ABSTRACT
SARS-CoV-2 infection has a wide spectrum of clinical manifestations secondary to the impairment of different organs, including kidney. Rhabdomyolysis is produced by disintegration of striated muscle and the liberation of its contents to the extracellular fluid and bloodstream. This may produce hydro electrolytic disorders and acute kidney injury. We report a 35-year-old female with a history of SARS-CoV-2 infection who was hospitalized because of respiratory failure and developed renal failure. The etiologic study showed elevated total creatine kinase levels and a magnetic resonance imaging confirmed rhabdomyolysis. The patient required supportive treatment with vasoactive drugs, mechanic ventilation and kidney replacement therapy. She had a favorable evolution with resolution of respiratory failure and improvement of kidney function.
Subject(s)
Humans , Female , Adult , Rhabdomyolysis/diagnosis , Rhabdomyolysis/virology , Acute Kidney Injury/diagnosis , Acute Kidney Injury/virology , COVID-19/complications , Renal Replacement TherapyABSTRACT
Renal involvement is a frequent complication in antineutrophil cytoplasmic antibodies (ANCA)associated vasculitides, adding morbidity and mortality, such as chronic kidney disease and the need for renal replacement therapy. With the aim of reaching a consensus on relevant issues regarding the diagnosis, treatment and follow-up of patients with these diseases, the Chilean Societies of Nephrology and Rheumatology formed a working group that, based on a critical review of the available literature and their experience, raised and answered consensually a set of questions relevant to the subject. This document includes aspects related to the clinical diagnosis, the histological characteristics, the therapeutic alternatives to induce and maintain the remission of the disease, relapse surveillance strategies and complementary therapies.
Subject(s)
Humans , Antibodies, Antineutrophil Cytoplasmic/blood , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications , Kidney Diseases/etiology , Kidney Diseases/therapy , Societies, Medical , Remission Induction , Chile , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/therapy , Maintenance ChemotherapyABSTRACT
Renal involvement affects over one half of patients with Systemic Lupus Erythematosus increasing their mortality and morbidity, including chronic renal disease and the need of renal replacement therapies. Aiming to achieve a consensus in the most relevant topics on diagnosis, therapy and follow-up of patients with lupus renal disease, the Chilean Societies of Nephrology and Rheumatology constituted a workgroup that, based on a critical review of the available literature and their experience, raised and answered by consensus a set of relevant questions. This document includes aspects related to the clinical diagnosis, the importance of a suitable histological classification, therapeutic alternatives to induce and maintain disease remission, strategies for follow-up, additional therapies and ginecological-obstetric issues.
Subject(s)
Humans , Lupus Erythematosus, Systemic/complications , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/therapy , Chile , Consensus , Renal Insufficiency, Chronic/diagnosisABSTRACT
Background: Patients with valvular heart disease are at high risk of acute renal failure after surgery with extracorporeal circulation. Aim: To describe changes in renal function parameters during surgery with extracorporeal circulation in patients with valvular heart disease and compare them with those found in patients undergoing elective coronary surgery Material and Methods: Two groups of patients were studied. Group 1 was composed by twelve patients undergoing elective coronary surgery and group 2 was composed by eleven patients undergoing surgery for heart valve replacement. Glomerular filtration rate and effective renal plasma now were estimated from inulin and the 131 I-hippuran clearance respectively, at five different times, during surgery and the postoperative period. Sodium filtration fraction and fractional excretion were calculated. Alpha and pi-glutathione s-transferase in urine were measured as markers of tubular damage in the pre and postoperative periods. Results: Effective renal plasma flow was reduced in both groups before induction of anesthesia, did not change during surgery and decreased significantly in patients with valvular disease in the postoperative period. Glomerular filtration rates were normal during all the study period. There was a non significant reduction of filtration fraction during extracorporeal circulation. Alpha and pi glutathione s-transferases were normal and did not change. Fractional excretion of sodium increased significantly postoperatively Conclusions: In patients with valvular disease undergoing surgery with extracorporeal circulation, renal function does not deteriorate. No significant difference was found when compared with patients undergoing coronary surgery. No evidence of functional and cellular renal disfunction or damage was found in both study groups.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cardiac Surgical Procedures , Extracorporeal Circulation , Heart Valve Diseases/surgery , Kidney Function Tests , Kidney/physiology , Analysis of Variance , Blood Urea Nitrogen , Glomerular Filtration Rate/physiology , Intraoperative Period , Kidney Tubules/physiology , Prospective Studies , Renal Circulation/physiology , Statistics, NonparametricABSTRACT
Se analiza el embarazo en la adolescencia, un problema de relevancia en Salud Pública en Chile, en la comuna de Curacaví, localidad agrícola cercana a Santiago. Se enfoca el estudio en base a las siguientes variables: características de las madres, algunas características del embarazo y del parto y características del hijo. Se constata un 19.6% de hijos de madres adolescentes en el total de inscritos en 1983 en el Hospital de Curacaví. Se comprueba un alto porcentaje de madres solteras. Destaca el alto porcentaje de recién nacidos con peso de nacimiento inferior a 3.000 grs. y una prevalencia de desnutrición de 29.3% que triplica la cifra nacional para el año en cuestión. Se determina un promedio de 5 consultas por niño y por año por morbilidad especialmente respiratoria y digestiva. Se observa correspondencia de estos resultados con los de estudios nacionales