Banca de DEFESA: CAMILA MODESTO NACIFE ADAME

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : CAMILA MODESTO NACIFE ADAME
DATE: 26/08/2021
TIME: 09:30
LOCAL: Apresentação via Google Meet
TITLE:

ESTIMATION OF GLOMERULAR FILTRATION RATE IN OBESE PATIENTS: comparative evaluation between formulas for calculation

KEY WORDS:

Glomerular Filtration Rhythm. Obesity.

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

Obesity is one of the most prevalent metabolic disorders of the 21st century. Its growing epidemic generates important consequences in public and individual health such as: diabetes, cardiovascular complications, cancer, asthma, sleep disorders, liver dysfunction, renal dysfunction and infertility (MANNA and JAIN, 2015).

Its etiology is complex and multifactorial, resulting from the interaction of genetic, environmental, emotional and lifestyle factors. Decreased physical activity and increased consumption of high caloric density foods are determining factors (abeso guideline, 2016). In humans, several other reward and emotional factors play a role in food intake, in addition to hunger (guideline of the endo Society 2014).

The disease not associated with genetic syndromes has polygenic inheritance, and the environment plays a fundamental role in genetically susceptible individuals (abeso guideline, 2016). Lifelong dietary patterns play a strong role in the development of chronic diseases, including diabetes and hypertension, the main risk factors for end-stage kidney disease (STD) (CAMARA et. al, 2017)

By 2025, an estimated 2.3 billion adults around the world are overweight, of which 700 million are diagnosed with obesity (WHO website). In Brazil, there was an increase of 67.8% in the years 2006 to 2018, representing a prevalence of 19.8% in the latter. Currently in the country, 20.7% of women and 18.7% of men are obese (ABESO website).

To define it, the WHO uses body mass index (BMI), body weight measurement adjusted for height, weight (kg)/height(m2). Calculation of simple interpretation and better correlation with other estimates of adiposity, besides eliminating the need for height/weight tables for specific genera. It is based on the observation that body weight is proportional to square dwell in adults with preserved anatomical composition (BRAY et al., 2018)

Studies with human and animal models show an association between obesity and end-stage renal disease, even after adjustments for systemic arterial hypertension and diabetes mellitus (MUNUSAMY et al., 2015). Around 50% of patients with type 2 diabetes mellitus will develop CKD, with obesity accounting for a 23% increase in risk. In addition, it is a risk factor for nephrolithiasis and renal neoplasia, influencing prognosis and associating with worse outcomes (TAHERGORABI, Z. et al., 2016).

The kidney and adipose tissue of the obese individual secrete pro-inflammatory cytokines, such as angiotensin II and leptin, among other adipocytokines with effects on doucytes, mesangial and tubular cells, which also express insulin and leptin receptors, crucial for maintaining cellular permoseletivity. The larger the adipose tissue, the greater the circulation of these substances and the inflammatory syndrome concomitant with obesity is related, among other alterations, to the appearance of glomerulosclerosis and tubulointerstitial atrophy. (COWARD and FORNONI, 2015).

In addition, excess weight is commonly accompanied by other components of metabolic syndrome and insulin resistance, which synergistically can induce the onset of kidney injury or exacerbate pre-existing pathologies. Most of these are possibly compensatory responses to the systemic increase in energy demand (TSUBOI et al., 2017). Its association with the rate of progression of chronic kidney disease (CKD) is related to many factors such as hyperfiltration, glomerular hypertension and hyperactivation of the anintho-angiotensin-aldosterone system (AAR) (BOUQUEGNEAU, 2015).

The condition called obesity-related glomerulopathy is characterized by glomerulomegaly, progressive glomerulosclerosis, and declining renal function. The rate of progression to end-stage renal disease (ESD) is slow and once renal damage is established, the disease progresses with the development of proteinuria. The marked difference in the prevalence of obesity compared to the prevalence of kidney disease demonstrates that obesity alone is not a sufficient risk factor for kidney disease. There are other factors that increase individual susceptibility to the disease. (TSUBOI et al., 2017).

Unsustained weight loss during treatment and recurrence of the disease is often observed, leading to the progression of target organ damage in many of these patients. Research efforts have focused not only on the factors that regulate energy balance, but also on the mechanisms of target organ injury; these are given from physical compression of the organ by excess weight to various pathological pathways (CHAD and HALL, 2016).

According to population estimates, there are currently 850 million people with kidney disease worldwide, resulting from various etiologies. Its chronic form causes at least 2.4 million deaths annually; in Brazil, around ten million people have the disease. 

BANKING MEMBERS:
Interna - 2272670 - ALINE CAVALCANTI DE QUEIROZ
Presidente - 1791653 - FLAVIO TELES DE FARIAS FILHO
Externa ao Programa - 2275760 - LIVIA LEITE GOES GITAI
Interna - 2370894 - MICHELLE JACINTHA CAVALCANTE OLIVEIRA
Interno - 1483526 - THIAGO SOTERO FRAGOSO
Interno - 1728726 - VALFRIDO LEAO DE MELO NETO