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1.
Article in English | WPRIM | ID: wpr-880365

ABSTRACT

BACKGROUND@#Epidemiological evidence has shown that serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, a diagnostic biomarker for heart failure, are positively associated with cardiovascular risk. Since NT-proBNP in serum is excreted in urine, it is hypothesized that urinary NT-proBNP concentrations are correlated with serum concentrations and linked with cardiovascular risk in the general population.@*METHODS@#A total of 3060 community-dwelling residents aged ≥ 40 years without history of cardiovascular disease (CVD) were followed up for a median of 8.3 years (2007-2015). Serum and urinary concentrations of NT-proBNP at baseline were compared. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between NT-proBNP concentrations and the risk of developing CVD were computed using the Cox proportional hazards model.@*RESULTS@#The median values (interquartile ranges) of serum and urinary NT-proBNP concentrations at baseline were 56 (32-104) pg/mL and 20 (18-25) pg/mL, respectively. There was a strong quadratic correlation between the serum and urinary concentrations of NT-proBNP (coefficient of determination [R@*CONCLUSIONS@#The present study demonstrated that urinary NT-proBNP concentrations were well-correlated with serum concentrations and were positively associated with cardiovascular risk. Given that urine sampling is noninvasive and does not require specially trained personnel, urinary NT-proBNP concentrations have the potential to be an easy and useful biomarker for detecting people at higher cardiovascular risk.


Subject(s)
Adult , Aged , Aged, 80 and over , Biomarkers/urine , Cardiovascular Diseases/urine , Female , Heart Failure/diagnosis , Humans , Incidence , Japan/epidemiology , Male , Middle Aged , Natriuretic Peptide, Brain/urine , Peptide Fragments/urine , Prospective Studies , Risk Assessment
2.
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
3.
J. bras. nefrol ; 41(2): 252-265, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012537

ABSTRACT

Abstract Involvement of the kidneys by lupus nephritis (LN) is one of the most severe clinical manifestations seen in individuals with systemic lupus erythematosus (SLE). LN is more frequent and severe in pediatric patients and has been associated with higher morbidity and mortality rates. This narrative review aimed to describe the general aspects of LN and its particularities when affecting children and adolescents, while focusing on the disease's etiopathogenesis, clinical manifestations, renal tissue alterations, and treatment options.


Resumo A nefrite lúpica (NL) é caracterizada pelo acometimento dos rins no contexto das diversas manifestações clínicas do Lupus Eritematoso Sistêmico (LES), e representa uma das manifestações clínicas mais graves da doença. A NL é mais frequente e mais grave nos pacientes pediátricos, em comparação com os adultos, e causa maiores taxas de morbidade e mortalidade. O objetivo desta revisão narrativa foi descrever os aspectos gerais da NL e suas particularidades em crianças e adolescentes, com foco em sua etiopatogênese, nas manifestações clínicas, nas alterações histopatológicas renais e na abordagem terapêutica.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Lupus Nephritis/pathology , Lupus Nephritis/epidemiology , Rare Diseases/pathology , Rare Diseases/epidemiology , Lupus Nephritis/diagnosis , Lupus Nephritis/drug therapy , Biomarkers/urine , Biomarkers/blood , Prevalence , Rare Diseases/diagnosis , Rare Diseases/drug therapy , Early Diagnosis
4.
J. pediatr. (Rio J.) ; 95(3): 328-333, May-June 2019. graf
Article in English | LILACS | ID: biblio-1012600

ABSTRACT

Abstract Objective: Posterior urethral valve is the most common lower urinary tract obstruction in male children. A high percentage of patients with posterior urethral valve evolve to end‐stage renal disease. Previous studies showed that cytokines, chemokines, and components of the renin-angiotensin system contribute to the renal damage in obstructive uropathies. The authors recently found that urine samples from fetuses with posterior urethral valve have increased levels of inflammatory molecules. The aim of this study was to measure renin-angiotensin system molecules and to investigate their correlation with previously detected inflammatory markers in the same urine samples of fetuses with posterior urethral valve. Methods: Urine samples from 24 fetuses with posterior urethral valve were collected and compared to those from 22 healthy male newborns at the same gestational age (controls). Renin-angiotensin system components levels were measured by enzyme‐linked immunosorbent assay. Results: Fetuses with posterior urethral valve presented increased urinary levels of angiotensin (Ang) I, Ang‐(1‐7) and angiotensin‐converting enzyme 2 in comparison with controls. ACE levels were significantly reduced and Ang II levels were similar in fetuses with posterior urethral valve in comparison with controls. Conclusions: Increased urinary levels of angiotensin‐converting enzyme 2 and of Ang‐(1‐7) in fetuses with posterior urethral valve could represent a regulatory response to the intense inflammatory process triggered by posterior urethral valve.


Resumo Objetivo: A válvula de uretra posterior é a obstrução do trato urinário inferior mais comum em crianças do sexo masculino. Uma alta porcentagem de pacientes com válvula de uretra posterior evolui para doença renal em estágio final. Estudos anteriores mostraram que citocinas, quimiocinas e componentes do sistema renina-angiotensina contribuem para o dano renal em uropatias obstrutivas. Recentemente, descobrimos que amostras de urina de fetos com válvula de uretra posterior tinham níveis aumentados de moléculas inflamatórias. O objetivo deste estudo foi medir as moléculas de renina-angiotensina e investigar sua correlação com marcadores inflamatórios previamente detectados nas mesmas amostras de urina de fetos com válvula de uretra posterior. Métodos: Amostras de urina de 24 fetos com válvula de uretra posterior foram coletadas e comparadas com amostras de urina de 22 recém-nascidos saudáveis de mesma idade gestacional (controles). Os níveis dos componentes de SRA foram medidos por ensaio de imunoabsorção enzimática. Resultados: Os fetos com válvula de uretra posterior apresentaram níveis urinários aumentados de angiotensina (Ang) I, Ang-(1-7) e enzima conversora de angiotensina 2 em comparação com os controles. Os níveis de enzima conversora de angiotensina eram significativamente menores e os níveis de Ang II eram semelhantes nos fetos com válvula de uretra posterior em comparação com os controles. Conclusões: O aumento dos níveis urinários de enzima conversora de angiotensina 2 e de Ang-(1-7) em fetos com válvula de uretra posterior poderia representar uma resposta regulatória ao intenso processo inflamatório desencadeado pela válvula de uretra posterior.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Peptide Fragments/urine , Urethra/abnormalities , Urethral Diseases/urine , Angiotensin I/urine , Angiotensin II/urine , Peptidyl-Dipeptidase A/urine , Fetus/abnormalities , Urethra/embryology , Urethral Diseases/diagnosis , Urethral Diseases/embryology , Biomarkers/urine , Case-Control Studies , Immunosorbent Techniques
5.
Rev. latinoam. enferm. (Online) ; 27: e3194, 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1043087

ABSTRACT

Objetivo verificar, por meio da tecnologia de biomarcador de cotinina urinária, a ocorrência da doença da folha verde do tabaco em trabalhadores que cultivam tabaco do tipo Burley. Método estudo caso-controle pareado, com base no status tabágico e na proporção 1:4, com participação de 20 trabalhadores-caso e 91 controles. Para a coleta de dados foi realizada entrevista por meio de inquérito domiciliar e coleta de urina para exame de cotinina. Foram utilizados os testes t de Student, Mann-Whitney, qui-quadrado de Pearson ou exato de Fisher. Resultados dos 23 casos suspeitos, 20 apresentaram níveis elevados de cotinina, sinais e sintomas de dor de cabeça, irritação de pele, náusea, enjoo e mal-estar geral, principalmente pela manhã. A maioria trabalhou com tabaco molhado decorrente do sereno e o clima estava quente. Conclusão verificam-se sinais sugestivos da doença da folha verde do tabaco nos trabalhadores do tabaco Burley. Faz-se necessária a atuação de profissionais de saúde no desenvolvimento de ações promotoras de saúde e preventivas sobre essa doença relacionada ao trabalho.


Objective using the urinary cotinine biomarker to verify the occurrence of green tobacco sickness in workers who cultivate Burley tobacco. Method paired case-control study, based on smoking status and on the 1:4 ratio, with participation of 20 case workers and 91 controls. Data collection included household surveys and urine collection for cotinine examination. Student's T-Test, the Mann-Whitney test, Pearson's chi-square or Fisher's exact tests were used. Results of the 23 suspected cases, 20 showed elevated levels of cotinine, signs and symptoms of headache, skin irritation, nausea, sickness and general malaise, especially in the morning. Most had worked with tobacco that was wet from the morning dew and when the weather was warm. Conclusion there are signs suggestive of green tobacco sickness in Burley tobacco workers. The action of health professionals is necessary for the development of health promotion and preventive actions addressing work-related illness.


Objetivo certificar, por medio de la tecnología de biomarcador de cotinina urinaria, la ocurrencia de la Enfermedad del Tabaco Verde en trabajadores que cultivan tabaco del tipo Burley. Método estudio caso-control pareado, con base en el status tabáquico y en la proporción 1:4, con la participación de 20 trabajadores-caso y 91 controles. Para la recopilación de datos se realizó una encuesta por medio de cuestionario domiciliar y de recolección de orina para análisis de cotinina. Se utilizaron las siguientes pruebas t de Student, Mann-Whitney, chi-cuadrado de Pearson o exacta de Fisher. Resultados de los 23 casos sospechosos, 20 presentaron niveles elevados de cotinina, señales y síntomas de dolor de cabeza, irritación de la piel, náusea, mareo y malestar general, principalmente por la mañana. La mayoría trabajó con tabaco mojado por el sereno y en un clima caluroso. Conclusión se certifican señales sugestivas de Enfermedad del Tabaco Verde en los trabajadores del tabaco Burley. Se hace necesaria la actuación de profesionales de la salud en el desarrollo de acciones promotoras de salud y preventivas de esta enfermedad relacionado con el trabajo.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tobacco/poisoning , Biomarkers/urine , Case-Control Studies , Occupational Exposure , Cotinine/urine , Headache , Nicotine/poisoning , Occupational Diseases
6.
Rev. Soc. Bras. Med. Trop ; 52: e20180300, 2019. tab, graf
Article in English | LILACS | ID: biblio-1041561

ABSTRACT

Abstract INTRODUCTION The nematode Caenorhabditis elegans was used as a biological sensor to detect the urine of sepsis patients (CESDA assay). METHODS C. elegans was aliquoted onto the center of assay plates and allowed to migrate towards sepsis (T) or control (C) urine samples spotted on the same plate. The number of worms found in either (T) or (C) was scored at 10-minute intervals over a 60-minute period. RESULTS The worms were able to identify the urine (<48 hours) of sepsis patients rapidly within 20 minutes (AUROC=0.67, p=0.012) and infection within 40 minutes (AUROC=0.80, p=0.016). CONCLUSIONS CESDA could be further explored for sepsis diagnosis.


Subject(s)
Humans , Animals , Biomarkers/urine , Chemotaxis , Caenorhabditis elegans , Sepsis/diagnosis , Time Factors , Sensitivity and Specificity , Sepsis/urine
7.
J. bras. nefrol ; 40(4): 339-343, Out.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-984578

ABSTRACT

ABSTRACT Introduction: preeclampsia can be associated with future renal disease. Objectives: To measure changes in renal function overtime in patients with preeclampsia. Methods: urine and serum samples from eleven patients with preeclampsia and eight patients with a normal pregnancy were obtained during pregnancy, postpartum, and 3 years after delivery. Urine podocalyxin, protein, and serum creatinine were measured. Results: after 3 years, there were no significant differences in urinary podocalyxin in patients with or without preeclampsia: 4.34 ng/mg [2.69, 8.99] vs. 7.66 ng/mg [2.35, 13], p = 0.77. The same applied to urinary protein excretion: 81.5 mg/g [60.6, 105.5] vs. 43.2 mg/g [20.9, 139.3] p = 0.23. Serum creatinine was 0.86 mg/dL [0.7, 0.9] vs. 0.8 mg/dL [0.68, 1] p = 0.74 in those with and without preeclampsia. In normal patients, urinary podocalyxin decreased from 54.4 ng/mg [34.2, 76.9] during pregnancy to 7.66 ng/mg [2.35, 13] three years after pregnancy, p = 0.01. Proteinuria decreased from 123.5 mg/g [65.9, 194.8] to 43.2 mg/g [20.9, 139.3], p = 0.12. In preeclampsia patients, urinary podocalyxin decreased from 97.5 ng/mg [64.9, 318.4] during pregnancy to 37.1 ng/mg within one week post-partum [21.3, 100.4] p = 0.05 and 4.34 ng/mg [2.69, 8.99] three years after, p = 0.003. Proteinuria was 757.2 mg/g [268.4, 5031.7] during pregnancy vs. 757.2 mg/g [288.2, 2917] postpartum, p = 0.09 vs. 81.5 mg/g [60.6, 105.5] three years later, p = 0.01. Two patients still had proteinuria after 3 years. Conclusions: in preeclampsia patients, postpartum urinary podocalyxin decreased before proteinuria. After three years, serum creatinine, urinary podocalyxin, and protein tended to normalize, although some patients still had proteinuria.


RESUMO Introdução: a pré-eclâmpsia pode estar associada à doença renal no futuro. Objetivos: medir mudanças na função renal ao longo do tempo em pacientes com pré-eclâmpsia. Métodos: amostras de urina e soro de onze pacientes com pré-eclâmpsia e oito pacientes com gravidez normal foram obtidas durante a gravidez, pós-parto e 3 anos após o parto. Medimos podocalixina na urina, proteína e creatinina sérica. Resultados: após 3 anos, não houve diferenças significativas na podocalixina urinária em pacientes com ou sem pré-eclâmpsia: 4,34 ng/mg [2,69, 8,99] versus 7,66 ng/mg [2,35, 13], p = 0,77. O mesmo se aplicou à excreção urinária de proteínas: 81,5 mg/g [60,6, 105,5] vs. 43,2 mg/g [20,9, 139,3] p = 0,23. A creatinina sérica foi de 0,86 mg/dL [0,7, 0,9] vs. 0,8 mg/dL [0,68, 1] p = 0,74 naqueles com e sem pré-eclâmpsia. Em pacientes normais, a podocalixina urinária diminuiu de 54,4 ng/mg [34,2, 76,9] durante a gestação para 7,66 ng/mg [2,35, 13] três anos após a gravidez, p = 0,01. A proteinúria diminuiu de 123,5 mg/g [65,9, 194,8] para 43,2 mg/g [20,9, 139,3], p = 0,12. Em pacientes com pré-eclâmpsia, a podocalixina urinária diminuiu de 97,5 ng/mg [64,9, 318,4] durante a gravidez para 37,1 ng/mg em uma semana de pós-parto [21,3, 100,4] p = 0,05 e 4,34 ng/mg [2,69, 8,99] três anos depois, p = 0,003. A proteinúria foi de 757,2 mg/g [268.4, 5031.7] durante a gravidez vs. 757,2 mg/g [288.2, 2917] pós-parto, p = 0.09 vs. 81.5 mg/g [60.6, 105.5] três anos depois, p = 0.01. Dois pacientes ainda apresentavam proteinúria após 3 anos. Conclusões: em pacientes com pré-eclâmpsia, a podocalixina urinária pós-parto diminuiu antes da proteinúria. Após três anos, a creatinina sérica, a podocalixina urinária e a proteína tenderam a se normalizar, embora alguns pacientes ainda tivessem proteinúria.


Subject(s)
Humans , Female , Adult , Pre-Eclampsia/physiopathology , Podocytes/pathology , Kidney/physiopathology , Kidney/pathology , Pre-Eclampsia/urine , Pre-Eclampsia/blood , Sialoglycoproteins/urine , Sialoglycoproteins/blood , Time Factors , Pregnancy , Biomarkers/urine , Biomarkers/blood , Prospective Studies , Follow-Up Studies
8.
J. bras. pneumol ; 44(6): 477-485, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-984599

ABSTRACT

ABSTRACT Objective: To determine the frequency of active smoking among patients with asthma and individuals without asthma by self-report and urinary cotinine measurement. Methods: This was a cross-sectional study conducted in the city of Salvador, Brazil, and involving 1,341 individuals: 498 patients with severe asthma, 417 patients with mild-to-moderate asthma, and 426 individuals without asthma. Smoking status was determined by self-report (with the use of standardized questionnaires) and urinary cotinine measurement. The study variables were compared with the chi-square test and the Kruskal-Wallis test. Results: Of the sample as a whole, 55 (4.1%) reported being current smokers. Of those, 5 had severe asthma, 17 had mild-to-moderate asthma, and 33 had no asthma diagnosis. Of the 55 smokers, 32 (58.2%) were daily smokers and 23 (41.8%) were occasional smokers. Urinary cotinine levels were found to be high in self-reported nonsmokers and former smokers, especially among severe asthma patients, a finding that suggests patient nondisclosure of smoking status. Among smokers, a longer smoking history was found in patients with severe asthma when compared with those with mild-to-moderate asthma. In addition, the proportion of former smokers was higher among patients with severe asthma than among those with mild-to-moderate asthma. Conclusions: Former smoking is associated with severe asthma. Current smoking is observed in patients with severe asthma, and patient nondisclosure of smoking status occurs in some cases. Patients with severe asthma should be thoroughly screened for smoking, and findings should be complemented by objective testing.


RESUMO Objetivo: Descrever a frequência de tabagismo ativo entre pacientes com asma e indivíduos sem asma, usando questionários padronizados e dosagem da cotinina urinária. Métodos: Estudo transversal realizado em Salvador (BA), com 1.341 indivíduos, sendo 498 com asma grave, 417 com asma leve/moderada e 426 sem asma. O tabagismo foi identificado por meio de autorrelato utilizando questionários e por mensuração da cotinina urinária. Para a comparação das variáveis estudadas, utilizaram-se os testes do qui-quadrado e de Kruskal-Wallis. Resultados: Dos 55 participantes (4,1%) que se declararam tabagistas atuais, 5, 17 e 33 eram dos grupos asma grave, asma leve/moderada e sem asma, respectivamente. Desses 55, 32 (58,2%) eram tabagistas diários e 23 (41,8%) eram tabagistas ocasionais. Observaram-se níveis elevados de cotinina urinária entre não fumantes autodeclarados e tabagistas pregressos, especialmente no grupo asma grave, o que sugere omissão do hábito atual de fumar. A carga tabágica entre os fumantes e a proporção de ex-tabagistas foram maiores no grupo asma grave do que no grupo asma leve/moderada. Conclusões: O tabagismo pregresso esteve associado à asma grave. Tabagismo atual também foi observado em alguns pacientes com asma grave e detectou-se omissão em alguns casos. A investigação de tabagismo deve ser meticulosa em pacientes com asma grave e a entrevista desses deve ser complementada por uma avaliação objetiva.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Asthma/epidemiology , Smoking/urine , Cotinine/urine , Self Report , Socioeconomic Factors , Severity of Illness Index , Brazil/epidemiology , Biomarkers/urine , Smoking/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Smokers/statistics & numerical data
9.
Acta toxicol. argent ; 26(2): 57-64, set. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-989212

ABSTRACT

Introducción: la exposición crónica al benceno y tolueno produce alteraciones sobre la médula ósea y el sistema nervioso central, entre otros. En orina, el ácido trans, trans mucónico (t, t-MA) es uno de los biomarcadores de exposición al benceno y el o-cresol (oCre) al tolueno. Objetivo: analizar los resultados de los niveles de t, t-MA y oCre urinarios en una población infanto-juvenil residente en Ciudad Autónoma de Buenos Aires y Conurbano Bonaerense potencialmente expuesta a benceno y tolueno ambiental. Materiales y métodos: se realizó un estudio retrospectivo de los resultados de t, t-MA y oCre urinarios. Las muestras de orina ingresaron al laboratorio con solicitud de t, t-MA (n=1519) y oCre (n=1447) durante el período 2011-2017 (rango etario entre 0 a 19 años). El t, t-MA se cuantificó por UFLC con detector de arreglo de diodos y el oCre por CG con detector de ionización por llama. Resultados: la edad promedio de los pacientes fue de 4,8 años y la mediana 4,6 años.Las concentraciones de t, t-MA urinario fueron: menor de 50 μg/l (44,8%); entre 50-500 μg/l (52,1%) y mayores de 500 μg/l (3,1%). Expresadas por gramo de creatinina: entre 15-163 μg/g creatinina (60,4%) y mayores de 163 μg/g creatinina (39,6%). El límite de cuantificación de t, t-MA fue de 50 μg/l. Las concentraciones de oCre urinario fueron: menor de 0,20 mg/l (97,7%) y entre 0,20-0,50 mg/l (2,3%) y mayor de 0,50 mg/l (0%). Expresadas por gramo de creatinina: menor de 0,30 mg/g creatinina en el 0,8% y mayores de 0,30 mg/g creatinina en el 1,5%. El límite de cuantificación de oCre fue de 0,20 mg/l. Conclusiones: los resultados del trabajo podrían indicar una contaminación ambiental persistente, en especial en el Conurbano Bonaerense, donde debería continuarse el monitoreo de algunas zonas. Pero, por otro lado, es de vital importancia tener en cuenta los factores de confusión, tales como la dieta, la exposición al humo de tabaco ambiental (fumador pasivo) y la tasa de excreción renal que llevarían a una sobre-estimación de los resultados y a una incorrecta toma de decisiones.


Introduction: Chronic exposure to benzene and toluene produces alterations in the bone marrow and the central nervous system, among other effects. In urine, trans, trans muconic acid (t, t-MA) is one of the biomarkers of exposure to benzene and o-cresol (oCre), to toluene. Objective: To analyze the results of urinary t, t-MA and oCre levels in an infant-juvenile population resident in the Autonomous City of Buenos Aires and the Conurbano Bonaerense, potentially exposed to environmental benzene and toluene. Materials and methods: A retrospective study of urinary t, t-MA and oCre results was performed. The urine samples entered the laboratory with the request of t, t-MA (n = 1519) and oCre (n = 1447) during the period 2011- 2017. The age range of the population was between 0 and 19 years. The t, t-MA was quantified by UFLC with diode array detector and the oCre by GC with flame ionization detector. Results: The average age of the patients was 4.8 years and the median age was 4.6 years. The urinary concentrations of t, t-MA were: below 50 μg/l (44.8%); between 50-500 μg/l (52.1%) and above 500 μg/l (3.1%). Expressed per gram of creatinine: between 15-163 μg/g creatinine (60.4%) and greater 163 μg/g creatinine (39.6%). The limit of quantification of t, t-MA was 50 μg/l. The urinary oCre concentrations were: less than 0.20 mg/l (97.7%) and between 0.20-0.50 mg/l (2.3%). Expressed per gram of creatinine: less than 0.30 mg/g creatinine in 0.8% and greater than 0.30 mg/g creatinine in 1.5%. The limit of quantification of oCre was 0.20mg/l. Conclusions: The results of the study could indicate persistent environmental contamination, especially in the Conurbano Bonaerense, where monitoring of some areas should be continued. However, it is of vital importance to take into account the confounding factors, such as diet, exposure to environmental tobacco smoke (passive smoking) and the rate of renal excretion, which would lead to an over-estimation of the results and to incorrect decision-making.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Toluene/poisoning , Toluene/urine , Benzene/poisoning , Biomarkers/analysis , Biomarkers/urine , Argentina/epidemiology , Urban Area , Chemical Compound Exposure , Inhalation Exposure/adverse effects , Environmental Pollution/adverse effects
10.
Arq. neuropsiquiatr ; 76(7): 452-458, July 2018. tab
Article in English | LILACS | ID: biblio-950560

ABSTRACT

ABSTRACT The purpose of this study was to determine the effect of lamotrigine (LTG) and levetiracetam (LEV) as mono- and polytherapy on biochemical markers of bone turnover and bone mineral density in Egyptian adult patients with epilepsy. Methods Forty-eight patients were divided into four groups: two received monotherapy of either LTG or LEV, and the other two groups received polytherapy comprising (valproate [VPA] + LTG or VPA + LEV). Thirty matched healthy participants were included in the study. Participants completed a nutritional and physical activity questionnaire. Biochemical markers of bone and mineral metabolism and bone mineral density of the lumbar spine were measured at baseline and at six months. Results In the LEV monotherapy group, the bone formation markers showed a significant decrease in serum alkaline phosphatase and serum osteocalcin levels while the bone resorption marker showed a significant increase in urinary deoxypyridinoline levels. After six months of treatment, bone mineral density showed a significant decrease in all treated groups, while among monotherapy groups, this significant decrease was more prevalent in the LEV monotherapy group compared with the LTG monotherapy group. Furthermore, there was significant negative correlation between urinary deoxypyridinoline levels and bone mineral density in the LEV monotherapy group. Conclusion Using new generation antiepileptics, LEV monotherapies and polytherapy showed harmful effects on bone but LTG did not.


RESUMO O objetivo deste estudo foi determinar o efeito da lamotrigina (LTG) e levetiracetam (LEV) como mono e politerapia em marcadores bioquímicos de remodelação óssea e densidade mineral óssea em pacientes adultos egípcios com epilepsia. Métodos Quarenta e oito pacientes foram divididos em quatro grupos: dois grupos receberam monoterapia de LTG ou LEV e os outros dois grupos receberam politerapia (valproato [VPA] + LTG ou VPA + LEV). Trinta participantes saudáveis controle foram incluídos no estudo. Os participantes preencheram um questionário nutricional e de atividade física. Marcadores bioquímicos do metabolismo ósseo e mineral e densidade mineral óssea da coluna lombar foram medidos no início e aos seis meses. Resultados No grupo de monoterapia LEV, os marcadores de formação óssea mostraram uma diminuição significativa nos níveis séricos de fosfatase alcalina e osteocalcina sérica, enquanto o marcador de reabsorção óssea mostrou um aumento significativo nos níveis de desoxipiridinolina urinária. Após seis meses de tratamento, a densidade mineral óssea mostrou uma diminuição significativa em todos os grupos tratados, enquanto entre os grupos de monoterapia, esta diminuição significativa foi mais prevalente no grupo de monoterapia LEV em comparação com o grupo de monoterapia LTG. Além disso, houve correlação negativa significativa entre os níveis de desoxipiridinolina urinária e densidade mineral óssea no grupo de monoterapia LEV. Conclusão Utilizando antiepilépticos de nova geração, as monoterapias LEV e a politerapia mostraram efeitos prejudiciais no osso, mas a LTG não.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Piracetam/analogs & derivatives , Triazines/adverse effects , Bone Density/drug effects , Valproic Acid/adverse effects , Bone Remodeling/drug effects , Anticonvulsants/adverse effects , Piracetam/administration & dosage , Piracetam/adverse effects , Triazines/administration & dosage , Biomarkers/urine , Biomarkers/blood , Case-Control Studies , Osteocalcin/blood , Valproic Acid/administration & dosage , Drug Therapy, Combination , Epilepsy/drug therapy , Lamotrigine , Levetiracetam , Amino Acids/urine , Anticonvulsants/administration & dosage
11.
Int. j. morphol ; 36(2): 655-660, jun. 2018. tab
Article in English | LILACS | ID: biblio-954168

ABSTRACT

The present study evaluated the effect of a 20-week concurrent training program on bone metabolism in elderly women. The sample consisted of 51 elderly women living in the municipality of Muriaé (MG), distributed into two groups: a concurrent training group (CTG = 25), with an average age of 69.44 ± 6.82 years, and a control group (CG = 26), with mean age of 68.30 ± 6.34 years. Biophysical parameters were determined based on weight, height and body mass index. Bone metabolism was assessed by collecting second-morning urine samples before and after intervention to analyze levels of the biochemical marker deoxypyridinoline (DPD), which quantifies bone resorption. Results: The results showed a post-intervention decline in DPD content in the GTC when compared to controls (p = 0.007) and an improvement in the variables weight, BMI and DPD between the GTC and GC (p = 0.000). Conclusion: Concurrent training was efficient in improving bone metabolism in the elderly population studied.


El presente estudio evaluó los efectos de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores. La muestra fue compuesta por 51 mujeres adultas mayores, residentes en el municipio de Muriaé (MG), voluntarias, distribuidas en dos grupos, un grupo participó en entrenamiento concurrente (GTC=25), con una edad media de 69,44±6,82 años y un grupo control (GC=26) con una media de 68,30±6,34 años. Los parámetros biofísicos se determinaron por medio del peso corporal, la estatura e índice de masa corporal. Para la evaluación del metabolismo óseo, se realizó la recolección de la orina matinal en el pre y post-test, utilizando como reactivo el marcador bioquímico de deoxipiridinolina (DPD) que cuantifica la reabsorción ósea. Los resultados mostraron una reducción en la concentración de DPD en el GTC cuando se compararon los grupos (p = 0,007) y la mejora de las variables, peso corporal, IMC y DPD entre el GTC y el GC en el post-test (p = 0,000). Se percibe que el entrenamiento concurrente, para las mujeres adultas mayores fue eficiente en la mejoría de las condiciones de salud del metabolismo óseo.


Subject(s)
Humans , Female , Aged , Bone and Bones/metabolism , Bone Resorption/urine , Exercise/physiology , Bone Density , Time Factors , Body Weight , Biomarkers/urine , Body Mass Index
12.
Acta toxicol. argent ; 26(1): 19-31, mayo 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-973613

ABSTRACT

Los piretroides son insecticidas ampliamente usados no sólo en el ámbito agropecuario y doméstico sino también en salud pública. Una vez absorbidos, son rápidamente metabolizados a compuestos polares eliminados por vía renal. Uno de los metabolitos común a un gran número de piretroides es el ácido 3-fenoxibenzoico (3-PBA) el cual es utilizado como marcador de exposición. Se presenta en este trabajo, la validación de una metodología analítica para la determinación del 3-PBA utilizando QuEChERS acoplado a microextracción líquido-líquido dispersiva con tricloroetileno como disolvente extractivo y cromatografía líquida de alta resolución con detector de foto-arreglo de diodos. La validación se realizó con muestras aisladas de orina de voluntarios adultos de ambos sexos sin exposición conocida y orina sintética. El método resultó lineal en el intervalo 9 μg L-1-79 μg L-1; los límites de detección y cuantificación fueron de 3 μg L-1 y 9 μg L-1, respectivamente. No se observaron señales de interferentes a los tiempos de retención del 3-PBA y del ácido 2-fenoxibenzoico (2-PBA), estándar interno, en las muestras de orina blanco. Las señales cromatográficas en las muestras enriquecidas fueron espectralmente homogéneas. Las precisiones intradiarias (RSDr%) (n= 5) para 9 μg L-1 estuvieron comprendidas entre 9,3%-9,9% y para 27 μg L-1 entre 5,9%-10,6%. Las precisiciones interdiarias (RSDint%) (n=15) para los mismos niveles de concentración fueron de 11,8% y 9,1%, respectivamente. El rango de porcentajes de recuperación para 9 μg L-1 fue de 87%-119% y para 27 μg L-1 de 70%-91%. Se evaluó la estabilidad del analito en la muestra y en el extracto. El analito resultó estable a -20 °C durante 7 días en la muestra y durante 1 día en el extracto. Los valores de incertidumbre relativa e incertidumbre expandida fueron evaluados mediante la ecuación de Horwitz, los resultados obtenidos fueron para el nivel 9 μg L-1 de 33% y 65% y para el nivel 27 μg L-1 de 28% y 55%. La aplicabilidad del método validado fue evaluada con muestras reales de personas sin exposición laboral conocida, quienes declararon haber usado insecticidas piretroides. El método resultó sensible y selectivo.


Pyrethroid insecticides are used not only in the agricultural and domestic environment, but also in public health. Once absorbed, they are rapidly metabolized into polar compounds eliminated by the kidneys. One of the metabolites common to many pyrethroids is 3-phenoxybenzoic acid (3-PBA) which are used to evaluate exposure. We present in this paper the validation of an analytical methodology for the determination of 3-PBA using QuEChERS coupled to dispersive liquid-liquid microextraction with trichloroethylene as an extractive solvent and high-performance liquid chromatography with a photodiode array detector. Validation was carried out with isolated samples of urine from adult volunteers of both sexes without exposure and synthetic urine. The method was linear in the interval 9 μg L-1-79 μg L-1; the limit of detection and quantitation were 3 μg L-1 and 9 μg L-1, respectively. Interfering signals were not observed in the blank urine samples and the chromatographic signals in the enriched samples were spectrally homogeneous. The within-run precision (RSDr%) (n = 5) for 9 μg L-1 were between 9.3%-9.9% and for 27 μg L-1 between 5.9%-10.6%. The between-run precision (RSDint%) (n = 15) for the same concentration levels were 11.8% and 9.1%, respectively. The recovery for 9 μg L-1 ranged from 87%-119% and for 27 μg L-1 from 70%-91 %. The stability of the analyte was evaluated in the sample and in the extract. The analyte in the sample was stable at -20 °C for 7 days and in the extract was stable for 1 day. The values of relative uncertainty and expanded uncertainty obtained by the Horwitz equation were 33% and 65% for 9 μg L-1, and 28% and 55% for 27 μg L-1. The applicability of the validated method was evaluated with real samples of people without known occupational exposure, who declared having used pyrethroid insecticides. The method was sensitive and selective.


Subject(s)
Humans , Pyrethrins/poisoning , Pyrethrins/toxicity , Biomarkers/urine , Biomarkers/analysis , Chromatography, Liquid/methods , Insecticides/poisoning , Insecticides/toxicity
13.
Säo Paulo med. j ; 136(2): 150-156, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-904146

ABSTRACT

ABSTRACT BACKGROUND: Evaluation of sodium and potassium intake can be carried out using different methods. Biological markers are able to capture intra and inter-individual variability and are used as separate measurements of consumption. The aim of this study was to test the validity of a single measurement of urinary sodium and potassium excretion as representative of habitual intake. DESIGN AND SETTING: Longitudinal study, federal university. METHODS: Food consumption data from a sample of adult university students and public servants (25 to 74 years old) were collected through 24-hour records and 12-hour urinary sodium and potassium excretion at five different times over a one-year period. The dietary data were entered into a nutritional research data software system and the sodium and potassium intakes were estimated. The variables were tested for normal distribution using the Kolmogorov-Smirnov test. One-way analysis of variance or the Kruskal-Wallis test was used to evaluate means. Correlations between measurements using Pearson or Spearman coefficients were calculated. The degree of agreement between the five measurements was given by the intraclass correlation coefficient. RESULTS: Satisfactory agreement was found between the five measurements of urinary sodium and potassium excretion over a year, with little variability in consumption. CONCLUSION: A single measurement of urinary sodium and potassium accurately estimated the usual average consumption of these electrolytes. This can be used in population-based studies.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Potassium/urine , Sodium/urine , Sodium, Dietary/administration & dosage , Diet Surveys , Potassium, Dietary/administration & dosage , Feeding Behavior , Energy Intake , Biomarkers/urine , Longitudinal Studies
14.
Rev. méd. Chile ; 146(3): 344-350, mar. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-961399

ABSTRACT

Glomerular filtration rate (GFR) is the best approximation to global renal function and its estimation is of great relevance for clinical practice. Since the measurement of GFR by reference methods is complex, costly and not widely available, its routine evaluation is performed using endogenous biomarkers. Within these, creatinine is the most commonly used. It allows the estimation of GFR by means of its clearance or by formulas based on its concentration on plasma. Creatinine measurement should be performed using enzimatic methods as they confer more accurate values than Jaffe methods, especially for normal and low creatinine levels.


Subject(s)
Humans , Creatinine/urine , Creatinine/blood , Glomerular Filtration Rate , Reference Values , Biomarkers/urine , Biomarkers/blood
15.
Clin. biomed. res ; 38(1): 50-57, 2018.
Article in English | LILACS | ID: biblio-994866

ABSTRACT

Introduction: Homocysteine (Hcy) tissue accumulation occurs in a metabolic disease characterized biochemically by cystathionine ß-synthase (CBS) deficiency and clinically by mental retardation, vascular problems, and skeletal abnormalities. Previous studies indicate the occurrence of DNA damage secondary to hyperhomocysteinemia and it was observed that DNA damage occurs in leukocytes from CBS-deficient patients. This study aimed to investigate whether an oxidative mechanism could be involved in DNA damage previously found and investigated the in vitro effect of N-acety-L-cysteine (NAC) on DNA damage caused by high Hcy levels. Methods: We evaluated a biomarker of oxidative DNA damage in the urine of CBS­deficient patients, as well as the in vitro effect of NAC on DNA damage caused by high levels of Hcy. Moreover, a biomarker of lipid oxidative damage was also measured in urine of CBS deficient patients. Results: There was an increase in parameters of DNA (8-oxo-7,8-dihydro-2'- deoxyguanosine) and lipid (15-F2t-isoprostanes levels) oxidative damage in CBS-deficient patients when compared to controls. In addition, a significant positive correlation was found between 15-F2t-isoprostanes levels and total Hcy concentrations. Besides, an in vitro protective effect of NAC at concentrations of 1 and 5 mM was observed on DNA damage caused by Hcy 50 µM and 200 µM. Additionally, we showed a decrease in sulfhydryl content in plasma from CBS-deficient patients when compared to controls. Discussion: These results demonstrated that DNA damage occurs by an oxidative mechanism in CBS deficiency together with lipid oxidative damage, highlighting the NAC beneficial action upon DNA oxidative process, contributing with a new treatment perspective of the patients affected by classic homocystinuria.


Subject(s)
Humans , Female , Child , Adolescent , Adult , Young Adult , Acetylcysteine/pharmacology , DNA Damage , Oxidative Stress , Cystathionine/metabolism , Deoxyguanosine/urine , Homocystinuria/genetics , Antioxidants/pharmacology , Biomarkers/urine , Case-Control Studies , Creatinine/urine , Comet Assay , Cystathionine/biosynthesis , Cystathionine/blood , Isoprostanes/analysis , Deoxyguanosine/analogs & derivatives , Homocysteine/blood , Homocystinuria/blood
16.
Braz. j. med. biol. res ; 51(4): e6487, 2018. tab, graf
Article in English | LILACS | ID: biblio-889057

ABSTRACT

Contrast-induced acute kidney injury (CI-AKI) is a serious complication of diagnostic coronary angiograph and percutaneous coronary intervention (PCI). However, the exact pathophysiological mechanisms underlying CI-AKI development are largely unknown. The present study examined whether urinary semaphorin 3A levels predict the development of CI-AKI in patients undergoing PCI. This study enrolled 168 patients with stable angina undergoing elective PCI. Serial urine samples, obtained at baseline and 2, 6, 12, 24, 36, and 48 h post-PCI were analyzed by semaphorin 3A and neutrophil gelatinase-associated lipocalin (NGAL) ELISA kit. AKI was defined as an increase in serum creatinine beyond 50% according to the RIFLE classification system. Receiver operator characteristic (ROC) curve analyses identified optimal semaphorin 3A and NGAL values for diagnosing CI-AKI. CI-AKI occurred in 20 of 168 patients. There were no significant differences in the baseline clinical characteristics and angiographic findings between non-AKI patients group and AKI patients group. Both urinary semaphorin 3A and NGAL levels significantly increased at 2 and 6 h post-PCI. ROC analysis showed that the cut-off value of 389.5 pg/mg semaphorin 3A at 2 h post-PCI corresponds to 94% sensitivity and 75% specificity and the cut-off value of 94.4 ng/mg NGAL at 2 h post-PCI corresponds to 74% sensitivity and 82% specificity. Logistic regression showed that semaphorin 3A levels at 2 and 6 h post-PCI were the significant predictors of AKI in our cohort. Urinary semaphorin 3A may be a promising early biomarker for predicting CI-AKI in patients undergoing PCI.


Subject(s)
Humans , Male , Female , Middle Aged , Contrast Media/adverse effects , Semaphorin-3A/urine , Acute Kidney Injury/chemically induced , Acute Kidney Injury/urine , Percutaneous Coronary Intervention/adverse effects , Biomarkers/urine , Predictive Value of Tests , ROC Curve , Acute Kidney Injury/diagnosis
17.
Int. braz. j. urol ; 43(5): 887-895, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-892897

ABSTRACT

ABSTRACT Aim: URS is a very commonly used procedure for treatment of ureter stones. Increased hydrostatic pressure in the collecting system linked to fluids used during the procedure may cause harmful effects on the kidney. The aim of this study is to determine whether the URS procedure has a negative effect on the kidney by investigating NGAL, KIM-1, FABP and Cys C levels in urine. Material and Methods: This study included 30 patients undergoing ureterorenoscopy (URS) for ureter stones. Urine samples were collected 5 times; before the URS procedure (control) and at 1, 3, 5 and 12 hours following the procedure. NGAL, KIM-1, FBAP and Cys C levels were measured in urine and compared with the control values. Results: The NGAL levels in urine before the procedure and at 1, 3, 5 and 12 hours after the procedure were 34.59±35.34; 62.72±142.32; 47.15±104.48; 45.23±163.16 and 44.99±60.79ng/mL, respectively (p=0.001). Similarly, the urinary KIM-1, FABP and Cys C levels were found to increase compared to control values; however this increase did not reach statistical significance (p >0.05). Conclusions: After the URS procedure, there were important changes in NGAL, FABP, KIM-1 and Cys C levels. These changes reached statistical significance for NGAL, but did not reach significance for the other parameters. In conclusion, the URS procedure significantly affects the kidney; however, this effect disappears over time.


Subject(s)
Humans , Male , Female , Adult , Aged , Biomarkers/urine , Ureteral Calculi/surgery , Ureteroscopy/methods , Middle Aged , Ureteral Calculi/urine , Cystatins/urine , Ureteroscopy/adverse effects , Fatty Acid-Binding Proteins/urine , Lipocalin-2/urine , Hepatitis A Virus Cellular Receptor 1/analysis
18.
Int. braz. j. urol ; 43(3): 549-555, May.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-840845

ABSTRACT

ABSTRACT Purpose The aim of this study was to investigate the urinary concentration of epidermal growth factor (EGF) and monocyte chemotactic protein-1 (MCP-1) as reflux nephropathy (RN) biomarkers before and after endoscopic treatment of moderate to severe vesico-ureteral reflux (VUR). Materials and methods A prospective study was carried out on 72 children with moderate to severe VUR. All patients underwent endoscopic treatment using Macroplastique® or Deflux®. Vesico-ureteral reflux resolution was tested by post-operative voiding cystourethrography after 3 months and 2 years. Follow-up urinary samples were collected at that time. Control samples were taken from healthy children with no clinical evidence of renal and bladder disease and no history of UTI. Results In VUR patients, pre-operative urinary EGF levels had a down-regulation when compared to controls. Following successful VUR repair, urinary EGF levels of VUR children progressively increased only at long term follow-up but without returning to normal levels. Urinary MCP-1 levels were highly expressed in pre-operative samples and decreased markedly during early post-operative measurements. Urinary MCP-1 levels did not further decreased in late post-operative follow-up. In fact, these levels remained significantly higher when compared to controls. Conclusions Urinary levels of EGF and MCP-1 may become useful markers for monitoring the response to surgical treatment in VUR patients. Although endoscopic VUR treatment is effective in reducing the inflammatory response, the persistence of significant abnormal levels of inflammatory cytokines (such as urinary MCP-1) at long term follow-up suggests that surgery alone may not completely treat the chronic renal inflammation evidenced in these children.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Urinary Tract Infections/diagnosis , Vesico-Ureteral Reflux/urine , Chemokine CCL2/urine , Epidermal Growth Factor/urine , Urinary Tract Infections/etiology , Vesico-Ureteral Reflux/surgery , Vesico-Ureteral Reflux/complications , Biomarkers/urine , Case-Control Studies , Prospective Studies
19.
Säo Paulo med. j ; 135(2): 133-139, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-846284

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) has become an important public health issue. The socioeconomic burden of renal replacement therapy (RRT) is very high, as is CKD-related cardiovascular mortality and morbidity. Preventive and therapeutic measures only have modest impact and more research is needed. Few cohort studies have been conducted on populations with CKD. Our aim was to establish a cohort that would include more advanced forms of CKD (stages 3 and 4). Data collection was focused on renal and cardiovascular parameters. DESIGN AND SETTING: Prospective cohort study; São Paulo, Brazil. METHODS: Recruitment took place in Hospital das Clínicas, São Paulo, from March 2012 to December 2013. Data relating to medical history, food-frequency questionnaire, anthropometry, laboratory work-up, calcium score, echocardiography, carotid intimal-medial thickness, pulse-wave velocity, retinography and heart rate variability were collected. A biobank including serum, plasma, post-oral glucose tolerance test serum and plasma, urine (morning and 24-hour urine) and DNA was established. RESULTS: 454 participants (60% men and 50% diabetics) of mean age 68 years were enrolled. Their mean estimated glomerular filtration rate-CKD Epidemiology Collaboration was 38 ml/min/1.73 m2. Follow-up is ongoing and the main outcomes are the start of RRT, cardiovascular events and death. CONCLUSIONS: The PROGREDIR cohort is a promising prospective study that will allow better understanding of CKD determinants and validation of candidate biomarkers for the risks of CKD progression and mortality.


RESUMO CONTEXTO E OBJETIVO: A doença renal crônica (DRC) tornou-se um problema de saúde pública. A carga socioeconômica da terapia renal substitutiva é muito elevada, assim como a morbimortalidade cardiovascular associada à DRC. Medidas terapêuticas e preventivas têm impacto parcial e novos estudos são necessários. Há poucos estudos de coorte em populações com DRC. Nosso objetivo foi criar uma coorte que contemplasse formas mais avançadas de DRC (estágios 3 e 4). A coleta de dados foi centrada em parâmetros renais e cardiovasculares. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectivo; São Paulo, Brasil. MÉTODOS: O recrutamento ocorreu entre março de 2012 e dezembro de 2013, no Hospital das Clínicas, em São Paulo. Foram coletados dados de história médica, questionário de frequência alimentar, antropometria, exames laboratoriais, escore de cálcio, ecocardiografia, espessura de camada médio-intimal de carótidas, velocidade de onda de pulso, retinografia e variabilidade de frequência cardíaca. Um biobanco incluindo soro, plasma, soro e plasma pós-teste oral de tolerância à glicose, urina (manhã e 24 horas) e DNA foi estabelecido. RESULTADOS: 454 participantes (60% homens e 50% diabéticos) com idade média de 68 anos foram recrutados. A taxa média de filtração glomerular estimada-Colaboração da Epidemiologia para DRC foi de 38,4 ml/min/1,73 m2. O seguimento está em andamento e os desfechos principais são: início de terapia renal substitutiva, eventos cardiovasculares e óbito. CONCLUSÃO: A coorte PROGREDIR é um estudo prospectivo promissor que permitirá melhor compreensão dos determinantes de DRC e a validação de biomarcadores candidatos para o risco de progressão de DRC e de mortalidade.


Subject(s)
Humans , Male , Female , Adult , Aged , Cardiovascular Diseases/etiology , Cardiovascular Diseases/mortality , Disease Progression , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/mortality , Brazil/epidemiology , Biomarkers/urine , Cardiovascular Diseases/diagnosis , Prospective Studies , Risk Factors , Cohort Studies , Renal Insufficiency, Chronic/diagnosis
20.
An. acad. bras. ciênc ; 89(1): 231-245, Jan,-Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-886627

ABSTRACT

ABSTRACT Bone turnover markers (BTMs) are product of bone cell activity and are generally divided in bone formation and bone resorption markers. The purpose of this review was to structure the available information on the use of BTMs in studies on small ruminants, especially for monitoring their variations related to diet, exercise, gestation and metabolic lactation state, circadian and seasonal variations, and also during skeletal growth. Pre-clinical and translational studies using BTMs with sheep and goats as animal models in orthopaedic research studies to help in the evaluation of the fracture healing process and osteoporosis research are also described in this review. The available information from the reviewed studies was systematically organized in order to highlight the most promising BTMs in small ruminant research, as well as provide a wide view of the use of sheep and goat as animal models in orthopaedic research, type of markers and commercial assay kits with cross-reactivity in sheep and goat, method of sample and storage of serum and urine for bone turnover markers determination and the usefulness and limitations of bone turnover markers in the different studies, therefore an effective tool for researchers that seek answers to different questions while using BTMs in small ruminants.


Subject(s)
Animals , Goats/physiology , Sheep/physiology , Bone Remodeling/physiology , Models, Animal , Bone Resorption/physiopathology , Bone Resorption/metabolism , Biomarkers/urine , Biomarkers/blood , Fracture Healing/physiology
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