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1.
Rev. cuba. pediatr ; 952023. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1441825

ABSTRACT

Introducción: El síndrome de cascanueces se considera una anomalía infrecuente y poco pensada en la práctica médica; su incidencia no está bien establecida debido a su sintomatología variada. La agenesia renal unilateral se estima entre 1/2500 y 1/4000 nacidos vivos. Objetivos: Describir una paciente de 18 años con sospecha prenatal de agenesia renal derecha confirmada por imágenes después del nacimiento, que ingresó por proteinuria. Presentación del caso: Paciente de 18 años con agenesia renal derecha conocida, en la que un examen de orina detectó proteinuria desde los 13 años. En su estudio se clasificó como proteinuria ortostática y evolutivamente refirió dolor lumbar izquierdo ligero y transitorio. En el ultrasonido renal, realizado para valorar crecimiento del riñón único, se detectó dilatación de la vena renal izquierda. Se repitió el estudio ecográfico para precisar ángulo aorto-mesentérico y dilatación de vena renal izquierda, y se confirmó el síndrome de cascanueces. Conclusiones: La asociación entre agenesia renal derecha y síndrome de cascanueces, resulta extremadamente rara, y, cuando se presenta con proteinuria ortostática y dolor lumbar ocasional, debe seguirse en forma expectante, pero no se necesita tratamiento quirúrgico en la mayoría de los casos(AU)


Introduction: Nutcracker syndrome is considered an infrequent and poorly thought out anomaly in medical practice; its incidence is not well established due to its varied symptomatology. Unilateral renal agenesis is estimated to be between 1/2500 and 1/4000 live births. Objectives: To describe an 18-year-old female patient with suspected pre-natal imaging-confirmed right renal agenesis after birth, who was admitted due to proteinuria. Case presentation: An 18-year-old female patient with known right renal agenesis, in whom a urine test detected proteinuria from the age of 13. In the study it was classified as orthostatic proteinuria and evolutionarily she referred mild and transient left low back pain. Renal ultrasound, performed to assess single kidney growth, showed dilation of the left renal vein. The ultrasound study was repeated to specify aorto-mesenteric angle and left renal vein dilation, and nutcracker syndrome was confirmed. Conclusions: The association between right renal agenesis and nutcracker syndrome is extremely rare, and, when it presents with orthostatic proteinuria and occasional low back pain, it should be followed expectantly, but surgical treatment is not needed in most cases(AU)


Subject(s)
Humans , Female , Adolescent , Proteinuria/urine , Renal Nutcracker Syndrome/diagnostic imaging , Solitary Kidney/diagnostic imaging , Renal Veins , Dilatation
2.
Rev. Col. méd. cir ; 159(1): 23-25, abr 2020. tab
Article in Spanish | LIGCSA, LILACS | 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 , Young Adult , Proteinuria/epidemiology , Pesticides/adverse effects , Proteinuria/diagnosis , Proteinuria/urine , Alcohol Drinking/adverse effects , Carbonated Beverages/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Prevalence , Cross-Sectional Studies , Risk Factors , Drinking , Guatemala/epidemiology , Kidney Diseases/diagnosis , Kidney Diseases/urine , Kidney Diseases/epidemiology
3.
Rev. méd. Chile ; 147(2): 173-180, Feb. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1004330

ABSTRACT

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


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Enalapril/therapeutic use , Losartan/therapeutic use , Renal Insufficiency, Chronic/drug therapy , Proteinuria/urine , Renin-Angiotensin System , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/standards , Enalapril/administration & dosage , Enalapril/standards , Disease Progression , Losartan/administration & dosage , Losartan/standards , Creatinine/blood , Diabetes Mellitus/drug therapy , Albuminuria/urine , Drug Therapy, Combination , Treatment Adherence and Compliance/psychology , Hypertension/drug therapy
4.
São Paulo med. j ; São Paulo med. j;137(1): 39-44, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-1004743

ABSTRACT

ABSTRACT BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Familial Mediterranean Fever/drug therapy , Quality of Life , Drug Resistance/drug effects , Colchicine/therapeutic use , Interleukin-1/antagonists & inhibitors , Antirheumatic Agents/therapeutic use , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Familial Mediterranean Fever/physiopathology , Proteinuria/urine , Reference Values , Time Factors , Turkey , Severity of Illness Index , Blood Sedimentation , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Treatment Outcome , Statistics, Nonparametric , Visual Analog Scale , Amyloidosis/physiopathology , Amyloidosis/drug therapy , Kidney Diseases/physiopathology , Kidney Diseases/drug therapy
5.
Rev. cuba. pediatr ; 90(2): 252-261, abr.-jun. 2018. tab
Article in Spanish | LILACS | ID: biblio-901485

ABSTRACT

Introducción: las infecciones del tracto urinario son un problema frecuente en la población pediátrica. La infección del tracto urinario recurrente tiene mayor riesgo de cicatrices renales y daño glomerular. Objetivo: describir la frecuencia de hematuria, presencia de proteínas en orina, elevación en tensión arterial y hallazgos ecográficos en pacientes pediátricos desde 1 mes hasta 14 años de edad, con diagnóstico de infección del tracto urinario. Métodos: estudio descriptivo transversal, realizado entre octubre de 2014 y febrero de 2016, en pacientes que asistieron al servicio de urgencias pediátricas del Hospital de San José, con diagnóstico de infección del tracto urinario. Resultados: se diagnosticaron 125 pacientes con infección del tracto urinario, la mediana de edad fue de 2,75 años, más frecuente en mujeres (75,2 por ciento) y la mayoría recibió tratamiento intrahospitalario (58,4 por ciento). Se observó que en el grupo de infección del tracto urinario recurrente fue más frecuente el hallazgo de hematuria, que en la infección del tracto urinario primer episodio (21,9 vs. 11,8 por ciento), al igual que las malformaciones renales (32,0 vs. 14,5 %). En la tensión arterial no se observaron grandes diferencias entre los grupos, con una frecuencia de tensión arterial elevada en hospitalizados de 19,6 por ciento para primer episodio, y 18,2 por ciento en recurrentes. La presencia anormal de proteínas en orina fue de 35,4 por ciento en el grupo de infección del tracto urinario primer episodio. Conclusiones: son frecuentes la presencia de hematuria, malformaciones renales y elevación de la tensión arterial en pacientes con infección del tracto urinario. Se encuentra una frecuencia inusual de pacientes con elevación de la presión arterial y proteínas en orina, probablemente por falsos positivos. Se debe insistir en seguimiento ambulatorio del uroanálisis y la tensión arterial, para garantizar que esta se normalice o para detectar daños permanentes(AU)


Introduction: urinary tract infections are a frequent problem in the pediatric population. Recurrent urinary tract infection has a higher risk of kidney scars and glomerular damage. Objective: to describe frequency of hematuria, presence of proteins in urine, increase of blood pressure, and ultrasound findings in pediatric patients from 1 month to 14 years old with a diagnosis of urinary tract infection. Methods: cross-sectional descriptive study conducted from October 2014 to February 2016, in patients who attended the pediatric emergency´s service of the Hospital of San José with a diagnosis of urinary tract infection. Results: 125 patients with urinary tract infection were diagnosed, the median age was 2.75 years, it was more frequent in women (75.2 percent) and the majority of them received intrahospital treatment (58.4 percent). It was observed that in the recurrent urinary tract infection group the finding of hematuria was more frequent, than in the group of urinary tract infection as a first episode (21.9 vs. 11.8 percent), as well as the renal malformations (32,0 vs. 14.5percent). In blood pressure, there were no large differences among the groups, with a rate of high blood pressure frequency in hospitalized patients of 19.6 percent for first episode, and 18.2 percent in recurrent patients. The abnormal presence of proteins in urine was of 35.4 percent in the group of urinary tract infection first episode(AU) Conclusions: the presence of hematuria, renal malformations and increase of blood pressure in patients with urinary tract infection are frequent. There is an unusual frequency of patients with high blood pressure and proteins in the urine, probably due to false positives. It must be addressed the ambulatory monitoring of urinalysis and blood pressure to ensure that it normalizes or to detect permanent damage


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Hematuria/urine , Urine/chemistry , Cross-Sectional Studies , Epidemiology, Descriptive , Proteinuria/urine
6.
Biomédica (Bogotá) ; Biomédica (Bogotá);37(4): 590-599, oct.-dic. 2017. tab
Article in Spanish | LILACS | ID: biblio-888502

ABSTRACT

Resumen La malaria produce complicaciones y muerte especialmente en poblaciones con acceso limitado a la atención en salud. La malaria grave puede reconocerse tempranamente mediante la detección en la orina de hallazgos como la hematuria, la coluria y la proteinuria. Se hizo una revisión narrativa basada en estudios sobre malaria grave y el empleo del análisis de orina mediante la consulta de 91 publicaciones. Mediante el análisis de la orina, se pueden detectar alteraciones metabólicas y lesiones en distintos órganos. En estudios recientes en Colombia se ha confirmado su utilidad como apoyo en el diagnóstico de la disfunción renal, la disfunción hepática y la anemia asociada con hemólisis, las cuales son complicaciones frecuentes en la malaria. El examen constituye una herramienta de fácil aplicación en la consulta ambulatoria y en pacientes hospitalizados para reconocer tempranamente casos complicados, y permite la detección oportuna de diferentes lesiones en el paciente con malaria, contribuyendo así a la reducción de la morbilidad grave y la mortalidad.


Abstract Malaria accounts for a significant morbidity and mortality rate around the world, especially in communities with limited access to healthcare. Some clinical signs in urine, like haematuria, coluria and proteinuria, help for the early diagnosis of severe malaria cases. A narrative review was conducted by analyzing 91 publications on studies about severe malaria cases and the use of urinalysis. A urinalysis can detect metabolic disturbances and organ injury. Its diagnostic utility for frequent complications caused by malaria, such as hepatic injury, kidney dysfunction and hemolysis, has been confirmed by recent Colombian studies. This test is an easy-to-use tool in outpatient clinics and with hospitalized patients to promptly recognize complicated cases, allowing the timely identification of different lesions in patients with malaria, thus contributing to the reduction of severe morbidity and mortality.


Subject(s)
Humans , Urinalysis , Malaria/urine , Proteinuria/urine , Proteinuria/etiology , Global Health , Hematuria/urine , Hematuria/etiology , Hemolysis , Kidney Diseases/urine , Kidney Diseases/etiology , Leukocyte Count , Liver Diseases/urine , Liver Diseases/etiology , Malaria/complications , Malaria/epidemiology
7.
Rev. bras. reumatol ; Rev. bras. reumatol;57(6): 535-544, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-899472

ABSTRACT

Abstract Aim Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65 ± 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006) and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027) were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 ± 16 months. Conclusion Our study indicated that familial Mediterranean fever constituted a large proportion of cases and increased number of patients with idiopathic amyloid A amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in amyloid A amyloidosis.


Resumo Objetivo: A amiloidose AA é uma complicação rara de condições inflamatórias crônicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva à insuficiência renal e à morte. Estudaram-se as características clínicas e a sobrevida em pacientes com amiloidose AA. Métodos: Analisaram-se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biópsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados: A maior parte dos pacientes (55,6%) tinha proteinúria na faixa nefrótica no momento do diagnóstico. Os distúrbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressão arterial diastólica no grupo de desfecho bom e o nível de fósforo no grupo de desfecho ruim foram mais elevados. Os níveis séricos de creatinina aumentaram após o tratamento em ambos os grupos, enquanto a proteinúria diminuiu no grupo de desfecho bom. O aumento na creatinina sérica e a diminuição na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnóstico, 18,5% e 27,2% de todos os pacientes tinham doença renal crônica avançada (estágios 4 e 5, respectivamente). A duração média da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de diálise durante o período de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Níveis elevados de pressão arterial sistólica [taxas de risco (HR) 1,03, intervalo de confiança (IC) de 95%: 1 a 1,06, p = 0,036], creatinina sérica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excreção urinária de proteínas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doença renal terminal. A mediana da sobrevida de pacientes com comprometimento de órgãos foi de 50,3 ± 16 meses. Conclusão: O presente estudo indicou que a FFM constituiu uma grande proporção de casos e crescente quantidade de pacientes com amiloidose AA idiopática. Adicionalmente, observou-se que a sobrevida do paciente não foi afetada pelas diferentes causas etiológicas na amiloidose AA.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Young Adult , Familial Mediterranean Fever/mortality , Renal Insufficiency, Chronic/mortality , Amyloidosis/mortality , Familial Mediterranean Fever/complications , Proteinuria/urine , Proportional Hazards Models , Retrospective Studies , Renal Dialysis/statistics & numerical data , Outcome Assessment, Health Care/statistics & numerical data , Creatinine/blood , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/therapy , Kaplan-Meier Estimate , Amyloidosis/complications , Amyloidosis/physiopathology , Middle Aged
8.
Arq. gastroenterol ; Arq. gastroenterol;53(3): 180-184, tab
Article in English | LILACS | ID: lil-787349

ABSTRACT

ABSTRACT Background - The increase in the survival following the introduction of highly active antiretroviral therapy (HAART) has seen the emergence of hepatitis C virus (HCV) infection, renal and cardiovascular diseases as important morbidity and mortality causes together with HIV. Objective - The present study aimed to investigate the differences between HIV/hepatitis C virus coinfected and HIV-monoinfected regarding demographic and clinical aspects from a HIV/AIDS clinic in Porto Alegre, Brazil. Methods - Review of medical records of 1,030 HIV infected individuals aged 18 years or more in an urban HIV/AIDS clinic based in Porto Alegre, Southern Brazil. Clinical and demographical Data were collected from the records of the patients attended between March 2008 and December 2012. Results - The present study is a cross-sectional study among HIV-infected patients attended at a public HIV/AIDS clinic in Porto Alegre, Brazil. The prevalence of hepatitis C virus in the present study cohort was 11.8% (CI 95%: 9.9%-13.8%). Hypertension and pathological proteinuria were more common in the coinfected compared to monoinfected group. By the other hand, dyslipidemia were more common among monoinfected patients. There was no difference between the groups regarding CD4+ count or HIV-RNA. Variables significant in the univariate analysis with P<0.05 were further analyzed using a Poisson regression model with robust variance. Coinfected were likely to be older, with lower lipid levels and higher prevalence of pathological proteinuria compared to HIV-monoinfected patients. Although coinfected patients had higher prevalence of tenofovir-based regimen, there was a strong association between hepatitis C virus individuals to pathological proteinuria and dyslipidemia. Conclusion - Clinicians should recognize that coinfected and monoinfected individuals are different groups regarding the traditional and HIV-related risk factors and should be managed and screened individually in order to prevent cardiovascular and renal complications.


RESUMO Contexto - O aumento da sobrevida após a introdução da terapia antirretroviral nos pacientes vivendo com HIV tem como consequência o aparecimento de doenças emergentes nestes pacientes, como a hepatite pelo vírus C, doenças renais e cardiovasculares. Objetivo - O presente estudo tem como objetivo investigar as diferenças entre monoinfectados por HIV e coinfectados por HIV/virus da hepatite C, considerando aspectos demográficos e clínicos de pacientes atendidos em uma clínica de HIV/AIDS em Porto Alegre, Brasil. Métodos - Revisão de prontuários médicos de 1.030 indivíduos vivendo com HIV em uma clínica especializada em Porto Alegre, Brasil. Dados clínicos e demográficos foram coletados a partir dos registros dos pacientes atendidos entre março de 2008 e dezembro de 2012 na referida clínica. Resultados - O presente estudo é um estudo transversal com indivíduos vivendo com HIV, atendidos em um serviço municipal de HIV/AIDS em Porto Alegre, Brasil. A prevalência de hepatite pelo vírus C na presente coorte de estudo foi 11,8% (IC 95%: 9,9%-13,8%). Hipertensão e proteinúria patológica eram ocorrências mais comuns em coinfectados do que monoinfectados. Por outro lado, dislipidemia foi mais comuns entre monoinfectados. Não houve diferença entre os grupos quanto contagem de linfócitos CD4 totais ou HIV-RNA. Variáveis significativas na análise univariada com P<0,05 foram ainda analisadas usando um modelo de regressão de Poisson com variância robusta. Coinfectados eram mais velhos, com os níveis de lipídios mais baixos e maior prevalência de proteinúria patológica em comparação com indivíduos monoinfectados. Apesar de os coinfectados apresentarem maior prevalência de estarem em uso de regime contendo tenofovir, houve uma forte associação dos indivíduos infectados pelo vírus da hepatite C com proteinúria patológica e ausência de dislipidemia. Conclusão - Clínicos devem reconhecer que coinfectados e monoinfectados pertencem a grupos diferentes quanto aos fatores de risco tradicionais e aqueles associados ao HIV, devendo estes serem manejados e rastreados de forma individual, para prevenir complicações cardiovasculares e renais.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , HIV Infections/epidemiology , Hepatitis C/epidemiology , Coinfection/epidemiology , Proteinuria/urine , Tobacco Use Disorder/complications , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Alcoholism/complications , Dyslipidemias/blood , Middle Aged
9.
Rev. méd. Chile ; 144(9): 1218-1221, set. 2016. ilus
Article in Spanish | LILACS | ID: biblio-830631

ABSTRACT

HIV infection has different clinical presentations. We report a 21-year-old male with longstanding isolated microscopic hematuria attributed to thin glomerular basement membrane disease, who after 15 years of follow-up presented with significant proteinuria. A kidney biopsy was performed, revealing the presence of tubulo-reticular inclusions in the glomerular endothelial cells. This finding led to suspect an HIV infection, which was verified. Antiretroviral therapy, angiotensin-converting enzyme and angiotensin II receptor blockers were prescribed. At 6 years of diagnosis the patient is asymptomatic and has normal kidney function. Microscopic hematuria and low level proteinuria persists.


Subject(s)
Humans , Male , Adult , Young Adult , AIDS-Associated Nephropathy/diagnosis , Hematuria/diagnosis , Proteinuria/urine , Time Factors , Biopsy , AIDS-Associated Nephropathy/complications , Hematuria/complications , Kidney Tubules/ultrastructure
10.
Rev. cuba. hematol. inmunol. hemoter ; 32(2): 160-175, abr.-jun. 2016. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-908295

ABSTRACT

La presencia de proteínas en la orina se denomina proteinuria, en adultos se define clínicamente por una excreción urinaria de proteínas superior a 150 mg en 24 horas y se produce por una alteración en la barrera de filtración glomerular, que permite el escape de las proteínas en la orina. La proteinuria es frecuente en diferentes enfermedades, particularmente en las gammapatías monoclonales. Los criterios para el diagnóstico de estas entidades incluyen la presencia de células plasmáticas anormales en la médula ósea, una proteína monoclonal en suero aumentada, una proteína monoclonal en orina o lesiones osteolíticas. Para el diagnóstico, evaluación y monitoreo del tratamiento de las gammapatías monoclonales se realizan los estudios electroforéticos de proteínas plasmáticas o proteinogramas séricos y urinarios, técnica que permite la separación de proteínas en función de su migración diferencial al ser sometidas a un campo eléctrico(AU)


The presence of protein in urine is called proteinuria in adults is clinically defined by a urinary excretion of more than 150 mg in 24 hours and proteins occurs by a change in the glomerular filtration barrier, which allows the escape of proteins in urine. Proteinuria is common in various diseases, particularly monoclonal gammopathies. The criteria for diagnosis of these entities include the presence of abnormal plasma cells in the bone marrow, a monoclonal protein increased serum, a monoclonal protein in urine or osteolytic lesions. For diagnosis, evaluation and treatment monitoring of monoclonal gammopathies, electrophoretic studies proteins plasma or serum and urinary proteinograms technique that allows separation of proteins based on their differential migration when subjected to an electric field is performed(AU)


Subject(s)
Humans , Electrophoresis/methods , Paraproteinemias/diagnosis , Proteinuria/diagnosis , Proteinuria/urine
11.
Clinics ; Clinics;71(5): 243-250, May 2016. tab, graf
Article in English | LILACS | ID: lil-782835

ABSTRACT

OBJECTIVE: This study investigated the correlation between the albumin-to-creatinine ratio in the urine and 24-hour urine proteinuria and whether the ratio can predict chronic kidney disease progression even more reliably than 24-hour proteinuria can, particularly in primary IgA nephropathy. METHODS: A total of 182 patients with primary IgA nephropathy were evaluated. Their mean urine albumin-to-creatinine ratio and 24-hour proteinuria were determined during hospitalization. Blood samples were also analyzed. Follow-up data were recorded for 44 patients. A cross-sectional study was then conducted to test the correlation between these parameters and their associations with chronic kidney disease complications. Subsequently, a canonical correlation analysis was employed to assess the correlation between baseline proteinuria and parameters of the Oxford classification. Finally, a prospective observational study was performed to evaluate the association between proteinuria and clinical outcomes. Our study is registered in the Chinese Clinical Trial Registry, and the registration number is ChiCTR-OCH-14005137. RESULTS: A strong correlation (r=0.81, p<0.001) was found between the ratio and 24-hour proteinuria except in chronic kidney disease stage 5. First-morning urine albumin-to-creatinine ratios of ≥125.15, 154.44 and 760.31 mg/g reliably predicted equivalent 24-hour proteinuria ‘thresholds’ of ≥0.15, 0.3 and 1.0 g/24 h, respectively. In continuous analyses, the albumin-to-creatinine ratio was significantly associated with anemia, acidosis, hypoalbuminemia, hyperphosphatemia, hyperkalemia, hypercholesterolemia and higher serum cystatin C. However, higher 24-hour proteinuria was only associated with hypoalbuminemia and hypercholesterolemia. Higher tubular atrophy and interstitial fibrosis scores were also associated with a greater albumin-to-creatinine ratio, as observed in the canonical correlation analysis. Finally, the albumin-to-creatinine ratio and 24-hour proteinuria were associated with renal outcomes in univariate analyses. CONCLUSION: This study supports the recommendation of using the albumin-to-creatinine ratio, rather than 24-hour proteinuria, to monitor proteinuria and prognosis in primary IgA nephropathy.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Creatinine/urine , Albuminuria/urine , Renal Insufficiency, Chronic/urine , Glomerulonephritis, IGA/urine , Proteinuria/urine , Time Factors , Biomarkers/urine , China , Cross-Sectional Studies , Predictive Value of Tests , Prospective Studies , Disease Progression , Renal Insufficiency, Chronic/classification
12.
Acta cir. bras ; Acta cir. bras;30(12): 824-830, Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-769502

ABSTRACT

ABSTRACT PURPOSE: To compare renal dysfunction after right nephrectomy and ligation of the right renal vein with preservation of kidney. METHODS: Animals' weight, pH, density, protein in urine and histological samples of the kidneys were evaluated. Fifteen female rats (Wistar) were divided into three groups. In the control group, right renal vein dissections were performed. In the second group, the right nephrectomy was performed. In the third group, the right renal vein was ligated and the kidney was preserved. Urine samples were taken before, three and seven days after the procedure. On the seventh postoperative day the kidneys were removed to histopathological study. Analysis by Student's t test was performed. RESULTS: weight loss, alterations of urine pH (p<0.05), in specific gravity, proteinuria (p<0.05) were found in groups 2 and 3; hemorrhagic infarction and edema were found after ligation of the right renal vein; changes in the left kidney were also observed on the seventh day. CONCLUSIONS:.


Subject(s)
Animals , Female , Kidney Diseases/etiology , Kidney/physiopathology , Nephrectomy/adverse effects , Postoperative Hemorrhage/etiology , Renal Veins , Body Weight , Disease Models, Animal , Kidney/pathology , Ligation/adverse effects , Proteinuria/urine , Rats, Wistar
13.
Article in English | IMSEAR | ID: sea-162089

ABSTRACT

Background: Proteinuria is recognized as one of the earliest sign of renal function deterioration in chronic smokers. Proteinuria occurs due to alteration in glomerular permeability and later due to failure of reabsorption of filtered protein by the tubular cells. Normally, most healthy adults excrete 20 – 150 mg of protein in urine over 24 hours. However, it is difficult to collect 24 hrs urine samples. Objectives: To advocate the use of PCI (protein creatinine index) in assessment of proteinuria and to compare dipstick result with PCI in the assessment of proteinuria in chronic cigarette smokers. Material & Methods: A total of 30 cigarette smokers and 40 age and sex matched controls were included for the study. A random specimen of urine collected from each cigarette smoker and non- smoker was tested quantitatively by manual sulfosalicylic acid colorimetric method for the estimation of protein concentration. Creatinine concentration in each specimen was measured by modified Jaffe’s method and the urinary PCI was calculated. Results: Normal range of PCI which has been established in this study is 50 to 259. Significantly higher amounts of protein were found to be excreted in urine in chronic smokers (9.313 ± 4.003 mg/dl) as compared to healthy non smokers (7.738 ± 2.05 mg/dl). On comparison of PCI between healthy non smoker and chronic smoker subjects, PCI has been found to be significantly elevated in chronic smokers (healthy non smoker- 118.32 ± 56.86, chronic smoker- 180.1 ± 88.23) (p=0.001). Conclusion: PCI of random urine sample can provide a very useful, simple and convenient method for the quantitative assessment of proteinuria to confirm the advent of kidney damage, avoiding the drawbacks of 24 hrs urine collection.


Subject(s)
Adult , Humans , Creatinine/analysis , Creatinine/urine , Proteinuria/analysis , Proteinuria/diagnosis , Proteinuria/urine , Reagent Strips/diagnosis , Renal Insufficiency/diagnosis , Renal Insufficiency/urine , Smoking/adverse effects , Smoking/urine , Young Adult
14.
Rev. chil. obstet. ginecol ; 80(1): 12-17, 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-743829

ABSTRACT

ANTECEDENTES: La evaluación precisa de la proteinuria constituye un pilar importante para el diagnóstico del síndrome hipertensivo del embarazo (SHE). El estándar dorado para esta medición es la recolección de orina en 24 horas, pero debido a la duración de la toma de la muestra, alternativas como la albuminuria semicuantitativa se utiliza con mayor frecuencia en los servicios de urgencia de nuestro país. OBJETIVO: Evaluar el rendimiento diagnóstico de la albuminuria semicuantitativa y su asociación con proteinuria de 24 horas en pacientes con SHE. MÉTODOS: Estudio retrospectivo de 145 pacientes con sospecha de SHE atendidas en el Hospital Padre Hurtado, Chile. A todas las pacientes se le realizó albuminuria semicuantitativa (categorizada entre 0+ y 4+) y proteinuria de 24 horas (positivo si >0,3 gramos/24 horas). Se realizó análisis por grupos compuestos de albuminuria semicuantitativa y resultado positivo en proteinuria de 24 horas. RESULTADOS: Se evidenció una sensibilidad de 50%, especificidad de 100%, VPP de 100%, VPN de 65,7%, LR+ de 50 y un LR- de 0,5. CONCLUSIÓN: La albuminuria semicuantitativa ≥2+ muestra una fuerte asociación con proteinuria ≥0,3 g/24 horas y es un método rápido para evaluar SHE.


BACKGROUND: One of the basis for the diagnosis of pregnancy induced hypertension syndrome (PIHS), includes the precise evaluation of proteinuria. The gold standard for its evaluation is the collection of a 24-hour urine specimen, but because it is a slow method, other alternatives, such as semi-quantitative albuminuria have been used more frequently on our emergency rooms. OBJECTIVE: To assess the diagnostic performance of semi-quantitative albuminuria and its association with proteinuria measured in a 24-hour urine specimen collection, in patients with PIHS. METHODS: Retrospective study of 145 patients with clinical suspicion of PIHS who assisted to Hospital Padre Hurtado, Chile. Semi-quantitative albuminuria (categorized as 0 to 4+) and proteinuria measured in a 24-hour urine specimen collection was measured on every patient. Abnormal values of proteinuria were considered when values exceeded 0.3 g/24 hours. Composite outcomes analysis was done between albuminuria groups and positive proteinuria in 24 hrs. RESULTS: Sensibility and specificity of semi-quantitative albuminuria was of 50% and 100%, respectively, with a PPV: 100%, NPV: 65.7%, LR+: 50 and a LR-: 0.5. CONCLUSION: semi-quantitative albuminuria ≥2+ shows a strong association with proteinuria ≥0.3 g/24 hours and it could be used as a fast method to assess PIHS.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Urinalysis/methods , Hypertension, Pregnancy-Induced/diagnosis , Hypertension, Pregnancy-Induced/urine , Albuminuria/urine , Proteinuria/urine , Syndrome , Time Factors , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity
15.
Einstein (Säo Paulo) ; 12(4): 413-419, Oct-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732452

ABSTRACT

Objective To evaluate the effect of maternal diabetes on the blood pressure and kidney function of female offspring, as well as if such changes exacerbate during pregnancy. Methods Diabetes mellitus was induced in female rats with the administration of streptozotocin in a single dose, one week before mating. During pregnancy, blood pressure was measured through plethysmography. On the 20th day of pregnancy, the animals were placed for 24 hours in metabolic cages to obtain urine samples. After the animals were removed from the cages, blood samples were withdrawn. One month after pregnancy, new blood and urine sample were collected. Kidney function was evaluated through proteinuria, plasma urea, plasma creatinine, creatinine excretion rate, urinary flow, and creatinine clearance. Results The female offspring from diabetic mothers showed an increase in blood pressure, and a decrease in glomerular filtration rate in relation to the control group. Conclusion Hyperglycemia during pregnancy was capable of causing an increase in blood pressure and kidney dysfunction in the female offspring. .


Objetivo Avaliar o efeito do diabetes materno sobre a pressão arterial e a função renal da prole feminina, bem como verificar se as alterações observadas se exacerbam durante a prenhez. Métodos O diabetes mellitus foi induzido em ratas com a administração de estreptozocina em dose única, uma semana antes do cruzamento. Durante a prenhez, foram feitas medidas da pressão arterial por pletismografia. No 20o dia da prenhez, os animais foram colocados durante 24 horas em gaiolas metabólicas para obtenção de amostras de urina. Após a retirada dos animais das gaiolas, foram obtidas amostras de sangue. Um mês após a prenhez, foram obtidas novas amostras de sangue e urina para as determinações. A função renal foi avaliada por meio de proteinúria, ureia plasmática, creatinina plasmática, carga excretada de creatinina, fluxo urinário e clearance de creatinina. Resultados As fêmeas da prole de mães diabéticas apresentaram elevação da pressão arterial e redução do ritmo de filtração glomerular em relação ao grupo controle. Conclusão A hiperglicemia durante a gestação foi capaz de causar elevação da pressão arterial e disfunção renal na prole de sexo feminino. .


Subject(s)
Animals , Female , Pregnancy , Diabetes Mellitus, Experimental/complications , Diabetic Nephropathies/etiology , Hypertension/etiology , Pregnancy in Diabetics , Prenatal Exposure Delayed Effects/etiology , Creatinine/blood , Disease Models, Animal , Diabetes Mellitus, Experimental/chemically induced , Diabetes Mellitus, Experimental/metabolism , Diabetic Nephropathies/physiopathology , Gestational Age , Glomerular Filtration Rate , Hyperglycemia/complications , Hypertension/physiopathology , Kidney/physiopathology , Pregnancy in Diabetics/metabolism , Prenatal Exposure Delayed Effects/physiopathology , Proteinuria/urine , Rats, Wistar , Reference Values , Streptozocin , Time Factors , Urea/blood
16.
Article in English | IMSEAR | ID: sea-162076

ABSTRACT

Introduction: Viral hepatitis, either acute or chronic, may lead to nephropathies as one of its multiple extrahepatic complications which often remain clinically silent for a long period and are overlooked. Proteinuria can be a useful tool for early detection of the underlying renal impairment. This study was undertaken to detect the presence of proteinuria and to assess and compare the level of proteinuria in HAV and HEV- infected cases; the two most common causes of acute hepatitis in Bangladesh. Method: For this 100 diagnosed patients of HAV & HEV (50 each) hepatitis were screened for isolated proteinuria in a random spot urine sample during their 3rd to 4th post-ecteric follow ups. Result: 43% HAV and 45% HEV patients had high spot urinary protein with maximum incidence (54 %) occurring in 3rd decades of life. The pattern of isolated proteinuria was significantly different in HAV vs HEV cases. The mean ± SD value of spot urinary protein of HEV females was significantly higher than that of HAV where highest rate (64%) of mild proteinuria was observed in HAV and maximum number (46%) of moderate proteinuria in HEV patients. Conclusion: Spot urinary protein concentration should be checked quantitatively in every HEV as well as HAV- hepatitis patient even when clinically improved.


Subject(s)
Adolescent , Adult , Female , Hepatitis A virus , Hepatitis E virus , Hepatitis, Viral, Human/epidemiology , Hepatitis, Viral, Human/complications , Hepatitis, Viral, Human/urine , Hospitals , Humans , Male , Kidney Diseases/diagnosis , Kidney Diseases/urine , Proteinuria/diagnosis , Proteinuria/epidemiology , Proteinuria/urine , Young Adult
17.
Rev. cuba. pediatr ; 86(2): 168-178, abr.-jun. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-721315

ABSTRACT

INTRODUCCIÓN: la microalbuminuria es considerada un marcador de disfunción endotelial, daño vascular, daño renal y enfermedad cardiovascular, considerada un factor de riesgo independiente de morbilidad y mortalidad. De igual manera, la proteinuria ha sido identificada como un factor de riesgo independiente de enfermedad renal crónica, y un predictor de todas las causas de mortalidad. Ambas, son relativamente frecuentes en los sujetos obesos. OBJETIVO: determinar la frecuencia de marcadores de daño vascular y renal en orina en niños y adolescentes obesos. MÉTODOS: se presenta un estudio observacional, analítico y prospectivo que incluyó a niños y adolescentes obesos atendidos en consulta de referencia "Obesidad y riñón", en el Hospital Pediátrico Docente de Centro Habana. El estudio fue realizado en el periodo comprendido entre enero de 2009 y diciembre de 2012. Se determinaron marcadores de daño vascular y renal en orina (microalbuminuria y proteinuria). El análisis estadístico fue realizado con el programa SPSS versión 13,0. RESULTADOS: solo a un paciente se le identificó proteinuria (0,5 %); sin embargo, al determinar la microalbuminuria, se encontró que más de la mitad (70,8 %) tenía este marcador de daño vascular y renal positivo. En el análisis histopatológico de la biopsia renal del paciente con proteinuria se encontró glomerulomegalia con lesión segmentaria de esclerosis y adherencia a la cápsula de Bowman. CONCLUSIONES: los niños y adolescentes obesos tienen una elevada frecuencia de positividad de marcadores de daño vascular y renal, fundamentalmente microalbuminuria.


INTRODUCTION: microalbuminuria is considered to be a marker of endothelial dysfunction, vascular damage, renal damage and cardiovascular disease in addition to be an independent risk factor for morbidity and mortality. Similarly, proteinuria has been identified as an independent risk factor for chronic renal disease and a predictor of all causes of mortality. Both are relatively frequent in obese subjects. OBJECTIVE: to determine the frequency of vascular and renal markers in the urine from obese children and adolescents. METHODS: prospective, observational and analytical study of obese children and adolescents seen at the reference service called obesity and kidney in the teaching pediatric hospital of Centro Habana. The study was conducted from January 2009 through December 2012. Vascular and renal markers were determined in the urine (microalbuminuria and proteinuria). The statistical analysis was based on SPSS program version 13.0. RESULTS: there was just one patient detected with proteinuria (0.5 %); however, in the microalbuminuria test, it was found that over half of the patients (70.8 %) were positive to this vascular and renal damage marker. In the histopathological analysis of the renal biopsy taken from the patient with proteinuria, segmental glomerulosclerosis and adhesion to Bowman's capsule was discovered. CONCLUSIONS: obese children and adolescents have very frequent positivity to vascular and renal damage markers, mainly microalbuminuria.


Subject(s)
Humans , Adolescent , Proteinuria/urine , Environmental Biomarkers , Albuminuria/etiology , Albuminuria/urine , Obesity/complications , Obesity/diagnosis , Epidemiology, Descriptive , Prospective Studies
18.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);60(2): 105-110, 2014. graf
Article in English | LILACS | ID: lil-710342

ABSTRACT

Objective: The present study aimed at assessing the association between environmental temperature and the relative humidity of the air with frequency of hypertensive disorders of pregnancy. Methods: A prospective and retrospective, descriptive, ecological study was held at a teaching maternity in Recife, Brazil. Data from all 26.125 pregnant women admitted between 2000 and 2006 were analysed and 5.051 had the diagnosis of hypertensive disorder of pregnancy. The incidence percentages were calculated monthly per deliveries. Data on mean monthly temperature and relative humidity of the air were collected and monthly comparisons were conducted. February was chosen as the reference month due to its lowest incidence of the disease. The relative chance of hypertensive disorders of pregnancy for each other month was estimated by odds ratio and Pearson's correlation coefficient was used to calculate the relation between the incidence of hypertensive disorders of pregnancy and the mean monthly temperature and relative air humidity. Results: February presented the lowest mean monthly incidence (9.95%) and August the highest (21.54%). Pearson correlation coefficient revealed a higher incidence of hypertensive disorders of pregnancy in the cooler months (r= -0.26; p=0.046) and no significant effect of relative air humidity (r=0.20; p=0.128). Conclusion: The incidence of hypertensive disorders of pregnancy may be affected by variations in temperature, increasing during cooler periods. .


Objetivo: O objetivo do presente estudo foi avaliar a associação entre a temperatura e umidade relativa do ar e a incidência de síndromes hipertensivas gestacionais. Métodos: Um estudo ecológico, prospectivo e retrospectivo, foi conduzido em uma maternidade-escola, na cidade do Recife, Brasil. Dados de todas as 26.125 gestantes, admitidas entre os anos de 2000 e 2006, foram analisados e 5.051 mulheres tiveram o diagnóstico de síndrome hipertensiva gestacional no momento da admissão. A incidência percentual foi calculada mensalmente, por número de partos. Dados referentes à temperatura média mensal e umidade relativa do ar mensal foram coletados e comparações feitas mês a mês quanto à incidência da doença. O mês de fevereiro foi escolhido como mês de referência por conta da sua menor incidência. O risco relativo de síndrome hipertensiva gestacional para cada outro mês foi calculado por odds ratio e o coeficiente de correlação de Pearson foi utilizado para calcular a relação entre a incidência da doença e a média mensal de temperatura e umidade relativa do ar. Resultados: O mês de fevereiro apresentou a menor incidência mensal da doença (9,95%) e agosto, a maior (21,54%). O coeficiente de correlação de Pearson demonstrou maior incidência de síndromes hipertensivas gestacionais nos meses mais frios (r= -0,26; p=0,046), e nenhum efeito significativo da umidade relativa do ar (r=0,20; p=0,128). Conclusão: A incidência de síndromes hipertensivas gestacionais parece ser afetada por variações na temperatura, com menor incidência nos períodos mais frios. .


Subject(s)
Female , Humans , Pregnancy , Humidity , Hypertension/epidemiology , Pregnancy Complications, Cardiovascular/epidemiology , Seasons , Temperature , Brazil/epidemiology , Incidence , Pre-Eclampsia/epidemiology , Prospective Studies , Proteinuria/urine , Retrospective Studies , Tropical Climate
19.
Rev. méd. Chile ; 141(11): 1470-1474, nov. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-704573

ABSTRACT

HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) represents a severe form ofpreeclampsia associated with serious maternal and fetal morbiditiesand even death. Usually HELLP syndrome appears during the evolution of a severepreeclampsia; however HELLP syndrome can have atypical clinical manifestations.We report a 22-year-old female who consulted at 20 weeks of pregnancy for lumbarpain, dysuria and fever. A urinalysis revealed the presence of white blood cells. Thepatient was admitted to hospital and treated with antimicrobials. Forty eight hoursafter admission a proteinuria of 440 mg/24 h was detected. A severe pre eclampsia-HELLP syndrome was diagnosed. However the patient remained with normal bloodpressure. An elevation of liver enzymes and creatinine were observed. Five dayslater fetal death was confirmed and an abortion was induced. The patient requireda platelet transfusion. Four days after the abortion, the patient was discharged ingood conditions.


Subject(s)
Female , Humans , Pregnancy , Young Adult , Blood Pressure/physiology , HELLP Syndrome/physiopathology , Pre-Eclampsia/physiopathology , Abortion, Induced , Fetal Death , HELLP Syndrome/diagnosis , Low Back Pain/etiology , Platelet Transfusion , Pre-Eclampsia/diagnosis , Proteinuria/urine , Reference Values
20.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;46(7): 567-573, ago. 2013. tab, graf
Article in English | LILACS | ID: lil-682402

ABSTRACT

Glycosaminoglycans (GAGs) participate in a variety of processes in the kidney, and evidence suggests that gender-related hormones participate in renal function. The aim of this study was to analyze the relationship of GAGs, gender, and proteinuria in male and female rats with chronic renal failure (CRF). GAGs were analyzed in total kidney tissue and 24-h urine of castrated (c), male (M), and female (F) Wistar control (C) rats (CM, CMc, CF, CFc) and after 30 days of CRF induced by 5/6 nephrectomy (CRFM, CRFMc, CRFF, CRFFc). Total GAG quantification and composition were determined using agarose and polyacrylamide gel electrophoresis, respectively. Renal GAGs were higher in CF compared to CM. CRFM presented an increase in renal GAGs, heparan sulfate (HS), and proteinuria, while castration reduced these parameters. However, CRFF and CRFFc groups showed a decrease in renal GAGs concomitant with an increase in proteinuria. Our results suggest that, in CRFM, sex hormones quantitatively alter GAGs, mainly HS, and possibly the glomerular filtration barrier, leading to proteinuria. The lack of this response in CRFMc, where HS did not increase, corroborates this theory. This pattern was not observed in females. Further studies of CRF are needed to clarify gender-dependent differences in HS synthesis.


Subject(s)
Animals , Female , Male , Castration , Glycosaminoglycans/urine , Gonadal Steroid Hormones/deficiency , Kidney Failure, Chronic/metabolism , Kidney/chemistry , Proteinuria/urine , Electrophoresis, Agar Gel , Electrophoresis, Polyacrylamide Gel , Glomerular Filtration Rate , Glycosaminoglycans/isolation & purification , Heparitin Sulfate/urine , Kidney Failure, Chronic/surgery , Kidney/surgery , Nephrectomy , Random Allocation , Rats, Wistar , Sex Factors
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