PERSPECTIVESalt and water retention in CKD patients: Too much of a good thing?Pedro Ponce
A 54-year-old patient with chronic kidney disease (CKD), stage 4, was admitted to the nephrology clinic, in the middle of August: he felt tired; his blood pressure was a little lower than usual; he had no oedema, his haemoglobin level had remained stable for a 6-month period but his serum creatinine had increased from 2.3 mg/dl since the last visit, 6 months ago, to 3.1 mg/dl.
Port J Nephrol Hypert 2017; 31(1): 5-6Advance Access publication 3 February 2017DOWNLOAD PDF
ORIGINAL ARTICLEAre Cranberry Capsules Effective and Safe in Preventing Urinary Tract Infections in Kidney Transplantation? A randomized pilot clinical trial.Tiago Assis Pereira, Ana Raquel Fernandes, Artur Mendes, Regina Oliveira, Ana Casqueiro, Rita Birne...
Introduction: Kidney transplant (KT) recipients are highly susceptible to urinary tract infections (UTIs).
Port J Nephrol Hypert 2017; 31(1): 7-13Advance Access publication 7 February 2017DOWNLOAD PDF
CASE REPORTMembranous nephropathy: A diagnostic and therapeutic challenge?Joana Gameiro, Sofia Jorge, José António Lopes, Lurdes Correia, António Gomes da Costa
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in Caucasian adults aged over 60 years old. Approximately two thirds of cases of membranous nephropathy (MN) in adults are primary (idiopathic), and the remaining are secondary forms which have been attributed to a variety of agents or conditions.
Port J Nephrol Hypert 2017; 31(1): 15-19Advance Access publication 14 February 2017DOWNLOAD PDF
CASE REPORTRare aetiology of obstructive kidney injury: Bilateral ureteral endometriosisMaria Inês Correia, Pedro Vieira, António M Gonçalves, José M Durães, Dina Santos, Nuno G Rosa, Gil Silva
Endometriosis is highly prevalent in women at the reproductive age, ranging from 6-10%, though ureteral involvement is rare, only seen in 0.1% of the cases, but may lead to urinary tract obstruction with potential renal function loss.
Port J Nephrol Hypert 2017; 31(1): 21-23Advance Access publication 22 February 2017DOWNLOAD PDF
COMMENTAnalysis of trends in prevalence, awareness, treatment and control of high blood pressure in Portugal: Examples of successful interventions against hypertensionMassimo Volpe, Giuliano Tocci
Essential hypertension is currently the major driver for cardiovascular (CV) morbidity and mortality worldwide.
Port J Nephrol Hypert 2017; 31(1): 25-27Advance Access publication 2 March 2017DOWNLOAD PDF
CASE REPORTKidney transplantation in a patient with preformed and exclusively anti-HLA-Cw donor specific antibodySofia Santos, Ana Castro, Andreia Campos, Sofia Pedroso, Leonídio Dias, Castro Henriques
We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant.
Port J Nephrol Hypert 2017; 31(1): 29-32Advance Access publication 8 March 2017DOWNLOAD PDF
COMMENTThe holy grail of renal protection in diabetes mellitus: is SGLT2 inhibition fulfilling its promise?Joaquim Calado
The manuscript from Lambers-Heerspink et al that appeared in this year’s January issue of the J Am Soc Nephrol1 reports a secondary analysis of the Canagliflozin Treatment and Trial Analysis versus Sulphonylurea (CANTATA-SU)2, that focus on the renal outcomes.
Port J Nephrol Hypert 2017; 31(1): 33-35Advance Access publication 10 March 2017DOWNLOAD PDF
NEPHROPATHOLOGY QUIZSevere granulomatosis with polyangiitisGisela Lage, Antónia Furtado, Ana Marta Gomes, Cátia Cunha, Daniela Lopes, Ana Ventura, Clara Almeida, João Carlos Fernandes
An 81-year-old female presented at the emergency room with asthenia, anaemia and oliguria. In the previous 6 months, she had experienced recurrent epistaxis, nasal crusting and saddle nose.
Port J Nephrol Hypert 2017; 31(1): 45-48Advance Access publication 27 March 2017DOWNLOAD PDF
PERSPECTIVELocal health communitiesCipriano Justo
Active citizenship is not based on the idea of practicing good or benevolent philanthropy, but on the principle of mutuality and reciprocity, the glue that binds people together and supports the construction of society.
Port J Nephrol Hypert 2017; 31(1): 39-43Advance Access publication 22 March 2017DOWNLOAD PDF
ORIGINAL ARTICLERenal involvement in rheumatoid arthritis: analysis of 53 renal biopsiesMário Góis, Fernanda Carvalho, Helena Sousa, Ana Carina Ferreira, João Sousa, Fernando Nolasco
Background: Rheumatoid arthritis (RA) is a systemic inflammatory disorder characterized by joint inflammation, associated with autoantibody production.
Port J Nephrol Hypert 2017; 31(1): 33-38Advance Access publication 10 March 2017DOWNLOAD PDF
NEPHROPATHOLOGY QUIZThe importance of protocol biopsy in kidney transplantation - A clinical case to solveHelena Sousa, Ana Rita Santos, Isabel Mesquita, Marina Vieira, Cecília Silva, Fernando Nolasco, Fernanda Carvalho
A 20-year-old man is referred to a nephrology consultation for a nephrotic syndrome.
Port J Nephrol Hypert 2016; 30(4): 312-317Advance Access publication 29 December 2016DOWNLOAD PDF
CASE REPORTType II mixed cryoglobulinaemia due to hepatitis C virus infection: The role of new direct-acting antivirals in a kidney transplant recipientRui Abreu, Patrícia Neto, Luís Oliveira, Presa Ramos, Teresa Morgado
Hepatitis C virus (HCV) infection remains prevalent in chronic kidney disease (CKD) patients. In a posttransplant patient, it can increase the risk for several complications such as transplant glomerulopathy and cryoglobulinaemia.
Port J Nephrol Hypert 2016; 30(4): 308-311Advance Access publication 2 January 2017DOWNLOAD PDF
ORIGINAL ARTICLECancer and End-Stage Kidney Disease: A Death Sentence?Teresa Chuva, José Maximino, Joselina Barbosa, Rui Henrique, Sandra Silva, Paulo Santos, Alfredo Loureiro
Background: End-stage kidney disease is associated with considerable morbidity and mortality, a feature that is shared with malignant neoplasms.
Port J Nephrol Hypert 2016; 30(4): 291-297Advance Access publication 28 December 2016DOWNLOAD PDF
PERSPECTIVEPrognostication in End-Stage Renal DiseaseAna Farinha
When outpatient haemodialysis programmes began, strict criteria were developed to deliver a limited resource to those patients who would benefit the most.
Port J Nephrol Hypert 2016; 30(4): 246-251Advance Access publication 22 December 2016DOWNLOAD PDF
PERSPECTIVEStrategic Health PlanningCipriano Justo
Strategic thinking requires making conscious choices on how to use limited resources to achieve a goal in response to a dynamic environment.
Port J Nephrol Hypert 2016; 30(4): 253-258Advance Access publication 16 December 2016DOWNLOAD PDF
ORIGINAL ARTICLEExit-site fungal infections - experience of a Peritoneal Dialysis UnitSofia Coelho, Ana Beco, Ana Oliveira, Carla Santos, Manuel Pestana
Introduction: Exit-site infections are an important complication of peritoneal dialysis; however, very little is known about fungi-related exit-site infections. The literature is very sparse and there are virtually no studies that report it. Objective: To evaluate in retrospect the risk factors associated with exit-site fungal infection and its development.
Port J Nephrol Hypert 2016; 30(4): 285-290Advance Access publication 25 November 2016DOWNLOAD PDF
CASE REPORTAcute kidney injury due to Q feverAna R. Fernandes, Francisco Gouveia, Márcio S. R. Viegas, Sofia S. Coelho, Elsa Q. Soares, Nuno Luís, Ana S. Natário, José C. Barreto
Coxiella burnetii (C. burnetii) causes a zoonotic disease – Q fever. This bacterium is highly resistant to harsh environmental conditions and causes an uncharacteristic clinical syndrome.
Port J Nephrol Hypert 2016; 30(4): 303-307Advance Access publication 25 November 2016DOWNLOAD PDF
REVIEW ARTICLEC3 glomerulopathies: A new category encompassing rare complement mediated glomerulonephritisFernanda Carvalho, Fernando Nolasco
Disease associated membranoproliferative glomerulonephritis (MPGN) has been well‑known for decades. Recently, advances in the understanding of the complement system have shown its direct influence on MPGN‑related conditions and conditions related to other morphologic entities.
Port J Nephrol Hypert 2016; 30(4): 239-245Advance Access publication 22 December 2016DOWNLOAD PDF
PERSPECTIVERenal transplantation - From childhood to adulthoodNatacha Rodrigues, Alice Santana, José Guerra
The difficulties inherent in transition from paediatric to adult units are universal to all chronic diseases in paediatric age.
Port J Nephrol Hypert 2016; 30(4): 252Advance Access publication 7 December 2016DOWNLOAD PDF
ORIGINAL ARTICLEMultiple myeloma and high cut-off haemodialysis: On the right track for better outcomes?Teresa Chuva, José Maximino, Joselina Barbosa, Paulo Santos, Sandra Silva, Ana Paiva, Jorge Baldaia, Teresa Santos, Alfredo Loureiro
Background: Acute kidney injury secondary to cast nephropathy is a common complication of multiple myeloma.
Port J Nephrol Hypert 2016; 30(4): 269-276Advance Access publication 30 January 2016DOWNLOAD PDF
ORIGINAL ARTICLEAn Automated Peritoneal Dialysis regimen is not detrimental to Residual Renal FunctionCristina Candido, Gloria del Peso, Gilda Carreño, Juan Santacruz, Rafael Sánchez-Villanueva, Ana Aguilar, Lucía Rodriguez-Gayo, Rafael Selgas, Mª Auxiliadora Bajo
Background: Residual Renal Function (RRF) preservation is related to survival in Peritoneal Dialysis (PD) patients. The effect of different PD modalities on RRF is unclear.
Port J Nephrol Hypert 2016; 30(4): 277-284Advance Access publication 25 November 2016DOWNLOAD PDF
MINI-REVIEWBK virus nephropathy in kidney transplantation - A literature review following a clinical casePatrícia Barreto, Manuela Almeida, Leonídio Dias, Pedro Vieira, Sofia Pedroso, La Salete Martins, António Castro Henriques, António Cabrita
Over the last 15 years, better immunosuppressive drugs have decreased acute rejection rates in kidney transplantation but have also led to an increase in the incidence and impact of BK virus nephropathy.
Port J Nephrol Hypert 2016; 30(4): 259-268Advance Access publication 18 July 2016DOWNLOAD PDF
CASE REPORTA rare malignancy in the post-transplant period: Myeloma cast nephropathyIsabel Mesquita; Helena Viana; Marília Possante; Cristina João; Susana Carvalho; Cecília Silva; Inês Aires; Aníbal Ferreira; Francisco Remédio; Fernanda Carvalho; Fernando Nolasco
Myeloma-associated renal disorders are rare events among renal transplants and can occur as recurrent or de novo disease.
Port J Nephrol Hypert 2016; 30(4): 298-302Advance Access publication 25 November 2016DOWNLOAD PDF
NEPHROPATHOLOGY QUIZAnaemia, acute renal failure and proteinuria - A case to solveHelena Sousa Viana, Marta Ruivo, Joaquim Calado, Fernanda Carvalho, Fernando Nolasco
A 70‑year‑old man was admitted to our hospital emergency for epigastralgy and haematemesis. He had a past history of: controlled long‑time hypertension, gastric ulcer complicated with perforation two years before and osteo‑articular pain with daily intake of paracetamol and metamizole.
Port J Nephrol Hypert 2016; 30(3): 228-231Advance Access publication 3 October 2016DOWNLOAD PDF
PERSPECTIVELow percentage of pre-transplant histological evaluation of extended criteria donors in Southern Portugal. Are these biopsies irrelevant or should we change our practice?Rita Magriço, Fernanda Carvalho
Kidney transplant offers the possibility of reduced mortality and improved quality of life and is at the top of the list of the most cost‑effective interventions in medicine.
Port J Nephrol Hypert 2016; 30(3): 177-179Advance Access publication 3 October 2016DOWNLOAD PDF
PERSPECTIVEIn clinical practice, more information is not always good: The problem of overdiagnosisAntónio Vaz Carneiro
The definition of disease is not as straightforward as it may seem. The combination of signs and symptoms, together with interpretation of the results of confirmatory ancillary tests, allows us to have a probabilistic estimate of disease but we can never be absolutely sure that a non‑ambiguous clinical entity is in play.
Port J Nephrol Hypert 2016; 30(3): 170-172Advance Access publication 13 September 2016DOWNLOAD PDF
PERSPECTIVEHepatitis c virus, still around after all these years: Enough is enoughRui Tato Marinho
Viral hepatitis. New light on an old disease was the title of an article published by Saul Kurgman in 1970, almost 50 years ago, in the Journal of the American Medical Association1, on an unknown viral agent that seemed to cause hepatitis.
Port J Nephrol Hypert 2016; 30(3): 173-176Advance Access publication 13 September 2016DOWNLOAD PDF
CASE REPORTFever of unknown origin and pericardial effusion in a haemodialysis patientTiago Assis Pereira, Margarida Gonçalves, João Torres, Ilídio Rodrigues, Ana Pires, Helena Boquinhas, José Barata
Introduction: Retroperitoneal fibrosis is a rare disorder. The idiopathic (IRF) form of the disease accounts for most of cases. Renal failure is a common finding, and some patients present with non-functioning kidneys, as a result of long-lasting obstructive uropathy.
Port J Nephrol Hypert 2016; 30(3): 223-227Advance Access publication 25 August 2016DOWNLOAD PDF
PERSPECTIVEAcute Kidney Injury Biomarkers - from bench to clinical useKarina Soto, Prasad Devarajan
Acute kidney injury (AKI) is common and the absolute incidence of AKI has increased over the last decade1. Almost 10% of hospitalized patients can develop AKI;incidence is even greater in the intensive care unit (ICU) and emergency department (ED) settings, respectively attaining 30% and 20% in Portugal2,3.
Port J Nephrol Hypert 2016; 30(3): 166-169Advance Access publication 9 September 2016DOWNLOAD PDF
CASE REPORTHemodialysis Reliable Outflow (HeRO) Graft device: a lifesaving solution in multiple vascular access failure haemodialysis patientsMiguel Bigotte Vieira, Tiago Ferreira, Alice Fortes, Pedro Martins, Augusto Ministro, Hugo Ferreira, Hugo Silva, Tiago Amaral, Cristina Resina, Joana Gameiro, Cristina Outerelo, Estela Nogueira, Sofia
The increasing prevalence of end‑stage chronic kidney disease associated with advances in treatment is expected to lead to improved survival rates of chronic haemodialysis patients in Portugal.
Port J Nephrol Hypert 2016; 30(3): 217-222Advance Access publication 31 August 2016DOWNLOAD PDF
ORIGINAL ARTICLEAldosterone levels in patients on haemodialysis: Relationship with body fat mass and adipocytokinesMJ Fernández-Reyes, M Heras, MJ Gonzalez Villalba, O. Rodriguez Fraga, A. Molina, R. Callejas, A. Rodríguez, V. Lopes, L. Calle
Background: It has been recently shown that serum aldosterone (SA) levels are correlated with insulin resistance, excess body fat and levels of adipocytokines. Aim: To establish SA levels in patients on haemodialysis (HD) and the possible association with excess body fat and/or serum adipocytokine levels.
Port J Nephrol Hypert 2016; 30(3): 199-204Advance Access publication 19 August 2016DOWNLOAD PDF
ORIGINAL ARTICLEMalignancy after renal transplantation: a single-centre experiencePedro Vieira, Patrícia Barreto, Sofia Pedroso, Manuela Almeida, La Salete Martins, Leonídio Dias, António Castro Henriques; António Cabrita
Introduction: Malignancy management in renal transplant recipients is becoming a major factor affecting long‑term patient survival. Thus, we intended to evaluate both incidence and prognosis of malignant diseases following renal transplantation at a single centre in Portugal.
Port J Nephrol Hypert 2016; 30(3): 205-209Advance Access publication 25 August 2016DOWNLOAD PDF
PERSPECTIVEA new era in the treatment of hepatitis C infection in uraemic patients: are we nearing the end of this challenging disease?Aníbal Ferreira, José Diogo Barata
Chronic hepatitis C virus (HCV) infection is one of the leading causes of chronic liver disease. It is estimated that between 80 and 160 million people worldwide are infected with this virus.
Port J Nephrol Hypert 2016; 30(3): 163-165Advance Access publication 18 July 2016DOWNLOAD PDF
NEPHROPATHOLOGY QUIZAn unexpected cause of chronic renal dysfunction and haemato-proteinuriaHelena Sousa Viana, Isabel Mesquita, Isabel Pataca, Fernanda Carvalho, Fernando Nolasco
A 62‑year‑old woman was referred to nephrology section for renal dysfunction. Initial laboratory workup was significant for a creatinine of 3.1 mg/dl, urea 119 mg/dl, and urinalysis showing haematuria (3+ red blood cells) and proteinuria (protein excretion 2+; 3.5 g/day).
Port J Nephrol Hypert 2016; 30(2): 153-156Advance Access publication 22 June 2016DOWNLOAD PDF
REVIEW ARTICLECorrecting acidosis in CKD patients. How much is too muchPedro Ponce
Acid-base balance is normally maintained by the renal excretion of the daily acid load, about 1mEq/kg/day, derived mostly from the generation of sulphuric acid during the metabolism of dietary amino-acids.
Port J Nephrol Hypert 2016; 30(2): 94-101Advance Access publication 21 June 2016DOWNLOAD PDF
COMMENTRenal angiomyolipomas, Tuberous Sclerosis Complex and mammalian target of rapamycin inhibitorsCatarina Teixeira, Edgar A F de Almeida
In this issue of the Journal Miguel Oliveira et al. report the case of a patient with a giant renal angiomyolipoma (AML) associated with tuberous sclerosis complex (TSC) who was treated with everolimus, one of the mammalian target of rapamycin (mTOR) inhibitors available for clinical use.
Port J Nephrol Hypert 2016; 30(2): 104-105Advance Access publication 15 June 2016DOWNLOAD PDF
EDITORIALObesity-related nephropathy in children - the need for greater awarenessLiane Correia-Costa, Ana Azevedo, Alberto Caldas Afonso
Fat accumulation is known to lead to the development of several cardiovascular risk factors and metabolic disturbances, such as hypertension, dyslipidaemia and insulin resistance.
Port J Nephrol Hypert 2016; 30(2): 89-93Advance Access publication 7 May 2016DOWNLOAD PDF
COMMENTIs ERT therapy beneficial in transplant patients with Fabry disease when the diagnosis is delayed?Renzo Mignani
Sofia Santos et al. report the favourable 19‑year outcome of deceased kidney transplantation in a 56‑year‑old male with classical Anderson‑Fabry Disease (AFD), whose diagnosis was made at age 43 – i.e., 5 years after having received a kidney allograft for end‑stage renal disease (ESRD) of uncertain aetiology – following the incidental observation of the typical corneal dystrophy of AFD (cornea verticillata) by an ophthalmologist.
Port J Nephrol Hypert 2016; 30(2): 106-107Advance Access publication 6 June 2016DOWNLOAD PDF
Mini-ReviewOxalate nephropathy following Roux-en-Y gastric bypass surgery - Mini-ReviewMiguel Verdelho, Marco Mendes, Francisco Ribeiro, Helena Sousa Viana, Fernanda Carvalho, Fernando Nolasco
Oxalate Nephropathy is characterised by the presence of tubular crystalline deposits of calcium oxalate, which can lead to both acute and chronic tubular injury and progressive renal failure.
Port J Nephrol Hypert 2016; 30(3): 180-184Advance Access publication 7 June 2016DOWNLOAD PDF
PERSPECTIVEDialysis time and survival: Pursuing fashionable trends of dubious importance?José Vinhas
The prestigious Journal of the American Medical Association published a study in 2000 by Barbara Starfield which revealed the extremely poor performance of the United States health care system when compared to that of other industrialised nations.
Port J Nephrol Hypert 2016; 30(2): 102-103Advance Access publication 17 May 2016DOWNLOAD PDF
ORIGINAL ARTICLEImplications for patients waiting for a kidney transplant of using the calculated panel reactive antibody (cPRA)Rita Magriço, Jorge Malheiro, Sandra Tafulo, Sofia Pedroso, Manuela Almeida, La Salete Martins, Leonídio Dias, António Castro Henriques, António Cabrita
Introduction: Kidney transplant improves survival even in highly‑sensitized (HS) patients. To overcome their disadvantage in accessing transplantation, those with high Complement Dependent Cytotoxic PRA (CDC‑PRA) receive additional points during allocation.
Port J Nephrol Hypert 2016; 30(2): 185-193Advance Access publication 5 May 2016DOWNLOAD PDF
COMMENTToo Much Medicine: A commentary for nephrologistsRichard J Glassock
The screening of populations of “apparently” health adults or children for the purpose of early detection of serious, possibly life-limiting diseases (such as cancer, heart or kidney disease) occurring in a pre-symptomatic form has become a very controversial issue in recent years.
Port J Nephrol Hypert 2016; 30(1): 000-000Advance Access publication 15 March 2016DOWNLOAD PDF
COMMENTStudies in which harm outweighs benefit but in which the intervention effect is presented mostly as beneficial would be better not published - A comment on the SPRINT trialAntónio Vaz Carneiro
Clinical practice in the XXI century is getting more complex and the role of scientific evidence to support clinical decision-making appears to no longer raise any question: most clinicians recognize that it is the combination of good quality scientific data applicable to our patients and the experience of the individual doctor that produces the best quality of care, with consistent and cost-effective results.
Port J Nephrol Hypert 2016; 30(1): 27-30Advance Access publication 22 March 2016DOWNLOAD PDF