Juliana L. Cury

Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional

OBJECTIVE To evaluate lung function and functional capacity in patients with chronic kidney failure (CKF) undergoing dialysis and in patients after kidney transplant. METHODS Seventy-two participants were evaluated: 32 patients with CKF on dialysis (DG) for at least six months, ten patients who had kidney transplants (TG) at least six months earlier, and 30 healthy subjects as a control group (CG). All groups were evaluated using spirometry, with maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), and using the six-minute walking test (6MWT). The SPSS 12.0 software was used for statistical analysis, with a minimum significance level of alpha<0.05. RESULTS There was a decreased lung function in the DG for FVC, FEV1, MVV, VC, MIP and MEP, and decreased FEV1 and MVV in the TG compared to the CG (one-way ANOVA/Fishers post-hoc; p<0.01). There was also an association (chi-square) between decreased MIP and belonging to the DG (alpha=0.5, p<0.001), between lower performance in the 6MWT for the DG and TG (p<0.01) compared to the CG (one-way ANOVA/Fishers post-hoc), and between MIP and MEP (Pearsons coefficient; r=0.752; p<0.01). CONCLUSIONS Patients with CKF undergoing dialysis showed impaired functional capacity and lung function that were not completely reverted in the kidney transplant patients.

Variação diurna de parâmetros de função pulmonar e de força muscular respiratória em pacientes com DPOC

OBJECTIVE To evaluate the magnitude of diurnal changes in the parameters of pulmonary function and respiratory muscle strength/endurance in a sample of patients with COPD. METHODS A group of 7 patients underwent spirometry, together with determination of MIP and MEP, at two distinct times (between 8:00 and 8:30 a.m. and between 4:30 and 5:00 p.m.) on a single day. Between assessments, the patients remained at rest in the laboratory. RESULTS In accordance with the Global Initiative for Chronic Obstructive Pulmonary Disease staging system, COPD was classified as moderate, severe, and very severe in 1, 3, and 3 of the patients, respectively. From the first to the second assessment, there were significant decreases in FVC, FEV1, and MEP (of 13%, 15%, and 10%, respectively), as well as (less than significant) decreases in PEF, MIP, and maximal voluntary ventilation (of 9%, 3%, and 11%, respectively). CONCLUSIONS In this sample of COPD patients, there were diurnal variations in the parameters of pulmonary function and respiratory muscle strength. The values of FEV1, FVC, and MEP were significantly lower in the afternoon than in the morning.

Animal model of chronic kidney disease using a unilateral technique of renal ischemia and reperfusion in White New Zealand rabbits

PURPOSE To establish a model of chronic kidney disease in White New Zealand rabbits, using an exclusive unilateral technique of renal ischemia and reperfusion. METHODS Twenty males White New Zealand rabbits were used. All animals were subjected to the following: pre-surgical blood collection (1st collection) for creatinine and urea serum analysis, left renal ischemia and reperfusion surgery technique, another blood sample was collected after 6 weeks post surgery (2nd collection), the last blood sample (3rd collection) blood sample was taken 11 weeks post surgery (pre-euthanasia), euthanasia and withdrawal of right and left kidney for histopathological analysis. RESULTS The creatinine levels after surgery was statistically significant higher in the 3rd collection, regarding the 1st and 2nd collection (p<0.05). A significant statistic increase for urea was showed only in the 2nd collection (p<0.05) when compared to the 1st and 3rd collections. Histopathological analysis showed bilateral lesions in the renal tissue, consistent to the process of ischemia and reperfusion. CONCLUSION This exclusive unilateral technique of renal ischemia and reperfusion without nephrectomy in White New Zealand rabbits, showed effectiveness in getting an animal model of chronic kidney disease.