The Brazilian collaborative registry for pediatric renal transplantation began in 2004 as a multicenter initiative aimed at analyzing, reporting, and disseminating the results of pediatric renal transplantation in Brazil. Data from all pediatric renal transplants performed from January 2004 to May 2018 at the 13 participating centers were analyzed. A total of 2744 pediatric renal transplants were performed in the thirteen participating centers. The median age at transplantation was 12.2 years, with the majority being male recipients (56%). The main underlying diseases were CAKUT (40.5%) and glomerulopathy (28%). 1981 (72%) of the grafts were from deceased donors (DD). Graft survival at one year (censored by death) was 94% in the live donor group (LD) and 91% in the DD group (log‐rank test P < 0.01). The patient’s survival at one and 5 years was 97% and 95% for the LD group and 96% and 93% for the DD group (log‐rank test P = 0.02). The graft loss rate was 19% (n = 517), more frequently caused by vascular thrombosis (n = 102) and chronic graft nephropathy (n = 90). DD recipients had 1.6 (1.0‐2.2) times greater chance of death and 1.5 (1.2‐1.8) times greater chance of graft loss compared to LD recipients. The mortality rate was 5.4% (n = 148), mainly due to infection (n = 69) and cardiovascular disease (n = 28). The results of this collaborative pediatric renal transplant record are comparable to other international registries, although we still have a high infection rate as a cause of death.

Curcumin is a polyphenol present in the rhizomes of the species Curcuma longa L. ("turmeric," Zingiberaceae), which has been used for centuries as an anti-inflammatory. We aimed to evaluate the anti-inflammatory effects of C. longa in renal injury induced by doxorubicin (DOX, 3.5 mg.kg IV). We studied four groups of Wistar rats: two groups with DOX-induced kidney injury, one fed with standard food and another with standard food mixed with C. longa (5 mg.g ). Two other control groups without kidney injury were fed with the same foods. We measured albuminuria, body weight, and food intake every 2 weeks. After 8 weeks, treatment with C. longa did not change albuminuria, but it significantly attenuated the excretion of urinary inflammatory markers monocyte chemoattractant protein-1 (MCP-1) and transforming growth factor-β (TGF-β) and significantly attenuated immunostaining for desmin, vimentin, and ED-1 cells in renal tissues of rats with DOX-induced kidney injury. In addition, treatment with C. longa resulted in significantly lower glomerular and tubule interstitial injury scores, compared with that in the DOX-STD group. In conclusion, administration of powdered rhizomes of C. longa for 8 weeks to rats with DOX-induced kidney injury did not reduce albuminuria but led to a significant decrease in urinary inflammatory markers MCP-1 and TGF-β and decreased histopathological alterations and immunostaining for desmin, vimentin, and ED-1 cells kidneys tissues.

Background Atypical Hemolytic Uremic Syndrome (aHUS) is an ultra-rare disease. Therefore, studies involving large samples are scarce, making registries powerful tools to evaluate cases. We present herein the first analysis of the Brazilian aHUS Registry (BRaHUS). Methods Analysis of clinical, laboratory, genetic and treatment data from patients inserted in the BRaHUS, from 2017 to 2020, as an initiative of the Rare Diseases Committee of the Brazilian Society of Nephrology. Results Cohort of 75 patients (40 adults and 35 pediatric). There was a predominance of females (56%), median age at diagnosis of 20.7 years, and a positive family history in 8% of cases. Renal involvement was observed in all cases and 37% had Low C3 levels. In the &lt;2 years of age-group, males were predominant. Children presented lower levels of hemoglobin (p = 0.01) and platelets (p = 0.003), and higher levels of LDH (p = 0.004) than adults. Genetic analysis performed in 44% of patients revealed pathogenic variants in 66.6% of them, mainly in CFH and the CFHR1-3 deletion. Plasmapheresis was performed more often in adults (p = 0.005) and 97.3% of patients were treated with eculizumab and its earlier administration was associated with dialysis-free after 3 months (p = 0.08). Conclusions The cohort of BRaHUS was predominantly composed of female young adults, with renal involvement in all cases. Pediatric patients had lower hemoglobin and platelet levels and higher LDH levels than adults, and the most common genetic variants were identified in CFH and the CFHR1-3 deletion with no preference of age, a peculiar pattern of Brazilian patients.

Introdução: A prevalência da DPOC no Brasil é estimada em 15,8%, segundo o estudo Platino 1. A maioria (87,5%) de seus pacientes permanecem sem diagnóstico 2. A realização da espirometria é uma estratégia recomendada pelo documento GOLD para confirmar o diagnóstico na DPOC3. A Boehringer Ingelheim do Brasil, desde o ano de 2012, realiza gratuitamente, em parceria com secretarias municipais, estaduais e instituições de saúde, exames de espirometria de acordo com a solicitação e autorização dos serviços, associado a programas de capacitação de agentes e profissionais de saúde4-9. Dados epidemiológicos apontam que os pacientes com DPOC com tratamento iniciado nas fases leves e moderadas da doença apresentam expectativa de vida de 14 anos, enquanto pacientes inicialmente tratados com diagnóstico nos graus grave e muito grave têm expectativa de vida de 10 anos 10. O tratamento da DPOC, seja através de monoterapia com LAMA, LABA, broncodilatação dupla (LAMA/LABA) ou na terapia tripla com a adição de CI leva a um menor número de exacerbações e, consequentemente, menos internações hospitalares11-13. O custo por internação no Brasil é estimado em, pelo menos, R$ 1.552,00 reais. Objetivo: A realização mais precoce de exames de espirometria oferecidos pela parceria público-privada com a Boehringer Ingelheim do Brasil visa ao diagnóstico e tratamento mais precoce da DPOC, com potencial diminuição da taxa de exacerbações graves e, consequentemente, de internações hospitalares. Métodos: Para esta análise, foram consideradas o número de espirometrias realizadas pela parceria da Boehringer Ingelheim de 2016 a 2018 em relação aos dados epidemiológicos brasileiros descritos no estudo Platino. Resultados: No período entre 01 de janeiro de 2017 e 31 de dezembro de 2018 foram realizadas 198.370 espirometrias (47.553 em 2016, 67.201 em 2017 e 83.616 em 2018), conforme dados demonstrados na figura 1. Figura 1. Número de espirometrias realizadas pela Boehringer Ingelheim do Brasil em parceria com instituições de saúde nos anos de 2016 a 2018. Dada a prevalência aproximada de 15,8% da DPOC em adultos acima de 40 anos no Brasil, o programa de espirometrias poderia ter identificado cerca de 31.342 casos de DPOC1,2,15. Destes, potencialmente 27.424 casos poderiam ser de novos diagnósticos (87,5% destes casos), de acordo com os dados de prevalência do estudo Platino3. O programa pode ter ajudado para diagnóstico mais precoce e possível instalação mais rápida de tratamento, trazendo benefícios clínicos e econômicos. Conclusões: Com o aumento do número de espirometrias promovido pela parceria público-privada, houve um potencial benefício no diagnóstico precoce de pacientes portadores de DPOC entre os anos de 2016 a 2018 com provável impacto positivo no tratamento precoce dos pacientes, o que pode ter gerado menor número de exacerbações e internações hospitalares.