamento da doença renal crônica: diálise(2016) ELIAS, Rosilene Motta; CASTRO, Manuel Carlos Martins