LUCIENE MACHADO DOS REIS
Projetos de Pesquisa
Unidades Organizacionais
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- 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.
- Can we compare serum sclerostin results obtained with different assays in hemodialysis patients?(2015) MOYSES, Rosa M. A.; JAMAL, Sophie A.; GRACIOLLI, Fabiana G.; REIS, Luciene M. dos; ELIAS, Rosilene M.Sclerostin, secreted by osteocytes, plays a key role in antagonizing bone formation. Recent studies, which seldom include chronic kidney disease (CKD) patients, have reported on the association of sclerostin and mortality, with contradictory results. The assay-linked variability may contribute to these discrepant results. We have compared sclerostin results obtained with two assays (TECO and Biomedica) in a cohort of 91 CKD patients undergoing hemodialysis. We found a strong correlation (r = 0.870, p < 0.0001) between the serum sclerostin concentrations measured by the two assays. Bland-Altman plot shows that, although there was a partial agreement between the assays, differences found for individual values (-0.27 +/- A 0.54; ranging from -1.3 to 0.8 ng/ml) were quite unpredictable. By using TECO, there was a significant relationship between serum sclerostin, and calcitonin (r = 0.224), IL-6 (r = 0.251) and FGF23 (r = 0.331) levels while no correlation was found with PTH or total alkaline phosphatase. Regarding Biomedica, there was a significant correlation with calcitonin (r = 0.260), and beta(2) microglobulin (r = 0.210), but no correlation with PTH or total alkaline phosphatase. Overall, 25.3 % among the patients had different classifications as to normal or high values, according to the manufacturer. Sclerostin levels should be interpreted with caution, as they can vary widely according to the assay used. Further studies are clearly needed before considering sclerostin as a true marker of mortality. Moreover, we do not know at present which serum sclerostin levels should be regarded as either normal or potentially dangerous in patients with CKD.
- Correction of metabolic acidosis in hemodialysis: consequences on serum leptin and mineral metabolism(2015) BALES, Alessandra M.; MOYSES, Rosa M. A.; REIS, Luciene M. dos; GRACIOLLI, Fabiana G.; HUNG, James; CASTRO, Manuel Carlos Martins; ELIAS, Rosilene M.Hyperleptinemia and metabolic acidosis (MA) are frequently observed in patients on hemodialysis (HD). While the role of leptin in patients on HD is not completely understood, HD only partially corrects MA. Both leptin and acidosis have effect on bone disease. The goal of the present study was to evaluate the effects of MA correction on chronic kidney disease-mineral and bone disorder laboratory parameters and leptin levels. Forty-eight patients on HD, aged 43 +/- A 19 years, were prospectively studied. Individual adjustments in the bicarbonate dialysate concentration were made to maintain pre-dialysis concentration a parts per thousand yen22 mEq/l. Blood gas analysis was done monthly for 4 months (M1-M4). From M0 to M4, serum albumin increased (from 3.5 +/- A 0.3 to 4.0 +/- A 0.3 g/l, p < 0.0001) while beta(2) microglobulin decreased (from 27.6 +/- A 8.3 to 25.8 +/- A 6.8 A mu g/ml, p = 0.025). Serum leptin decreased in all but three patients, as well as leptin/adiponectin ratio (p < 0.0001). There was a decrease in ionized serum calcium (from 5.0 +/- A 0.5 to 4.7 +/- A 0.5 mg/dl, p = 0.002) and an increase in parathyroid hormone (PTH) [from 191 (85, 459) to 446 pg/ml (212, 983), p < 0.0001] and in serum phosphate (from 5.4 +/- A 1.4 to 5.8 +/- A 1.1 mg/dl, p = 0.048). MA correction in HD patients can decrease leptin, an atherogenic marker. The impact of such treatment extends to uremic bone disease, as decrease in serum calcium and increase in PTH. However, this could be an undesirable effect because it may aggravate a secondary hyperparathyroidism. Whether the reduction in leptin levels has impact on outcomes in patients on hemodialysis deserves further investigation.