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1.
ABCS health sci ; 47: e022204, 06 abr. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1363533

ABSTRACT

INTRODUCTION: Kidney transplantation (KT) is the renal replacement therapy (RRT) of choice for patients with chronic kidney disease (CKD). However, not every KT is successful and some patients persist on RRT. OBJECTIVE: To model a logistic regression with pre- and post-KT risk covariates capable of predicting secondary allograft dysfunction in need of RRT or reaching stage V of CKD until the first six months post-KT. METHODS: Cohort with KT recipients from Northeastern Brazil. Medical records of KT performed between 2011-2018 were analyzed. KT-recipients with insufficient data or who abandoned follow-up were excluded. The covariables analyzed were: demographic; infectious; pre- and post-KT comorbidities; panel reactive-antibodies; number of HLA mismatches; acute rejection episodes mediated by T-cell (ACR) or antibodies (AAR) six months after KT; and laboratory tests six months after KT. RESULTS: Covariates with higher risk for the analyzed outcomes six months after KT were: elderly KT recipients (OR:1.41; CI95%:1.01-1.99), time between onset of RRT and KT (ΔT-RRT&KT)>10years (OR:3.54; CI95%:1.27-9.87), diabetes mellitus (DM) pre-KT (OR:3.35; CI95%:1.51-7.46), pyelonephritis (OR:2.45; CI95%:1.24-4.84), polyomavirus nephropathy (OR:4.99; CI95%:1.87-13.3), AAS (OR:4.82; CI95%:1.35-17.2), 24h-proteinuria ≥300mg/24h (OR:5.05; CI95%:2.00-12.7) and serum calcium (Ca) <8.5mg/dL (OR:4.72; CI95%:2.00-11.1). The multivariate model presented an accuracy of 88.1% and the mean variance inflation factor is 1.81. CONCLUSION: Elderly-recipients, ΔT-RRT&KT>10 years, pre-KT DM, and post-KT aggressions until six months (pyelonephritis, polyomavirus nephropathy, ABMR, 24h-proteinuria≥300mg/24h, and Ca<8.5mg/dL) are associated with high predictive power for secondary allograft dysfunction in need of RRT or reaching CKD stage V until the first six months post-KT.


INTRODUÇÃO: Transplante renal (TR) é a terapia renal substitutiva (TRS) de escolha para pacientes com doença renal crônica (DRC). Entretanto, nem todo TR é bem-sucedido e alguns pacientes persistem em TRS. OBJETIVO: Modelar uma regressão logística com covariáveis de risco pré e pós-TR preditora da disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR. MÉTODOS: Coorte com receptores transplantados realizado em hospital no Nordeste brasileiro. Analisou-se registros médicos dos TR realizados entre 2011-2018. Receptores com dados insuficientes ou que abandonaram seguimento foram excluídos. Foram analisadas covariáveis: demográficas; infecciosas; comorbidades pré e pós-TR; painel de reatividade; incompatibilidades de HLA; episódios de rejeições agudas mediadas por células-T ou por anticorpos; exames laboratoriais seis meses pós-TR. RESULTADOS: Receptores idosos (OR:1,41; IC95%:1,01-1,99), tempo entre início da TRS e TR (∆T-TRS&TR)>10 anos (OR:3,54; IC95%:1,27-9,87), diabetes mellitus (DM) pré-TR (OR:3,35; IC95%:1,51-7,46), pielonefrite (OR:2,45; IC95%:1,24-4,84), nefropatia por poliomavírus (OR:4,99; IC95%:1,87-13,3), RAMA (OR:4,82; IC95%:1,35-17,2), proteinúria de 24h (Pt24h) ≥300mg/24h (OR:5,05; IC95%:2,00-12,7) e cálcio sérico (Ca)<8,5mg/dL (OR:4,72; IC95%:2,00-11,1) foram identificadas como covariáveis de maior risco para os desfechos analisados até seis meses pós-TR. O modelo multivariado apresentou acurácia de 88,1% e fator de inflação da variância médio de 1,81. CONCLUSÃO: Receptores idosos, ∆T-TRS&TR>10anos, DM pré-TR e agressões até seis meses pós-TR (pielonefrite, nefropatia por poliomavírus, RAMA, Pt24h≥300mg/24h e Ca<8,5mg/dL), apresentam alto poder preditivo para disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR.


Subject(s)
Humans , Male , Female , Risk Factors , Kidney Transplantation , Renal Insufficiency, Chronic , Allografts , Proteinuria , Pyelonephritis , Logistic Models , Retrospective Studies , Renal Dialysis , Immunosuppression , BK Virus , Disease Progression , Hypocalcemia
2.
J. pediatr. (Rio J.) ; 97(6): 646-650, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350973

ABSTRACT

Abstract Objective: Henoch-Schönlein purpura is a systemic vasculitis that mainly occurs in children. Renal impairment is a major complication of Henoch-Schönlein purpura, but there is no established predictive marker for renal involvement. Thus, in this study, we investigated the risk factors for renal involvement in children with Henoch-Schönlein purpura. Method: The medical records of children newly diagnosed as having Henoch-Schönlein purpura between 2005 and 2020 were reviewed retrospectively. Selected laboratory data were recorded before treatment initiation. The date and the age at diagnosis; sex; and the presence of arthralgia, gastrointestinal and renal involvement were obtained retrospectively. Results: This study included a total of 186 patients with Henoch-Schönlein purpura. Among them, 36.0% had renal involvement; 28.4% had only microscopic hematuria, 53.7% had nonnephrotic range proteinuria, and 17.9% had nephrotic-range proteinuria during follow-up. The mean age was higher (p = 0.016) and female sex was predominant (p = 0.001) in patients with renal involvement than in those without renal involvement. Blood neutrophil/lymphocyte ratio (p = 0.002) and platelet/lymphocyte ratio (p = 0.002) were significantly higher than that of the patients without renal involvement. No statistically significant differences were observed in the hemoglobin concentration, platelet count, presence of arthralgia, and gastrointestinal involvement between patients with and without renal involvement. Logistic regression analysis revealed female sex (odd ratio = 3.213) and neutrophil/lymphocyte ratio (odd ratio = 1.329) as risk factors for renal involvement. Conclusions: Female sex and high neutrophil/lymphocyte ratio were risk factors for renal involvement in Henoch-Schönlein purpura.


Subject(s)
Humans , Female , Child , Proteinuria , Biomarkers , Retrospective Studies , Risk Factors
3.
Mali méd. (En ligne) ; 36(2): 45-50, 20210812. Tableaux
Article in English | AIM, AIM | ID: biblio-1283919

ABSTRACT

Le rein est une des cibles de Covid-19.L'atteinte peut se présenter sous forme d'une insuffisance rénale aigue (5-35% des patients), d'une hématurie (30-40%) et/ou d'une protéinurie (40-65%). Nous rapportons deux cas d'insuffisance rénale aigue due au Covid-19 au Mali. Il s'agit d'une femme de 63 ans et d'un homme de 60 ans, de race noire et tous deux diabétiques. Les circonstances de découverte de l'insuffisance rénale ont été l'oligurie dans les deux cas et l'hématurie macroscopique totale dans le deuxième cas. Conclusion : Les atteintes rénales deviennent de plus de plus fréquentes au cours de l'infection à Covid-19. Nous suggérons de les rechercher systématiquement dès que le diagnostic de cette infection est posé.


Subject(s)
Humans , Proteinuria , Acute Kidney Injury , COVID-19 , Hematuria , Mali
4.
Rev. bras. ciênc. vet ; 28(1): 57-60, jan./mar. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1368822

ABSTRACT

Objetivou-se verificar a compatibilidade entre diferentes marcas de tiras reagentes para urinálise, tanto de uso veterinário, como de uso humano, e confrontar os parâmetros semiquantitativos desse instrumento com métodos quantitativos. Para isso, foram analisadas 77 amostras frescas de urina de cães e gatos e testados 04 modelos de tiras reagentes. Quanto à densidade urinária, houve correlação razoável entre os métodos quantitativo e semiquantitativo naquelas amostras com pH ácido, mas não naquelas com pH neutro ou alcalino. Quanto à concentração proteica, houve similaridade de 53,3% a 83,3% entre as marcas testadas e quando comparadas com a análise fotométrica houve uma correlação razoável (rs = 0,69752 a 0,75074). Em ponto de corte de 15mg/dL de proteína, a sensibilidade da tira reagente foi 82,5% e 100% para urina canina e felina, respectivamente. No tocante à hematúria, houve divergência razoável entre a sedimentoscopia e as diferentes marcas de tiras reativas. Quanto à piúria, há uma baixa sensibilidade das tiras em relação às amostras caninas com muitos resultados falso-negativos (33% a 75%), enquanto em amostras felinas a sensibilidade foi de 100%. Assim, independente da marca, as tiras reagentes devem servir apenas como teste rápido de triagem, sendo mais apropriado o uso de métodos quantitativos na avaliação clínica do paciente a partir da urinálise.


The aim was to verify the compatibility between different brands of urinary dipsticks, for both human and veterinary use, and to compare the semiquantitative parameters of this instrument with quantitative methods. For this, 77 fresh samples of urine from dogs and cats were analyzed e and 04 models of reagent strips were tested. Regarding urinary density, a reasonable correlation was observed between the quantitative and semiquantitative methods in those samples with acidic pH, which did not occur in those with neutral or alkaline pH. Regarding the protein concentration, there was similarity from 53.3% to 83.3% between the brands and in the comparative analysis between the control strip and the photometric analysis, there was a reasonable correlation (rs = 0.69752 to 0.75074). In cut-off point of 15mg/dL protein, the sensitivity of the reagent strip was 82.5% and 100% for canine and feline urine, respectively. Regarding hematuria, there was a reasonable divergence of results between sedimentation and tested dipsticks. As for pyuria, there is a low sensitivity of the strips in relation to canine samples with many false negative results (33% to 75%), while in feline samples the sensitivity was 100%. Thus, regardless of the brands, the reagent strips should serve only as a rapid screening test, while the use of quantitative methods in the clinical evaluation of the patient from urinalysis is more appropriate.


Subject(s)
Animals , Cats , Dogs , Reagent Strips/analysis , Cats/urine , Urinalysis/methods , Dogs/urine , Efficiency , Indicators and Reagents/analysis , Proteinuria/veterinary , Pyuria/veterinary , Urine Specimen Collection/methods , Hematuria/veterinary
6.
Pesqui. vet. bras ; 41: e06905, 2021. graf
Article in English | LILACS, VETINDEX | ID: biblio-1351277

ABSTRACT

In the search for an early biomarker of renal injury, this study aimed to determine the urinary protein profile of dogs with leishmaniasis without treatment and treated as determined by Brazilian legislation. The identification of proteinuria, its classification and the circumstances in which it takes place instigated this study. For this, 30 dogs from an outpatient clinic at a Veterinary Hospital in Belo Horizonte were evaluated. All animals underwent clinical and laboratory tests, which included renal biomarkers. The proteins were characterized using the SDS-page electrophoresis technique, and thus, a urinary protein profile was developed comparing patients considered clinically healthy with dogs infected with leishmaniasis that were under treatment and with untreated infected dogs. The results showed that the hematological and biochemical parameters showed similar behavior between the groups of healthy dogs and dogs with leishmaniasis treated, however a very heterogeneous pattern of urinary proteins can be observed and differed between healthy animals and animals with leishmaniasis, as well as between treated and untreated animals. The results suggest that the classification of proteinuria can be a tool that helps in the staging of animals infected with L. infantum and can differentiate them as to the severity of existing kidney injuries.(AU)


Na busca por um biomarcador precoce de injúria renal, este trabalho teve como objetivo determinar o perfil proteico urinário de cães infectados com leishmaniose sem tratamento e tratados conforme determina a legislação brasileira. A identificação da proteinúria, sua classificação e as circunstâncias em que ocorrem instigaram este estudo. Para tanto, foram avaliados 30 cães oriundos do atendimento clínico ambulatorial de um Hospital Veterinário em Belo Horizonte. Todos os animais passaram por exame clínico e laboratorial, que incluíram biomarcadores renais. As proteínas foram caracterizadas através da técnica de eletroforese por SDS-PAGE, e assim, foi elaborado um perfil proteico urinário comparando pacientes considerados clinicamente hígidos, com cães infectados por Leishmania (L.) infantum e que estavam sob tratamento e cães infectados não tratados. Os resultados demonstraram que os parâmetros hematológicos e bioquímicos apresentaram comportamento semelhante entre os grupos de cães hígidos e de cães infectados com L. infantum tratados, entretanto um padrão muito heterogêneo de proteínas urinárias pode ser observado e diferiu entre animais hígidos e animais com leishmaniose, assim como entre os animais tratados e não tratados. Os resultados sugerem que a classificação da proteinúria pode ser uma ferramenta que auxilia no estadiamento de animais infectados por L. infantum podendo diferenciá-los quanto à gravidade de lesões renais existentes.(AU)


Subject(s)
Animals , Dogs , Proteinuria , Biomarkers , Dogs/microbiology , Electrophoresis , Leishmania , Leishmaniasis , Kidney
7.
Article in English | WPRIM | ID: wpr-888489

ABSTRACT

OBJECTIVES@#To study the expression of adipokines in children with primary nephrotic syndrome (PNS) before and after treatment and its correlation with blood lipids, as well as the role of adipokines in PNS children with hyperlipidemia.@*METHODS@#A total of 90 children who were diagnosed with incipient PNS or recurrence of PNS after corticosteroid withdrawal for more than 6 months were enrolled as subjects. Thirty children who underwent physical examination were enrolled as the control group. Venous blood samples were collected from the children in the control group and the children with PNS before corticosteroid therapy (active stage) and after urinary protein clearance following 4 weeks of corticosteroid therapy (remission stage). ELISA was used to measure the levels of adipokines. An automatic biochemical analyzer was used to measure blood lipid levels.@*RESULTS@#Compared with the control group, the children with PNS had a significantly lower level of omentin-1 in both active and remission stages, and their level of omentin-1 in the active stage was significantly lower than that in the remission stage (@*CONCLUSIONS@#Omentin-1 may be associated with disease activity, dyslipidemia, and proteinuria in children with PNS. Blood lipid ratios may be more effective than traditional blood lipid parameters in monitoring early cardiovascular risk in children with PNS.


Subject(s)
Adipokines , Chemokines , Child , Cytokines/metabolism , GPI-Linked Proteins/metabolism , Humans , Hyperlipidemias , Lectins/metabolism , Lipids , Nephrotic Syndrome/drug therapy , Proteinuria
8.
Article in Chinese | WPRIM | ID: wpr-879857

ABSTRACT

OBJECTIVE@#To study the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CTX) in the treatment of children with Henoch-Schönlein purpura nephritis (HSPN) and nephrotic-range proteinuria.@*METHODS@#A prospective clinical trial was conducted in 68 pediatric patients who were admitted to the Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics and who were diagnosed with HSPN and nephrotic-range proteinuria from August 2016 to November 2019. The patients were randomly divided into two groups:MMF treatment (@*RESULTS@#At months 3, 6, and 12 of treatment, there was no significant difference in the complete remission rate and the response rate between the MMF treament and CTX treatment groups (@*CONCLUSIONS@#MMF and CTX have similar efficacy and safety in the treatment of HSPN children with nephrotic-range proteinuria.


Subject(s)
Child , Cyclophosphamide/adverse effects , Humans , Immunosuppressive Agents/adverse effects , Mycophenolic Acid/adverse effects , Nephritis/drug therapy , Prospective Studies , Proteinuria/etiology , Purpura, Schoenlein-Henoch/drug therapy , Retrospective Studies
9.
Autops. Case Rep ; 11: e2021328, 2021. graf
Article in English | LILACS | ID: biblio-1339243

ABSTRACT

Background Acute tubulointerstitial nephritis (ATIN) is a very rare paraneoplastic manifestation in patients with multiple myeloma (MM). It is an uncommon pattern of renal disease in such patients. Case presentation We report a case of an 82-year-old male who was admitted with acute kidney injury. Renal biopsy showed typical findings of light chain-associated ATIN with scattered inflammatory cells in the interstitium and associated active tubulitis. No other common manifestations of MM were present at the time of presentation, including hypercalcemia, hyperuricemia, proteinuria, bone pain or lytic bone lesions. Subsequent immunoassays revealed significant serum lambda light chain burden and Bence Jones protein in urine. Immunofluorescence demonstrated linear tubular basement membranes with positive staining for lambda light chain (3+). Electron microscopy (EM) further showed interstitial edema and inflammation. All the aforementioned findings are consistent with ATIN and supported the diagnosis of MM. Conclusions In conclusion, light chain-associated ATIN should be considered in the differential diagnosis of acute interstitial nephritis. Henceforth, serum free light chains as well as serum and urine protein electrophoresis should be included in the workup of such patients.


Subject(s)
Humans , Male , Aged, 80 and over , Multiple Myeloma/complications , Nephritis, Interstitial/complications , Proteinuria , Hyperuricemia , Diagnosis, Differential , Electrophoresis , Acute Kidney Injury , Hypercalcemia
10.
Ciencia Tecnología y Salud ; 8(2): 134-146, 2021. il 27 c
Article in Spanish | LILACS-Express | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1353050

ABSTRACT

El Hospital Nacional Dr. Mario Catarino Rivas (hospital de segundo nivel de atención), sirve como centro de atención para embarazos de alto riesgo de la zona noroccidental de Honduras; reportó 1,702 casos de trastor-nos hipertensivos del embarazo en 2017 y 2,070 casos en 2018. Se caracterizó pacientes con signos y síntomas de trastornos hipertensivos del embarazo agrupadas desde un punto de vista obstétrico, epidemiológico y clínico. Se realizó un estudio, descriptivo de corte transversal en gestantes que presentaron cefalea, cifras tensionales elevadas (≥ 140/90mmHg); registrando ausencia o presencia de proteinuria, atendidas en la emergencia de labor y parto de un hospital nacional de segundo nivel de atención en San Pedro Sula, Honduras, desde junio hasta octubre del 2019. Se incluyeron 110 pacientes de entre 18-43 años, mestizas y amas de casa, la edad gestacional promedio por fecha de ultima menstruación de 37.7 semanas; el 28.2% presentó preeclampsia severa. Las manifestaciones clínicas frecuentes fueron edema de miembros inferiores y cefalea. El 57.3% desarrolló trabajo de parto espontá-neo, la resolución del embarazo fue cesárea en el 57.3% de las gestantes. Respecto al producto de la concepción, 66.4% tenían peso normal y talla apropiada para la edad gestacional, un APGAR de 8 al primer minuto y de 9 a los 5 minutos. En este estudio, se reporta una prevalencia del 13.72% con respecto a los trastornos hipertensivos del embarazo. Particularmente en pacientes mayores de 35 años, multípara, con índice de masa corporal ≥ 32 kg/m2, presentando antecedentes de hipertensión arterial, diabetes mellitus y preeclampsia.


The National Hospital Dr. Mario Catarino Rivas (second-level care hospital), serves as a care center for high-risk pregnancies in the northwestern part of Honduras; it reported 1,702 cases of hypertensive disorders of pregnancy in 2017 and 2,070 cases in 2018. Patients with signs and symptoms of hypertensive disorders of preg-nancy were characterized grouped from an obstetric, epidemiological and clinical point of view. A descriptive cross-sectional study was carried out in pregnant women who presented headache, high blood pressure (≥ 140 / 90mmHg); registering the absence or presence of proteinuria in urine, attended in the labor and delivery emer-gency of a national hospital of second level of care in San Pedro Sula, Honduras; from June to October 2019. 110 patients between 18-43 years old, mixed race and housewives were included, the average gestational age by date of last menstruation of 37.7 weeks, 28.2% presented severe preeclampsia. The frequent clinical manifestations were lower limb edema and headache. 57.3% developed spontaneous labor, the pregnancy termination route was cesarean section in 57.3% of pregnant women. Regarding the product of conception, 69.1% had weight and height appropriate for gestational age, an APGAR of 8 at the first minute and of 9 at 5 minutes. In this study, a prevalence of 13.72% is reported with respect to hypertensive disorders of pregnancy. Particularly in patients older than 35 years, multiparous, with a body mass index ≥ 32 kg / m2, presenting a history of arterial hypertension, diabetes mellitus and pre-eclampsia.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Cesarean Section/methods , Gestational Age , Pregnancy, High-Risk , Natural Childbirth , Pre-Eclampsia/diagnosis , Proteinuria/complications , Infant, Newborn/growth & development , Labor, Obstetric , Diabetes, Gestational/diagnosis , HELLP Syndrome/diagnosis , Eclampsia/diagnosis , Headache/diagnosis , Honduras
11.
Rev. colomb. nefrol. (En línea) ; 7(supl.2): 273-279, jul.-dic. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1251590

ABSTRACT

Resumen Como es bien sabido, desde el mes de diciembre se encendieron las alarmas por la aparición de la enfermedad COVID-19 (Coronavirus 2019) en China, la cual es causada por el virus SARS-CoV-2 y se ha expandido a nivel mundial. Entre los síntomas frecuentes encontramos fiebre, fatiga, mialgias, tos seca, anorexia, disnea y producción de esputo y síntomas menos comunes como cefalea, odinofagia, rinorrea y otra sintomatología diferente a la respiratoria, como síntomas gastrointestinales dados por náuseas y diarrea. La proteinuria en cualquier grado, la hematuria de cualquier grado, el aumento de la elevación de la creatinina en pacientes con creatinina basal elevada y la generación de AKI 2 y 3 son los directamente relacionados con la mortalidad intrahospitalaria desde el punto de vista renal, lo que hace que debamos estudiar más aun la enfermedad renal crónica, para poder tomar las medidas necesaria de prevención. En cuanto a la hidratación, se considera, por lo tanto, que si el paciente presenta buena diuresis, los 2 litros de excreción serían necesarios para eliminar los solutos no necesarios del cuerpo, considerando que esta cantidad se logra sumando también las pérdidas extrarrenales; entonces, si el paciente mantiene una función urinaria adecuada a pesar de su grado de insuficiencia renal, una ingesta de líquidos entre 2,5 y 3,5 litros logra las metas. Los pacientes con enfermedad renal crónica deben tomar las medidas de prevención, aún más por ser población de riesgo, recordando por lo tanto algunas, las cuales son la mejor estrategia para evitar la transmisión viral: lavado frecuente de manos, distanciamiento social, evitar contacto con personas infectadas o con sospecha de infección por el virus SARS-CoV-2, usar tapabocas, mantener higiene en su domicilio, lavar superficies o limpiarlas con sustancias a base de alcohol, y algo que no se puede olvidar: estamos aprendiendo del virus, y debemos mantenernos informados del comportamiento del mismo y de los cambios que este pueda generar en la población y en el comportamiento de la enfermedad, para así mismo tomar las medidas.


Abstract As is well known since December, alarms went off for the appearance of the COVID-19 disease (Coronavirus 2019) in China, which is caused by the SARS-CoV-2 virus and has spread worldwide. Frequent symptoms include fever, fatigue, myalgia, dry cough, anorexia, dyspnea and sputum production, and less common symptoms such as headache, odynophagia, rhinorrhea, and other symptoms other than breathing, such as gastrointestinal symptoms due to nausea and diarrhea. Proteinuria in any degree, hematuria of any degree, increased creatinine variation in a patient with elevated baseline creatinine, and the generation of AKI 2 and 3 are those directly related to in-hospital mortality from the renal point of view, which means that we must study chronic kidney disease even more, in order to take the necessary preventive measures. Regarding hydration, it is considered, therefore, that if the patient presents good diuresis, the 2 liters of excretion would be necessary to eliminate the unnecessary solutes from the body, considering that this amount is achieved by also adding extrarenal losses. Therefore, if the patient maintains adequate urinary function despite his degree of kidney failure, a fluid intake of between 2.5 and 3.5 liters achieves the goals, also taking into account. Patients with chronic kidney disease should take preventive measures, even more so as they are a risk population, therefore remembering some, which are the best strategy to avoid viral transmission: frequent hand washing, social distancing, avoiding contact with people infected or suspected of infection with the SARS-CoV-2 virus, wearing face masks, maintaining hygiene at home, washing surfaces or cleaning them with alcohol-based substances and something that cannot be forgotten, remember that we are learning from the virus and that we must keep us informed of the behavior of the same and of the changes that it may generate in the population and in the behavior of the disease, so as to take the measures.


Subject(s)
Humans , Male , Female , Renal Insufficiency, Chronic , COVID-19 , Patients , Proteinuria , Colombia , Acute Kidney Injury , Organism Hydration Status
12.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1185-1196, July-Aug. 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1131484

ABSTRACT

Glomerular proteinuria is characterized by the loss of high-molecular-weight proteins (HMWPs), while tubulointerstitial proteinuria is characterized by the loss of low-molecular-weight proteins (LMWPs). The objective was to assess the molecular weight of urinary proteins (MWUP) in dogs with naturally acquired CKD and determine the proportion of HMWPs and LMWPs according to CKD stage. Twenty-eight dogs with CKD were recruited and divided into 4 groups based on serum creatinine (Cr) levels (group1: Cr<1,4, n=8; group2: 1,45,0, n=5). The control group consisted of 5 healthy dogs. The MWUP was determined by SDS-PAGE. The urinary protein-to-creatinine ratio (UP/C) was used to quantitatively assess proteinuria. The electrophoresis pattern revealed a proportionally greater loss of HMWPthan of LMWP in all groups with CKD and an increased loss of LMWP in group 4 (P<0.05). These results suggest a predominance of glomerular injuries throughout all stages of CKD in these dogs and an increase in tubulointerstitial injury towards the end-stage of the disease. The results of the present study support the recommendation of SDS-PAGE as an effective technique for the qualitative assessment of proteinuria, as well as a method for assessing the severity and location of renal injury.(AU)


A proteinúria glomerular é caracterizada pela perda de proteínas de alto peso molecular (PAPM), enquanto a proteinúria tubulointersticial se caracteriza pela perda de proteínas de baixo peso molecular (PBPM). O objetivo do trabalho foi determinar o peso molecular das proteínas urinárias (PMPU) de cães com DRC naturalmente adquirida e a proporção de PAPM e PBPM de acordo com o estágio da DRC. Foram utilizados 28 cães com DRC, divididos em quatro grupos, de acordo com o nível sérico de creatinina (cr) (grupo 1: cr<1,4, n=8; grupo 2: 1,45,0, n=5). O grupo controle era composto por cinco cães saudáveis. O PMPU foi determinado por SDS-PAGE. A relação proteína:creatinina urinária (RPCU) foi utilizada como um método quantitativo de proteinúria. A eletroforese revelou uma perda proporcionalmente maior de PAPM, quando comparada às PBPM, em todos os grupos de DRC, bem como uma perda crescente de PBPM no grupo 4 (P<0,05). Esses resultados sugerem uma predominância de lesão glomerular em todos os estágios de DRC nesses cães e uma progressão crescente na lesão túbulo-intersticial no estágio terminal da doença. Os resultados deste estudo reafirmam a recomendação de que a eletroforese de proteínas urinárias é uma técnica qualitativa efetiva de avaliação da proteinúria, bem como um método que permite avaliar a extensão e a localização da lesão renal.(AU)


Subject(s)
Animals , Dogs , Proteinuria/diagnosis , Proteinuria/veterinary , Creatinine/analysis , Renal Insufficiency, Chronic/veterinary , Electrophoresis/veterinary
13.
Rev. colomb. nefrol. (En línea) ; 7(1): 130-134, ene.-jun. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1144380

ABSTRACT

Resumen En pacientes con enfermedad renal se ha reportado la presencia de células renales reactivas, cuyas alteraciones morfológicas severas dificultan su clasificación e interpretación. El conocimiento de las características morfológicas y los patrones de sedimentos en donde se presentan pueden ser de ayuda para su manejo en los departamentos médicos correspondientes. Aquí, nosotros reportamos la presencia de células agrupadas en acinos, con abundante citoplasma, cariomegalia, contornos nucleares irregulares y nucléolos prominentes, acompañados de cilindruria y cuerpos ovales grasos en el sedimento urinario de dos pacientes con diabetes mellitus, las cuales fueron sugestivas de células renales reactivas.


Abstract In patients with kidney disease, the presence of reactive renal cells has been reported. These cells show several morphological alterations that difficult their classification and interpretation. Therefore, the knowledge of its morphological characteristics and sediments patterns where they can be found will helpful for their correct management by medical departments. Here, we reported the presence of renal cells grouped in acinus with abundant cytoplasm, cariomegaly, irregular nuclear contours and prominent nucleoli, accompanied with cilindruria and fatty oval bodies in the urinary sediment of two patients with Diabetes Mellitus, these cells were named as reactive renal cells.


Subject(s)
Humans , Male , Female , Renal Insufficiency, Chronic , Patients , Proteinuria , Diabetes Mellitus , Epithelial Cells , Hematuria , Mexico
14.
Rev. Col. méd. cir ; 159(1): 23-25, abr 2020. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1247543

ABSTRACT

Objetivo: determinar la presencia de proteinuria en habitantes de una aldea de la región costera de Santa Rosa, Guatemala, julio del año 2019. Material y métodos: estudio descriptivo y transversal, en una muestra de 575 habitantes de la aldea Casas Viejas, captada por durante cuatro jornadas médicas. Las muestras de orina fueron analizadas con tiras reactivas. Resultados: de los habitantes que participaron, 55.48 % (319) fueron de sexo femenino, la mediana de edad fue de 24 años, el 39.820% (229) estudiante y el 85.2 % (490) sin antecedentes patológicos. De los factores predisponentes de enfermedad renal, el 56.170% (323) consume antiinflamatorios no esteroideo -AINES-, el 82.26 % (473) bebidas carbonatadas, el 13.570% (78) bebidas alcohólicas; la mediana de consumo de agua fue de 6 vasos diarios y 13.22 % (76) han estado expuestos a agroquímicos. Proteinuria se documentó en 8.87 % (51) de los habitantes. Conclusiones: más de la mitad de los sujeto de estudio son de sexo femenino y sin antecedentes patológicos; de los factores predisponentes a enfermedad renal los más frecuentes son el consumo de -AINES-, bebidas carbonatadas y la hidratación inadecuada. Nueve de cada cien sujetos de estudio presentan proteinuria.


Objetive: to establish urine protein presence in inhabitants of a small village of the coastal region in Santa Rosa, Guatemala. July 2019. Material y methods: Descriptive and transversal study performed on 575 persons from Casas Viejas village, using a nonprobabilistic sampling. Proteinuria was determined by urine test strips. Results: Of the persons studied, 55.48% (319) were female, mean age was 24 years old, 39.82% (229) were students and 85.25% had no pathological background. Predisposing factors of kidney disease were noted, 56.17% (323) consumed Non-steroidal Anti-inflammatory Drugs (NSAIDs), 82.26% (473) consumed carbonated drinks, 13.57% (78) alcoholic beverages, the mean water consumption was 6 glasses per day, and 13.22% (76), were exposed to agrochemical pesticides. Proteinuria was found in 8.87% (51) of the sample. Conclutions: more than half of population were female and didn´t showed pathological signs. Predisposing factors to kidney disease were, frequent NSAIDs use, carbonated drinks consumption a no adequate hydration. Nine of each one hundred people studied presented urine protein.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Pesticides/adverse effects , Proteinuria/diagnosis , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Kidney Diseases/diagnosis , Reagent Strips , Socioeconomic Factors , Carbonated Beverages/adverse effects , Alcoholic Beverages , Guatemala
15.
Med. UIS ; 33(1): 73-80, ene.-abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1124988

ABSTRACT

Resumen En el mundo, se ha evidenciado un aumento de los casos de sífilis, de sífilis gestacional y de sífilis congénita. Se presenta el caso de un recién nacido con sífilis congénita, hijo de una madre con sífilis latente de duración indeterminada (VDRL 1:4 diluciones) diagnosticada y tratada a la semana 12 de gestación, VIH negativa, con compañero seronegativo para sífilis; a pesar del tratamiento con tres dosis de 2'400 000 U de penicilina benzatínica, no modificó los títulos del VDRL ni en el control de la semana 25 de gestación, ni en el momento del parto. En el posparto, la madre fue diagnosticada con neurosífilis y recibió tratamiento con penicilina cristalina durante 14 días. El recién nacido fue diagnosticado con sífilis congénita por presentar VDRL 1:4 diluciones, aumento de aminotransferasas, hematuria y proteinuria, recibiendo tratamiento con penicilina cristalina durante 10 días. La paciente evolucionó favorablemente y el control a los 6 meses fue normal. Deben fomentarse medidas útiles en la prevención de la sífilis gestacional: métodos de barrera, conocimiento de la enfermedad y asistencia a control prenatal. Es fundamental identificar y tratar a las gestantes con sífilis mediante tamizaje serológico para prevenir la sífilis congénita; el seguimiento serológico debe ser estricto para verificar la eficacia del tratamiento e investigar las gestantes que no modifican los títulos después del tratamiento. MÉD.UIS.2020;33(1):73-80.


Abstract In the world, there has been an increase in cases of syphilis, gestational syphilis and congenital syphilis. It's presented the case of a newborn with congenital syphilis, son of a mother with latent syphilis of indeterminate duration (VDRL 1: 4 dilutions) diagnosed and treated at week 12 of gestation, HIV negative, with seronegative partner for syphilis; despite treatment with three doses of 2'400 000 U of benzathine penicillin, the VDRL titres remained unaltered on both the control of the 25th week of gestation and at the time of delivery. The mother, in the postpartum period, was diagnosed with neurosyphilis and was treated with crystalline penicillin for 14 days. The newborn was diagnosed with congenital syphilis by presenting 1:4 VDRL dilutions, increased aminotransferases, hematuria and proteinuria; he was treated with crystalline penicillin for 10 days. Useful measures should be promoted in the prevention of gestational syphilis such as barrier methods, knowledge of the disease and assistance to prenatal control. It is mandatory to identify and treat pregnant women with syphilis by serological screening for the disease in order to prevent congenital syphilis. Serological follow-up should be strict to verify the effectiveness of the treatment and to investigate pregnant women who do not modify the titres after treatment. MÉD.UIS.2020;33(1):73-80.


Subject(s)
Humans , Male , Infant, Newborn , Syphilis, Congenital , Syphilis, Latent , Penicillin G Benzathine , Proteinuria , Treponema pallidum , Infant, Newborn , Pregnancy , Syphilis , Transaminases , Hematuria , Neurosyphilis
16.
Pesqui. vet. bras ; 40(2): 113-120, Feb. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1098439

ABSTRACT

Patients with chronic kidney disease (CKD) have paradoxical hemostatic potential because they have bleeding episodes but are also prone to thrombosis. Few studies have evaluated blood viscoelastic properties in dogs with kidney disease; on the other hand, hypercoagulability has been observed in these patients. It is also emphasized that the platelet function and its participation in this process have not yet been fully understood. The objective of this study was to evaluate and compare the Thrombin Generation Test (TGT) and also viscoelastic properties of the blood measured by thromboelastometry (TEM) in dogs with proteinuria in CKD. Twenty healthy dogs (Control Group) and 19 dogs with CKD in stage III or IV, classified according to International Renal Interest Society - IRIS, were selected, and the reference test of urine protein:creatinine ratio (UPCR) should be greater than one (CKD group). Blood samples for TEM, thrombin generation, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), and fibrinogen concentration was collected at a single time for both groups after inclusion criteria being confirmed. Statistical analysis was performed according to the distribution of variables at 5% significance level. Differences were observed between healthy dogs and those with proteinuria in CKD noted in TEM. The TGT was unable to differentiate between sick and healthy groups. However, when the nephropathy was stratified, increases in TTP and peak thrombin concentration by TGT were observed in females and dogs over 30 days of diagnosis of CKD. Both tests signaled a discrete state of hypercoagulability. In fact, TEM is more sensitive to detect hypercoagulability in dogs with CKD. However, the TGT has potential clinical application by allowing long-term sample storage.(AU)


Os pacientes com doença renal crônica (DRC) apresentam um potencial hemostático paradoxal, pois apresentam episódios de sangramento, mas também são propensos à trombose. Poucos estudos avaliaram as propriedades viscoelásticas sanguíneas em cães com doenças renais, entretanto, a hipercoagulabilidade já foi observada nestes pacientes. Ressalta-se ainda que a função plaquetária e sua participação neste processo ainda não foram totalmente esclarecidas. O objetivo foi avaliar e comparar o teste de geração de trombina (TGT) e as propriedades viscoelásticas sanguíneas medidas pela tromboelastometria (TEM) em cães com DRC proteinúrica. Foram selecionados 20 cães saudáveis (grupo controle) e 19 cães com DRC em estágios III ou IV classificados segundo o IRIS e a relação proteína/creatinina urinária maior que um (grupo DRC). As amostras de sangue para a realização da tromboelastometria (TEM), geração de trombina, tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA) e concentração de fibrinogênio foram colhidas em momento único para ambos os grupos após os critérios de inclusão confirmados. A análise estatística foi realizada de acordo com a distribuição das variáveis, ao nível de 5% de significância. Foi observada diferença entre os cães saudáveis e os com DRC proteinúrica observados na TEM. O teste de geração de trombina não foi capaz de diferenciar os grupos doente e saudável. Entretanto, quando os nefropatas foram analisados de forma estratificada, foram observados aumentos do ETP e da concentração máxima de trombina (peak) pelo TGT em fêmeas e em cães com mais de 30 dias de diagnóstico da DRC. Ambos os testes sinalizando para um discreto estado de hipercoagulabiliade. A tromboelastometria é mais sensível para detectar a hipercoagulabilidade em cães com DRC. Entretanto, o teste de geração de trombina tem melhor aplicabilidade por permitir o armazenamento da amostra em longo prazo.(AU)


Subject(s)
Animals , Dogs , Thrombosis/prevention & control , Thrombin , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/veterinary , Hemorrhage/prevention & control , Hemorrhage/veterinary , Hemostasis , Proteinuria/veterinary , Thrombelastography/veterinary
17.
Article in English | WPRIM | ID: wpr-782247

ABSTRACT

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


Subject(s)
Albuminuria , Chronic Disease , Humans , Hypertension , Kidney Diseases , Mass Screening , Proteinuria , Renal Insufficiency, Chronic , Sensitivity and Specificity
19.
Rev Assoc Med Bras (1992) ; 66(Suppl 2): 112-117, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136381

ABSTRACT

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.


RESUMO OBJETIVO Apresentar uma revisão sobre as alterações renais nos pacientes com COVID-19. MÉTODOS Foi realizada uma revisão sistemática de literatura para buscar estudos referentes a pacientes com alterações renais clínicas, laboratoriais e anatomopatológicas durante a infecção por SARS-CoV-2. A busca foi realizada nas bases de dados eletrônicos PubMed, Scopus e Embase, com as palavras-chaves: "COVID-19", "coronavirus", "Sars-CoV-2", "kidney injury" e "kidney disease", para identificar artigos originais publicados na literatura até 07 de maio de 2020. Quinze estudos trouxeram alterações renais clínicas e laboratoriais dos pacientes com COVID-19, e três abordaram análises anatomopatológicas. DISCUSSÃO A Lesão renal aguda (LRA) foi um achado relevante nos pacientes com COVID-19. Houve também alterações significativas nos exames laboratoriais que indicam lesão renal, como o nível de creatinina e ureia séricas, proteinúria e hematúria. As alterações laboratoriais e a LRA foram importantes nos pacientes que desenvolveram o quadro grave da doença. Há considerável prevalência de LRA nos grupos de pacientes que vieram a óbito. Na análise histopatológica de pacientes com SARS-CoV-2 foram encontrados achados renais sugestivos que o vírus poderia ter efeitos diretos sobre o rim. CONCLUSÃO A COVID-19 é uma doença que, apesar de acometer principalmente os pulmões, também acomete os rins. Aumento das escórias nitrogenadas, hematúria, proteinúria e LRA foram achados frequentes em pacientes com quadros graves da COVID-19. Esses achados foram relacionados a maior mortalidade. É necessária a realização de mais estudos com enfoque nas alterações renais e suas implicações no quadro clínico causadas pelo novo coronavírus.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Acute Kidney Injury/etiology , Betacoronavirus/isolation & purification , Pneumonia, Viral/metabolism , Pneumonia, Viral/urine , Pneumonia, Viral/epidemiology , Proteinuria/etiology , Urine/chemistry , Coronavirus Infections , Coronavirus Infections/metabolism , Coronavirus Infections/urine , Coronavirus Infections/epidemiology , Creatinine/blood , Acute Kidney Injury/physiopathology , Pandemics , Betacoronavirus , Hematuria/etiology
20.
Article in English | WPRIM | ID: wpr-827400

ABSTRACT

In this paper, 2 cases of collagen Type Ⅲ glomerulopathy were analyzed. The clinical manifestations mainly included nephrotic syndrome, proteinuria, hypertension and renal dysfunction. One patient showed that the complement factor H-related protein 5 (CFHR5) gene was likely a disease-causing mutation. The pathological examination of renal tissues showed hyperplasia of mesangial matrix, sub-endothelial insertion, and double-track formation. Immunohistochemistry of Type III collagen was positive. Electron microscopy revealed that massive collagen fibers (40-70 nm in diameter) deposited in the mesangial matrix and basement membrane. As for the follow-up results, the normal renal function had kept steady and the proteinuria was moderate in 1 case treated with angiotensin Ⅱ receptor blocker. Due to other system disease, another case developed into acute kidney injury and then received hemodialysis. The clinical manifestations of collagen Type Ⅲ glomerulopathy was atypical, the light microscope pathological features were various, and the disease was mainly diagnosed by electron microscopy and immunohistochemistry.


Subject(s)
Collagen Type III , Genetics , Glomerular Mesangium , Humans , Kidney Diseases , Kidney Glomerulus , Proteinuria
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