RESUMO
Renal papillary necrosis is an infrequent cause of hematuria characterized by ischemic necrosis of the renal medulla, especially the papilla. Its most common cause is analgesic abuse. Despite being oligo-symptomatic, in many cases its presence is associated with serious functional sequelae. Imaging, especially computed tomography, is essential to make the diagnosis. We report a 63-year-old female studied for an asymptomatic microscopic hematuria whose tomographic study showed a bilateral renal papillary necrosis. No etiology was found, and she evolved with a spontaneous complete remission.
Assuntos
Hematúria , Necrose Papilar Renal , Feminino , Humanos , Medula Renal , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Renal papillary necrosis is an infrequent cause of hematuria characterized by ischemic necrosis of the renal medulla, especially the papilla. Its most common cause is analgesic abuse. Despite being oligo-symptomatic, in many cases its presence is associated with serious functional sequelae. Imaging, especially computed tomography, is essential to make the diagnosis. We report a 63-year-old female studied for an asymptomatic microscopic hematuria whose tomographic study showed a bilateral renal papillary necrosis. No etiology was found, and she evolved with a spontaneous complete remission.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hematúria , Necrose Papilar Renal , Tomografia Computadorizada por Raios X , Medula RenalRESUMO
Chronic kidney disease is associated with an increase in cardiovascular risk and mortality, and a decrease in the health-related quality of life. It is known that the physical capacity of patients with chronic kidney disease is lower than their healthy counterparts. It also decreases progressively after the start of hemodialysis, even leading to the loss of functional independence. There is a positive association between exercise and improvement of many targets in chronic kidney disease, especially in dialysis patients, such as cellular apoptosis, immune improvement and inflammation. In addition, several clinical studies and systematic reviews show an improvement in different clinical and laboratory variables and suggest a lower mortality, proving a reduction of health care economic costs. Exercise intervention in dialysis is safe. Although different guidelines promote exercise, it is necessary to work on its implementation on a large scale.
Assuntos
Humanos , Exercício Físico/fisiologia , Insuficiência Renal Crônica/terapia , Terapia por Exercício , Qualidade de Vida , Diálise Renal , Medicina Baseada em Evidências , Insuficiência Renal Crônica/fisiopatologiaRESUMO
Chronic kidney disease is associated with an increase in cardiovascular risk and mortality, and a decrease in the health-related quality of life. It is known that the physical capacity of patients with chronic kidney disease is lower than their healthy counterparts. It also decreases progressively after the start of hemodialysis, even leading to the loss of functional independence. There is a positive association between exercise and improvement of many targets in chronic kidney disease, especially in dialysis patients, such as cellular apoptosis, immune improvement and inflammation. In addition, several clinical studies and systematic reviews show an improvement in different clinical and laboratory variables and suggest a lower mortality, proving a reduction of health care economic costs. Exercise intervention in dialysis is safe. Although different guidelines promote exercise, it is necessary to work on its implementation on a large scale.
Assuntos
Terapia por Exercício , Exercício Físico/fisiologia , Insuficiência Renal Crônica/terapia , Medicina Baseada em Evidências , Humanos , Qualidade de Vida , Diálise Renal , Insuficiência Renal Crônica/fisiopatologiaRESUMO
BACKGROUND: Health-related quality of life (HRQOL) among patients on chronic hemodialysis (CHD), is associated with mortality, complications and compliance to treatment. AIM: To assess HRQOL in a group of patients on CHD. PATIENTS AND METHODS: A cross-sectional multicenter study was carried out, involving 224 patients from five CHD units (3 private and 2 public) in Bio Bio Region, using the Kidney Disease Quality of Life -36 items (KDQOL-36) questionnaire and Karnofsky scale. Scores range from 0 to 100, with higher values representing a better HRQOL. RESULTS: Physical and Mental scales and subscales of symptoms, effect and the burden of kidney disease subscales rendered scores below 50 (the referential value), in 80%, 61%, 8%, 43% and 80% of evaluations, respectively. The lower scores were observed in patients with diabetes, coronary artery disease, hypoalbuminemia, serum creatinine below 9.4 mg/dL, age >or=55 years and in those with a low economic and educational level (p <0.05). CONCLUSIONS: HRQOL in patients on hemodialysis had values below the referential score in subjects with diabetes and coronary artery disease, poor nutritional status and a low educational and socioeconomic level. The incorporation of support professionals, such as social workers, psychologists, dieticians, covering psychosocial factors, could improve the patients quality of life.
