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1.
Rev. cuba. oftalmol ; 34(1): e899, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289522

ABSTRACT

Objetivo: Caracterizar los pacientes con retinopatía diabética desde el punto de vista epidemiológico y clínico. Métodos: Se realizó un estudio descriptivo y transversal en el Centro Oftalmológico de Santiago de Cuba, desde octubre del año 2017 hasta octubre de 2019, en una población de 42 pacientes diabéticos tipo 2. Resultados: Predominaron los pacientes con tiempo de diabetes mellitus mayor de 10 años, y edades de 55 años o más (60,0 por ciento); el mayor porcentaje correspondió al color de piel negra (66,7 por ciento ); la agudeza visual mayor de 0,6 se presentó en el 49,4 por ciento de los casos; la retinopatía diabética proliferativa fue la más presentada con 55,9 por ciento. Hubo predominio, además, de los valores de hemoglobina glicosilada por encima del 7 por ciento y de la normoalbuminuria con 46,7 y 66,7 por ciento, respectivamente, en ambos grupos. Conclusiones: Los valores elevados de hemoglobina glicosilada y la normoalbuminuria se asocian, desde el punto de vista clínico, a la retinopatía diabética proliferativa(AU)


Objective: Characterize diabetic retinopathy patients from a clinical and epidemiological point of view. Methods: A descriptive cross-sectional study was conducted of 42 type 2 diabetic patients at Santiago de Cuba Ophthalmology Center from October 2017 to October 2019. Results: A predominance was found of patients who had had diabetes mellitus for more than 10 years and were aged 55 years or over (60.0 percent); black skin color prevailed with 66.7 percent; visual acuity above 0.6 was present in 49.4 percent of the cases, and proliferative diabetic retinopathy was the most common type (55.9 percent). In both groups glycosylated hemoglobin values above 7 percent prevailed, whereas normal albuminuria was predominant with 46.7 percent and 66.7 percent, respectively. Conclusions: High glycosylated hemoglobin and normal albuminuria values are clinically associated to proliferative diabetic retinopathy(AU)


Subject(s)
Humans , Middle Aged , Glycated Hemoglobin A/adverse effects , Diabetic Retinopathy/epidemiology , Albuminuria/etiology , Visual Acuity , Epidemiology, Descriptive , Cross-Sectional Studies , Hemoglobinuria/diagnosis
2.
Rev. Assoc. Med. Bras. (1992) ; 67(2): 313-317, Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287809

ABSTRACT

SUMMARY INTRODUCTION: Sickle cell anemia affects more than 30 million people worldwide. Chronic kidney disease develops in 40% of individuals. The death rate of patients with sickle nephropathy is still high, with little known predictors related to its development. To answer the question "What predictors are associated with the onset of chronic kidney disease in patients with sickle cell anemia?", this article seeks to contribute to a better understanding of sickle nephropathy, making possible a new look at the sickle cell anemia and its kidney complications. METHODS: A systematic review was developed, using the PRISMA recommendation, for cohort studies on predictors related to the outcome of sickle nephropathy in patients with sickle cell anemia. RESULTS: Initially 321 studies were identified in Pubmed, of which six were selected to compose this systematic review. Lower hemoglobin levels, increased ages and albuminuria were the most pointed predictors associated with chronic kidney disease. CONCLUSION: The main predictors associated with the development of chronic kidney disease in individuals with sickle cell anemia were lower hemoglobin levels, increased ages, and albuminuria. New studies evaluating predictors for the development of chronic kidney disease in sickle cell anemia are needed to better understand its installation and prevent its progression.


Subject(s)
Humans , Renal Insufficiency, Chronic/etiology , Anemia, Sickle Cell/complications , Kidney Diseases , Cohort Studies , Albuminuria/etiology , Kidney
3.
Ciênc. Saúde Colet ; 26(1): 339-350, jan. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1153735

ABSTRACT

Resumo O objetivo do presente estudo foi verificar a prevalência de DRC e os fatores a ela associados em adultos jovens (18-59 anos) de Rio Branco, Acre. Trata-se de um inquérito de base populacional realizado em 2014, nas zonas urbana e rural do município de Rio Branco, Acre. A DRC foi definida pela taxa de filtração glomerular (TFG) < 60 ml/min/1,73 m², estimada pela CKD-EPI, e presença de albuminúria > 29 mg/g. Medidas de associação foram estimadas por regressão logística, com grau de confiança de 95%. A prevalência geral de DRC foi de 6,2%. A presença de DRC foi maior entre as mulheres, naqueles com 40 a 59 anos, de cor da pele não-branca, com menor escolaridade e entre os sedentários. Houve diferenças estatisticamente significativas na distribuição segundo a presença de DRC nas variáveis hipertensão arterial, diabetes e internação nos últimos 12 meses. A DRC entre os adultos esteve associada ao sexo feminino (OR: 2,41; IC95%: 1,14-5,12), diabetes (OR: 4,67; IC95%: 1,28-17,03) e hipertensão arterial (OR: 1,98; IC95%: 1,16-3,37). A DRC apresenta alta prevalência e está associada às doenças crônicas, evidenciando a necessidade de medidas em saúde pública para detecção precoce e prevenção da sua progressão.


Abstract The scope of this study was to establish the prevalence of CKD and associated factors among young adults (18-59 years of age) from Rio Branco in the State of Acre. It involved a population-based survey conducted in 2014, in the urban and rural areas of the municipality and CKD was defined as the glomerular filtration rate (GFR) < 60ml/min/1.73m², estimated by the CKD-EPI, and the presence of albuminuria > 29 mg/g. Association measures were estimated by logistic regression, with a confidence level of 95%. The overall prevalence of CKD was 6.2%. The presence of CKD was higher among women, aged 40 to 59 years, with non-white skin color, with lower schooling, and of sedentary disposition. There were statistically significant differences in the distribution according to the presence of CKD in the hypertension, diabetes and hospitalization variables over the past 12 months. CKD among adults was associated with the female sex (OR: 2.41, 95%CI: 1.14-5.12), diabetes (OR: 4.67, 95%CI: 1.28-17.03) and arterial hypertension (OR: 1.98; 95%CI: 1.16-3.37). CKD reveals a high prevalence and is associated with chronic diseases, calling for the need for public health measures for early detection and prevention of its progression.


Subject(s)
Humans , Female , Young Adult , Diabetes Mellitus/epidemiology , Renal Insufficiency, Chronic/epidemiology , Hypertension/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Albuminuria , Glomerular Filtration Rate
4.
Rev. bras. anal. clin ; 52(4): 359-365, 20201230. tab, graf
Article in Portuguese | LILACS | ID: biblio-1223708

ABSTRACT

Objetivo: Avaliar a correlação entre os níveis de hemoglobina glicada A1c (HbA1c) e os valores de microalbuminúria como parâmetro auxiliar no diagnóstico precoce de dano renal. Métodos: Analisaram-se 56 pacientes que apresentaram os exames de glicemia de jejum, HbA1c e microalbuminúria, durante o período de um ano em um laboratório do município de Videira-SC. A análise dos dados foi realizada pelo teste de correlação de Pearson's estabelecendo como valores estatisticamente significativos p < 0,05. Resultados: Os valores de glicose de jejum se apresentaram alterados em ambos os sexos e faixa etária. Na hemoglobina glicada indivíduos do sexo feminino com faixa etária de até 60 anos de idade demostraram maiores alterações no controle glicêmico. Para os resultados de micro­albuminúria, 68% dos participantes apresentaram valores normais e 32% exibiram valores acima dos de referência, indicando presença de microalbuminúria e possível dano renal. Os valores mostraram correlação entre microalbuminúria e HbA1c em mulheres e homens respectivamente (p < 0,0001). Conclusão: Quando os valores de HbA1c apresentaram-se aumentados consequentemente os valores de microalbuminúria também estavam elevados. Portanto, a utilização desses marcadores na busca de identificar danos renais é fundamental.


Objective:This study aimed to evaluate the correlation between the levels of glycated hemoglobin A1c (HbA1c) and the values of microalbuminuria as an auxiliary parameter in the early diagnosis of kidney damage. Methods: Fifty-six patients who had fasting blood glucose, HbA1c and microalbuminuria tests were analyzed during a period of one year in a laboratory in the municipality of Videira-SC. Data analysis was performed using Pearson's correlation test, establishing as statistically significant values p < 0.05. Results: Fasting glucose values were altered in both sexes and age groups. In glycated hemoglobin, female individuals aged up to 60 years old showed greater changes in glycemic control. For the results of microalbuminuria, 68% of the participants had normal values and 32% showed values above those of reference, indicating the presence of microalbuminuria and possible kidney damage. The values showed a correlation between microalbuminuria and HbA1c in women and men respectively (p <0.0001). Conclusion: When the HbA1c values were consequently increased, the microalbuminuria values were also high. Therefore, the use of these markers in the search to identify kidney damage is essential.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Glycated Hemoglobin A , Glycemic Index , Diabetes Mellitus , Albuminuria
5.
Rev. cuba. oftalmol ; 33(3): e900, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139087

ABSTRACT

RESUMEN Objetivo: Identificar la relación de la hemoglobina glicosilada y la albuminuria con la progresión de la retinopatía diabética. Métodos: Se realizó un estudio descriptivo y transversal en el Centro Oftalmológico de Santiago de Cuba desde octubre del año 2017 hasta octubre de 2019. La muestra fue de 42 pacientes diabéticos tipo 2. Resultados: Predominaron los pacientes con tiempo de diabetes mellitus mayor de 10 años y las edades de 55 años o más con el 60,0 por ciento. El color de piel negra fue mayor con 66,7 por ciento; la agudeza visual mayor de 0,6 se presentó en el 49,4 por ciento y la retinopatía diabética proliferativa fue la más presentada con 55,9 por ciento. Predominaron además valores de hemoglobina glicosilada mayores de 7 por ciento en ambos grupos y la normoalbuminuria fue la que predominó en ambos grupos con 46,7 y 66,7 por ciento. Conclusiones: Los valores elevados de hemoglobina glicosilada y la normoalbuminuria se asocian de forma clínica a retinopatía diabética proliferativa(AU)


ABSTRACT Objective: Identify the relationship of glycosylated hemoglobin and albuminuria to progression of diabetic retinopathy. Methods: A descriptive cross-sectional study was conducted at Santiago de Cuba Ophthalmology Center from October 2017 to October 2019. The sample was 42 type 2 diabetic patients. Results: A predominance was found of patients with diabetes mellitus for more than 10 years and the 55 years and over age group (60.0 percent). Black skin color prevailed with 66.7 percent, visual acuity above 0.6 was present in 49.4 percent, and proliferative diabetic retinopathy was the most common type (55.9 percent). In both groups glycosylated hemoglobin values above 7 percent prevailed and normal albuminuria was predominant with 46.7 percent and 66.7 percent. Conclusions: High glycosylated hemoglobin and normal albuminuria values are clinically associated to proliferative diabetic retinopathy(AU)


Subject(s)
Humans , Middle Aged , Glycated Hemoglobin A/adverse effects , Visual Acuity , Diabetic Retinopathy/diagnosis , Albuminuria/etiology , Epidemiology, Descriptive , Cross-Sectional Studies
6.
Rev. bras. anal. clin ; 52(1): 71-76, 20200330. tab, graf
Article in Portuguese | LILACS | ID: biblio-1104476

ABSTRACT

Objetivo: Este trabalho teve como objetivo analisar se há uma elevada concentração de microalbuminúria causada pelo consumo excessivo de suplementos e/ou alimentos à base de proteínas. Métodos: Foram avaliados indivíduos do sexo masculino que praticam atividade física regularmente e, por buscarem um melhor rendimento esportivo, fazem uso de algum tipo de suplementação proteica além do consumo diário de proteína através da alimentação. Esses indivíduos foram entrevistados, responderam um questionário alimentar e disponibilizaram para o estudo uma amostra de urina aleatória para determinação de microalbuminúria. Resultados: Os resultados da dosagem de microalbuminúria se apresentaram dentro dos valores de referência. Conclusão: Pode-se concluir que a taxa de microalbuminúria aumenta proporcionalmente, ainda que dentro dos padrões de normalidade, em indivíduos que possuem uma ingestão maior de proteínas diárias oriundas tanto da suplementação artificial quanto da alimentação.


Subject(s)
Humans , Male , Female , Exercise , Dietary Supplements , Albuminuria
7.
Article in English | WPRIM | ID: wpr-782247

ABSTRACT

30 mg/g), the concordance rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of UACR, analyzed using MEDITAPE UC-11A, were 80.5, 97.5, 67.0, 70.3, and 97.1%, respectively. Using UPCR, analyzed via quantitative assay, as a reference to estimate proteinuria (UPCR >0.15 g/g), the concordance rate, sensitivity, specificity, PPV, and NPV of UPCR, analyzed using MEDITAPE UC-11A, were 86.7, 94.4, 81.5, 77.6, and 95.6%, respectively.CONCLUSIONS: UACR and UPCR, analyzed using MEDITAPE UC-11A, exhibited relatively high sensitivity and NPV, which is beneficial for laboratory screening for both albuminuria and proteinuria.


Subject(s)
Albuminuria , Chronic Disease , Humans , Hypertension , Kidney Diseases , Mass Screening , Proteinuria , Renal Insufficiency, Chronic , Sensitivity and Specificity
8.
Article in Chinese | WPRIM | ID: wpr-878843

ABSTRACT

To observe the multi-targeted therapeutic effects of Huangkui Capsules(HKC)on insulin resistance(IR)and urine microalbumin in the early diabetic kidney disease(DKD)patients. The case data from the 83 DKD patients at G2 and A2 stage were collected respectively and analyzed retrospectively. According to the different treatment,all patients were divided into the control(A)group(40 cases)and the treated(B)group(43 cases). Among them,the A group patients were received "routine basic treatment";the B group patients were received "routine basic treatment+HKC". For the 2 group patients,firstly,the baseline parameters before receiving the treatment were compared respectively,and then,the changes of the total scores of traditional Chinese medicine(TCM) syndromes and the indicators of IR,urine protein,renal function,blood lipids and safety after receiving the treatment for 8 weeks were compared,respectively. Furthermore,for the all patients,the correlation analysis between IR and urine protein or IR and the total scores of TCM syndromes was carried out,respectively. The results showed that,for the B group patients received "routine basic treatment",their total scores of TCM syndromes,urine protein indicators including urine microalbumin(micro-UAlb) and urine microalbumin/urinary creatinine(UACR),IR indicators including fasting serum insulin(FIN)and homeostasis model assessment of insulin resistance(HOMA-IR)were significantly improved,respectively. For the all DKD patients,before and after the treatment,the main IR indicators(FIN and HOMA-IR)were positively correlated with urine protein indicators(micro-UAlb and UACR). The main IR indicators(FIN and HOMA-IR) were also positively correlated with the total scores of TCM syndromes. In addition,2 treatments had no significant effects on renal function,blood lipids and safety indicators in the all DKD patients. Overall, "routine basic treatment+HKC" can ameliorate IR and reduce urine microalbumin in the early DKD patients. Its therapeutic targets may be not only proteinuria,but also IR,which is the upstream risk factor of proteinuria.


Subject(s)
Albuminuria , Capsules , Diabetes Mellitus , Diabetic Nephropathies , Drugs, Chinese Herbal , Humans , Insulin , Insulin Resistance , Kidney , Retrospective Studies
9.
Article in Chinese | WPRIM | ID: wpr-880774

ABSTRACT

OBJECTIVE@#To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou.@*METHODS@#Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR.@*RESULTS@#Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups (@*CONCLUSIONS@#Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.


Subject(s)
Adult , Aged , Albuminuria/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Female , Glomerular Filtration Rate , Glucose , Humans , Middle Aged , Prevalence , Renal Insufficiency, Chronic/epidemiology , Risk Factors
10.
J. bras. nefrol ; 41(4): 509-517, Out.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056618

ABSTRACT

Abstract Introduction: Although microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk. Thus, new biomarkers that would help to predict DN risk earlier and possibly prevent the occurrence of end-stage kidney disease are being investigated. Objective: To investigate the role of zinc-alpha-2-glycoprotein (ZAG) as an early marker of DN in type 2 diabetic (T2DM) patients. Methods: 88 persons were included and classified into 4 groups: Control group (group I), composed of normal healthy volunteers, and three patient groups with type 2 diabetes mellitus divided into: normo-albuminuria group (group II), subdivided into normal eGFR subgroup and increased eGFR subgroup > 120 mL/min/1.73m2), microalbuminuria group (group III), and macroalbuminuria group (group IV). All subjects were submitted to urine analysis, blood glucose levels, HbA1c, liver function tests, serum creatinine, uric acid, lipid profile and calculation of eGFR, urinary albumin creatinine ratio (UACR), and measurement of urinary and serum ZAG. Results: The levels of serum and urine ZAG were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied groups regarding serum and urinary ZAG was found. Urine ZAG levels were positively correlated with UACR. Both ZAG levels were negatively correlated with eGFR. Urine ZAG levels in the eGFR ˃ 120 mL/min/1.73m2 subgroup were higher than that in the normal eGFR subgroup. Conclusion: These findings suggest that urine and serum ZAG might be useful as early biomarkers for detection of DN in T2DM patients, detectable earlier than microalbuminuria.


Resumo Introdução: Embora a microalbuminúria continue sendo o padrão ouro para a detecção precoce da nefropatia diabética (ND), ela não é um preditor suficientemente preciso do risco de ND. Assim, novos biomarcadores para prever mais precocemente o risco de ND e possivelmente evitar a ocorrência de doença renal terminal estão sendo investigados. Objetivo: Investigar a zinco-alfa2-glicoproteína (ZAG) como marcador precoce de ND em pacientes com debates mellitus tipo 2 (DM2). Métodos: Os 88 indivíduos incluídos foram divididos em quatro grupos: grupo controle (Grupo I), composto por voluntários saudáveis normais; e três grupos de pacientes com DM2 assim divididos: grupo normoalbuminúria (Grupo II), subdivididos em TFG normal e TFG > 120 mL/min/1,73 m2), grupo microalbuminúria (Grupo III) e grupo macroalbuminúria (Grupo IV). Todos foram submetidos a urinálise e exames para determinar glicemia, HbA1c, função hepática, creatinina sérica, ácido úrico, perfil lipídico, cálculo da TFG, relação albumina/creatinina (RAC) e dosagem urinária e sérica de ZAG. Resultados: Os níveis séricos e urinários de ZAG foram mais elevados nos pacientes com DM2 em comparação aos controles. Foi identificada diferença estatisticamente significativa entre os grupos estudados em relação aos níveis séricos e urinários de ZAG. Os níveis urinários de ZAG foram positivamente correlacionados com a RAC. Ambos os níveis de ZAG foram negativamente correlacionados com TFG. Os níveis urinários de ZAG no subgrupo com TFG ˃ 120 mL/min/1,73m2 foram maiores do que no subgrupo com TFG normal. Conclusão: Constatamos que a ZAG sérica e urinária pode ser um útil biomarcador precoce para detecção de ND em pacientes com DM2, sendo detectável mais precocemente que microalbuminúria.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Biomarkers/analysis , Seminal Plasma Proteins/analysis , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/physiopathology , Case-Control Studies , Predictive Value of Tests , Sensitivity and Specificity , Risk Assessment , Creatinine/blood , Early Diagnosis , Diabetes Mellitus, Type 2/urine , Diabetic Nephropathies/urine , Diabetic Nephropathies/blood , Albuminuria/urine , Glomerular Filtration Rate/physiology , Kidney Failure, Chronic/prevention & control
11.
J. bras. nefrol ; 41(3): 412-422, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040242

ABSTRACT

Abstract Diabetic kidney disease (DKD) is a chronic complication of diabetes mellitus associated with significant morbidity and mortality regarded as a global health issue. MicroRNAs - small RNA molecules responsible for the post-transcriptional regulation of gene expression by degradation of messenger RNA or translational repression of protein synthesis - rank among the factors linked to the development and progression of DKD. This study aimed to offer a narrative review on investigations around the use of microRNAs in the diagnosis, monitoring, and treatment of DKD. Various microRNAs are involved in the pathogenesis of DKD, while others have a role in nephroprotection and thus serve as promising therapeutic targets for DKD. Serum and urine microRNAs levels have also been considered in the early diagnosis and monitoring of individuals with DKD, since increases in albuminuria, decreases in the glomerular filtration rate, and progression of DKD have been linked to changes in the levels of some microRNAs.


Resumo A doença renal do diabetes (DRD) é uma complicação crônica do diabetes mellitus associada à elevada morbidade e mortalidade, considerada um problema de saúde mundial. Dentre os fatores associados ao desenvolvimento e à progressão da DRD, destacam-se os microRNAs, que consistem em pequenas moléculas de RNA que regulam a expressão gênica por meio da degradação pós-transcricional do RNA mensageiro ou inibição translacional da síntese proteica. Este estudo teve como objetivo realizar uma revisão narrativa buscando investigar os microRNAs como auxiliares no diagnóstico, monitoramento e tratamento da DRD. Vários microRNAs estão envolvidos na patogênese da DRD, enquanto que outros têm papel nefroprotetor, consistindo assim em alvos terapêuticos promissores para o tratamento da DRD. A dosagem laboratorial dos microRNAs no soro e na urina também é muito promissora para o diagnóstico precoce e o monitoramento da DRD, já que os níveis de alguns microRNAs se alteram antes do aumento da albuminúria e da diminuição da taxa de filtração glomerular e podem ainda se alterar com a progressão da DRD.


Subject(s)
Humans , Animals , Rats , MicroRNAs/urine , MicroRNAs/blood , Diabetic Nephropathies/drug therapy , Biomarkers/urine , Biomarkers/blood , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/genetics , Diabetic Nephropathies/pathology , Albuminuria , Molecular Targeted Therapy , Glomerular Filtration Rate
12.
J. bras. nefrol ; 41(3): 315-322, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040245

ABSTRACT

Abstract Introduction: It is hypothesized that increased macrophage migration inhibitory factor (MIF) expression may contribute to diabetic nephropathy (DN) pathogenesis. The aim of the present study was to investigate the renal effects of MIF inhibition in a diabetic experimental model. Methods: Eighteen male Wistar rats (230 ± 20 g) were divided into three groups: 1) control, 2) diabetic (STZ, 50 mg/kg, dissolved in saline, ip), 3) diabetic + MIF antagonist (p425, 1 mg/kg per day, ip, on the 21th day, for 21 consecutive days). The treatment started since we founwd a significant increase in urine albumin excretion (UAE) rate in the diabetic rats in comparison with the control rats. The rats were kept individually in metabolic cages (8 AM-2 PM) and urine samples were collected in the 21 and 42th day. At the end, blood and tissue samples were collected for biochemical (BS, UPE, urine GAG, BUN, Cr, Na, and K) and histological analyses. Results: The results of this study showed that MIF antagonist (p425) significantly decreased urine protein and GAG excretion, urine protein/creatinine ratio, and serum BUN and Cr in the streptozotocin-induced DN in the rats. Pathological changes were significantly alleviated in the MIF antagonist (p425)-administered DN rats. Conclusion: Collectively, these data suggested that MIF antagonist (p425) was able to protect against functional and histopathological injury in the DN.


Resumo Introdução: Supõe-se que elevações da expressão do fator de inibição da migração de macrófagos (MIF) possam contribuir para a patogênese da nefropatia diabética (ND). O objetivo do presente estudo foi investigar os efeitos renais da inibição do MIF em um modelo experimental diabético. Métodos: Dezoito ratos Wistar machos (230 ± 20g) foram divididos em três grupos: 1) controle, 2) diabético (STZ 50 mg/kg dissolvida em soro fisiológico, IP), 3) diabético + antagonista do MIF (p425 1 mg/kg por dia IP no 21o dia por 21 dias consecutivos). O tratamento começou após a identificação de aumento significativo na albuminúria nos ratos diabéticos em relação aos controles. Os ratos foram mantidos individualmente em gaiolas metabólicas (8h-14h) e amostras de urina foram colhidas no 21o e no 42o dia. Ao final do estudo, amostras de sangue e tecido foram colhidas para análises bioquímicas (BS, excreção urinária de proteína, excreção urinária de GAGs, BUN, Cr, Na e K) e histológicas. Resultados: O presente estudo demonstrou que o antagonista do MIF (p425) diminuiu significativamente proteinúria, excreção urinária de GAGs , relação proteína/creatinina na urina, BUN e Cr no grupo com ND induzida por estreptozotocina. As alterações patológicas foram significativamente abrandadas nos ratos com ND que receberam antagonista do MIF (p425). Conclusão: Coletivamente, os dados sugerem que o antagonista do MIF (p425) teve efeito protetor contra lesões funcionais e histopatológicas da ND.


Subject(s)
Animals , Male , Rats , Macrophage Migration-Inhibitory Factors/antagonists & inhibitors , Intramolecular Oxidoreductases/antagonists & inhibitors , Protective Agents/therapeutic use , Protective Agents/pharmacology , Diabetes Mellitus, Experimental/pathology , Diabetic Nephropathies/therapy , Blood Glucose , Rats, Wistar , Streptozocin/pharmacology , Creatinine/urine , Creatinine/blood , Diabetes Mellitus, Experimental/chemically induced , Diabetes Mellitus, Experimental/urine , Diabetes Mellitus, Experimental/blood , Diabetic Nephropathies/urine , Diabetic Nephropathies/pathology , Diabetic Nephropathies/blood , Albuminuria/drug therapy , Disease Models, Animal , Glycosaminoglycans/urine , Kidney/pathology , Macrophage Activation
13.
Rev. Assoc. Med. Bras. (1992) ; 65(9): 1155-1160, Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041075

ABSTRACT

SUMMARY OBJECTIVE In this study, we aimed to analyze the relationship between serum uric acid (UA) and microalbuminuria as a marker of renal injury in type 2 diabetes mellitus. METHODS A total of 100 patients with type 2 diabetes mellitus were enrolled in the study. Participants were divided into two groups according to the urinary microalbumin/creatinine ratio: diabetic nephropathy and non-nephropathy group. UA and microalbuminuria were compared between the study groups. RESULTS Serum UA levels of diabetic nephropathy patients were significantly higher than those in the non-nephropathy group (UA in patients with diabetic nephropathy groups: 6.3 (1.82) mg/dl, UA in patients of the non-nephropathic group: 4.85 (1.92) mg/dl) (p<0.001). There was a correlation between microalbuminuria and UA (r=0.238). This correlation was statistically significant (p=0.017). CONCLUSION UA levels may be an important predictor of nephropathy in diabetic patients.


RESUMO OBJETIVO O objetivo deste estudo foi analisar a relação entre o ácido úrico sérico e a microalbuminúria como marcador de lesão renal no diabetes mellitus tipo 2. MÉTODOS Um total de 100 pacientes com diabetes mellitus tipo 2 foram inscritos no estudo. Os grupos de estudo foram divididos em dois, de acordo com a relação microalbumina/creatinina na urina: nefropatia diabética e grupo não nefropático. UA e microalbuminúria foram comparados entre os grupos de estudo. RESULTADOS Os níveis séricos de AU de pacientes com nefropatia diabética foram significativamente maiores do que o grupo sem nefropatia (AU em pacientes com grupos de nefropatia diabética: 6,3 (1,82) mg/dl, AU em pacientes com grupos não nefropáticos: 4,85 (1,92) mg/dl ) (p<0,001). Houve correlação entre microalbuminúria e AU (r=0,238). Essa correlação foi estatisticamente significativa (p=0,017). CONCLUSÃO Os níveis de AU podem ser um importante preditor de nefropatia em pacientes diabéticos.


Subject(s)
Humans , Male , Female , Aged , Uric Acid/blood , Hyperuricemia/complications , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/etiology , Biomarkers/blood , Retrospective Studies , Sensitivity and Specificity , Creatinine/urine , Diabetes Mellitus, Type 2/blood , Diabetic Nephropathies/blood , Albuminuria/urine , Glomerular Filtration Rate , Middle Aged
14.
J. bras. nefrol ; 41(2): 176-184, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012539

ABSTRACT

Abstract Introduction: The aim of the study was to report the implementation of a functional network for the early diagnosis of chronic kidney disease (CKD) in patients with risk factors and the coordinated work between primary and specialized care in social security in Perú. Material and methods: A cross-sectional analysis of the data of patients evaluated in a health network in the city of Lima (2013 to 2016), older than 18 years, with risk factors for CKD, evaluated with serum creatinine and creatine albumin ratio in random urine (ACR). A multivariate logistic regression analysis was performed to evaluate the factors associated with the finding of CKD. Results: The implementation included training in renal health, installation of a digital database, organization of laboratories, and empowerment of primary care. We evaluated 42,746 patients of which 41.8% were men, with median age 69.2 years. The most frequent cause of detection was hypertension (HBP): 23,921 (55.9%). The prevalence of CKD was 12,132 (28.4%), the most frequent stage of CKD was 3a: 4735 (39.0%). Of the total, 6214 (14.5%) patients had microalbuminuria and 1335 (3.1%), macroalbuminuria. The risk of CKD increased 2.5 times (95% CI: 2.3-2.7) in patients with diabetes (DM) and HBP, in men (OR 1.2, 95% CI: 1.2-1.3) and as age increased (> 77 years: OR 2.7, 95% CI: 2.5-2.8). The identification of the disease in the primary care setting is 60% less likely than in specialized care. Conclusions: One of every four patients are diagnosed with CKD, and the simultaneous diagnosis of DM and HBP and old age are the most important factors.


Resumo Introdução: O objetivo do presente estudo foi descrever a implementação de uma rede funcional para o diagnóstico precoce de doença renal crônica (DRC) em pacientes com fatores de risco e o coordenar os trabalhos entre atenção primária e especializada no sistema de seguridade social peruano. Material e métodos: Análise transversal dos dados de pacientes maiores de 18 anos com fatores de risco para DRC avaliados em uma rede de saúde na cidade de Lima (2013 a 2016) por meio de creatinina sérica e relação albumina/creatinina (RAC) em amostra aleatória de urina. Análise de regressão logística multivariada foi executada para avaliar os fatores associados à presença de DRC. Resultados: A implementação incluiu treinamento em saúde renal, instalação de um banco de dados digital, organização de laboratórios e empoderamento da atenção primária. Foram avaliados 42.746 pacientes, dos quais 41,8% eram homens, com idade mediana de 69,2 anos. A causa mais comum de detecção foi hipertensão, observada em 23.921 indivíduos (55,9%). A prevalência de DRC foi de 12.132 (28,4%), com estágio 3A sendo o mais frequente com 4735 casos (39,0%). Do total, 6214 (14,5%) pacientes apresentavam microalbuminúria e 1335 (3,1%) macroalbuminúria. O risco de DRC foi 2,5 vezes maior (IC 95%: 2,3-2,7) nos pacientes com diabetes e hipertensão, em homens (OR 1,2, IC 95%: 1,2-1,3) e idosos (> 77 anos: OR 2,7, IC 95%: 2,5-2,8). A identificação da doença no cenário da atenção primária é 60% menos provável do que na atenção especializada. Conclusões: Um em cada quatro pacientes é diagnosticado com DRC. Idade avançada e diagnóstico simultâneo de DM e hipertensão são os fatores mais relevantes.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Primary Health Care , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/epidemiology , Ambulatory Care Facilities , Peru/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Creatinine/blood , Early Diagnosis , Diabetes Complications , Albuminuria , Renal Insufficiency, Chronic/etiology , Hypertension/complications
15.
J. bras. nefrol ; 41(2): 193-199, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012542

ABSTRACT

Abstract Objective: To describe the frequency of albuminuria in overweight and obese children and adolescents and to relate it to the severity of obesity, pubertal staging, associated morbidities and the glomerular filtration rate. Method: Cross-sectional study including 64 overweight and obese children and adolescents between 5 and 19 years of age. Data collected: weight, height, waist circumference and systemic arterial pressure. Laboratory tests: lipid profile; glycemia and insulin, used to calculate the Homeostasis Model Assessment (HOMA-IR); C-reactive protein; glutamic-pyruvic transaminase and albuminuria in an isolated urine sample (cutoff <30 mg/g). Creatinine was used to calculate the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2). Results: The mean age was 11.6 ± 3.4 years, 32 (50%) and 29 (45.3%) were male and prepubertal. Forty-six (71.9%) had severe obesity. The frequency and median (min/max) of the observed values for albuminuria (> 30 mg/g) were 14 (21.9%) and 9.4 mg/g (0.70, -300.7 mg/g). The mean eGFR was 122.9 ± 24.7 mL/min/1.73 m2. There was no significant correlation between body mass index, pubertal staging, insulin and HOMA-IR with albuminuria values and neither with eGFR. Children with albuminuria tended to have higher values of diastolic blood pressure (75.0 ± 12.2 vs. 68.1 ± 12.4, p = 0.071). Conclusion: Albuminuria, although frequent in children and adolescents with obesity, was not associated with other morbidities and the glomerular filtration rate in these patients.


Resumo Objetivo: Descrever a frequência de albuminúria em crianças e adolescentes com sobrepeso e obesidade e relacioná-la com a gravidade da obesidade, estadiamento puberal, morbidades associadas e com a taxa de filtração glomerular. Método: Estudo transversal incluindo 64 crianças e adolescentes com sobrepeso e obesidade entre 5 e 19 anos de idade. Dados coletados: peso, estatura, circunferência abdominal e pressão arterial sistêmica. Exames laboratoriais: perfil lipídico; glicemia e insulina, utilizados para cálculo do Homeostasis Model Assessment (HOMA-IR); proteína C reativa; transaminase glutâmico-pirúvica e albuminúria em amostra isolada de urina (ponto de corte < 30 mg/g). A creatinina foi utilizada para o cálculo da taxa de filtração glomerular estimada (eTFG, mL/min/1,73m2). Resultados: A média de idade foi 11,6±3,4 anos, 32 (50%) e 29 (45,3%) eram do gênero masculino e pré-púberes. Quarenta e seis (71,9%) apresentavam obesidade grave. A frequência e a mediana (min/max) dos valores observados para albuminúria (> 30 mg/g) foram 14 (21,9%) e 9,4 mg/g (0,70; -300,7 mg/g). A média da eTFG foi 122,9±24,7 mL/min/1,73 m2. Não houve correlação significante entre o índice de massa corporal, estadiamento puberal, insulina e HOMA-IR com os valores de albuminúria e nem com a eTFG. Crianças com albuminúria tiveram tendência a valores mais elevados de pressão arterial diastólica (75,0±12,2 vs 68,1±12,4, p = 0,071). Conclusão: A albuminúria, apesar de frequente em crianças e adolescentes com obesidade, não se associou com outras morbidades e nem com a taxa de filtração glomerular nesses pacientes.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Albuminuria/epidemiology , Pediatric Obesity/epidemiology , Glomerular Filtration Rate , Severity of Illness Index , Blood Pressure , Body Mass Index , Prevalence , Cross-Sectional Studies , Morbidity , Puberty , Creatinine/blood , Insulin/blood
16.
Rev. habanera cienc. méd ; 18(2): 217-230, mar.-abr. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1014164

ABSTRACT

Introducción: La hipertensión arterial es un poderoso factor de riesgo de daño renal. La prevalencia es muy alta entre los pacientes con Enfermedad Renal Crónica. Objetivo: Determinar la presencia de Microalbuminuria y su valor como marcador de daño renal en pacientes con diagnóstico de Hipertensión arterial. Material y Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de 123 pacientes. Se determinó edad, sexo, cifras de colesterol, triglicéridos, creatinina y microalbuminuria y factores de riesgo vascular. Se utilizó la estadística descriptiva e inferencial. Resultados: El 40,7 Microalbuminuria as a marker of kidney damage in patients with arterial hypertension de los pacientes pertenecen al grupo de más de 70 años con predominio del sexo masculino (65 por ciento), 62,6 Microalbuminuria as a marker of kidney damage in patients with arterial hypertension presentaron microalbuminuria, 97,3 Microalbuminuria as a marker of kidney damage in patients with arterial hypertension tenían factores de riesgo asociados con prevalencia aumentada del tabaquismo, dislipidemia, obesidad y enfermedades vasculares asociadas con RP>1. Predominó el grupo mayor de 70 años, del sexo masculino, con presencia de microalbuminuria. La presencia de más de tres factores de riesgo se asoció a la microalbuminuria. La presencia de microalbuminuria aumentó con los años de evolución de la enfermedad. Predominó el estadio 3 de la Enfermedad Renal Crónica en los pacientes con hipertensión arterial y microalbuminuria y se relacionó directamente con los años de evolución de la hipertensión arterial. Conclusiones: La determinación de la microalbuminuria en los pacientes con hipertensión arterial es un marcador de riesgo importante y sencillo para determinar el daño renal subclínico y está muy relacionado con el incremento de la edad del paciente, años de hipertensión y asociación con otros factores de riesgo vasculares(AU)


Introduction: Arterial hypertension is a powerful risk factor for kidney damage. The prevalence is very high among patients with chronic kidney disease. Objective: To determine the presence of microalbuminuria as a marker of kidney damage in patients with arterial hypertension admitted between September 2016 and September 2017. Material and Methods: A descriptive, longitudinal, prospective study was conducted in 123 patients. Age; sex; cholesterol, triglycerides, creatinine and microalbuminuria levels and vascular risk factors were determined. Descriptive and inferential statistics were used. Results: The 40.7 percent of patients belong to the group of patients of age more than 70 years, predominating the male sex (65 percent); 62.6 percent of them presented microalbuminuria and 97.3 percent had risk factors associated with an increased prevalence of smoking, dyslipidemia, obesity, and vascular diseases associated with RP> 1. The group of patients older than 70 years, male, and with presence of microalbuminuria predominated in the study. The presence of more than three risk factors was associated with microalbuminuria. The presence of microalbuminuria increased with the years of evolution of the disease. Stage 3 of chronic kidney disease predominated in patients with arterial hypertension and microalbuminuria and it was directly related to the years of evolution of arterial hypertension. Conclusions: The determination of microalbuminuria in patients with arterial hypertension is a simple and important risk marker to determine subclinical kidney damage and it is closely related to the increase in the age of the patient, the years of hypertension, and the association with other risk factors for vascular disease(AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Albuminuria/complications , Renal Insufficiency, Chronic/etiology , Hypertension/complications , Risk Factors , Albuminuria/diagnosis , Hypertension/epidemiology
17.
J. bras. nefrol ; 41(1): 48-54, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1002416

ABSTRACT

ABSTRACT Aim: To determine the prevalence of chronic kidney disease (CKD) and the epidemiological, clinical, and laboratory factors associated with CKD in Mexican HIV-infected patients. Methods: Cross-sectional study. We included 274 patients with HIV/AIDS. CKD was defined by the estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2 assessed by CKD-EPI) and albuminuria criteria from KDIGO guidelines. Clinical, epidemiological, and laboratory characteristics were compared between patients with and without CKD. The factors associated with CKD were assessed by logistic regression analysis. Results: The mean age was 41±11 years, and 72.3% of the patients were men. The global prevalence of CKD was 11.7% (n = 32); 7.2% (n = 20) were defined by eGFR criterion; 7.6% (n = 21), by the albuminuria criterion; and 3.2% (n = 9), by both CKD criteria. The most frequently observed stages of CKD were KDIGO G3A1 stage with 4.7% (n = 13), KDIGO G1A2 stage with 3.6% (n = 10) and KDIGO G3A2 stage with 1.7% (n = 5). The factors associated with CKD were use of abacavir/lamivudine (OR 3.2; 95% CI 1.1-8.9; p = 0.03), a CD4 lymphocyte count < 400 cells/µL (OR 2.6; 95% 1.03-6.4, p = 0.04), age (OR 1.1; 95% CI 1.04-1.2, p = 0.001) and albuminuria (OR 19.98; 95% CI: 5.5-72.2; p < 0.001). Conclusions: CKD was a frequent complication in HIV-infected patients. These findings confirm the importance of screening and the early detection of CKD, as well as the importance of identifying and treating traditional and non-traditional risk factors associated with CKD.


RESUMO Objetivo: Determinar a prevalência de doença renal crônica (DRC) e os fatores epidemiológicos, clínicos e laboratoriais associados à DRC em pacientes mexicanos infectados pelo HIV. Métodos: Estudo transversal. Incluímos 274 pacientes com HIV/AIDS. A DRC foi definida pela taxa de filtração glomerular estimada (TFGe < 60 mL/min/1,73 m2, avaliada pelo CKD-EPI) e pelos critérios de albuminúria das diretrizes do KDIGO. As características clínicas, epidemiológicas e laboratoriais foram comparadas entre pacientes com e sem DRC. Os fatores associados à DRC foram avaliados por análise de regressão logística. Resultados: A média da idade foi de 41 ± 11 anos e 72,3% dos pacientes eram homens. A prevalência global de DRC foi de 11,7% (n = 32); 7,2% (n = 20) foram definidos pelo critério TFGe; 7,6% (n = 21), pelo critério da albuminúria; e 3,2% (n = 9), pelos dois critérios para DRC. Os estágios mais frequentemente observados da DRC foram o estágio KDIGO G3A1 com 4,7% (n = 13); estágio KDIGO G1A2 com 3,6% (n = 10) e estágio KDIGO G3A2 com 1,7% (n = 5). Os fatores associados à DRC foram o uso de abacavir/lamivudina (OR 3,2; IC95% 1,1-8,9; p = 0,03), contagem de linfócitos CD4 < 400 células/µL (OR 2,6; 95% 1,03-6,4, p = 0,04), idade (OR 1,1; IC95% 1,04-1,2, p = 0,001) e albuminúria (OR 19,98; IC95%: 5,5-72,2; p < 0,001). Conclusões: A DRC foi uma complicação frequente em pacientes infectados pelo HIV. Esses achados confirmam a importância do rastreamento e da detecção precoce da DRC, bem como a importância de identificar e tratar os fatores de risco tradicionais e não tradicionais associados à DRC.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , HIV Infections/complications , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/epidemiology , Dideoxynucleosides/adverse effects , Logistic Models , Prevalence , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Age Factors , CD4 Lymphocyte Count , Lamivudine/adverse effects , Anti-HIV Agents/adverse effects , Diabetes Complications , Albuminuria , Glomerular Filtration Rate , Hypertension/complications , Mexico/epidemiology
18.
Rev. méd. Chile ; 147(2): 173-180, Feb. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1004330

ABSTRACT

Background: To reduce the progression of chronic kidney disease (CKD) and cardiovascular risk, the guidelines recommend the blockade of the renin-angiotensin-aldosterone system (RAAS) in patients with proteinuria. Aim: To assess the frequency of enalapril or losartan use in diabetics or hypertensive patients with stage 3 CKD. Material and Methods: Review of clinical records of patients with CKD in an urban primary care clinic. Results: We identified 408 subjects aged 40 to 98 years (66% women) with stage 3 CKD. Sixty six percent had only hypertension and 34% were diabetic with or without hypertension. Seventy four percent received RAAS blockers (52% used enalapril, 45% losartan and 2% both medications). RAAS blockers were used in 70% of hypertensive and 78% of diabetic patients. The prescription in hypertensive diabetics with microalbuminuria was lower than in those without microalbuminuria (72% vs 87%, p < 0.05), but the opposite occurred in pure hypertensive patients with and without microalbuminuria (88% vs 69%, p < 0.05). There were no significant differences in blood pressure levels, microalbuminuria or serum potassium levels between RAAS blocker users and non-users. No differences were observed either between enalapril and losartan users. Conclusions: The adherence to clinical guidelines is insufficient and users of the recommended drugs did not achieve the expected goals.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Enalapril/therapeutic use , Losartan/therapeutic use , Renal Insufficiency, Chronic/drug therapy , Proteinuria/urine , Renin-Angiotensin System , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/standards , Enalapril/administration & dosage , Enalapril/standards , Disease Progression , Losartan/administration & dosage , Losartan/standards , Creatinine/blood , Diabetes Mellitus/drug therapy , Albuminuria/urine , Drug Therapy, Combination , Treatment Adherence and Compliance/psychology , Hypertension/drug therapy
19.
Rev. saúde pública (Online) ; 53: 44, jan. 2019. tab
Article in English | LILACS | ID: biblio-1004503

ABSTRACT

ABSTRACT OBJECTIVE To verify the prevalence of chronic kidney disease and the factors associated to it in older adults (≥ 60 years). METHODS This is a population-based research conducted in 2014, involving 1,016 older adults living in urban and rural areas of the municipality of Rio Branco, Acre. Chronic kidney disease was defined by glomerular filtration rate < 60 ml/min/1.73 m 2 , estimated by the equations of the Chronic Kidney Disease Epidemiology Collaboration, and the presence of albuminuria > 29 mg/g. Association measure were estimated by gross and adjusted odds ratio (OR), with a confidence level of 95% (95%CI). RESULTS The overall prevalence of chronic kidney disease was 21.4% in older adults, with the associated factors age, diabetes (OR = 3.39; 95%CI 2.13-5.40), metabolic syndrome (OR = 2.49; 95%CI 1.71-3.63), self-assessment of poor health (OR = 1.79; 95%CI 1.10-2.91), arterial hypertension (OR = 1.82; 95%CI 1.04-3.19) and obesity (OR = 1.69; 95%CI 1.02-2.80). CONCLUSIONS The prevalence of chronic kidney disease was high in older adults, being associated with age, self-assessment of health as bad or very bad, obesity, diabetes and metabolic syndrome.


RESUMO OBJETIVO Verificar a prevalência de doença renal crônica e os fatores a ela associados em idosos (≥ 60 anos). MÉTODOS Trata-se de um inquérito de base populacional realizado em 2014, envolvendo 1.016 idosos residentes nas zonas urbana e rural do município de Rio Branco, Acre. A doença renal crônica foi definida pela taxa de filtração glomerular < 60 ml/min/1,73 m 2 , estimada pelas equações da Chronic Kidney Disease Epidemiology Collaboration , e presença de albuminúria > 29 mg/g. Medidas de associação foram estimadas por regressão logística (OR) bruta e ajustada, com grau de confiança de 95% (IC95%). RESULTADOS A prevalência geral de doença renal crônica foi de 21,4% nos idosos, com os fatores associados idade, diabetes (OR = 3,39; IC95% 2,13-5,40), síndrome metabólica (OR = 2,49; IC95% 1,71-3,63), autoavaliação de saúde ruim (OR = 1,79; IC95% 1,10-2,91), hipertensão arterial (OR = 1,82; IC95% 1,04-3,19) e obesidade (OR = 1,69; IC95% 1,02-2,80). CONCLUSÕES A prevalência de doença renal crônica foi alta entre os idosos, estando associada com idade, autoavaliação de saúde como ruim ou muito ruim, obesidade, diabetes e síndrome metabólica.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Renal Insufficiency, Chronic , Renal Insufficiency, Chronic/epidemiology , Brazil/epidemiology , Sex Factors , Prevalence , Risk Factors , Creatinine/blood , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Diabetes Complications/epidemiology , Albuminuria , Dyslipidemias/complications , Dyslipidemias/epidemiology , Diagnostic Self Evaluation , Glomerular Filtration Rate , Hypertension/complications , Hypertension/epidemiology , Middle Aged , Obesity/complications , Obesity/epidemiology
20.
Article in English | WPRIM | ID: wpr-758974

ABSTRACT

BACKGROUND: Cancer risk and epidemiology in pre-dialysis chronic kidney disease (CKD) warrant further investigation in a large-scale cohort. METHODS: We performed a nationwide population-based study using the national health insurance database of Korea. We screened records from 18,936,885 individuals who received a national health examination ≥ 2 times from 2009 to 2016. Pre-dialysis CKD was identified based on serum creatinine and dipstick albuminuria results. Individuals with preexisting cancer history, renal replacement therapy, or transient CKD were excluded. A control group without evidence of kidney function impairment and matched for age, sex, low-income status, and smoking history was included. Risk of cancers, as identified in the claims database, was investigated using a multivariable Cox regression model including matched variables and other unmatched clinical characteristics as covariates. RESULTS: A total of 471,758 people with pre-dialysis CKD and the same number of matched controls were included. Urinary (adjusted hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.82–2.13) and hematopoietic (adjusted HR, 1.53; 95% CI, 1.38–1.68) malignancy risk was increased in pre-dialysis CKD and all CKD stages. However, the risk of digestive cancer was lower in the pre-dialysis CKD group (adjusted HR, 0.89; 95% CI, 0.87–0.92). The risk of digestive, respiratory, thyroid, and prostate malignancy demonstrated a non-linear association with CKD stage, with stage 1 or stage 4/5 CKD without dialysis demonstrating relatively lower risk. CONCLUSION: Cancer risk varied in pre-dialysis CKD compared to controls, and the association between cancer risk and CKD stage varied depending on the cancer type.


Subject(s)
Albuminuria , Cohort Studies , Comorbidity , Creatinine , Dialysis , Epidemiology , Kidney , Korea , National Health Programs , Prostate , Renal Insufficiency, Chronic , Renal Replacement Therapy , Smoke , Smoking , Thyroid Gland
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