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
8 resultados
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bookPart O idoso em diálise: Particularidades, cuidados e prognóstico(2015) ÁLVARES, Valeria Regina de Cristo; ELIAS, Rosilene Motta- 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.
- ANALYSIS OF PREDICTING FACTORS OF MORTALITY IN INCIDENT HEMODIALYSIS PATIENTS(2015) MAGALHAES, Luciene P.; REIS, Luciene M. dos; GRACIOLLI, Fabiana G.; ELIAS, Rosilene M.; MOYSES, Rosa M. A.; JORGETTI, Vanda
bookPart Doença renal crônica(2015) SILVA, Bruno Caldin da; ELIAS, Rosilene Motta- Is urinary density an adequate predictor of urinary osmolality?(2015) SOUZA, Ana Carolina P.; ZATZ, Roberto; OLIVEIRA, Rodrigo B. de; SANTINHO, Mirela A. R.; RIBALTA, Marcia; ROMAO JR., Joao E.; ELIAS, Rosilene M.Background: Urinary density (UD) has been routinely used for decades as a surrogate marker for urine osmolality (U-osm). We asked if UD can accurately estimate U-osm both in healthy subjects and in different clinical scenarios of kidney disease. Methods: UD was assessed by refractometry. U-osm was measured by freezing point depression in spot urines obtained from healthy volunteers (N = 97) and in 319 inpatients with acute kidney injury (N = 95), primary glomerulophaties (N = 118) or chronic kidney disease (N = 106). Results: UD and U-osm correlated in all groups (p < 0.05). However, a wide range of U-osm values was associated with each UD value. When UD was <= 1.010, 28.4% of samples had U-osm above 350 mOsm/kg. Conversely, in 61.6% of samples with UD above 1.020, U-osm was below 600 mOsm/kg. As expected, U-osm exhibited a strong relationship with serum creatinine (S-creat), whereas a much weaker correlation was found between UD and Screat. Conclusion: We found that UD is not a substitute for U-osm. Although UD was significantly correlated with U-osm, the wide dispersion makes it impossible to use UD as a dependable clinical estimate of U-osm. Evaluation of the renal concentrating ability should be based on direct determination of U-osm.
- Parathyroidectomy: better late than never(2015) ELIAS, Rosilene M.; GOLDENSTEIN, Patricia T.; MOYSES, Rosa M. A.
- Is parathyroidectomy always good for the heart?(2015) ARAUJO, Maria Julia C. L. N.; ELIAS, Rosilene M.; MOYSES, Rosa M. A.