VERA HERMINA KALIKA KOCH
Projetos de Pesquisa
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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
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conferenceObject Pediatric peritoneal dialysis in Brazil: document by the Brazilian Society of Nephrology, Brazilian Society of Pediatrics, Brazilian Association of Organ Transplantation, and the Brazilian Association of Dialysis and Transplant Centers.(2023) PENIDO, Maria Goretti Moreira Guimaraes; PALMA, Lilian Monteiro Pereira; BRESOLIN, Nilzete Liberato; TAVARES, Marcelo Sousa; SYLVESTRE, Lucimary Castro; ANDRADE, Olberes Vitor Braga de; BERNARDES, Rejane Paula; BANDEIRA, Maria de Fatima Santos; GARCIA, Clotilde Druck; KOCH, Vera Hermina Kalika; BELANGERO, Vera Maria Santoro; UHLMANN, Anelise; KAUFMAN, Arnauld; ANDRADE, Maria Cristina; SILVA, Roxana Almeida Roque Fontes- Obesity Facts and Their Influence on Renal Function Across the Life Span(2021) KOCH, Vera H.Obesity is a chronic disease, with a rapidly increasing prevalence worldwide. Body mass index (BMI) provides the most useful population-level measure of overweight and obesity. For adults, overweight is defined as a BMI (Kg/m(2)) >= 25, and obesity as a BMI >= 30, for non-Asians and >= 27.5 for Asians. Abdominal obesity can be defined as a waist circumference equal to or higher than 102 cm for men and >= 88 cm for women. The definition of children and adolescents BMI changes with age and sex. Obesity may be exogenous or endogenous obesity, the latter is multifactorial and predominantly manifested during childhood. Presently, overweight and obesity are linked to more deaths worldwide than underweight. The total kidney glomerular filtration rate (GFR) is determined by the sum of nephrons and the GFR within each nephron or single nephron GFR. In clinical practice, GFR is more frequently calculated by GFR estimating equations based upon the plasma levels of creatinine, cystatin C, or both. The measured value of plasma creatinine is strongly influenced by non-GFR factors, by its tubular and gastrointestinal secretion, and by the problems associated with the lack of standardization of creatinine's laboratory assay discrediting it as an ideal GFR biomarker. Unlike creatinine, cystatin C plasma levels are mainly determined by GFR. Obesity may affect the kidney, via development of systemic arterial hypertension and/or diabetes mellitus, or directly, by ectopic accumulation of adipose tissue in the kidney. As obesity is a clinical condition associated with altered body composition, creatinine may not be the ideal biomarker for GFR measurement in obese individuals.
conferenceObject The hip and spine mobility is diminished in enuretic children and teenagers(2013) PEREIRA, Rita Pavione Rodrigues; KOCH, Vera Herminakalika; GONCALVES, Monica Maria Ribeiro; MILHORATTI, Thais de Souza; PACHECO, Daniela Castro; TANAKA, Clarice- The challenges of the pandemic and the vaccination against covid-19 in pediatric patients with kidney disease(2023) SOEIRO, Emilia Maria Dantas; PENIDO, Maria Goretti Moreira Guimaraes; PALMA, Lilian Monteiro Pereira; BRESOLIN, Nilzete Liberato; LIMA, Eduardo Jorge da Fonseca; KOCH, Vera Hermina Kalika; TAVARES, Marcelo de Sousa; SYLVESTRE, Lucimary; BERNARDES, Rejane de Paula; GARCIA, Clotilde Druck; ANDRADE, Maria Cristina de; KAUFMAN, Arnauld; CHOW, Charles Yea Zen; MARTINS, Suelen Bianca Stopa; CAMARGO, Suzana Friedlander Del NeroThe covid-19 vaccine confers direct protection and reduces transmission rates of the virus and new variants. Vaccines from Pfizer/BioNTech and CoronaVac have been cleared for children in Brazil. They are safe, effective, and immunogenic. There are no known complications associated with the use of steroids or vaccines in pediatric patients with covid-19 and nephrotic syndrome. With or without immunosuppression, these patients are not at increased risk of severe covid-19, and steroids are safe for them. A milder form of covid-19 occurs in patients with chronic kidney disease without the need for hospitalization. The vaccine response may be reduced and/or the duration of antibodies after vaccination may be shorter than in the general population. However, considering risk of exposure, vaccination against covid-19 is recommended. It is believed that patients with hemolytic-uremic syndrome are at higher risk of severe covid-19. Vaccination is recommended, although specific data on the safety and efficacy of the covid-19 vaccine are limited. There is agreement that the benefits of induced immunity outweigh the risks of immunization. Vaccination against covid-19 is recommended for children and adolescents needing kidney transplantation or who have undergone transplantation. These patients present decreased immune response after vaccination, but immunization is recommended because the benefits outweigh the risks of vaccination. Current recommendations in Brazil stipulate the use of the messenger RNA vaccine. This paper aims to provide pediatric nephrologists with the latest knowledge about vaccination against covid-19 for children with kidney disease.
- Pediatric peritoneal dialysis in Brazil: a discussion about sustainability. A document by the Brazilian Society of Nephrology, the Brazilian Society of Pediatrics, the Brazilian Association of Organ Transplantation, and the Brazilian Association of Dialysis and Transplant Centers(2022) PALMA, Lilian Monteiro Pereira; PENIDO, Maria Goretti Moreira Guimarães; BRESOLIN, Nilzete Liberato; TAVARES, Marcelo de Sousa; SYLVESTRE, Lucimary; ANDRADE, Olberes Vitor Braga de; BERNARDES, Rejane de Paula; BANDEIRA, Maria de Fátima Santos; GARCIA, Clotilde Druck; KOCH, Vera Hermina Kalika; BELANGERO, Vera Maria Santoro; UHLMANN, Anelise; SOEIRO, Emília Maria Dantas; KAUFMAN, Arnauld; ANDRADE, Maria Cristina de; SILVA, Roxana de Almeida Roque Fontes; CALICE-SILVA, Viviani; VIEIRA, Marcos Alexandre; MEREGE NETO, Osvaldo VieiraAbstract Introdução: A diálise peritoneal (DP) é importante para a pediatria. Este estudo mostrou dados de centros brasileiros que utilizam DP pediátrica. Método: Estudo transversal, observacional, descritivo com questionário eletrônico. Incluiu-se pacientes de 0-18 anos em DP cadastrados nos bancos de dados dos diversos centros. Questionário preenchido anonimamente, sem dados de identificação. Foi adotada metodologia quantitativa. Resultados: 212 pacientes estão em DP no Brasil (agosto, 2021). 80% têm menos de 12 anos de idade. A maioria realiza DP automatizada e 74% são dependentes do Sistema Único de Saúde. Em 25% dos centros faltou material de DP e em 51% os pacientes pediátricos foram convertidos de DP para HD. Conclusão: A maioria dos pacientes tinha menos de 12 anos e era dependente do SUS. A escassez de insumos aconteceu em 25% dos centros. Esses dados apontam para o problema da sustentabilidade de DP, única alternativa de TRS em crianças muito pequenas.
- Risk factors of acute kidney injury in very low birth weight infants in a tertiary neonatal intensive care unit(2023) MORAES, Lucas Hirano Arruda; KREBS, Vera Lucia Jornada; KOCH, Vera Hermina Kalika; MAGALHAES, Natalia Assis Medeiros; CARVALHO, Werther Brunow deObjective: Acute kidney injury (AKI) in the neonatal period is associated with worst outcomes as increased mortality and increased length of hospital stay. Very low birth weight (VLBW) newborns are at higher risk for developing several other conditions that are associated with worst outcomes. Understanding the risk factors for AKI may help to prevent this condition and improve neonatal care for this population. Methods: This retrospective cohort study included 155 very low birth weight newborns admitted between 2015 and 2017. The authors compared the newborns who developed neonatal AKI with the non-AKI group and analyzed the main risk factors for developing AKI in the population. The authors also performed an analysis of the main outcomes defined as the duration of mechanical ventilation, length of stay, and death. Results: From the cohort, a total of 61 (39.4%) patients had AKI. The main risk factors associated with Neonatal AKI were necrotizing enterocolitis (aOR 7.61 [1.69 - 34.37]; p = 0.008), neonatal sepsis (aOR 2.91 [1.17 - 7.24], p = 0.021), and hemodynamic instability (aOR 2.99 [1.35 - 6.64]; p = 0.007). Neonatal AKI was also associated with an increase in the duration of mechanical ventilation in 9.4 days (p = 0.026) and in an increase in mortality 4 times (p = 0.009), after adjusting for the other variables. Conclusion: The present results highlight the importance of minimizing sepsis and necrotizing enterocolitis, as well as the importance of identifying hemodynamic instability, to prevent AKI and diminish the burden of morbimortality in VLBW newborns. (c) 2022 Sociedade Brasileira de Pediatria.
conferenceObject POSTURAL CONTROL IN CHILDREN AND TEENAGERS WITH ENURESIS(2013) PEREIRA, Rita Pavione Rodrigues; KOCH, Vera HerminaKalika; FAGUNDES, Simone Nascimento; ROSSI, Aline; VIEIRA, Juliane de Oliveira Marques; TANAKA, Clarice