RESUMO
People are exposed to various potentially toxic agents and conditions in their natural and occupational environments. These agents may be physical or chemical, may enter the human body through oral, inhalational, or transdermal routes, and may exert effects on all organ systems. Several well-known as well as lesser known associations exist between chronic kidney disease (CKD) and both environmental agents and conditions, such as heavy metals, industrial chemicals, elevated ambient temperatures, and infections. The effects of these agents may be modulated by genetic susceptibility and other comorbid conditions and may lead to the development of acute and CKD. In this article, we present environmental factors that are associated with CKD.
Assuntos
Exposição Ambiental , Poluentes Ambientais/efeitos adversos , Infecções/complicações , Nefropatias/etiologia , Exposição Ocupacional , Ácidos Aristolóquicos/efeitos adversos , Nefropatia dos Bálcãs/etiologia , Doença Crônica , Medicamentos de Ervas Chinesas/efeitos adversos , Doenças Endêmicas , Golpe de Calor/complicações , Humanos , Infecções/epidemiologia , Nefropatias/induzido quimicamente , Nefropatias/epidemiologia , Falência Renal Crônica/induzido quimicamente , Falência Renal Crônica/epidemiologia , Metais Pesados/efeitos adversos , Nicarágua/epidemiologia , Esforço Físico , Recidiva , Sri Lanka/epidemiologiaRESUMO
OBJECTIVE: Placental soluble fms-like tyrosine kinase-1 may contribute to the pathogenesis of preeclampsia. Here we describe alterations in serum angiogenic factor levels in women with multiple gestation pregnancies, a major preeclampsia risk factor. STUDY DESIGN: We collected serial serum specimens from 101 pregnant women at high preeclampsia risk between 22 and 36 weeks' gestation. Soluble fms-like tyrosine kinase-1 and placental growth factor were measured by enzyme-linked immunosorbent assay. Women who had preeclampsia or gestational hypertension develop were excluded. RESULTS: Maternal soluble fms-like tyrosine kinase-1 was higher in multiple gestation (n = 20) compared with high-risk singleton (n = 81) pregnancies for each gestational age range examined. Maternal placental growth factor was significantly higher in multiple vs high-risk singletons before 31 weeks' gestation, whereas the soluble fms-like tyrosine kinase-1/placental growth factor ratio was higher in multiple vs high-risk singletons after 27 weeks. CONCLUSION: Alterations in circulating angiogenic factors are present in women with multiple gestations and may contribute to higher preeclampsia risk in this population.
