Banca de DEFESA: LIVIA MARIA BORGES AMARAL TENORIO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : LIVIA MARIA BORGES AMARAL TENORIO
DATE: 28/04/2022
TIME: 14:00
LOCAL: famed
TITLE:

Inflammation and risk of sarcopenia in diabetic individuals with chronic kidney disease during the COVID pandemic 19.

KEY WORDS:

diabetes, chronic kidney disease, obesity, COVID 19, sarcopenia

PAGES: 35
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

INTRODUCTION: Diabetic nephropathy is the main complication that leads diabetic patients to hemodialysis. At this time of pandemic by COVID 19, patients with diabetes, especially the obese diabetics, are part of the risk group that can evolve with the most severe presentation of the disease. In obese individuals with diabetes and patients with chronic kidney disease, the inflammatory process occurs in an exacerbated manner with the uncontrolled elevation of inflammatory cytokines and may have an unfavorable outcome. The sarcopenia present in these patients also appears as a complicating factor during the pandemic period, with repercussions still uncertain in this scenario. OBJECTIVE: To investigate the risk of sarcopenia and inflammatory response in diabetic patients with chronic kidney disease, underconservative treatment during the COVID pandemic 19. MATERIALS AND METHODS: The dissertation presents two products. Product 1 is a review article "Metabolic pathways and hyperinflammation in covid 19 in chronic renal diabetic obese patients and their post-infection physical rehabilitation", published in the Journal of Development ISSN: 2525-8761, DOI: https://doi.org/10.34117/bjdv7n7-167. The second product refers to a cross-sectional study, observational, and the sample was calculated from 40 diabetic patients undergoing conservative treatment for Chronic Kidney Disease (CKD), with < 60mL/min/1.73m² (GFR calculated with ckd-EPI formula) of both sexes, assisted by the Integrated Nephrology Center of the Professor Alberto Antunes University Hospital (HUPAA) during the COVID pandemic 19. The collection was carried out from January to July 2021. The study was done in two stages, the first being retrospective observational by collecting data from medical records, including socioeconomic, anthropometric (weight and height) and biochemical data (blood count, urea, creatinine, albumin, fasting glycemia, lipidogram, C-reactive protein, ferritin, uric acid, sodium, potassium, calcium, phosphorus, PTH and 25-hydroxy-vitamin D). The second part was the collection of blood samples for the evaluation of inflammatory cytokines (IL-1β, IL-6, IL-8, TGF-β) and screening of sarcopenia by applying the SARC-F<® questionnaire. RESULTS: Forty-one patients (63.8% elderly and 36.1% adults) were evaluated, and a high percentage of obesity was observed (mean BMI 30.4Kg/m², with SD 6.541, p 0.001), with 39.02% of obese individuals and the presence of a decreased glomerular filtration rate (mean GFR of 38.2mL/min/1.73m², with SD 14.68, p 0.039). Of this population, 36 people answered the SARC-F questionnaire to assess the risk of sarcopenia and we found 38.9% of signs suggestive of sarcopenia, which indicates to continue with the investigation later and greater attention to care. The variables related to personal and health data were analyzed regarding the association with nutritional status and no statistical significance was found. Personal and health data when associated with nutritional status did not differ, however, the risk of sarcopenia was associated with the fasting glucose value (p 0.017) with low association effect. The correlation analysis using spearman rho coefficient, performed between nutritional status and nonlinear variables, found a positive relationship between obesity and glomerular filtration rate, fasting glycemia and glycated hemoglobin. Inflammatory markers will be analyzed at a later stage. CONCLUSION: The studied population represents patients with advanced stage of diabetic chronic kidney disease and the obesity rate appears high in this sample. This fact may be related to the presence of sarcpenic obesity, considering the data of the SARC-F. In addition, the positive correlations between obesity and GFR, fasting glycemia and glycated hemoglobin reflect the metabolic repercussions to which this nutritional profile is associated, according to the literature.

BANKING MEMBERS:
Externo à Instituição - BRAULIO CESAR DE ALCANTARA MENDONCA
Interna - 4364569 - FABIANA ANDREA MOURA
Interno - 1791653 - FLAVIO TELES DE FARIAS FILHO
Presidente - 3621153 - JULIANA CELIA DE FARIAS SANTOS
Interno - 384.145.544-15 - SAMIR BUAINAIN KASSAR - UNCISAL