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Efeito agudo do exercicío físico aeróbico na atividade nervosa simpática periférica de pacientes portadores de doença renal crônica - estágio III; Acute effectof aerobic exercise in the muscle sympathetic nerve activity in patients with chronic kidney disease stage III

Aprile, Daniele Cristina Bosco
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 04/02/2010 Português
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96.09%
A principal causa de mortalidade nos pacientes com doença renal crônica é a doença cardiovascular. A alta prevalência de hipertensão arterial nestes pacientes e sua relação com riscos cardiovasculares são indiscutíveis. A doença renal crônica é caracterizada pela hiperatividade simpática, o que contribui para gênese ou agravo da hipertensão arterial. O exercício aeróbico reduz a pressão arterial e a atividade nervosa simpática em diversas populações, mas seus efeitos não são claros em pacientes com doença renal crônica. O objetivo deste estudo foi avaliar nestes pacientes as respostas hemodinâmicas e neurais ao exercício estático com handgrip após uma sessão de exercício aeróbio. Nove pacientes, portadores de doença renal crônica no estágio III (52±8 anos) e doze indivíduos saudáveis (50±5 anos), em ordem aleatória, realizaram uma sessão de exercício aeróbio em ciclo ergômetro (45 minutos a 50% do Vo2pico) e uma sessão de repouso (repouso sentado por 45 minutos). Após as sessões, foram registradas no período basal e durante o exercício estático com handgrip (3 minutos a 30% da contração voluntária máxima): atividade nervosa simpática periférica (microneurografia), pressão arterial...

Terapia celular em gatos portadores de doença renal crônica: avaliação laboratorial e imagiológica; Stem cell therapy in cats carriers of chronic kidney disease: laboratorial and imaging evaluation

Santos, Juliana Passos Alves dos
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 19/12/2012 Português
Relevância na Pesquisa
96.06%
A doença renal crônica é uma das maiores causas de enfermidade e óbito de gatos geriátricos e carreia o declínio da função renal. A forma crônica é caracterizada por persistir um período prolongado de tempo e de prognóstico reservado. Atualmente, a reposição hídrica, a hemodiálise e o transplante são as opções de terapia. Como a terapia com células-tronco tem sido extensivamente estudada nos últimos anos devido a sua capacidade de melhorar a função de órgão lesionados, inclusive os rins, este estudo teve como objetivo avaliar o efeito do transplante de células-tronco de tecido adiposo de gatos, bem como estudar a contribuição de exames complementares laboratoriais e de imagem na evolução terapêutica dos animais. As células provenientes deste tecido apresentaram morfologia fibroblastóide; aderência ao plástico; diferenciaram em osteócitos, condrócitos e adipócitos e expressaram marcadores de superfície característicos de células-tronco mesenquimais. Além disso, quando injetadas em camundongos imunossuprimidos nude não apresentaram formações tumorais. Para triar os animais com a doença renal crônica para este estudo foram realizados exames de sangue, urina e ultrassonografia de 97 animais...

Elevated levels of plasma osteoprotegerin are associated with all-cause mortality risk and atherosclerosis in patients with stages 3 to 5 chronic kidney disease

Nascimento,M.M.; Hayashi,S.Y.; Riella,M.C.; Lindholm,B.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 Português
Relevância na Pesquisa
96.05%
Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and plays a role in vascular calcification. We evaluated the relationship between osteoprotegerin levels and inflammatory markers, atherosclerosis, and mortality in patients with stages 3-5 chronic kidney disease. A total of 145 subjects (median age 61 years, 61% men; 36 patients on hemodialysis, 55 patients on peritoneal dialysis, and 54 patients with stages 3-5 chronic kidney disease) were studied. Clinical characteristics, markers of mineral metabolism (including fibroblast growth factor-23 [FGF-23]) and inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6 [IL-6]), and the intima-media thickness (IMT) in the common carotid arteries were measured at baseline. Cardiac function was assessed by color tissue Doppler echocardiography. After 36 months follow-up, the survival rate by Kaplan-Meier analysis was significantly different according to OPG levels (χ 2=14.33; P=0.002). Increased OPG levels were positively associated with IL-6 (r=0.38, P<0.001), FGF-23 (r=0.26, P<0.001) and hsCRP (r=0.0.24, P=0.003). In addition, OPG was positively associated with troponin I (r=0.54, P<0.001) and IMT (r=0.39, P<0.0001). Finally...

The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease

Sette,Luís Henrique Bezerra Cavalcanti; Lopes,Edmundo Pessoa de Almeida
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2015 Português
Relevância na Pesquisa
96.12%
OBJECTIVE: This study sought to determine the serum aminotransferase levels of patients with predialysis chronic kidney disease and establish their relationships with serum creatinine levels and glomerular filtration rate. METHODS: Patients with chronic kidney disease were evaluated between September 2011 and May 2012. Aminotransferase and creatinine serum levels were measured using an automated kinetic method, and glomerular filtration rates were estimated using the Cockroft-Gault and Modification of Diet in Renal Disease formulas to classify patients into chronic kidney disease stages. RESULTS: Exactly 142 patients were evaluated (mean age: 64±16 years). The mean creatinine serum level and glomerular filtration rate were 3.3±1.2 mg/dL and 29.1±13 mL/min/1.73 m2, respectively. Patients were distributed according to their chronic kidney disease stages as follows: 3 (2.1%) patients were Stage 2; 54 (38%) were Stage 3; 70 (49.3%) were Stage 4; and 15 (10.5%) were Stage 5. The mean aspartate aminotransferase and alanine aminotransferase serum levels showed a reduction in proportion to the increase in creatinine levels (p=0.001 and p=0.05, respectively) and the decrease in glomerular filtration rate (p=0.007 and p=0.028...

The Association between Individual and Combined Components of Metabolic Syndrome and Chronic Kidney Disease among African Americans: The Jackson Heart Study

Mendy, Vincent L.; Azevedo, Mario J.; Sarpong, Daniel F.; Rosas, Sylvia E.; Ekundayo, Olugbemiga T.; Sung, Jung Hye; Bhuiyan, Azad R.; Jenkins, Brenda C.; Addison, Clifton
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
96.16%
Introduction: Approximately 26.3 million people in the United States have chronic kidney disease and many more are at risk of developing the condition. The association between specific metabolic syndrome components and chronic kidney disease in African American individuals is uncertain. Methods: Baseline data from 4,933 participants of the Jackson Heart Study were analyzed. Logistic regression models were used to estimate the odds and 95% confidence intervals of chronic kidney disease associated with individual components, metabolic syndrome, the number of components, and specific combinations of metabolic syndrome components. Results: Metabolic syndrome was common with a prevalence of 42.0%. Chronic kidney disease was present in 19.4% of participants. The prevalence of metabolic components was high: elevated blood pressure (71.8%), abdominal obesity (65.8%), low fasting high density lipoprotein cholesterol (37.3%), elevated fasting glucose (32.2%) and elevated triglycerides (16.2%). Elevated blood pressure, triglycerides, fasting blood glucose, and abdominal obesity were significantly associated with increased odds of chronic kidney disease. Participants with metabolic syndrome had a 2.22-fold (adjusted odds ratio (AOR) 2.22; 95% CI...

Characterisation of markers associated with systemic inflammation in children with Chronic Kidney Disease.

Nairn, Judith
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2008 Português
Relevância na Pesquisa
96.07%
Chronic Kidney Disease (CKD) is a progressive condition that in the majority of cases leads to End Stage Renal Failure (ESRD) and the need for dialysis, with the only cure being renal transplant. CKD affects both adults and children; however the underlying causes of the disease are different. CKD in adults is most commonly secondary to diabetes and/or hypertension while CKD in children is usually caused by congenital structural abnormalities that result directly in renal dysfunction. There have been numerous reports of inflammatory and immunological disturbances in adult CKD that involve both the cellular and humoral immune systems. Consequences of these include an increased rate of cardiovascular disease (CVD), decreased response to vaccinations, as well as increased rates of infection, anaemia and malnutrition. Children with CKD display many of the clinical complications seen in adult kidney disease that are associated with inflammatory and immunological changes. In adults however, many of the primary conditions associated with CKD are inherently pro-inflammatory; therefore it is not clear whether the inflammatory changes observed in adults with CKD are due to pre-existing inflammatory conditions, renal disease per se or a combination of both. The majority of CKD in children is caused by conditions that are not inflammatory in nature. This presents a unique opportunity to study the inflammatory consequences of CKD alone...

Feline hyperthyroidism : a longitudinal comparative study of patients in the presence or absence of concurrent chronic kidney disease

Oswald, Lara Andreia Silva
Fonte: Universidade de Lisboa. Faculdade de Medicina Veterinária Publicador: Universidade de Lisboa. Faculdade de Medicina Veterinária
Tipo: Dissertação de Mestrado
Publicado em 19/11/2015 Português
Relevância na Pesquisa
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Dissertação de Mestrado Integrado em Medicina Veterinária; ABSTRACT - Feline Hyperthyroidism: a longitudinal comparative study of patients in the presence or absence of concurrent chronic kidney disease - Feline hyperthyroidism is the most common endocrinopathy of the domestic cat and is caused by the multi-systemic effects of increased circulating concentrations of thyroid hormones T3 and T4. Geriatric feline patients also frequently suffer from concurrent chronic kidney disease, often only noticeable when thyrotoxicosis is addressed and the glomerular filtration rate diminishes, allowing the diagnosis of this underlying disease. The prediction or detection of underlying renal disease is vital for the establishment of appropriate treatment and avoiding further renal damage. Laboratorial screenings are seldom valuable in its diagnosis, as hyperthyroidism “masks” many of the alterations associated with the renal disorder. This study shows that serum concentrations of urea may be used as a diagnostic indicator of chronic kidney disease, with a 70% sensitivity. Determination of a cut-off value of 11.6 mmol/L and 135.5 μmol/L for reference levels of serum concentrations of urea and creatinine, respectively, proved to significantly beneficial as diagnostic indicators of underlying chronic kidney disease...

Relation between serum cathepsin D levels and endothelial dysfunction in patients with chronic kidney disease

Ozkayar,Nihal; Piskinpasa,Serhan; Akyel,Fatma; Turgut,Didem; Bulut,Mesudiye; Turhan,Turan; Dede,Fatih
Fonte: Nefrología (Madrid) Publicador: Nefrología (Madrid)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2015 Português
Relevância na Pesquisa
96.08%
We aimed to investigate the role of cathepsin D, an inflammatory and atherosclerotic mediator, in endothelial dysfunction in chronic kidney disease. The study included 65 patients with stage 2-4 chronic kidney disease (35 females, 30 males; mean age, 55.8±15.6 years). Serum creatinine and cathepsin D levels and glomerular filtration rates (GFRs) were determined, and brachial flow-mediated dilation (FMD) percentage was measured by two-dimensional gray scale and color flow Doppler and vascular imaging. FMD ≤6% was considered to indicate endothelial dysfunction. Mean GFR, median creatinine levels, and median cathepsin D levels were 40.2±11.2mL/min/1.73m², 1.7mg/dL, and 819.75ng/mL, respectively. Endothelial dysfunction was present in 30 of the 65 patients (46.2%). There was a significant difference between groups with and without endothelial dysfunction in terms of cathepsin D (p=0.001) and creatinine (p=0.03) levels, and negative and significant correlations were found between brachial artery FMD% and cathepsin D (r=-0.359, p=0.003) and creatinine (r=-0.304, p=0.014) levels. Cathepsin D, which is known to be associated with atherosclerosis, may play a role in the process of endothelial dysfunction. Further studies are essential to determine the exact function of cathepsin D in endothelial dysfunction in chronic kidney disease and to determine its value as a tool for early diagnosis and target for treatment of cardiovascular diseases in patients with chronic kidney disease.

The use of statins in patients with chronic kidney disease not in dialysis: A scientific review

Carneiro,António Vaz
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
Relevância na Pesquisa
96.06%
Chronic kidney disease is a major risk factor for the incidence and severity of coronary artery disease. Patients with CKD present accelerated atherosclerosis and are prone to serious heart disease, including heart failure, before they ever reach dialysis. They have a worse cardiovascular (CV) prognosis then other patients after acute myocardial infarction (AMI), and after revascularisation. The main aim of this review article is the presentation and discussion of the best available evidence on the use of statins in patients with hyperlipidaemia and CKD not on dialysis. This paper is not based on a systematic review of the best clinical evidence on the subject of statins and CKD. It is a scientific review based on recent studies (randomised controlled trials, systematic reviews and observational studies) on risk modulation with lipid-lowering drugs in CKD. The evidence on which this paper is based was identified by searching the best available secondary sources as well as primary databases if needed. There are a series of statements that can be made on the effects of statins in patients with CKD not on dialysis. Firstly, the combination ezetimibe/simvastatin reduces AMI, non-haemorrhagic stroke and revascularisation in these patients...

Phosphate balance in chronic kidney disease?: the chicken or the egg

Adragão,Teresa; Frazão,João M.
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2012 Português
Relevância na Pesquisa
96.08%
In chronic kidney disease patients there are three main stimuli for parathyroid hormone (PTH) secretion by the chief cell in the parathyroid glands: hypocalcaemia, low 1,25(OH)2D3 levels and hyperphosphataemia. FGF23 is a regulator of phosphate and vitamin D metabolism. The discovery of FGF23 actions enlightened our understanding of the development of secondary hyperparathyroidism in CKD patients. The main systemic factors that stimulate FGF23 secretion by the osteocyte in the bone appear to be phosphate load and 1,25(OH)2D3. In the kidney, FGF23 decreases the number of Na/Pi co-transporters IIa and IIc in the tubular cell and promotes phosphaturia. FGF23 also reduces 1,25(OH)2D3 levels by inhibiting, in the kidney, its production by 1-alpha-hydroxylase and stimulating its degradation by 24-hydroxylase. Increase in FGF23 levels has been described in early 2 and 3 CKD stages preceding the decrease of 1,25(OH)2D3 levels and hyperphosphatemia. In this sequence of events, increase of FGF23 in CKD patients seems to be a novel mechanism for the early decline of 1,25(OH)2D3 levels observed in these patients. It was hypothesised that klotho deficiency creates a tissue resistance to FGF23 which is responsible for the increase of FGF23 levels. Reduced renal expression of klotho has been demonstrated in CKD patients preceding FGF23 increase. Chronic kidney disease may be considered a state of klotho deficiency with increase of FGF23 levels. Klotho deficiency may be the initial alteration for the development of phosphate retention and secondary hyperparathyroidism in CKD patients. In this article we review the classic and new pathways involved in the development of secondary hyperparathyroidism in chronic kidney disease and the subsequent actions ensuing from this knowledge. It is possible that...

Chronic kidney disease in patients with acute myocardial infarction without ST segment elevation: therapeutic nihilism?

Santos,M. Teresa; Ferreira,Rute M.; Rosario,Cristina; Carneiro,Liliana; Costa,J. Maximino; Veloso,Ana; Gavina,Cristina
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 Português
Relevância na Pesquisa
96.13%
Background: Chronic kidney disease is an independent risk factor for mortality after acute coronary syndrome. Our aim was to characterize the in-hospital management and outcomes of patients with chronic kidney disease in the setting of non-ST-segment elevation myocardial infarction. Methods: This is a single centre, prospective and observational study, including 230 consecutive patients admitted with the diagnosis of non-ST-segment elevation myocardial infarction. Glomerular filtration rate was estimated using the Modification of Diet in Renal Disease Study formula and in-hospital therapies and outcomes were recorded. Results: Overall, 25.7% of patients had moderate to severe chronic kidney disease. Patients with chronic kidney disease were less likely to undergo coronary angiography (27% vs. 81%, p < 0.001) and receive less evidence-based therapies, including aspirin (86.4% vs. 98.8%, p < 0.001), clopidogrel (74.6% vs. 90.6%, p = 0.002), angiotensin-converting enzyme inhibitor and/or angiotensin II receptor blocker (54.2% vs. 90.6%, p < 0.001) or anticoagulant therapy (83.1% vs. 95.9%, p = 0.001). In addition, the in-hospital mortality was higher for patients with chronic kidney disease (15.3% vs. 2.9%; p = 0.002). Conclusion: Non-ST-segment elevation myocardial infarction patients with chronic kidney disease have higher in-hospital mortality. The underuse of evidence-based therapies and interventions can help to explain these results.

Chronic kidney disease in the Caribbean

Soyibo,AK; Roberts,L; Barton,EN
Fonte: West Indian Medical Journal Publicador: West Indian Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 Português
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96.11%
Globally, diabetes mellitus and hypertension are major causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Reports from the Caribbean renal registry have also identified diabetes mellitus and hypertension as the leading causes of chronic kidney disease and end-stage renal failure. Chronic non-communicable diseases including chronic kidney disease continue to be a major financial challenge in the Caribbean. Patients with chronic kidney disease have high rates of healthcare utilization, morbidity and mortality, and hence constitute a significant economic and clinical burden to the healthcare system. Emphasis should be placed on ways to reduce the incidence of kidney disease and the progression to dialysis. The most economically feasible form of renal replacement therapy that offers the best quality of life should be sought.

Chronic kidney disease and associated risk factors in the Bajo Lempa region of El Salvador: nefrolempa study, 2009

Orantes,Carlos M.; Herrera,Raúl; Almaguer,Miguel; Brizuela,Elsy G.; Hernández,Carlos E.; Bayarre,Héctor; Amaya,Juan C.; Calero,Denis J.; Orellana,Patricia; Colindres,Rosa M.; Velázquez,María E.; Núñez,Sonia G.; Contreras,Verónica Mabel; Castro,Ber
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2011 Português
Relevância na Pesquisa
96.22%
INTRODUCTION: In El Salvador, end-stage renal disease is the leading cause of hospital deaths in adults, the second cause of death in men and the fifth leading cause of death in adults of both sexes in the general population. OBJECTIVE: Identify risk factors for chronic kidney disease and urinary markers of renal and vascular damage, measure kidney function and characterize prevalence of chronic kidney disease in persons aged >18 years in the Bajo Lempa region of El Salvador. METHODS: A cross-sectional analytical epidemiological study was carried out using active screening for chronic kidney disease and associated risk factors in individuals aged >18 years in the Bajo Lempa Region, a rural, coastal area in El Salvador. Door-to-door visits and clinical examinations were conducted. Epidemiological and clinical data were collected including: family and personal clinical history of disease; biological, behavioral, social and environmental risk factors; physical measurements; urinalysis for markers of renal and vascular damage; and blood tests (serum creatinine, serum glucose, lipid profile). Glomerular filtration rate was calculated using the Modification of Diet in Renal Disease formula. Chronic kidney disease case confirmation was done three months later. Multiple logistic regression was used for data analysis. RESULTS: A total of 375 families and 775 individuals (343 men...

Chronic kidney disease of unknown etiology in agricultural communities

Almaguer,Miguel; Herrera,Raúl; Orantes,Carlos M.
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.07%
In recent years, Central America, Egypt, India and Sri Lanka have reported a high prevalence of chronic kidney disease of unknown etiology in agricultural communities, predominantly among male farmworkers. This essay examines the disease's case definitions, epidemiology (disease burden, demographics, associated risk factors) and causal hypotheses, by reviewing published findings from El Salvador, Nicaragua, Costa Rica, Sri Lanka, Egypt and India. The range of confirmed chronic kidney disease prevalence was 17.9% - 21.1%. Prevalence of reduced glomerular filtration (<60 mL/min/1.73 m² body surface area) based on a single serum creatinine measurement was 0% - 67% men and 0% - 57% women. Prevalence was generally higher in male farmworkers aged 20 - 50 years, and varied by community economic activity and altitude. Cause was unknown in 57.4% - 66.7% of patients. The dominant histopathological diagnosis was chronic tubulointerstitial nephritis. Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved. Further etiological research is needed...

Epidemiology of chronic kidney disease in adults of Salvadoran agricultural communities

Orantes,Carlos M.; Herrera,Raúl; Almaguer,Miguel; Brizuela,Elsy G.; Núñez,Lilian; Alvarado,Nelly P.; Jackeline Fuentes,E.; Bayarre,Héctor D.; Amaya,Juan Carlos; Calero,Denis J.; Vela,Xavier F.; Zelaya,Susana M.; Granados,Delmy V.; Orellana,Patricia
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.19%
INTRODUCTION: In El Salvador, chronic kidney disease is a serious and growing public health problem. Chronic renal failure was the first cause of hospital deaths in men and the fifth in women in 2011. OBJECTIVE: Determine prevalence of CKD, CKD risk factors (traditional and nontraditional) and renal damage markers in the adult population of specific rural areas in El Salvador; measure population distribution of renal function; and identify associated risk factors in CKD patients detected. METHODS: A cross-sectional analytical epidemiological study was conducted based on active screening for chronic kidney disease and risk factors in persons aged ≥18 years during 2009 - 2011. Epidemiological and clinical data were gathered through personal history, as well as urinalysis for renal and vascular damage markers, determinations of serum creatinine and glucose, and estimation of glomerular filtration rates. Chronic kidney disease cases were confirmed at three months. Multiple logistical regression was used for statistical analysis. RESULTS: Prevalence of chronic kidney disease was 18% (23.9% for men and 13.9% for women) in 2388 persons: 976 men and 1412 women from 1306 families studied. Chronic kidney disease with neither diabetes nor hypertension nor proteinuria ≥1 g/L (51.9%) predominated. Prevalence of chronic renal failure was 11% (17.1% in men and 6.8% in women). Prevalence of renal damage markers was 12.5% (higher in men): microalbuminuria...

Spatial distribution of unspecified chronic kidney disease in El Salvador by crop area cultivated and ambient temperature

VanDervort,Darcy R.; López,Dina L.; Orantes,Carlos M.; Rodríguez,David S.
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.1%
INTRODUCTION: Chronic kidney disease of unknown etiology is occurring in various geographic areas worldwide. Cases lack typical risk factors associated with chronic kidney disease, such as diabetes and hypertension. It is epidemic in El Salvador, Central America, where it is diagnosed with increasing frequency in young, otherwise-healthy male farmworkers. Suspected causes include agrochemical use (especially in sugarcane fi elds), physical heat stress, and heavy metal exposure. OBJECTIVE: To evaluate the geographic relationship between unspecifi ed chronic kidney disease (unCKD) and nondiabetic chronic renal failure (ndESRD) hospital admissions in El Salvador with the proximity to cultivated crops and ambient temperatures. METHODS: Data on unCKD and ndESRD were compared with environmental variables, crop area cultivated (indicator of agrochemical use) and high ambient temperatures. Using geographically weighted regression analysis, two model sets were created using reported municipal hospital admission rates per ten thousand population for unCKD 2006- 2010 and rates of ndESRD 2005-2010. These were assessed against local percent of land cultivated by crop (sugarcane, coffee, corn, cotton, sorghum, and beans) and mean maximum ambient temperature...

Clinical characteristics of chronic kidney disease of nontraditional causes in Salvadoran farming communities

Herrera,Raúl; Orantes,Carlos M.; Almaguer,Miguel; Alfonso,Pedro; Bayarre,Héctor D.; Leiva,Irma M.; Smith,Magaly J.; Cubias,Ricardo A.; MD,Carlos G. Torres; Almendárez,Walter O.; Cubias,Francisco R.; Morales,Fabrizio E.; Magaña,Salvador; Amaya,Juan C.;
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.16%
INTRODUCTION: Chronic kidney disease is a serious health problem in El Salvador. Since the 1990s, there has been an increase in cases unassociated with traditional risk factors. It is the second leading cause of death in men aged >18 years. In 2009, it was the first cause of in-hospital death for men and the fifth for women. The disease has not been thoroughly studied. OBJECTIVE: Characterize clinical manifestations (including extrarenal) and pathophysiology of chronic kidney disease of nontraditional causes in Salvadoran farming communities. METHODS: A descriptive clinical study was carried out in 46 participants (36 men, 10 women), identified through chronic kidney disease population screening of 5018 persons. Inclusion criteria were age 18 - 59 years; chronic kidney disease at stages 2, 3a and 3b, or at 3a and 3b with diabetes or hypertension and without proteinuria; normal fundoscopic exam; no structural abnormalities on renal ultrasound; and HIV-negative. Examinations included social determinants; psychological assessment; clinical exam of organs and systems; hematological and biochemical parameters in blood and urine; urine sediment analysis; markers of renal damage; glomerular and tubular function; and liver, pancreas and lung functions. Renal...

Histopathology of chronic kidney disease of unknown etiology in Salvadoran agricultural communities

López-Marín,Laura; Chávez,Yudit; García,Xenia A.; Flores,Walter M.; García,Yesenia M.; Herrera,Raúl; Almaguer,Miguel; Orantes,Carlos M.; Calero,Denis; Bayarre,Héctor D.; Amaya,Juan Carlos; Magaña,Salvador; Espinoza,Paul A.; Serpas,Lisbeth
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.1%
INTRODUCTION: For at least a decade, a chronic kidney disease unassociated with diabetes mellitus, hypertension or any of the more common traditional causes, has been reported in Salvadoran agricultural communities. OBJECTIVE: Characterize histopathology of chronic kidney disease of unknown etiology in patients from Salvadoran agricultural communities, describe renal damage associated with each disease stage, and assess associations between histopathological alterations and sociodemographic variables. METHODS: The study involved 46 patients of both sexes, aged ≥18 years. After clinical, laboratory and imaging examinations, kidney biopsies were performed and renal tissue assessed for interstitial fibrosis, tubular atrophy, interstitial inflammatory infiltration, sclerosis, increase in glomerular size and extraglomerular vascular lesions (according to the Banff 97 classification used for kidney transplant rejection). Special staining was done: Schiff periodic acid, Masson trichrome and methenamine silver. Immunofluorescence techniques were used to evaluate IgA, IgG, IgM, complement C1q and C3, fibrin, and kappa and lambda light chain deposits. RESULTS: The main findings were interstitial fibrosis and tubular atrophy with or without inflammatory monocyte infiltration. In addition...

Chronic kidney disease and associated risk factors in two Salvadoran farming communities, 2012

Vela,Xavier F.; Henríquez,David O.; Zelaya,Susana M.; Granados,Delmy V.; Hernández,Marcelo X.; Orantes,Carlos M.
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.1%
INTRODUCTION: Chronic kidney disease is a global pandemic, affecting the majority of countries in the world. Its prevalence is approximately 10% and it is associated mainly with diabetes and high blood pressure. In El Salvador, it is the leading cause of hospital deaths among men. OBJECTIVE: Determine prevalence of chronic kidney disease and its risk factors in two Salvadoran farming communities. METHODS: From March through September 2012, a descriptive cross-sectional study was conducted in two Salvadoran farming communities: Dimas Rodríguez (El Paisnal municipality) and El Jícaro (San Agustín municipality). The research involved both epidemiological and clinical methods. An active search for chronic kidney disease and its risk factors was carried out in the population aged >15 years. House-to-house visits were carried out to take family and individual health histories and gather data on social conditions and risk factors. A physical examination was performed, along with laboratory tests (urinalysis and blood chemistry) to measure renal function and detect markers for renal damage. RESULTS: A total of 223 persons of both sexes were studied. Overall prevalence of chronic kidney disease was 50.2%. Prevalence of chronic renal failure was 16.1%...

Update on uncertain etiology of chronic kidney disease in Sri Lanka's north-central dry zone

Wanigasuriya,Kamani
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
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INTRODUCTION: This manuscript updates a review previously published in a local journal in 2012, about a new form of chronic kidney disease that has emerged over the past two decades in the north-central dry zone of Sri Lanka, where the underlying causes remain undetermined. Disease burden is higher in this area, particularly North Central Province, and affects a rural and disadvantaged population involved in rice-paddy farming. Over the last decade several studies have been carried out to estimate prevalence and identify determinants of this chronic kidney disease of uncertain etiology. OBJECTIVE: Summarize the available evidence on prevalence, clinical profile and risk factors of chronic kidney disease of uncertain etiology in the north-central region of Sri Lanka. METHODS: PubMed search located 16 manuscripts published in peer-reviewed journals. Three peer-reviewed abstracts of presentations at national scientific conferences were also included in the review. RESULTS: Disease prevalence was 5.1% - 16.9% with more severe disease seen in men than in women. Patients with mild to moderate stages of disease were asymptomatic or had nonspecific symptoms; urinary sediments were bland; 24-hour urine protein excretion was <1 g; and ultrasound demonstrated bilateral small kidneys. Interstitial fibrosis was the main pathological feature on renal biopsy. The possibility of environmental toxins affecting vulnerable population groups in a specific geographic area was considered in evaluating etiological factors. Pesticide residues were detected in affected patients' urine...