RESUMO
BACKGROUND: The aim of this report is to describe the effect of daily hemodialysis on the growth of children with end-stage renal disease (ESRD). METHODS: We performed a prospective, observational study on 24 children with ESRD undergoing daily hemodialysis (DHD). The control group comprised 26 children on concurrent conventional hemodialysis (CHD), and the follow-up for both groups was 9.3 ± 3.0 months. No patient received growth hormone (GH) therapy. RESULTS: At the onset of the study, the height-for-age Z-score was -2.12 ± 1.54 in the CHD group and -2.84 ± 2.27 in the DHD group (p = 0.313). Assuming an increase of 0.5 standard deviation scores (SDS) of the height-for-age parameter as an improvement of growth, there were 33 % of patients in the DHD group and 8 % in the CHD group (p = 0.035). The cumulative probability of gain in height for age at 12 months was 40 % in the DHD group versus 15 % in the CHD group (p = 0.047). Also, 98 % of patients in the DHD group had an adequate total caloric intake, whereas 38 % in the CHD group reached this goal (p < 0.001). No patient left the study due to intensification of the dialysis modality. CONCLUSIONS: Our data show that the DHD favored a 0.5 SDS height gain in a third of patients without GH treatment. Dialysis intensification was not a cause for treatment dropouts, and DHD should be considered as a treatment for selected cases, especially small children.
Assuntos
Estatura , Desenvolvimento Infantil , Falência Renal Crônica/terapia , Diálise Renal/métodos , Adolescente , Fatores Etários , Estudos de Casos e Controles , Criança , Pré-Escolar , Ingestão de Energia , Feminino , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/fisiopatologia , Humanos , Lactente , Falência Renal Crônica/complicações , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Masculino , Estado Nutricional , Estudos Prospectivos , Diálise Renal/efeitos adversos , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
Abscesso primario do psoas nao e uma doenca comum. O quadro clinico em crianca muitas vezes e inespecifico, podendo levar a atraso no diagnostico. Os autores descrevem um caso de abscesso primario do psoas em menina de sete anos de idade, com acometimento secundario da articulacao do quadril. O diagnostico foi confirmado atraves de tomografia computadorizada de abdome e pelve. E apresentada uma revisao da literatura sobre as manifestacoes clinicas, patogenese, diagnostico diferencial, etiologia, abordagem diagnostica e terapeutica desta patologia
