[Rehabilitation of the patients suffering from chronic calculous pyelonephritis].

The objective of the present study was to develop a new technology for the balneotherapeutic treatment of the patients with urolithiasis by means of combined application of mineral water, mineral baths (1 therapeutic complex), sinusoidal modulated current (SMC-phoresis of nicotinamide), and preparations inhibiting urine concrement formation. The overall efficacy of this combined balneo-, physio-, radio-, and pharmacotherapy of the patients presenting with secondary calculous pyelonephritis amounted to 94% compared with 73.4% using balneotherapy alone (p1-2 < 0.05). Summation of positive effects of balneo-, physio-, radio-, and pharmacotherapies promoted normalization of the functional state of the kidneys and the upper urinary tracts which in its turn contributed to the improvement of the patient's quality of life.

Prevalencia de la enfermedad renal crónica determinada mediante la aplicación de ecuaciones predictias en personas hipertensas atendidas en atención primaria / Prevalence of Chronic Kidney Disease in Hypertensive Persons Attended in Primary Care from Spain Determined by Application of Estimating Equations

Fundamento: La enfermedad renal crónica (ERC) constituye un importante problema de salud en las sociedades desarrolladas vinculado al progresivo envejecimiento de la población y a la elevada prevalencia de patologías como la hipertensión arterial (HTA) y la diabetes mellitus. Los objetivos de este trabajo son: estudiar la función renal (FR) en las personas hipertensas mediante ecuaciones predictivas y creatinina plasmática (Crp). Conocer el porcentaje de personas con enfermedad renal crónica (ERC) que presentan valores normales de Crp. Analizar los factores que colaboran en el deterioro de su FR.Metodos: Estudio descriptivo transversal de las personas con hipertensión arterial (HTA). Se determinó Crp y tensión arterial (TA). Se calculó el filtrado glomerular mediante las fórmulas de Cockroft-Gault y MDRD. Se registraron los años de evolución de la HTA. Se realizó estudio descriptivo de las variables estudiadas y se analizó la posible dependencia entre algunas mediante regresión lineal múltiple..Resultados: Se estudió un total de 52 pacientes (57,7% mujeres). Edad media 72,4 ± 10,8. Un 32,6% (Cockcroft-Gault)o un 21,5% (MDRD) cumplían criterio de ERC. Predomina la ERC en las mujeres. El 21,4% (Cockcroft-Gault) y 9,5% (MDRD) de pacientes con ERC tenían valores normales de Crp. No encontramos dependencia lineal entre las cifras de TA y la FR. El cumplimiento de los objetivos de TA no supone un menor desarrollo de ERC. En los varones encontramos dependencia lineal entre la FR (MDRD) y los años de evolución de la HTA.Conclusiones: La ERC es una patología frecuente en las personas hipertensas. La utilización sistemática de ecuaciones predictivas facilita la detección de ERC oculta en pacientes con Crp normal (AU)

Background: To study the renal function (FR) of the hypertensive patients by means of estimating equations and serum creatinine (Crp). To calculate the percentage of patients with chronic kidney disease (ERC) that present normal values of Crp. To analyze which factors collaborate in the deterioration of the FR.Methods: Descriptive cross-sectional study of patients with HTA. Crp and arterial tension (TA) were determined. The glomerular filtration rate was calculated by means of Cockroft-Gault and MDRD’s formula. The years of evolution of the HTA were registered. A descriptive study of the variables and the possible dependence among them was completed, using several times linear multiple regression.Results: 52 patients were studied (57,7% women). Average age 72,4 ± 10,8. 32,6% (Cockcroft-Gault) or 21,5% (MDRD) were fulfilling ERC criterion. The ERC was mainly diagnosed in females. 21,4% (Cockcroft-Gault) and 9,5 % patients (MDRD) with ERC had normal Crp values. We do not find linear dependence between the numbers of TA and the FR. The TA check-up objectives do not suppose less development of ERC. In males we find linear dependence within the FR (MDRD) and the years of evolution of the HTA.Conclusion: The ERC is a frequent pathology in the hypertense persons. The systematical utilization of estimating equations facilitates the detection of hidden ERC in patients with normal Crp (AU)

[Bicarbonate calcium mineral water with carbon dioxide in rehabilitation of children with dismetabolic nephropathies complicated by renal inflammation]. / Uglekislaia gidrokarbonatnaia kal'tsievaia mineral'naia voda v reabilitatsii detei s dismetabolicheskimi nefropatiiami v sochetanii s vospalitel'nymi zabolevaniiami pochek.

A renal function was studied in children with dismetabolic nephropathy and renal inflammation before and after spa treatment with low-mineral water from the spring "Gornovodnoye". Drinking the water resulted in intensification of 24-h diuresis in increasing proportion of sodium and chlorine ions concentrations and decreasing proportion of calcium and magnesium ions concentrations. A membrane-stabilizing action of Gornovodnenskaya mineral water reduced oxaluria and uraturia. An effective scheme of balneotherapy is proposed.

Fatores de risco no tratamento do cálculo coraliforme por nefrolitotomia percutânea / Risk factors for treatment of staghorn stones by peercutaneous nephrolithomy

No tratamento do cálculo coraliforme por nefrolititomia percutânea, há cirurgias com poucas dificuldades e pacientes que evoluem sem complicações, como há casos muito difíceis, com pós-operatório extremamente complicado. O objetivo deste estudo é analisar os fatores de risco pré, intra e pós-operatórios, relacionados com complicações e insucessos da nefrolitotomia percutânea no tratamento do cálculo coraliforme. Foram estudados 57 pacientes portadores de 72 cálculos coraliformes. Houve correlação estatisticamente significante entre complicação e os seguintes fatores: infecção do trato urinário no pré-operatório e número de punções renais. Em relação a insucesso os fatores de risco foram: infecção do trato urinário no pré-operatório e via excretora sem dilatação / During a percutaneous nephrolithotomy (PNL) procedure there are cases with no difficulties and no complications. In the other hand, there are cases very hard to treat with a higher surgical risk and post-operative complications.The goal of this study is to analyze the pre, intra and postoperative risk factors related to surgical complications and nonsuccess rates of PNL as treatment for staghorn stone. Fifty-seven patients with seventy-two staghorn calculi were studied. There have been significant statistical correlation between complications and: postoperative urinary tract infections and the number of renal access required. When considering nonsuccess rate, there was association with the following risk factors: postoperative urinary tract infections and absence of dilatation of collecting system...

Fatores de risco no tratamento do cálculo coraliforme por nefrolitotomia percutânea / Risk factors for treatment of staghorn stones by percutaneous nephrolithotomy

No tratamento do cálculo coraliforme por nefrolititomia percutânea, há cirurgias com poucas dificuldades e pacientes que evoluem sem complicações, como há casos muito difíceis, com pós-operatório extremamente complicado. O objetivo deste estudo é analisar os fatores de risco pré, intra e pós-operatórios, relacionados com complicações e insucessos da nefrolitotomia percutânea no tratamento do cálculo coraliforme. Foram estudados 57 pacientes portadores de 72 cálculos coraliformes. Houve correlação estatisticamente significante entre complicação e os seguintes fatores: infecção do trato urinário no pré-operatório e número de punções renais. Em relação a insucesso os fatores de risco foram: infecção do trato urinário no pré-operatório e via excretora sem dilatação.

During a percutaneous nephrolithotomy (PNL) procedure there are cases with no difficulties and no complications. In the other hand, there are cases very hard to treat with a higher surgical risk and post-operative complications.The goal of this study is to analyze the pre, intra and postoperative risk factors related to surgical complications and nonsuccess rates of PNL as treatment for staghorn stone. Fifty-seven patients with seventy-two staghorn calculi were studied. There have been significant statistical correlation between complications and: postoperative urinary tract infections and the number of renal access required. When considering nonsuccess rate, there was association with the following risk factors: postoperative urinary tract infections and absence of dilatation of collecting system.

Nefrostomía percutánea ambulatoria en la clínica de Marly: técnica corriente y microtécnica

Se presenta la experiencia en la clínica de Marly en Nefrostomías percutáneas ambulatorias, practicadas con técnica convencional y microtécnica, mediante la utilización de microguías, aguja de Chiba y catéteres delgados. Durante 36 meses se practicaron 99 nefrstomías en 86 pacientes, con diferentes patologías de base: Uroliatiasis (71 pacientes), neoplasias del tracto urogenital con obstrucción (11 pacientes), lesiones iatrogénicas del ureter (3 pacientes) y tuberculosis bovina (1 paciente). Se describen las técnicas utilizadas y resultados. Como compilaciones se presentaron 13 desalojos (con recolocación posterior ambulatoria), bacteremias inmediatas en 18 pacientes manejados con antibioticoterapia dos de los cuales se manejaron intrahospitalariamente. La nefrostomía con micropunción disminuyó el tiempo promedio de procedimiento (25.8 minutos vs 43.3 minutos, con un promedio total de 39.9 min. y SD de 11.248); la nefrostomía ambulatoria disminuye los costos del procedimiento, disminuye la morbilidad y es mejor aceptada por el paciente. Se utiliza como método predominante de imagen la ecografía, con lo cual disminuimos la relación tanto para el paciente como para el personal. La hefrostomia intrahospitalaria solamente se debe practicar en pacientes con indicaciones claras que contraindioquen el procedimiento ambulatorio