A low body mass index (BMI) and serum albumin are associated with increased risk of mortality in patients with chronic kidney disease (CKD). The purpose of this study was to evaluate BMI and serum albumin as predictors of all-cause and cardiovascular (CV) mortality in hemodialysed (HD) patients. We describe the results of a five-year retrospective observational study with 187 HD patients (54.9 +/- 15.6 years old, 54% men, and 46% suffering from diabetes) from RenalCor Clinic in Rio de Janeiro, Brazil. The influence of serum albumin levels and BMI (determined every three months) over all-cause mortality was examined using a Cox model, while the influence of the same factors over CV mortality among all-cause mortality was modeled through a logistic regression. During the five years, 26.7% of the patients died, 62% of which due to CV disease (CVD). Analysis by the Cox model showed that low serum albumin and low BMI were significant predictors of mortality. Patients with higher BMI had a lower hazard of death for all-cause mortality (hazard ratio [HR] = 0.92; P ( )= 0.035) and a 1 g/l increase in serum albumin was associated with significantly lower hazard of death (hazard ratio = 0.9679; P < 0.001). The highest BMI value (>30 kg/m(2)) was significantly associated with an increase of odds of CV mortality (odds ratio = 1.22, P = 0.03). We confirm here in a Brazilian cohort of hemodialysis patients that both low BMI (<19 kg/m(2)) and hypoalbuminemia are strong predictors of death.

Traditionally, deep carious lesions are treated by removal of all carious tissue, which may lead to pulp exposure. To minimize this risk, conservative carious tissue removal techniques have been proposed, including partial removal and stepwise excavation. However, there is no consensus in the literature about which is the better technique. Thus, the aim of this article is to describe and discuss the main techniques for carious tissue removal, according to scientific evidence. It was observed that both stepwise excavation and partial carious tissue removal presented lower pulp exposure rates and higher success rates. Clinical Relevance: Clinicians must be aware that conservative carious tissue removal techniques, such as stepwise excavation and partial carious tissue removal, present lower pulp exposure rates and higher success rates than traditional methods.