ABSTRACT
BACKGROUND: There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE). METHODS: This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted. RESULTS: A total of 92 patients were included, with a mean age of 36 ± 9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (or 9.9, 95% ci 1.2-96.3, p < 0.0001). CONCLUSION: AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.
Subject(s)
Adult , Female , Humans , Male , AIDS-Related Opportunistic Infections/complications , Acute Kidney Injury/etiology , Hyponatremia/etiology , Toxoplasmosis, Cerebral/complications , AIDS-Related Opportunistic Infections/mortality , Acute Kidney Injury/mortality , Cohort Studies , Hospital Mortality , Hyponatremia/mortality , Retrospective Studies , Toxoplasmosis, Cerebral/mortalityABSTRACT
Objetivo: Avaliar a eficácia do tratamento do diabetes mellitus tipo 1 por um período de 18 meses, em 17 pacientes, utilizando-se um processo de infusäo subcutânea contínua de insulina (ISCI) e de um análogo da insulina (insulina lispro) através de uma bomba infusora. Estudamos os seguintes parâmetros: hemoglobina glicosilada, peso, índice de massa corpórea, relaçäo insulina/peso, quantidade de insulina/dia administrada, relaçäo da insulina administrada na forma de .bolus (antes das refeiçöes) com a insulina basal e efeitos adversos desta terapia. Após esse período observamos que os pacientes estavam melhor controlados com níveis de HbAI c significativamente reduzidos (p< 0,05). Apresentavam uma reduçäo significativa da relaçäo insulina/peso (p< 0,05) e melhor aproveitamento da insulina relacionado a alimentaçäo dado pelo aumento significativo da relaçäo bolus/basal quando comparado com a relaçäo de insulina regular/NPH antes do tratamento (p< 0,05).