ABSTRACT
Abstract Objective: To assess trends and predictors of the glomerular filtration rate (GFR) after renal mass cryoablation in patients with and without history of renal impairment. Materials and Methods: This was a retrospective study of 39 patients who underwent computed tomography-guided percutaneous cryoablation of a renal mass, divided into two groups: those with prior renal impairment (PRI+); and those without prior renal impairment (PRI−). The GFR trend and the chronic kidney disease stage were evaluated at baseline, as well as at 1, 6, and 12 months after cryoablation. Predictors of GFR at 1 and 6 months were modeled with linear regression. Results: In both groups, the mean GFR at 1 month and 6 months was significantly lower than at baseline (p < 0.001 and p = 0.01, respectively). Although the GFR was lower across all time points in the PRI+ group (−26.1; p < 0.001), the overall trend was not statistically different from that observed in the PRI− group (p = 0.89). Univariate analysis showed that the decline in GFR at 1 and 6 months correlated with the baseline GFR (0.77 and 0.63; p < 0.001 and p = 0.03, respectively) and with the size of the ablation zone (−7.6 and −12.84, respectively; p = 0.03 for both). However, in the multivariate model, baseline GFR was predictive only of GFR at 1 month (p < 0.001). Conclusion: The trend in GFR decline after cryoablation is similar for patients with and without a history of renal impairment. Baseline GFR predicts the mean GFR in the early post-cryoablation period.
Resumo Objetivo: Medir as tendências iniciais da função renal pela taxa de filtração glomerular (TFG) em pacientes com e sem comprometimento renal prévio após crioablação renal. Materiais e Métodos: Este é um estudo retrospectivo de 39 pacientes submetidos a crioablação percutânea guiada por tomografia computadorizada de massa renal. Os pacientes foram divididos em dois grupos: com comprometimento renal prévio (CRP+) e sem comprometimento renal prévio (CRP-). As tendências da TFG foram avaliadas nos tempos 0, 1, 6 e 12 meses com o estadiamento de doença renal crônica. Preditores da TFG em 1 e 6 meses foram modelados usando regressão linear. Resultados: Em ambos os grupos houve declínio da TFG média após 1 e 6 meses (p < 0,001 e p = 0,01, respectivamente). Apesar de o grupo CRP+ demonstrar média menor da TFG em cada um dos tempos (−26,1; p < 0,001), a tendência de forma geral não foi estatisticamente diferente do grupo CRP- (p = 0,89). Análise univariada mostrou correlação da TFG no tempo 0 (0,77 e 0,63; p < 0,001 e p = 0,03, respectivamente) e tamanho da ablação (−7,6 e −12,84; p = 0,03), com declínio em 1 e 6 meses. Porém, no modelo multivariado, apenas a TFG no tempo 0 foi preditiva da TFG em 1 mês (p < 0,001). Conclusão: A curva de tendência de declínio da TFG após crioablação foi similar entre os pacientes dos grupos CRP+ e CRP-, sem mudanças no estadiamento de função renal. A TFG no tempo 0 foi preditiva da TFG média no período de crioablação inicial.
ABSTRACT
ABSTRACT PURPOSE: To compare renal dysfunction after right nephrectomy and ligation of the right renal vein with preservation of kidney. METHODS: Animals' weight, pH, density, protein in urine and histological samples of the kidneys were evaluated. Fifteen female rats (Wistar) were divided into three groups. In the control group, right renal vein dissections were performed. In the second group, the right nephrectomy was performed. In the third group, the right renal vein was ligated and the kidney was preserved. Urine samples were taken before, three and seven days after the procedure. On the seventh postoperative day the kidneys were removed to histopathological study. Analysis by Student's t test was performed. RESULTS: weight loss, alterations of urine pH (p<0.05), in specific gravity, proteinuria (p<0.05) were found in groups 2 and 3; hemorrhagic infarction and edema were found after ligation of the right renal vein; changes in the left kidney were also observed on the seventh day. CONCLUSIONS:.
Subject(s)
Animals , Female , Kidney Diseases/etiology , Kidney/physiopathology , Nephrectomy/adverse effects , Postoperative Hemorrhage/etiology , Renal Veins , Body Weight , Disease Models, Animal , Kidney/pathology , Ligation/adverse effects , Proteinuria/urine , Rats, WistarABSTRACT
Objective: To investigate the association between kidney dysfunction and haplotypes in sickle cell disease. Methods: A cohort of 84 sickle cell disease patients, treated in a public health service in Fortaleza, Brazil, was studied. Hemoglobin S haplotypes were obtained from 57 patients as they had recently received blood transfusions with 18 of them agreeing to undertake urinary concentrating ability and acidification tests. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease Study equation. Urinary concentration was evaluated utilizing the urinary and serum osmolality ratio (U/Posm) after 12 hours of water deprivation. Urinary acidification was evaluated by measuring the urinary pH before and after the administration of oral CaCl2. The analysis of the haplotypes of the beta S gene cluster was carried out by polymerase chain reaction-restriction fragment length polymorphism. The analysis of variance (ANOVA) test was used for multiple comparisons of means and the Newman-Keuls test was used to identify which groups were significantly different. Results: The mean age of the patients was 33 ± 13 years with 64.2% being females. The glomerular filtration rate was normal in 25 cases (30%) and a rate > 120 mL/min was seen in 52 cases (62%). Urinary concentration deficit was found in all patients who underwent the test and urinary acidification in 22%. There was no significant difference when comparing patients with the Bantu/Bantu and ...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Haplotypes , beta-Globins , Hemoglobinopathies , Anemia, Sickle Cell , Kidney/physiopathology , Kidney Function TestsABSTRACT
To investigate the possible nephrotoxicity of Compound Decoction of Caulis Aristolochiae Manshuriensis (CDCAM). Body weight, blood pressure, hemoglobin and renal functions, especially of urinary low-molecular weight protein in patients were observed before and after a short-term ( 0.05 ).[Conclusion]The nephrotoxicity of Caulis Aristolochiae Manshuriensis may be associated with the long-term over-dose administration and without TCM syndrome differentiation.