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INTRODUCTION: Diagnosis and staging of chronic kidney disease (CKD) is important for management and prevention of renal disease progression. It is unclear whether K/DOQI guidelines of the National Kidney Foundation are applicable to diagnosis of CKD in renal transplant recipients (RTRs) and which method is most appropriate for estimating glomerular filtration. OBJECTIVES: To determine the prevalence and staging of CKD in RTRs, according to K/DOQI guidelines, and the prevalence of complications of CKD. SUBJECTS AND METHODS: This cross-sectional study included RTRs at least six months post-transplantation followed at a single out-patient service. The glomerular filtration rate (GFR) was estimated with two different equations: the MDRD equation (Modification of Diet in Renal Disease) with four variables (age, creatinine level, gender, and race) and the Cockcroft-Gault (CG) formula. Patients with GFR more than 60 mL/min/1.73 m2 were diagnosed with CKD only in the presence of renal damage (hematuria, proteinuria, or evidence of injury in renal biopsy). CKD staging was compared to the two equations and the prevalence of complications was determined. RESULTS: The study evaluated 241 RTRs (average age: 40.6 +/- 12.5 yr, 62.2% male; 4.5% black, 50.6% from cadaveric donors). Average follow-up time was 6.8 +/- 6.1 yr and the average baseline creatinine level was 1.48 +/- 0.72 mg/dL. CKD was diagnosed in 70.5% of RTRs, of whom 52.9% (MDRD)/47.6% (CG) were classified as Stage III (GFR: 30-59 mL/min/1.73 m2). The agreement between the two methods was very close with regard to CKD diagnosis (kappa = 0.92) and close for stage-dependent prevalence (kappa = 0.68). The prevalence of anemia, hypocalcemia, hyperphosphatemia (HF), hyperuricemia (HU), and systemic arterial hypertension (SAH) was 10.6%, 7.6%, 10.3%, 54%, and 73.4% for patients with CKD. Significant differences were observed for HU, HF and SAH in patients without CKD. Anemia, HU and SAH were associated with CKD stage (p < 0.001). CONCLUSION: The prevalence of CKD in the study population was high (70.5%). The two equations tested correlated closely when used for GFR estimation. Routine CKD staging in RTRs would provide patients with safer and more appropriate management.

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Objetivo: Identificar o perfil sociodemográfico dos acadêmicos de Medicina e avaliar a prevalência de sintomas de estresse nesses estudantes. Métodos: A população estudada respondeu ao Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), para identificação de sintomas de estresse e a um questionário sociodemográfico. Resultados: Duzentos estudantes de Medicina, matriculados nos Ciclos Básico ou Clínico da Universidade Federaldo Ceará (UFC), foram estudados. Houve predominância do sexo masculino (54,5%), solteiros (100%), naturais de Fortaleza (87%), com idade média de 21 (± 2,3) anos. As alunas apresentaram níveis de sintomas de estresse maiores do que os estudantes homens, representando 30,1% e 19,6%, respectivamente (p ≤ 0,001). A prevalência de sintomas de estressefoi de 49,7%, sendo o quarto semestre o período com níveis mais altos desses sintomas (p = 0,002). Conclusões: Conclui-se que estudantes de Medicina da Universidade Federal do Ceará (UFC) têm níveis de estresse similares àqueles relatados para amostras internacionais.

Objective: To study the social-demographic profile of Medical students and assess the prevalence of stress symptoms in these students. Methods: The Inventory of Symptoms of Stress forAdults of Lipp (ISSL) was used to evaluate the symptoms of stress and a questionnaire was applied to identify the participants' social-demographic characteristics. Results: Two hundred Medical students registered at the Federal University of Ceará (UFC), taking Basic and Clinical courses, wereinterviewed. Participants were predominantly male (54.5%), single (100%), born in Fortaleza (87%), mean age 21 years (SD = 2.3). Female students showed higher levels of stress' symptoms than male students, 30.1% and 19.6% respectively, (p ≤ 0.001). The prevalence of symptoms of stresswas 49.7% and students attending the fourth semester showed the highest levels of symptoms (p = 0.002). Conclusions: The conclusion is that Medical students at UFC have levels of stress similar to those reported in international studies.

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