EMMANUEL DE ALMEIDA BURDMANN
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Acute Kidney Injury Caused by Bothrops Snake Venom(2011) SGRIGNOLLI, Livia Rodrigues; MENDES, Gloria Elisa Florido; CARLOS, Carla Patricia; BURDMANN, Emmanuel A.Medically important venomous snakes in Latin America belong to the genus Bothrops, Crotalus, Lachesis and Micrurus. The Bothrops genus is responsible for the majority of accidents. The WHO globally estimates 2,500,000 poisonous snakebites and 125,000 deaths annually. In its last report in 2001, the Brazilian Ministry of Health accounted 359 deaths due to snakebites, of which the Bothrops genus was responsible for 185. Snake venoms cause local and systemic damage, including acute kidney injury, which is the most important cause of death among patients surviving the early effects of envenoming by the Crotalus and Bothrops genuses. Venom-induced acute kidney injury is a frequent complication of Bothrops snakebite, carrying relevant morbidity and mortality.
- Dengue-associated acute kidney injury(2015) OLIVEIRA, Joao Fernando Picollo; BURDMANN, Emmanuel A.Dengue is presently the most relevant viral infection transmitted by a mosquito bite that represents a major threat to public health worldwide. Acute kidney injury (AKI) is a serious and potentially lethal complication of this disease, and the actual incidence is unknown. In this review, we will assess the most relevant epidemiological and clinical data regarding dengue and the available evidence on the frequency, etiopathogenesis, outcomes and treatment of dengue-associated AKI.
- A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries(2020) MELO, Fernando de Assis Ferreira; MACEDO, Etienne; BEZERRA, Ana Caroline Fonseca; MELO, Waledya Araujo Lopes de; MEHTA, Ravindra L.; BURDMANN, Emmanuel de Almeida; ZANETTA, Dirce Maria TrevisanObjectives Although the majority of the global population lives in developing countries, most of the epidemiological data related to intensive care unit (ICU) acute kidney injury (AKI) comes from developed countries. This systematic review aims to ascertain the methodology of studies on ICU AKI patients in developing and developed countries, to determine whether epidemiological comparisons between these two settings are possible, and to present a summary estimate of AKI incidence. Methods A systematic review of published studies reporting AKI in intensive care units (2005-2015) identified in PubMed, LILACS, and IBECs databases was conducted. We compared developed and developing countries by evaluating study methodology, AKI reference serum creatinine definitions, population characteristics, AKI incidence and mortality. AKI incidence was calculated with a random-effects model. Results Ninety-two studies were included, one of which reported data from both country categories: 60 from developed countries (1,057,332 patients) and 33 from developing countries (34,539 patients). In 78% of the studies, AKI was defined by the RIFLE, AKIN or KDIGO criteria. Oliguria had 11 different definitions and reference creatinine 23 different values. For the meta-analysis, 38 studies from developed and 18 from developing countries were selected, with similar AKI incidence: 39.3% and 35.1%, respectively. The need for dialysis, length of ICU stay and mortality were higher in developing countries. Conclusion Although patient characteristics and AKI incidence were similar in developed and developing countries, main outcomes were worse in developing country studies. There are significant caveats when comparing AKI epidemiology in developed and developing countries, including lack of standardization of reference serum creatinine, oliguria and the timeframe for AKI assessment. Larger, prospective, multicenter studies from developing countries are urgently needed to capture AKI data from the overall population without ICU access.
- Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference(2020) LINDNER, Gregor; BURDMANN, Emmanuel A.; CLASE, Catherine M.; HEMMELGARN, Brenda R.; HERZOG, Charles A.; MLYSZKO, Jolanta; NAGAHAMA, Masahiko; PECOITS-FILHO, Roberto; RAFIQUE, Zubaid; ROSSIGNOL, Patrick; SINGER, Adam J.Hyperkalemia is a common electrolyte disorder observed in the emergency department. It is often associated with underlying predisposing conditions, such as moderate or severe kidney disease, heart failure, diabetes mellitus, or significant tissue trauma. Additionally, medications, such as inhibitors of the renin-angiotensin-aldosterone system, potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs, succinylcholine, and digitalis, are associated with hyperkalemia. To this end, Kidney Disease: Improving Global Outcomes (KDIGO) convened a conference in 2018 to identify evidence and address controversies on potassium management in kidney disease. This review summarizes the deliberations and clinical guidance for the evaluation and management of acute hyperkalemia in this setting. The toxic effects of hyperkalemia on the cardiac conduction system are potentially lethal. The ECG is a mainstay in managing hyperkalemia. Membrane stabilization by calcium salts and potassium-shifting agents, such as insulin and salbutamol, is the cornerstone in the acute management of hyperkalemia. However, only dialysis, potassium-binding agents, and loop diuretics remove potassium from the body. Frequent reevaluation of potassium concentrations is recommended to assess treatment success and to monitor for recurrence of hyperkalemia.
- International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology(2015) MEHTA, Ravindra L.; CERDA, Jorge; BURDMANN, Emmanuel A.; TONELLI, Marcello; GARCIA-GARCIA, Guillermo; JHA, Vivekanand; SUSANTITAPHONG, Paweena; ROCCO, Michael; VANHOLDER, Raymond; SEVER, Mehmet Sukru; CRUZ, Dinna; JABER, Bertrand; LAMEIRE, Norbert H.; LOMBARDI, Raul; LEWINGTON, Andrew; FEEHALLY, John; FINKELSTEIN, Fredric; LEVIN, Nathan; PANNU, Neesh; THOMAS, Bernadette; ARONOFF-SPENCER, Eliah; REMUZZI, Giuseppe
- Acute kidney injury: global health alert(2013) LI, Philip Kam Tao; BURDMANN, Emmanuel A.; MEHTA, Ravindra L.Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional, and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high-risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians, and other health-care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI. Kidney International (2013) 83, 372-376; doi:0.1038/ki.2012.427; published online 9 January 2013
- Balanço hídrico, injúria renal aguda e mortalidade de pacientes em unidade de terapia intensiva(2014) ÁVILA, Maria Olinda Nogueira; ROCHA, Paulo Novis; ZANETTA, Dirce Maria Trevisan; YU, Luis; BURDMANN, Emmanuel de AlmeidaAcute kidney injury (AKI) has a high hospital incidence and is associated to significant morbidity and mortality. Sepsis, major surgery and low cardiac output are the main cause of AKI worldwide. In the majority of these situations, volume expansion is part of both prevention and therapeutic management, restoring peripheral perfusion and attenuating drug nephrotoxicity. Early and aggressive volume resuscitation in septic patients halts tissue ischemia and is associated with higher survival. However, a liberal fluid infusion strategy after six hours can cause fluid overload. Fluid overload has been associated with morbidity and mortality increase in critically ill patients. Herein, we present a review of the main studies that assessed the effects of net fluid balance/fluid overload on the morbidity and mortality of critically ill patients. We suggest that positive water balance may be used as a potential early biomarker of AKI in these patients.
- Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents(2017) BURDMANN, Emmanuel A.; JHA, VivekanandSouth and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. In addition to hospital-acquired acute kidney injury in tertiary care centers, these countries face a large preventable burden of community-acquired acute kidney injury secondary to tropical infectious diseases or animal venoms, affecting previously healthy young individuals. This article reviews the epidemiology, clinical picture, prevention, risk factors, and pathophysiology of acute kidney injury associated with tropical diseases (malaria, dengue, leptospirosis, scrub typhus, and yellow fever) and animal venom (snakes, bees, caterpillars, spiders, and scorpions) in tropical regions of Asia and Latin America, and discusses the potential future challenges due to emerging issues.
- Strategies of the Brazilian Chronic Kidney Disease Prevention Campaign (2003-2009)(2011) MASTROIANNI-KIRSZTAJN, Gianna; BASTOS, Marcus G.; BURDMANN, Emmanuel A.In Brazil, as in the rest of the world, the prevalence of chronic kidney disease (CKD) is increasing. In order to alert the population, health professionals and authorities to this risk, in 2003, the Brazilian Society of Nephrology launched a CKD prevention campaign called 'Previna-se'. In addition, since its onset, Brazil has participated in the World Kidney Day efforts and has developed several prevention strategies. Here, we summarize the main strategies adopted in this campaign (population screening, events and meetings, distribution of educational materials, routine report of estimated glomerular filtration rate) and our initial results, sharing practical experience that could be useful in other developing countries.
- BIOPSY PROVEN ACUTE TUBULAR NECROSIS DUE TO RHABDOMYOLYSIS IN A DENGUE FEVER PATIENT: A CASE REPORT AND REVIEW OF LITERATURE(2014) REPIZO, Liliany P.; MALHEIROS, Denise M.; YU, Luis; BARROS, Rui T.; BURDMANN, Emmanuel A.Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.