Browsing by Author "Borges, Henrique"
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- Calcium/magnesium ratio in patients with diabetes and chronic kidney disease: a risk factor for cardiovascular diseasePublication . Borges, Henrique; Afonso, Rita; Marques, Roberto Calças; Jerónimo, Teresa; Silva, AnaChronic Kidney Disease (CKD) and Diabetes Mellitus (DM) are significant risk factors for Cardiovascular (CV) Disease. Patients with CKD and/or DM exhibit higher incidence and prevalence of CV events compared to the general population. Hypomagnesemia and elevated calcium-magnesium (Ca:Mg) ratios have been identified as independent risk factors for CV-related deaths. The aim of this study is to determine the relationship between Ca:Mg and the prognosis of CV disease in patients with CKD and DM.
- The usefulness of calcium/magnesium ratio in the risk stratification of early onset of renal replacement therapyPublication . Afonso, Rita; Marques, Roberto; Borges, Henrique; Cabrita, Ana; Silva, Ana PaulaA growing number of studies have reported a close relationship between high serum calcium (Ca)/low serum magnesium (Mg) and vascular calcification. Endothelial dysfunction and vascular inflammation seem plausible risk factors for the enhanced progression of kidney disease. The aim of this study was to evaluate the role of the Ca/Mg ratio as a predictor of the early onset of renal replacement therapy (RRT). Methods: This was a prospective study conducted in an outpatient low-clearance nephrology clinic, enrolling 693 patients with stages 4–5 of CKD. Patients were divided into two groups according to the start of renal replacement therapy (RRT). Results: The kidney’s survival at 120 months was 60% for a Ca–Mg ratio < 6 and 40% for a Ca–Mg ratio ≥ 6 (p = 0.000). Patients who started RRT had lower levels of Hb, Ca, Mg, albumin, and cholesterol and higher values of phosphorus, the Ca/Mg ratio, and PTH. High values of phosphorus and the Ca/Mg ratio and low levels of Mg and GFR were independent predictors of entry into RRT. A high Ca/Mg ratio, high phosphorus levels, and low levels of GFR were associated with a cumulative risk for initiation of RRT. Conclusions: In our population, the Ca/Mg ratio is an independent predictive factor for the initiation of a depurative technique.
- Tip lesion variant of focal and segmental glomerulosclerosis in a COVID-19 patientPublication . Afonso, Rita Serra; Calças Marques, Roberto; Borges, Henrique; Carias, Eduarda; Domingos, Ana Teresa; Cabrita, Ana; Sampaio, Sandra; Silva, Ana PaulaAcute kidney injury is a common complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathologic findings are continually being reported, showing a probably multifactorial etiology. The authors present a case of a patient diagnosed with a tip lesion variant of focal segmental glomerulosclerosis (FSGS) in the setting of COVID-19. A 43-year-old African American female with no known renal disease presented to the emergency department with a 6-day history of fatigue, headache, hypoageusia, myalgia, cough, nausea, and vomiting. Laboratory tests confirmed SARS-CoV-2 infection. During hospitalization, there was a progressive decline in kidney function and evidence of nephrotic-range proteinuria without nephrotic syndrome. Biopsy specimen showed a tip lesion variant of FSGS. Genetic test revealed a homozygous variant of uncertain clinical significance (c.397G>A [p.V133M]) in the epithelial membrane protein 2 (EMP2) gene. To our knowledge, this is the first case report of a tip lesion in a COVID-19 patient with no renal history. More studies are warranted to define susceptible groups and identify the detailed mechanisms of COVID-19-related kidney disease that would allow for specific management of this complication.