Rosa Maria Affonso Moysés

Universidade de São Paulo

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i-10 index

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Co-Authors

Vanda Jorgetti

Universidade de São Paulo

133

Rosilene Motta Elias

Universidade Nove de Julho

Luciene M. dos Reis

Universidade de São Paulo

Melani Ribeiro Custódio

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Maria Aparecida Dalboni

Universidade Nove de Julho

Rosilene M. Elias

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Aluízio Barbosa Carvalho

Universidade Federal de São Paulo

Pieter Evenepoel

KU Leuven

Tilman B. Drüeke

Inserm

Detlef Schlöndorff

Délégation Paris 6

Cooperative Institutions

Universidade de São Paulo

296

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

237

Cancer Genetics (United States)

199

Health & Life (Taiwan)

199

Délégation Paris 6

199

Suzuki (Japan)

199

Center for Translational Molecular Medicine

195

RELX Group (United States)

185

Improvement Service

Universidade Federal de São Paulo

Author Statistics

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Early Control of PTH and FGF23 in Normophosphatemic CKD Patients

Clinical Journal of the American Society of Nephrology (2009)

Rodrigo Cardoso de Oliveira Ana Cancela Fabiana G. Graciolli Luciene M. dos Reis Sérgio Antônio Draibe

Levels of parathyroid hormone (PTH) and the phosphaturic hormone FGF23, a fibroblast growth factor (FGF) family member, increase early in chronic kidney disease (CKD) before the occurrence of hyperphosphatemia. This short-term 6-wk dose titration study evaluated the effect of two phosphate binders on PTH and FGF23 levels in patients with CKD stages 3 to 4.

Sevelamer

Phosphate binder

10.2215/cjn.05420709

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Citations (353)

Quelante de fosfato na diálise: um estudo transversal sobre adesão dos pacientes e sobrecarga de comprimidos

Brazilian Journal of Nephrology (2025)

Brunelle Bruna Scavello Coelho Ferezin Luiza K. Araujo Carolina M. Lima Hugo Abensur Benedito Jorge Pereira

Resumo Introdução: Quelantes de fosfato (P) estão entre os medicamentos mais comumente prescritos para controlar níveis de P em pacientes com DRC em diálise. Ainda há escassez de dados sobre adesão aos quelantes de P, sem comparações entre modalidades dialíticas. Métodos: Acessamos fatores associados à adesão ao quelante de P entre pacientes em diálise em um hospital universitário. A adesão foi calculada como a razão entre número de comprimidos tomados por dia, conforme relatado, e número de comprimidos prescritos. Pacientes foram considerados não aderentes se a adesão fosse ao menos 20% menor ou 30% maior do que o prescrito. Resultados: Os pacientes (N = 137) eram jovens, predominantemente mulheres, em diálise por um período mediano de 53 meses. Sevelamer e carbonato de cálcio foram prescritos como quelantes de P para 70,8% e 10,2% dos pacientes, respectivamente, sem diferença entre modalidades dialíticas (p = 0,839). P correlacionou-se com número de comprimidos prescritos (r = 0,368; p = 0,001) e número de comprimidos tomados por dia (r = 0,275; p = 0,001). Encontramos hiperfosfatemia em 52 pacientes (36,4%). A adesão ao carbonato de Ca e sevelamer foi de 100% e 68,4%, respectivamente. Pacientes não aderentes eram mulheres, mais jovens, com albumina e ureia séricas mais elevadas e menor cálcio sérico. A regressão logística mostrou que sexo feminino (HR 3,30; IC 95%: 1,39–7,84; p = 0,007) e hemodiálise vs. diálise peritoneal (HR 4,55; IC 95%: 1,26–16,39; p = 0,021) permaneceram independentemente associados ao comportamento de não adesão. Conclusão: O presente estudo sugere que estratégias para aumentar a adesão devem ser implementadas. A relação entre adesão ao quelante de fosfato e melhores desfechos merece investigação mais aprofundada.

10.1590/2175-8239-jbn-2024-0075pt

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Calcium Regulation and Management of Hypo- and Hypercalcemia

Nephrology Self-Assessment Program (2023)

Silvia Titan Rosa Maria Affonso Moysés

10.58483/nsap.00182022

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Disturbances of Wnt/ -catenin pathway and energy metabolism in early CKD: effect of phosphate binders

Nephrology Dialysis Transplantation (2013)

Rodrigo Cardoso de Oliveira Fabiana G. Graciolli Luciene M. dos Reis Ana Cancela Lílian Cuppari

Mineral bone disorder (MBD) is an early complication of chronic kidney disease (CKD), with complex interactions in the bone-kidney-energy axis. These events lead to impaired bone remodelling, which in turn is associated with cardiovascular disease. Recently, we reported on a positive effect of phosphate binder treatment on bone remodelling markers and a reduction in serum FGF-23 levels in predialysis-CKD patients. The goal of the present study of this trial was to examine the effects of phosphate binders on energy-regulating hormones and Wnt pathway.In this present post hoc analysis of the above randomized, open-label, 8-week trial, which compared the effects of increasing doses of sevelamer-HCl or calcium acetate on various CKD-MBD parameters in 40 normophosphatemic CKD Stage 3-4 patients, we measured serum sclerostin, Dickkopf-1, leptin, adiponectin and serotonin concentrations.Serum sclerostin, Dickkopf-1 and leptin were elevated at baseline despite normal calcium, phosphorus levels and daily urinary phosphorus excretion. There were significant and positive correlations between sclerostin and FGF-23, as well between leptin and Dickkopf-1. Treatment with both phosphate binders led to a significant decrease in phosphate overload. However, sevelamer-HCl, but not with calcium acetate, led to a significant decrease in serum FGF-23, sclerostin and leptin, and to a significant increase in bone alkaline phosphatase levels.Early stages of CKD are associated with an impairment of the Wnt pathway, as reflected by elevated sclerostin, and a dysregulation of energy-regulating hormones. Many of these disturbances can be ameliorated by phosphate binder treatment, more with sevelamer-HCl than with calcium acetate.

Sclerostin

Bone remodeling

DKK1

10.1093/ndt/gft234

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Citations (43)

Persistent hyperparathyroidism as a risk factor for long-term graft failure: the need to discuss indication for parathyroidectomy

Surgery (2018)

Maria Júlia Correia Lima Nepomuceno Araújo Janaina Almeida Mota Ramalho Rosilene Motta Elias Vanda Jorgetti William Carlos Nahas

10.1016/j.surg.2017.12.010

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Citations (53)

Hemodynamic Behavior During Hemodialysis: Effects of Dialysate Concentrations of Bicarbonate and Potassium

Kidney & Blood Pressure Research (2014)

Bruno Caldin da Silva Geraldo Rubens Ramos de Freitas Vitor B. Silva Hugo Abensur Cláudio Luders

In a previous study we demonstrated that mild metabolic alkalosis resulting from standard bicarbonate haemodialysis induces hypotension. In this study, we have further investigated the changes in systemic haemodynamics induced by bicarbonate and calcium, using non-invasive procedures.In a randomized controlled trial with a single-blind, crossover design, we sequentially changed the dialysate bicarbonate and calcium concentrations (between 26 and 35 mmol/l for bicarbonate and either 1.25 or 1.50 mmol/l for calcium). Twenty-one patients were enrolled for a total of 756 dialysis sessions. Systemic haemodynamics was evaluated using pulse wave analysers. Bioimpedance and BNP were used to compare the fluid status pattern.The haemodynamic parameters and the pre-dialysis BNP using either a high calcium or bicarbonate concentration were as follows: systolic blood pressure (+5.6 and -4.7 mmHg; P < 0.05 for both), stroke volume (+12.3 and +5.2 ml; P < 0.05 and ns), peripheral resistances (-190 and -171 dyne s cm(-5); P < 0.05 for both), central augmentation index (+1.1% and -2.9%; ns and P < 0.05) and BNP (-5 and -170 ng/l; ns and P < 0.05). The need of staff intervention was similar in all modalities.Both high bicarbonate and calcium concentrations in the dialysate improve the haemodynamic pattern during dialysis. Bicarbonate reduces arterial stiffness and ameliorates the heart tolerance for volume overload in the interdialytic phase, whereas calcium directly increases stroke volume. The slight hypotensive effect of alkalaemia should motivate a probative reduction of bicarbonate concentration in dialysis fluid for haemodynamic reasons, only in the event of failure of classical tools to prevent intradialytic hypotension.

Bicarbonate

Crossover study

10.1159/000368459

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Citations (272)

IL-1β, TNF-α, TGF-β, and bFGF expression in bone biopsies before and after parathyroidectomy

Kidney International (2003)

Francisco R. Lello Santos Rosa Maria Affonso Moysés Fábio Luiz de Menezes Montenegro Vanda Jorgetti Irene L. Noronha

10.1046/j.1523-1755.2003.00835.x

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Citations (54)

Factors Associated with Intradialytic Phosphate Removal in Hemodialysis Patients before and after Parathyroidectomy