ABSTRACT
Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.
Resumo Objetivo: Avaliar taxas de sucesso e de complicações de biópsias renais guiadas por ultrassonografia em um hospital terciário. Materiais e Métodos: Análise retrospectiva de 97 biópsias renais realizadas entre 1º de março de 2017 e 31 de outubro de 2019, guiadas por ultrassonografia e executadas por um único médico radiologista. Resultados: Oitenta e sete biópsias apresentaram diagnóstico anatomopatológico definitivo. Cinco biópsias foram inconclusivas (5,4%) e precisaram de um segundo procedimento. Houve complicações em sete procedimentos (7,6%), todas devidamente solucionadas. Conclusão: A biópsia renal guiada por ultrassonografia demonstrou ser um método efetivo e seguro para o diagnóstico de nefropatias, com elevada taxa de sucesso em sua execução.
ABSTRACT
JUSTIFICATIVA E OBJETIVOS: A doença de Fabry (DF) é uma doença genética, rara, caracterizada pela ausência ou diminuição da atividade da enzima Alfa galactosidase A (alfa-GAL), que acarreta a deposição lisossomal de algumas moléculas, sendo a principal delas a globotriaosilceramida (GL-3). Esse acúmulo progressivo pode levar a doença renal crônica terminal (DRCt), com necessidade de terapia renal substitutiva (TRS). Devido à disponibilidade do tratamento de reposição enzimática desde 2001, que visa impedir a progressão da doença, e frente ao grande número de pacientes que iniciam TRS sem etiologia definida da doença renal crônica terminal, o objetivo do estudo foi realizar uma revisão sistemática da literatura em busca de artigos relacionados à prevalência da Doença de Fabry entre a população em diálise (hemodiálise ou diálise peritoneal). CONTEÚDO: Revisão sistemática da literatura na base de dados Medline até Março de 2014, sem data inicial determinada, seguindo critérios estabelecidos. Foram selecionados 22 artigos. Nestes trabalhos, foram avaliados no total 28.960 pacientes (18.958 homens e10.002 mulheres), e a prevalência de portadores da Doença de Fabry nas populações em diálise estudadas variou de 0 a 1,16%. CONCLUSÕES: A presente revisão atestou pela necessidade de inclusão da pesquisa da Doença de Fabry entre os portadores de doença renal crônica terminal, devido à possibilidade real de tratamento, que visa diminuir o acometimento de outros órgãos pelo acúmulo de GL-3, propiciando também o rastreamento familiar em busca do diagnóstico precoce...
BACKGROUND AND OBJECTIVES: Fabry disease (FD) is a genetic and rare disorder characterized by absent or decreased activity of the enzyme alpha galactosidase A (alfa-GAL), which carries the lysosomal deposition of various molecules, the main one being the globotriaosylceramide (GL-3). This progressive buildup can lead to chronic renal disease (ESRD) requiring renal replacement therapy (RRT). Due to the availability of enzyme replacement therapy since 2001, aimed at preventing the progression of the disease, and with the large number of patients starting renal replacement therapy unknown etiology of ESRD, the study objective was to systematically review the literature for articles related to the prevalence of Fabry disease among the population on dialysis (hemodialysis or peritoneal dialysis). CONTENTS: Systematic review of the literature on the Medline database until March 2014, no specific start date, following established criteria. 22 articles were selected. In these works, were evaluated in total 28,960 patients (18,958 men and 10,002 women), and the prevalence of patients with FDon dialysis in the populations studied ranged from 0 to 1.16%. CONCLUSIONS: This review attested by the need to include the research of Fabry disease among patients with chronic renal disease, due to the possibility of treatment, which aims to reduce the involvement of other organs by the accumulation of GL-3,also providing family screening in search of early diagnosis...
Subject(s)
Humans , Fabry Disease/epidemiology , Mass Screening , Renal Dialysis , Kidney Diseases/epidemiologyABSTRACT
Some infections can be the cause of secondary nephrotic syndrome. The aim of this study was to describe the experience of a Renal Disease Reference Clinic from Central Brazil, in which serological markers of some infectious agents are systematically screened in children with nephrotic syndrome. Data were obtained from the assessment of medical files of all children under fifteen years of age, who matched nephrotic syndrome criteria. Subjects were tested for IgG and IgM antibodies against T. gondii and cytomegalovirus; antibodies against Herpes simplex, hepatitis C virus and HIV; and surface antigen (HBsAg) of hepatitis B virus. The VDRL test was also performed. 169 cases were studied. The median age on the first visit was 44 months and 103 (60.9%) patients were male. Anti-CMV IgG and IgM were found in 70.4% and 4.1%, respectively. IgG and IgM against Toxoplasma gondii were present in 32.5% and 5.3%, respectively. Two patients were positive for HBsAg, but none showed markers for HIV, hepatitis C, or Treponema pallidum. IgG and IgM against herpes simplex virus were performed on 54 patients, of which 48.1% and 22.2% were positive. IgM antibodies in some children with clinical signs of recent infection suggest that these diseases may play a role in the genesis of nephrotic syndrome.
Algumas infecções podem ser causa de síndrome nefrótica. O objetivo desse estudo foi descrever a experiência de clínica pediátrica de doenças renais do Brasil Central, onde marcadores sorológicos de algumas doenças infecciosas são sistematicamente avaliados em crianças com síndrome nefrótica. Dados foram obtidos de registros médicos de todas as crianças com menos de 15 anos que preenchiam critérios de síndrome nefrótica. Os participantes foram testados para presença de IgG e IgM contra Toxoplasma gondii e citomegalovirus; anticorpos contra herpes simples, vírus da hepatite C e HIV, além do antígeno de superfície da hepatite B (HBsAg). VDRL também foi testado. 169 casos foram estudados. A idade média na primeira visita foi 44 meses e 103 eram do sexo masculino (60.9%). Anti-CMV IgG e IgM foram identificados em 70,4% e 4,1%, respectivamente. IgG e IgM contra T. gondii eram positivos em 32,5% e 5,3%. Dois pacientes eram HBsAg positivos, mas nenhum mostrou positividade para HIV, hepatite C ou sífilis. IgG e IgM contra herpes simples foram realizados em 54 pacientes, dos quais 48,1% e 22,2% eram positivos. Anticorpos IgM positivos em algumas crianças com sinais clínicos de infecção recente sugerem que essas doenças podem exercer um papel na gênese da síndrome nefrótica.
Subject(s)
Child, Preschool , Female , Humans , Male , Nephrotic Syndrome/parasitology , Nephrotic Syndrome/virology , Biomarkers/blood , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/diagnosis , Enzyme-Linked Immunosorbent Assay , HIV Infections/complications , HIV Infections/diagnosis , Hepatitis B/complications , Hepatitis B/diagnosis , Hepatitis C/complications , Hepatitis C/diagnosis , Herpes Simplex/complications , Herpes Simplex/diagnosis , Syphilis/complications , Syphilis/diagnosis , Toxoplasmosis/complications , Toxoplasmosis/diagnosisABSTRACT
Introduction: Viral hepatitis, either acute or chronic, may lead to nephropathies as one of its multiple extrahepatic complications which often remain clinically silent for a long period and are overlooked. Proteinuria can be a useful tool for early detection of the underlying renal impairment. This study was undertaken to detect the presence of proteinuria and to assess and compare the level of proteinuria in HAV and HEV- infected cases; the two most common causes of acute hepatitis in Bangladesh. Method: For this 100 diagnosed patients of HAV & HEV (50 each) hepatitis were screened for isolated proteinuria in a random spot urine sample during their 3rd to 4th post-ecteric follow ups. Result: 43% HAV and 45% HEV patients had high spot urinary protein with maximum incidence (54 %) occurring in 3rd decades of life. The pattern of isolated proteinuria was significantly different in HAV vs HEV cases. The mean ± SD value of spot urinary protein of HEV females was significantly higher than that of HAV where highest rate (64%) of mild proteinuria was observed in HAV and maximum number (46%) of moderate proteinuria in HEV patients. Conclusion: Spot urinary protein concentration should be checked quantitatively in every HEV as well as HAV- hepatitis patient even when clinically improved.