Recomendaciones para el manejo de los pacientes con Enfermedad Renal Crónica o Insuficiencia Renal Aguda durante la epidemia de coronavirus (COVID-19) / Recommendations for the management of patients with Chronic Kidney Disease or Acute Kidney Failure during the coronavirus epidemic

En el marco de la contingencia por COVID 19 que está atravesando nuestro país, es preciso dar Recomendaciones para el manejo de los pacientes con Enfermedad Renal Crónica o Insuficiencia Renal Aguda durante la epidemia de coronavirus (COVID-19)

A Case of Myotonic Dystrophy with Electrolyte Imbalance

Type 1 myotonic dystrophy (DM1) is an autosomal-dominant inherited disorder with a multisystem involvement, caused by an abnormal expansion of the CTG sequence of the dystrophic myotonia protein kinase (DMPK) gene. DM1 is a variable multisystem disorder with muscular and nonmuscular abnormalities. Increasingly, endocrine abnormalities, such as gonadal, pancreatic, and adrenal dysfunction are being reported. But, Electrolytes imbalance is a very rare condition in patients with DM1 yet. Herein we present a 42-yr-old Korean male of DM1 with abnormally elevated serum sodium and potassium. The patient had minimum volume of maximally concentrated urine without water loss. It was only cured by normal saline hydration. The cause of hypernatremia was considered by primary hypodipsia. Hyperkalemic conditions such as renal failure, pseudohyperkalemia, cortisol deficiency and hyperkalemic periodic paralysis were excluded. Further endocrine evaluation suggested selective hyperreninemic hypoaldosteronism as a cause of hyperkalemia.

Medición comparativa de la densidad urinaria: tira reactiva, refractómetro y densímetro / Comparative measurement of urine specific gravity: reagent strips, refractometry and hydrometry

La densidad urinaria se utiliza enla clínica para evaluar la capacidad renal de concentrar y diluir la orina. Se puede medir mediante tres métodos: urodensímetro (UD), refractómetro(RE) y tiras reactivas (TR).Objetivo. Evaluar la exactitud de diferentes métodos de medición de la densidad urinaria.Diseño del estudio. Transversal, comparativo, con recolección prospectiva de datos.Material y métodos. Se analizaron 156 muestras de orina de pacientes pediátricos, durante abrily mayo de 2007. Se determinó, en forma simultánea, la densidad urinaria mediante UD, RE y TR, y se midió osmolaridad por punto de congelación;la osmolaridad urinaria fue el métodode referencia. Se calculó la correlación entre los distintos métodos (UD, TR y RE) contra la osmolaridad mediante el coeficiente de correlación lineal de Pearson.Resultados. Se encontró una correlación positiva y aceptable con la osmolaridad tanto del RE como del UD (r= 0,81 y r= 0,86 respectivamente).Las tiras reactivas presentaron baja correlación (r= 0,41). También, observamos buena correlaciónentre las mediciones por UD y RE (r= 0,89).Las mediciones obtenidas por TR, en cambio, tuvieron mala correlación cuando se compararoncon UD (r= 0,46). Se encontraron valores más altos de densidad medidos con RE con respecto al UD.Conclusiones. Las TR no constituyen un método confiable para la determinación de la densidad urinaria y debería ser abandonada como prueba de rutina. En cambio, tanto el UD como el RE sonalternativas aceptables para determinar la densidad urinaria, siempre y cuando el seguimiento del paciente se realice con el mismo método.

Hypokalemia-induced Polyuria with Nocturia after Intravenous Methylprednisolone Pulse Therapy in a Henoch-Schonlein Purpura Nephritis Patient

Patients with moderate to severe degrees of Henoch-Schonlein purpura (HSP) nephritis receive high-dose intravenous methylprednisolone pulse therapy (IMPT). Although the regimen is generally safe and effective, various complications occasionally develop. administration of excessive corticosteroid can induce urinary potassium wasting leading to hypokalemia. Polyuria, one of the complications of hypokalemia, is related to both increased thirst and mild nephrogenic diabetes insipidus. And hypokalemia itself also impairs the maximal renal urinary concentration ability. Although polyuria or nocturia after IMPT is not common, it is correctable immediately by oral potassium supplementation. Therefore, during IMPT, careful history taking of nocturia as well as monitoring urine volume, serum and urine potassium level at regular follow-up are necessary because even mild hypokalemia can provoke urine concentrating ability defect. We experienced a case of 11 year-old boy with HSP nephritis who suffered from hypokalemia-induced polyuria with nocturia right after IMPT.

Rosiglitazona, agonista do PPAR-y "Peroxisome Proliferator-Activated Receptor-y" reverte a nefrotoxicidade induzida pelo tenofovir-DF / The peroxisome proliferator-activated receptor-y agonist rosiglitazone reverses tenofovir-induced nephrotoxicity

Introdução: A nefrotoxicidade dos antiretrovirais constituem atualmente fator importante na morbidade e mortalidade de pacientes com HIV. O tenofovir DF (TDF) se enquadra em um dos antiretrovirais mais lesivos ao rim. Conhecer seu mecanismo de nefrotoxicidade e estudar medidas protetoras podem melhorar seu uso clínico. Material e Métodos: Ratos foram tratados durante 30 dias com uma de duas doses de TDF (50 ou 300mg/Kg de dieta), sendo que um grupo teve adicionado em sua dieta maleato de rosiglitazona (RSG) na dose de 92mg/Kg de dieta nos últimos 15 dias. Após esse período, os ratos foram colocados em gaiola metabólica e sacrificados. Foram estudados parâmetros bioquímicos, fluxo sanguíneo renal e os rins extraídos para expressão semiquantitativa dos transportadores epiteliais tubulares. Resultados: Os animais que receberam TDF em dose alta apresentaram insuficiência renal severa acompanhada de redução da expressão da oxido-nítrico sintase endotelial e vasoconstricção renal intensa. Todos esses parâmetros foram parcialmente revertidos pela administração de RSG. Baixas doses de TDF não causou alteração significativa do ritmo de filtração glomerular, porém induziu fosfatúria, acidose tubular proximal, poliúria e redução da capacidade de concentração urinária. Essas alterações foram associadas a redução da expressão de alguns transportadores epiteliais (cotransportador sódio-fosforo, contratransportador sódio-hidrogênio tipo 3 e aquaporina tipo 2). Não foi caracterizado síndrome de Fanconi, pois não houve proteinúria ou glicosúria. O tratamento com RSG reverteu todos os parâmetros de nefrotoxicidade estudados, normalizando as alterações bioquímicas urinárias e a expressão dos transportadores de membrana. Conclusões: Os achados desses experimentos tem potencial aplicação clínica em pacientes com nefrotoxicidade induzida pelo TDF, especialmente naqueles com hipofosfatemia e/ou redução do ritmo de filtração glomerular.

Objective: To characterize the mechanisms of tenofovir disoproxil fumarate (TDF)- induced nephrotoxicity and the protective effects of rosiglitazone (RSG), a peroxisome proliferator-activated receptor-y agonist. Methods: Rats were treated for 30 days with one of two TDF doses (50 or 300 mg/kg of food), to which RSG (92 mg/kg of food) was added for the last 15 days. Biochemical parameters were measured, and renal tissue was extracted for immunoblotting. Results: Mean daily ingestion was comparable among all the treated groups. Highdose TDF induced severe renal failure accompanied by reduced expression of endothelial nitric-oxide synthase and intense renal vasoconstriction. All of these features were ameliorated by RSG administration. Low-dose TDF did not alter the glomerular filtration rate but induced significant phosphaturia, proximal tubular acidosis and polyuria, as well as reducing urinary concentrating ability. These alterations were caused by specific downregulation of the sodium-phosphorus cotransporter, sodium/hydrogen exchanger 3 and aquaporin 2. No Fanconi's syndrome was identified (proteinuria was normal and there was no glycosuria). Treatment with RSG reversed TDF-induced tubular nephrotoxicity, normalizing urinary biochemical parameters and membrane transporter protein expression. Conclusion: These findings have potential clinical applications in patients presenting with TFV-induced nephrotoxicity, especially in those presenting with hypophosphatemia or a reduction in glomerular filtration rate.

Renal Effects of Prostaglandins and Cyclooxygenase-2 Inhibitors

Prostaglandins (PGs) with best-defined renal functions are PGE2 and prostacyclin (PGI2). These vasodilatory PGs increase renal blood flow and glomerular filtration rate under conditions associated with decreased actual or effective circulating volume, resulting in greater tubular flow and secretion of potassium. Under conditions of decreased renal perfusion, the production of renal PGs serves as an important compensatory mechanism. PGI2 (and possibly PGE2) increases potassium secretion mainly by stimulating secretion of renin and activating the renin-angiotensin system, which leads to increased secretion of aldosterone. In addition, PGE2 is involved in the regulation of sodium and water reabsorption and acts as a counterregulatory factor under conditions of increased sodium reabsorption. PGE2 decreases sodium reabsorption at the thick ascending limb of the loop of Henle probably via inhibition of the Na+-K+-2Cl-cotransporter type 2 (NKCC2). Cyclooxygenase inhibitors may enhance urinary concentrating ability in part through effects to upregulate NKCC2 in the thick ascending limb of Henle's loop and aquaporin-2 in the collecting duct. Thus, they may be useful to treat Bartter's syndrome and nephrogenic diabetes insipidus.

Surgical reduction of the renal mass in rats: morphologic and functional analysis on the remnant kidney

OBJETIVO: O estudo analisou os efeitos bioquímicos e morfológicos sobre o rim remanescente em ratos submetidos à ablação cirúrgica progressiva da massa renal.MÉTODOS: Foram utilizados 60 ratos machos Wistar, pesando entre 210 e 380g, distribuídos em 3 grupos contendo 20 animais cada. Os ratos dos grupos denominados de 1,2 e 3 foram submetidos à remoção cirúrgica de tecido renal equivalente a ½, 2/3 e 5/6 da massa renal total, respectivamente. Os grupos foram então subdivididos em 2 subgrupos e reoperados em 24 horas (subgrupos 1B, 2B, 3B) e em 8 semanas (subgrupos 1C, 2C, 3C) para remoção do rim remanescente. Foram obtidas coletas de urina de 24 horas e sangue para análise da creatinina sérica, depuração da creatinina e proteinúria na primeira intervenção cirúrgica e por ocasião da reoperação. O rim remanescente foi submetido à avaliação macroscópica do grau de hipertrofia e à análise histológica. RESULTADOS: Houve aumento significativo do volume do rim remanescente (164%) e presença de esclerose glomerular em 40% dos animais submetidos à ablação de 5/6 da massa renal. Alterações funcionais caracterizadas pelo aumento da excreção urinária de proteínas (50% no grupo 3), elevação dos níveis séricos da creatinina (261% subgrupo 2B; 371% subgrupo 3B; 118% subgrupo 3C) e redução significativa da depuração de creatinina (controle x subrupo 3C = 2,88 x 1,15ml/min :p<0,05) foram também observadas. CONCLUSÃO: A hipertrofia renal compensatória bem como a injúria glomerular traduzida sob a forma de proteinúria e esclerose estão intimamente relacionadas ao volume do rim remanescente, sendo, portanto, mais evidentes quando uma maior fração de tecido renal é extraída.

Concentración mínima inhibitoria y concentración mínima bactericida de ciprofloxacina en bacterias uropatógenas aisladas en el Instituto nacional de Enfermedades Neoplásicas / Minimal inhibitory concentration and minimal bactericidal concentration of ciprofloxacin in uropathogens isolated at Instituto Nacional de Enfermedades Neoplásicas

La infección urinaria (ITU) es fácilmente manejada por el huésped normal pero puede causar problemas en pacientes inmunosuprimidos, requiriendo antimicrobianos en dosis bactericidas y no solo bacteriostáticas que aseguren tratamientos efectivos. En nuestro medio Ciprofloxacina es un antimicrobiano de uso frecuente en este tipo de infecciones, sin embargo no se evalúa de manera rutinaria el comportamiento de las cepas patógenas con respecto a parámetros microbiológicos como la Concentración Mínima Inhibitoria (CMI), menos aún la Concentración Mínima Bactericida (CMB). Objetivos: Determinar la relación entre la CMI y la CMB de Ciprofloxacina frente a gérmenes aislados a partir de ITU de pacientes hospitalizados y ambulatorios del INEN. Materiales y Métodos: Se aislaron 132 cepas de bacilos gramnegativos uropatógenos aislados de consultorio externo y pacientes hospitalizados, se determinó la susceptibilidad antimicrobiana de las cepas bacterianas usando la Concentración Mínima Inhibitoria por el método de macrodilución en caldo y posteriormente se determinó la Concentracion Mínima Bactericida por el método de dilución en agar. Resultados: Se detectó niveles de resistencia a Ciprofloxacina de 49 por ciento y 73 por ciento en cepas aisladas de pacientes de consultorio externo y pacientes hospitalizados,respectivamente. En el estudio se encontró una diferencia altamente significativa entre la CMB y la CMI tanto en cepas de pacientes hospitalizados como en cepas de consultorio externo (p<0.0001). Conclusiones: Resulta necesario implementar en los laboratorios microbiológicos métodos como la CMI y CMB, herramientas importantes para identificar características de la actividad antibacteriana de los antimicrobianos empleados en nuestro medio. De igual forma se debería evaluar el uso de las fluoroquinilonas, principalmente Ciprofloxacina en pacientes inmunosuprimidos restringiendo su administración para aquellos casos en que esté confirmada su susceptibilidad in vitro.

Efeitos renais da haploinsuficiência do gene Pkd1 (Polycystic kidney disease 1) em camundongos / Renal effects of Pkd1 gene haploinsufficiency in mice

Vários estudos mostram que na doença renal policística autossômica dominante os cistos surgem a partir de um mecanismo de "dois-golpes". A patogênese das manifestações não-císticas, contudo, é pouco compreendida. Neste estudo usamos uma linhagem de camundongos endogâmica com uma mutação nula em Pkd1, onde animais heterozigotos apresentam formação cística renal mínima até 40 semanas de idade. O clearance de inulina e o número de glomérulos foram menores em machos Pkd1+/- que Pkd1+/+, enquanto o volume glomerular médio foi maior em heterozigotos. A excreção urinária de NO2/NO3 não diferiu significantemente entre os dois grupos. Avaliamos a osmolalidade urinária máxima em machos e fêmeas Pkd1+/- and Pkd1+/+, porém não foi detectada diferença significante entre os grupos heterozigoto e selvagem. Nossos resultados oferecem evidência direta de que a haploinsuficiência de Pkd1 resulta em anormalidades anatômicas e funcionais renais e sugerem que o estado haploinsuficiente de Pkd1 possa resultar na redução do número de néfrons por diminuir a ramificação tubular renal durante a nefrogênese.

Several studies show that in autosomal dominant polycystic kidney disease cysts arise through a "two-hit" mechanism. The pathogenesis of non-cystic features, however, is poorly understood. In this study we used an inbred mouse line with a null mutation of Pkd1, where heterozygotes had minimal renal cyst formation up to 40 weeks of age. Inulin clearance and the number of glomeruli were lower in Pkd1+/- than in Pkd1+/+ males, while a higher average glomerular volume was observed in heterozygotes. The urinary excretion of NO2/NO3 did not significantly differ between the two groups. Maximal urinary osmolality was evaluated in Pkd1+/- and Pkd1+/+ males and females, but no significant difference was detected between the heterozygous and the wild type groups. Our results provide direct evidence that haploinsufficiency for Pkd1 results in anatomic and functional abnormalities of the kidney and suggest that Pkd1 haploinsufficiency may result in a reduced number of nephrons by diminishing renal tubule branching during nephrogenesis.

The Changes of Aquaporin-2 Expression in Rats with Lithium Induced Nephrogenic Diabetes Insipidus after Hydrochlorothiazide Administration / 대한신장학회잡지

BACKGROUND: Thiazides have been used in nephrogenic diabetes insipidus (NDI) patients to decrease urine volume, but the mechanism of antidiuretic effect is not known yet. Recently, it has been demonstrated that abundance of aquaporin-2 (AQP2) was decreased in lithium induced NDI. We performed this study to investigate the effect of hydrochlorothiazide (HCTZ) in lithium induced NDI rats and the change of AQP2 expression. METHODS: NDI was induced in 7 male Spraque- Dawley rats by feeding lithium carbonate containing rat chow (40 mmol/kg) for 5 weeks. 4 rats were control group. HCTZ 3.75 mg/day (n=3 among lithium treated; Li+TZ) or vehicle (n=4 among lithium treated and control; Li and Control, respectively) was infused to the rats through osmotic minipump for the last 7 days. Urine volume and urine osmolality were measured. Kidneys were processed for immunohistochemistry and immunoblotting using antibody to AQP2. RESULTS: Li+TZ showed decreased urine volume (46+/-11 mL/day for Li+TZ vs. 127+/-1 mL/day for Li, p<0.05) and higher urine osmolality (557+/-139 mmol/kgH2O for Li+TZ vs. 207+/-9 mmol/kgH2O for Li, p<0.05) comparing to Li. In semi-quantitative immunoblotting using whole kidney homogenate, Li+TZ showed increase in AQP2 expression comparing to Li (39+/-2% for Li+TZ vs. 20+/-9% for Li, p<0.05, % of normal controls). In immunohistochemistry, AQP2 expression in cortex was markedly decreased after lithium treatment. But, AQP2 expression was slightly increased after HCTZ treatment. CONCLUSION: HCTZ treatment partially increased urine concentrating ability and AQP2 expression in rats with lithium induced NDI. We concluded that partial improvement in urine concentrating ability might be associated with upregulation of AQP2.

Purificación del benzoil-mercaptoacetil triglicina, complementado con evaluaciones biológicas / Purification of benzoil-mercaptoacetil triglicine, complemented with biological evaluations

La síntesis se realiza por la técnica de W. Brandau. La purificación se realizó por cristalización fraccionada en metanol: agua (80:20), monitoreada por HPLC. Se obtienen varios precipitados, con los cuales se preparan minilotes de prueba, que se marcan con Tc 99m y se realizaron los controles radioquímicos y las evaluaciones biológicas. Los resultados obtenidos son los siguientes: la pureza química del Bz-MAG3 se incrementa de un 70 por ciento a un 98,12 por ciento del compuesto activo, con un rendimiento del 25 por ciento aproximadamente; la pureza radioquímica de los precipitados puros es mayor del 98 por ciento y el porcentaje de dosis de inyección en riñones se incrementa de un 8 por ciento a un 30 por ciento a los 5 minutos post-inyección en ratones sanos. El porcentaje de excreción renal promedio a los 60 minutos es mayor del 90 por ciento, porcentaje que garantizará una buena calidad de imágenes gammagráficas renales.

Revisão: células da medula interna renal como modelo de resposta ao estresse osmótico / Renal inner medulla cells a model of response to osmotic stress

A capacidade máxima de concentração urinária completa-se no período pós-nascimento. O rim humano alcança a capacidade adulta em aproximadamente 18 meses de idade, enquanto o rim murino, a seis semanas de idade. O sistema de contra-corrente renal, responsável pelo gradiente osmático axial córtico-medular, base do mecanismo de concentração urinária, continua a se desenvolver (aumentar) no período pós-natal. O processo de formação da urina concentrada requer que as células da medula interna renal sobrevivam e funcionem em altas concentrações de NACI e uréia. Estas células enfrentam rápidas flutuações na osmolaridade, podendo alcançar menos de 100m Osm durante condições de diluição máxima e mais de 3000m Osm durante a desidratação, em roedores. Tais mudanças excepcionais nas concentrações de NACI e uréia causam profundas alterações nas funções celulares, tais como redução do volume celular, aumento na força iônica intracelular e inibição do processo biossintético. Para sobreviver em um meio tão hostil, as células da medula interna renal desenvolveram um programa especializado que as tornam capazes de adaptarem-se ao meio hiperosmático. Este programa envolve a ativação de transdução de sinal de kinases, síntese de proteínas de estresse ou heat shock proteins (Hsps) e acúmulo de osmóis orgânicos compatíveis, que restabelecem o volume intracelular e reduzem a força iônica.

Inter-observer and intra-observer reproducibility of diferential Tc-99m DMSA uptake

One hundred and twenty-eight patients referred for DMSA scintigraphy were analyzed retrospectively. Two nuclear medicine specialists drew regions of interest around each kidney twice in different times. The first and the second observer's intraobserver and interobserver correlation coefficients were 0,998, 0,999, and 0,999, respectively. There was an excellent correlation (p<0,005). The mean absolute difference between the first and the second measurements of the first observer was 0,69 ñ 0,94 and the one of the second observer was 0,5 ñ 0,68. We conclude that measurement of relative renal function with Tc-99m scintigraphy is a reliable, simple and reproducible method

Effects of Bilateral Ureteral Obstruction on Renal Aquaporin Expression / 대한신장학회잡지

BACKGROUND: Obstruction of urinary tract is common cause of renal disfunction. Recent discovery of aquaporin water channels expressed in the kidney and various organs has faciliated our understanding of water transport across the permeable epithelial cell membrane. This study was performed to investigate the effects of bilateral ureteral obstruction on renal expression and cellular distribution of these water channels in rat kidney. METHODS: Male Sprague-Dawley rats were divided two groups. The abdominal cavity was opened and 2-0 silk ligatures were proximally placed on both ureters in experimental group. Sham-operated group was treated in the same procedures except ligation. After closure of the abdomen, the animals were maintained for 48 hr while being given food and water ad libitum. Kidney sections of both groups were processed for immunohistochemistry using antibodies to aquaporin-1, 2, 3, and 4. RESULTS: Immunoreactivity for aquaporin-1 of sham-operated kidney was detected in the apical and basolateral plasma membrane of proximal tubules and thin limb of Henle loop. That of bilateral ureteral obstructed kidney was decreased in the both tubules, especially in the proximal tubules and thin limb of Henle loop of inner medulla. Immunoreactivity for aquaporin-2 of sham-operated kidney was the most prominent in apical region and moderate in cytoplasm of the principal cells of entire collecting ducts. That of obstructed kidney was markedly decreased in entire collecting duct, especially inner medulla except inner stripe of outer medulla. The decrease was in parallel between the apical region and cytoplasm. Immunoreactivity for aquaporin-3 of sham-operated kidney was the most prominent in the basolateral plasma membrane of principal cells of entire collecting duct. That of obstructed kidney was decreased in entire collecting duct. Papillary epithelium was stained in obstructed kidney. Immunoreactivity for aquaporin-4 of sham-operated kidney was moderate in the basolateral plasma membrane of principal cells of collecting ducts of inner stripe of outer medulla and inner medulla. In obstructed kidney, immunoreactivity was detected in cortical and outer stripe of outer medullary collecting duct, and decreased in inner stripe of outer medulla and inner medulla. A marked heterogeneity was observed in inner medullary collecting duct. CONCLUSION: These results indicate that alterations of expression of aquaporin proteins after bilateral ureteral obstruction may lead to change in renal functions, such as urine concentrating ability.

Expression and Distribution of Aquaporin-2, -3 and -4 in Developing Rat Kidney / 대한비뇨기과학회지

PURPOSE: The aquaporins (AQPs) are transmembrane water channel proteins. It is well known that AQP2, -3 and -4 contribute to the urinary concentration in collecting duct (CD) and also reported the presence of these three AQPs in the connecting tubule (CNT). Newborn rats are not capable of producing a concentrated urine. Rats develop the ability to concentrate urine after birth. The purpose of this study was to establish the time of the expression and the distribution of AQP2, -3 and -4 in the developing rat kidney. MATERIALS AND METHODS: Sprague-Dawley rats were used in all experiments. Kidneys were obtained from 16, 18 and 20-day-old fetuses and 1, 4, 7, 14 and 21-day-old pups and preserved and processed for immunohistochemical studies using a preembedding immunoperoxidase procedure. AQP2, -3 and -4 immunoreactivity was detected using rabbit polyclonal antibody and donkey anti-rabbit IgG. RESULTS: AQP2, -3 and -4 appeared first in 16-day-old fetuses in the CD and in 18-day-old fetuses in the CNT. Immunoreactivity for AQP2, -3 and -4 was markedly increased after birth and gradually increased during development. In CNT cells and principal cells, AQP2, -3 and -4 were not distinctly demonstrated on the apical, lateral and basal plasma membrane respectively until 21 days after birth. Distinct polarity of these AQPs both in CNTcells and principal cells were observed at 21 days after birth. CONCLUSIONS: AQP2 -3, and -4 were expressed not only in CD but also in CNT before developing of urine concentrating ability during development and it is concluded that their expression and distribution in CNT may play a role in the development of urine concentration abilities in rat kidney.

Evaluación clínica de la correlación entre el volumen prostático, el flujo urinario, la edad y el residuo posciccional en 250 pacientes con trastornos miccionales / Clinical evaluation of the correlation between prostatic volume (PV), peak flow rate (PFR), age, and post void residual urine (PVR) in 250 patients with lower urinary tract symptoms (LUTS)

Objetivo: Interpretar clínicamente los resultados de la correlación existente entre los parámetros objetivos que utilizamos en la evaluación de pacientes portadores de síntomas urinarios, en relación con la presencia de HPB. Material y métodos: se evaluó la variación de las relaciones entre el tscto rectal, la flujometría, el volumen prostático, la edad y el residuo, en 250 pacientes con síntomas urinarios. Resultados: El tamaño de la próstata aumentó con la edad, con un brusco incremento en la década de los 50 años (p<0,01), el Qmax fue menor (p<0,01) y el residuo fue más frecuente (p<0,01) cuanto más grande ( o más pesada) fue la próstata; del mismo modo se relacionó el menor flujo con la mayor prevalencia de residuo (p<0,01). mientras que la edad no demostró una influencia significativa (p>0.05) para condicionar estos resultados. Conclusión En los pacientes que consultan por trastornos miccionales en asociación con HPB clínicamente demostrable se observa una correlación estadísticamente significativa entre el mayor tamaño de la misma, un flujo bajo, menor de 10ml/s y la presencia de residuo posmicional clínicamente significativo, independientemente de la edad

Densidad urinaria: correlación entre urodensímetro y tiras reactivas / Specific gravity: correlation between urinometer and reagent strips

Se midió la densidad de 113 muestras de orina con urodensímetro y con tiras reactivas Combur 10 Test (Boehringer Mannheim), con el objetivo de estudiar comparativamente ambos métodos y ver si existe una correlación entre ellos. El test t mostró que existen diferencias significativas entre los valores obtenidos con urodensímetro y las tiras reactivas (P = 0,024), siendo la medida de estas diferencias: d = 0,0013. No se encontró una fuerte correlación entre ambos métodos: (r = 0,78) (y = 0,141 + 0,86 .x.). Como conclusión se considera que si bien existen diferencias estadísticamente significativas entre los valores de ambos métodos, dichas diferencias son pequeñas desde el punto de vista clínico en la mayoría de los casos. Las tiras reactivas constituyen un método práctico para los análisis de rutina, pero para el estudio y seguimiento del enfermo renal es conveniente el uso del urodensímetro