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1.
Oncología (Ecuador) ; 31(3): 176-187, 30-diciembre-2021.
Article in Spanish | LILACS | ID: biblio-1352463

ABSTRACT

Introducción: La Nefropatía Inducida por Contraste (NIC) es una complicación causada por la ad-ministración intravenosa de medios de contrastes para estudios imagenológicos, lo cual incrementa la morbi-mortalidad y costos hospitalarios. La incidencia oscila el 2% en personas sin factores de riesgo, pudiendo llegar hasta el 25 a 50% cuando se asocian factores predisponentes. El objetivo de este estudio fue evaluar el desarrollo de NIC en pacientes oncológicos y no oncológicos hospitaliza-dos, sus características clínicas, prevalencia, factores asociados y aplicación de una escala de riesgo pre exposición. Metodología: Se realizó un estudio de casos y controles en los Hospitales "Abel Gilbert Pontón" y el Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" - Guayaquil en el período Abril a Septiembre del 2020. La muestra fue no probabilística, de pacientes con y sin diagnóstico oncológico. En ambos grupos se requirió una tomografía contrastada. Se registró edad, sexo, tipo de cáncer, presencia de Diabetes Tipo 2 (DMT2), Hipertensión arterial, creatinina basal y a las 48 horas. Se usó una escala de preexposición para NIC. Se compara las prevalencias con Chi2, y las asociaciones con Odds Ratio. Resultados: Fueron 100 casos y 100 controles. La prevalencia de NIC fue 28% en no oncológicos y 22% en oncológicos (P=0.33), el factor de riesgo asociado fue la Diabetes Mellitus tipo 2 (OR 2.19 [IC95% 1.0007 ­ 4.808; P=0.0498). El valor de creatinina previa no tuvo efecto sobre el desenlace de nefropatía. La distribución de categorías pre exposición no mostró diferencias significativas entre los pacientes que desarrollaron NIC en relación con los que no desarrollaron (P=0.063). Conclusión: El desarrollo de NIC no se ve influenciado por edad, sexo, paciente e HTA, pero si se ve asociado a la presencia de DM2. La estratificación de riesgo pre exposición no fue de utilidad en este caso, su distribución fue similar en pacientes con o sin NIC


Introduction: Contrast Induced Nephropathy (CIN) is a complication caused by intravenous administration of contrast media for imaging studies, which increases morbidity and mortality and hospital costs. The incidence ranges from 2% in people without risk factors, and can reach up to 25 to 50% when predisposing factors are associated. The objective of this study was to evaluate the develop-ment of CIN in hospitalized cancer and non-cancer patients, their clinical characteristics, prevalence, associated factors, and the application of a pre-exposure risk scale. Methodology: A case-control study was carried out at the "Abel Gilbert Pontón" Hospitals and the "Dr. Juan Tanca Marengo "- Guayaquil in the period April to September 2020. The sample was non-probabilistic, of patients with and without oncological diagnosis. Contrast tomography was required in both groups. Age, sex, type of cancer, presence of Type 2 Diabetes (T2DM), arterial hypertension, creatinine at baseline and at 48 hours were recorded. A pre-exposure scale for CIN was used. The prevalences are compared with Chi2, and the associations with Odds Ratio. Results: There were 100 cases and 100 controls. The prevalence of CIN was 28% in non-cancer patients and 22% in oncological patients (P = 0.33). The associated risk factor was Type 2 Diabetes Mellitus (OR 2.19 [95% CI 1.0007 - 4.808; P = 0.0498). The previous creatinine value had no effect on the outcome of nephropathy. The distribution of pre-exposure categories did not show significant differences between the patients who developed CIN in relation to those who did not develop (P = 0.063). Conclusion: The development of CIN is not influenced by age, sex, patient and hypertension, but is associated with the presence of DM2. Pre-exposure risk stratification was not useful in this case, its distribution was similar in patients with or without CIN


Subject(s)
Humans , Adult , Middle Aged , Contrast Media , Kidney Diseases , Tomography , Risk Factors , Creatinine
2.
Arch. argent. pediatr ; 119(4): e335-e339, agosto 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281757

ABSTRACT

La nefropatía por inmunoglobulina M (NIgM) es una glomerulopatía idiopática caracterizada por depósitos mesangiales globales y difusos de IgM. Se realizó un estudio retrospectivo de las características clínicas e histopatológicas de los pacientes con NIgM atendidos en nuestro servicio. De 241 biopsias renales, 21 correspondieron a NIgM (8,7 %). Se incluyeron 18 pacientes (14 de sexo femenino, mediana de edad: 3,08 años). Se excluyó a 1 paciente por enfermedad sistémica asociada y a 2 por seguimiento menor a 1 año. Catorce pacientes se manifestaron con síndrome nefrótico (SN) y 4 con proteinuria aislada o asociada a hematuria. En la microscopia óptica, 13 presentaron hiperplasia mesangial, y 5 esclerosis focal y segmentaria. De los pacientes con SN, 7 fueron corticorresistentes, 4 corticodependientes y 3 presentaban recaídas frecuentes. Todos los pacientes con SN y 1 con proteinuria-hematuria recibieron inmunosupresores; los 18 pacientes recibieron, además, antiproteinúricos. Luego de 5,2 años (2-17,5) de seguimiento, 6 pacientes evolucionaron a enfermedad renal crónica


Immunoglobulin M nephropathy (IgMN) is an idiopathic glomerulopathy characterized by diffuse global mesangial deposits of IgM. We retrospectively studied the clinical and histopathological characteristics of the patients with IgMN seen in our service. Of 241 renal biopsies, 21 corresponded to IgMN (8.7 %). One patient was excluded due to associated systemic disease and 2 due to follow-up less than 1 year, 18 were included (14 girls, median age 3.08 years). Fourteen manifested with nephrotic syndrome (NS) and the remaining with proteinuria (isolated or associated with hematuria). On light microscopy, 13 had hyperplasia with mesangial expansion and 5 had focal and segmental sclerosis. Of the patients with NS, 7 were steroid-resistant, 4 steroid-dependent, and 3 frequent relapsers. All patients with NS and 1 with proteinuria-hematuria received immunosuppressants; the 18 patients also received antiproteinuric drugs. After 5.2 years (2-17.5) of follow-up, 6 patients developed chronic kidney disease.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Immunoglobulin M , Nephrotic Syndrome/pathology , Nephrotic Syndrome/therapy , Kidney Diseases , Nephrotic Syndrome/diagnosis
3.
Arq. bras. cardiol ; 116(6): 1048-1056, Jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1278321

ABSTRACT

Resumo Fundamento A nefropatia induzida por contraste (NIC) está associada a um risco aumentado de eventos cardiovasculares adversos maiores (ECAM), e a associação entre NIC e mecanismos oxidativos está bem documentada. Objetivo Este estudo visou avaliar a relação entre os níveis séricos da molécula de lesão renal-1 (KIM-1) e a NIC em pacientes idosos com infarto do miocárdio sem supradesnivelamento do segmento ST (IAMSSST). Métodos O presente estudo incluiu um total de 758 pacientes com IAMSSST que foram submetidos a intervenção coronária percutânea (ICP); 15 desenvolveram NIC após a ICP e outros 104 constituíram o grupo controle, pareado por idade > 65 anos. Foram registrados os valores laboratoriais desde a linha de base até o período entre 48 e 72 horas e os achados clínicos. Os pacientes foram acompanhados durante um ano. Foram considerados significativos valores de p < 0,05. Resultados A NIC foi observada em 12,60% dos pacientes. A KIM-1 sérica foi significativamente mais alta no grupo com NIC que no grupo sem NIC (14,02 [9,53 - 19,90] versus 5,41 [3,41 - 9,03], p < 0,001). O escore Mehran foi significativamente mais alto no grupo com NIC do que no grupo sem NIC (14 [5 - 22] versus 5 [2 - 7], p = 0,001). Os ECAM foram significativamente maiores no grupo com NIC do que no grupo sem NIC (7 [46,70%] versus 12 [11,50%], p = 0,001). A análise de regressão logística multivariada mostrou que o nível de KIM-1 basal (OR = 1,652, IC 95%: 1,20 - 2,27, p = 0,002) e o escore Mehran (OR = 1,457, IC 95%: 1,01 - 2,08, p = 0,039) foram preditores independentes da NIC em pacientes idosos com IAMSSST. Conclusão A concentração sérica basal de KIM-1 e o escore de Mehran são preditores independentes de NIC em pacientes idosos com IAMSSST. Além disso, todas as causas de mortalidade, morte cardiovascular, reinfarto do miocárdio, acidente vascular cerebral e MACE foram significativamente maiores no grupo CIN no acompanhamento de um ano. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Abstract Background Contrast-induced nephropathy (CIN) is associated with an increased risk of major adverse cardiovascular events (MACE), and the association between CIN and oxidative mechanisms is well documented. Objective This study aimed to evaluate the relationship between serum levels of kidney injury molecule-1 (KIM-1) and CIN in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods This study included a total of 758 patients with NSTEMI, who underwent percutaneous coronary intervention (PCI); 15 developed CIN after PCI, and another 104 were the control group, matched for age > 65 years. Baseline to 48-to-72-hour laboratory values and clinical outcomes were recorded. Patients were followed during one year. P values of < 0.05 were considered significant. Results CIN was observed in 12.60% of the patients. Serum KIM-1 was significantly higher in the CIN group than in the non-CIN group (14.02 [9.53 - 19.90] vs. 5.41 [3.41 - 9.03], p < 0.001). The Mehran score was significantly higher in the CIN group than in the non-CIN group (14 [5 - 22] vs. 5 [2 - 7], p = 0.001). MACE were significantly higher in the CIN group than in the non-CIN group (7 [46.70%] vs. 12 [11.50%], p = 0.001). Multivariate logistic regression analysis showed that baseline KIM-1 level (OR = 1.652, 95% CI: 1.20 - 2.27, p = 0.002) and Mehran score (OR = 1.457, 95% CI: 1.01 - 2.08, p = 0.039) were independent predictors of CIN in elderly patients with NSTEMI. Conclusion Baseline serum KIM-1 concentration and Mehran score are independent predictors of CIN in elderly patients with NSTEMI. Additionally, all-cause mortality, cardiovascular death, myocardial reinfarction, stroke, and MACE were significantly higher in the CIN group at one-year follow-up. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Subject(s)
Humans , Aged , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Kidney Diseases , Risk Factors , Contrast Media , Kidney
4.
Rev. colomb. anestesiol ; 49(2): e300, Apr.-June 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1251499

ABSTRACT

Abstract Introduction Although the use of matching techniques in observational studies has been increasing, it is not always adequate. Clinical trials are not always feasible in critically ill patients with renal outcomes, and observational studies are an important alternative. Objective Through a scoping review, determine the available evidence on the use of matching methods in studies involving critically ill patients and renal outcome assessments. Methods Medline, Embase, and Cochrane databases were used to identify articles published between 1992 and week 10 of 2020. Studies had to assess different exposures in critically ill patients with renal outcomes using propensity score matching. Results Most publications are cohort studies 94 (94.9%), with five (5.1%) reporting cross-sectional studies. The main pharmacological intervention was the use of antibiotics in seven studies (7.1%) and the main risk factor studied was renal injury prior to ICU admission in 10 studies (10.1%). The use of standardized means to assess balance of baseline characteristics was found in only 28 studies (28.2%). Most studies 95 (96%) used logistic regression to calculate the propensity score. Conclusion Major inconsistencies were observed regarding the use of methods and reporting of findings. Considerations related to the use of propensity score matching methods and reporting of findings are summarized.


Resumen Introducción El uso de técnicas de emparejamiento en estudios observacionales ha ido en aumento y no siempre se usa adecuadamente. Los experimentos clínicos no siempre son factibles en los pacientes críticos con desenlaces renales, por lo que los estudios observacionales son una alternativa importante. Objetivo Mediante una revisión de alcance, determinar la evidencia disponible sobre la utilización de los métodos de emparejamiento en los estudios que incluyen pacientes críticamente enfermos y que evalúan desenlaces renales. Métodos Se utilizaron las bases de datos de Medline, Embase, y Cochrane para identificar artículos publicados entre 1992 y 2020 hasta la semana 10, que estudiaran diferentes exposiciones en el paciente crítico con desenlaces renales y utilizaran métodos de emparejamiento por propensión. Resultados La mayoría de las publicaciones (94) son estudios de Cohorte (94,9 %), cinco estudios (5,1 %) correspondieron a cross-secctional. La principal intervención farmacológica fue el uso de antibióticos en siete estudios (7,1 %) y el principal factor de riesgo estudiado fue la lesión renal previa al ingreso a UCI en diez estudios (10,1 %). El balance entre las características de base evaluado mediante medias estandarizadas se encontró solo en 28 estudios (28,2 %). La mayoría de los estudios 95 (96 %) utilizaron regresión logística para calcular el índice de propensión. Conclusiones Se observaron grandes inconsistencias en la utilización de los métodos y en el informe de los hallazgos. Se hace un resumen de los aspectos por considerar en la utilización de los métodos y reporte de los hallazgos con el emparejamiento por índice de propensión.


Subject(s)
Humans , Critical Illness , Renal Replacement Therapy , Critical Care , Libraries, Digital , Propensity Score , Acute Kidney Injury , Kidney Diseases
5.
Rev. bras. med. esporte ; 27(2): 147-150, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1280062

ABSTRACT

ABSTRACT Introduction: The indiscriminate use of androgenic steroids may have deleterious effects on human tissue. Objectives: Evaluate the effects of chronic administration of the steroid nandrolone decanoate (DECA) on autonomic cardiovascular modulation, kidney morphometry and the association between these variables in Wistar rats subjected to physical training with swimming. Methods: Thirty-two male Wistar rats aged 20 weeks were distributed among four experimental groups according to the training received: sedentary control (SC), sedentary treated with DECA (SD), trained control (TC) and trained treated with DECA (TD). The hemodynamic parameters, including blood pressure and variations in systolic blood pressure (SBPV) and diastolic blood pressure (DBPV), and kidney morphometry were evaluated. The level of significance adopted was 5%. Results: The SD group had higher baseline SBP and DBP values when compared to the SC, TC and TD groups, which were similar to each other. The rats in the SD group had higher systolic blood pressure (SBPV) and diastolic blood pressure (DBPV) variation values and higher absolute and normalized values in the LF band of the DBPV when compared to the animals in the SC, TC and TD groups. The animals in the SD group had a significantly higher rate of kidney fibrosis compared to the SC, TC and TD groups. There were no significant differences between the sympathetic modulation of SBPV through the LF component and kidney fibrosis. Conclusions: Physical training with swimming was effective in preventing the increase in blood pressure levels and lowering the occurrence of kidney fibrosis in animals treated with anabolic steroids. Level of Evidence IV; Series of cases .


RESUMEN Introducción: El uso indiscriminado de esteroides androgénicos puede tener consecuencias nocivas para el organismo. Objetivo: Evaluar los efectos de la administración crónica del esteroide decanoato de nandrolona (DECA) en ratones Wistar sometidos a entrenamiento físico con natación, sobre la modulación autonómica cardiovascular, morfometría renal y asociación entre esas variables. Métodos: Fueron utilizados 32 ratones Wistar machos con edad de 20 semanas, distribuidos en 4 grupos experimentales de acuerdo con el tratamiento recibido: sedentarios controles (SC), sedentarios que recibieron el DECA (SD), entrenados controles (EC) y entrenados que recibieron el DECA (ED). Se evaluaron parámetros hemodinámicos, como presión arterial y variación de la presión arterial sistólica (VPAS) y diastólica (VPAD) y morfometría renal. El nivel de significancia adoptado fue de 5%. Resultados: El grupo SD presentó valores basales mayores de PAS y PAD cuando comparados a los grupos SC, EC y ED, los cuales fueron semejantes entre sí. Los animales del grupo SD tuvieron valores mayores de la variancia de VPAS y VPAD y valores absolutos mayores y normalizados de la banda LF de la VPAD, en comparación con los animales de los grupos SC, EC y ED. El grupo SD tuvo tasa significativamente mayor de fibrosis renal en comparación con los animales de los grupos SC, EC y ED. No se evidenciaron diferencias considerables entre la modulación simpática de la VPAS a través del componente LF y fibrosis renal. Conclusiones: El entrenamiento físico con natación fue efectivo en prevenir el aumento de niveles presóricos y disminuir la ocurrencia de fibrosis renal en animales tratados con esteroide anabolizante. Nivel de Evidencia IV; Serie de casos .


RESUMO Introdução: O uso indiscriminado de esteroides androgênicos pode ter consequências deletérias no organismo. Objetivo: Avaliar os efeitos da administração crônica do esteroide decanoato de nandrolona (DECA) em ratos Wistar submetidos a treinamento físico com natação sobre a modulação autônoma cardiovascular, morfometria renal e associação entre essas variáveis. Métodos: Foram utilizados 32 ratos Wistar machos com idade de 20 semanas, distribuídos em 4 grupos experimentais de acordo com o tratamento recebido: sedentários controles (SC), sedentários que receberam o DECA (SD), treinados controles (TC) e treinados que receberam o DECA (TD). Avaliaram-se parâmetros hemodinâmicos, como pressão arterial e variação da pressão arterial sistólica (VPAS) e diastólica (VPAD) e morfometria renal. O nível de significância adotado foi de 5%. Resultados: O grupo SD apresentou valores basais maiores de PAS e PAD quando comparado aos grupos SC, TC e TD, os quais foram semelhantes entre si. Os animais do grupo SD tiveram valores maiores da variância da VPAS e VPAD e valores absolutos maiores e normalizados da banda LF da VPAD, em comparação com os animais dos grupos SC, TC e TD. O grupo SD teve taxa significativamente maior de fibrose renal em comparação com os animais dos grupos SC, TC e TD. Não se evidenciaram diferenças consideráveis entre a modulação simpática da VPAS através do componente LF e fibrose renal. Conclusões: O treinamento físico com natação foi efetivo em prevenir o aumento de níveis pressóricos e diminuir a ocorrência de fibrose renal em animais tratados com esteroide anabolizante. Nível de Evidência IV; Série de casos .


Subject(s)
Animals , Male , Rats , Autonomic Nervous System/drug effects , Swimming , Cardiovascular System/drug effects , Nandrolone Decanoate/adverse effects , Anabolic Agents/adverse effects , Kidney Diseases/chemically induced , Physical Conditioning, Animal , Rats, Wistar , Disease Models, Animal , Arterial Pressure/drug effects , Kidney Diseases/prevention & control
6.
Arch. argent. pediatr ; 119(5): e480-e486, oct. 2021. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1292126

ABSTRACT

El bajo peso al nacer (BP, < 2500 g), la restricción del crecimiento intrauterino (RCIU) y el parto prematuro (PP, < 37 semanas de gestación) son los factores clínicos más habituales para la programación alterada del número de nefronas y se asocian con un mayor riesgo de hipertensión, proteinuria y enfermedad renal futura en la vida. En la actualidad la evaluación indirecta del número total de nefronas mediante el uso de marcadores en el período posnatal representa el enfoque principal para evaluar el riesgo de evolución futura de los trastornos renales en los recién nacidos con BP, RCIU o PP.Se presentan los avances en la investigación en animales y sobre marcadores bioquímicos en humanos, y recomendaciones para la prevención del daño renal preconcepcional, incluidos los factores sociales y las enfermedades crónicas. La evidencia demuestra que la restricción de crecimiento y la prematuridad solas son capaces de modular la nefrogénesis y la función renal y, cuando son concurrentes, sus efectos tienden a ser acumulativos.


A low birth weight (LBW, < 2500 g), intrauterine growth restriction (IUGR), and preterm birth (PB, < 37 weeks of gestational age) are the most common clinical factors for an altered programming of nephron number and are associated with a greater risk for hypertension, proteinuria, and kidney disease later in life. At present, an indirect assessment of total nephron number based on postnatal markers is the most important approach to evaluate the risk for future kidney disorders in newborn infants with a LBW, IUGR or PB.Here we describe advances made in animal experiments and biochemical markers in humans, and the recommendations for the prevention of preconception kidney injury, including social factors and chronic diseases. According to the evidence, IUGR and prematurity alone can modulate nephrogenesis and kidney function, and, if occurring simultaneously, their effects tend to be cumulative.


Subject(s)
Humans , Animals , Female , Pregnancy , Infant, Newborn , Adult , Premature Birth , Kidney Diseases/etiology , Kidney Diseases/epidemiology , Infant, Low Birth Weight , Gestational Age , Kidney , Nephrons
7.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 61-66, 20210000.
Article in Spanish | LILACS | ID: biblio-1178623

ABSTRACT

Introducción: Identificar factores de riesgo para pérdida de la sensibilidad protectora es fundamental para prevenir el Pie Diabético. Objetivos: Analizar los factores de riesgo asociados a la pérdida de la sensibilidad protectora en pacientes con diabetes mellitus y sus complicaciones. Materiales y métodos: diseño observacional, de casos y controles. Se incluyó pacientes de ambos sexos, con diabetes mellitus; ≥ 18 años, a quienes se realizó el Test de monofilamento en la Unidad Multidisciplinaria Hospital de Clínicas, de enero 2014 a julio 2019. Factores de riesgo considerados: edad, años de diabetes mellitus, Hba1c, HTA, dislipidemia; se tuvo en cuenta las complicaciones: retinopatía, enfermedad arterial periférica = ITB <0,9 derecho e izquierdo, enfermedad renal= ClCr <60 ml/min/m2 (MDRD), amputaciones (mayores y menores). Resultados: De 100 pacientes; 33% con pérdida de la sensibilidad protectora; edad 59±9,7 años; 55% masculino. Factores de riesgo: edad: 57,7±1,0 años sin pérdida de la sensibilidad protectora y 61,2±9 años con pérdida de la sensibilidad protectora, p=0.08; años de diabetes mellitus 9,4±8,4 vs 11,5± 8,7 p=0,20; HbA1C 8,8± 2,7% vs 9,1±2% p=0,50; HTA 63,5% vs 75,6% p=0,20; dislipidemias 75,9% vs 57,69%, p=0,09; complicaciones con pérdida de la sensibilidad protectora: retinopatía 88% vs 57,5% OR=1,67, p=0,02. ClCr 84±40,3 ml/min vs 90,9±30,4, p=0,40. Enfermedad arterial periférica derecha 27,78% vs 11,1% OR=0,1, p=0,10; enfermedad arterial periférica izquierda 20% vs 7 15,5% OR=1 p=0,60; amputación 17,5% vs 7,9% OR=2,01, p=0,06. Conclusión: con pérdida de la sensibilidad protectora: la edad, años de diabetes mellitus fueron mayores. HTA fue más frecuente y Hba1c más elevada; nefropatía, enfermedad arterial periférica y amputación con mayor frecuencia, todas no significativas. La retinopatía fue más frecuente en forma significativa.


Introduction: Identifying risk factors for loss of protective sensitivity is essential to prevent Diabetic Foot. Objectives: To analyze the risk factors associated with the loss of protective sensitivity in patients with diabetes mellitus and its complications. Materials and methods: observational, case-control design. Patients of both sexes were included, with diabetes mellitus; ≥ 18 years, who underwent the Monofilament Test in the Multidisciplinary Unit Hospital de Clínicas, from January 2014 to July 2019. Risk factors considered: age, years of diabetes mellitus, Hba1c, HT, dyslipidemia; Complications were taken into account: retinopathy, peripheral arterial disease = ABI <0.9 right and left, kidney disease = CrCl <60 ml / min / m2 (MDRD), amputations (major and minor). Results: Of 100 patients; 33% with loss of protective sensitivity; age 59 ± 9.7 years; 55% male. Risk factors: age: 57.7 ± 1.0 years without loss of protective sensitivity and 61.2 ± 9 years with loss of protective sensitivity, p = 0.08; years of diabetes mellitus 9.4 ± 8.4 vs 11.5 ± 8.7 p = 0.20; HbA1C 8.8 ± 2.7% vs 9.1 ± 2% p = 0.50; HTN 63.5% vs 75.6% p = 0.20; dyslipidemias 75.9% vs 57.69%, p = 0.09; complications with loss of protective sensitivity: retinopathy 88% vs 57.5% OR = 1.67, p = 0.02. CrCl 84 ± 40.3 ml / min vs 90.9 ± 30.4, p = 0.40. Right peripheral arterial disease 27.78% vs 11.1% OR = 0.1, p = 0.10; left peripheral arterial disease 20% vs 7 15.5% OR = 1 p = 0.60; 17.5% amputation vs 7.9% OR = 2.01, p = 0.06. Conclusion: with loss of protective sensitivity: age, years of diabetes mellitus were older. HBP was more frequent and Hba1c higher; nephropathy, peripheral arterial disease and amputation with greater frequency, all not significant. Retinopathy was significantly more frequent.


Subject(s)
Diabetic Foot , Diabetes Mellitus , Dyslipidemias , Peripheral Arterial Disease , Amputation , Risk Factors , Kidney Diseases
8.
Infectio ; 25(1): 45-48, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1154401

ABSTRACT

Resumen La vasculitis leucocitoclastica es una patologìa que compromete los vasos pequeños y cuya causa predominantemente se ha descrito como idiopatica. Se presenta el caso de una mujer de 78 años hipertensa, diabética y con enfermedad renal crónica en estadio 5, que presentó lesiones limitadas a la piel posterior a la administración de oxacilina para manejo de bacteremia por SAMS. La presentación clínica se basó en purpuras palpables predominantemente en miembros inferiores y lesiones dolorosas coalescentes que formaban ampollas de contenido hemorrágico. Estas lesiones resolvieron gradualmente después del cambio de la terapia mencionada anteriormente. La biopsia fue compatible con vasculitis leucocitoclástica, con paraclínicos que descartaron causas infecciosas y autoinmunes.


Abstract Leukocytoclastic vasculitis is a pathology that involves small vessels and whose cause has been predominantly described as idiopathic. The clinical case of a 78-year-old woman with hypertension, diabetic and chronic stage 5 kidney disease, who presented limited skin lesions after administration of oxacillin for management of bacteremia by MSSA. The clinical presentation consisted on palpable purpura predominantly in the lower limbs and painful coalescent lesions that formed blisters of hemorrhagic content. Lesions gradually resolved after the change of the therapy mentioned above. The biopsy was compatible with leukocytocastic vasculitis, with paraclinics who ruled out infectious and autoimmune causes.


Subject(s)
Humans , Male , Aged , Vasculitis, Leukocytoclastic, Cutaneous , Oxacillin , Blister , Renal Insufficiency, Chronic , Kidney Diseases
9.
Int. j. med. surg. sci. (Print) ; 8(1): 1-13, mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1151571

ABSTRACT

Las complicaciones cardiovasculares representan la principal causa de morbilidad y mortalidad en pacientes con enfermedad renal crónica, por lo que el objetivo de este artículo es demostrar la influencia de la permanencia de la fístula arteriovenosa sobre variables eco cardiográficamente mensuradas en el corazón izquierdo. Para ello, se definió un estudio multivariable, longitudinal, prospectivo y controlado de grupos independientes después de una intervención que incluyó 39 pacientes a los que se le cerró el angioacceso (grupo de estudio) y 42 que no fueron expuestos a la cirugía (grupo control). Ambos grupos exhibían trasplante renal funcionante. Los principales resultados surgenal comparar el predominio entre el grupo de estudio con el de control, la edad promedio; 45,6 y 44,1 años, el sexo masculino, 24 (60%) y 23 (53,5%) y el color de la piel blanca; 33 (82,5%) y 32 (74,4%). La etiología de la nefropatía originaria más frecuente fue la nefropatía vascular hipertensiva; 12 (30%) vs 14 (32,6%). Entre las manifestaciones clínicas, en el grupo de estudio se evidenció remisión de las palpitaciones y la disnea de esfuerzo. Respecto a la tensión arterial, para la sistólica oscilaba; de 123 ±13,4 a 120,5 ±9,2 vs de 125,6 ±8,4 a 128 ±8,3 mm Hg (p= 0,000), mientras la diastólica variaba de; 76,8 ±7,5 a 76,3 ±6,2 vs 78,6 ±4,9 a 82,4 ±3,9 mm Hg (p= 0,000). El hematocrito comportaba valores equivalentes; 0,43 ±0,06 y 0,45 ±0,06 vs 0,42 ±0,05 y 0,42 ±0,06 l/l (p= 0,035) y la creatinina sérica mostró descenso en los pacientes intervenidos de; 106,8 ± 26,2 hasta 99,8 ±23,9 µ Mol/l vs 114 ±27,8 a 120,3 ±31 µ Mol/l (p= 0,002). Las variables ecocardiográficas mensuradas comparativamente según la localización de los angioaccesos a nivel del codo izquierdo; diámetro del ventrículo izquierdo: 3,12 ±4,08 vs 1,48 ±3,46 mms (p=0,001), fracción de eyección del ventrículo izquierdo: 2,99 ±5,47 vs -1,98 ±6,23 % (p=0,018) y el volumen telediastólico: -23 ±33,41 vs 10,86 ±36,87 ml (p=0,006). El codo contralateral revelaba; para la fracción de eyección del ventrículo izquierdo: 3,32 ±3,42 vs -2,18 ±4,78 % (p=0,037) y para el gasto cardíaco: -1,29 ±0,88 vs -0,26 ±0,86 l/min (0,020). Las conclusiones demuestran que el cierre del angioacceso a pacientes con trasplante renal funcionante respecto a los no intervenidos, contribuye a la regresión de las alteraciones morfológicas y hemodinámicas constatadas por ecocardiografía transtorácica en el corazón izquierdo a nivel de las diferentes localizaciones de los accesos vasculares.


Cardiovascular complications represent the main cause of morbidity and mortality in patients with chronic renal disease, so the objective of this article is to demonstrate the influence of the patency of the arteriovenous fistula on echocardiographic variables measured in the left heart. For this, a multivariate study, longitudinal, prospective and controlled study of independent groups after an intervention that included 39 patients who had their angioaccess closed (study group) and 42 who were not exposed to surgery (control group). Both groups exhibited functional kidney transplantation. The main results emerge when comparing the prevalence between the study group and the control group, the average age; 45.6 and 44.1 years, the male sex, 24 (60%) and 23 (53.5%) and the white skin color; 33 (82.5%) and 32 (74.4%). The most frequent etiology of the original nephropathy was hypertensive vascular nephropathy; 12 (30%) vs 14 (32.6%). Among the clinical manifestations, remission of palpitations and dyspnea on exertion were evidenced in the study group. With regard to blood pressure, for the systolic it ranged from 123 ±13.4 to 120.5 ±9.2 vs. 125.6 ±8.4 to 128 ±8.3 mmHg (p= 0.000), while the diastolic varied from; 76.8 ±7.5 to 76.3 ±6.2 vs. 78.6 ±4.9 to 82.4 ±3.9 mmHg (p= 0.000). The hematocrit had equivalent values; 0.43 ±0.06 and 0.45 ±0.06 vs 0.42 ±0.05 and 0.42 ±0.06 l/l (p= 0.035) and the serum creatinine showed decrease in the operated patients from; 106.8 ±26.2 to 99.8 ±23.9 µMol/l vs 114 ±27.8 to 120.3 ±31 µMol/l (p= 0.002). The echocardiographic variables measured comparatively according to the location of the angioaccesses at the left elbow level; diameter of the left ventricle: 3.12 ±4.08 vs 1.48 ±3.46 mms (p=0.001), ejection fraction of the left ventricle: 2.99 ±5.47 vs -1.98 ±6.23 % (p=0.018) and the telediasolic volume: -23 ±33.41 vs 10.86 ±36.87 ml (p=0.006). The contralateral elbow revealed; for the left ventricular ejection fraction: 3.32 ±3.42 vs -2.18 ±4.78 % (p=0.037) and for cardiac output: -1.29 ±0.88 vs -0.26 ±0.86 l/min (0.020). The conclusions show that the our study has shown that closing the angioaccess to patients with functioning renal transplants with respect to those not operated, contributes to the regression of morphological and hemodynamic alterations observed by transthoracic echocardiography in the left heart at the different locations of the vascular accesses.


Subject(s)
Humans , Male , Female , Arteriovenous Fistula/physiopathology , Renal Dialysis , Renal Insufficiency, Chronic , Longitudinal Studies , Arteriovenous Fistula/surgery , Kidney Transplantation/adverse effects , Kidney Diseases/complications
10.
Int. braz. j. urol ; 47(2): 464-467, Mar.-Apr. 2021.
Article in English | LILACS | ID: biblio-1154453

ABSTRACT

ABSTRACT Purpose: To report a case of successful removal of right staghorn renal calculi in a 3-year-old girl with Arnold-Chiari malformation and multiple urogenital anomalies. Case report: A 3-year-old female child with the diagnosis of Arnold-Chiari type 2 malformation was referred to our clinic due to presence of 9 kidney stones with a total volume of 10743mm3. The total of the longest diameters of all stones was calculated as 11.4cm. The patient had a urogenital septum, bifid bladder, and duplicated collecting system on the right side. An 18F Amplatz sheath was placed and mini-percutaneous nephrolithotomy was performed successfully by laser and pneumatic lithotripter. Any residual urinary tract stones or urinary tract infection were not detected during the 6th-month follow-up. Conclusion: Urolithiasis requires a thorough understanding of the underlying causes, as well as an effective and minimally invasive treatment. It is important for urologists to understand the complexity of the optimal stone management in pediatric patients in order to maximize treatment efficacy and minimize morbidity. We conclude that it is essential to treat urolithiasis in a single session in children with urogenital anomalies and accompanying congenital anomalies who have past surgical history.


Subject(s)
Humans , Child , Nephrostomy, Percutaneous , Kidney Calculi/surgery , Kidney Calculi/diagnostic imaging , Solitary Kidney , Nephrolithotomy, Percutaneous , Kidney Diseases , Retrospective Studies , Treatment Outcome , Kidney/surgery , Kidney/diagnostic imaging
11.
Rev. cuba. invest. bioméd ; 40(1): e599, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289439

ABSTRACT

Introducción: Las infecciones de tracto urinario se encuentran entre las infecciones de mayor prevalencia en la parte clínica. Son un problema de salud global y se pueden presentar con o sin síntomas. Los agentes bacterianos aislados en mayor frecuencia son Escherichia coli, Klebsiella spp y Proteus spp. Objetivo: Caracterizar las infecciones de tracto urinario producidas por enterobacterias productoras de betalactamasas de espectro extendido en pacientes hospitalizados, Lima 2016-2018. Métodos: Se realizó un estudio descriptivo en 2 instituciones prestadoras de salud, en Lima, Perú, durante el periodo 2016-2018, a partir de los aislamientos de patógenos blee asociados a infecciones de tracto urinario. Se tuvieron en cuenta variables sociodemográficas, enfermedades asociadas, agentes aislados, tratamiento y respuesta clínica. Resultados: Se obtuvo un registro de 117 pacientes, con edad promedio de 58,18 ± 11,8 años; 65,0 por ciento fueron mujeres y 89,74 por ciento provenían del área urbana de Lima. Las enfermedades asociadas más frecuentes fueron diabetes (39,3 por ciento) y enfermedad renal moderada o grave (12,8 por ciento), con índice de Charlson medio de 2,70 ± 1,21. Los agentes aislados más comunes fueron Escherichia coli (92,3 por ciento), Klebsiella spp (6,0 por ciento) y Proteus spp (1,7 por ciento). Los tratamientos empíricos usados fueron ampicilina/sulbactam (18,9 por ciento), ciprofloxacino (49,6 por ciento) y nitrofurantoína (16,7 por ciento). El 49,2 por ciento de los pacientes recibió tratamiento dirigido, 22,8 por ciento ertapenem y 13,9 por ciento piperacilina/tazobactam. Conclusiones: Las personas con diabetes y enfermedad renal son un grupo vulnerable a las infecciones de tracto urinario. El agente causal aislado en mayor frecuencia fue Escherichia coli blee+. Los tratamientos de inicio luego de la identificación clínica de la infección urinaria fueron ciprofloxacino y cefalosporinas. Una vez obtenidos los resultados microbiológicos se modificó el tratamiento antibiótico a carbapenémicos y penicilinas. La revaloración de los antibióticos usados en pacientes con enfermedades asociadas es importante para el éxito del tratamiento(AU)


Introduction: Urinary tract infections are among the most prevalent infections in clinical practice. They are a global health problem and may present with or without symptoms. The bacterial agents most commonly isolated are Escherichia coli, Klebsiella spp. and Proteus spp. Objective: Characterize urinary tract infections caused by extended-spectrum betalactamase producing enterobacteria in hospitalized patients from Lima in the period 2016-2018. Methods: A descriptive study was conducted at two health institutions from Lima, Peru, in the period 2016-2018, based on isolation of ESBL pathogens associated to urinary tract infections. Attention was paid to sociodemographic variables, associated conditions, agents isolated, treatment and clinical response. Results: A sample was selected of 117 patients; mean age was 58.18 ± 11.8 years; 65.0 percent were women and 89.74 percent came from the urban area of Lima. The most common associated conditions were diabetes (39.3 percent) and moderate or serious kidney disease (12.8 percent), with a mean Charlson index of 2.70 ± 1.21. The most common isolated agents were Escherichia coli (92.3 percent), Klebsiella spp. (6.0 percent and Proteus spp. (1.7 percent). The empirical treatments used were ampicillin/sulbactam (18.9 percent), ciprofloxacin (49.6 percent) and nitrofurantoin (16.7 percent). 49.2 percent of the patients received targeted treatment, 22.8 percent ertapenem and 13.9 percent piperacillin/tazobactam. Conclusions: People with diabetes and kidney disease are vulnerable to urinary tract infections. The causative agent most commonly isolated was ESBL Escherichia coli. The initial treatments indicated after clinical identification of urinary infection were ciprofloxacin and cephalosporins. When microbiological results were obtained, antibiotic therapy was changed to carbapenems and penicillins. Reassessment of the antibiotics used in patients with associated conditions is important for the success of the treatment(AU)


Subject(s)
Humans , Male , Female , Urinary Tract , Carbapenems , Kidney Diseases/drug therapy , Anti-Bacterial Agents
12.
Ciênc. cuid. saúde ; 20: e57925, 2021. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1356125

ABSTRACT

RESUMO Objetivo: identificar evidências científicas acerca dos fatores potenciais para o desenvolvimento de doença renal crônica em adolescentes e jovens. Método: revisão integrativa, utilizando uma ficha de seleção para extração dos dados das pesquisas nas bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde, National Library of Medicine e Web Of Science, acessada via portal Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, no período de agosto de 2021, o que incluiu 12 artigos. A análise dos resultados da revisão ocorreu a partir da síntese de cada estudo primário. Resultados: as evidências científicas apontaram, como fatores potenciais para o desenvolvimento de doença renal crônica em adolescentes e jovens, as doenças crônicas, como diabetes, hipertensão, obesidade, e os fatores de risco, como uso de analgésicos, sobrepeso, baixo peso ao nascer e prematuridade. Conclusão: concluiu-se que é necessário um acompanhamento, a partir de estratégias coletivas ou individuais de educação em saúde, desses adolescentes, jovens e suas famílias, pois as doenças crônicas e fatores de risco podem ser prevenidos ou controlados.


RESUMEN Objetivo: identificar evidencias científicas acerca de los posibles factores para el desarrollo de enfermedad renal crónica en adolescentes y jóvenes. Método: revisión integradora, utilizando una ficha de selección para recolección de los datos de las investigaciones en las bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud, National Library of Medicine y Web Of Science, accedida a través del portal Coordinación de Perfeccionamiento de Personal de Nivel Superior, en el período de agosto de 2021, lo que incluyó 12 artículos. El análisis de los resultados de la revisión ocurrió a partir de la síntesis de cada estudio primario. Resultados: las evidencias científicas señalaron, como factores potenciales para el desarrollo de enfermedad renal crónica en adolescentes y jóvenes, las enfermedades crónicas, como diabetes, hipertensión, obesidad, y los factores de riesgo, como uso de analgésicos, sobrepeso, bajo peso al nacer y prematuridad. Conclusión: es necesario un acompañamiento, a partir de estrategias colectivas o individuales de educación en salud, de esos adolescentes, jóvenes y sus familias, pues las enfermedades crónicas y los factores de riesgo pueden ser prevenidos o controlados.


ABSTRACT Objective: to identify scientific evidence on the potential factors for the development of chronic kidney disease in adolescents and young people. Method: integrative review, using a selection form for extraction of research data in the databases: Latin American and Caribbean Literature on Health Sciences, National Library of Medicine and Web of Science, accessed via the Coordination for the Improvement of Higher Education Personnel portal, in the period of August 2021, which included 12 articles. The analysis of the review results occurred from the synthesis of each primary study. Results: scientific evidence pointed out, as potential factors for the development of chronic kidney disease in adolescents and young people, the chronic diseases, such as diabetes, hypertension and obesity, as well as the risk factors, such as painkiller use, overweight, low birth weight and prematurity. Conclusion: it was concluded that it is necessary to follow-up, from collective or individual health education strategies, these adolescents, young people and their families, because chronic diseases and risk factors can be prevented or controlled.


Subject(s)
Humans , Male , Female , Adolescent , Chronic Disease , Adolescent , Kidney Diseases , Infant, Low Birth Weight , Infant, Premature , Diabetes Mellitus , Overweight , Analgesics , Hypertension , Obesity
14.
Rev. ANACEM (Impresa) ; 15(1): 33-39, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1281420

ABSTRACT

INTRODUCCIÓN: El cólico renal es una condición médica común en los servicios de urgencia. Representa la manifestación clínica más frecuente de urolitiasis, cuya patogenia es multifactorial, con tasas de prevalencia varía de 1% a 20% y una recurrencia a 10 años del 42% al 50%. OBJETIVO: Establecer el perfil clínico-epidemiológico, como también el diagnóstico y manejo de los pacientes hospitalizados por cólico renal en el Hospital Clínico Herminda Martín (HCHCM). MATERIAL Y MÉTODO: Estudio descriptivo retrospectivo en pacientes hospitalizados con diagnóstico de cólico renal en el HCHM de Chillán en el período marzo 2014-marzo 2019. Se estudiaron las variables: sexo, edad, presentación clínica de ingreso, factores de riesgo asociados, motivo de hospitalización, resultados imagenológicos y manejo clínico. Resultados. El 52,45% correspondió a pacientes de sexo masculino, encontrándose la mayor cantidad de pacientes en el intervalo de 40-49 años. La obesidad, antecedente de urolitiasis e hipertensión arterial fueron las patologías asociadas más frecuentes. En la mayoría de los pacientes, el motivo de la hospitalización fue la refractariedad al tratamiento analgésico, alcanzando un 86,76%. El 56,37% de los pacientes recibió manejo médico expulsivo y a un 19,11% de los pacientes se le realizó una intervención quirúrgica durante la hospitalización. CONCLUSIÓN: El perfil de éstos pacientes no sólo permite establecer medidas que podrían evitar un evento litiásico, sino que además se demuestra la necesidad de realizar un manejo óptimo que puede evitar reconsultas, sobrecarga de los servicios de urgencia, aumento de días cama y complicaciones.


INTRODUCTION: Renal colic is a common condition in the emergency department. It represents the most frequent clinical manifestation of urolithiasis, whose prevalence rate varies between 1% to 20%. Its pathogenesis is multifactorial, with a recurrence of 10 years from 42-50%. OBJECTIVE: Establish the clinical-epidemiological profile, as well as the diagnosis and management of patients hospitalized for renal colic at the Herminda Martín Clinical Hospital(HCHM). MATERIALS AND METHODS: A retrospective descriptive study of hospitalized patients diagnosed with renal colic at the HCHM, March 2014-March 2019, the variables were studied: sex, age, the clinical presentation of admission, associated risk factors, the reason for hospitalization, imaging results, and management. Results: 52.45% were male patients, with the highest number of patients in the range of 40-49 years. Obesity, a history of urolithiasis and hypertension, occurred more frequently within the associated pathologies. In most patients, refractable to analgesic treatment was the reason for hospitalization, reaching 86.76%. 56.37% of patients received expulsion medical management, and 19.11% of patientshad surgeryduring hospitalization. CONCLUSION: The profile of these patients not only allows them to establish measures that could prevent a lithiasis event but also shows the need for effective management of patients who can avoid reconsults, an overload of emergency services, increasedbed days and complications


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Renal Colic/diagnosis , Hospitalization , Kidney Diseases/diagnosis , Epidemiology, Descriptive , Retrospective Studies , Emergency Service, Hospital/statistics & numerical data , Renal Colic/surgery , Renal Colic/epidemiology , Renal Colic/diagnostic imaging
15.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 1388-1394, jan.-dez. 2021. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1292015

ABSTRACT

Objective:To analyze how the literature presents the quality of life in renal transplant patients. Methods: base review study: MEDLINE, LILACS and SCIELO. The descriptors kidney Transplantation and quality of life were used, combined with the boolean operator and. After considering the criteria, 15 articles were fully analyzed.Results: the publications showed that the transplantation contributes to the improvement of the patient's quality of life, although, compared to the general population, this quality is lower. Factors such as: presence of comorbidities, transplantation time, educational level and psychological aspects influence the patient's view of their quality of life.Conclusion: the quality of life after transplantation is surrounded by multiple aspects and particularities. Finding the benefits of transplantation for the renal patient does not exempt the possibility of negative dimensions that may compromise the perception of quality of life


Objetivo: Analisar como a literatura apresenta a qualidade de vida em paciente transplantado renal. Métodos: estudo de revisão nas bases: MEDLINE, LILACS e SCIELO. Utilizou-se os descritores "Kidney Transplantation" e "Quality of Life", combinando-se com o operador booleano AND. Após consideração dos critérios, foram analisados integralmente 15 artigos. Resultados: As publicações evidenciaram que o transplante contribui para melhoria da qualidade de vida do paciente, ainda assim, se comparado à população geral essa qualidade é inferior. Fatores como: presença de comorbidades, tempo de transplante, nível de escolaridade e aspectos psicológicos influenciam a visão que o paciente possui da sua qualidade de vida. Conclusão: a qualidade de vida após o transplante é envolta de múltiplos aspectos e particularidades. A constatação dos benefícios do transplante para o doente renal, não isenta a possibilidade da existência de dimensões negativas as quais podem comprometer a percepção da qualidade de vida.


Objetivo: Analizar cómo la literatura presenta la calidad de vida en pacientes con trasplante renal.Métodos: estudio de revisión base: MEDLINE, LILACS y SCIELO. Se utilizaron los descriptores trasplante de riñón y calidad de vida, combinados con el operador booleano and. Después de considerar los criterios, 15 artículos fueron completamente analizados. Resultados: las publicaciones mostraron que el trasplante contribuye a la mejora de la calidad de vida del paciente, aunque, en comparación con la población general, esta calidad es menor. Factores como: presencia de comorbilidades, tiempo de trasplante, nivel educativo y aspectos psicológicos influyen en la visión del paciente sobre su calidad de vida.Conclusión: la calidad de vida después del trasplante está rodeada de múltiples aspectos y particularidades. Encontrar los beneficios del trasplante para el paciente renal no exime la posibilidad de dimensiones negativas que pueden comprometer la percepción de la calidad de vida


Subject(s)
Humans , Male , Female , Quality of Life , Kidney Transplantation , Kidney Diseases/surgery
16.
Braz. j. med. biol. res ; 54(3): e9206, 2021. graf
Article in English | LILACS | ID: biblio-1153519

ABSTRACT

Renal fibrosis is one of the most significant pathological changes after ureteral obstruction. Transforming growth factor-β (TGF-β) signaling pathway plays essential roles in kidney fibrosis regulation. The aims of the present study were to investigate effects of microRNA-302b (miR-302b) on renal fibrosis, and interaction between miR-302b and TGF-β signaling pathway in murine unilateral ureteral obstruction (UUO) model. Microarray dataset GSE42716 was downloaded by retrieving Gene Expression Omnibus database. In accordance with bioinformatics analysis results, miR-302b was significantly down-regulated in UUO mouse kidney tissue and TGF-β1-treated HK-2 cells. Masson's trichrome staining showed that miR-302b mimics decreased renal fibrosis induced by UUO. The increased mRNA expression of collagen I and α-smooth muscle actin (α-SMA) and decreased expression of E-cadherin were reversed by miR-302b mimics. In addition, miR-302b up-regulation also inhibited TGF-β1-induced epithelial mesenchymal transition (EMT) of HK-2 cells by restoring E-cadherin expression and decreasing α-SMA expression. miR-302b mimics suppressed both luciferase activity and protein expression of TGF-βR2. However, miR-302b inhibitor increased TGF-βR2 luciferase activity and protein expression. Meanwhile, miR-302b mimics inhibited TGF-βR2 mRNA expression and decreased Smad2 and Smad3 phosphorylation in vivo and in vitro. Furthermore, over-expression of TGF-βR2 restored the miR-302b-induced decrease of collagen I and α-SMA expression. In conclusion, this study demonstrated that miR-302b attenuated renal fibrosis by targeting TGF-βR2 to suppress TGF-β/Smad signaling activation. Our findings showed that elevating renal miR-302b levels may be a novel therapeutic strategy for preventing renal fibrosis.


Subject(s)
Humans , Animals , Rats , Ureteral Obstruction/pathology , Signal Transduction , Transforming Growth Factor beta/metabolism , MicroRNAs/genetics , Smad Proteins , Kidney Diseases/genetics , Fibrosis , Cell Line , Epithelial-Mesenchymal Transition , Kidney/pathology , Kidney Diseases/pathology
18.
J. venom. anim. toxins incl. trop. dis ; 27: e20200187, 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1351016

ABSTRACT

Background: The efficacy of bone marrow mesenchymal stromal cells (BM-MSC) and its extracellular vesicles has been demonstrated for a broad spectrum of indications, including kidney diseases. However, BM-MSC donor characteristics and their potential are not usually considered. Therefore, the present work aims to evaluate the nephroprotective capacity of sEV secreted by BM-MSC from trained rats inunilateral ureteral obstruction (UUO) model. Methods: BM-MSC was characterized by their differentiation potential and immunophenotypic markers. The sEV were isolated by ultracentrifugation and characterized by nanoparticle tracking analysis and western blot. Its miRNA cargo was examined by quantitative PCR analysis for miR-26a, 126a, and 296. Wistar rats were submitted to UUO procedure and concomitantly treated with sEV secreted by BM-MSC from the untrained andtrained rats. The kidney tissue from all groups was evaluated for fibrosis mediators (transforming growth factor beta1 and collagen), CD34-angiogenesis marker, and hypoxia-inducible factor 1 alpha (HIF-1α). Results: Treadmill training stimulated in BM-MSC the production of sEV loaded with pro-angiogenic miR-296. The treatment with this sEVin UUO-rats was able to attenuate collagen accumulation and increase CD34 and HIF-1α in the kidney tissue when compared to untrained ones. Tubular proximal cells under hypoxia and exposed to BM-MSC sEV demonstrate accumulation in HIF-1α and NFR-2 (nuclear factor erythroid 2-related factor 2), possibly to mediate the response to hypoxia and oxidative stress, under these conditions. Conclusion: The BM-MSC sEV from trained animals presented an increased nephroprotective potential compared to untrained vesicles by carrying 296-angiomiR and contributing to angiogenesis in UUO model.(AU)


Subject(s)
Ureteral Obstruction , Extracellular Vesicles , Kidney Diseases , Hypoxia , Oxidative Stress
19.
J. venom. anim. toxins incl. trop. dis ; 27: e20200154, 2021. graf
Article in English | LILACS, VETINDEX | ID: biblio-1287093

ABSTRACT

Inflammation is closely related to renal diseases. This is particularly true for renal diseases caused by infections as in viral diseases. In this review, we highlight the inflammatory mechanisms that underlie kidney dysfunction in SARS-CoV-2, human immunodeficiency (HIV), hepatitis C (HCV), and hepatitis B (HBV) infections. The pathophysiology of renal involvement in COVID-19 is complex, but kidney damage is frequent, and the prognosis is worse when it happens. Virus-like particles were demonstrated mostly in renal tubular epithelial cells and podocytes, which suggest that SARS-CoV-2 directly affects the kidneys. SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptor, which is found in endothelial cells, to infect the human host cells. Critical patients with SARS-CoV-2-associated acute kidney injury (AKI) show an increase in inflammatory cytokines (IL-1β, IL-8, IFN-γ, TNF-α), known as cytokine storm that favors renal dysfunction by causing intrarenal inflammation, increased vascular permeability, volume depletion, thromboembolic events in microvasculature and persistent local inflammation. Besides AKI, SARS-CoV-2 can also cause glomerular disease, as other viral infections such as in HIV, HBV and HCV. HIV-infected patients present chronic inflammation that can lead to a number of renal diseases. Proinflammatory cytokines and TNF-induced apoptosis are some of the underlying mechanisms that may explain the virus-induced renal diseases that are here reviewed.(AU)


Subject(s)
Hepatitis B virus , HIV , Hepacivirus , COVID-19 , Glomerulonephritis , Inflammation , Kidney Diseases
20.
J. venom. anim. toxins incl. trop. dis ; 27: e20200162, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1346434

ABSTRACT

Inflammatory processes are believed to play an important role in immune response to maintain tissue homeostasis by activating cellular signaling pathways and releasing inflammatory mediators in the injured tissue. Although acute inflammation can be considered protective, an uncontrolled inflammation may evolve to tissue damage, leading to chronic inflammatory diseases. Inflammation can be considered the major factor involved in the pathological progression of acute and chronic kidney diseases. Functional characteristics of this organ increase its vulnerability to developing various forms of injuries, including acute kidney injury (AKI) and chronic kidney disease (CKD). In view of translational research, several discoveries should be considered regarding the pathogenesis of the inflammatory process, which results in the validation of biomarkers for early detection of kidney diseases. Biomarkers enable the identification of proinflammatory mediators in kidney affections, based on laboratory research applied to clinical practice. Some inflammatory molecules can be useful biomarkers for the detection and diagnosis of kidney diseases, such as neutrophil gelatinase-associated lipocalin, kidney injury molecule-1 and interleukin 18.(AU)


Subject(s)
Biomarkers , Acute Kidney Injury/veterinary , Inflammation , Kidney Diseases , Wounds and Injuries
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