ABSTRACT
Introducción: La Enfermedad Renal Crónica ha cobrado interés debido a su alta tasa de morbimortalidad. Además de las causas vasculares y de la diabetes mellitus, se ha identificado una causa de Origen Desconocido en jóvenes agricultores. Objetivo: El objetivo del estudio es determinar la prevalencia de la población en hemodiálisis, sospechosa de la Nefritis Intersticial Crónica en Comunidades Agrícolas, para categorizar la verdadera etiología de su patología renal. Metodología: Se aplicó un diseño observacional descriptivo durante los meses de diciembre de 2022, enero y febrero de 2023; y se encuestó a 684 pacientes de ambos sexos en 8 centros de hemodiálisis de la Capital y el Departamento Central del Paraguay. Resultados: La prevalencia de casos sospechosos por la exposición a factores de riesgo resultó ser del 18.1%. Esta cifra podría ser mayor, ya que 22.6% de los pacientes con diabetes mellitus tipo 2, no presentó retinopatía clínica ni otros signos clínicos de la enfermedad al momento del diagnóstico de la falla renal. Este panorama nos advierte de un probable diagnóstico desacertado en una cantidad considerable de pacientes. Conclusión: La importancia de esta investigación se sustenta en generar acciones preventivas en la población agrícola y concientizar a la sociedad médica de la relevancia diagnóstica de esta patología para mejorar la calidad y pronóstico de vida en la población paraguaya.
Introduction: Chronic Kidney Disease has gained interest due to its high morbidity and mortality rate. In addition to vascular causes and diabetes mellitus, an unknown cause has been identified in young farmers. Objective: This study aims to determine the prevalence of the population on hemodialysis, suspected of Chronic Interstitial Nephritis in agricultural communities, to categorize the true etiology of their renal pathology. Methodology: A descriptive observational design was applied during December 2022, January, and February 2023; and 684 patients of both sexes were surveyed in 8 hemodialysis centers in the Capital and the Central Department of Paraguay. Results: The prevalence of suspected cases due to the exposure to risk factors was 18.1%. This figure could be higher since 22.6% of patients with type 2 diabetes mellitus did not present clinical retinopathy or other clinical signs of the disease at the time of the diagnosis of kidney failure. This scenario warns us of a probable misdiagnosis in a considerable number of patients. Conclusion: The importance of this research lies in generating preventive actions in the agricultural population and raising awareness in the medical community about the diagnostic relevance of this pathology to improve the quality and prognosis of life in the Paraguayan population.
Subject(s)
Chronic Kidney Diseases of Uncertain Etiology , HemodiafiltrationABSTRACT
BACKGROUND: Acidophilic microorganisms like Leptospirillum sp. CF 1 thrive in environments with extremely low pH and high concentrations of dissolved heavy metals that can induce the generation of reactive oxygen species (ROS). Several hypothetical genes and proteins from Leptospirillum sp. CF 1 are known to be up regulated under oxidative stress conditions. RESULTS: In the present work, the function of hypothetical gene ABH19_09590 from Leptospirillum sp. CF 1 was studied. Heterologous expression of this gene in Escherichia coli led to an increase in the ability to grow under oxidant conditions with 5 mM K2CrO4 or 5 mM H2O2. Similarly, a significant reduction in ROS production in E. coli transformed with a plasmid carrying ABH19_09590 was observed after exposure to these oxidative stress elicitors for 30 min, compared to a strain complemented with the empty vector. A co transcriptional study using RT PCR showed that ABH19_09590 is contained in an operon, here named the "och" operon, that also contains ABH19_09585, ABH19_09595 and ABH19_09600 genes. The expression of the och operon was significantly up regulated in Leptospirillum sp. CF 1 exposed to 5 mM K2CrO4 for 15 and 30 min. Genes of this operon potentially encode a NADH:ubiquinone oxidoreductase, a CXXC motif containing protein likely involved in thiol/disulfide exchange, a hypothetical protein, and a di hydroxy acid dehydratase. A comparative genomic analysis revealed that the och operon is a characteristic genetic determinant of the Leptospirillum genus that is not present in other acidophiles. CONCLUSIONS: Altogether, these results suggest that the och operon plays a protective role against chromate and hydrogen peroxide and is an important mechanism required to face polyextremophilic conditions in acid environments.