HUGO ABENSUR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Letter(2024) KASSAR, Liliana de Meira Lins; SENNA, Joao Paulo; WAYLA, Karoline; ARAUJO, Luiza Karla R. P.; PEREIRA, Benedito J.; ABENSUR, Hugo; ELIAS, Rosilene M.
- Interactions between kidney disease and diabetes: dangerous liaisons(2016) PECOITS-FILHO, Roberto; ABENSUR, Hugo; BETONICO, Carolina C. R.; MACHADO, Alisson Diego; PARENTE, Erika B.; QUEIROZ, Marcia; SALLES, Joao Eduardo Nunes; TITAN, Silvia; VENCIO, SergioBackground: Type 2 diabetes mellitus (DM) globally affects 18-20 % of adults over the age of 65 years. Diabetic kidney disease (DKD) is one of the most frequent and dangerous complications of DM2, affecting about one-third of the patients with DM2. In addition to the pancreas, adipocytes, liver, and intestines, the kidneys also play an important role in glycemic control, particularly due to renal contribution to gluconeogenesis and tubular reabsorption of glucose. Methods: In this review article, based on a report of discussions from an interdisciplinary group of experts in the areas of endocrinology, diabetology and nephrology, we detail the relationship between diabetes and kidney disease, addressing the care in the diagnosis, the difficulties in achieving glycemic control and possible treatments that can be applied according to the different degrees of impairment. Discussion: Glucose homeostasis is extremely altered in patients with DKD, who are exposed to a high risk of both hyperglycemia and hypoglycemia. Both high and low glycemic levels are associated with increased morbidity and shortened survival in this group of patients. Factors that are associated with an increased risk of hypoglycemia in DKD patients include decreased renal gluconeogenesis, deranged metabolic pathways (including altered metabolism of medications) and decreased insulin clearance. On the other hand, decrease glucose filtration and excretion, and inflammation-induce insulin resistance are predisposing factors to hyperglycemic episodes. Conclusion: Appropriate glycaemic monitoring and control tailored for diabetic patients is required to avoid hypoglycaemia and other glycaemic disarrays in patients with DM2 and kidney disease. Understanding the renal physiology and pathophysiology of DKD has become essential to all specialties treating diabetic patients. Disseminating this knowledge and detailing the evidence will be important to initiate breakthrough research and to encourage proper treatment of this group of patients.
- The Th17/IL-17 Axis and Kidney Diseases, With Focus on Lupus Nephritis(2021) PAQUISSI, Feliciano Chanana; ABENSUR, HugoSystemic lupus erythematosus (SLE) is a disease characterized by dysregulation and hyperreactivity of the immune response at various levels, including hyperactivation of effector cell subtypes, autoantibodies production, immune complex formation, and deposition in tissues. The consequences of hyperreactivity to the self are systemic and local inflammation and tissue damage in multiple organs. Lupus nephritis (LN) is one of the most worrying manifestations of SLE, and most patients have this involvement at some point in the course of the disease. Among the effector cells involved, the Th17, a subtype of T helper cells (CD4+), has shown significant hyperactivation and participates in kidney damage and many other organs. Th17 cells have IL-17A and IL-17F as main cytokines with receptors expressed in most renal cells, being involved in the activation of many proinflammatory and profibrotic pathways. The Th17/IL-17 axis promotes and maintains repetitive tissue damage and maladaptive repair; leading to fibrosis, loss of organ architecture and function. In the podocytes, the Th17/IL-17 axis effects include changes of the cytoskeleton with increased motility, decreased expression of health proteins, increased oxidative stress, and activation of the inflammasome and caspases resulting in podocytes apoptosis. In renal tubular epithelial cells, the Th17/IL-17 axis promotes the activation of profibrotic pathways such as increased TGF-beta expression and epithelial-mesenchymal transition (EMT) with consequent increase of extracellular matrix proteins. In addition, the IL-17 promotes a proinflammatory environment by stimulating the synthesis of inflammatory cytokines by intrinsic renal cells and immune cells, and the synthesis of growth factors and chemokines, which together result in granulopoiesis/myelopoiesis, and further recruitment of immune cells to the kidney. The purpose of this work is to present the prognostic and immunopathologic role of the Th17/IL-17 axis in Kidney diseases, with a special focus on LN, including its exploration as a potential immunotherapeutic target in this complication.
- Nebivolol, a β1-adrenergic blocker, protects from peritoneal membrane damage induced during peritoneal dialysis (vol 7, pg 30133, 2016)(2017) LIAPPAS, Georgios; GONZALEZ-MATEO, Guadalupe; AGUIRRE, Anna Rita; ABENSUR, Hugo; ALBAR-VIZCAINO, Patricia; PARRA, Emilio Gonzalez; SANDOVAL, Pilar; RAMIREZ, Laura Garcia; PESO, Gloria del; ACEDO, Juan Manuel; BAJO, Maria A.; SELGAS, Rafael; TOMERO, Jose A. Sanchez; LOPEZ-CABRERA, Manuel; AGUILERA, Abelardo
- A feasibility study of avoiding positive calcium balance and parathyroid hormone increase in patients on peritoneal dialysis(2022) PIRACIABA, Maria Clara Teixeira; CORDEIRO, Lilian; GUIMARAES, Erica Adelina; ABENSUR, Hugo; PEREIRA, Benedito Jorge; JORGETTI, Vanda; MOYSES, Rosa Maria Affonso; ELIAS, Rosilene MottaBackground: The effect of the dialysate calcium concentration (D[Ca]) on mineral and bone metabolism in patients on peritoneal dialysis (PD) is overlooked. D[Ca] of 1.75 mmol/L is still prescribed to many patients on PD around the world. Previous studies on the effects of reducing D[Ca] have been carried out before the incorporation of calcimimetics in clinical practice. We hypothesized that a reduction in D[Ca] is safe and without the risk of a rise in serum parathyroid hormone (PTH).Methods: In this non-randomized clinical trial, the D[Ca] was reduced from 1.75 mmol/L to 1.25 mmol/L for one year in prevalent patients on PD. Demographic, clinical, and CKD-MBD-related biomarkers were evaluated at baseline, 3, 6, and 12 months of follow-up.Results: 20 patients completed 1-year follow-up (56 +/- 16 years, 50 % male, 25 % diabetic, 55 % with baseline parathyroid hormone - PTH >300 pg/mL). Over time, there was no significant change in calcium, phosphate, total alkaline phosphatase, 25(OH)-vitamin D or PTH, although adjustments in calcitriol and sevelamer prescription were required. After 1 year, absolute and percentual change in PTH levels were 36 (-58, 139) pg/mL, and 20 % (-28, 45) respectively. The proportion of patients with PTH > 300 pg/mL did not change during the follow-up (p = 0.173).Conclusion: Knowing the risk of a positive calcium balance in patients on PD, reducing the D[Ca] concentration is a safe and valuable option, although medication adjustments are needed to detain PTH rising.
- Estimated glomerular filtration rate in clinical practice: Consensus positioning of the Brazilian Society of Nephrology (SBN) and Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML)(2024) KIRSZTAJN, Gianna Mastroianni; SILVA JUNIOR, Geraldo Bezerra da; SILVA, Artur Quintiliano Bezerra da; ABENSUR, Hugo; ROMAO JUNIOR, Joao Egidio; BASTOS, Marcus Gomes; CALICE-SILVA, Viviane; CARMO, Lilian Pires de Freitas do; SANDES-FREITAS, Taina Veras de; ABREU, Patricia Ferreira; ANDREGUETTO, Bruna Dolci; CORTES, Luiz Gustavo Ferreira; OLIVEIRA, Maria Gabriela de Lucca; VIEIRA, Luisane Maria Falci; MOURA-NETO, Jose A.; ANDRIOLO, AdagmarChronic kidney disease (CKD) represents one of today's main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease - Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice.