RESUMO
No disponible
Assuntos
Humanos , Doadores Vivos , Transplante de Rim/métodos , Insuficiência Renal Crônica/cirurgia , Complicações Pós-Operatórias/epidemiologia , Função Retardada do Enxerto/epidemiologia , Nefrectomia/éticaRESUMO
No disponible
No disponible
Assuntos
Humanos , Transplante de Rim/estatística & dados numéricos , Doadores de Tecidos/provisão & distribuição , Espanha/epidemiologia , Doadores Vivos/provisão & distribuição , Listas de Espera , Morte Encefálica , Transplante/tendênciasRESUMO
No disponible
Assuntos
Humanos , Pessoa de Meia-Idade , Tendão do Calcâneo , Diálise Renal , Anti-Infecciosos , Ofloxacino , TendinopatiaRESUMO
El diagnóstico diferencial entre la nefritis intersticial inmunoalérgica (NIIA) y la enfermedad por ateroembolismo de colesterol (AE) puede ser muy difícil por presentarse a menudo ambas entidades como fracasos renales agudos con eosinofilia llamativa y lesiones cutáneas. Realizamos un estudio comparativo retrospectivo de las series de NIIA y de AE registradas en nuestro Hospital, en el período comprendido entre 1980 y diciembre del 2000. En total, se estudiaron 42 pacientes diagnosticados de NIIA y 16 pacientes diagnosticados de AE. Se analizaron los parámetros epidemiológicos, clínicos, analíticos y de evolución renal, así como la morbi-mortalidad. Se encontraron diferencias significativas en las prevalencias de sexo masculino (100% frente a 57%, p 1 g/día en un porcentaje mayor de casos de AE (44% vs 26%, p < 0,05), sin observarse diferencias en la presencia de eosinofilia (88% en la AE vs 64% en la NIIA pNS), microhematuria o leucocituria. Desde el punto de vista del pronóstico renal y la morbi-mortalidad asociada, se observa una evolución casi constante hacia la IRC terminal en el AE, así como una mortalidad elevada (69% vs 5%, p < 0,001), que contrasta con la mejor evolución de los casos con NIIA. En conclusión, la presencia de determinados datos clínicos y analíticos, en conjunto, nos permiten una orientación inicial para el diagnóstico diferencial entre ambas entidades
The commonest clinical presentation of both immunoalergic interstitial nephritis (IIN) and atheroembolic renal disease (ATD) is an acute renal failure accompanied by skin lesions and eosinophilia. As a consequence, differential diagnosis between both entities is often very difficult. We have performed a comparative retrospective study of those patients diagnosed as having IIN or ATD in our Hospital in the period 1980-2000. A total of 42 patients have been diagnosed of IIN and 16 of ATD. Demographic data, as well as clinical and laboratory parameters and outcomes of every studied patient were analysed. We found a significantly higher prevalence of male sex (100% vs 57%, p 1 g/24 h was significantly higher, but no differences between both groups in the prevalence of urinary sediment abnormalities were observed. The prevalence of absolute eosinophilia was high in both groups (88% among ATD patients, 64% among IIN patients; pNS). Prognosis of both entities was clearly different: Almost all patients with ATD died (69%) or evolved to end-stage renal failure, whereas most patients with IIN showed a recovery of renal function after withdrawal of responsible drugs and steroid treatment. In summary, the analysis of clinical and laboratory data allows an initial differential diagnosis in patients suspected as having IIN or ATD
