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Sample records for del angiomiolipoma renal

  1. Sangrado de angiomiolipoma renal en paciente con síndrome de genes contiguos (TSC2/PKD1 tras 17 años de tratamiento renal sustitutivo

    Directory of Open Access Journals (Sweden)

    Mónica Furlano

    2017-01-01

    Full Text Available Presentamos el caso de un varón de 32 años, con síndrome de genes contiguos TSC2/PKD1, que le ocasiona esclerosis tuberosa (ET y poliquistosis renal autosómica dominante simultáneamente. Evolucionó a enfermedad renal terminal y se realizó trasplante renal a los 12 años. Los riñones presentaban angiomiolipomas (AML, que son tumores benignos frecuentes en pacientes con ET. A los 17 años postrasplante, presentó un cuadro de dolor abdominal, anemización y hematoma retroperitoneal. Dicho hematoma se produjo por el sangrado de los AML. Como tratamiento se realizó embolización selectiva. Nuestro paciente podría haberse beneficiado en el momento del trasplante renal del tratamiento con inhibidores de mTOR. Este fármaco actúa como inmunosupresor y reductor tumoral en la ET, al disminuir el riesgo de rotura y hemorragia. En este paciente no se administró porque cuando se trasplantó no se conocía la relación de los inhibidores de mTOR con la ET. Este caso confirma que, a pesar de tratarse de pacientes trasplantados o en diálisis, el riesgo de sangrado por los AML persiste, por lo cual se propone realizar controles periódicos de los riñones propios y valorar la nefrectomía.

  2. Angiomiolipoma renal masivo como causa de sangrado retroperitoneal espontáneo Massive renal angyomiolipoma as a cause of spontaneous retroperitoneal bleeding

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    Lilia M. Uriburu

    2008-09-01

    Full Text Available Introducción: El angiomiolipoma (AML es un tumor renal benigno, compuesto por una cantidad variable de tejido adiposo, músculo liso y vasos sanguíneos; que habitualmente crece dentro del espacio perinéfrico y suele complicarse con hemorragia intratumoral y menos frecuentemente perinéfrica y retroperitoneal, la cual se encuentra condicionada por el tamaño de la lesión. Objetivos: Evaluar dentro de las diferentes causas de sangrado retroperitoneal espontáneo al AML masivo, en confrontación con otras causas. Material y Métodos: Se estudiaron 3 pacientes con AML masivo previamente desconocidos y sangrado retroperitoneal. Dos de ellos fueron estudiados con resonancia magnética, en secuencias de T1 SE, T2 TSE con supresión grasa, T1 TSE con supresión grasa sin y con gadolinio. Uno fue estudiado con tomografía computada (TC pre y post administración de contraste EV. Resultados: De los 3 pacientes estudiados, todos presentaron masas renales cuyos tamaños variaron entre 10 y 26 cm. de diámetro mayor, las cuales presentaron sangrado intratumoral y retroperitoneal de jerarquía. Conclusión: El AML masivo como causante de hemorragia retroperitoneal espontánea es por lo tanto una patología a tener en cuentaIntroduction: The angyomiolipoma (AML is a benign renal tumor formed by a variable amount of adipose tissue, soft tissue and blood vessels; it generally grows within the perinephric space and it usually may complicate with intra-tumoral bleeding and less frequently with perinephric and retroperitoneal bleeding, which is conditioned by the size of the lesion. Objectives: To evaluate according to the different causes of spontaneous retroperitoneal bleeding the massive AML in contrast to other causes. Material and Methods: Three patients with massive AML who presented retroperitoneal bleeding were studied. Two of them were studied by MRI with T1 and T2 sequences, after and before the administration of gadolinium, with fat supression

  3. Nefrectomía parcial laparoscópica en angiomiolipoma gigante

    OpenAIRE

    2008-01-01

    Introducción: El angiomiolipoma es un tumor renal benigno constituido fundamentalmente por vasos sanguíneos, músculo liso y tejido adiposo. El tratamiento depende del tamaño, sintomatología y condición general del paciente. El manejo quirúrgico se debe enfocar en la preservación de la mayor cantidad de parénquima renal posible, siendo la nefrectomía parcial laparoscópica una alternativa a considerar. Reporte del caso: Paciente de 31 años de edad, sexo femenino, consulta en agosto del 2002 por...

  4. Bilateral giant renal angiomyolipoma associated with hepatic lipoma in a patient with tuberous sclerosis Angiomiolipomas renais gigantes bilateralmente associados a lipoma hepático em pacientes com esclerose tuberosa

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    Edison Daniel Schneider-Monteiro

    2003-01-01

    Full Text Available OBJECTIVE: To report a case of bilateral giant renal angiomyolipoma associated with tuberous sclerosis, with successful treatment, and to review the literature concerning angiomyolipoma treatment. CASE REPORT: Patient with tuberous sclerosis and angiomyolipoma diagnosed by ultrasonography during her pregnancy. At that time, the angiomyolipoma on the right side was 9 cm in diameter. Conservative management was selected during her pregnancy. The patient returned 7 years later, with a 24.7 x 19.2 x 10.7 cm tumor on the right side and another of 13 x 11.5 x 6.5 cm on the left side, in addition to multiple small angiomyolipomas. A nephron-sparing surgery with tumoral enucleation was performed on the right side, and after 3 months, the tumor on the left side was removed. Renal function in the post-operative period was preserved, and contrast medium progression was uniform and adequate in both kidneys. CONCLUSION: We conclude that an angiomyolipoma larger than 4 cm should be removed surgically, since they have a greater growth rate and pose a risk of hemorrhage. Resection of smaller tumors is safe and has decreased morbidity. Tumoral enucleation is an effective treatment method that preserves kidney function.OBJETIVO: Relatar um caso de angiomiolipoma gigante, bilateral, associado a esclerose tuberosa, tratado com sucesso e revisar a literatura concernente ao tratamento do angiomiolipoma. RELATO DO CASO: Paciente portadora de esclerose tuberosa, com diagnóstico de angiomiolipoma realizado por ultra-sonografia durante gestação. O tumor apresentava 9cm de diâmetro, à direita. Optou-se por conduta conservadora durante a gestação, e a paciente retornou somente 7 anos após, com tumor de 24,7 x 19,2 x 10,7 cm à direita e outro à esquerda de 13 x 11,5 x 6,5 cm, além de múltiplos angiomiolipomas pequenos. Realizada inicialmente ressecção tumoral à direita, por enucleação, com preservação do parênquima renal, e 3 meses após à esquerda. A

  5. Embolização arterial superseletiva para tratamento de angiomiolipoma em paciente com rim único

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    Adenauer Marinho de Oliveira Góes Junior

    Full Text Available Resumo Os autores relatam o caso de uma paciente jovem previamente submetida a nefrectomia direita por apresentar angiomiolipomas renais (AMLRs e portadora de dois volumosos angiomiolipomas no rim esquerdo remanescente. A paciente foi encaminhada pelo urologista para tratamento endovascular. Realizou-se embolização superseletiva de um dos tumores, localizado no polo renal inferior e em situação subcapsular; apesar de várias tentativas, não foi obtido um cateterismo seletivo suficiente para embolizar o segundo angiomiolipoma (localizado no polo renal superior sem que um volume considerável de parênquima renal adjacente sofresse isquemia. O procedimento e a recuperação da paciente transcorreram sem complicações. A paciente recebeu alta no primeiro pós-operatório e vem sendo acompanhada ambulatorialmente há 9 meses sem intercorrências. É feita uma breve revisão sobre indicações, aspectos técnicos e complicações do tratamento endovascular dos AMLRs, além de serem discutidas vantagens dessa técnica quando comparada à ressecção cirúrgica dos tumores.

  6. Estudio del impacto del índice de masa corporal pretrasplante sobre el pronto funcionamiento del injerto renal

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    Rafael Fernández Castillo

    Full Text Available Introducción: la obesidad y el sobrepeso presentan efectos adversos sobre la salud, lo que contribuye a la aparición de enfermedades metabólicas y cardiovasculares que ponen en peligro la integridad del injerto. Objetivo: investigar la influencia del IMC pretrasplante renal sobre el funcionamiento del injerto renal al año de trasplante mediante el estudio de cuatro métodos distintos de medir la filtración glomerular. Material y métodos: en este trabajo se ha seguido a 1.336 pacientes de ambos sexos trasplantados renales; se les realizaron mediciones pretrasplante y postrasplante de parámetros bioquímicos, mediciones antropométricas y función renal mediante medidas de filtrado glomerular. Resultados: a mayor índice de masa corporal pretrasplante se produce una disminución del filtrado glomerular medido por cuatro métodos distintos, así como mayor porcentaje de rechazos. Conclusiones: un IMC elevado pretrasplante contribuye a la disfunción del injerto, a una disminución del filtrado glomerular y a complicaciones del injerto en el primer año postrasplante.

  7. Modulación del crecimiento en osteodistrofia renal. [Growth modulation in renal osteodystrophy

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    Fernando Miscione

    2012-12-01

    Full Text Available Introducción La Osteodistrofia Renal provoca desejes progresivos en los miembros inferiores, siendo la deformidad más frecuente el genu valgo. El crecimiento guiado (hemiepifisiodesis es útil en la corrección de deformidades angulares en la edad pediátrica. El objetivo de este trabajo es mostrar los resultados y complicaciones de esta técnica quirúrgica aplicada a fisis patológicas. Material y métodos Se presentan 11 pacientes (20 rodillas con diagnóstico de insuficiencia renal crónica y genu valgo, tratados en nuestro servicio con hemiepifisiodesis transitoria. Se colocaron placas en 8 en 4 pacientes y grapas en 7 casos restantes. Se evaluó el eje mecánico radiográfico pre y post operatorio y las complicaciones relativas a cada implante. Resultados Se logró la corrección completa en 4 pacientes, 1 caso sobrellevó deformidad rebote, y en los restantes se obtuvo mejoría sin llegar a la normalización óptima del eje mecánico. Conclusiones La corrección obtenida se relaciona claramente con la normalidad de la función renal. Los pacientes trasplantados consiguieron una normalización en el  crecimiento óseo remanente. No tuvimos diferencia en los resultados ni en las complicaciones entre los dos tipos de implantes empleados.

  8. Rol de las claudinas en el manejo renal del calcio

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    Armando Luis Negri

    2015-07-01

    Full Text Available Los canales paracelulares que se encuentran en las uniones estrechas tienen un papel fundamental en los flujos iónicos transepiteliales. Esta vía está formada por un gran número de proteínas, entre ellas, las claudinas. En el epitelio renal, las claudinas confieren selectividad iónica a la unión estrecha. La rama gruesa ascendente de Henle (RGAH es el segmento tubular renal más importante en la reabsorción tubular de calcio. Sus células forman una barrera impermeable al agua, transportan activamente sodio y cloro por la vía transcelular y proveen una vía paracelular para la reabsorción selectiva de calcio. Varios estudios han llevado a un modelo en el que distintas claudinas forman el canal paracelular, especialmente la claudina 16 y 19. La claudina 16 media la permeabilidad paracelular catiónica en la RGAH mientras que la claudina 19 incrementa la selectividad catiónica de la claudina 16 bloqueando la permeabilidad aniónica. Recientemente se ha encontrado que la actividad promotora de la claudina 14 está localizada exclusivamente en la RAGH. Cuando se coexpresa con la claudina 16, la claudina 14 inhibe la permeabilidad de la claudina 16, reduciendo la permeabilidad paracelular al calcio. El proceso de reabsorción de calcio en la RGAH está estrechamente regulado por el receptor sensor de calcio (CaSR que monitorea los niveles circulantes de Ca ajustando la tasa de excreción renal de forma acorde. Dos micro-ARN, los mir-9 y mir-374, son regulados directamente por el CaSR. Los miR-9 y miR-374 suprimen la traslación del ARNm de la claudina 14 e inducen su decaimiento.

  9. Farmacodinâmica do cisatracúrio no transplante renal Farmacodinámica del cisatracúrio en el transplante renal Cisatracurium pharmacodynamics in renal transplantation

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    Ismar Lima Cavalcanti

    2002-06-01

    del cisatracúrio, especialmente en los enfermos con insuficiencia orgánica, parece ser benéfica, debido a su eliminación órgano independiente de Hofmann y menor tendencia a liberar histamina. Este trabajo tiene como objetivo determinar, en enfermos portadores de insuficiencia renal crónica, la farmacodinámica del cisatracúrio durante el transplante renal. MÉTODO: Fueron estudiados 30enfermos divididos en dos grupos, 15 con función renal normal sometidos a cirugía bucomaxilo-facial y 15 portadores de insuficiencia renal crónica sometidos a transplante renal bajo anestesia general con etomidato, sufentanil y sevoflurano en concentraciones entre 0,5 y 1% de fracción expirada. Recibieron dosis venosa de 0,15 mg.kg-1 de cisatracúrio en la inducción y 0,05 mg.kg-1 todas las veces que T1 recuperaba 25%. La función neuromuscular fue monitorizada de forma continua por aceleromiografia utilizando el patrón de estimulación secuencia de cuatro estímulos, a través de la estimulación supramáxima del nervio ulnar. RESULTADOS: Los resultados referentes a la farmacodinámica del cisatracúrio muestran que el inicio de acción (4,1 y 4,9 min, la duración clínica (68,9 y 75,4 min y el índice de recuperación (20,2 y 28 min fueron semejantes entre los grupos normal e insuficiencia renal, respectivamente. Los tiempos para la relación T4/T1 llegar a 0,7 (34,3 y 51,4 min y 0,9 (49,7 y 68,6 min a partir del último 25% de T1 presentaron diferencia estadísticamente significante entre los grupos, con los mayores valores en el grupo de insuficiencia renal. La razón de acumulación fue igual a 1,08. CONCLUSIONES: El inicio de acción, la duración clínica y el índice de recuperación son semejantes entre los dos grupos, el tiempo para la relación T4/T1 llegar a 0,7 ó 0,9 fue mayor en el grupo de insuficiencia renal de que en el grupo normal y el cisatracúrio no presentó efecto acumulativo en el grupo de insuficiencia renal.BACKGROUND AND OBJECTIVES

  10. La dieta del paciente renal: ¿Se puede incluir pescado? Renal patient's diet: Can fish be included?

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    M. I. Castro González

    2012-10-01

    Full Text Available Introducción: El tratamiento de las enfermedades renales, que son un grave problema de salud pública, es muy complicado. La terapia nutrimental busca retardar la progresión de la enfermedad, mantener un buen estado nutricio y prevenir el desarrollo de comorbilidades. Objetivo: El objetivo del presente estudio fue analizar diez especies de pescado de consumo cotidiano para identificar aquellas que por su bajo aporte de fósforo, proteína de alto valor biológico y su aporte de ácidos grasos n-3 puedan incluirse en la dieta del paciente renal. Material y métodos: Se analizaron las siguientes especies: Bonito, Cabezona, Chucho, Escolar, Espada, Golondrina, Lenguado, Lobina, Mojarra rayada y Pámpano, siguiendo las técnicas de la AOAC y Keller, para determinar su contenido de proteína, fósforo, sodio, potasio, colesterol, vitaminas D3 y E y ácidos grasos n-3 EPA + DHA. Posteriormente se evaluaron las relaciones entre estos nutrimentos. Resultados: Las especies analizadas presentaron valores de proteína desde 16,5 g/100 g de filete (Lobina hasta 27,2 g/100 g (Cabezona, el valor de fósforo más bajo fue de 28,6 mg/100 g (Mojarra rayada y el más alto fue 216,3 mg/100 g (Chucho. 80% de las especies presentaron > 100 mg EPA + DHA en 100 g de filete. Por su relación Fósforo/g Proteína todos los pescados excepto Escolar y Espada, pueden incluirse; la relación más baja de fósforo/EPA + DHA se presentó en Bonito, Escolar, Golondrina, Lobina, Mojarra rayada. Conclusiones: El Pámpano es la especie más recomendada para los pacientes renales por las relaciones entre todos sus nutrimentos; aunque todas las especies, excepto Escolar y Espada, pueden formar parte de la alimentación renal.Introduction: Medical and nutritional treatment for renal disease, now a major public health issue, is highly complicated. Nutritional therapy must seek to retard renal dysfunction, maintain an optimal nutritional status and prevent the development of

  11. Modulación del crecimiento en osteodistrofia renal. [Growth modulation in renal osteodystrophy

    OpenAIRE

    Fernando Miscione; Rodolfo Goyeneche; Claudio Primomo; Horacio Miscione

    2012-01-01

    Introducción La Osteodistrofia Renal provoca desejes progresivos en los miembros inferiores, siendo la deformidad más frecuente el genu valgo. El crecimiento guiado (hemiepifisiodesis) es útil en la corrección de deformidades angulares en la edad pediátrica. El objetivo de este trabajo es mostrar los resultados y complicaciones de esta técnica quirúrgica aplicada a fisis patológicas. Material y métodos Se presentan 11 pacientes (20 rodillas) con diagnóstico de insuficiencia renal ...

  12. Mecanismos del daño celular en la insuficiencia renal aguda Mechanisms of cell damage in acute renal failure

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    José Martínez

    1989-01-01

    Full Text Available

    Los mecanismos del da no celular en la insuficiencia renal aguda Incluyen alteraciones en la producción de energía, la permeabilidad celular y el transporte de calcio. Dichas alteraciones producen cambios progresivos en la estructura celular que pueden ser reversibles si desaparece la causa que llevó a la falla renal, excepto cuando se alcanza la fase final de la lesión de la membrana y se llega a necrosis celular. Este mismo fenómeno probablemente ocurre tambIén en situaciones clínicas.

    The mechanisms of cellular damage In acute renal failure Include alterations In energy production, cell membrane permeability and calcium transport. These changes lead to progressive damage of the whole cellular structure which In general can be reversible If the precipitating cause disappears, except when the final stages of cell membrane lesion take place and cellular necrosis has occurred. This phenomenon probably applies for the clinical settling as well.

  13. Evolución del peso en pacientes durante el primer año del trasplante renal

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    Pilar López Garrigós

    Full Text Available Durante el primer año de trasplante renal es frecuente una ganancia de peso, debido, entre otros a la dieta, sedentarismo, e inmunosupresores, pudiendo aumentar los factores de riesgo del síndrome metabólico. Objetivos: Conocer la evolución del peso de nuestros pacientes durante el primer año del trasplante, y analizar la influencia con las distintas variables asociadas al paciente, sexo, edad, IMC, tratamiento inmunosupresor entre otras. Determinar la asociación entre la ganancia de peso y la aparición de factores de riesgo, como hipertensión arterial, diabetes y dislipidemia. Material y Método: Estudio retrospectivo y analítico. Se estudiaron 100 pacientes con un año de evolución en el trasplante, del Hospital Virgen de la Salud de Toledo. Sé analizaron datos antropométricos, demográficos y clínicos. La ganancia de peso se distribuyo según a las variables del estudio. Resultados: La ganancia de peso al año del trasplante afecto a 93 pacientes, con una media de 7,21 kg ±5,87. El 44,1% aumento su peso por encima de la media, y el 23,7% gano > 10 kg. La prevalencia de sobrepeso y obesidad antes del trasplante fue 57% y 76% después del trasplante. Los hombres ganaron ligeramente más peso que las mujeres. Los más jóvenes < 49 años ganaron más peso, media 9,3 kg. Mayor incidencia de diabetes, hipertensión y dislipemias en los pacientes con sobrepeso y obesidad. Conclusiones: La mayoría de los pacientes aumentaron significativamente de peso al año del trasplante, asociándose con varios de los factores del síndrome metabólico. - Importante la educación, por parte de la enfermería, del paciente para fomentar hábitos de vida saludable.

  14. [Current status of alternative therapies renal function at the Instituto Mexicano del Seguro Social].

    Science.gov (United States)

    Méndez-Durán, Antonio; Ignorosa-Luna, Manuel Humberto; Pérez-Aguilar, Gilberto; Rivera-Rodríguez, Francisco Jesús; González-Izquierdo, José Jesús; Dávila-Torres, Javier

    2016-01-01

    Introducción: el IMSS realiza de manera sistemática la actualización de datos de los pacientes en terapias sustitutivas de la función renal (TSFR) mediante un registro electrónico denominado: Censo de administración de pacientes con Insuficiencia Renal Crónica (CIRC), cuyo objetivo es conocer la prevalencia de pacientes con insuficiencia renal crónica y el comportamiento de las TSFR en el IMSS. Métodos: estudio retrospectivo, incluye 212 hospitales de segundo nivel con programas de diálisis, pacientes pediátricos y adultos. Datos obtenidos del CIRC de enero a diciembre de 2014, cédulas numeral y nominal de diálisis peritoneal (DP) y hemodiálisis (HD). Se identifica prevalencia de pacientes y terapias por delegación, distribución por género y edad, causa de la enfermedad renal, la morbilidad y mortalidad. Resultados: 55 101 pacientes, de los cuales fueron 29 924 masculinos (54 %) y 25 177 femeninos (46 %); edad promedio 62.1 años (rng: 4 a 90); pensionados 20 387 (36.9 %). Las causas de la insuficiencia renal fueron: diabetes 29 054 (52.7 %), hipertensión arterial 18 975 (34.4%), glomerulopatías crónicas 3951 (7.2 %), riñones poliquísticos 1142 (2.1 %), congénitos 875 (1.6 %), y otras 1104 (2 %). La HD se otorgó en 41 % de los pacientes y la DP al 59 % restante; el costo anual fue de 5 608 290 622 pesos. Conclusiones: la prevalencia incrementada de diabetes mellitus e hipertensión arterial repercuten en el inicio de una TSFR, las cuales muestran un panorama financiero catastrófico para el Instituto.

  15. La dieta del paciente renal: ¿Se puede incluir pescado?

    OpenAIRE

    M. I. Castro González; A. G. Maafs Rodríguez; C. Galindo Gómez

    2012-01-01

    Introducción: El tratamiento de las enfermedades renales, que son un grave problema de salud pública, es muy complicado. La terapia nutrimental busca retardar la progresión de la enfermedad, mantener un buen estado nutricio y prevenir el desarrollo de comorbilidades. Objetivo: El objetivo del presente estudio fue analizar diez especies de pescado de consumo cotidiano para identificar aquellas que por su bajo aporte de fósforo, proteína de alto valor biológico y su aporte de ácidos grasos n-3 ...

  16. Sol de invierno: aspectos emocionales del paciente renal crónico

    Directory of Open Access Journals (Sweden)

    Tânia Rudnicki

    2006-01-01

    Full Text Available El presente artículo discute las principales características emocionales asociadas a la forma como los pacientes con insuficiencia renal crónica se enfrentan al tratamiento de hemodiálisis. El proceso de adaptación que se plantea, elemento importante en las emociones de las personas, involucra como protagonistas principales al paciente y sus maneras particulares de defensa ante la enfermedad, así como el apoyo de los recursos médicos hospitalarios, el equipo humano que le sostiene y la familia como aristas importantes para evitar problemas de aislamiento en el paciente. Del equilibrio de este proceso de adaptación, se previenen, como en toda enfermedad crónica, problemas subyacentes a la autoestima del paciente, la imagen corporal que construye y dificultades centradas a sus relaciones cotidianas.

  17. Revisión de conocimientos sobre el fracaso renal agudo en el contexto del paciente crítico

    OpenAIRE

    Romero García, Marta; Delgado-Hito, Pilar; Cueva Ariza, Laura de la

    2013-01-01

    El fracaso renal agudo afecta entre un 1 y un 25% de los pacientes ingresados en unidades de cuidados intensivos, cifras que varían según la población y los criterios estudiados. Las complicaciones derivadas del fracaso renal agudo (hipervolemia, acidosis metabólica, hiperpotasemia, hemorragias) se tratan pero la mortalidad sigue siendo elevada a pesar de los avances tecnológicos de los últimos años ya que, habitualmente, el fracaso renal agudo está asociado a sepsis, insuficiencia respirator...

  18. Impacto del Modelo Moderador del Riesgo en la Enfermedad Renal Crónica. IPS COMFANDI, Cali, 2006

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    Luis Mariano Otero

    2007-09-01

    Full Text Available Objetivo: Evaluar si un modelo de atención que se lleva a cabo en el nivel básico de la IPS COMFANDI y se fundamenta en una intervención temprana de factores de riesgo cardioavascular y aplicado a pacientes con distintos grados de enfermedad renal crónica, genera cambios significantes en parámetros clínicos y de laboratorio que se traduzcan en estabilización o regresión de la enfermedad.Materiales y métodos: Se seleccionaron al azar 362 pacientes con diversos grados de enfermedad renal del programa de riesgo cardiovascular (diabetes mellitus e hipertensión arterial, DM e HTA con dos mediciones una antes y otra después de la intervención con intervalo de por lo menos 6 meses. Se realizaron pruebas de hipótesis de Wilcoxon para comparar medianas de las variables de interés clínico y de laboratorio así como la dinámica de cambio en la proporción de pacientes según estadío KDOQUI en ambos tiempos Resultados: En total se evaluaron 8 parámetros, 4 clínicos y 4 de laboratorio, así como la proporción de pacientes según estadío de nefropatía (KADOQUI entre un tiempo y el otro. En las variables clínicas como tensión arterial sistólica, diastólica, media y proteinuria en 24 h, las diferencias encontradas entre antes y después de la intervención tuvieron significancia estadística. Pero, tanto en el índice de masa corporal (IMC como en la glucemia y la microalbuminuria no hubo diferencias estadísticamente significantes entre las dos mediciones. Conclusión: La puesta en marcha de un modelo de atención en el nivel básico, que se centre en disminuir el riesgo de desarrollar enfermedad renal crónica, por medio de una terapia intensiva, en enfermedades como DM e HTA, produce resultados favorables en las segundas mediciones de variables clave de la enfermedad renal crónica y sugiere un impacto positivo en este problema de salud pública en Colombia.

  19. Supervivencia del injerto y del receptor en el trasplante renal en el hospital Guillermo Gran Benavente (Concepción, Chile

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    Magali Rodríguez Vidal

    2014-12-01

    Full Text Available Al ser el trasplante renal la mejor opción terapéutica para el tratamiento de la Insuficiencia Renal Terminal, en la ciudad de Concepción (Chile, se inició el programa de Trasplante Renal (TX en el año 1994. El objetivo de este trabajo es caracterizar la supervivencia del injerto renal de los TX realizados un hospital, de dicha ciudad mediante un estudio descriptivo, transversal, correlacional y comparativo de los resultados obtenidos en dos periodos, A: de 1994 a 2003 y, B: de 2004 a 2012. El análisis estadístico se realizó con el software SPSSv20.0. La funcion de supervivencia con la prueba no-paramétrica de Kaplan-Meier; y para comparaciones de variables se utilizó el test log-rank. De los resultados obtenidos cabe destacar que la supervivencia del paciente trasplantado en el período A fue mejor el primer al año (96%, pero fue menor a los 3 (90%, 5 (86% y 10 años (72% respecto al período B en que los valores fueron al año 95%, a los 3 el 90% a los 5 y 10 años el 87% y a los 10 años. La supervivencia del injerto también fue mayor en el periodo A que en el B, y mejor cuando hubo un tiempo de isquemia inferior a 24 horas y sin diferencias en relación al sexo del donante y del receptor y al tipo de tratamiento inmunosupreso. Las infeciones fueron la primera causa de muerte del paciente y las complicaciones quirúrgicas la principal causa de la pérdida del injerto.

  20. La dieta del paciente renal: ¿Se puede incluir pescado?

    Directory of Open Access Journals (Sweden)

    M. I. Castro González

    2012-10-01

    Full Text Available Introducción: El tratamiento de las enfermedades renales, que son un grave problema de salud pública, es muy complicado. La terapia nutrimental busca retardar la progresión de la enfermedad, mantener un buen estado nutricio y prevenir el desarrollo de comorbilidades. Objetivo: El objetivo del presente estudio fue analizar diez especies de pescado de consumo cotidiano para identificar aquellas que por su bajo aporte de fósforo, proteína de alto valor biológico y su aporte de ácidos grasos n-3 puedan incluirse en la dieta del paciente renal. Material y métodos: Se analizaron las siguientes especies: Bonito, Cabezona, Chucho, Escolar, Espada, Golondrina, Lenguado, Lobina, Mojarra rayada y Pámpano, siguiendo las técnicas de la AOAC y Keller, para determinar su contenido de proteína, fósforo, sodio, potasio, colesterol, vitaminas D3 y E y ácidos grasos n-3 EPA + DHA. Posteriormente se evaluaron las relaciones entre estos nutrimentos. Resultados: Las especies analizadas presentaron valores de proteína desde 16,5 g/100 g de filete (Lobina hasta 27,2 g/100 g (Cabezona, el valor de fósforo más bajo fue de 28,6 mg/100 g (Mojarra rayada y el más alto fue 216,3 mg/100 g (Chucho. 80% de las especies presentaron > 100 mg EPA + DHA en 100 g de filete. Por su relación Fósforo/g Proteína todos los pescados excepto Escolar y Espada, pueden incluirse; la relación más baja de fósforo/EPA + DHA se presentó en Bonito, Escolar, Golondrina, Lobina, Mojarra rayada. Conclusiones: El Pámpano es la especie más recomendada para los pacientes renales por las relaciones entre todos sus nutrimentos; aunque todas las especies, excepto Escolar y Espada, pueden formar parte de la alimentación renal.

  1. Enfermedad perinatal y viabilidad celular renal postmortem in vitro en el Hospital Universitario del Valle, Cali.

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    Alvaro Dueñas L

    2009-10-01

    Full Text Available Se estudiaron 357 neonatos ² 3 días de edad, fallecidos en la sala de Cuidados Intensivos del Recién Nacido (CIRENA y 39 mortinatos de la sala de partos, del Hospital Universitario del Valle (HUV en Cali, Colombia, para buscar posibles relaciones entre los antecedentes de enfermedad perinatal y la viabilidad celular renal postmortem (VCRP in vitro. Se logró demostrar una VCRP total de 60%. ésta fue significativamente mayor en mortinatos ²2,500 g de peso (88%, y significativamente menor en neonatos de >2,500 g de peso al nacer con antecedente materno de eclampsia (26%. Además, se observó una tasa de mortalidad hospitalaria de 22% en los 3,628 neonatos admitidos a CIRENA entre octubre 1, 1992 y diciembre 31, 1994. El mayor riesgo de muerte fue para los neonatos ²3 días de edad (16% y el menor para aquellos entre los 4 y 7 días de edad (2%. Los antecedentes maternos de enfermedad perinatal más comunes fueron eclampsia (33% y ruptura prematura de membranas (31%. La mayoría de los neonatos admitidos a CIRENA (73% fueron ²2,500 g de peso al nacer.

  2. Gammagrafía renal en niños con primera infección febril del tracto urinario

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    María Caridad Duarte Pérez

    2012-12-01

    Full Text Available Introducción: la infección del tracto urinario es una de las infecciones bacterianas más frecuentes en la infancia. Objetivos: conocer las alteraciones renales en la fase aguda de la primera infección febril del tracto urinario, y relacionarlas con las variables estudiadas. Métodos: se estudiaron 211 niños con diagnóstico microbiológico de primera infección febril del tracto urinario, a los cuales se les realizó gammagrafía renal con Tc-DMSA en la fase aguda de la infección. Los resultados de la gammagrafía se correlacionaron con la duración e intensidad de la fiebre antes del diagnóstico, los reactantes de la fase aguda (hemograma, eritrosedimentación y proteína C reactiva y los resultados de los estudios imaginológicos (ultrasonido renal y uretrocistografía miccional. Resultados: predominó el sexo femenino y el 82,4 % de los pacientes fueron menores de un año. El 54 % de los pacientes presentaron alteraciones gammagráficas, y el patrón de hipocaptación del radiofármaco fue el hallazgo que predominó en el 70 % de ellos. Se encontró asociación significativa al relacionar la duración e intensidad de la fiebre con las alteraciones renales. De los parámetros de laboratorio, la leucocitosis superior a 15 000, la eritrosedimentación acelerada y la proteína C reactiva elevada, tuvieron significación estadística con las alteraciones renales, y los hallazgos radiológicos detectados por el ultrasonido renal y uretrocistografía miccional se correlacionaron estadísticamente con la afectación renal detectada con la gammagrafía. Conclusiones: un porcentaje elevado de los pacientes presentó extensión de la infección al parénquima renal, y las variables clínicas, de laboratorio e imaginológicas estudiadas fueron parámetros orientadores de daño renal.

  3. Comportamiento del fallo renal agudo en niños con sepsis grave Behavior of acute renal failure in children presenting with severe sepsis

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    María del Carmen Saura Hernández

    2010-03-01

    Full Text Available INTRODUCCIÓN. El objetivo de esta investigación fue determinar los factores de riesgo asociados al fallo renal agudo (FRA en un grupo de niños con sepsis grave atendidos entre enero del 2004 y diciembre del 2008. MÉTODOS. Se realizó un estudio observacional y analítico con una muestra de 171 pacientes. Se constituyeron dos grupos: el de estudio, integrado por 38 pacientes con estado de choque séptico o disfunción múltiple de órganos (DMO y FRA, y un grupo control, conformado por 133 niños en igual estadio de sepsis pero con función renal normal. Se revisaron las historias clínicas y se tuvieron en cuenta variables epidemiológicas, factores de riesgo de FRA y evolución de los casos. RESULTADOS. La incidencia de FRA fue del 22,2 %, y aunque disminuyó considerablemente en los 3 últimos años del estudio, la mortalidad fue del 42,1 %, mayoritariamente en el DMO (89,5 %. Se encontró dependencia entre la insuficiencia renal y la respuesta diurética no adecuada a la fluidoterapia (51,2 %, la inestabilidad hemodinámica por más de 24 h (46,5 %, la disfunción miocárdica (43,3 % y el uso de medicamentos nefrotóxicos (42,8 %. CONCLUSIONES. La respuesta diurética no adecuada a la fluidoterapia, la inestabilidad hemodinámica por más de 24 h, la disfunción miocárdica y el uso de medicamentos nefrotóxicos incrementan el riesgo de FRA en la sepsis grave, la cual duplica la mortalidad en relación con los pacientes que conservan la función renal. No obstante, la prevención de las formas graves de sepsis y un tratamiento adecuado de ésta disminuyen la incidencia de FRA.INTRODUCTION: The aim of present research was to determine the risk factor associated with the acute renal failure (ARF in a group of children with severe sepsis seen between January, 2004 and December, 2008. METHODS: An analytical and observational study was conducted in a sample including 171 patients. There were two groups: the study-group with 138 patients with

  4. Trasplante renal procedente de donantes con criterios expandidos: análisis del perfil del donante y receptor, evolución clínica y supervivencia a largo plazo

    OpenAIRE

    Gavela Martínez, Eva

    2015-01-01

    El trasplante renal es el tratamiento de elección para el paciente con enfermedad renal crónica avanzada, mejorando la calidad de vida y la supervivencia del paciente en comparación con las otras alternativas de tratamiento sustitutivo renal. En los últimos años, la mayor experiencia adquirida en el manejo del paciente trasplantado, junto con la imperiosa necesidad de ofertar riñones para los pacientes incluidos en lista de espera, han motivado la aceptación de injertos renales de donantes ca...

  5. Aplicación de las redes neuronales artificiales a la predicción del resultado a corto, medio y largo plazo del transplante renal pediatrico.

    OpenAIRE

    Serrano Durbá, Agustin

    2004-01-01

    RESUMEN Introducción: Se plantea la aplicación de esta herramienta novedosa en el problema de la indicación del trasplante renal infantil (TRI). Objetivos: 1) Desarrollar un modelo neuronal para identificar, con la mayor sensibilidad y especificidad, la evolución a corto, medio y largo plazo del TRI mediante el empleo de factores pre-trasplante. 2) Contrastar la capacidad clasificatoria de las redes neuronales artificiales (RNA) frente a la regresión logística (RL) en el TRI. 3) Determi...

  6. Cuidando do ser humano hipertenso e protegendo sua função renal Cuidando del ser humano hipertenso y protegiendo su función renal Caring for hipertensive patient and protection his renal function

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    Cássia Orsolin

    2005-06-01

    Full Text Available Trata-se de um estudo exploratório-descritivo sobre a compreensão dos efeitos da função renal e sua relação com a hipertensão realizada com doze integrantes de 18 a 60 anos de um grupo de hipertensos vinculados a uma Unidade Básica de Saúde de um município do norte do Rio Grande do Sul. A coleta de dados realizou-se de março a maio de 2004, através de entrevistas grupais, abordando a técnica focal. A análise foi realizada conforme o método de análise temática e posterior categorização. Os resultados demonstraram que os integrantes, apesar de conhecerem, em parte, a fisiopatologia renal, não a vêem como conseqüência da hipertensão arterial.Tratase de una investigación exploratorio-descriptiva sobre la comprención de los efectos de la función renal y su relación con la hipertensión realizada con doce integrantes de 18 a 60 años de un grupo de hipertensos vinculados a una unidad básica de salud de un município del norte del Rio Grande del Sul. La coleta de datos se realizó entre marzo y mayo del 2004, a través de entrevistas de grupos, abordando la técnica focal. El análisis fue realizado de acuerdo al método de análisis temática y posterior categorización. Los resultados demonstraron que los integrantes, apesar de conoceren, en parte, la fisiopatología renal, no la ven como consecuente de la hipertensión arterial.This is an exploratory-descriptive study about the comprehension of the effects of renal function and its relation to hipertension. The study was carried out with 12 members of a hipertension group (range from 18-60 years-old entailed to a Basic Health Unit from a municipality of Rio Grande do Sul State. Data collection was carried out from March to May, 2004, by means of groupal interviews, approaching the focal technique. Analysis was proceeded according to thematic analysis and later categorization. Results demonstrated that the members, despite partially know renal physiopathology, they don

  7. Absorción renal de agua: del nefrón aislado a los canales de agua a Aquaporinas

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    Guillermo Whittembury

    1997-10-01

    Full Text Available Se revisan brevemente: Los sitios de absorción del filtrado glomerular en diversos segmentos del nefrón, los sitios de acción de la hormona antidiurética (HAD, los conceptos que llevan a proponer que existen canales de agua en el túbulo renal proximal. llamados ahora Aquaporinas (AQP, algunas características biofísicas (diámetro equivalente y longitud del filtro de selectividad de la AQP-l en el túbulo renal proximal, estructura molecular de las AQP, algunas características de las AQP- 1-5, localización de las AQP 1-4 en el nefrón y algunos ejemplos de "fisiopatología molecular", que muestran que fallas genéticas en etapas de la acción de HAD en los túbulos colectores de los nefrones permiten describir varias formas de "diabetes insípida" renal. Hay métodos para dosar AQP-2 en orina. Esto simplificará el diagnóstico diferencial entre diversas formas de diabetes insípida. Estos hallazgos han sido posibles por los avances recientes en la biología molecular de las AQP. Sólo se citan algunas referencias críticas. (Rev Med Hered 1997; 8: 158-161

  8. Daño renal cortical en niños con primera infección del tracto urinario alto

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    Tulio Antonio Amaya Sorto

    2012-03-01

    Full Text Available Introducción: entre el 5 y 22 % de los niños que padecen pielonefritis aguda desarrollarán cicatriz renal. Objetivo: describir los aspectos clínico-epidemiológicos del daño renal cortical en niños con la primera infección del tracto urinario alto. Métodos: estudio observacional prospectivo y longitudinal sobre el daño renal cicatricial en niños con la primera infección urinaria alta, ingresados en el servicio de nefrología del Hospital Pediátrico Universitario "William Soler", entre el 1º de enero de 2008 y diciembre 31 de 2009. Se diagnosticaron 50 pacientes, y 38 reunieron criterios para incluirlos en el estudio. Los pacientes tenían una edad media de 18 meses. A los 38 pacientes se les realizó ultrasonido renal durante la fase aguda de la enfermedad, y gammagrafía renal estática entre 6 y 12 meses después del cuadro agudo, para precisar la lesión renal cortical. En los casos con cicatriz renal, ausencia o disminución de captación del radiofármaco (99mTc-DMSA, se les realizó uretrocistografía miccional para precisar la existencia de reflujo vesicoureteral. Resultados: 28 pacientes (73,7 % son del sexo femenino, 17 (44,7 % menores de 6 meses, 17 (44,7 % tienen entre 6 y 36 meses, y 4 (10,6 % > 3 años. La infección urinaria fue atípica en 23 (60,5 %, y el germen aislado, la Escherichia coli en 33 (86,8 %. El ultrasonido de la fase aguda demostró dilatación pélvica renal en 3 (7,9 % y asimetría renal en 1 (2,6 %. En 2 pacientes (5,2 % se demostró cicatriz renal y en 11 (28,4 % hipofunción de la corteza renal. La uretrocistografía miccional demostró reflujo vesicoureteral grado III en una niña, que además, tenía cicatriz renal. No existió relación entre el inicio de los síntomas, comienzo de la terapeútica y lesión cortical. Conclusiones: los factores de riesgo para desarrollar cicatriz renal pospielonefrítica fueron: sexo femenino, edad menor de 3 años y reflujo vesicoureteral grado III.

  9. Influencia del tratamiento quirúrgico de la próstata sobre la función renal en pacientes con insuficiencia renal crónica secundaria a hiperplasia prostática benigna

    OpenAIRE

    Aguirre Castañeda, Roxana; Alarcon Isidro, Edith; Del Castillo Mory, Alfonso; García Vera, José; Paucar Zapata, Alex; Quiroga Vera, Fernando; Loza Munárriz, César; Medina Ninacondor, Raúl; Melgarejo Zevallos, Weymar; ZEGARRA MONTES, Luis

    2013-01-01

    Objetivo: Evaluar la influencia del tratamiento quirúrgico sobre la función renal en pacientes con Insuficiencia Renal Crónica (IRC) causada por Hiperplasia Prostática Benigna (HPB). Material y métodos: Es un estudio descriptivo, retrospectivo y analítico de series de casos; cuya variable resultado principal fue el delta de creatinina (creatinina post cirugía - creatinina pre-cirugía), los deltas de creatinina negativos se categorizaron como mejoría de la función renal y los deltas de creatin...

  10. Gammagrafía renal en niños con primera infección febril del tracto urinario Renal scintigraphy in children with first febrile urinary tract infection

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    María Caridad Duarte Pérez

    2012-12-01

    Full Text Available Introducción: la infección del tracto urinario es una de las infecciones bacterianas más frecuentes en la infancia. Objetivos: conocer las alteraciones renales en la fase aguda de la primera infección febril del tracto urinario, y relacionarlas con las variables estudiadas. Métodos: se estudiaron 211 niños con diagnóstico microbiológico de primera infección febril del tracto urinario, a los cuales se les realizó gammagrafía renal con Tc-DMSA en la fase aguda de la infección. Los resultados de la gammagrafía se correlacionaron con la duración e intensidad de la fiebre antes del diagnóstico, los reactantes de la fase aguda (hemograma, eritrosedimentación y proteína C reactiva y los resultados de los estudios imaginológicos (ultrasonido renal y uretrocistografía miccional. Resultados: predominó el sexo femenino y el 82,4 % de los pacientes fueron menores de un año. El 54 % de los pacientes presentaron alteraciones gammagráficas, y el patrón de hipocaptación del radiofármaco fue el hallazgo que predominó en el 70 % de ellos. Se encontró asociación significativa al relacionar la duración e intensidad de la fiebre con las alteraciones renales. De los parámetros de laboratorio, la leucocitosis superior a 15 000, la eritrosedimentación acelerada y la proteína C reactiva elevada, tuvieron significación estadística con las alteraciones renales, y los hallazgos radiológicos detectados por el ultrasonido renal y uretrocistografía miccional se correlacionaron estadísticamente con la afectación renal detectada con la gammagrafía. Conclusiones: un porcentaje elevado de los pacientes presentó extensión de la infección al parénquima renal, y las variables clínicas, de laboratorio e imaginológicas estudiadas fueron parámetros orientadores de daño renal.Introduction: the urinary tract infection is one of the most frequent bacterial infections in the childhood. Objectives: to learn about the acute renal alterations in

  11. El ejercicio físico en el tratamiento del enfermo con insuficiencia renal crónica (IRC)

    OpenAIRE

    Fayad Saeta, Sara; Escalona Labaceno, Roberto; Feraud Temó, Gustavo

    2005-01-01

    El trabajo aborda una problemática relacionada con el proceso terapéutico de la Insuficiencia Renal Crónica en su fase dialítica, sobre la cual diferentes publicaciones invocan el efecto renoprotector y otras bondades terapéuticas del ejercicio físico, pero no se objetiviza su introducción en el proceso. Esto puede ser el resultado de que no abunden programas de ejercicios físicos, elaborados científicamente con este fin. En el presente trabajo, se hace la propuesta de un programa de ...

  12. Fallas del mercado de la salud en Colombia: el caso de la insuficiencia renal crónica

    OpenAIRE

    Chicaíza, Liliana

    2005-01-01

    La insuficiencia renal crónica es una de las patologías de alto costo con mayor impacto financiero para el Sistema General de Seguridad Social en Salud de Colombia. La alta concentración de casos de alto costo en algunas empresas del sector hizo necesaria la redistribución de recursos y pacientes para contrarrestar el desequilibrio financiero. El artículo señala que la inducción a la demanda es la principal falla de este mercado oligopólico. Expone algunas hipótesis sobre los incentivos de la...

  13. El ejercicio físico en el tratamiento del enfermo con insuficiencia renal crónica (IRC)

    OpenAIRE

    Fayad Saeta, Sara; Escalona Labaceno, Roberto; Feraud Temó, Gustavo

    2005-01-01

    El trabajo aborda una problemática relacionada con el proceso terapéutico de la Insuficiencia Renal Crónica en su fase dialítica, sobre la cual diferentes publicaciones invocan el efecto renoprotector y otras bondades terapéuticas del ejercicio físico, pero no se objetiviza su introducción en el proceso. Esto puede ser el resultado de que no abunden programas de ejercicios físicos, elaborados científicamente con este fin. En el presente trabajo, se hace la propuesta de un programa de ...

  14. Utilidad de la recolección de orina de dos horas para el diagnóstico del tipo de acidosis tubular renal

    OpenAIRE

    Margarita Irene Rocha-Gómez; Samuel Zaltzman-Girshëvich; Silvestre García-de la Puente

    2015-01-01

    La acidosis tubular renal se caracteriza por acidosis metabólica hiperclorémica. El diagnóstico del tipo de acidosis tubular renal se realiza mediante la medición del transporte tubular máximo de bicarbonato y de la capacidad de acidificación urinaria; sin embargo, estas pruebas son invasivas y requieren determinaciones especializadas. Objetivo: comparar la utilidad de la recolección urinaria de dos horas, una prueba relativamente simple y al alcance de muchos laboratorios, con la medició...

  15. Factores asociados a pielonefritis y daño renal permanente en niños con primera infección febril del tacto urinario

    OpenAIRE

    Duarte Pérez, María Caridad

    2015-01-01

    La pielonefritis aguda (PNA) en la infancia, se asocia a la presencia de malformaciones nefro-urológicas y a un mayor riesgo de cicatrices renales, de ahí el interés de realizar el presente estudio prospectivo, longitudinal, descriptivo y analítico, con el objetivo de determinar los factores asociados con la misma y el daño renal permanente (DRP), en pacientes pediátricos con la primera infección febril del tracto urinario, que ingresaron en el Hospital Pediátrico “Juan Manuel Márquez”, del a...

  16. Validación de las ecuaciones predictivas del filtrado glomerular en pacientes adultos con enfermedad renal crónica

    OpenAIRE

    Fontseré Baldellou, Néstor

    2008-01-01

    Títol obtingut de la portada digitalitzada Consultable des del TDX La Enfermedad Renal Crónica (ERC) representa actualmente un importante problema de salud de ámbito mundial. Los datos del Registro de Enfermos Renales de la Sociedad Española de Nefrología (SEN) coinciden en señalar que España se encuentra entre los países europeos con una mayor prevalencia de ERC terminal, factor estrechamente relacionado con la mayor longevidad de la población actual y la mayor prevalencia de diabetes ...

  17. Predicción del riesgo cardiovascular en pacientes con enfermedad renal crónica

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    Santiago Cedeño Mora

    2017-05-01

    Conclusiones: Las escalas de predicción de RCV (FRS-CVD y ASCVD [AHA/ACC 2013] pueden estimar la probabilidad de sufrir ECV ateroscleróticos en pacientes con ERC independientemente de la función renal, albuminuria y antecedente de ECV.

  18. Immunobiology of renal transplant Inmunología del trasplante renal historia de los trasplantes y del complejo mayor de histocompatibilidad

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    Jorge Eliécer Ossa Londoño

    1990-02-01

    Full Text Available

    This article reviews the development of organ transplantation from the early beginning when fiction and superstition prevailed, to the current times when, with the participation of surgeons, oncologists, geneticists and immunologists, the concept of the Major Histocompatibility Complex was developed and later on the complexity of these markers was worked out and was used to match Donors and Recipients thus making transplants feasible. Hopefully molecular biology will help to open a new era in transplantation to make this form of therapy more reliable and safely applicable to other organs.

    En este artículo se revisa el desarrollo de los trasplantes de órganos desde los primeros tiempos cuando prevalecían la ficción y la superstición, hasta la actualidad cuando, con la participación secuencial y sistemática de cirujanos, oncólogos, geneticistas e inmunólogos se descubrió el Complejo Mayor de Histocompatibilidad y más tarde se redujo la complejidad de estos marcadores hasta poderlos utilizar para el apareamiento Donador/Receptor y aumentar el éxito del trasplante. Se espera que la biología molecular ayude a abrir una nueva era en esta área para mejorar la eficiencia de esta forma de terapia y ampliar su uso a otros órganos.

  19. Histofisiología del epitelio renal de helix aspersa (mollusca, gastropoda, pulmonata, stylommatophora)

    OpenAIRE

    Sánchez Aguayo, Inmaculada

    1983-01-01

    La excreción es, por definición, la separación de los productos de desecho de los fluidos tisulares y corporales, y su eliminación del organismo. Además, se considera como el resultado de la filtración del líquido de la sangre, de la reabsorción de ciertos compuestos y de la secreción de sustancias en el interior de túbulos excretores. Los productos de desecho son el resultado del metabolismo celular. Aunque en general son productos finales de procesos catabólicos, también pueden incluir ...

  20. Histofisiología del epitelio renal de helix aspersa (mollusca, gastropoda, pulmonata, stylommatophora)

    OpenAIRE

    Sánchez Aguayo, Inmaculada

    1983-01-01

    La excreción es, por definición, la separación de los productos de desecho de los fluidos tisulares y corporales, y su eliminación del organismo. Además, se considera como el resultado de la filtración del líquido de la sangre, de la reabsorción de ciertos compuestos y de la secreción de sustancias en el interior de túbulos excretores. Los productos de desecho son el resultado del metabolismo celular. Aunque en general son productos finales de procesos catabólicos, también pueden incluir ...

  1. Fallas del mercado de la salud en Colombia: el caso de la insuficiencia renal crónica

    Directory of Open Access Journals (Sweden)

    Chicaíza , Liliana

    2005-06-01

    Full Text Available La insuficiencia renal crónica es una de las patologías de alto costo con mayor impacto financiero para el Sistema General de Seguridad Social en Salud de Colombia. La alta concentración de casos de alto costo en algunas empresas del sector hizo necesaria la redistribución de recursos y pacientes para contrarrestar el desequilibrio financiero. El artículo señala que la inducción a la demanda es la principal falla de este mercado oligopólico. Expone algunas hipótesis sobre los incentivos de las empresas y muestra que la entidad reguladora debe intervenir en el control de los precios y la calidad y, sobre todo, adaptar medidas orientadas a prevenir la enfermedad.

  2. Nutritional status in children with chronic renal failure in outpatient pediatric nephrology clinic at the Hospital Universitario del Valle, Cali

    Directory of Open Access Journals (Sweden)

    Adela Isabel Herrera

    2009-12-01

    Full Text Available Introduction: Chronic renal disease (CRD can compromise nutritional status in children. Nutritional assessment should be performed in early stages of CRD in order to maintain growth, as well as to prevent malnutrition and to diminish progression of renal diseases and metabolic consequences of uremia. Objective: Evaluation of nutritional status of children with moderate CRD stages 2- 4 by means of anthropometry, biochemical profile and dietary survey by records of last three days. Methods: A descriptive observational study was performed to a total of 17 patients that attended to pediatric nephrology service at the Hospital Universitario del Valle, from December 2007 to March 2008. Results: Of the children 65% were males, mean age was 6.2 for males and 10.3 for females. Causes of CRD were reflux nephropathy in 41%. Malnutrition under-2 Standard Deviation for height and weight for the age was found in 30% of patients. The measurement of triceps fold, showed moderate undernourishment in 75% of the children. According to the biochemical data 5 patients (29% had serum albumin Conclusions: These results support that an early nutritional intervention, is essential in children with of CRD in early stages; nutritional deficiencies were found in early stages of disease. It is essential to consume 100% of calories and other nutrients to avoid growth deficit and other important alterations.

  3. Resumen ejecutivo del documento de consenso sobre el manejo de la patología renal en pacientes con infección por VIH

    OpenAIRE

    Górriz, José Luis; Gutiérrez, Félix; Trullás Vila, Joan Carles; Arazo, Piedad; Arribas, José Ramón; Barril, Guillermina; Cervero, Miguel; Cofán, Frederic; Domingo, Pere; Estrada, Vicente; Fulladosa, Xavier; Galindo, María J.; Gracia, Silvia; Iribarren, José A.; Knobel Freud, Hernando Javier

    2014-01-01

    El objetivo de este documento es actualizar las recomendaciones sobre la evaluación y el manejo de la afectación renal en pacientes con infección por el VIH del año 2010. La función renal debe monitorizarse en todos los pacientes e incluir la medida de la concentración sérica de creatinina, la estimación del filtrado glomerular (ecuación CKD-EPI), la medida del cociente proteína/creatinina en orina y un sedimento urinario. El estudio básico de la función tubular ha de incluir la concentración...

  4. Meta-Análisis. Efecto del trasplante renal, hepático, cardíaco y pancreático-renal en la calidad de vida de las personas adultas

    OpenAIRE

    Gómez Ortega, Olga Rocío

    2016-01-01

    Este Meta-Análisis (MA) determinó, a partir de la integración de 92 estudios publicados entre 1980-2012, en diferentes fuentes de búsqueda, formal e informal, la magnitud del efecto que la terapia del trasplante renal (n=49), hepático (n=31), cardíaco (n=8) y pancreático –renal (n=4) tiene sobre la Calidad de Vida Global-CVG, Física-CVF, Psicológica-CVPs y Social–CVS de las personas adultas con enfermedades en estado terminal, con daño irreversible de un órgano vital, trasplantadas. Método...

  5. Influencia del tratamiento quirúrgico de la próstata sobre la función renal en pacientes con insuficiencia renal crónica secundaria a hiperplasia prostática benigna

    Directory of Open Access Journals (Sweden)

    Roxana Aguirre Castañeda

    2002-07-01

    Full Text Available Objetivo: Evaluar la influencia del tratamiento quirúrgico sobre la función renal en pacientes con Insuficiencia Renal Crónica (IRC causada por Hiperplasia Prostática Benigna (HPB. Material y métodos: Es un estudio descriptivo, retrospectivo y analítico de series de casos; cuya variable resultado principal fue el delta de creatinina (creatinina post cirugía - creatinina pre-cirugía, los deltas de creatinina negativos se categorizaron como mejoría de la función renal y los deltas de creatinina positivos como deterioro de la función renal. Resultados: De 40 casos, 24 cumplían con los criterios de inclusión. La edad promedio fue de 67.2 ± 6.8 años. El síntoma más frecuente fue el chorro urinario delgado presentándose en 20 (83.3% pacientes. Trece(54.17% pacientes tuvieron una próstata mediana, quienes con los pacientes de próstata grande refirieron con mayor frecuencia el síntoma de polaquiuria (p=0.03. El tratamiento quirúrgico de pacientes con IRC por HPB produjo una mejoría de la función renal en el 83% de los casos. Solo 4(16.67% pacientes tuvieron delta de creatinina positivo con disminución de la función renal post-cirugía. Se encontró una correlación directa entre la edad y el delta de creatinina (r=0.55 (p=0.004 traduciendo una asociación del deterioro de la función renal post-cirugía con la edad. Conclusiones: El tratamiento quirúrgico de pacientes con IRC por HPB produjo una mejoría de la función renal en la mayoría de los pacientes evaluados en este estudio. No se identificó factores de riesgo relacionados con un deterioro o mejoría de la función renal post-cirugía. (Rev Med Hered 2002; 13: 99-104.

  6. Manejo del cólico renal en urgencias de un hospital de tercer nivel Nephritic colic management in an emergency room of a referral hospital

    OpenAIRE

    2010-01-01

    Fundamento. El objetivo del presente trabajo es conocer las características epidemiológicas, el manejo diagnóstico y terapéutico, su seguimiento y la incidencia de diagnósticos alternativos en una muestra de pacientes diagnosticados de cólico renal en el Servicio de Urgencias de un Hospital de tercer nivel. Material y métodos. Estudio descriptivo retrospectivo de 182 pacientes seleccionados aleatoriamente que consultan por clínica compatible con cólico renal en un hospital de tercer nivel, va...

  7. Sol de invierno: aspectos emocionales del paciente renal crónico

    OpenAIRE

    Tânia Rudnicki

    2006-01-01

    El presente artículo discute las principales características emocionales asociadas a la forma como los pacientes con insuficiencia renal crónica se enfrentan al tratamiento de hemodiálisis. El proceso de adaptación que se plantea, elemento importante en las emociones de las personas, involucra como protagonistas principales al paciente y sus maneras particulares de defensa ante la enfermedad, así como el apoyo de los recursos médicos hospitalarios, el equipo humano que le sostiene y la famili...

  8. Riesgo de daño renal cicatrizal después de infección del tracto urinario en recién nacidos Risk of cicatricial renal damage after urinary tract infection in newborns

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Alvarez

    2007-03-01

    Full Text Available El presente trabajo se realizó con el objetivo de determinar la prevalencia de daño renal cicatrizal e identificar los factores de riesgo a él contribuyentes en niños recién nacidos con la primera infección del tracto urinario. Se llevó a cabo un estudio analítico de factores de riesgo, caso-control, con regresión logística binominal, en recién nacidos con infección del tracto urinario de localización alta, adquirida en la comunidad, que fueron ingresados consecutivamente en el Hospital Pediátrico Universitario «Juan M. Márquez», entre febrero de 1992 y diciembre de 2004. Se realizó gammagrafía renal con DMSA para identificar cicatrices renales. Las pruebas de chi cuadrado y regresión logística se aplicaron para identificar factores de riesgo independientes. La prevalencia de daño renal cicatrizal fue de 25,4 %. En el modelo de regresión se incluyeron para análisis multivariado los factores de riesgo: ultrasonido prenatal con pielectasia, microorganismo diferente de Escherichia coli, ultrasonido renal posnatal con anomalías, presencia de reflujo vesicoureteral de cualquier grado, reinfección en los primeros 3 meses de vida, sexo masculino, retardo en inicio del tratamiento antibiótico ≥ 4 d, leucocituria ≥ 10 000/mL, respuesta desfavorable al tratamiento inicial y bacteriemia al mismo microorganismo de la infección urinaria. Finalmente solo resultaron significativos (p The present paper was aimed at determining the prevalence of cicatricial renal damage and to identify the risk factors contributing to it in newborns with urinary tract infection for the first time. An analytical case-control study of the risk factors was conducted by binominal logistic regression in newborns with an upper urinary tract infection acquired in the community that were consecutively admitted in “ Juan Manuel Márquez” University Children Hospital from February 1992 to December 2004. A renal scintigraphy with DMSA was performed to

  9. Agentes calciomiméticos en el tratamiento del hiperparatiroidismo secundario a la insuficiencia renal crónica Calcimimetic agents in the treatment of hyperparathyroidism secondary to chronic renal failure

    Directory of Open Access Journals (Sweden)

    A. L. Negri

    2003-04-01

    Full Text Available La reciente identificación y clonación del receptor sensor de calcio (RSCa ha permitido tener una mejor comprensión de la regulación normal del metabolismo del calcio y entender un número de trastornos relativamente poco frecuentes del metabolismo mineral. En la glándula paratiroides el RSCa es el mecanismo responsable de modular la liberación de la hormona paratiroidea en función del nivel de calcio extracelular. Este descubrimiento también ha permitido desarrollar drogas que imitan o potencian las acciones del calcio extracelular sobre el RSCa (llamadas calciomiméticos que disminuyen la secreción de paratohormona sin incrementar el calcio sérico. Los calciomiméticos de última generación son pequeñas moléculas orgánicas que actúan como moduladores alostéricos del RSCa y se encuentran en su fase inicial de desarrollo clínico. A pesar de que la experiencia obtenida con estas drogas hasta ahora es limitada, ellas han mostrado ser efectivas para reducir los niveles de paratohormona en pacientes con hiperparatiroidismo secundario a fallo renal terminal sin inducir efectos secundarios de importancia. Es por ello que los compuestos calciomiméticos tienen un considerable potencial como nuevas drogas para el tratamiento del hiperparatiroidismo secundario y de la enfermedad ósea secundaria a la insuficiencia renal.The recent discovery and cloning of the extra cellular calcium sensing receptor (CaSR has allowed a better understanding of the regulation of normal calcium metabolism and of rare disturbances in mineral metabolism. In the parathyroid glands the CaSR is responsable for modulating parathyroid hormone release as a function of the extra cellular calcium level. This discovery has allowed the development of drugs that mimics or potentiates the actions of extra cellular calcium on the CaSR, called calcimimetics that decrease parathyroid hormone secretion without increasing serum calcium. The new calcimimetics are small organic

  10. Early Referral e prevenzione secondaria dell'insufficienza renale cronica benefici per il paziente e per la sostenibilità del sistema dialisi

    OpenAIRE

    Chiarini, Alessandra

    2011-01-01

    Attività di ricerca nell'ambito dell'inidirizzo nefrologia clinica, valutando: la popolazione dei pazienti in trattamento sostitutivo in particolare incidenza e prevalenza dei pazienti in trattamento renale sostitutivo nell'Azienda USL di Cesena dal 2000 al 2009 confronto con i dati del registro italiano (analisi retrospettiva). Analisi di questa popolazione e in particolare referral nefrologico e applicazione di misure atte a ridurre la progressione dell'IRC (prevenzione secondaria, terziari...

  11. Programación temprana de alteraciones en el sistema del óxido nítrico renal y vascular inducidas por la deficiencia de cinc

    Directory of Open Access Journals (Sweden)

    María A. Costa

    2008-01-01

    Full Text Available Resumen:IntroducciónNumerosos estudios mostraron que la deficiencia nutricional durante la vida fetal y posnatal predisponen al desarrollo de patologías en la vida adulta, como la hipertensión arterial y las enfermedades renales. La distribución ubicua del cinc y sus propiedades químicas determinan su esencialidad en los sistemas biológicos.ObjetivosEvaluar si las alteraciones renales y cardiovasculares en la vida adulta inducidas por la restricción moderada de cinc durante la vida fetal, la lactancia y/o el crecimiento se asocian con cambios en el sistema del óxido nítrico.Material y métodosRatas Wistar hembra recibieron durante la preñez hasta el destete de las crías una dieta control o una baja en cinc. Luego del destete, las crías macho se asignaron al azar a dos grupos que recibieron una dieta control o una baja en cinc durante 60 días.ResultadosLos resultados mostraron que el aporte insuficiente de cinc durante el crecimiento previo y/o posterior al destete indujo un aumento de la presión arterial y una disminución del volumen de filtrado glomerular en la vida adulta, asociados con una disminución del sistema del óxido nítrico renal y vascular. Además, el bajo aporte de este mineral durante la vida fetal indujo un peso menor al nacer, que se correlacionó en forma negativa con la presión arterial en la vida adulta.ConclusionesEste trabajo brinda evidencias importantes que sugieren que el aporte inadecuado de cinc durante el crecimiento prenatal y posnatal constituye un factor de riesgo cardiovascular y renal, dado que induce alteraciones en la regulación de la presión arterial y en la función renal en el individuo adulto.REV ARGENT CARDIOL 2008;76:459-464.

  12. Hepatic and renal metallothionein concentrations in Commerson's dolphins (Cephalorhynchus commersonii) from Tierra del Fuego, South Atlantic Ocean.

    Science.gov (United States)

    Cáceres-Saez, Iris; Polizzi, Paula; Romero, Belén; Dellabianca, Natalia A; Ribeiro Guevara, Sergio; Goodall, R Natalie P; Cappozzo, H Luis; Gerpe, Marcela

    2016-07-15

    The Commerson's dolphin is the most common endemic odontocete of subantarctic waters of Tierra del Fuego, Argentina incidentally caught in fishing nets. The species is classified as "Data Deficient" by the IUCN. Metallothioneins (MTs) are considered as suitable biomarkers for health and environmental monitoring. The aims of the study were to assess MT concentrations in the liver and kidney of bycaught specimens. Moreover, correlations with Zn, Se, Cd, Ag and Hg, and the molar ratios of MT:metals were estimated to evaluate if there is an indication of their respective protective role against metal toxicity in tissues. Hepatic and renal MT concentrations were similar, ranging from 11.6 to 29.1nmol·g(-1) WW, and Kidney/Liver ratios ranging from 0.73 to 1.93 corresponded to normal ranges. Results suggest that MTs are related to physiological ranges for the species. This information constitutes the first MT report on Commerson's dolphins and possibly considered as baseline for species' conservation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Intra and interobserver variability of renal allograft ultrasound volume and resistive index measurements; Variabilita' intra- ed interoperatore delle misure ecografiche del volume e dell'indice di resistenza del rene trapiantato

    Energy Technology Data Exchange (ETDEWEB)

    Mancini, Marcello; Liuzzi, Raffaele [CNR, Napoli (Italy). Istituto di biostrutture e bioimmagini; Daniele, Stefania; Raffio, Teresa; Salvatore, Marco [Napoli Univ., Napoli (Italy). Dipartimento di diagnostica per immagini; Sabbatini, Massimo; Cianciaruso, Bruno [Napoli Univ., Napoli (Italy). Istituto di nefrologia medica; Ferrara, Liberato Aldo [Napoli Univ., Napoli (Italy). Dipartimento di medicina clinica e sperimentale

    2005-04-01

    Purpose: Aim of the presents study was to evaluate the repeatability and reproducibility of the Doppler Resistive Index (R.I.) and the Ultrasound renal volume measurement in renal transplants. Materials and methods: Twenty -six consecutive patients (18 men, 8 women) mean age of 42,8{+-}12,4 years (M{+-}SD)(range 22-65 years) were studied twice by each of two trained sonographers using a color Doppler ultrasound scanner. Twelve of them had a normal allograft function (defined as stable serum creatinine levels {<=}123,76 {mu}mol/L), whilst the remaining 14 had decreased allograft function (serum creatinine 132.6-265.2 {mu}mol/L). Results were given as mean of 6 measurements performed at upper, middle and lower pole of the kidney. Intra- and interobserver variability was assessed by the repeatability coefficient and coefficient of variation (CV). Results: Regarding Resistive Index measurement, repeatability coefficient was between 0.04 and 0.06 and the coefficient of variation was <5%. The analysis of the Student's test did not show any significant difference between the measurements (t=0.15; p=0.87 n.s.). A good reproducibility was also detected in US measurements of renal length and volume. Conclusions: These results suggest that Color Doppler Resistive Index measurements of renal allograft and Ultrasound renal volume measurements are repeatable and reproducible. [Italian] Scopo: Valutare la ripetibilit� e la riproducibilit� delle misurazioni ecografiche dell'Indice di Resistenza (I.R.) e del volume del rene trapiantato. Materiale e metodi: Ventisei pazienti (18 uomini, 8 donne) con et� media di 42,8{+-}12,4 anni (M{+-}SD)(range 22-65 anni) sono stati studiati consecutivamente due volte con eco-color-Doppler da due ecografisti esperti. Dodici pazienti avevano funzione renale normale (livello serico di creatina stabilmente {<=}123,76 {mu}mol/L, i rimanenti 14 avevano una lieve e stabile disfunzione del rene trapiantato (creatina serica 132.6-265.2 {mu

  14. The role of interventional radiology in the management of kidney transplant complications; Ruolo della radiologia interventistica nel trattamento delle complicanze del trapianto renale

    Energy Technology Data Exchange (ETDEWEB)

    Carrafiello, Gianpaolo; Lagana, Domenico; Mangini, Monica; Cafaro, Tamara; Recaldini, Chiara; Genovese, Eugenio; Fugazzola, Carlo [Insubria Univ., Varese (Italy). Cattedra di radiologia; Cuffari, Salvatore [Ospedale di circolo, Varese (Italy). Servizio di anestesia e rianimazione

    2005-09-15

    Purpose. To evaluate the role and the effectiveness of interventional radiology in the treatment of renal transplant complications. Materials and methods. From 1996 to 2004 a total of 288 kidney transplants from cadavers were performed in our Institute. The kidney was always collocated in iliac fossa by creating a vascular anastomosis with the external iliac artery and vein; in all cases the ureter was implanted into the recipient bladder. During the follow-up, 34 complications were observed. Twenty-seven complications in 25 patients (20 males and 5 females; age 35-65 years) were treated by a radiologic procedure: 9 renal artery stenosis and 1 native external iliac artery stenosis (by PTA), 5 ureteral obstructions (by nephrostomy and ureteral stenting), 8 ureteral leaks (by nephrostomy, in 2 cases associated to ureteral stenting) and 4 limphoceles (by percutaneous ultrasound-guided catheter drainage). Results. Primary technical success was obtained in 20/27 cases (74%). Success was obtained with a second interventional procedure in 3/27 cases, 2 limphoceles and 1 ureteral fistula (secondary technical success: 85.2%), with a clinical final success in 23/27 cases (85.2%). We observed a peri-procedural complication rate of 3.7% (1 renal artery post-PTA dissection during a restenosis treatment). Four cases (1 renal arterial post-PTA dissection, 1 ureteral obstructions, 1 ureteral leak and llimphocele) needed a surgical correction (14.8%). Conclusions. Interventional radiology is the first therapeutic approach to treat renal transplant complications. It shows good technical and clinical results and a low complication rate. Surgery had to be considered only if minimally invasive procedures are infeasible or ineffective. [Italian] Scopo. Valutare l'efficacia delle procedure di radiologia interventistica nel trattamento delle complicanze del trapianto renale. Materiale e metodi. Dal 1996 al 2004 sono stati eseguiti, presso il nostro centro 288 trapianti renali da

  15. O Transplante renal sob a ótica de crianças portadoras de insuficiência renal crônica em tratamento dialítico: estudo de caso El transplante renal bajo la óptica de los niños que llevan la insuficiencia renal crónica en el tratamiento dialítico: estudio del caso The renal transplant under the optics of children with chronic renal insufficiency in dialysis treatment: study of case

    Directory of Open Access Journals (Sweden)

    Vanessa Grespan Setz

    2005-09-01

    Full Text Available INTRODUÇÃO: Para compreender quais são as implicações da doença crônica para a criança e seus familiares é necessário partir-se da premissa de que a doença crônica não pode ser curada e que a cura almejada pode se transformar em mito perigoso, que compromete todo o processo de desenvolvimento da criança. OBJETIVOS: Compreender o significado do transplante renal para crianças em tratamento dialítico e conhecer suas expectativas em relação a este tratamento. MÉTODO: Estudo qualitativo, utilizando o Estudo de Caso como método de investigação e os pressupostos de Mayeroff como referencial teórico-filosófico. Para coleta de dados foram utilizadas as técnicas de entrevista semi-estruturada e o Desenho-Estória com tema. Foram entrevistadas 15 crianças em tratamento dialítico e hemodialítico, com idades entre 6 e 16 anos que consentiram em participar do estudo RESULTADO: Da análise de conteúdo emergiram quatro categorias: Construindo o conhecimento sobre o transplante; Buscando entender a espera pelo transplante; Criando expectativas de mudanças; Em contato com a frustração. E do desenho-estória com tema a categoria: Desvelando os sentimentos através do desenho. Neste artigo apresentaremos os resultados referentes às questões semi-estruturadas que emergiram das falas dos sujeitos. CONCLUSÃO: O estudo possibilitou compreender que as crianças percebem a realização do transplante renal como a única possibilidade de voltarem a vivenciar uma vida normal.RESUMEN INTRODUCCIÓN: Para comprender cuales son las implicaciones de la enfermedad crónica para el niño y sus familiares és necessário partir del presupuesto de que la enfermedad crónica no puede ser curada y que la cura deseada puede se transformarse en un mito peligroso, que puede comprometer todo el proceso de desarrolo del niño. OBJETIVOS: Compreender el significado del transplante renal para los niños en tratamiento dialítico y conocer sus expectativas

  16. Cuantificación del deterioro funcional durante seis meses en pacientes renales en estadio terminal

    Directory of Open Access Journals (Sweden)

    Lucía Ortega Pérez de Villar

    2015-12-01

    Full Text Available Introducción: Los pacientes en tratamiento de diálisis presentan una disminución de la función física, sin embargo, no hay estudios que demuestren el ritmo al que se produce este deterioro funcional. El objetivo principal es cuantificar el deterioro funcional de los pacientes en tratamiento de diálisis durante seis meses. Métodos: 43 pacientes en tratamiento de diálisis de dos centros de Valencia (España (edad 61.3 (14.7 años fueron analizados después de 6 meses. Los participantes completaron el Short Physical Performance Battery, equilibrio monopodal, el Timed Up and Go Test, Sit to stand to Sit Test 10 y 60, dinamometría de mano; elevación de talón y 6 minutos marcha. Además se recogieron datos de las historias clínicas y de las analíticas. Resultados: Tres de las pruebas mejoraron significativamente tras el periodo de 6 meses de observación: el Sit To Stand 10, la dinamometría de la mano derecha y la dinamometría de la mano izquierda, pero sin alcanzar un cambio clínico relevante. Por otro lado, otras medidas no obtuvieron un deterioro significativo como fueron el Short Physical Performance Battery, el Sit to Stand 60, la elevación del talón izquierdo y el 6 minutos marcha. Conclusiones: Después de 6 meses, en ninguna de las pruebas de capacidad funcional se observa un deterioro significativo. Se recomienda a los centros de hemodiálisis realizar un seguimiento de capacidad funcional anualmente, ya que con un periodo de 6 meses no se encuentran cambios significativos.

  17. Estudio, mediante métodos de imagen no invasivos, de las modificaciones y complicaciones de la circulación arterial y venosa del injerto renal en el periodo post-operatorio

    OpenAIRE

    Pérez Fontán, Francisco Javier

    2011-01-01

    [Resumen] LOS OBJETIVOS DE ESTE ESTUDIO SON DETERMINAR LOS PARAMETROS QUE TIENEN INFLUENCIA EN EL DESARROLLO DE ALTERACIONES DEL INDICE DE RESISTIVIDAD (R.I.) EN EL POSTOPERATORIO INMEDIATO. ESTUDIAR LAS ALTERACIONES QUE PRODUCEN EN LA RESISTENCIA VASCULAR DEL INJERTO AL RECHAZO TUBULO INTERSTICIAL (RATI), RECHAZO VASCULAR (RV), Y NECROSIS TUBULAR (NTA). DETERMINAR LAS ALTERACIONES PRODUCIDAS A NIVEL DEL ESPECTRO DOPPLER POR LA ESTENOSIS DE LA ARTERI RENAL PRINCIPAL (EARP) Y VER SI ES...

  18. Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice Alteración del patrón hormonal regulatorio renal durante la ictericia obstructiva experimental

    Directory of Open Access Journals (Sweden)

    F. J Padillo

    2009-06-01

    Full Text Available Objective: the alteration of hormones regulating sodium and water status is related to renal failure in obstructive jaundice (OJ. Experimental design: OJ was induced by common bile duct ligation. Samples were obtained from the control (SO and OJ groups at 24 and 72 hours, and at 7 days. Different parameters related to biliary obstruction, liver and renal injury, and vasoactive mediators such as renin, aldosterone, endothelin-1 (ET-1 and prostaglandin E2 (PGE2 were studied. Results: bile duct ligation caused an increase in total bilirubin (p < 0.001 and alkaline phosphatase (AP (p < 0.001. The SO and OJ groups had the same values for diuresis, renin, and creatinine clearance at 24 h. However, animals with OJ had a lower sodium concentration in urine than SO animals (p < 0.01, as well as an increase in aldosterone levels (p < 0.03. ANP levels were moderately increased during OJ but did not reach statistical significance when compared to the SO group. In contrast, OJ animals showed a rise in serum ET-1 concentration (p < 0.001 and increased PGE2 in urine (p < 0.001. Conclusions: biliary obstruction induced an increase in ET-1 release and PGE2 urine excretion. These hormones might play a role during the renal complications associated with renal disturbances that occur during OJ.

  19. Transplante renal, control del daño postreperfusión con citocina similar a la cardiotrofina (NNT-1/BSF-3)

    OpenAIRE

    Moreno Andrés, María Pilar

    2016-01-01

    [ES]La enfermedad renal crónica constituye una de las principales causas de muerte en el mundo industrializado, se estima en más de 1,4 millones de personas. En el año 2005 más de 40.000 personas en España, alrededor de 1.000 por millón, estaban en tratamiento renal sustitutivo, cifra que se estima aumentará en los próximos 10 años en aproximadamente el 8% anual. El trasplante está hoy considerado como parte del arsenal terapéutico en el estadio terminal de diversas patologías que afectan...

  20. Transplante renal, control del daño postreperfusión con citocina similar a la cardiotrofina (NNT-1/BSF-3)

    OpenAIRE

    Moreno Andrés, María Pilar

    2015-01-01

    [ES]La enfermedad renal crónica constituye una de las principales causas de muerte en el mundo industrializado, se estima en más de 1,4 millones de personas. En el año 2005 más de 40.000 personas en España, alrededor de 1.000 por millón, estaban en tratamiento renal sustitutivo, cifra que se estima aumentará en los próximos 10 años en aproximadamente el 8% anual. El trasplante está hoy considerado como parte del arsenal terapéutico en el estadio terminal de diversas patologías que afectan...

  1. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  2. Predicción de daño renal en pacientes con primera infección febril del tracto urinario

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    María Caridad Duarte Pérez

    2011-06-01

    Full Text Available INTRODUCCIÓN. La infección del tracto urinario (ITU es una de las infecciones bacterianas más frecuentes en la infancia. El objetivo de esta investigación fue identificar los factores de riesgo de daño renal permanente en pacientes con primera ITU febril. MÉTODOS. Se realizó un estudio prospectivo que incluyó a 100 niños con diagnóstico clínico y microbiológico de primera ITU febril, a los cuales se les realizó una gammagrafía renal con Tc99m DMSA en la fase aguda de la infección (quienes presentaron alteraciones gammagráficas se sometieron a una segunda evaluación 9 a 12 meses después de la infección aguda. Se investigó la relación de los resultados de la primera y segunda gammagrafía con la duración e intensidad de la fiebre antes del diagnóstico y tratamiento, los reactantes de la fase aguda (leucograma, eritrosedimentación globular y proteína C reactiva [PCR], y los estudios radiológicos (ecografía renal y uretrocistografía miccional. RESULTADOS. Predominó el sexo femenino y el 86 % de los pacientes fueron menores de un año. El 58 % de los niños presentaron alteraciones gammagráficas agudas, y el patrón de hipocaptación focal del radiofármaco fue el hallazgo que predominó en el 75,8 % de ellos. La PCR fue la única variable que se asoció significativamente con las alteraciones renales agudas. El 20 % de los pacientes presentó daño renal permanente y, de las variables utilizadas, solo la eritrosedimentación acelerada y la función renal relativa (FRR ≤ 43 % en la primera gammagrafía tuvieron significación estadística en relación con la presencia de cicatriz renal. CONCLUSIONES. Un porcentaje elevado de los pacientes presentó extensión de la infección al parénquima renal y la PCR fue la única variable que se relacionó con las alteraciones agudas. Se demostró daño renal permanente en el 20 % de los pacientes, y la eritrosedimentación y la FRR disminuida fueron las variables con significaci

  3. Injuria Renal Aguda aplicando escala de pRifle en Niños del Hospital Universitario del Valle: características clínicas, manejo y evolución

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    Consuelo Restrepo de Rovetto

    2012-09-01

    Full Text Available  Objective: to know the epidemiology of Acute Kidney Injury (AKI in the pediatric population at Hospital Universitario del Valle (HUV, a tertiary University Hospital in Cali, Colombia. Methods: We obtained a series of cases through daily surveillance for a seven-month period (June 1 to December 31, 2009 in patients older than 30 days and under 18 years at HUV. We excluded patients with previous diagnosis of chronic renal failure. The new pRIFLE scale was used to define AKI. Results: 27 patients were detected, with mean age of 36 months. Incidence of AKI was 0.38% from pediatric admissions and 6.2% from the pediatric intensive care unit (pICU admissions. The pRIFLE scale at study entrance was: Risk: 2 patients, Injury: 8, Failure: 17. Etiology of AKI was: pre-renal in 89%, primary renal disease in 3.7%, and post-renal in 7.4%. There was an association of AKI with sepsis in 66.7% and 48.2% progressed to septic shock. Six patients required renal replacement therapy, all required peritoneal dialysis. The AKI was multi-factorial in 59.3% and associated with systemic multi-organ failure in 59.3%. At study entry, 63% patients were in pICU. The average hospital stay was 21.3 ± 9.2 days. Six children died, 16 resolved AKI, and nine were left with renal sequelae. Conclusions: We recommended pRIFLE scale for early diagnosis of AKI in all pediatric services. Education in pRIFLE scale, prevention of AKI, and early management of sepsis and hypovolemia is recommended.

  4. Dificultades y estrategias en el manejo del régimen terapéutico en el paciente renal crónico en hemodiálisis

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    António Filipe Cristóvão

    Full Text Available Objetivo: identificar las dificultades de los pacientes de hemodiálisis en el manejo del régimen terapéutico, las estrategias para hacer frente a estas dificultades e identificar factores que influyen en la gestión del tratamiento. Pacientes y métodos: se realizaron entrevistas semiestructuradas a una muestra intencional de 20 pacientes adultos, de dos centros de hemodiálisis, sometidas a análisis de contenido temático. Resultados: la mayor parte de las dificultades es en el área psicosocial: restricción de líquidos; dieta restrictiva; tener que realizar hemodiálisis; duración del tratamiento; tomar la medicación; limitaciones de vacaciones. Para hacer frente a las dificultades, los participantes utilizan más las estrategias de resolución de problemas que las estrategias para el control de las emociones. Conclusiones: el equipo de salud, la familia y la función renal residual, facilitan el manejo del tratamiento, mientras que el calor del verano y el humo son factores de complicación. Las enfermeras han de entender cómo los pacientes controlan el régimen de tratamiento, para promover mejor su autonomía.

  5. Prevalencia de los mecanismos de adaptación del paciente con enfermedad renal bajo tratamiento de hemodiálisis

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    David Jahel García Avendaño

    2016-01-01

    Full Text Available Introducción: La enfermedad renal crónica es resultante de diversas enfermedades crónico degenerativas. El paciente con dicha enfermedad y sometido a hemodiálisis sufre muchos cambios en su estilo de vida. Es por ello que es importante evaluar la prevalencia de los mecanismos de adaptación en el paciente en los aspectos psicológico, afectivo y social. Objetivo: Identificar la prevalencia de los mecanismos adaptativos en el área de lo psicológico, afectivo y social que utiliza el paciente con insuficiencia renal crónica bajo tratamiento de hemodiálisis. Materiales y Métodos: Es un estudio descriptivo de tipo cuantitativo, se utilizó el cuestionario “Mecanismos de adaptación de los pacientes con enfermedad renal crónica en terapia de hemodiálisis”. Se realizó en el año 2010; y presentó un coeficiente del Alfa de Cronbach de 7.0, los datos se analizaron mediante estadística descriptiva. Resultados y Discusión: El estudio arrojó una prevalencia en los mecanismos afectivos, con un 71.4% en la adaptación comprometida; los mecanismos  sociales sobresalen con un 61.9% en la adaptación compensatoria; no evidenciando porcentajes favorables en los mecanismos psicológicos. Conclusiones: La mayoría de las personas con enfermedad renal bajo tratamiento de hemodiálisis, utilizan diferentes mecanismos de adaptación a su proceso lo cual depende completamente del ambiente en el que se desarrollan y el acompañamiento familiar que reciben. Cómo citar este artículo: García DJ, Ochoa MC, Martínez NE, Gonzáles B, Sánchez M, Martínez M. Prevalencia de los mecanismos de adaptación del paciente con enfermedad renal bajo tratamiento de hemodiálisis. Rev Cuid. 2016; 7(1: 1144-51. http://dx.doi.org/10.15649/cuidarte.v7i1.167

  6. Estudio longitudinal del peso e índice de masa corporal tras el trasplante renal durante 5 años de evolución

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    Rafael Fernández Castillo

    2014-08-01

    Full Text Available Introducción: El aumento de peso después del trasplante es relativamente común, además suele ser multifactorial y suele estar influenciado por glucocorticoides y los medicamentos inmunosupresores, pudiendo retrasar la función del injerto y provocar complicaciones graves de salud. Objetivos: Evaluar los cambios en el peso, grado de obesidad e índice de masa corporal asi como el efecto que el tratamiento inmunosupresor produce sobre estos 5 años postrasplante renal sobre estos. Métodos: La muestra estuvo formada por 119 pacientes trasplantados renales, 70 hombres y 49 mujeres, trasplantados renales, que asistieron durante cinco años a la consulta postrasplante. A todos los pacientes se realizaron mediciones pretrasplante y postrasplante (desde el 1º año hasta el 5º año de peso, altura e índice de masa corporal calculado mediante la fórmula peso/talla2 relacionándolo con el tratamiento inmunosupresor que tomaban. Resultados: Existe un aumento considerable del índice de masa corporal, peso y grado de obesidad en el primer año tras el trasplante aumentando mas lentamente en los siguientes cuatro años. El tipo de tratamiento inmunosupresor influencia el peso y grado de obesidad que se produce en este periodo de tiempo. Conclusiones: Hay una elevada prevalencia sobrepeso y obesidad tras el trasplante especialmente durante el primer año. Al año los pacientes ganan una media de 6,6 kg de peso y una media de 2,5 kg/m² en su IMC. Durante el tratamiento se debe minimizar las dosis de esteroides e incluir tratamiento dietético y ejercicio físico adecuado.

  7. Influencia de la consulta de acogida en diálisis sobre la elección del tratamiento renal sustitutivo

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    Francisco Cirera Segura

    Full Text Available Introducción: Creamos la consulta de acogida en diálisis donde aseguramos la elección del tratamiento renal sustitutivo garantizada por la Ley de autonomía del paciente. Objetivos: • Valorar la utilidad de la consulta de acogida para garantizar la elección del tratamiento. • Analizar la elección del tratamiento según la procedencia del paciente tras pasar por consulta. Material y método: Estudio descriptivo prospectivo de un año. Historia clínica y entrevistas como fuentes primarias. Resultados: En 2014 iniciaron hemodiálisis 273 pacientes. Pasaron por la consulta de toma de decisiones 175, de los que fueron incidentes 168. Analizamos 120 pacientes de ERCA. El 66,7% realizó elección en ERCA, 100% en la consulta. De los 48 pacientes no ERCA, realizaron elección: 3,7% procedente de otras especialidades, 7,7% de trasplantados y 100% de diálisis peritoneal. En la consulta el 100% hizo elección, pasando del 20% al 100% en pacientes no ERCA. La hemodiálisis fue el tratamiento más elegido independientemente de la procedencia, excepto en el caso de los pacientes procedentes de diálisis peritoneal. Se aumentó el número de pacientes que eligieron diálisis peritoneal tras el paso por la consulta. Conclusión: La consulta de acogida fue eficaz para asegurar que se realizara la elección del tratamiento renal sustitutivo. Tras el paso por la consulta de acogida y la de toma de decisiones, la procedencia de los pacientes deja de ser importante para realizar la elección del tratamiento. Todos los pacientes eligieron contando con la misma información, aumentando la elección de la diálisis peritoneal.

  8. Valor de referencia del cambio en el seguimiento de los factores bioquímicos de riesgo cardiovascular en pacientes con enfermedad renal crónica terminal

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    Corte Arboleya, Zoraida

    2016-01-01

    Las enfermedades cardiovasculares son la principal causa de morbi-mortalidad en pacientes con enfermedad renal crónica terminal (ERCT), observándose una tasa de mortalidad cardiovascular entre 10 y 20 veces superior al de la población general. Este incremento del riesgo cardiovascular tiene una etiología multifactorial, asociándose a la elevada prevalencia y al efecto acumulativo de factores de riesgo convencionales, no convencionales y específicos de la uremia. En este contexto, una correcta...

  9. Aplicación de una pauta de hemodiálisis incremental, basada en la función renal residual, al inicio del tratamiento renal sustitutivo

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    José L. Merino

    2017-01-01

    Conclusiones: La HD incremental, con 2 sesiones de HD/semana, puede ser una alternativa en un grupo seleccionado de pacientes. Esta modalidad puede preservar la función renal residual en buena medida, al menos durante el primer año. Aunque probablemente no sea aplicable a todos los pacientes que inician TRS, puede y debe ser una alternativa inicial que considerar.

  10. Validación del Índice de Bien-estar Personal en personas con enfermedad renal crónica

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    Luís Manuel Mota de Sousa

    Full Text Available Objetivo: verificar las propiedades psicométricas del Índice de bien-estar personal (IBP en personas con enfermedad renal crónica en programa de hemodiálisis. Método: Se trata de un estudio metodológico. La muestra aleatoria es constituida por 171 personas con Enfermedad Renal Crónica (ERC sometida a hemodiálisis en dos clínicas en la región de Lisboa, Portugal. La recogida de datos fue realizada entre mayo y junio de 2015. Se evaluaron las propiedades psicométricas: validad (constructo, predictiva convergente, y discriminativa, confiabilidad por medio de la consistencia interna (α de Cronbach y estabilidad (Coeficiente de Correlación de Spearman-Brown y Coeficiente de Correlación Intraclasse (CCI. Resultados: El IBP presenta una dimensión ajustada a los datos. La satisfacción con la salud es lo que más contribuye para el IBP. Tiene validad convergente con Felicidad Subjetiva y Afecto Positivo y Afecto Negativo. Tiene poder discriminativo en la nacionalidad. El a Cronbach fue de 0,82. Teste Re-teste para cuestionario 0, 92 e CCI= 0,95, para entrevista 0,85 y CCI= 0,89. Conclusiones: La versión portuguesa del IBP es válida y reproducible en personas con ERC, tanto por cuestionario como por entrevista.

  11. EFECTO NEFROPROTECTOR DEL ÁCIDO ASCÓRBICO EN UN MODELO DE DAÑO RENAL INDUCIDO POR GENTAMICINA EN CONEJOS

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    Javier Antonio Padilla Funes

    2013-08-01

    Full Text Available Objetivo. Uno de los efectos secundarios mas notables de la Gentamicina es su nefrotoxicidad. En este estudio se propone el posible efecto nefroprotector del acido ascorbico como barredor de radicales libres de oxigeno. Metodología. Se ejecuto un estudio experimental en 24 conejos machos, raza Nueva Zelanda, cuyo peso fue de 1,5 +/- 0,5 Kg. Los sujetos experimentales fueron distribuidos en tres grupos. El grupo Control se manejo con Gentamicina a dosis de 80 mg/Kg/dia por via IM. El grupo Acido Ascorbico se trato a dosis de 200 mg/kg/dia via IP y Gentamicina 80mg/Kg/dia IM. El grupo Sham se manejo con SSN 0,9% por via IP e IM, durante cinco dias consecutivos, para cada grupo. Se determinaron los siguientes parametros: creatinina serica, N-Acetil s-D glucosaminidasa urinaria (NAG-U, diuresis e histopatologia de las muestras renales. Resultados. La creatinina serica fue significativamente mayor para el grupo Control respecto al grupo Acido Ascorbico (p<0,05. Respecto a la diuresis, se observo una tendencia a la poliuria en el grupo Control. En cuanto a NAG-U, se observo inhibicion completa de la actividad enzimatica en el grupo Acido Ascorbico. El analisis histopatologico demuestra hallazgos de necrosis tubular aguda en el 100% del grupo control, mientras que en el grupo Acido Ascorbico se obtuvo en un 50% de los sujetos unicamente detritos intraluminales. Conclusiones. La administracion concomitante de Acido Ascorbico con Gentamicina, disminuye significativamente el dano tubular renal, evidenciado en los valores de creatinina serica, NAG, diuresis e histopatologia renal.

  12. Estudio documental (2006-2013 sobre el autocuidado en el día a día del paciente con enfermedad renal crónica

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    Ana Julia Carrillo Algarra

    2013-09-01

    Full Text Available Objetivo: Describir las actividades de autocuidado realizadas por los pacientes con enfermedad renal crónica (ERC que se encuentran en los diferentes tratamientos sustitutivos, reportadas en la literatura científica durante el período 2006 a 2013. Material y método: Estudio documental de corte cualitativo, en el cual se revisaron artículos originales de cualquier nacionalidad, publicados en español, inglés y portugués, indexados en las bases de datos: Elsevier Instituciones, ScienceDirect, Ciberindex, Nursing@Ovid, Ebsco Host, Pubmed Scielo, Lilacs, usando los descriptores autocuidado, cuidado de si, autogestión, ERC, hemodiálisis, diálisis peritoneal y trasplante renal. Para el análisis de los datos se utilizó el análisis de contenido. Resultados: Se seleccionaron ocho artículos que respondieron al objetivo del estudio, siete realizados en Brasil y uno en Canadá. Seis eran cualitativos. Todos realizados por Enfermeras, dos de ellos presentan explícitamente orientación teórica disciplinar. Promedio de publicación uno por año. Emergieron seis categorías: Mantenimiento y mejora de la aptitud/condición física; Mantenimiento y mejora del estado nutricional: comportamiento alimentario, Recreación como medida de autocuidado, Protección y mantenimiento de la función de la fistula arteriovenosa, Uso de terapia farmacológica como medida de autocuidado y Desde la experiencia y la construcción del conocimiento: algunas prácticas autocuidado. Conclusiones: Mantenimiento de la condición física y del estado nutricional fueron las actividades de autocuidado que emergieron con mayor relevancia. En la producción científica del autocuidado en pacientes con ERC en tratamientos sustitutivos, se resalta el liderazgo enfermero, pero se evidencia baja producción, especialmente en países en vía de desarrollo.

  13. “PARTICIPACIÓN DEL SISTEMA RENINA ANGIOTENSINA EN ALTERACIONES RENALES Y MITOCONDRIALES EN LA HIPERTENSIÓN ARTERIAL TEMPRANA”

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    López Castillo, Lilia

    2012-01-01

    La hipertensión arterial (HA) tiene como órgano blanco al corazón, cerebro, riñón y la vasculatura, siendo las causas principales de mortalidad. Uno de los sistemas implicados en regular la presión arterial (PA) es el sistema renina angiotensina (SRA) renal, este controla la PA tanto a corto como a largo plazo. La angiotensina II (Ang ll) al ser el mediador más importante de este sistema, tiene una participación importante en la homeostasis renal y cardiovascular, mediando sus ...

  14. La ozonoterapia protege los túbulos proximales de la corteza renal del daño por isquemia-reperfusión. Estudio morfométrico preliminar

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    Enoy Leiva Pantoja

    2010-01-01

    Full Text Available La isquemia-reperfusión renal es causa de insuficiencia renal aguda, la cual presenta un elevado índice de mortalidad. Actualmente, los tratamientos empleados en la recuperación del riñón sometido a isquemia-reperfusión tienen un éxito limitado. Por tanto, se hace necesaria la búsqueda de estrategias terapéuticas efectivas que ayuden a prevenir el daño renal. La característica histopatológica más prominente de la isquemia-reperfusión renal es la lesión de los túbulos proximales corticales. El objetivo de este trabajo fue evaluar el efecto del precondicionamiento oxidativo con ozono sobre la morfología de los túbulos proximales de la corteza renal, ante el daño por isquemia-reperfusión. Se estudiaron fragmentos de corteza renal procedentes de 16 ratas, divididas en cuatro grupos: controles, dañadas por isquemia-reperfusión (60 min de isquemia seguidos por 180 min de reperfusión y dos grupos de ratas precondicionadas con ozono (0,5 y 1,1 mg/kg de peso corporal respectivamente y sometidas a isquemia-reperfusión. Las muestras se procesaron según la técnica convencional de inclusión en resina Spurr. Se realizaron cortes semifinos, que se analizaron cualitativa y cuantitativamente por Microscopia Óptica. Se identificaron los marcadores morfológicos del daño renal inducido por isquemia-reperfusión sobre los túbulos proximales renales: pérdida del ribete en cepillo, dilatación tubular, aumento de áreas y perímetros tubulares, necrosis celular y aumento de núcleos de células epiteliales en la luz tubular, relacionado con la formación de cilindros. El precondicionamiento oxidativo con ozono condujo a la recuperación de la morfología de los túbulos proximales. Al propiciar la protección de las células epiteliales de los túbulos proximales renales, la ozonoterapia podría considerarse una herramienta efectiva ante el daño por isquemia-reperfusión renal.

  15. La lipocalina asociada con la gelatinasa de neutrófilos como factor temprano de predicción de la función retardada del injerto renal

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    John Fredy Nieto-Ríos

    2016-06-01

    Conclusión. Los niveles de lipocalina urinaria asociada a la gelatinasa de neutrófilos a las 48 horas del trasplante renal predijeron la función retardada, incluida la necesidad de diálisis, pero no fueron superiores a los de la creatinina sérica para la detección temprana.

  16. Perfil do doente renal crônico no ambulatório multidisciplinar de um hospital universitário Perfil del enfermo renal crónico de consultorios externos multidisciplinario de un hospital universitario Demographic profile of individuals with chronic renal disease from a multidisciplinary outpatient clinic of a university teaching hospital

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    Simone Martins Rembold

    2009-01-01

    Full Text Available OBJETIVO: Descrever o perfil do cliente com doença renal crônica em tratamento conservador no Ambulatório Multidisciplinar do Hospital Universitário Antonio Pedro. MÉTODOS: O estudo é descritivo tendo sido analisados 72 prontuários de pacientes atendidos nos anos de 2006 a 2008. Os dados foram processados eletronicamente com o auxílio dos programas EXCEL 2007 e SPSS 13.0. RESULTADOS: A média de idade dos pacientes foi 59 + 14 anos sendo 60% do sexo feminino. Em relação à escolaridade, 42% tinham ensino fundamental incompleto. A maior parte encontrava-se no estágio 4 da doença renal crônica, sendo as principais doenças de base o diabetes mellitus e a hipertensão arterial. Mais de 80% usavam anti-hipertensivos, e mais da metade usava diuréticos. O sintoma predominante foi a noctúria. Apenas em sete pacientes foi confeccionada fístula artério-venosa. CONCLUSÃO: A população atendida no referido ambulatório consistiu, na sua maior parte de pacientes na quinta ou sexta década de vida, com predominância do sexo feminino. A maioria encontrava-se no estágio 4 da classificação do DOQI para doença renal crônica sendo diabetes a principal causa da doença renal.OBJETIVO: Describir el perfil del cliente con enfermedad renal crónica en tratamiento conservador en Consultorio Externo Multidisciplinario del Hospital Universitario Antonio Pedro. MÉTODOS: Se trata de un estudio descriptivo en el que se analizaron 72 historias clínicas de pacientes atendidos en los años de 2006 a 2008. Los dados fueron procesados electrónicamente con la ayuda de los programas EXCEL 2007 y SPSS 13.0. RESULTADOS: El promedio de edad de los pacientes fue entre 59 + 14 años siendo el 60% del sexo femenino. En relación a la escolaridad, el 42% tenían primaria incompleta. La mayor parte se encontraba en la fase 4 de la enfermedad renal crónica, siendo las principales enfermedades de base la diabetes mellitus y la hipertensión arterial. Más del

  17. Displasia renal multiquística: curso clínico y evaluación del riñón contralateral

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    Iris de Castaño

    2009-12-01

    Full Text Available Introducción: La displasia renal multiquística (DRM unilateral es una malformación frecuentemente encontrada en el ultrasonido obstétrico. En Colombia no existen publicaciones sobre las características clínicas y el comportamiento de esta enfermedad que permitan sugerir el tipo de estudios que se deben practicar en la fase inicial y en el seguimiento de estos niños.Objetivos: Describir las características clínicas de 40 pacientes con DRM unilateral con énfasis en la evaluación del riñón contralateral (RC con respecto a sus funciones, tamaño y frecuencia de malformación urológicas asociadas.Metodología: Estudio descriptivo de pacientes menores de 18 años con diagnósticos pre o postnatales de DRM unilateral, atendidos en la consulta externa de nefrología pediátrica del Hospital Infantil Club Noel entre julio de 1997 y diciembre de 2007.Resultados: Se encontraron 40 pacientes. En ellos 88% el diagnóstico se hizo antes de nacer; 55% eran de sexo masculino, con una edad promedio al ingreso de 2 meses (rangos, 1 y 42 meses. En el RC se descubrió hidronefrosis (HN en 2 casos (5% y reflujo vesicoureteral (RVU grados I yII en 3 casos (9%. El cálculo de la filtración glomerular fluctuó entre 81 ml/min/1.73 y 193 ml/min/1.73 (media, 105. Sólo uno de los 38 renogramas fue anormal e informó la presencia de una cicatriz renal. En el control ecográfico de 31 pacientes los quistes desaparecieron en 13 y persistían en 18, con una media de 60 meses (rango, 24 y 132 meses. El tiempo de seguimiento promedio fue 60 meses con un rango entre 15 y 132 meses.Conclusiones: En este grupo de pacientes se encontró buen pronóstico del RC: ninguno presentó disminución de la filtración glomerular y la frecuencia de malformaciones urológicas como la HN y el RVU fue muy baja. El ultrasonido renal (UR es indispensable en la evaluación inicial y seguimiento de los casos. Es recomendable practicar al comienzo un renograma, preferiblemente con 99

  18. Displasia renal multiquística: curso clínico y evaluación del riñón contralateral

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    Iris De Castaño

    2010-08-01

    Full Text Available Introducción: La displasia renal multiquística (DRM unilateral es una malformación frecuentemente encontrada en el ultrasonido obstétrico. En Colombia no existen publicaciones sobre las características clínicas y el comportamiento de esta enfermedad que permitan sugerir el tipo de estudios que se deben practicar en la fase inicial y en el seguimiento de estos niños. Objetivos: Describir las características clínicas de 40 pacientes con DRM unilateral con énfasis en la evaluación del riñón contralateral (RC con respecto a sus funciones, tamaño y frecuencia de malformación urológicas asociadas. Metodología: Estudio descriptivo de pacientes menores de 18 años con diagnósticos pre o postnatales de DRM unilateral, atendidos en la consulta externa de nefrología pediátrica del Hospital Infantil Club Noel entre julio de 1997 y diciembre de 2007. Resultados: Se encontraron 40 pacientes. En ellos 88% el diagnóstico se hizo antes de nacer; 55% eran de sexo masculino, con una edad promedio al ingreso de 2 meses (rangos, 1 y 42 meses. En el RC se descubrió hidronefrosis (HN en 2 casos (5% y reflujo vesicoureteral (RVU grados I yII en 3 casos (9%. El cálculo de la filtración glomerular fluctuó entre 81 ml/min/1.73 y 193 ml/min/1.73 (media, 105. Sólo uno de los 38 renogramas fue anormal e informó la presencia de una cicatriz renal. En el control ecográfico de 31 pacientes los quistes desaparecieron en 13 y persistían en 18, con una media de 60 meses (rango, 24 y 132 meses. El tiempo de seguimiento promedio fue 60 meses con un rango entre 15 y 132 meses. Conclusiones: En este grupo de pacientes se encontró buen pronóstico del RC: ninguno presentó disminución de la filtración glomerular y la frecuencia de malformaciones urológicas como la HN y el RVU fue muy baja. El ultrasonido renal (UR es indispensable en la evaluación inicial y seguimiento de los casos. Es recomendable practicar al comienzo un renograma, preferiblemente

  19. EFECTO NEFROPROTECTOR DEL ÁCIDO ASCÓRBICO EN UN MODELO DE DAÑO RENAL INDUCIDO POR GENTAMICINA EN CONEJOS

    Directory of Open Access Journals (Sweden)

    Javier Antonio Padilla Funes

    2012-01-01

    Full Text Available Objetivo. Uno de los efectos secundarios más notables de la Gentamicina es su nefrotoxicidad. En este estudio se propone el posible efecto nefroprotector del ácido ascórbico como barredor de radicales libres de oxígeno. Metodología. Se ejecutó un estudio experimental en 24 conejos machos, raza Nueva Zelanda, cuyo peso fue de 1,5 +/- 0,5 Kg. Los sujetos experimentales fueron distribuidos en tres grupos. El grupo Control se manejó con Gentamicina a dosis de 80 mg/Kg/día por vía IM. El grupo Ácido Ascórbico se trató a dosis de 200 mg/kg/día vía IP y Gentamicina 80mg/Kg/día IM. El grupo Sham se manejó con SSN 0,9% por vía IP e IM, durante cinco días consecutivos, para cada grupo. Se determinaron los siguientes parámetros: creatinina sérica, N-Acetil ß-D glucosaminidasa urinaria (NAG-U, diuresis e histopatología de las muestras renales. Resultados. La creatinina sérica fue significativamente mayor para el grupo Control respecto al grupo Ácido Ascór- bico (p<0,05. Respecto a la diuresis, se observó una tendencia a la poliuria en el grupo Control. En cuanto a NAG-U, se observó inhibición completa de la actividad enzimática en el grupo Ácido Ascórbico. El análisis histopatológico demuestra hallazgos de necrosis tubular aguda en el 100% del grupo control, mientras que en el grupo Ácido Ascórbico se obtuvo en un 50% de los sujetos únicamente detritos intraluminales. Conclusiones. La administración concomitante de Ácido Áscórbico con Gentamicina, disminuye significativamente el daño tubular renal, evidenciado en los valores de creatinina sérica, NAG, diuresis e histopatología renal.

  20. Estudio del estrés oxidativo en pacientes con enfermedad renal crónica: prediálisis, hemodiálisis y diálisis peritoneal

    OpenAIRE

    Puchades Montesa, María Jesús

    2011-01-01

    INTRODUCCIÓN La Enfermedad Renal Crónica (ERC) es el paradigma del riesgo cardiovascular. En ella confluyen multitud de factores de riesgo clásicos (HTA, Diabetes…), aparte de que la insuficiencia renal es un potente predictor de enfermedad cardiovascular. El estrés oxidativo está implicado de forma directa en la formación de la placa de ateroma y se ha demostrado que está presente en la ERC desde su inicio, sin embargo el papel de las técnicas dialíticas está aún por determinar. Si me...

  1. Estado nutricional de niños con enfermedad renal crónica en la consulta de nefrología pediátrica del Hospital Universitario del Valle, Cali

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    Adela Isabel Herrera

    2009-06-01

    Full Text Available Introducción: En la edad pediátrica la enfermedad renal crónica (ERC puede afectar el estado nutricional. Es importante evaluarla en su fase inicial y en su progresión, para favorecer o mantener el crecimiento, disminuir el grado de desnutrición, retrasar la progresión hacia la fase terminal y minimizar las consecuencias metabólicas de la uremia.Objetivos: Evaluar el estado nutricional de niños con ERC estadíos 2 a 4 mediante índices antropométricos, perfil bioquímico y encuesta dietaria por recordatorio de 3 días.Metodología: Estudio descriptivo de observaciones sobre 17 pacientes que consultaron al servicio de nefrología pediátrica del Hospital Universitario del Valle, durante el período de diciembre 2007 a marzo 2008.Resultados: Del total de niños 65% (n=11 eran de sexo masculino, con edad promedio de 6.2 años para los varones y 10.3 para las niñas. El diagnóstico nefrológico predominante fue nefropatía por reflujo en 41%. La desnutrición severa determinada a través de los índices talla/edad y peso/edad (<-2DS estuvo presente en 30% de los casos. Según la antropometría del brazo por pliegue cutáneo del tríceps (PCT<2DS 75% de los niños presentaron desnutrición moderada. Según los datos bioquímicos se encontró albúmina sérica disminuida (<3.5 g/dl en 5 casos, 29% de los niños. A través de la encuesta dietaria se evidenció disminución del consumo de calorías, calcio, hierro y zinc. La ingesta de sodio estuvo por encima de lo recomendado en 150%.Conclusiones: Se pudo determinar que la evaluación nutricional temprana es básica en el manejo y tratamiento de pacientes con ERC moderada, pues se evidenciaron deficiencias nutricionales desde el comienzo de la enfermedad. Es importante el consumo de por lo menos 100% de las recomendaciones de calorías y otros nutrientes en niños con ERC para evitar el retardo en el crecimiento y otras alteraciones.

  2. Problemas renales de la cirrosis Renal problems of cirrhosis

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    Alvaro García

    1992-02-01

    Full Text Available Presentamos una revisión actualizada y condensada acerca de los problemas renales más relevantes que ocurren en la cirrosis tales como las alteraciones en el manejo del sodio y del agua, el tratamiento de la ascitis y el edema y el enfoque de la falla renal que ocurre en esta enfermedad, es decir síndrome hepato-renal y necrosis tubular aguda.

    We present a condensed and updated review on the most common renal problems occurring in cirrhosis such as the handling of sodium and water, the treatment of ascites and edema and the approach to the renal failure that frequently takes place in this disease, namely hepato-renal syndrome and acute tubular necrosis.

  3. Manejo del cólico renal en urgencias de un hospital de tercer nivel Nephritic colic management in an emergency room of a referral hospital

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    M.A. Aibar-Arregui

    2010-08-01

    Full Text Available Fundamento. El objetivo del presente trabajo es conocer las características epidemiológicas, el manejo diagnóstico y terapéutico, su seguimiento y la incidencia de diagnósticos alternativos en una muestra de pacientes diagnosticados de cólico renal en el Servicio de Urgencias de un Hospital de tercer nivel. Material y métodos. Estudio descriptivo retrospectivo de 182 pacientes seleccionados aleatoriamente que consultan por clínica compatible con cólico renal en un hospital de tercer nivel, valorando su manejo inicial, seguimiento al alta y diagnósticos alternativos. Resultados. El 55,4% fueron varones, la edad media fue de 47,7 años y el 40% de los casos se produjeron en primavera. En todos los pacientes se realizó analítica urinaria (62,7% tira reactiva y 72% sedimento apareciendo alteraciones en más del 70%. La función renal se deterioró en el 26,4 % de los casos, siempre de forma transitoria. La prueba de imagen realizada con más frecuencia fue la radiografía de abdomen (81,9% seguida de la ecografía (25,8%. El tratamiento incluyó fluidoterapia en el 31,3% y el analgésico más usado fue el metamizol (61% seguido del ketorolaco (44,5%. El 46,2% de los pacientes necesitó más de un analgésico. Un total de 24 pacientes precisaron ingreso hospitalario y 5 de ellos cirugía urgente. El 24,1% presentó recaídas en los seis meses posteriores. El 41,6% fue remitido al Servicio de Urología al alta. El 18,1% presentaron diagnósticos alternativos, siendo la pielonefritis aguda el más frecuente de ellos (55%. Conclusiones. Hemos detectado una importante variación en el manejo diagnóstico y terapéutico de estos pacientes. El uso de guías clínicas debe permitirnos unificar el manejo del paciente con cólico renal tanto en urgencias como posteriormente. El alto porcentaje de diagnósticos alternativos nos obliga a descartar sistemáticamente patologías más graves.Background. To evaluate the diagnostic and therapeutic

  4. Insuficiencia renal aguda.

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    Carlos Hernán Mejía

    2009-10-01

    Full Text Available La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción de sodio y osmolaridad, el uroanálisis y la ecografía renal. Su tratamiento consiste en una adecuada recuperación del volumen, manejo de los diuréticos, soporte nutricional, conservación del equilibrio hidroelectrolítico y brindar terapia de diálisis si hay toxicidad urémica, hipercaliemia severa (>6.5 mEq/l, acidosis metabólica o sobrecarga severa de volumen.

  5. Factores de riesgo de la litiasis renal oxalocálcica: estudio del estrés crónico como factor etiológico y de su influencia a nivel bioquímico

    OpenAIRE

    Arzoz Fàbregas, Montserrat

    2011-01-01

    INTRODUCCIÓN La urolitiasis es una enfermedad multifactorial crónica. Dentro de los factores de riesgo extrínsecos al individuo, existen pocos trabajos que evalúen el estrés crónico (EC), mediante los acontecimientos vitales estresantes (AV), como factor de riesgo de la litiasis oxalocálcica (OxCa). El EC implica una activación del cortisol y éste puede aumentar la excreción urinaria del calcio al competir con la aldosterona a nivel intracelular renal. Además, se ha demostrado que animales so...

  6. Costo efectividad del tratamiento de denervación renal vs. mejor tratamiento médico estándar disponible en el control de la hipertensión resistente en Colombia

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    Juan E. Valencia

    2014-06-01

    Full Text Available Objetivo: Mediante la adaptación a Colombia del modelo realizado por BresMed y previo análisis de transferibilidad, se realizó un análisis de costo-efectividad del tratamiento de denervación renal vs. mejor tratamiento estándar en el control de la hipertensión resistente y los eventos cardiovasculares relacionados. Métodos: Se construyó un modelo de Markov con 32 estados de salud y siete resultados finales: accidente cerebrovascular, infarto del miocardio, enfermedad coronaria, falla cardiaca, enfermedad renal crónica terminal, mortalidad cardiovascular y muerte. Se consideró un horizonte de toda la vida, la perspectiva desde el pagador y una tasa de descuento del 3%. Para el cálculo de las probabilidades de sufrir eventos se utilizaron las ecuaciones de riesgo de Framingham y las efectividades se tomaron del estudio clínico SYMPLICITY HTN-2. Los costos se extrajeron del entorno local y las tasas de mortalidad del Observatorio global de salud de la Organización Mundial de la Salud. Los resultados incluyeron los costos de cada alternativa de tratamiento, así como los años de vida ajustados a calidad ganados. Se realizaron análisis determinístico y probabilístico. Resultados: El tratamiento de denervación renal produjo 12,48 años de vida ajustados a calidad ganados a un costo de US $46.509 vs. 11,68 años de vida ajustados a calidad ganados del mejor tratamiento estándar a un costo de US $41.199, con un costo incremental por años de vida ajustados a calidad ganados de US $6.612. Tanto el análisis de sensibilidad univariado como el probabilístico, mostraron la robustez de los resultados. Conclusiones: El tratamiento de denervación renal, con un costo incremental por años de vida ajustados a calidad ganados de $6.612, muy por debajo de 1 PIB per cápita de Colombia, mostró ser altamente costo-efectivo.

  7. Trauma renal Renal trauma

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    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  8. Renal arteriography

    Science.gov (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  9. Valoración del estado nutricional y consumo alimentario de los pacientes en terapia renal sustitutiva mediante hemodiálisis

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    M.ª Concepción Pereira Feijoo

    Full Text Available Introducción: La malnutrición proteico-energética es un hecho frecuente entre los pacientes en tratamiento sustitutivo renal con hemodiálisis y a ello contribuye, además de la propia técnica dialítica, la dieta inadecuada. Objetivos: Valorar la evolución del estado nutricional y la ingesta alimentaria de los pacientes de 3 unidades de hemodiálisis extrahospitalaria, tras una intervención enfermera educativa. Pacientes y métodos: Hemos realizado un estudio transversal en 66 pacientes de 3 unidades extrahospitalarias (44 hombres y 23 mujeres con dosis de diálisis medida por KT/V > 1,3 .Se hizo una determinación del estado nutricional por métodos convencionales y del consumo alimentario mediante encuesta dietética, determinándose mediante soporte informático el índice de alimentación saludable, identificando los déficits y/o excesos de nutrientes en cada paciente. Se llevaron a cabo intervenciones educativas personalizadas dirigidas a corregir los excesos o déficits de nutrientes detectados en los pacientes, y se volvieron a hacer las mismas valoraciones a los seis meses. Resultados: La prevalencia de desnutrición es leve en el 41% de hombres y 43% de las mujeres y moderada en el 34% de los hombres y 21% de las mujeres. El índice de alimentación saludable era inadecuado en el 37,31% de los pacientes en el análisis basal y postintervención educativa paso al 18,8%. La ingesta media energética es elevada (1398.86 Kcal/paciente/día con alto consumo de colesterol y déficit de aminoácidos. Se detectó un alto consumo de hidratos de carbono simples (> 20% y un elevado uso de proteínas de origen animal. El contenido mineral y vitamínico de la dieta es muy deficiente, destacando el bajo consumo de Vitamina D (1.45±2.55 ng y elevado de fósforo (1052.28±356.23 m/día. Conclusion: Tras una intervención educativa sobre nuestros pacientes, corrigiendo hábitos dietéticos no saludables, hemos conseguido mejorar su estado

  10. Evolução da função renal de pacientes portadores do Vírus da Imunodeficiência Humana/ Síndrome da Imunodeficiência Adquirida Evolución de la función renal de pacientes portadores del Virus de la Inmunodeficiencia Humana/ Síndrome de la Inmunodeficiencia Adquirida Renal function in patients with Human Immunodeficiency Virus

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    Daniane Bornea Friedl

    2009-01-01

    Full Text Available OBJETIVO: Avaliar a evolução da função renal em pacientes portadores do Vírus da Imunodeficiência Humana que iniciaram acompanhamento no Centro de Controle de Doenças Infecciosas do Hospital São Paulo/ Universidade Federal de São Paulo. MÉTODOS: Estudo retrospectivo realizado através da análise de 200 prontuários selecionados de forma aleatória. RESULTADOS: Perfil predominante masculino, cor branca, idade média de 45 anos, mais de 50 meses de diagnóstico, co-morbidades adquiridas variando de zero a nove doenças, creatinina média de 0,93mg/dl e a grande maioria realizando tratamento medicamentoso. CONCLUSÃO: O grupo analisado não mostrou alteração significativa em relação à função renal entre a primeira e a última consulta.OBJETIVO: Evaluar la evolución de la función renal en pacientes portadores del Virus de la Inmunodeficiencia Humana que iniciaron acompañamiento en el Centro de Control de Enfermedades Infecciosas del Hospital Sao Paulo/ Universidad Federal de Sao Paulo. MÉTODOS: Estudio retrospectivo realizado a través del análisis de 200 historias clínicas seleccionadas de forma aleatoria. RESULTADOS: Perfil predominante masculino, raza blanca, edad promedio de 45 años, más de 50 meses de diagnóstico, comorbidades adquiridas variando de cero a nueve enfermedades, creatinina promedio de 0,93mg/dl y la gran mayoría realizando tratamiento medicamentoso. CONCLUSIÓN: El grupo analizado no mostró alteración significativa en relación a la función renal entre la primera y la última consulta.OBJECTIVE: To evaluate the renal function in patients with Human Immunodeficiency Virus who were attending the Center for Infectious Diseases Control of the São Paulo Hospital of the Federal University of São Paulo. METHODS: This retrospective study consisted of the review of 200 randomly selected medical records. RESULTS: Patients were predominant white males with a mean age of 45 years. They had been diagnosed with

  11. Valoración en un solo paso del potencial donante renal: Angiografía y urografía por RM con correlación quirúrgica One-step MR angiography and urography in the evaluation of potential renal living donors.

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    María Bolaño Vega

    2011-12-01

    Full Text Available Objetivos. Evaluar el rendimiento diagnóstico de la angiografía renal (ARM y urografía (URM por Resonancia Magnética (RM en potenciales donantes de riñón mediante la correlación con hallazgos quirúrgicos. Materiales y Métodos. Se evaluaron 55 potenciales donantes mediante protocolo angiográfico y urográfico en múltiples fases en un resonador de 1,5 T. La ARM valoró la existencia de variantes anatómicas o alteraciones estructurales arteriales o venosas y la URM valoró el parénquima renal y el sistema colector en fases nefrográfica y excretora. Los resultados fueron comparados con hallazgos quirúrgicos. Resultados. La correlación se realizó en 42 donantes efectivos. En ellos, se observó una especificidad de la ARM del 94% y una exactitud diagnóstica del 93%. Se identificaron variantes anatómicas y alteración estructural arterial en el 29% de los pacientes. La valoración venosa y urográfica de la RM resultó concordante quirúrgicamente en todos los casos. Conclusión. Las imágenes de RM proveen un método seguro y eficaz para la valoración prequirúrgica renal de forma integral en potenciales donantes de riñón.Objectives. To evaluate diagnostic accuracy of renal MRangiography(MRA and MR- urography (MRU in the assessment of normal anatomy and renal vascular pathology in potential renal living donors compared with surgical findings. Materials and Methods. Evaluation of 55 potential living donors performing one-step MR angiography and MR urography in a 1.5 T magnet. MRA evaluated the presence of anatomic variants or arterial or venous pathologic conditions. MRU depicted renal parenchyma anatomy and collector system. These results were compared with surgical findings. Results. MRA and MRU findings were actually compared with surgical findings in 42 effective donors. MRA specificity was 94 % and diagnostic accuracy was 93 %. Anatomic variants and arterial structural abnormalities were detected in 29 % of patients. Venous

  12. Programa para la detección precoz de la insuficiencia renal crónica en la población de "Gombe", un barrio de Kinshasa, capital de la República Democrática del Congo

    OpenAIRE

    Kiketa Mayivanga, Arlette

    2014-01-01

    El objetivo principal de este trabajo din de máster es la detección precoz de la insuficiencia renal crónica en la población de “Gombe”, un barrio en Kinshasa, la capital de la República Democrática del Congo. Los objetivos específicos son: 1. Difundir este programa de detección precoz de la insuficiencia renal crónica en la población de “Gombe” un barrio de Kinshasa a través de los principales medios de comunicación locales y lugares en los que el programa se va a desarrollar. 2. Sensibil...

  13. Renal Osteodystrophy

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    Aynur Metin Terzibaşoğlu

    2004-12-01

    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  14. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Acute renal failure Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico: Actualización. Consenso SEMICYUC-SENPE: Insuficiencia renal aguda

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    J. López Martínez

    2011-11-01

    Full Text Available Nutritional support in acute renal failure must take into account the patient's catabolism and the treatment of the renal failure. Hypermetabolic failure is common in these patients, requiring continuous renal replacement therapy or daily hemodialysis. In patients with normal catabolism (urea nitrogen below 10 g/day and preserved diuresis, conservative treatment can be attempted. In these patients, relatively hypoproteic nutritional support is essential, using proteins with high biological value and limiting fluid and electrolyte intake according to the patient's individual requirements. Micronutrient intake should be adjusted, the only buffering agent used being bicarbonate. Limitations on fluid, electrolyte and nitrogen intake no longer apply when extrarenal clearance techniques are used but intake of these substances should be modified according to the type of clearance. Depending on their hemofiltration flow, continuous renal replacement systems require high daily nitrogen intake, which can sometimes reach 2.5 g protein/kg. The amount of volume replacement can induce energy overload and therefore the use of glucose-free replacement fluids and glucosefree dialysis or a glucose concentration of 1 g/L, with bicarbonate as a buffer, is recommended. Monitoring of electrolyte levels (especially those of phosphorus, potassium and magnesium and of micronutrients is essential and administration of these substances should be individually-tailored.El soporte nutricional en la insuficiencia renal aguda está condicionado por el catabolismo del paciente y por el tratamiento del fallo renal. En el paciente crítico es frecuente el fracaso hipermetabólico que obliga a técnicas continuas de reemplazo renal o a hemodiálisis diarias. En los enfermos con catabolismo normal (aparición de nitrógeno ureico inferior a 10 g/día y diuresis conservada se puede intentar un tratamiento conservador. En estos casos es preciso realizar un soporte nutricional

  15. Nutrición y enfermedad renal

    OpenAIRE

    Iris de Castaño; Consuelo de Rovetto

    2007-01-01

    El riñón juega un papel importante en la regulación interna del organismo a través de las funciones excretoras, metabólicas y endocrinas. La insuficiencia renal aguda, IRA, se caracteriza por un rápido deterioro de la función renal con acumulación de productos nitrogenados como la urea y la creatinina y desequilibrio del agua y de los electrólitos. La falla renal crea un estado de desequilibrio metabólico proporcional a la perdida de la función renal. Dentro de los factores importantes para d...

  16. Consenso Delphi sobre el diagnóstico y manejo de la dislipidemia en pacientes con enfermedad renal crónica: análisis post-hoc del estudio DIANA

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    Aleix Cases Amenós

    2016-11-01

    Conclusiones: El consenso en analizar el perfil lipídico en los pacientes con ERC indica el reconocimiento del alto riesgo cardiovascular de esta enfermedad. La ausencia de acuerdo en considerar la función renal o la albuminuria, tanto en la elección de la estatina como durante el seguimiento, indica un conocimiento limitado de las diferencias entre estatinas en relación con la ERC, por lo que sería deseable disponer de una guía/documento de consenso sobre uso de estatinas en la ERC.

  17. El entrenamiento de fuerza reduce la acidosis metabólica y la hipertrofia hepática y renal consecuentes del consumo de una dieta hiperproteica en ratas Resistance training reduces the metabolic acidosis and hepatic and renal hypertrophy caused by the consumption of a high protein diet in rats

    OpenAIRE

    2011-01-01

    Introducción: El consumo de dietas hiperproteicas (HP) podría tener un efecto adverso sobre la acidosis metabólica y la salud hepática y renal. Sin embargo, existen pocos estudios que analicen los efectos del entrenamiento de fuerza sobre los parámetros sensibles de ser alterados por dichas dietas. Material y métodos: Un total de 32 ratas Wistar adultas fueron distribuidas de forma aleatoria en 4 grupos experimentales (n = 8): dieta normoproteica o HP, con o sin entrenamiento de fuerza. Las d...

  18. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  19. Trasplante renal Kidney transplant

    Directory of Open Access Journals (Sweden)

    P. Martín

    2006-08-01

    Full Text Available El trasplante renal es la terapia de elección para la mayoría de las causas de insuficiencia renal crónica terminal porque mejora la calidad de vida y la supervivencia frente a la diálisis. El trasplante renal de donante vivo es una excelente alternativa para el paciente joven en situación de prediálisis porque ofrece mejores resultados. El tratamiento inmunosupresor debe ser individualizado buscando la sinergia inmunosupresora y el mejor perfil de seguridad, y debe adaptarse a las diferentes etapas del trasplante renal. En el seguimiento del trasplante renal hay que tener muy en cuenta los factores de riesgo cardiovascular y los tumores puesto que la muerte del paciente con injerto funcionante es la segunda causa de pérdida del injerto tras el primer año del trasplante. La función alterada del injerto es un factor de mortalidad cardiovascular independiente que requerirá seguimiento y control de todas sus complicaciones para retrasar la entrada en diálisis.The kidney transplant is the therapy of choice for the majority of the causes of chronic terminal kidney insufficiency, because it improves the quality of life and survival in comparison with dialysis. A kidney transplant from a live donor is an excellent alternative for the young patient in a state of pre-dialysis because it offers the best results. Immunosuppressive treatment must be individualised, seeking immunosuppressive synergy and the best safety profile, and must be adapted to the different stages of the kidney transplant. In the follow-up to the kidney transplant, cardiovascular risk factors and tumours must be especially taken into account, given that the death of the patient with a working graft is the second cause of loss of the graft following the first year of the transplant. The altered function of the graft is a factor of independent cardiovascular mortality that will require follow-up and the control of all its complications to postpone the entrance in dialysis.

  20. Telopéptido carboxilo terminal del colágeno tipo I (b-CTX sérico y compromiso óseo en la insuficiencia renal crónica Serum b-Type I collagen carboxyterminal telopeptide (b-CTXs and bone involvement in chronic renal failure

    Directory of Open Access Journals (Sweden)

    Beatriz Oliveri

    2005-08-01

    Full Text Available La osteodistrofia renal (ODR se caracteriza por alteraciones óseas. Se evaluaron métodos bioquímicos alternativos a la biopsia ósea en pacientes renales para determinar cambios rápidos del remodelamiento óseo en 43 pacientes predialíticos (PD y 49 hemodializados (HD. Los PD presentaron fosfatemia, fosfatasa alcalina ósea (FAO, hormona paratiroidea intacta (PTHi y b-telopéptido carboxilo terminal del colágeno tipo I (bCTXs mayores y clearence de creatinina (Ccr menores (p40 ml/min. En PD, bCTXs (pAn increase in parathyroid hormone (PTH levels in chronic renal failure (CRF induces bone abnormalities known as renal osteodystrophy (ROD. The aim of the present study was to evaluate alternative biochemical methods to bone biopsy, to evaluate changes in bone remodeling in renal patients. Intact PTH (iPTH and bone markers were measured in 43 predialysis (PD, 49 hemodialysis patients (HD and 185 controls. bCTXs, bone alkaline phosphatase (bAL, iPTH were higher and creatinine clearance (Ccr was lower in PD and HD compared with controls (p40 ml/min. bCTXs (p<0.05 in PD and bCTXs and bAL in HD patients were higher than controls, even when iPTH was within normal range (<65 pg/ml. Patients with severe secondary hyperparathyroidism showed higher bone markers than patients with normal or moderately increased iPTH (p<0.001. These results suggest that even when there is no increase in iPTH, bone remodeling increases (possibly due to other factors exhibiting higher bone resorption, and bCTXs would seem to be an adequate non-invasive tool to assess early bone changes in CRF and prevent future fractures. Bone marker measurements in ROD would be useful to identify patients who may require bone biopsy. However, further studies comparing both methods must be performed before replacing bone biopsy with serum b-CTX.

  1. Percepções do paciente em lista de espera para o transplante renal Percepciones del paciente en lista de espera para el transplante renal Feelings of patients on the waiting list for a kidney transplant

    Directory of Open Access Journals (Sweden)

    Rosiele Vemdrame Flores

    2004-12-01

    Full Text Available Estudo exploratório descritivo, com abordagem qualitativa cujo objetivo foi: conhecer as percepções dos pacientes em lista de espera para transplante renal. O local da pesquisa foi a Unidade de Hemodiálise de um hospital universitário de Porto Alegre. Os participantes foram os pacientes ativos na lista de espera para fazer o transplante renal, sendo a amostra constituída de 09 portadores de IRC, que realizam hemodiálise. Como resultados identificou-se as seguintes percepções: esperança, ansiedade, liberdade, ambivalência, medo, culpa e fé. A dependência da diálise para sobreviver remete o paciente ao confronto com a morte e a descrença, ao mesmo tempo em que busca força e fé para lutar e manter-se na espera por um doador.Estudio exploratorio descriptivo, con abordaje cualitativo cuyo objetivo fue: conocer las percepciones de los pacientes en lista de espera para transplante renal. El local de la encuesta fue la Unidad de Hemodiálisis de un hospital universitario de Porto Alegre. Los participantes fueron los pacientes activos en la lista de espera para hacer el transplante renal, siendo la muestra constituida de 09 portadores de IRC (Insuficiencia Renal Crónica, que realizan hemodiálisis. Como resultados se identificaron las siguientes percepciones: esperanza, ansiedad, libertad, ambivalencia, miedo, culpa y fe. La dependencia de la diálisis para supervivir remete al paciente al enfrentamiento con la muerte y la descreencia, al mismo tiempo en que busca fuerza y fe para luchar y mantenerse en la espera por un donador.A descriptive and exploratory study with a qualitative approach whose aim was to get to know the feelings of patients on the waiting list for a kidney transplant. The research was conducted at the Hemodialysis Unit of a university hospital of Porto Alegre. The participants were the active patients on the waiting list for a kidney transplant. The sample comprised 9 patients affected with chronic renal

  2. Costo-utilidad del trasplante renal frente a la hemodiálisis en el tratamiento de la insuficiencia renal crónica terminal en un hospital peruano Cost utility of renal transplant vs. hemodialysis in the treatment of end stage chronic kidney failure in a peruvian hospital

    Directory of Open Access Journals (Sweden)

    Ricardo E. Loza-Concha

    2011-09-01

    Full Text Available Objetivos. Determinar y comparar las razones de costo-utilidad de los trasplantes renales con donante cadavérico (TRDC practicados en el Hospital Nacional Guillermo Almenara Irigoyen los años 2000-2001, frente a hemodiálisis (HD, cinco años después del inicio del tratamiento. Material y métodos. Se realizó un estudio de costo utilidad, estudiando a todos los pacientes continuadores cinco años post TRDC, a quienes se asignó como controles, dos pacientes con cinco años de HD pareados por edad, sexo y tiempo de enfermedad. Se evaluaron los costos de cada procedimiento, los años de vida ajustados a la calidad (AVAC utilizando el cuestionario SF-36v2TM y se calcularon las razones de costo utilidad (CU y costo utilidad incremental (CUI. Resultados. Se realizaron 58 TRDC los años 2000-2001. Cinco años después, 17 (29 % pacientes fallecieron y 27 (47 % continuaron con su tratamiento post-TRDC. Treinta y uno (53 % TRDC fracasaron; 26 % por rechazo al trasplante, 55 % por complicación y 19 % por tratamiento irregular. Los puntajes SF-36v2TM promedio obtenidos por los TRDC y HD fueron 95±13 y 87±18 puntos respectivamente. En ambos años, los AVAC obtenidos por los TRDC y HD fueron de 251 y 229 puntos respectivamente; las razones de CU para los TRDC y los HD fueron de USD 11 984 y USD 9243, y la razón de CUI fue de USD 40 669. Conclusiones. Los TRDC realizados los años 2000-2001, cinco años después resultaron menos costo útiles que las HD; y los TRDC realizados el 2000 tuvieron una menor razón de costo utilidad incremental que los efectuados el 2001, probablemente por su mayor razón de tratamientos irregulares.Objectives. To assess and compare the cost utility of the cadaveric donor renal transplant (CDRT at the Hospital Nacional Guillermo Almenara Irigoyen between 2000 to 2001, against haemodialysis (HD, 5 years after treatment initiation. Materials and Methods. A cost utility study design was used, which evaluated every patient

  3. Infeccion urinaria temprana en trasplante renal: Factores de riesgo y efecto en la sobrevida del injerto Early urinary tract infection in kidney transplantation: Risk factors and impact on graft sur-vival

    Directory of Open Access Journals (Sweden)

    Pablo A. Cepeda

    2005-10-01

    Full Text Available La infección urinariatemprana del injerto (IUTI, definida como infección urinaria sintomática en los primeros 3 meses del trasplante, su efecto sobre la sobrevida del injerto y los factores de riesgo han sido poco estudiados. Los objetivos del presente análisis fueron conocer factores de riesgo para IUTI, analizar agentes causantes e impacto en la sobrevida del injerto. En forma retrospectiva se analizaron pacientes que recibieron trasplante renal durante 1997-2000 en el Hospital Privado - Centro Médico de Córdoba. Se dividió en dos grupos de pacientes, según presencia (grupo IUTI o ausencia (grupo control de IUTI. Los factores de riesgo se analizaron con el modelo de riesgos proporcionales de Cox y la sobrevida del injerto con el método de Kaplan-Meier. Recibieron trasplante renal 226 pacientes consecutivos. La IUTI se presentó en 55 (24.3%. Factores de riesgo asociados con IUTI: antecedentes de maniobras urológicas invasivas (RR=4.34, IC 95% 1.42-13.21, diabetes mellitus (RR=3.79, IC 95% 1.42-10.14, infección por citomegalovirus (RR=2.9, IC 95% 1.02-8.24 y antecedente de trasplante previo (RR=2.83, IC 95% 1.08-7.45. El retardo en la función del injerto (RR=0.38, IC 95% 0.15-0.94 se asoció con menor incidencia de IUTI. Agentes más frecuentes: Klebsiella pneumoniae (36%, Pseudomonas aeruginosa (24% y Escherichia coli (9%. La sobrevida del injerto a los 2 años en el grupo IUTI (87.2% no fue diferente del control (81.2%, P = 0.32. En esta serie las maniobras urológicas invasivas fueron el principal factor de riesgo asociado a IUTI. No hubo disminución de la sobrevida del injerto asociada a IUTI. La alta prevalencia de uropatógenos no coli requiere mayor evaluación.The early urinary tract infection (EUTI in kidney transplant recipients is an infection develop during the first 3 months post transplant surgery. The effect of EUTI on graft survival and risk factors have been scarcely studied. Our objetives were the evaluation of

  4. REPERCUSION DE LA SALUD MENTAL EN LA CALIDAD DE VIDA DE PACIENTES DIAGNOSTICADOS CON INSUFICIENCIA RENAL CRÓNICA TERMINAL CON TRATAMIENTO AMBULATORIO DEL HOSPITAL ESSALUD AREQUIPA 2013

    OpenAIRE

    MORALES CHURA, DANNYS MILAGROS

    2014-01-01

    PORCENTAJE SALUD FÍSICA PORCENTAJE ROL FÍSICO PORCENTAJE FUNCIÓN SOCIAL PORCENTAJE DOLOR CORPORAL PORCENTAJE ÁREA DE SALUD MENTAL PORCENTAJE SALUD GENERAL CUESTIONARIO SALUD MENTAL PORCENTAJE DEL FACTOR SATISFACCIÓN PERSONAL PORCENTAJE DEL FACTOR ACTITUD PRO SOCIAL PORCENTAJE DEL FACTOR AUTO CONTROL PORCENTAJE DEL FACTOR AUTONOMÍA ÁREA DE SALUD GENERAL PORCENTAJE DE FACTOR RESOLUCIÓN DE PROBLEMAS PORCENTAJE DE FACTOR DE RELACIONES INTERPERSONALES CUADROS COMPARATIVOS DE SALUD FÍSICA Y SALUD M...

  5. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  6. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  7. Evaluación de la toxicidad hepática y renal aguda y subaguda del látex de Croton palanostigma (sangre de grado en animales de experimentación

    Directory of Open Access Journals (Sweden)

    Miguel Sandoval

    2005-06-01

    Full Text Available Objetivo: Determinar la toxicidad hepática y renal de la administración oral del látex de Croton palanostigma, en dosis terapéutica y de mayor concentración. Materiales y Métodos: Se evaluó 60 ratas albinas, machos, en dos grupos: con administración oral aguda por 7 dìas y otro con administración oral subaguda por 30 días ad libitum. En cada grupo se tuvo tres subgrupos: (A Látex diluido 1/1000 (dosis terapéutica, (B Látex diluido 1/100, (C Agua (grupo control. Medimos el peso del animal y consumo del bebedero. Después, bajo anestesia con éter, se obtuvo sangre por punción cardiaca y se centrifugó a 5000 rpm por 5 minutos para obtener plasma sanguíneo. Se determinó actividad de gamma glutamil transferasa y fosfatasa alcalina, se evaluó niveles de urea, creatinina, proteínas totales, albúmina y globulinas por espectrofotocolorimétría. Resultados: El consumo promedio del látex en el primer grupo fue: en A, 0,14 mL.kg-1/día-1/rata-1; en B, 1,34 mL/kg-1/día-1/rata-1; y, en C, agua. En el segundo grupo, fue: en A, 0,13 mL/kg-1/día-1/rata-1; en B, 1,21 mL/kg-1/día-1/rata-1; y, en C, agua. No hubo diferencia significativa en el consumo del látex diario entre los grupos tratados a 7 y 30 días. Las actividades de gamma glutamil transferasa y fosfatasa alcalina, así como los metabolitos sanguíneos y ratios hígado/peso animal y riñones/peso animal, de los grupos experimentales vs. grupo control, no presentaron diferencias significativas (p>0,05. Conclusiones: En condiciones experimentales, la administración oral de sangre de grado, aguda y subaguda, en dosis terapéuticas y de mayor concentración, no produce alteraciones bioquímicas hepáticas ni renales en animales de experimentación.

  8. Manejo de accesos vasculares permanentes para hemodiálisis en los pacientes con enfermedad renal crónica del Hospital Hormero Castanier Crespo

    OpenAIRE

    Ortega Cárdenas, Raquel Fernanda

    2016-01-01

    La enfermedad renal crónica afecta en promedio a una de cada diez personas en todo el mundo y se asocia con la diabetes mellitus y la hipertensión arterial siendo estas dos sus precursoras, tal como lo describe la Organización Mundial de la Salud (2014). Se estima que la prevalencia de enfermedades como la falla renal aumenta proporcionalmente con la esperanza de vida, permitiendo evidenciar el deterioro de órganos vitales como el riñón y las complicaciones derivadas de ello, como los altos c...

  9. Nutritional status of zinc and activity superoxide dismutase in chronic renal patients undergoing hemodialysis Estado nutricional del zinc y actividad de la enzima superóxido dismutasa en pacientes con enfermedad renal crónica en hemodiálisis

    Directory of Open Access Journals (Sweden)

    R. C. Noleto Magalhães

    2011-12-01

    Full Text Available Introduction: Chronic kidney disease promotes changes in the zinc nutritional status and in the antioxidant defense system. This study assessed the relationship between the parameters of the zinc nutritional status and the activity of superoxide dismutase in patients with chronic renal failure who are receiving hemodialysis. Methods: 134 individuals, aged between 18 and 85 years, were divided into two groups: case group (hemodialyzed patients, n = 63 and control group (n = 71. Zinc concentrations in plasma and erythrocytes were determined using the flame atomic absorption spectrophotometry technique. The activity of superoxide dismutase enzyme was determined according to Ransod kit. Results: The mean values of plasma zinc were 62.02 ± 13.59 μg/dL and 65.58 ± 8.88 μg/dL, and for erythrocytary zinc the values were 54.52 ± 22.82 μgZn/gHb and 48.01 ± 15.08 μgZn/gHb for the chronic renal patients and the control group, respectively. The activity of superoxide dismutase was significantly lower in patients when compared with the control group (p Introducción: La enfermedad renal crónica produce cambios en el estado nutricional del zinc y en el sistema de defensa antioxidante. Por lo tanto, este estudio investigó la relación entre parámetros del estado nutricional del zinc y la actividad de la enzima superóxido dismutase en pacientes con enfermedad renal crónica en hemodiálisis. Métodos: Se incluyeron 134 personas, de 20 a 59 años de edad que fueron divididos en dos grupos: grupo caso (pacientes en hemodiálisis, n = 63 y grupo control (n = 71. El zinc plasmático y eritrocitario fueron analizados según el método de espectrofotometría de absorción atómica. La actividad de la enzima superóxido dismutasa fue analizada de acuerdo con Kit Ransod. Resultados: Los valores medios de zinc plasmatico fueron 62,02 ± 13,59 μg/dL y 65,58 ± 8,88 μg/dL y los valores de zinc eritrocitario fueron 54,52 ± 22,82 μgZn/gHb y 48,01 ± 15,08

  10. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  11. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  12. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  13. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  14. Análisis de costes del programa integrado de tratamiento renal sustitutivo en la provincia de Toledo (2012-2013

    Directory of Open Access Journals (Sweden)

    José L. Conde Olasagasti

    2017-05-01

    Conclusiones: Nuestros resultados son consistentes con otros publicados, aunque arrojan valores paciente/año ligeramente superiores, debido a que incluyen elementos como farmacia extrahospitalaria, carga hospitalaria y transporte sanitario. La contribución creciente del Tx a la sobrevida del conjunto de la población en TRS contiene los costes globales y reduce el coste paciente/año, lo que hace sostenible el TRS.

  15. Renal teratogens.

    Science.gov (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  16. Estudi de l'estrès oxidatiu i del perfil metabòlic de malalts renals crònics no dialitzats i dialitzats

    OpenAIRE

    Muñoz Cortés, Mónica

    2016-01-01

    La malaltia renal crònica (MRC) representa un gran desafiament per als sistemes de salut públics. Els pacients amb MRC presenten alteracions metabòliques causades per la pròpia disfunció renal, que es reflecteixen a la seva clínica i estan molt lligades amb l’estat d’estrès oxidatiu que pateixen. El present treball té com a objectiu estudiar el nivell d’estrès oxidatiu dins la MRC en dos fases: abans que sigui necessari el tractament amb diàlisi i en pacients amb diàlisi, així com també dete...

  17. Protocolos de selección y estudio del donante y receptor, aplicables a la práctica chilena, en trasplante renal

    Directory of Open Access Journals (Sweden)

    B. Jorge Morales, Dr.

    2010-03-01

    Full Text Available En el trasplante de órganos siempre hay un donante y receptor cuyas voluntades deben ser respetadas y que deben ser estrictamente evaluados desde el punto de vista médico, social, psicológico y moral para determinar la idoneidad de cada uno para recibir la acción médica. En el presente artículo se describen las pautas para estudiar a un potencial donante renal vivo o cadavérico y a los potenciales receptores de un trasplante renal para evitar yerros que compliquen el trasplante o atenten contra normas éticas y científicas básicas universalmente aceptadas que se aplican al trasplante de órganos sólidos en general y de riñón en particular.

  18. Relación del estado de salud bucal y condiciones socioeconómicas en el paciente con enfermedad renal crónica en tratamiento

    OpenAIRE

    Navia Jutchenko, María Fernanda; Muñoz López, Eliana Elisa; López Soto, Olga Patricia

    2013-01-01

    Objetivo Caracterizar la salud bucal en pacientes tratados con diferentes tipos de diálisis o con trasplante renal.Materiales y Método Este trabajo descriptivo consideró 336 pacientes, el 49 % recibía hemodiálisis, 34 % diálisis peritoneal, 7 % prediálisis y 10 % trasplante renal. La información fue tomada de una base de datos inicial que en este artículo aplicó un análisis multivariado. Las variables ilustrativas fueron edad, género, estado civil, ocupación, educación, índice de higiene oral...

  19. Caracterização e etiologia da insuficiência renal crônica em unidade de nefrologia do interior do Estado de São Paulo Caracterización y etiología de la insuficiencia renal crónica en unidad de nefrología del interior del Estado de São Paulo Characterization and etiology of the chronic renal failure in a countryside nephrology unit of São Paulo State

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Helú Mendonça Ribeiro

    2008-01-01

    Full Text Available OBJETIVOS: Caracterizar os pacientes com insuficiência renal crônica (IRC em programa dialítico; verificar as causas de IRC; identificar as doenças associadas a IRC; levantar o tipo de tratamento e o acesso atual destes pacientes. MÉTODOS: Trata-se de um estudo descritivo epidemiológico, realizado em uma Unidade de Nefrologia e foram incluídos todos os pacientes cadastrados no Programa Nefro Data. RESULTADOS: Dos 217 pacientes cadastrados na unidade em estudo, observamos 68,2% com idade superior a 40 anos e 59,4% do sexo masculino. Quanto à doença de base, 31,3% dos pacientes apresentavam Nefroesclerose Hipertensiva e 25,3% Diabetes Mellitus (DM, seguido da Glomerulonefrite com 24,5%. Quanto às doenças associadas, 42,4% dos pacientes possuiam Hipertensão Arterial Sistêmica (HAS, 24,9% não possuiam comorbidades, 19,8% HAS e DM. Quanto ao tipo de acesso vascular 70,5% possuiam fístula artériovenosa, sendo a utilização de cateter de Tenckhoff exclusivo da diálise peritoneal em 13,3%. CONCLUSÃO: Concluiu-se que os resultados permitem um melhor planejamento frente às necessidades reais dos pacientes.OBJETIVOS: Caracterizar a los pacientes con insuficiencia renal crónica (IRC que participan en un programa dialítico; verificar las causas de la IRC; identificar las enfermedades asociadas a la IRC; levantar el tipo de tratamiento y el acceso actual de esos pacientes. MÉTODOS: Se trata de un estudio descriptivo epidemiológico, realizado en una Unidad de Nefrología en el que fueron incluidos todos los pacientes registrados en el Programa Nefro Data. RESULTADOS: De los 217 pacientes registrados en la Unidad en estudio, observamos que el 68,2% tenían edad superior a 40 años y el 59,4% eran del sexo masculino. En cuanto a la enfermedad de base, el 31,3% de los pacientes presentan Nefroesclerosis Hipertensiva y el 25,3% Diabetes Mellitus (DM, seguido de la Glomerulonefritis con el 24,5%. Respecto a las enfermedades asociadas, el 42

  20. Adaptación en español del nuevo sistema de codificación de enfermedad renal primaria de la European Renal Association-European Dialysis and Transplant Association (ERA-EDTA

    Directory of Open Access Journals (Sweden)

    Óscar Zurriaga

    2015-07-01

    Conclusiones: La traducción y adaptación al español representa una mejora para la introducción y uso del nuevo sistema de codificación de ERP, ya que puede contribuir a reducir el tiempo dedicado a la codificación y también el período de adaptación de los profesionales a los nuevos códigos.

  1. Sarcoidose renal

    Directory of Open Access Journals (Sweden)

    AQUINO MARIA ENEDINA CLAUDINO DE

    2001-01-01

    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  2. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  3. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  4. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  5. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  6. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  7. Utilidad del factor de crecimiento fibroblástico 23 en la prevención de enfermedades cardiovasculares en pacientes con enfermedad renal crónica

    Directory of Open Access Journals (Sweden)

    Ibón Santos

    2016-07-01

    Full Text Available El factor de crecimiento de fibroblastos 23 es una proteína recientemente descubierta, producida por osteocitos y cuya función principal es regular la homeostasis del fosfato y del calcio en el metabolismo mineral óseo. Algunos estudios han encontrado evidencia que sugiere la asociación entre el aumento de las concentraciones del factor de crecimiento fibroblástico 23 y la aparición de diferentes patologías cardiovasculares como: la hipertrofia ventricular izquierda, la falla cardiaca, el choque cardiogénico, la ateroesclerosis, la calcificación vascular, la fibrilación auricular y el accidente cerebrovascular. Sin embargo, son necesarios más estudios para esclarecer el rol de esta hormona y las patologías antes mencionadas.

  8. El entrenamiento de fuerza reduce la acidosis metabólica y la hipertrofia hepática y renal consecuentes del consumo de una dieta hiperproteica en ratas Resistance training reduces the metabolic acidosis and hepatic and renal hypertrophy caused by the consumption of a high protein diet in rats

    Directory of Open Access Journals (Sweden)

    V. A. Aparicio

    2011-12-01

    Full Text Available Introducción: El consumo de dietas hiperproteicas (HP podría tener un efecto adverso sobre la acidosis metabólica y la salud hepática y renal. Sin embargo, existen pocos estudios que analicen los efectos del entrenamiento de fuerza sobre los parámetros sensibles de ser alterados por dichas dietas. Material y métodos: Un total de 32 ratas Wistar adultas fueron distribuidas de forma aleatoria en 4 grupos experimentales (n = 8: dieta normoproteica o HP, con o sin entrenamiento de fuerza. Las dietas estuvieron basadas en un hidrolizado de proteína de lactosuero (whey. Tras 90 días de diseño experimental los animales fueron sacrificados para los posteriores análisis. Resultados y discusión: El consumo de una dieta HP provocó acidosis metabólica (hipercalcemia e hipocitraturia urinarias, acidificación del pH urinario y niveles elevados de urea plasmática, (P Introduction: High protein (HP diet consumption may adversely affect metabolic acidosis and hepatic and renal health. Despite such potentially adverse effect, there are only few studies analyzing the effects of resistance training on the parameters that could be altered by such diets. Material and methods: A total of 32 adult male Wistar rats were randomly distributed in 4 experimental groups (n = 8: normoprotein or HP diets, with or without resistance training. Diets were based on a whey protein hydrolyzate, and the experimental period lasted for 90 days. Results and discussion: Consumption of HP diets and resistance training significantly affected food intake, body composition and plasmatic levels of total cholesterol and triglycerides. Consumption of HP diets led to a considerable increase in liver and kidney weight (P < 0.001, urinary volume and acidity, as well as in the urinary excretion of Ca, with a parallel reduction in the urinary excretion of citrate (P < 0.05. The buffering action of resistance training on such diet-induced alterations was especially evident in the

  9. Efeitos hemodinâmicos e renais da injeção de doses elevadas de clonidina no espaço peridural do cão Efectos hemodinámicos y renales de la inyección de dosis elevadas de clonidina en el espacio peridural del perro Hemodynamic and renal effects of high epidural clonidine doses in dogs

    Directory of Open Access Journals (Sweden)

    Nilson Camargo Roso

    2005-06-01

    ébito cardíaco e aumento da relação depuração de para-aminohipurato de sódio/débito cardíaco. CONCLUSÕES: Nas condições realizadas e nas doses empregadas, pode-se concluir que a clonidina não promoveu alteração da função renal, mas diminuiu valores hemodinâmicos (freqüência e débito cardíaco.JUSTIFICATIVA Y OBJETIVOS: No existen estudios que relaten las repercusiones renales determinadas por la inyección de dosis elevadas de clonidina en el espacio peridural. La finalidad del estudio fue evaluar los efectos hemodinámicos y renales determinados por la inyección de dosis elevadas de clonidina en el espacio peridural del perro. MÉTODO: Veinte animales anestesiados con tiopental sódico y fentanil fueron distribuidos eventualmente y de forma doblemente encubierta en dos grupos: Grupo 1 ó placebo (n = 10, que recibió 0,2 mL.kg-1 de solución fisiológica, y Grupo 2 ó clonidina (n = 10, que recibió 0,2 mL.kg-1 de una solución conteniendo 50 µg.mL-1 de clonidina, en el espacio peridural. Fueron evaluados los siguientes parámetros hemodinámicos: frecuencia cardiaca (FC: lat.min-1; presión arterial media (PAM: mmHg; presión de la arteria pulmonar ocluida (PAOP: mmHg; débito cardíaco (DC: L.min-1; volumen sistólico (VS: mL; también, los siguientes parámetros de la función renal fueron evaluados: flujo sanguíneo renal (FSR: mL.min-1; resistencia vascular renal (RVR: mmHg.mL-1.min; volumen urinario minuto (VUM: mL.min-1; depuración de creatinina (DCr: mL.min-1; depuración de para-aminohipurato (DPAH: mL.min-1; fracción de filtración (FF; depuración de sodio (DNa: mL.min-1; depuración de potasio (DK: mL.min-1; excreción fraccionaria de sodio (EFNa: %; excreción urinaria de sodio (UNaV: µEq.min-1; excreción urinaria de potasio (UKV: µEq.min-1. El experimento consistió en tres momentos de 20 minutos cada uno. Los datos fueron colectados a los 10 minutos de cada momento y la diuresis, en el inicio y al final de cada momento. Al t

  10. Utility of helical computed tomography in the management of renal colic; Utilidad de la tomografia computarizada helicoidal en el manejo del colico nefritico

    Energy Technology Data Exchange (ETDEWEB)

    Martel, J.; Cruz, R. de la; Rengifo, D. [Fundacion Hospital Alcorcon. Madrid (Spain)

    2000-07-01

    In recent years, noncontrast helical computed tomography has modified the imaging techniques employed in the management of patients who arrive in the emergency service presenting signs of renal colic. Based on the literature and our own experience with 140 patients who complained of pain suggestive of a colic probably due to stone disease, we review the radiological features of this entity and discuss the utility of the technique in confirming the diagnosis, predicting the clinical course and detecting other diseases that present with identical symptomatology. (Author) 20 refs.

  11. Avaliação do grau de satisfação de pacientes renais crônicos em hemodiálise La satisfacción del pacientes con la insuficiência renal crónica en hemodiálisis Evaluation of satisfaction in patients with chronic renal disease on hemodylysis

    Directory of Open Access Journals (Sweden)

    Claudia Bernardi Cesarino

    2009-01-01

    Full Text Available OBJETIVO: Identificar o grau de satisfação de pacientes portadores de insuficiência renal crônica em relação aos serviços prestados e às condições físicas da Unidade de Hemodiálise do Hospital de Base de São Jose do Rio Preto - SP. MÉTODOS: Estudo descritivo que utilizou um questionário com escala tipo Likert aplicado em 81 pacientes em tratamento hemodialítico no Serviço de Nefrologia do referido Hospital. RESULTADOS: Foi identificado que 53% dos usuários estavam muito satisfeitos e 47% satisfeitos. Apesar dos resultados apontarem para um alto grau de satisfação com os serviços prestados e condições físicas do ambiente, os usuários relataram algumas limitações. CONCLUSÃO: A avaliação da satisfação de pacientes possibilitou algumas opções para um repensar da prática dos profissionais da saúde, oferecendo subsídios no processo de gestão, objetivando a melhoria contínua do serviço.OBJETIVO: Identificar el grado de satisfacción de pacientes portadores de insuficiencia renal crónica en relación a los servicios prestados y a las condiciones físicas de la Unidad de Hemodiálisis del Hospital de Base de Sao José do Rio Preto - SP. MÉTODOS: Se trata de un estudio descriptivo en el que se utilizó un cuestionario con una escala tipo Likert aplicado a 81 pacientes con tratamiento de hemodiálisis en el Servicio de Nefrología del referido Hospital. RESULTADOS: Fue identificado que el 53% de los usuarios estaban muy satisfechos y el 47% satisfechos. A pesar que los resultados apuntaron un alto grado de satisfacción con los servicios prestados y las condiciones físicas del ambiente, los usuarios relataron algunas limitaciones. CONCLUSIÓN: La evaluación de la satisfacción de pacientes posibilitó algunas opciones para un repensar de la práctica de los profesionales de la salud, ofreciendo subsidios en el proceso de gestión, con el objetivo de una mejora continua del servicio.OBJECTIVE: To identify the

  12. Supervivencia del injerto renal según la categoría de Banff 2013 en biopsia por indicación

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    Carlos Arias-Cabrales

    2016-11-01

    Conclusiones: La clasificación de Banff 2013 permite el diagnóstico histológico en el 95% de las biopsias por indicación. La categoría 6 es la más frecuente, pero se observa una modificación en la histopatología predominante según el tiempo postrasplante. Los cambios mediados por anticuerpos se asocian con peor supervivencia del injerto.

  13. Carcinomas cutáneos en los pacientes receptores de un trasplante renal estudio de su incidencia, identifiación de las variables clínicas relacionadas e investigación de su relación con la infección por el virus del papiloma humano /

    OpenAIRE

    Fuente González, María José

    2004-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Introducción: Los carcinomas cutáneos son las neoplasias más frecuentes en los receptores de un trasplante renal (RTRs). Hasta el momento, los datos existentes sobre los factores de riesgo para el desarrollo de estos carcinomas y su posible relación con la infección por el virus del papiloma humano (VPH) en los RTRs son controvertidos. Objectivos : Investigar, prospectivamente, la incidencia acumulada de lesiones cancero...

  14. Correlación entre nivel de conocimiento sobre alimentación y estado nutricional en pacientes sometidos a hemodiálisis del centro nefrológico integral renal care de Huánuco Junio - octubre 2014

    OpenAIRE

    Aurazo Mercado, Claudia; Rivera Aguado, María del Pilar

    2015-01-01

    Objetivo. Establecer la correlación entre el nivel de conocimiento sobre alimentación y el estado nutricional de los pacientes sometidos a hemodiálisis del Centro Nefrológico Integral Renal Care de Huánuco durante el periodo Junio a Octubre del año 2014. Materiales y métodos. Se realizó una investigación observacional, analítico correlacional de dos variables cualitativas ordinales, de corte transversal. La población de estudio estuvo conformada por 43 pacientes en hemodiálisis. Se evaluó...

  15. Renal Cysts

    Science.gov (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  16. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  17. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  18. Prevalencia de enfermedad renal en niños aparentemente sanos con antecedente familiar de terapia de reemplazo renal

    OpenAIRE

    Medeiros, Mara; Andrade Veneros, Gioconda Daniela; Toussaint Martínez de Castro, Georgina,; Ortiz Vásquez, Lourdes; Hernández Sánchez, Ana María; Olvera, Nadia; Obrador Vera, Gregorio Tomás; Velásquez Jones, Luis

    2015-01-01

    Introducción: Se ha mencionado que tener un familiar directo con enfermedad renal es un factor de riesgo para el padecimiento. El objetivo del estudio fue conocer la prevalencia de enfermedad renal temprana en niños familiares de pacientes con enfermedad renal crónica terminal (ERCT). Métodos: Se realizó un estudio de tamiz en niños aparentemente sanos, familiares en primer o segundo grado de pacientes con ERCT en programa reemplazo renal (hemodiálisis o trasplante renal). Previa firma de ...

  19. Trasplante renal: efectos en el perfil cognoscitivo

    Directory of Open Access Journals (Sweden)

    Sofía Sánchez-Román

    2010-07-01

    Full Text Available Objetivo. Valorar el impacto del Trasplante Renal exitoso sobre el funcionamiento cognoscitivo de los pacientes con Insuficiencia Renal Crónica (IRC. Método. Se aplicó el Neuropsi Atención y Memoria, el Hospital Anxiety and Depression Scale, la Escala de Somnolencia de Epworth y la Escala Isquémica de Hachinski a 42 pacientes con IRC y 41 donadores vivos sanos (grupo control. De los 42 pacientes que fueron sometidos a trasplante renal, se evaluó con los mismos instrumentos a 28 de ellos en un tiempo de 6 meses posterior a su trasplante. Se valoró en los mismos tiempos a sus donadores renales (grupo control. Resultados. El funcionamiento cognoscitivo global del grupo IRC mejoró después del trasplante renal aún controlando los efectos de aprendizaje. Las áreas en las que el grupo postrasplantado mejoraron fueron el Stroop y la evocación verbal a largo plazo haciendo uso de claves. Conclusiones. El trasplante renal se aprecia como una solución ideal que elimina factores (medibles o no medibles que están impactando en el funcionamiento cognoscitivo.

  20. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  1. Nephrolithiasis Anotaciones sobre litiasis renal

    Directory of Open Access Journals (Sweden)

    Gonzálo Mejía

    1989-03-01

    Full Text Available

    Nephrolithiasis is a relatively common disease in medical practice. There are no recent, updated reviews on this topic in Colombian literature and to fill this need the present one was written. The different aspects of calcium lithiasis are analyzed in a practical and simplified although comprehensive way, emphasizing pathophysiology, patient evaluation, management of lithiasis (fluids, diet and drug therapy and new methods for stone removal. Other types of calculi are briefly discussed. Management of the renal colic is not included.

    La litiasis renal es un trastorno relativamente frecuente en la práctica médica. No existe en la literatura colombiana una revisión reciente y actualizada acerca de este tema por lo cual se escribió la presente. En una forma práctica y simplificada, pero completa, se analizan los diferentes aspectos relacionados con la litiasis por calcio y, brevemente, se mencionan otros tipos de cálculos. Se hace énfasis en fisiopatología, evaluación del paciente, manejo de la litiasis (líquidos, dieta y drogas y nuevos métodos de extracción del cálculo. No se incluye el manejo del cólico renal.

  2. Efeitos do pneumoperitônio sobre a hemodinâmica e função renais de cães ventilados com volume e pressão controlados Efectos del pneumoperitonio sobre la hemodinámica y función renal de perros ventilados con volumen y presión controlados Effects of pneumoperitoneum on renal hemodynamics and function of dogs under volume and pressure-controlled ventilation

    Directory of Open Access Journals (Sweden)

    Armando Vieira de Almeida

    2004-06-01

    modalidades ventilatorias a las repercusiones renales durante el pneumoperitonio. El objetivo de este trabajo fue evaluar las alteraciones en la hemodinámica y función renal determinadas por el pneumoperitonio en perros con ventilación a volumen y presión controlados. MÉTODO: Dieciséis perros anestesiados con tiopental sódico y fentanil fueron divididos en Grupo 1, volumen controlado y Grupo 2, presión controlada y sometidos a pneumoperitonio de 10 y 15 mmHg. Fueron estudiados flujo sanguíneo renal, resistencia vascular renal, depuración de para-aminohipurato de sodio, sodio plasmático, potasio plasmático, osmolalidad plasmática, depuración de creatinina, fracción de filtración, volumen urinario, osmolalidad urinaria, depuración osmolar, depuración de agua libre, depuración de sodio, excreción urinaria de sodio, excreción fraccionaria de sodio, depuración de potasio, excreción urinaria de potasio, excreción fraccionaria de potasio. Los datos fueron colectados en 4 momentos. M1, antes del pneumoperitonio; M2, 30 minutos después pneumoperitonio con 10 mmHg; M3, 30 minutos después pneumoperitonio con 15 mmHg; M4, 30 minutos después de la deflación del pneumoperitonio. RESULTADOS: Las depuraciones de para-aminohipurato de sodio y creatinina permanecieron constantes en ambos grupos durante el experimento. Los valores plasmáticos del sodio y del potasio no se alteraron. Ocurrió diminución a partir de M2 de la depuración y de la excreción fraccionaria de potasio en ambos grupos. CONCLUSIONES: Las modalidades ventilatórias no determinaron diferencias en la hemodinámica renal entre los grupos estudiados. El pneumoperitonio, ocasionando compresión del parenquima renal, puede tener determinado alteraciones en la reabsorción y/o secreción del potasio.BACKGROUND AND OBJECTIVES: There are no studies associating ventilatory mode effects on renal repercussions during pneumoperitoneum. This study aimed at evaluating pneumoperitoneum-induced renal

  3. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  4. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  5. Causas de enfermedad renal crónica en niños atendidos en el Servicio de Nefrología Pediátrica del Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1960 y 2010 = Etiology of chronic kidney disease: fifty-year experience (1960-2010 at the Pediatric Nephrology Service, Hospital Universitario San Vicente de Paúl (Medellín, Colombia

    Directory of Open Access Journals (Sweden)

    Vanegas Ruiz, Juan José

    2011-12-01

    Full Text Available La insuficiencia renal crónica es el resultado del deterioro progresivo e irreversible de la función renal, que genera incapacidad del riñón para remover los productos de desecho y mantener el equilibrio ácido básico. El objetivo de este estudio fue identificar las causas de insuficiencia renal crónica en nuestros pacientes y su importancia relativa en este desenlace. Se hizo un estudio descriptivo retrospectivo de corte transversal, basado en la revisión de 367 registros pertenecien­tes al Servicio de Nefrología Infantil, de pacientes con diagnóstico de insuficiencia renal crónica (IRC, que acudieron al Servicio de Consulta Externa del Hospital Universitario San Vicente de Paúl, de Medellín, entre el 01 de enero de 1960 y el 30 de agosto de 2010. De los 367 pacientes, 199 (54,2% fueron hombres y 168 (45,8%, mujeres; las enfermedades predominantes como causa de la IRC fueron: reflujo vésico-ureteral (37,1%, hidronefrosis (24,0%, valvas de la uretra posterior (13,4%, glomerulonefritis aguda (12,3%, síndrome nefrótico (11,2% e hipoplasia renal (9,3%.

  6. Las células T reguladoras y su influencia en la sobrevida del trasplante renal Regulatory T cells and their influence in kidney allograft survival

    Directory of Open Access Journals (Sweden)

    Sonia Y. Velásquez

    2007-10-01

    Full Text Available La respuesta inmune desencadenada frente a un trasplante alogénico conduce usualmente a una respuesta efectora que resulta en el rechazo del aloinjerto; sin embargo, algunos individuos mantienen un trasplante funcionante a largo plazo sin signos de rechazo (tolerancia operacional, aun en ausencia de inmunosupresión. Se ha sugerido que los mismos mecanismos son responsables para la tolerancia hacia antígenos propios y aloantígenos. Uno de estos mecanismos es la regulación inmune y se han identificado varias subpoblaciones de células con propiedades reguladoras. Entre ellas, la población celular mejor caracterizada corresponde a las células T reguladoras (Tregs. Aunque las Tregs en ratones son CD4+CD25+, en humanos el fenotipo de las Treg está restringida a las células T CD4 con alta expresión de CD25 (CD25high y del factor de transcripción Foxp3. El análisis fenotípico y funcional de las células T reguladoras o supresoras circulantes en pacientes trasplantados tal vez sea útil para la detección de pacientes tolerantes operacionales. Además, una futura manipulación in vitro de estas células con fines terapéuticos podría conducir a lograr la inducción de tolerancia in vivo en el trasplante clínico. Aquí, revisamos la evidencia experimental y clínica del papel de las células reguladoras en la biología del trasplante.The immune response elicited by an allogenic transplant usually leads to an effector response resulting in allograft rejection; however, some individuals maintain a long-term functioning transplant without signs of rejection (operational tolerance even in the absence of immunosuppression. It has been suggested that the same mechanisms are responsible for tolerance to self-antigens and alloantigens. One of such mechanisms is immune regulation and several cell subsets with regulatory properties have been identified. Among them, the best characterized cell populations are the regulatory T cells (Treg. Although

  7. The influence of social support on strengthening families of children with chronic renal failure La influencia del apoyo social para el fortalecimiento de las familias de niños con insuficiencia renal crónica A influência do apoio social para o fortalecimento de famílias com crianças com insuficiência renal crônica

    Directory of Open Access Journals (Sweden)

    Érica Simpionato de Paula

    2008-08-01

    Full Text Available This paper presents a study of the families of children on peritoneal dialysis, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. Our discussion is located in the context of inequalities between developed and developing countries. For this qualitative study, a content analysis was conducted in order to elicit themes from the raw data related to the lived experience of four families that have a child with chronic renal failure. The data were collected mainly by in-depth interviews and the construction of genograms and ecomaps. The identification and characterization of the families' social supports and networks allowed nurses and families to strengthen their coping mechanisms. Because families are dealing with severe economic problems, they need better supportive programs to guide their offspring to their full potential.Este artículo es un estudio sobre las familias de niños con diálisis peritoneal, que destaca la identificación del apoyo y las redes sociales para fortalecer intervenciones dirigidas para la promoción de la salud, en un contexto de desigualdad entre los países desarrollados y en desarrollo. Estudio cualitativo a través del análisis de contenido, con el objetivo de identificar temas en base a datos empíricos de niños de cuatro familias con insuficiencia renal. La recopilación de datos realizada a través de entrevistas a profundidad, construcción de genogramas y ecomapas. La identificación y las características de las redes sociales y de apoyo permitieron a los enfermeros y familias mejorar su utilización y fortalecer las formas de enfrentar la situación. Como las familias tenían graves problemas económicos, necesitaban de programas de apoyo adecuados para ayudar a sus hijos a desenvolverse al máximo.Este artigo apresenta um estudo sobre famílias de crianças em diálise peritoneal, enfatizando a identificação de apoios e de redes sociais para

  8. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  9. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  10. Lesão renal aguda após revascularização do miocárdio com circulação extracorpórea Lesión renal aguda post-revascularización del miocardio con circulación extracorpórea Acute kidney injury after on-pump coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Maurício de Nassau Machado

    2009-09-01

    Full Text Available FUNDAMENTO: A lesão renal aguda (LRA é uma doença complexa para a qual, atualmente, não há uma definição padrão aceita. A AKIN (Acute Kidney Injury Network representa uma tentativa de padronização dos critérios para diagnóstico e estadiamento da LRA, baseando-se nos critérios RIFLE (risk, injury, failure, loss, e end-stage kidney disease, publicados recentemente. OBJETIVOS: Avaliar a incidência e mortalidade associada à LRA em pacientes submetidos à revascularização do miocárdio (RM com circulação extracorpórea (CEC. MÉTODOS: O total de 817 pacientes foi dividido em dois grupos: LRA negativa (-, com 421 pacientes (51,5%, e LRA positiva (+, com 396 pacientes (48,5%. Foi considerado LRA a elevação da creatinina em 0,3 mg/dl ou aumento em 50% da creatinina em relação a seu valor basal. RESULTADOS: A mortalidade em 30 dias dos pacientes com e sem LRA foi de 12,6 % e 1,4%, respectivamente (p 14 dias - 14% vs. 2%; p FUNDAMENTO: Lesión renal aguda (LRA es una compleja enfermedad, la que, actualmente, no tiene definición patrón acepta. AKIN (Acute Kidney Injury Network representa una tentativa de estandardización de criterios para el diagnostico y estadiamiento de LRA basado en los criterios RIFLE (risk, injury, failure, loss, y end-stage kidney disease publicados recientemente. OBJETIVO: Evaluar la incidencia y mortalidad asociada a LRA en pacientes sometidos a revascularización del miocardio (RM con circulación extracorpórea (CEC. MÉTODOS: El total de 817 pacientes fueron divididos en dos grupos: LRA negativa (-, con 421 pacientes (51,5%, y LRA positiva (+, con 396 pacientes (48,5%. LRA fue considerada la elevación de creatinina en 0,3 mg/dl el aumento en 50% de creatinina en relación a su valor basal. RESULTADOS: La mortalidad dentro de 30 días de los pacientes con y sin LRA ha sido de 12,3 y 1,4%, respectivamente (p14 días, 14 versus 2%; pBACKGROUND: The acute kidney injury (AKI is a complex disease for which

  11. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  12. Estado nutricional de los pacientes con insuficiencia renal crónica atendidos en el programa de Hemodiálisis del Hospital Clínico-Quirúrgico "Hermanos Ameijeiras" Nutritional status in chronic renal failure patients assisted at the hemodialysis program of the "Hermanos Ameijeiras" Hospital

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    V. Ordóñez Pérez

    2007-12-01

    Full Text Available Introducción: La heterogenidad de las tasas de desnutrición asociada a la Insuficiencia Renal Crónica (IRC en Hemodiálisis (HD implica rendimiento(s dispar(es del(los indicador(es empleado(s. Objetivos: Identificar aquellos indicadores que mejor describan el estado nutricional y la evolución natural del paciente con IRC en HD. Escenario: Programa de Hemodiálisis, Servicio de Nefrología, Hospital Clínico-Quirúrgico "Hermanos Ameijeiras" (Ciudad La Habana, Cuba. Métodos: Se reclutaron 28 pacientes. Se registraron los ingresos entre diciembre 2001-diciembre 2002. Se registró la condición (Vivo/Fallecido al año de observación. A cada paciente se le rellenó la Encuesta Subjetiva Global (ESG. El perfil nutricional incluyó: talla, peso, circunferencia del brazo (CB, pliegue cutáneo tricipital (PCT, albúmina y conteo total de linfocitos (CTL. El estado nutricional descrito mediante la albúmina y la CB se correlacionó con la ESG, la ocurrencia de ingresos y la condición final. Resultados: Las tasas de desnutrición fueron: (albúmina Introduction: Heterogeneity of malnutrition rates associated with End-Stage Renal Disease (ESRD under Haemodialysis (HD points towards differing performances of the used indicators. Objectives: To identify those indicators that better describe the nutritional state of the patient with ESRD under HD. Setting: Program of Haemodialysis, Service of Nephrology, "Hermanos Ameijeiras" Hospital (Havana City, Cuba. Methods: Twenty-eight patients were recruited. Hospital admissions between december 2001-december 2002 were recorded. The condition of the patient (alive/deceased after one year of observation was registered. The Subjective Global Assessment (SGA form was administered to each patient. The nutritional profile included: height, weight, mid-arm circumference (MAC, triceps skinfold (TSF, albumin and total lymphocyte count (TLC. Nutritional status as described by means of albumin and MAC was correlated with

  13. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  14. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  15. Recupero della funzione renale in pazienti con acute kidney injury (AKI) sottoposti a terapia sostitutiva renale

    OpenAIRE

    Cibelli, Loredana

    2013-01-01

    L’insufficienza renale acuta(AKI) grave che richiede terapia sostitutiva, è una complicanza frequente nelle unità di terapia intensiva(UTI) e rappresenta un fattore di rischio indipendente di mortalità. Scopo dello studio é stato valutare prospetticamente, in pazienti “critici” sottoposti a terapie sostitutive renali continue(CRRT) per IRA post cardiochirurgia, la prevalenza ed il significato prognostico del recupero della funzione renale(RFR). Pazienti e Metodi:Pazienti(pz) con AKI dopo ...

  16. Renal tuberculosis

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    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  17. Renale Osteopathie

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    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  18. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  19. Comparación entre las ecuaciones CKD-EPI y MDRD para la estimación del filtrado glomerular en pacientes con enfermedad renal crónica

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    Guillermo J. Rosa-Diez

    2011-08-01

    Full Text Available La ecuación MDRD para la estimación del índice de filtrado glomerular (IFG, es la estrategia más utilizada para evaluar pacientes con enfermedad renal crónica (ERC. Sin embargo, puede subestimar el IFG con el riesgo de asignar al paciente a estadios más avanzados de ERC. La nueva ecuación CKD-EPI, mejoraría la exactitud y precisión de las estimaciones. Sus autores sugieren que reemplace a la anterior. No habiendo comparaciones de estas ecuaciones aplicadas en un gran número de pacientes en nuestro país, nuestro objetivo fue realizarla en una amplia cohorte de pacientes. Se evaluó la concordancia de asignación en estadios de ERC entre ambas ecuaciones, tomando como referencia los datos surgidos de MDRD. Se calculó la media de las diferencias de los IFG obtenidos empleando ambas ecuaciones y se aplicó el análisis estadístico de Bland-Altman. Se estudió una cohorte de 9 319 pacientes con una media de creatinina sérica de 1.60 ± 1.03 mg/dl, 67% de sexo femenino y edad media 58 ± 20 años. En el grupo total, CKD-EPI presentó una media de IFG 0.61 ml/min/1.73 m² mayor que MDRD (p: NS. En los estadios 2 y 3A las medias del IFG fueron respectivamente 6.95 ± 4.76 y 3.21 ± 3.31, y la concordancia de 81 y 74%. El porcentaje de pacientes con un IFG menor de 60 ml/min/1.73 m², se redujo de 76.3% (MDRD a 70.1% (CKD-EPI. Por lo tanto, la nueva ecuación CKD-EPI disminuye el número de pacientes con IFG debajo de 60 ml/min/1.73 m² y asigna estadios de IFG más elevado a un número mayor de pacientes.

  20. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  1. Biopsia Renal en receptores de Trasplante Renal: cuidados de enfermería y complicaciones

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    Esther Sanz Izquierdo

    Full Text Available Introducción: La biopsia renal percutánea es una herramienta fundamental para el manejo del paciente trasplantado renal. La prueba es primordial para detectar y/o prevenir cualquier disfunción en el injerto, siendo un procedimiento tanto diagnóstico como preconizador. Objetivo: Describir los cuidados de enfermería e identificar las complicaciones derivadas de la biopsia renal en los receptores de Trasplante Renal. Material y métodos: Estudio cuantitativo, descriptivo y transversal realizado en la Unidad de Trasplante Renal, Servicio de Nefrología, del 2008 al 2014. La población objeto de estudio son los receptores de Trasplante Renal (TR. La muestra está compuesta por 368 biopsias renales de seguimiento que ingresan para someterse a una biopsia renal. Los criterios de inclusión son ser mayores de 18 años, trasplantados y que han firmado el consentimiento informado. Se recogen datos sociodemográficos, clínico-asistenciales y complicaciones post-biopsia renal. Resultados: Desde 1980 hasta el 2014 se han llevado a cabo 1868 TR, de 2008 a 2014 se estudiaron 368 biopsias de seguimiento. Se monitoriza la Tensión Arterial y la coagulación pre biopsia. Tras el procedimiento, se controla la presencia de sangrado por micción y constantes vitales. Inicialmente el reposo absoluto era de 24 h, a partir de 2014 se reduce a 6 horas, recomendando reposo relativo al alta, las complicaciones fueron mínimas. Conclusiones: Los resultados indican que la biopsia renal es un procedimiento eficaz, con escasas complicaciones. Destacar el papel de enfermería en la detección precoz de complicaciones.

  2. Qualidade de vida de pessoas com doença renal crônica em tratamento hemodialítico Calidad de vida del paciente renal crónico en tratamiento hemodialítico Quality of life in chronic kidney failure patients receiving hemodialysis treatment

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    Marielza R. Ismael Martins

    2005-10-01

    Full Text Available Este estudo descritivo objetiva avaliar a qualidade de vida de pessoas em tratamento de hemodiálise (HD e identificar as atividades cotidianas que podem comprometer sua qualidade de vida. Foram pesquisadas 125 pessoas com insuficiência renal crônica (IRC em tratamento de hemodiálise, mediante o Questionário Genérico de Qualidade de Vida SF-36 e as atividades cotidianas por uma entrevista semi-estruturada. Os dados foram submetidos à análise estatística, com nível de significância de 5%. Os resultados evidenciaram prejuízo na qualidade de vida, demonstrando menores escores nos domínios dos aspectos físicos, emocionais e vitalidade. Verificou-se correlação negativa entre tempo de HD e componente físico (r = - 0,75. As atividades corporais e recreativas foram as mais comprometidas tanto na amostra global quanto na estratificada por sexo. Observou-se correlação negativa entre tempo de HD e as atividades cotidianas: trabalho, atividades domésticas e atividades práticas.Estudio descriptivo que objetiva analizar las variables de la calidad de vida del enfermo renal crónico en tratamiento hemodialítico (HD y conocer las actividades cotidianas y las implicaciones en la calidad de vida. Se investigó a 125 enfermos renales crónicos en tratamiento hemodialítico mediante el Cuestionario Genérico de la Calidad de Vida SF-36, y las actividades cotidianas a través de entrevista semiestructurada. Los datos fueron sometidos al análisis estadístico con nivel de significancia de 5%. Los resultados revelaron empeoramiento de la calidad de vida en aspectos físicos, emocionales y vitalidad. Se encontró correlación negativa entre tiempo de HD y las variables da calidad de vida en el componente físico (r = - 0.75. Las actividades corporales y de recreación fueron las más perjudicadas en la muestra global y la muestra estratificada en género. El tiempo de HD también tiene correlación negativa con las actividades cotidianas de

  3. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  4. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  5. Traumatismo renal

    OpenAIRE

    Rocha, Sofia Rosa Moura Gomes da

    2009-01-01

    Introdução: A realização deste trabalho visa a elaboração de uma revisão sistematizada subordinada à temática da traumatologia renal. Objectivos: Os principais objectivos deste trabalho são: apurar a etiologia, definir a classificação, analisar o diagnóstico e expôr o tratamento e as complicações. Desenvolvimento: Os traumatismos são a principal causa de morte antes dos 40 anos. O rim é o órgão do aparelho génito-urinário mais frequentemente atingido. Os traumatismos renais são mais fre...

  6. Rol del profesional de Enfermería en terapias de reemplazo renal, diálisis peritoneal / Nursing’s Role in Renal Replacement Therapies, Peritoneal / Dialysis Papel do profissional de Enfermagem em terapias de substituição renal, diálise peritoneal

    OpenAIRE

    Maricel Licht-Ardila, Enf. Esp.; Jennifer Almeida-Arias, Enf.; Fabiola Bolívar-Salazar, Enf.; Yessica Galván-Mármol, Enf.; Silvia García-Trujillo, Enf.

    2014-01-01

    Introducción: La enfermedad renal crónica es considerada un problema de salud pública en el ámbito mundial, debido a su prevalencia e incidencia creciente en la población. El profesional de enfermería asiste al paciente con su patología de base e integra a la familia en la realización de actividades que contribuyen al cuidado y prevención de la enfermedad o a la recuperación de su salud, por lo que el rol principal está orientado a ayudar al paciente, a conservar o lograr su independencia y g...

  7. Mucinous Adenocarcinoma of Renal Pelvis. A Case Presentation Adenocarcinoma mucinoso de pelvis renal. Presentación de un caso

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    Caridad Socorro Castro

    2012-02-01

    Full Text Available

    Malignant neoplasms of the kidney represent about 2% of all cancers, being renal cell carcinoma the most frequent presentation in this group with a frequency of 80% to 90%. Adenocarcinoma of the renal pelvis is a rare neoplasm, which occurs in less than 1% of patients with renal malignancies and is associated, most of the times, to inflammatory processes of the organ and to renal stones. For all these reasons it was decided to publish a clinical case diagnosed in the Anatomical Pathology Department of the Dr. Gustavo Aldereguía Lima General University Hospital in Cienfuegos. A female patient over forty years old presented this histological variant of kidney cancer.

    Las neoplasias malignas del riñón representan alrededor del 2 % de todos los cánceres, el carcinoma de células renales es el más frecuente dentro de este grupo con una frecuencia del 80 al 90 %. El adenocarcinoma de pelvis renal es una neoplasia muy rara, que se presenta en menos del 1 % de los pacientes con neoplasias malignas renales, asociada, la mayoría de las veces, a procesos inflamatorios del  órgano y litiasis. Por tales razones se decidió la publicación de un caso clínico diagnosticado  en el Departamento de Anatomía Patológica del Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, con esta variante histológica de cáncer renal, en una mujer en la cuarta década de la vida.

  8. A low-cost method to test cytotoxic effects of Crotalus vegrandis (Serpentes: Viperidae venom on kidney cell cultures Un método de bajo costo para probar los efectos citotóxicos del veneno de Crotalus vegrandis (Serpentes: Viperidae en cultivos de células renales

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    María E. Girón

    2005-06-01

    Full Text Available The pathogenesis of the renal lesion upon envenomation by snakebite has been related to myolysis, hemolysis, hypotension and/or direct venom nephrotoxicity caused by the venom. Both primary and continuous cell culture systems provide an in vitro alternative for quantitative evaluation of the toxicity of snake venoms. Crude Crotalus vegrandis venom was fractionated by molecular exclusion chromatography. The toxicity of C. vegrandis crude venom, hemorrhagic, and neurotoxic fractions were evaluated on mouse primary renal cells and a continuous cell line of Vero cells maintained in vitro. Cells were isolated from murine renal cortex and were grown in 96 well plates with Dulbecco's Modified Essential Medium (DMEM and challenged with crude and venom fractions. The murine renal cortex cells exhibited epithelial morphology and the majority showed smooth muscle actin determined by immune-staining. The cytotoxicity was evaluated by the tetrazolium colorimetric method. Cell viability was less for crude venom, followed by the hemorrhagic and neurotoxic fractions with a CT50 of 4.93, 18.41 and 50.22 µg/mL, respectively. The Vero cell cultures seemed to be more sensitive with a CT50 of 2.9 and 1.4 µg/mL for crude venom and the hemorrhagic peak, respectively. The results of this study show the potential of using cell culture system to evaluate venom toxicity.La patogénesis de la lesion renal ha sido relacionada a la miolisis, hemólisis, hipotensión y/o el efecto directo del veneno. Tanto el cultivo primario o el cultivo celular continuo proveen una alternativa in vitro para la evaluación cuantitativa de la toxicidad de venenos de serpiente. El veneno crudo de Crotalus vegrandis fue fraccionado por una cromatografía de exclusión molecular. La toxicidad del veneno crudo de C. vegrandis, sus fracciones hemorrágicas y neurotóxicas fueron evaluadas en células renales primarias de ratón y una línea continua de células Vero mantenidas in vitro. Las c

  9. Nutrición y enfermedad renal

    Directory of Open Access Journals (Sweden)

    Iris de Castaño

    2007-03-01

    Full Text Available El riñón juega un papel importante en la regulación interna del organismo a través de las funciones excretoras, metabólicas y endocrinas. La insuficiencia renal aguda, IRA, se caracteriza por un rápido deterioro de la función renal con acumulación de productos nitrogenados como la urea y la creatinina y desequilibrio del agua y de los electrólitos. La falla renal crea un estado de desequilibrio metabólico proporcional a la perdida de la función renal. Dentro de los factores importantes para disminuir la progresión de la insuficiencia renal crónica, IRC, están el control de la proteinuria y el control de la hipertensión arterial. Algunos pacientes no alcanzan a ingerir de manera voluntaria los requerimientos calóricos y de volumen adecuados y necesitan soporte con alimentación enteral con sonda nasogástrica o nasoyeyunal con bombas de infusión.

  10. Efeitos do halotano, isoflurano e sevoflurano nas respostas cardiovasculares ao pinçamento aórtico infra-renal: estudo experimental em cães Efectos del halotano, isoflurano y sevoflurano en las respuestas cardiovasculares al pinzamiento aórtico infra-renal: estudio experimental en perros Effects of halothane, isoflurane and sevoflurane on cardiovascular responses to infrarenal aortic cross-clamping: experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    2003-08-01

    pinzamiento infra-renal de la aorta abdominal puede producir alteraciones hemodinámicas. El objetivo del estudio fue evaluar los efectos del halotano, isoflurano y sevoflurano sobre la función cardiovascular, en perros sometidos al pinzamiento aórtico infra-renal. MÉTODO: El estudio aleatorio fue realizado en 30 perros, distribuidos en tres grupos, de acuerdo con el anestésico halogenado utilizado durante la anestesia, en concentraciones equipotentes de 0,75 CAM: GH (n=10 - halotano a 0,67%; GI (n=10 - isoflurano a 0,96%; y GS (n=10 - sevoflurano a 1,8%. En todos los animales fue realizada ligadura infra-renal de la aorta, por período de 30 min. Los atributos hemodinámicos fueron estudiados en los momentos: C (Control, Ao15 y Ao 30, respectivamente después de15 y 30 min del pinzamiento aórtico, y DAo y DAo15, respectivamente, inmediatamente y después de15 min del despinzamiento aórtico. RESULTADOS: Durante el pinzamiento aórtico hubo, en todos los grupos, aumento de las presiones arterial media y del átrio derecho, y de los índices cardíaco, sistólico y de trabajo sistólico de los ventrículos derecho e izquierdo. La presión de la arteria pulmonar aumentó en GI y GS y la presión pulmonar ocluida en GH y GI. Después del despinzamiento aórtico, hubo normalización de los atributos que se habían elevado, con excepción de los índices cardíaco y sistólico, que continuaron elevados, acompañados de diminución del índice de resistencia vascular sistémica. No hubo diferencia significante entre los grupos en relación a los atributos estudiados, con excepción de la frecuencia cardíaca que fue siempre menor en GH, en relación a los demás grupos, durante el pinzamiento y despinzamiento aórtico. CONCLUSIONES: En el perro, en las condiciones experimentales empleadas, la inhalación del halotano, isoflurano y sevoflurano en concentraciones equipotentes (0,75 CAM no atenúa las respuestas cardiovasculares al pinzamiento aórtico infra-renal.BACKGROUND AND

  11. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  12. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  13. Progresión de la Poliquistosis renal autosómica dominante: Influencia de polimorfismos de genes de sintasa endotelial del óxido nítrico (ecNOS y del sistema renina-angiotensina Glomerular filtration rate decline in autosomic dominant polycystic kidney disease. Influence of endothelial NO synthase (ecNOS and renin angiotensin system gene polymorphisms

    Directory of Open Access Journals (Sweden)

    Pablo Azurmendi

    2004-04-01

    Full Text Available La velocidad de progresión (VdP de la poliquistosis renal autosómica dominante (PQRAD es variable. Estudiamos la asociación de los polimorfismos AGTM235T (angiotensinógeno, AT1A1166C (ATR1 y ecNOSGlu298Asp (NO sintasa endotelial con la VdP en 88 pacientes. VdP fue estimada por 1/Cr pl vs edad. Consideramos edades de Cr pl 2 y 6 mg/dl como comienzo de progresión (E2 y arribo a insuficiencia renal crónica terminal (E6, respectivamente. Los polimorfismos se estudiaron por PCR-RFLP. El grupo en su totalidad presentó VdP (ml/min/año de 6.9±0.5, E2 y E6 de 48.9±1.3 y 55.0±1.4 años y tensión arterial media (TAM de 111.2±1.2 mmHg. Según E6 observamos dos grupos (£ y > a 55 años. En £ 55 (fenotipo PKD1, n=42, E2 y E6 del genotipo CC de AT1A1166C fueron 36.0±1.2 y 41.4±0.9 años vs. AA-AC (42.8±1.0 y 47.5±0.8, p Glomerular filtration rate decline (GFRd is variable in autosomic dominant polycystic kidney disease (ADPKD. In 88 ADPKD patients, GFRd was assessed by 1/S Cr and compared with the association to AT1A1166C (AT1R, AGTM235T (angiotensinogen and ecNOSGlu298Asp (NO endothelial synthase polymorphisms. Age at S Cr values of 2 and 6 mg/dl were assumed as beginning of progressive phase (A2 and end-stage-renal disease (A6, respectively. Polymorphisms were studied by PCR-RFLP. The group as a whole showed GFRd (ml/min/year of 6.9±0.5; A2 and A6 of 48.9±1.3 and 55.0±1.4 years and mean arterial pressure of 111.2±1.2 mmHg. When A6 was considered, two populations were defined (£ and > 55 years. In £ 55 (assumed as PKD1 phenotype (n=42, A2 and A6 of the AT11166CC genotype were 36.0±1.2 and 41.4±0.9 years vs AA-AC (42.8±1.0 and 47.5±0.8, p<0.001. A2 and A6 of the ecNOS298Asp/Asp genotype were 34.8±1.5 and 41.1±0.6 years vs. Glu/Glu-Glu/Asp (42.4±0.9 and 47.1±0.8, p<0.02. In AGT235TT genotype, GFRd was 12.4±2.2 ml/min/year vs MM-MT (7.9±0.7, p<0.03. This difference was also observed when all ADPKD patients were considered (TT

  14. Compromiso renal en pacientes HIV+

    Directory of Open Access Journals (Sweden)

    María Marta Pernasetti

    2010-06-01

    Full Text Available Varias complicaciones nefrológicas pueden ocurrir durante la infección por el virus de la inmunodeficiencia humana (HIV especialmente en estadios avanzados de la enfermedad o relacionadas con otras infecciones o drogas. Poco conocida es la prevalencia de alteraciones renales subclínicas de pacientes HIV+ surgidas como complicación o relacionadas a la infección y/o tratamiento. Realizamos un corte transversal de pacientes asintomáticos HIV+ referidos en forma consecutiva al consultorio de nefrología para la detección de alteraciones nefrológicas. Se estudiaron 52 pacientes adultos mediante exámenes de sangre y orina, ultrasonido y biopsia renal. Edad media 39.9 ± 10.6 años, 88% varones, tiempo de diagnóstico de la infección: 53.2 ± 41.2 (2-127 meses. El 71% tenían síndrome de inmunodeficiencia adquirida (HIV-sida y el 77% recibían con antirretrovirales. La carga viral al momento del estudio fue 7043 ± 3322 copias y el recuento de CD4+ 484 ± 39 cel/mm³. El 30.7% presentó alteraciones del sedimento urinario: albuminuria: 16.6%, hematuria microscópica: 11.5%, hipercalciuria: 10.8% y cristaluria 6%. La media del filtrado glomerular fue 102.2 ± 22.9 ml/min (rango: 34-149. El 41% presentó anormalidades que corresponderían a enfermedad renal crónica (estadios 1 a 3. Los pacientes con alteraciones tenían mayor edad, con duración más prolongada de la infección. Las anomalías renales no se asociaron con mayor prevalencia de HIV-sida. Dos pacientes fueron biopsiados, con hallazgos de nefritis túbulo-intersticial crónica con cristales y glomerulonefritis por IgA. No hubo hallazgos de nefropatía por HIV. El amplio espectro y la alta prevalencia de anormalidades nefrológicas subclínicas encontradas sugieren que los pacientes asintomáticos HIV+ deberían realizar evaluaciones nefrológicas de rutina.

  15. [Renal leiomyoma. Case report].

    Science.gov (United States)

    Joual, A; Guessous, H; Rabii, R; Benjelloun, M; Benlemlih, A; Skali, K; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

  16. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P

    2007-01-01

    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  17. Traumatismo renal: Diagnóstico y tratamiento

    Directory of Open Access Journals (Sweden)

    Itsel Vela Caravia

    2003-06-01

    Full Text Available Se investigaron aleatoriamente 57 pacientes con el diagnóstico de traumatismo renal y egresados vivos entre 1993 y 1999. Se valoró como la causa predominante del traumatismo renal a los accidentes del tránsito y la incidencia mayor apareció en los hombres blancos entre 25 y 34 años. Los traumatismos renales cerrados ocurrieron en el 91,2 % y los penetrantes el 8,7 %. Los de grado I representaron el 77,1 %, los del grado II el 12,2 % y los de grado III el 10,5 % del total. En el traumatismo grado I predominó el tratamiento médico conservador; en el grado II un tratamiento conservador quirúrgico y en el grado III predominó el tratamiento no conservador. Se consideró que con un diagnóstico y tratamiento adecuados, mediante una clasificación correcta del traumatismo renal, se puede producir una salvación de la unidad renal afectada57 patients with the diagnosis of kidney traumatism who were discharged alive were investigated at random. Car accidents were asessed as the predominating cause of kidney traumatism. The highest incidence was observed among white men aged 25-34. The closed kidney traumatisms occurred in 91.2 % and the penetrating in 8.7 %. The degree 1 traumatisms accounted for 77.1 %, the degree II for 12.2 % and the degree III for 10.5 % of the total. In degree I traumatism, it was observed a predominance of the conservative medical treatment; in the degree II, a surgical conservative treamtent; and in the degree III, the non-conservative treatment. It was considered that with an adequate diagnosis and treatment and by a correct classification of the renal traumatism, the affected renal unit may be saved

  18. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  19. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  20. Efecto del cambio de posición de decúbito supino a decúbito prono en la presión intraabdominal y su relación con la función renal

    OpenAIRE

    Cuartero Sala, Mireia; Betbesé Roig, Antoni-Jordi

    2012-01-01

    Es tracta d'un estudi observacional prospectiu en 18 pacients afectats de la síndrome de destret respiratori agut que van requerir un canvi de posició de decúbit supí a decúbit pron per tal de millorar l'oxigenació. La hipòtesi de treball era que aquest canvi de posició podia augmentar la pressió intraabdominal i, en conseqüència, alterar la funció renal per causa prerrenal. Foren registrades variables hemodinàmiques, respiratòries i pressions intrabdominals, i valorada la funció renal. La po...

  1. Refractory anemia leading to renal hemosiderosis and renal failure

    OpenAIRE

    Sujatha Siddappa; K M Mythri; Kowsalya, R.; Ashish Parekh

    2011-01-01

    Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  2. Refractory anemia leading to renal hemosiderosis and renal failure

    Directory of Open Access Journals (Sweden)

    Sujatha Siddappa

    2011-01-01

    Full Text Available Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  3. Renal replacement therapy for acute renal failure.

    Science.gov (United States)

    Macedo, E; Bouchard, J; Mehta, R L

    2009-09-01

    Renal replacement therapy became a common clinical tool to treat patients with severe acute kidney injury (AKI) since the 1960s. During this time dialytic options have expanded considerably; biocompatible membranes, bicarbonate dialysate and dialysis machines with volumetric ultrafiltration control have improved the treatment for acute kidney injury. Along with advances in methods of intermittent hemodialysis, continuous renal replacement therapies have gained widespread acceptance in the treatment of dialysis-requiring AKI. However, many of the fundamental aspects of the renal replacement treatment such as indication, timing of dialytic intervention, and choice of dialysis modality are still controversial and may influence AKI patient's outcomes. This review outlines current concepts in the use of dialysis techniques for AKI and suggests an approach for selecting the optimal method of renal replacement therapy.

  4. Renal function after renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    George S. Hanzel; Mark Downes; Peter A. McCullough

    2005-01-01

    @@ Atherosclerotic renal artery stenosis (ARAS), a common clinical finding, is increasing in prevalence as the population ages. ARAS is seen in ~ 7% of persons over 65 years of age1 and in ~ 20% of patients at the time of coronary angiography.2 It is an important cause of chronic kidney disease and may result in 11-14% of cases of end stage renal disease.3

  5. Trastorno emocional en el paciente renal trasplantado

    Directory of Open Access Journals (Sweden)

    Fanny Moreno Rubio

    Full Text Available Introducción: el trasplante renal, siendo una terapia que mejora la calidad de vida de los pacientes con insuficiencia Renal Crónica, representa un nuevo reto para el paciente, que lo lleva a presentar trastornos emocionales tales como ansiedad y depresión asociados a factores de riesgo. Objetivo: describir la ansiedad y la depresión de pacientes trasplantados del Hospital de San José a través de la escala Hospital Anxiety and Depression Scale (HADS. Materiales y métodos: se hizo un estudio descriptivo de cohorte transversal, durante los meses de abril-septiembre del 2015. Donde se incluyeron los pacientes pertenecientes al programa de trasplante del Hospital de San José. Aplicando como instrumento la escala HADS, datos sociodemográficos, comorbilidades y tiempo pos trasplante. Resultados: se aplicó el instrumento a 176 pacientes de los cuales 10.7% presentaron ansiedad como problema clínico; con un tiempo pos trasplante ente 5-10años y 1.13% depresión como problema clínico. La comorbilidad prevalente fue Hipertensión Arterial (HTA con 31.2%. Conclusión: no se evidencio datos significativos de ansiedad y depresión en los pacientes del programa de trasplante renal que asistían a control en el Hospital de San José. Sin embargo se considera necesario el apoyo interdisciplinario durante las consultas de seguimiento mensual, viendo al paciente holístico y resaltando la importancia del personal de enfermería en la detección precoz de los trastornos emocionales.

  6. Influence of low-protein dietetic foods consumption on quality of life and levels of B vitamins and homocysteine in patients with chronic renal failure Influencia del consumo de alimentos dietéticos bajos en proteína sobre la calidad de vida y los niveles de vitaminas B y homocisteína en pacientes con insuficiencia renal crónica

    Directory of Open Access Journals (Sweden)

    C. Sánchez

    2010-04-01

    Full Text Available Objective: The aim of the study was to determine whether the consumption of low protein dietetic foods® improved the quality of life and nutritional status for vitamins B and homocysteine in patients with chronic renal failure. Methodology: This nutritional-intervention involved 28 men and 21 women, divided into two groups. The control-group consumed a low-protein diet prescribed, and the experimental-group consumed a diet in which some commonly used foods were replaced by low-protein dietetic foods. The study lasted 6 months. Food consumption was assessed by 24-h recall. Vitamin B6 as αEAST was measured in blood. Creatinine, urea, vitamin B12, folate and homocysteine were measured in plasma. The impact on the patients' quality of life from consuming the dietetic foods was assessed via the SF-36 questionnaire. Results: After 6 months, the protein intake among the experimental-group had decreased by 40%, and the urea/creatinine ratio and αEAST activity were also lower. The results of the SF-36 questionnaire show that the patients in the experimental-group obtained higher scores in the categories of general health and physical status. Conclusions: The dietetic foods were very well accepted by all patients and their use allowed a better control of the protein intake, improved B6 status and a better quality of life.Objetivo: Se estudió si el consumo de productos dietéticos bajos en proteína® mejora la calidad de vida y el estado nutricional en vitaminas B y homocisteína en pacientes con insuficiencia renal crónica (IRC. Material y métodos: La intervención nutricional se llevó a cabo durante 6 meses en un grupo de pacientes con IRC (28 hombres y 21 mujeres divididos en dos grupos. El grupo control consumió la dieta prescrita para la IRC. El grupo experimental consumió una dieta en donde parte de los alimentos fueron sustituidos por los productos dietéticos bajos en proteína. El consumo de alimentos fue analizado mediante recordatorio

  7. Imaging of renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. E-mail: vladimir.jevtic@mf.uni-lj.si

    2003-05-01

    Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

  8. Non-mycotic anastomotic pseudoaneurysm of renal allograft artery. Case Report.

    Science.gov (United States)

    Ardita, Vincenzo; Veroux, Massimiliano; Zerbo, Domenico; D'Arrigo, Giuseppe; Caglià, Pietro; Veroux, Pierfrancesco

    2016-06-20

    Le complicanze vascolari dopo il trapianto renale non sono comuni, e nella maggior parte dei casi si presentano nel periodo post-trapianto precoce. Gli pseudoaneurismi arteriosi coinvolgono l’anastomosi arteriosa del rene trapiantato e nella maggior parte dei casi riconoscono una eziologia micotica. Una donna di 62 anni, che è stata sottoposta otto mesi prima ad un trapianto renale, presentava un vago dolore in fossa iliaca destra. L’ecografia del rene trapiantato dimostrava la presenza di un’area ipoecogena in corrispondenza dell’ilo renale, che all’ecocolordoppler appariva riccamente vascolarizzata. La tomografia computerizzata confermava la diagnosi di pseudo-aneurisma anastomotico di 33 mm di diametro, coinvolgente l’arteria del rene trapiantato. La paziente è stata dunque sottoposta a intervento chirurgico di aneurismectomia, con successivo bypass fra arteria renale del rene trapiantato e arteria iliaca interna. La continuità arteriosa iliaca è stata dunque ristabilita attraverso un by-pass iliaco-esterno-femorale comune in vena safena invertita. L’ecocolordoppler intraoperatorio dimostrava la corretta perfusione del graft renale e la corretta pervietà del by-pass iliacofemorale. Il decorso post-operatorio è stato privo di complicanze significative, eccettuata una linforrea inguinale risolta spontaneamente in 22a giornata post-operatoria. Sei mesi dopo la procedura, la paziente è in ottime condizioni generali, con una funzionalità renale conservata e una corretta pervietà del by-pass iliacofemorale. Lo pseudo-aneurisma dell’arteria renale rappresenta una rara complicanza del trapianto renale. Nella maggior parte dei casi riconosce una eziologia micotica, spesso a causa di contaminazione diretta del graft durante le procedure di prelievo o conservazione dell’organo. Il trattamento è molto complesso, e in molti casi richiede l’espianto del graft. Tuttavia, in alcuni casi selezionati, è possibile eseguire il trattamento dell

  9. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen;

    2014-01-01

    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

  10. Insuficiencia renal aguda.

    OpenAIRE

    Carlos Hernán Mejía

    2009-01-01

    Acute renal failure (ARF) is a clinic syndrome characterized by decline in renal function occurring over a short time period. Is a relatively common complication in hospitalized critically ill patients and is associated with high morbidity and mortality. ARF has often a multi-factorial etiology syndrome usually approached diagnostically as pre-renal, post-renal, or intrinsic ARF. Most intrinsic ARF is caused by ischemia or nephrotoxins and is classically associated with acute tubular necrosis...

  11. Isolated Renal Hydatidosis Presenting as Renal Mass: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Datteswar Hota

    2015-07-01

    Full Text Available Hydatid disease is a parasitic infestation by larval form of Echinococcus granulosus. Isolated renal involvement is extremely rare. There are no specific signs and symptoms of renal hydatidosis. However it may present as palpable mass, flank pain, hematuria, malaise, fever, and hydatiduria or as a complication of it such as infection, abscess, hemorrhage, necrosis and pelviureteric junction obstruction, renal failure etc. Except hydatiduria, none are pathognomonic for renal hydatidosis. There is no literature on renal hydatidosis presenting as renal mass we report 2 cases of isolated renal hydatidosis, which mimicked a renal mass on imaging study.

  12. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...... metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available...

  13. Renal pelvis or ureter cancer

    Science.gov (United States)

    Transitional cell cancer of the renal pelvis or ureter; Kidney cancer - renal pelvis; Ureter cancer ... Cancer can grow in the urine collection system, but it is uncommon. Renal pelvis and ureter cancers ...

  14. [Hemorrhagic bilateral renal angiomyolipoma].

    Science.gov (United States)

    Benjelloun, Mohamed; Rabii, Redouane; Mezzour, Mohamed Hicham; Joual, Abdenbi; Bennani, Saâd; el Mrini, Mohamed

    2003-09-01

    Renal angiomyolipoma is a rare benign tumour, often associated with congenital diseases especially de Bourneville's tuberous sclerosis. Bilateral angiomyolipoma is exceptional. The authors report a case of bilateral renal angiomyolipoma in a 33-year-old patient presenting with haemorrhagic shock. In the light of this case and a review of the literature, the authors discuss the diagnostic and therapeutic aspects of this disease.

  15. FARMACOFISIOLOGÍA RENAL

    Directory of Open Access Journals (Sweden)

    Musso CG

    2014-03-01

    Full Text Available Renal physiology plays a key role in the pharmacokinetics of many drugs. Knowledge of the particularities of each nephron function (filtration, secretion, reabsorption and excretion and each of renal tubular transport mechanisms (simple diffusion, facilitated diffusion, facilitated transport, active transport, endocytosis and pinocytosis is fundamental to achieve better management of drug prescriptions.

  16. Primary renal hydatidosis

    Directory of Open Access Journals (Sweden)

    Johnsy Merla Joel

    2016-01-01

    Full Text Available Echinococcosis or hydatidosis caused by the tapeworm, Echinococcus granulosus, has the highest prevalence in endemic regions and sheep farming areas. The most common organ involved is the liver (50–75% followed by the lungs (15–20% and other organs (10–20%. Primary involvement of the kidney without the involvement of the liver and lungs, i.e., isolated renal hydatid disease is extremely rare even in endemic areas. The incidence of renal echinococcosis is 2–4%. Renal hydatid cysts usually remain asymptomatic for many years and are multiloculated. A 63-year-old male presented with left loin pain. Computed tomography scan abdomen revealed a presumptive diagnosis of renal hydatid disease. The nephrectomy specimen received in histopathology confirmed the diagnosis. We describe a rare case of primary renal hydatidosis.

  17. Revisión actualizada sobre la insuficiencia renal aguda: estudio de un caso

    OpenAIRE

    Andreu Periz, Lola; Force Sanmartín, Enriqueta

    2003-01-01

    La insuficiencia renal aguda (IRA) o fracaso renal agudo es un síndrome clínico caracterizado por un deterioro brusco, frecuentemente reversible, de la función renal que provoca fallo de la homeostasia y se acompaña de retención de productos terminales del metabolismo nitrogenado, como la urea y la creatinina, junto con alteraciones del equilibrio hidroelectrolítico y ácidobase. Suele observarse oliguria (diuresis inferior a 400 ml/24 h), aunque algunas formas clínicas...

  18. Plan de cuidados en una paciente con insuficiencia renal aguda. Caso Clínico

    OpenAIRE

    Delgado-Hito, Pilar; Romero García, Marta

    1999-01-01

    La Insuficiencia Renal Aguda puede definirse como una reducción o cese brusco de la función renal. Debido a la importancia del riñón en el mantenimiento del medio extracelular, la disminución aguda de la función renal afectará muchos, en realidad, la mayoría de los sistemas orgánicos. Los síntomas de presentación, curso clínico y complicaciones son manifestaciones de estos...

  19. Nutritional status of zinc and activity superoxide dismutase in chronic renal patients undergoing hemodialysis Estado nutricional del zinc y actividad de la enzima superóxido dismutasa en pacientes con enfermedad renal crónica en hemodiálisis

    OpenAIRE

    R. C. Noleto Magalhães; C. Guedes Borges de Araujo; V. Batista de Sousa Lima; J. Machado Moita Neto; N. do Nascimento Nogueira; D. do Nascimento Marreiro

    2011-01-01

    Introduction: Chronic kidney disease promotes changes in the zinc nutritional status and in the antioxidant defense system. This study assessed the relationship between the parameters of the zinc nutritional status and the activity of superoxide dismutase in patients with chronic renal failure who are receiving hemodialysis. Methods: 134 individuals, aged between 18 and 85 years, were divided into two groups: case group (hemodialyzed patients, n = 63) and control group (n = 71). Zinc concentr...

  20. Renal replacement therapy after cardiac surgery; renal function recovers

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin Julia; Kandler, Kristian; Agerlin Windeløv, Nis

    2013-01-01

    To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy.......To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy....

  1. High-protein diets and renal status in rats.

    Science.gov (United States)

    Aparicio, V A; Nebot, E; García-del Moral, R; Machado-Vílchez, M; Porres, J M; Sánchez, C; Aranda, P

    2013-01-01

    Introducción: Las dietas hiperproteicas (HP) pueden afectar la función renal. El objetivo del presente estudio fue examinar los efectos de una dieta HP sobre parámetros renales plasmáticos, urinarios y morfológicos en ratas. Material y métodos: Veinte ratas Wistar fueron distribuidas aleatoriamente en 2 grupos experimentales con dieta HP o normoproteicas durante 12 semanas. Resultados y discusión: El peso corporal final fue un 10% inferior en el grupo de dieta HP (p dieta HP (p = 0,001) y el pH urinario un 15% más ácido (p dieta HP (p dieta HP (p dieta hiperproteica promueve un peor perfil renal, especialmente en los marcadores urinarios y morfológico, que podrían aumentar el riesgo de desarrollar enfermedades renales a largo plazo.

  2. pacientes con insuficiencia renal terminal

    Directory of Open Access Journals (Sweden)

    Karen Herrera Herrera

    2011-01-01

    Full Text Available La presente investigación fundamenta en la clínica psicoanalítica el estudio de dos casos de tres personas diagnosticadas con IRT que reciben tratamiento de hemodiálisis, en razón a que dadas las características y el aumento de los reportes que se presentan, ya esto se considera un problema de salud pública. El objetivo principal es describir las características dinámicas del proceso de duelo en pacientes con IRT en un centro de terapia renal de la ciudad de Cartagena. El procedimiento metodológico empleó un diseño de tipo cualitativo; la investigación se desarrolló con un diseño clínico mediante el estudio de casos, y fundamentada en la hermenéutica psicoanalítica. Todo esto respaldado en la historia clínica, la entrevista semiestructurada individual y familiar, los test proyectivos, test del dibujo de la figura humana Machover y TAT de Murray, para la debida integración de los análisis. Se concluye que predominan funciones fallidas de los progenitores y que son individuos provenientes de familias psicosomáticas, que utilizan la enfermedad para obtener un beneficio secundario.

  3. Renal neuroendocrine tumors

    Directory of Open Access Journals (Sweden)

    Brian R Lane

    2009-01-01

    Full Text Available Objectives: Neuroendocrine tumors (NETs are uncommon tumors that exhibit a wide range of neuroendocrine differentiation and biological behavior. Primary NETs of the kidney, including carcinoid tumor, small cell carcinoma (SCC, and large cell neuroendocrine carcinoma (LCNEC are exceedingly rare. Materials and Methods: The clinicopathologic features of renal NETs diagnosed at a single institution were reviewed along with all reported cases in the worldwide literature. Results: Eighty renal NETs have been described, including nine from our institution. Differentiation between renal NETs and the more common renal neoplasms (renal cell carcinoma, transitional cell carcinoma can be difficult since clinical, radiographic, and histopathologic features overlap. Immunohistochemical staining for neuroendocrine markers, such as synaptophysin and chromogranin, can be particularly helpful in this regard. Renal carcinoids are typically slow-growing, may secrete hormones, and pursue a variable clinical course. In contrast, SCC and LCNEC often present with locally advanced or metastatic disease and carry a poor prognosis. Nephrectomy can be curative for clinically localized NETs, but multimodality treatment is indicated for advanced disease. Conclusions: A spectrum of NETs can rarely occur in the kidney. Renal carcinoids have a variable clinical course; SCC and LCNEC are associated with poor clinical outcomes. Diagnosis of NETs, especially LCNEC, requires awareness of their rare occurrence and prudent use of immunohistochemical neuroendocrine markers.

  4. Pregnancy and renal transplantation.

    Science.gov (United States)

    Başaran, O; Emiroğlu, R; Seçme, S; Moray, G; Haberal, M

    2004-01-01

    Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia.

  5. Renal autotransplantation: current perspectives.

    Science.gov (United States)

    Stewart, B H; Banowsky, L H; Hewitt, C B; Straffon, R A

    1976-01-01

    Autotransplantation, with or without an extracorporeal renal operation, has been done 39 times in 37 patients. Indications for the procedure included severe ureteral injury in 4 patients, failed supravesical diversion in 2, renal carcinoma in a solitary kidney in 1, renovascular hypertension in 1 and donor arterial reconstruction before renal transplantation in 29. Success was obtained in all but 2 procedures, both of which involved previously operated kidneys with severe inflammation and adhesions involving the renal pelvis and pedicle. Based on our experience and a review of currently available literature we believe that renal autotransplantation and extracorporeal reconstruction can provide the best solution for patients with severe renovascular and ureteral disease not correctable by conventional operative techniques. The technique can be of particular value in removing centrally located tumors in solitary kidneys and in preparing donor kidneys with abnormal arteries for renal transplantation. The role of autotransplantation in the management of advanced renal trauma and calculus disease is less clear. A long-term comparison of patients treated by extracorporeal nephrolithotomy versus conventional lithotomy techniques will be necessary before a conclusion is reached in these disease categories.

  6. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  7. INTERMEDIATE SYNDROME: A TYPICAL PATTERN OF PRE-RENAL ACUTE RENAL FAILURE IN THE ELDERLY

    Directory of Open Access Journals (Sweden)

    Greloni G

    2004-01-01

    Full Text Available Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatible with parenchymal renal insufficiency (elevated urinary sodium, plasma urea and creatinine, but with a positive response to hydration. The main characteristics of the aged kidney that predispose to the development of an intermediate syndrome are: the vascular dysautonomy and reduced capability of sodium and water reabsorption. The intermediate syndrome is a typical pattern of pre-renal insufficiency in the elderly. RESUMEN: La insuficiencia renal aguda es frecuente en el anciano. Esto se debe por un lado a los cambios estructurales y funcionales propios del riñón senil, y por otro a la gran exposición que esta población tiene a la polifarmacia, y su reducida capacidad para metabolizar los medicamentos. En este reporte presentamos el caso de una mujer de 70 años que desarrolló una insuficiencia renal aguda secundaria a severa deshidratación, mostrando un patrón clínico y de laboratorio propio de un sindrome intermedio: laboratorios compatibles con una insuficiencia renal parenquimatosa (sodio urinario, uremia y creatininemia elevadas, pero con una respuesta favorable a la hidratación. Las principales características del riñón senil que predisponen al desarrollo del sindrome intermedio: son la disautonomía vascular y la reducida capacidad en la recuperación de sodio y agua El sindrome intermedio es un patrón típico de insuficiencia prerrenal en el anciano.

  8. Valoración del estado nutricional en los diferentes estadios de la enfermedad renal crónica y su relación con el estrés oxidativo y la inflamación

    OpenAIRE

    Tomás Simó, Patricia

    2015-01-01

    La enfermedad cardiovascular es la principal causa de morbi-mortalidad en la enfermedad renal crónica (ERC) a nivel mundial secundaria a un proceso de aterosclerosis acelerada. Los factores clásicos predictivos están ampliamente presentes en esta población, pero no tienen potencia suficiente para justificar la alta incidencia y evolución de esta patología. Se ha demostrado como factores de riesgo ligados al propio estado urémico son los responsables de la marcada susceptibilidad a desarrollar...

  9. Calidad de vida relacionada con la salud en la enfermedad renal crónica: relevancia predictiva del estado de ánimo y la sintomatología somática

    Directory of Open Access Journals (Sweden)

    Carmen M. Perales Montilla

    2016-05-01

    Conclusiones: El estado anímico es un mejor predictor de los componentes físico y mental de la CVRS que el número e intensidad de los síntomas físicos informados por los pacientes. Estos resultados señalan la importancia de evaluar e intervenir sobre los estados emocionales negativos (depresión y ansiedad en los pacientes renales. Estas intervenciones pueden repercutir en una menor interferencia de la enfermedad sobre la CVRS en el paciente en hemodiálisis.

  10. Midterm renal functions following acute renal infarction

    Directory of Open Access Journals (Sweden)

    Sakir Ongun

    2015-10-01

    Full Text Available The aim of this study was to explore clinical features of renal infarction (RI that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA only, whereas patients with atrial fibrillation (AF or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8% with RI had atrial fibrillation (AF as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9% had elevated serum lactate dehydrogenase (LDH, 18 patients (78.2% had leukocytosis, and 16 patients (69.5% had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m2 at admission and increased to 82.3 ± 23.4 mL/min/1.73 m2 at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  11. Midterm renal functions following acute renal infarction.

    Science.gov (United States)

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven

    2015-10-01

    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m(2) at admission and increased to 82.3 ± 23.4 mL/min/1.73 m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  12. Lactulose and renal failure.

    Science.gov (United States)

    Vogt, B; Frey, F J

    1997-01-01

    The introduction of lactulose as a new therapeutic agent for treatment of hepatic encephalopathy was a major breakthrough in this field. It was hypothesized that lactulose might prevent postoperative renal impairment after biliary surgery in patients with obstructive jaundice. The presumable mechanism purported was the diminished endotoxinemia by lactulose. Unfortunately, such a reno-protective effect has not been shown conclusively until now in clinical studies. In chronic renal failure lactulose is known to promote fecal excretion of water, sodium, potassium, amonium, urea, creatinine and protons. Thus, lactulose could be useful for the treatment of chronic renal failure. However, compliance to the therapy represents a major problem.

  13. Renal tubule cell repair following acute renal injury.

    Science.gov (United States)

    Humes, H D; Lake, E W; Liu, S

    1995-01-01

    Experimental data suggests the recovery of renal function after ischemic or nephrotoxic acute renal failure is due to a replicative repair process dependent upon predominantly paracrine release of growth factors. These growth factors promote renal proximal tubule cell proliferation and a differentiation phase dependent on the interaction between tubule cells and basement membrane. These insights identify the molecular basis of renal repair and ischemic and nephrotoxic acute renal failure, and may lead to potential therapeutic modalities that accelerate renal repair and lessen the morbidity and mortality associated with these renal disease processes. In this regard, there is a prominent vasoconstrictor response of the renal vasculature during the postischemic period of developing acute renal failure. The intravenous administration of pharmacologic doses of atrial natriuretic factor (ANF) in the postischemic period have proven efficacious by altering renal vascular resistance, so that renal blood flow and glomerular filtration rate improve. ANF also appears to protect renal tubular epithelial integrity and holds significant promise as a therapeutic agent in acute renal failure. Of equal or greater promise are the therapeutic interventions targeting the proliferative reparative zone during the postischemic period. The exogenous administration of epidermal growth factor or insulin-like growth factor-1 in the postischemic period have effectively decreased the degree of renal insufficiency as measured by the peak serum creatinine and has hastened renal recovery as measured by the duration of time required to return the baseline serum creatinine values. A similarly efficacious role for hepatocyte growth factor has also been recently demonstrated.

  14. Renal scintigraphy in veterinary medicine.

    Science.gov (United States)

    Tyson, Reid; Daniel, Gregory B

    2014-01-01

    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  15. Coma mixedematoso e insuficiencia renal: Reporte de casos y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Ray Ticse

    2011-04-01

    Full Text Available El coma mixedematoso es una rara complicación del hipotiroidismo y está asociado a trastornos en la reabsorción de electrolitos, disminución del filtrado glomerular y flujo plasmático renal. Se sabe que estas alteraciones pueden ser reversibles con la terapia de reemplazo hormonal con levotiroxina. Se presentan tres pacientes con coma mixedematoso que presentaron insuficiencia renal, quienes fallecieron a pesar del tratamiento. Se realiza una revisión de la literatura. (Rev Med Hered 2011;22:82-85.

  16. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Girish D. Bakhshi

    2012-03-01

    Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

  17. Renal protection in diabetes

    DEFF Research Database (Denmark)

    Parving, H H; Tarnow, L; Rossing, P

    1996-01-01

    BACKGROUND: The combination of diabetes and hypertension increases the chances of progressive renal disorder and, ultimately, renal failure. Roughly 40% of all diabetics, whether insulin-dependent or not, develop diabetic nephropathy. Diabetic nephropathy is the single most important cause of end......-stage renal disease in the Western world and accounts for more than a quarter of all end-stage renal diseases. Diabetic nephropathy is a major cause of increased morbidity and mortality in diabetic patients. Increased arterial blood pressure is an early and common phenomenon in incipient and overt diabetic...... nephropathy. The relationship between arterial blood pressure and diabetic nephropathy is a complex one, with diabetic nephropathy increasing blood pressure and blood pressure accelerating the course of nephropathy. OVERVIEW: Calcium antagonists antagonize preglomerular vasoconstriction. Additional putative...

  18. Renal primitive neuroectodermal tumors.

    Science.gov (United States)

    Bartholow, Tanner; Parwani, Anil

    2012-06-01

    Primitive neuroectodermal tumors exist as a part of the Ewing sarcoma/primitive neuroectodermal tumor family. These tumors most commonly arise in the chest wall and paraspinal regions; cases with a renal origin are rare entities, but have become increasingly reported in recent years. Although such cases occur across a wide age distribution, the average age for a patient with a renal primitive neuroectodermal tumor is the mid- to late 20s, with both males and females susceptible. Histologically, these tumors are characterized by pseudorosettes. Immunohistochemically, CD99 is an important diagnostic marker. Clinically, these are aggressive tumors, with an average 5-year disease-free survival rate of only 45% to 55%. Given that renal primitive neuroectodermal tumor bears many similarities to other renal tumors, it is important to review the histologic features, immunostaining profile, and genetic abnormalities that can be used for its correct diagnosis.

  19. Renal vein thrombosis

    Science.gov (United States)

    ... Saunders; 2012:chap 34. Read More Acute kidney failure Arteriogram Blood clots Dehydration Nephrotic syndrome Pulmonary embolus Renal Tumor Review Date 5/19/2015 Updated by: Charles Silberberg, ...

  20. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie;

    2014-01-01

    -resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according......Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after...... undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility...

  1. [OSTEOPOROSIS AND BODY MASS INDEX IN RENAL TRANSPLANT RECIPIENTS].

    Science.gov (United States)

    López Ruiz, María del Carmen; Ortega Martínez, Ana Raquel; Fernández Castillo, Rafael; Esteban de la Rosa, Rafael José; Bravo Soto, Juan Antonio

    2015-08-01

    Introducción y objetivos: tras el trasplante renal es frecuente un aumento de peso, así como un elevado porcentaje de obesidad en estos pacientes. Por otro lado, tras el trasplante se produce una pérdida de la masa ósea, siendo la prevalencia de osteoporosis y fracturas óseas mayor que en la población general. Objetivos: explorar la relación entre el índice de masa corporal y la prevalencia de osteopenia y osteoporosis en una población de trasplantados renales. Material y método: estudio longitudinal prospectivo sobre una muestra de 306 trasplantados renales. Se exploraron las relaciones entre el peso y el índice de masa corporal con la prevalencia de osteopenia y osteoporosis a nivel femoral y lumbar en el momento del trasplante y a los 12 meses del mismo. Resultados: se halló una alta prevalencia de sobrepeso (35,6%) y obesidad (14,1%) tras el trasplante renal y al año del mismo (42,2% y 24,2%, respectivamente). Se hallaron diferencias estadísticamente significativas (p = 0,049) entre el peso en el momento del trasplante y la presencia de osteopenia u osteoporosis al año del mismo a nivel lumbar, siendo el peso medio más elevado entre los pacientes con osteoporosis. La media del IMC fue más elevada (p = 0,028) en los pacientes osteoporóticos (26,59 kg/m2) que en los pacientes con osteopenia (24,23 kg/m2). Conclusiones: nuestros resultados parecen estar en concordancia con recientes estudios realizados en la población general, que muestran el sobrepeso como un posible factor perjudicial para el hueso.

  2. Complete renal recovery from severe acute renal failure after thrombolysis of bilateral renal vein thrombosis.

    Science.gov (United States)

    Ramadoss, Suresh; Jones, Robert G; Foggensteiner, Lukas; Willis, Andrew P; Duddy, Martin J

    2012-10-01

    A previously healthy young man presented with acute renal failure due to extensive spontaneous deep vein thrombosis, including the inferior vena cava (IVC) and both renal veins. The patient was treated with selectively delivered thrombolytic therapy over a 7-day-period, which resulted in renal vein patency and complete recovery of renal function. A stent was placed over a segment stenosis of the IVC. No thrombophilic factors were identified. Bilateral renal vein thrombosis in young fit individuals is an unusual cause of acute renal failure. Thrombolytic therapy, even with delay, can completely restore renal function.

  3. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  4. Renal papillary necrosis

    Directory of Open Access Journals (Sweden)

    Stephen A. Geller

    2013-12-01

    Full Text Available In 1877, Dr. Nikolaus Friedreich (1825-1882; student of Virchow who became Professor of Pathology at Heidelberg and who also described Friedreich’s ataxia first described renal papillary necrosis (RPN in patients with prostatic hypertrophy and secondary hydronephrosis. Thereafter in 1937, Froboese and Günther emphasized the association of this entity with diabetes mellitus. These authors also observed renal papillary necrosis in cases of urinary tract obstruction even in the absence of diabetes mellitus.

  5. [Hyperuricemia and renal risk].

    Science.gov (United States)

    Viazzi, Francesca; Bonino, Barbara; Ratto, Elena; Desideri, Giovambattista; Pontremoli, Roberto

    2015-01-01

    Recent studies have revealed an association between elevated levels of uric acid and conditions correlated to chronic kidney diseases such as hypertension, cardiovascular and cerebral disease, insulin resistance. Several pathogenetic mechanisms at cellular and tissue levels could justify a direct correlation between serum uric acid levels and renal damage. Growing evidence indicating a correlation between urate lowering therapy and renal morbidity could encourage the use of urate lowering therapy in primary or secondary prevention in chronic kidney disease.

  6. Laparoscopic Renal Cryoablation

    Science.gov (United States)

    Schiffman, Marc; Moshfegh, Amiel; Talenfeld, Adam; Del Pizzo, Joseph J.

    2014-01-01

    In light of evidence linking radical nephrectomy and consequent suboptimal renal function to adverse cardiovascular events and increased mortality, research into nephron-sparing techniques for renal masses widely expanded in the past two decades. The American Urological Association (AUA) guidelines now explicitly list partial nephrectomy as the standard of care for the management of T1a renal tumors. Because of the increasing utilization of cross-sectional imaging, up to 70% of newly detected renal masses are stage T1a, making them more amenable to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. Cryosurgery has emerged as a leading option for renal ablation, and compared with surgical techniques it offers benefits in preserving renal function with fewer complications, shorter hospitalization times, and allows for quicker convalescence. A mature dataset exists at this time, with intermediate and long-term follow-up data available. Cryosurgical recommendations as a first-line therapy are made at this time in limited populations, including elderly patients, patients with multiple comorbidities, and those with a solitary kidney. As more data emerge on oncologic efficacy, and technical experience and the technology continue to improve, the application of this modality will likely be extended in future treatment guidelines. PMID:24596441

  7. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  8. Targeting Strategies for Renal Cell Carcinoma: From Renal Cancer Cells to Renal Cancer Stem Cells

    OpenAIRE

    Zhi-xiang Yuan; Jingxin Mo; Guixian Zhao; Gang Shu; Hua-lin Fu; Wei Zhao

    2016-01-01

    Renal cell carcinoma (RCC) is a common form of urologic tumor that originates from the highly heterogeneous epithelium of renal tubules. Over the last decade, targeting therapies to renal cancer cells have transformed clinical care for RCC. Recently, it was proposed that renal cancer stem cells (CSCs) isolated from renal carcinomas were responsible for driving tumor growth and resistance to conventional chemotherapy and radiotherapy, according to the theory of CSCs; this has provided the rati...

  9. RENAL MALIGNANT NEOPLASMS: RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Elisangela Giachini

    2017-06-01

    Full Text Available The aim of this study is to evaluate the incidence and prevalence of malignant kidney tumors, to contribute to identifying factors which the diagnosis of renal cell carcinomas. Through this study, we understand that kidney disease over the years had higher incidence rates, especially in adults in the sixth decade of life. The renal cell carcinoma (RCC is the third most common malignancy of the genitourinary tract, affecting 2% to 3% of the population. There are numerous ways of diagnosis; however, the most important are ultrasonography, magnetic resonance imaging and computed tomography. In general most of the patients affected by the CCR, have a good prognosis when diagnosed early and subjected to an effective treatment. This study conducted a literature review about the CCR, through this it was possible to understand the development needs of the imaging methods used for precise diagnosis and classification of RCC through the TNM system.

  10. Insuficiencia renal crónica y crecimiento

    Directory of Open Access Journals (Sweden)

    T. Pasqualini

    2003-12-01

    Full Text Available El retardo de crecimiento es uno de los mayores problemas de los niños con insuficiencia renal crónica (IRC. En 77% de los varones y 71% de las mujeres con IRC diagnosticada durante la niñez, la altura adulta se halla por debajo del percentilo 3. Los factores que influencian el crecimiento antes del trasplante (Tx son las alteraciones nutricionales, metabólicas y endocrinas; post Tx: la terapia corticoidea inmunosupresora y la alteración de la función del injerto. Sesenta a 64% de los niños llegan al Tx renal con gran deterioro de talla (mediana de talla -2.5 desvíos estándar, DS, no existiendo diferencia entre el DS de talla en el momento del Tx y el DS de talla adulta. Para mejorar el crecimiento post Tx renal, se ha intentado disminuir la dosis de corticoides, administrarlos en días alternos o utilizar corticoides con menos efectos sobre el crecimiento como el deflazacort. Varios estudios demostraron que el tratamiento con hormona de crecimiento (GH es efectivo y esto condujo a que el FDA (Food and Drug Administration lo aprobara como tratamiento de los niños, antes de ser sometidos al Tx renal. La magnitud del aumento de la velocidad de crecimiento es mayor durante el tratamiento conservador, post Tx algo menor, observándose la menor respuesta durante la diálisis. Asimismo, la ganancia de talla se correlaciona con mayor duración del tratamiento con GH durante la etapa prepuberal. Como conclusión, si el deterioro de talla es importante, lo ideal es comenzar el tratamiento a edades tempranas, en la etapa del tratamiento conservador, tratar de acortar el tiempo de diálisis, lograr una talla mejor al momento del Tx, teniendo en cuenta que la talla final está fuertemente relacionada con la talla alcanzada al momento del primer Tx.Many children with chronic renal insufficiency (CRI show growth retardation. Our objective is to describe the natural history of growth in patients with CRI, its pathogenesis and its optimization. Final

  11. Malignant renal tumors in children

    Directory of Open Access Journals (Sweden)

    Justin Scott Lee

    2015-05-01

    Full Text Available Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

  12. Síndrome metabólico y enfermedad renal

    Directory of Open Access Journals (Sweden)

    P. Alfredo Molina, Dr.

    2010-07-01

    Full Text Available Estudios epidemiológicos han señalado que el Síndrome Metabólico (SM es un factor de riesgo independiente, que incidiría en el desarrollo de daño renal crónico, existiendo además una relación gradual entre el número de componentes del SM y la prevalencia de enfermedad renal crónica (ERC. El SM corresponde a una agrupación de factores de riesgo: Obesidad abdominal, hipertrigliceridemia, colesterol HDL bajo, elevación de la presión arterial, elevación de la glicemia en ayunas, que se asocian a un aumento del riesgo de desarrollo de diabetes mellitus y enfermedades cardiovasculares. Debido a limitaciones metodológicas de los estudios actuales, no ha sido posible demostrar si el SM es causa o efecto de ERC. Se describen los mecanismos fisiopatológicos del SM y de su asociación a ERC. La American Heart Association recomienda un manejo agresivo y enfocado en los múltiples factores de riesgo del SM; sin embargo, aún no existen estudios que hayan evaluado si este tipo de intervenciones en pacientes con SM puede reducir la incidencia o la progresión de ERC. Se requieren estudios prospectivos e intervencionales que permitan medir de manera exacta el impacto del tratamiento del SM y la obesidad en el riesgo de ERC.

  13. Infección por virus BK en paciente pediátrico trasplantado renal BK virus infection in a pediatric renal transplant recipient

    Directory of Open Access Journals (Sweden)

    R. Bonaventura

    2005-09-01

    Full Text Available El poliomavirus humano BK causa infección primaria asintomática en la niñez, estableciendo latencia principalmente en el tracto urinario. En individuos con alteración en la inmunidad celular se puede producir su reactivación desencadenando patología a nivel renal. Por estas razones es particularmente importante en la población pediátrica trasplantada renal, en la que puede producir la infección primaria cuando el paciente está inmunosuprimido. En nuestro trabajo se realizó el seguimiento de un paciente de 5 años trasplantado renal en octubre de 2003 que 45 días post-trasplante sufrió un deterioro del órgano injertado. Desde la fecha del trasplante hasta junio de 2004 se produjeron 3 episodios de alteración en la función renal, durante los cuales se analizaron muestras de sangre, orina, biopsia renal y líquido de linfocele. Para el diagnóstico difererencial entre rechazo agudo versus causa infecciosa se emplearon técnicas de detección para los virus BK, CMV y ADV, además del estudio citológico del tejido renal. Los resultados obtenidos junto con la clínica del paciente indican un probable caso de infección por BK. La importancia de realizar el diagnóstico diferencial entre rechazo agudo y la infección por BK radica en que la conducta en cuanto a la terapia inmunosupresora es opuesta en cada caso.BK Human Polyomavirus causes an asymptomatic primary infection in children, then establishing latency mainly in the urinary tract. Viral reactivation can lead to renal pathology in individuals with impaired cellular immune response. This is particularly important in pediatric transplant recipients, who can suffer a primary infection when immunosupressed. We followed up the case of a 5 years old patient who received a renal transplant in October 2003, and presented damaged graft 45 days after the intervention. The patient suffered 3 episodes of renal function failure between October 2003 and June 2004. Blood, urine, renal biopsy

  14. Percutaneous renal tumour biopsy.

    Science.gov (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo

    2014-09-01

    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  15. “The renal system at a glance” encargo de traducción emitido por la editorial médica panamericana: análisis del texto traducido

    OpenAIRE

    García García-Faria, Enrique

    2015-01-01

    Treball de Final de Màster Universitari en Traducció Medicosanitària (Pla de 2013). Codi: SBA031. Curs acadèmic 2014-2015 El presente documento recoge un análisis exhaustivo y detallado del texto traducido para la asignatura Prácticas Profesionales, cursada durante el máster universitario en Traducción médico-sanitaria (2014-2015) impartido por la Universitat Jaume I de Castellón. La elaboración de este escrito, que hace las veces de trabajo final de máster (TFM), nos permitirá...

  16. Can renal infarction occur after renal cyst aspiration? Case report.

    Science.gov (United States)

    Emre, Habib; Soyoral, Yasemin Usul; Tanik, Serhat; Gecit, Ilhan; Begenik, Huseyin; Pirincci, Necip; Erkoc, Reha

    2011-01-01

    Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.

  17. Factores predictivos de nefropatía no diabética en pacientes diabéticos. Utilidad de la biopsia renal

    OpenAIRE

    Bermejo García, Sheila; Soler, María José; Gimeno Beltran, Javier; Barrios Barrera, Clara; Rodríguez, Eva; Mojal, Sergio; Pascual Santos, Julio

    2016-01-01

    Antecedentes y objetivos: La afectación renal del diabético solo puede determinarse mediante biopsia renal, que presenta una elevada prevalencia de lesiones no diabéticas. Los objetivos del estudio fueron determinar la predictibilidad de nefropatía no diabética (NND) en diabéticos, estudiar diferencias de supervivencia y pronóstico renal, evaluar las lesiones histológicas en nefropatía diabética (ND) y el efecto de la proteinuria en la supervivencia y pronóstico renal en esta población. Mater...

  18. Imaging chronic renal disease and renal transplant in children

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, Jim; Easty, Marina [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)

    2010-06-15

    At Great Ormond Street Hospital we have the highest number of paediatric renal transplant patients in Europe, taking cases from across the United Kingdom and abroad. Our caseload includes many children with rare complicating medical problems and chronic renal failure related morbidity. This review aims to provide an overview of our experience of imaging children with chronic renal failure and transplants. (orig.)

  19. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  20. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted...

  1. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  2. Dyslipoproteinemia in renal transplantation.

    Directory of Open Access Journals (Sweden)

    Gunjotikar R

    1994-01-01

    Full Text Available Twenty-seven live related donor renal allograft recipients were evaluated for dyslipoproteinemia. Twenty-two patients received dual immunosuppression with prednisolone and azathioprine. Five patients received cyclosporin as well. Total cholesterol (Tch, triglycerides (TG, HDL cholesterol (HDLch, LDL cholesterol (LDLch and VLDL cholesterol (VLDLch levels were estimated. Fifteen (56% patients showed significant lipoprotein abnormalities. Renal allograft recipients showed significantly lower levels of Tch (p < 0.05 and LDLch (p < 0.05 and higher levels of TG (p < 0.005 and HDLch (p < 0.05. Diet and beta blockers did not influence lipoprotein levels. A significant negative correlation was noted between post-transplant duration and Tch, TG and VLDLch levels. Increased TG levels were associated with increase in weight and higher daily prednisolone dosage at the time of evaluation. The study confirms the existence of dyslipoproteinemia in renal allograft recipients.

  3. Renal (Kidney) Manifestations in TSC

    Science.gov (United States)

    ... International TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of ... sclerosis complex (TSC) will develop some form of renal (kidney) disease during their lifetime. There are three ...

  4. Renal involvement in antiphospholipid syndrome.

    Science.gov (United States)

    Pons-Estel, Guillermo J; Cervera, Ricard

    2014-02-01

    Renal involvement can be a serious problem for patients with antiphospholipid syndrome (APS). However, this complication has been poorly recognized and studied. It can be present in patients who have either primary or systemic lupus erythematosus-associated APS. Clinical and laboratory features of renal involvement in APS include hypertension, hematuria, acute renal failure, and progressive chronic renal insufficiency with mild levels of proteinuria that can progress to nephrotic-range proteinuria. The main lesions are renal artery stenosis, venous renal thrombosis, and glomerular lesions (APS nephropathy) that may be acute (thrombotic microangiopathy) and/or chronic (arteriosclerosis, arterial fibrous intimal hyperplasia, tubular thyroidization, arteriolar occlusions, and focal cortical atrophy). APS can also cause end-stage renal disease and allograft vascular thrombosis. This article reviews the range of renal abnormalities associated with APS, and their diagnosis and treatment options.

  5. [Renal transplantation and urinary lithiasis].

    Science.gov (United States)

    Lechevallier, E; Saussine, C; Traxer, O

    2008-12-01

    Renal lithiasis in renal donors is rare. A renal stone in a donor, or in a renal transplant, is not a contraindication for harvesting nor transplantation. If possible, the stone must be removed at the time of the transplantation. The risk of lithiasis is increased in the renal transplant recipient, with a frequency of 2-6%. Metabolic abnormalities for lithiasis are frequent and can be induced by the immunosuppressive treatment, anticalcineurins. Lithiasis can have a poor prognosis in the renal recipient with a risk for infection or renal dysfunction. Small (renal transplant can be followed-up. Stones of 0.5-1.5cm need an extracorporeal lithotripsy with a previous safety JJ stent. Stones greater than 1.5cm can be treated by ureteroscopy or percutaneous surgery.

  6. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  7. Renal Artery Stent Outcomes

    Science.gov (United States)

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.

    2016-01-01

    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  8. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  9. Renal lithiasis and nutrition.

    Science.gov (United States)

    Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafel M

    2006-09-06

    Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified through diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine) is discussed.

  10. Pediatric Renal Neoplasms.

    Science.gov (United States)

    Ranganathan, Sarangarajan

    2009-03-01

    Renal tumors in childhood consist of a diverse group of tumors ranging from the most common Wilms' tumor, to the uncommon and often fatal rhabdoid tumor. Diagnosis is based on morphologic features and aided by ancillary techniques such as immunohistochemistry and cytogenetics. Molecular techniques have helped identify a group of pediatric renal cell carcinomas that have specific translocations, called translocation-associated carcinomas. Differential diagnosis of the various tumors is discussed. Pathogenesis and nephroblastomatosis, the precursor lesions of Wilms tumor, also are discussed briefly, as are the handling of these tumor specimens and prognostic factors. Copyright © 2009 Elsevier Inc. All rights reserved.

  11. Gravidez e transplante renal

    OpenAIRE

    Andrade, Joana Rita Ferreira

    2014-01-01

    Enquadramento: A gravidez é rara em mulheres com Doença Renal Crónica, sobretudo em estadio avançado, em virtude de várias condicionantes como a disfunção ovárica, hemorragias vaginais anovulatórias e amenorreia. Contudo, após transplante renal é possível alimentar o sonho de constituir família, mas é preciso considerar os riscos aumentados para o enxerto e a maior susceptibilidade para complicações da gravidez. Objectivo: Avaliar os riscos e identificar as variáveis que influenciam o suce...

  12. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M

    2006-09-01

    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  13. Resultados clínicos de trasplantes de riñón en pacientes con enfermedad renal en etapa terminal secundaria a nefritis lupus, enfermedad poliquística renal y nefropatía diabética

    Directory of Open Access Journals (Sweden)

    John Fredy Nieto-Ríos

    2016-04-01

    Full Text Available Antecedentes:Pacientes con nefritis lúpica pueden progresar a enfermedad renal crónica terminal (10-22%; en estos pacientes el trasplante renal debe ser considerado como la terapia de elección. Objetivo: Evaluar los desenlaces clínicos de un grupo de pacientes con enfermedad renal crónica terminal por nefropatía lúpica, enfermedad renal poliquística y nefropatía diabética que fueron sometidos a trasplante renal en el Hospital Pablo Tobón Uribe.Métodos:Estudio retrospectivo, descriptivo, realizado en un solo centro de trasplante renal, durante el período 2005-2013.Resultados:Se evaluaron 136 pacientes: 27 con nefritis lúpica (19.9%, 31 con enfermedad renal poliquística (22.8% y 78 con nefropatía diabética (57.4%. La supervivencia del injerto a uno, tres y cinco años fue de de 96.3%, 82.5% y 82.5% en nefropatía lúpica, 90%, 86% y 76.5% en enfermedad renal poliquística y 91.7%, 80.3% y 67.9% en nefropatía diabética respectivamente, sin diferencias estadísticas significativas (Long Rank test= 0.488. La tasa de recurrencia de nefritis lúpica posterior al trasplante renal fue de 0.94%/persona-año. Tener lupus vs diabetes o enfermedad renal poliquística no fue un factor de riesgo para disminución del tiempo de supervivencia del injerto (Hazard ratio= 1.43; 95% IC= 0.52-3.93.Conclusiones:Los pacientes enfermedad renal crónica terminal secundaria a nefritis lúpica, que son llevados a trasplante renal tienen tasas de éxito similar en cuanto a supervivencia del injerto y del paciente, al compararlos con otras enfermedades renales. La tasa de complicaciones y el riesgo de recurrencia de la nefropatía lúpica son bajos. El trasplante renal debe ser considerado como la terapia de elección para los pacientes con enfermedad renal crónica estadio terminal secundaria a nefritis lúpica.

  14. Branchio-oto-renal syndrome.

    Science.gov (United States)

    Jalil, Jawad; Basheer, Faisal; Shafique, Mobeen

    2014-05-01

    The association of branchial arch anomalies (branchial cysts, branchial fistulas), hearing loss and renal anomalies constitutes the branchio-oto-renal (BOR) syndrome also known as Melnick Fraser syndrome. We present a case of this rare disorder in a girl child who presented with profound deafness, preauricular pits, branchial sinuses and renal hypoplasia.

  15. Drug-induced renal disease.

    Science.gov (United States)

    Curtis, J R

    1979-11-01

    The clinical manifestations of drug-induced renal disease may include all the manifestations attributed to natural or spontaneous renal diseases such as acute renal failure, chronic renal failure, acute nephritic syndrome, renal colic, haematuria, selective tubular defects, obstructive nephropathy, etc. It is therefore vital in any patient with renal disease whatever the clinical manifestations might be, to obtain a meticulous drug and toxin inventory. Withdrawal of the offending drug may result in amelioration or cure of the renal disorder although in the case of severe renal failure it may be necessary to utilise haemodialysis or peritoneal dialysis to tide the patient over the period of acute renal failure. Analgesic nephropathy is an important cause of terminal chronic renal failure and it is therefore vital to make the diagnosis as early as possible. The pathogenesis of some drug-induced renal disorders appears to be immunologically mediated. There are many other pathogenetic mechanisms involved in drug-induced renal disorders and some drugs may under appropriate circumstances be responsible for a variety of different nephrotoxic effects. For example, the sulphonamides have been incriminated in examples of crystalluria, acute interstitial nephritis, acute tubular necrosis, generalised hypersensitivity reactions, polyarteritis nodosa and drug-induced lupus erythematosus.

  16. Management of chronic renal failure.

    NARCIS (Netherlands)

    de Zeeuw, D.; Apperloo, AJ; de Jong, P.

    1992-01-01

    There is growing evidence that treatment of patients with renal function impairment will undergo a major shift within the next few years. Along with more or less successful attempts to alleviate the signs and symptoms of reduced renal function, new insights into renal pathophysiology as well as new

  17. Enfermedad renal crónica asociada a diacetilmorfina (heroína

    Directory of Open Access Journals (Sweden)

    Jon Kepa Balparda Arias

    2008-12-01

    Full Text Available El uso de sustancias ilícitas es un problema de grandes proporciones a nivel mundial, y el daño renal crónico asociado a éstas no es una complicación del todo rara. Los principales cuadros patológicos renales asociados a la Heroína comprenden el síndrome nefrótico, la amiloidosis, la nefritis intersticial y la glomerulonefritis aguda.  El cuadro clínico del paciente es aquel de todo paciente con enfermedad renal crónica según el estadío en que se encuentre.  El tratamiento es similar a la de los cuadros renales crónicos de cualquier causa primaria o secundaria. 

  18. Adenocarcinoma mucinoso de pelvis renal. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Caridad Socorro Castro

    2012-02-01

    Full Text Available Las neoplasias malignas del riñón representan alrededor del 2 % de todos los cánceres, el carcinoma de células renales es el más frecuente dentro de este grupo con una frecuencia del 80 al 90 %. El adenocarcinoma de pelvis renal es una neoplasia muy rara, que se presenta en menos del 1 % de los pacientes con neoplasias malignas renales, asociada, la mayoría de las veces, a procesos inflamatorios del  órgano y litiasis. Por tales razones se decidió la publicación de un caso clínico diagnosticado  en el Departamento de Anatomía Patológica del Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, con esta variante histológica de cáncer renal, en una mujer en la cuarta década de la vida.

  19. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  20. Management of Renal Cysts

    Science.gov (United States)

    Nalbant, Ismail; Can Sener, Nevzat; Firat, Hacer; Yeşil, Süleyman; Zengin, Kürşad; Yalcınkaya, Fatih; Imamoglu, Abdurrahim

    2015-01-01

    Background and Objectives: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. Methods: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. Results: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. Conclusion: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy. PMID:25848184

  1. Rupture of Renal Transplant

    Directory of Open Access Journals (Sweden)

    Shona Baker

    2015-01-01

    Full Text Available Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L. LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day three after transplant, he developed pain/graft swelling and another significant haemorrhage with cardiovascular compromise which did not respond to aggressive resuscitation. At reexploration, the renal allograft was found to have a longitudinal rupture and was removed. Histology showed features of type IIa Banff 97 acute vascular rejection, moderate arteriosclerosis, and acute tubular necrosis. Conclusion. Possible ways of avoiding allograft rupture include use of well-matched, good quality kidneys; reducing or managing risk factors that would predispose to delayed graft function; ensuring a technically satisfactory transplant procedure with short cold and warm ischemia times; and avoiding large donor-recipient age gradients.

  2. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam

    1996-01-01

    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence an

  3. Estimación renal mediante cuatro ecuaciones

    OpenAIRE

    Coca Rojo, Armando

    2012-01-01

    1: Todos los métodos de estimación del aclaramiento de creatinina miden dicho parámetro de forma indirecta y ninguno recoge su valor real. El estándar de oro para la evaluación de la función renal es el aclaramiento de inulina, una prueba reservada en la práctica debido a su complejidad a la investigación médica. 2: Existen valores extremos que hacen del aclaramiento de creatinina un parámetro menos fiable de lo que cabría esperar, especialmente en aquellos pacientes con ed...

  4. Insuficiencia renal aguda asociada a picadura de abeja africanizada

    Directory of Open Access Journals (Sweden)

    Verny Huertas-Franco

    2008-03-01

    Full Text Available Se presenta el caso de un adulto mayor diabético tipo 2, que sufrió un ataque masivo de abejas africanizadas, y llegó a la sala de emergencias tres horas después del inicio del ataque. El paciente presentó insuficiencia renal aguda por combinación de factores, y se recuperó con tratamiento de diálisis temprana. Se discuten los problemas que refieren estos pacientes, y cuál sería el manejo ideal de tales casos.

  5. Obesidad y enfermedad renal: consecuencias ocultas de la epidemia

    Directory of Open Access Journals (Sweden)

    Csaba P. Kovesdy

    2017-07-01

    Full Text Available La obesidad se ha convertido en una epidemia mundial, y se ha proyectado que su prevalencia se incrementrá en un 40% en la próxima década. Esta creciente prevalencia supone implicaciones tanto para el riesgo de desarrollo de diabetes y enfermedades cardiovasculares como para el desarrollo de enfermedad renal crónica. Un elevado índice de masa corporal es uno de los factores de riesgo más importantes para el desarrollo de enfermedad renal crónica. En individuos afectados por la obesidad, tiene lugar una hiperfiltración compensatoria necesaria para alcanzar la alta demanda metabólica secundaria al aumento del peso corporal. El incremeno de la presión intraglomerular puede generar daño renal y elevar el riesgo de desarrollar enfermedad renal crónica a largo plazo. La incidencia de glomerulopatía asociada a obesidad se ha incrementado 10 veces en los últimos años. Así mismo se ha demostrado que la obesidad es un factor de riesgo para el desarrollo de nefrolitiasis y un número de neoplasias, incluyendo cáncer renal. Este año, el Día Mundial del Riñón promueve la educación acerca de las consecuencias nocivas de la obesidad y su asociación con la enfermedad renal, abogando por un estilo de vida saludable y la implementación de políticas publicas de salud que promuevan medidas preventivas alcanzables.

  6. ``Aggressive`` renal angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Cittadini, G. Jr. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, F. [Univ. of Trieste (Italy). Dept. of Radiology; Danza, F.M. [Catholic Sacro Cuore Univ., Rome (Italy). Dept. of Radiology; Derchi, L.E. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, R.S. [Univ. of Trieste (Italy). Dept. of Radiology

    1996-11-01

    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an `aggressive` appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG).

  7. Estudio ecocardiográfico del patrón geométrico, la función sistólica y la función diastólica del ventrículo izquierdo en pacientes con enfermedad renal crónica avanzada en diálisis

    OpenAIRE

    Roselló Serralta, Araceli

    2013-01-01

    La enfermedad cardiovascular es la principal causa de morbimortalidad en la enfermedad renal crónica avanzada (ERCA), y sus principales manifestaciones son la insuficiencia cardíaca congestiva (ICC), la cardiopatía isquémica y las alteraciones ecocardiográficas. La ICC en la ERCA tiene una prevalencia elevada (30-40%) con pronóstico adverso, y los factores predictores de su aparición son la cardiopatía isquémica, la hipertensión arterial (HTA) y la disfunción diastólica. La cardiopatía is...

  8. Causas de proteinuria post-renal en el perro: Estudio retrospectivo de 162 casos

    Directory of Open Access Journals (Sweden)

    Zaragoza-Bayle, C.

    2009-05-01

    Full Text Available ResumenLa proteinuria se define como la cantidad anormalmente elevada deproteínas presente en la orina. Dichas proteínas pueden tener un origen pre-renal, renal o post-renal. Una proteinuria de origen post-renal, a su vez, puede tener causas urinarias o extraurinarias y, generalmente, está asociada a inflamación del tracto urinario inferior. En este estudio se revisaron 162 análisis de orina con sus correspondientes historias clínicas de pacientes procedentes del Hospital Clínico Veterinario de la Universidad de Extremadura (UEx para conocer las causas relacionadas con la proteinuria post-renal debido a su importancia a la hora de instaurar un tratamiento adecuado. Los resultados demostraron que las cistitis bacterianas y la urolitiasis fueron las causas más comunes de proteinuriapos-renal. La sintomatología clínica encontrada generalmente fue laasociada a inflamación del tracto urinario inferior como hematuria conpolaquiuria y/o disuria.

  9. Insuficiencia renal aguda asociada a picadura de abeja africanizada Acute renal failure secondary to africanized bee stings

    Directory of Open Access Journals (Sweden)

    Verny Huertas-Franco

    2008-03-01

    Full Text Available Se presenta el caso de un adulto mayor diabético tipo 2, que sufrió un ataque masivo de abejas africanizadas, y llegó a la sala de emergencias tres horas después del inicio del ataque. El paciente presentó insuficiencia renal aguda por combinación de factores, y se recuperó con tratamiento de diálisis temprana. Se discuten los problemas que refieren estos pacientes, y cuál sería el manejo ideal de tales casos.This is the case of an elderly patient who suffered multiple Africanized bee stings. He developed acute renal failure as a complication. He however recovered completely after treatment with peritoneal dialysis and hemodialysis.

  10. Chronic renal disease in pregnancy.

    Science.gov (United States)

    Ramin, Susan M; Vidaeff, Alex C; Yeomans, Edward R; Gilstrap, Larry C

    2006-12-01

    The purpose of this review was to examine the impact of varying degrees of renal insufficiency on pregnancy outcome in women with chronic renal disease. Our search of the literature did not reveal any randomized clinical trials or meta-analyses. The available information is derived from opinion, reviews, retrospective series, and limited observational series. It appears that chronic renal disease in pregnancy is uncommon, occurring in 0.03-0.12% of all pregnancies from two U.S. population-based and registry studies. Maternal complications associated with chronic renal disease include preeclampsia, worsening renal function, preterm delivery, anemia, chronic hypertension, and cesarean delivery. The live birth rate in women with chronic renal disease ranges between 64% and 98% depending on the severity of renal insufficiency and presence of hypertension. Significant proteinuria may be an indicator of underlying renal insufficiency. Management of pregnant women with underlying renal disease should ideally entail a multidisciplinary approach at a tertiary center and include a maternal-fetal medicine specialist and a nephrologist. Such women should receive counseling regarding the pregnancy outcomes in association with maternal chronic renal disease and the effect of pregnancy on renal function, especially within the ensuing 5 years postpartum. These women will require frequent visits and monitoring of renal function during pregnancy. Women whose renal disease is further complicated by hypertension should be counseled regarding the increased risk of adverse outcome and need for blood pressure control. Some antihypertensives, especially angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, should be avoided during pregnancy, if possible, because of the potential for both teratogenic (hypocalvaria) and fetal effects (renal failure, oliguria, and demise).

  11. Characterization of diabetic patients undergoing dialysis at hospital Universitario San Vicente de Paúl, in Medellín, Colombia Características de los pacientes con diagnóstico de diabetes mellitus en diálisis en la Unidad Renal del Hospital Universitario San Vicente de Paúl, Medellín-Colombia

    Directory of Open Access Journals (Sweden)

    Alberto Villegas Perrasse

    2005-04-01

    educational and intervention programs to promote self-care conducts and healthy life styles, with participation of a multidisciplinary group, in order to improve the quality of life of these patients. La diabetes mellitus (DM es una de las principales causas de insuficiencia renal en el mundo. En Colombia y Latinoamérica existen pocos estudios sobre los diabéticos en diálisis. Las alteraciones en pacientes dializados diabéticos son mayores que en los no diabéticos y muchas complicaciones asociadas a la DM ya están presentes al iniciar la diálisis. Objetivo: determinar las características de los pacientes diabéticos sometidos a diálisis. Metodología: se realizó un estudio descriptivo de corte, al total de la población con DM en diálisis en la Unidad Renal (UR del Hospital Universitario San Vicente de Paúl, (HUSVP a mayo 31 de 2003. Se aplicó una encuesta semiestructurada, tomando los datos clínicos y de laboratorio de las historias de los pacientes. Resultados: de la población en diálisis (396 pacientes, 102 (25.7% tienen diagnóstico de nefropatía diabética; de estos 15.3% tienen el diagnóstico de DM desde hace menos de 5 años. Tienen DM 65 (29.8% de los 218 pacientes en hemodiálisis y 37 (20.8% de los 178 en diálisis peritoneal. De estos 102 pacientes se logró estudiar en detalle a 98, de los cuales 57 (58.2% fueron hombres y 41 (41.8% mujeres. La edad promedio fue 60 años (rango 28-82. El tiempo promedio en diálisis era de 1.53 años; 88 pacientes (89.8% tenían DM tipo 2; 92 pacientes eran hipertensos (93.9%; tenían sobrepeso 47 pacientes (47.9%, se halló hipercolesterolemia en 58.2%, hipertrigliceridemia en 55.1%, retinopatía en 79.6%, ceguera total o parcial por DM en 25.5%, neuropatía en 62.2%, y enfermedad cardiovascular en 84.6%. Proporciones minoritarias de los pacientes cumplían con las conductas de autocuidado. Conclusiones: la nefropatía diabética es la primera causa de ingreso a diálisis en nuestra UR; la asociada a la DM2 es

  12. CUTANEOUS MANIFESTATIONS OF CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    R. Suganya Gnanadeepam

    2017-07-01

    Full Text Available BACKGROUND The kidney and the skin are the two large networks of the body with abundant blood supply associated with various cutaneous manifestations. This study aims to detect the various cutaneous manifestations and its incidence in patients with chronic renal failure and renal transplantation. MATERIALS AND METHODS This study was done for a period of 1 year from January 2016 to December 2016 at Nephrology OPD ward and Medicine wards, Government KAPV Medical College Hospital, Trichy. During this period, 100 patients who had the presence of skin manifestations were selected and studied (80 renal failure patients and 20 renal transplantation patients. RESULTS Most of the specific cutaneous manifestations of chronic renal failure and renal transplantation were noted in this study. Pruritus and xerosis were the most common manifestations noted in chronic renal failure while infections was commonly noted in renal transplantation patients. CONCLUSION Pruritus and xerosis were the most common among the specific cutaneous manifestations in chronic renal failure followed by nail abnormalities and pigmentary changes. Cutaneous manifestations of renal transplantation were mostly due to infections of which fungal infection is the most common followed by viral infection.

  13. Transarterial embolization for serious renal hemorrhage following renal biopsy.

    Science.gov (United States)

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei

    2013-01-01

    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  14. Papel de las mitocondrias y el estrés oxidativo en el proceso inflamatorio renal

    OpenAIRE

    Walter Manucha

    2014-01-01

    La muerte celular programada y la fibrosis renal son procesos inherentes a la enfermedad renal crónica y, en tal sentido, ha sido recientemente descripta una clara desregulación de la maquinaria respiratoria mitocondrial en pacientes con enfermedad renal crónica asociada con un aumento del estrés oxidativo. Las células tubulares lesionadas vinculadas a los macrófagos intersticiales y miofibroblastos producen citoquinas y factores de crecimiento que promueven un estado inflamatorio, inducen la...

  15. Diarrea aguda en trasplantes renales y reno-pancreáticos

    OpenAIRE

    2015-01-01

    La diarrea es una complicación frecuente y potencialmente grave del trasplante renal. Se describen aquí, en un estudio de corte transversal, las características epidemiológicas y microbiológicas de la diarrea aguda y persistente en pacientes internados con trasplante renal o reno-páncreas. Se incluyeron 52 pacientes internados en un hospital de la Ciudad de Buenos Aires, 42 (80.8%) habían recibido un trasplante renal y 10 (19.2%) reno-páncreas. La diarrea fue el motivo de ingreso en 34 casos ...

  16. Actualización en técnicas continuas de reemplazo renal

    OpenAIRE

    Romero García, Marta; Cueva Ariza, Laura de la; Delgado-Hito, Pilar

    2013-01-01

    El fracaso renal agudo afecta a un 25% de los pacientes hospitalizados en las unidades de cuidados intensivos. A pesar de los avances tecnológicos, la mortalidad de estos pacientes sigue siendo elevada debido a las complicaciones asociadas. Uno de los tratamientos del fracaso renal agudo son las técnicas continuas de reemplazo renal ya que permiten tratar las complicaciones y disminuir la mortalidad. El conocimiento y la habilidad de la enfermera en relación con estas técnicas serán decisivos...

  17. Terapia antihipertensiva en enfermedad renal crónica

    Directory of Open Access Journals (Sweden)

    V. Rodrigo Tagle, Dr.

    2010-07-01

    Full Text Available La enfermedad renal crónica (ERC constituye una de las causas más frecuentes de hipertensión arterial (HTA secundaria. Existe una nueva clasificación de la ERC basada en la presencia de un daño estructural con o sin un deterioro de la velocidad de filtración glomerular (VFG. La prevalencia de la HTA varía principalmente según la magnitud de la VFG y la etiología de la enfermedad del parénquima renal. Los mecanismos hipertensógenos primordiales son: la retención de sodio e hipervolemia, y la activación del eje renina angiotensina aldosterona. La HTA es también un factor de progresión de la ERC. La terapia se basa en la restricción de sodio, diuréticos y bloqueadores del eje renina angiotensina. Consideraciones farmacológicas y clínicas son fundamentales para un efectivo uso de esta terapia. Los objetivos son la prevención cardiovascular y renal, a través de la obtención de determinados niveles de presión arterial (PA.

  18. Documento de consenso para la detección y manejo de la enfermedad renal crónica

    OpenAIRE

    2014-01-01

    La enfermedad renal crónica (ERC) es un importante problema de salud pública que puede afectar en sus diferentes estadios a cerca del 10% de la población española y que supone una elevada morbimortalidad, así como un importante consumo de recursos al Sistema Nacional de Salud. Diez sociedades científicas involucradas en el manejo del paciente renal nos hemos puesto de acuerdo para hacer una puesta al día del anterior documento de consenso sobre ERC de 2007. El presente es la edición abreviada...

  19. Fracaso renal agudo secundario a crisis de hipercalcemia muy severa por hiperparatiroidismo primario

    OpenAIRE

    Chacón, Andrea; Vilar, Ana; Arroyo, David; Sarró, Felipe; Craver Hospital, Lourdes; Ros López, Susana; López, Carolina; Castillo, Alex; Matias-Guiu, Xavier; Fernández i Giráldez, Elvira

    2015-01-01

    La crisis hipercalcémica es una forma de presentación poco frecuente del hiperparatiroidismo primario. Solo existen pequeñas series de casos reportadas en la literatura1 and 2. Se caracteriza por hipercalcemia severa, insuficiencia renal y alteración del estado de conciencia. Presentamos el caso de un paciente de 70 años, que ingresa por fracaso renal agudo desencadenado por una crisis de hipercalcemia en el contexto de un hiperparatiroidismo primario no conocido previamente. Se discute la co...

  20. Evaluación de la función renal en pacientes con enfermedad renal crónica (ERC) sin tratamiento sustitutorio, tras un programa de intervención nutricional (PIN): estudio aleatorizado

    OpenAIRE

    Beltrán López, Antonio

    2016-01-01

    La Enfermedad Renal Crónica (ERC) se define como la disminución de la función renal, donde se reduce el filtrado glomerular (FG) estimado < 60 ml/min/1,73m2 o como la presencia de daño renal de forma persistente durante al menos tres meses. La enfermedad renal crónica (ERC) es una patología progresiva que afecta cada vez más a la población, el daño renal aumenta con el paso del tiempo, siendo su resultado el tratamiento renal sustitutivo, trasplante o incluso la muerte, el gran problema es qu...

  1. MR imaging findings of renal infarction induced by renal artery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Woo; Kim, Suck; Kim, Yong Woo; Hu, Jin Sam; Choi, Sang Yoel; Moon, Tae Yong; Lee, Suck Hong; Kim, Byung Su; Lee, Chang Hun [Pusan National Univ., Pusan (Korea, Repulic of). Coll. of Medicine

    1998-02-01

    To assess the usefulness of diffusion-weighted imaging (DWI) in evaluating serial parenchymal changes in renal infarction induced by renal artery ligation, by comparing this with the conventional spin echo technique and correlating the results with the histopathological findings. In 22 rabbits, renal infarction was induced by ligation of the renal artery. Spin-echo T1-weighted imaging (T1WI), turbo spin-echo (TSE) T2-weighted imaging (T2WI), and DWI were performed, using a 1.5-T superconductive unit, at 30 minutes, 1 hour, 2,3,6, 12 and 24 hours, and 2, 3, 7 and 20 days after left renal artery ligation. Changes in signal intensity on T1WI, T2WI, and DWI were correlated with histopathologic findings. Diffusion-weighted imaging is useful for the detection of hyperacute renal infarction, and the apparent diffusion coefficient may provide additional information concerning its evolution. (author). 21 refs., 9 figs.

  2. Renal subcapsular haematoma: an unusual complication of renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; CHEN Shan-wen; ZHANG Hong-kun; WANG Shuo

    2011-01-01

    After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.

  3. Dopamins renale virkninger

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal

    1990-01-01

    Dopamine is an endogenic catecholamine which, in addition to being the direct precursor of noradrenaline, has also an effect on peripheral dopaminergic receptors. These are localized mainly in the heart, splanchnic nerves and the kidneys. Dopamine is produced in the kidneys and the renal metaboli...... dialysis unnecessary in a number of patients on account of increased diuresis and natriuresis. The effect of GFR and the significance for the prognosis are not known....

  4. Renal lithiasis and nutrition

    OpenAIRE

    Prieto Rafel M; Costa-Bauza Antonia; Grases Felix

    2006-01-01

    Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of...

  5. Evolución de la función renal en un grupo de pacientes con estenosis de la/s arteria renal sometidos a tratamiento revascularizador.

    OpenAIRE

    Marin Valencia, Adriana Lucia; Tovar, José Luis

    2013-01-01

    La estenosis de l'artèria renal és una causa freqüent d'hipertensió arterial secundària i insuficiència renal. Els estudis disponibles no han demostrat superioritat de la revascularització sobre el tractament mèdic, generant controvèrsia quant a l'elecció del tractament. En el servei de nefrología de l'Hospital Vall d'Hebron es va realitzar un estudi observacional en 47 pacients amb estenosis d'artèria renal sotmesos a revascularització. Al final del seguiment es va obtenir una estabilització...

  6. Nutrition and renal disease.

    Directory of Open Access Journals (Sweden)

    Iris de Castaño

    2009-11-01

    Full Text Available Kidney plays an important roll in body homeostasis through excretory, metabolic and endocrine functions. Kidneys filter fluids and solutes and reabsorbed water , electrolytes an minerals. Urine volume and solute excretion are adjusted to keep composition of the extracellular space, serum osmolarity and intravascular volume in constant balance. Kidneys also regulate acid base equilibrium, hormone metabolism and excretion and amino acid concentration. Vitamin D hydroxylation takes place in the kidney, this is the active form of this vitamin, which inhibits PTH. In addition they produce erythropoietin which control hemoglobin concentration in erythrocytes. When renal insufficiency develops, and glormerular filtration rate is between 50 to 75% of normal, this functions are decreased .When renal function is less than 10%, this functions ceased. In children small changes in water, solute, acid base, calcium and phosphorus can alter normal growth and development. If kidneys can not maintain internal equilibrium, specific nutrients should be used. Compensation should be done according to age, type or renal disease and level of glomerular filtration rate.

  7. Renal artery aneurysm mimicking renal calculus with hydronephrosis.

    Science.gov (United States)

    Chen, Shanwen; Meng, Hongzhou; Cao, Min; Shen, Baihua

    2013-06-01

    A 51-year-old woman was found to have a left renal calculus with hydronephrosis. She underwent unsuccessful extracorporeal shock wave lithotripsy, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In view of the unusual shape of the calculus and absence of abnormalities in urine sediment, preoperative computed tomography and renal angiography were performed, which instead showed a calcified left renal artery aneurysm. Subsequent efforts to perform an aneurysmectomy also failed, eventually necessitating left nephrectomy. This case illustrates the pitfalls in the diagnosis of a renal artery aneurysm, which is a relatively common condition that may have unusual presentations. Hence, it is suggested that the possibility of a renal artery aneurysm be considered in the differential diagnosis when one detects a renal calculus with an unusual appearance. In addition, we propose that 3-dimensional reconstruction computed tomography be performed before considering surgical options for such renal calculi to rule out the possibility of a renal artery aneurysm.

  8. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris

    2008-01-01

    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  9. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2003-12-15

    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  10. Cell therapy in renal and cardiovascular disease Terapia celular en enfermedades renales y cardiovasculares

    Directory of Open Access Journals (Sweden)

    Juan Manuel Senior Sánchez

    2006-01-01

    Full Text Available Although there have been important advances in the field of molecular biology, the mechanisms responsible for nephrogenesis and the factors that modulate the process of development, proliferation, growth, and maturation during fetal and adult life have not been thoroughly explained. Animals, including mammals, share the intrinsic ability to regenerate tissues and organs as an important biological defense mechanism. In the case of the kidney, after tissue damage secondary to injury, anatomical and functional recovery of integrity is achieved, accompanied by the activation of a complex, poorly understood process, leading to the replacement of damaged tubular cells by functional ones that reorganize tubular architecture. This regeneration and repair process is produced by somatic, exogenous, adult stem cells, and probably by intrinsic renal stem cells, that are responsible for maintaining renal homeostasis Aunque se han logrado grandes avances en el campo de la biología molecular, todavía no se han esclarecido completamente los mecanismos responsables de la organogénesis y los factores que modulan el proceso de desarrollo, proliferación, crecimiento y maduración celulares durante la vida fetal y adulta. Los animales comparten la capacidad de regenerar tejidos y órganos, como un mecanismo biológico importante de defensa. En el caso del riñón, luego del daño tisular secundario a una noxa, se produce recuperación anatómica y funcional de la integridad, acompañada por la activación de un proceso sofisticado, mal comprendido, que lleva al reemplazo de las células tubulares dañadas por otras funcionalmente normales que reorganizan la arquitectura tubular. Este fenómeno de recambio se produce gracias a la presencia de células madre adultas somáticas exógenas, responsables del proceso de mantenimiento de la homeostasis renal, y posiblemente por células renales intrínsecas.

  11. Haemostatic aspects of renal transplantation.

    Science.gov (United States)

    Sørensen, P J; Schmidt, E B; Knudsen, F; Nielsen, A H; Kristensen, S D; Dyerberg, J; Kornerup, H J

    1988-01-01

    Platelet function and protein C activity and antigen level was studied in 31 renal transplant recipients and 10 healthy controls. The patients were divided into three groups: (I) cyclosporin treated, (II) azathioprine treated, and (III) azathioprine treated patients with chronic rejection. The platelet function in the renal transplant patients was normal and there was no difference between groups I and II. The specific activity of protein C was decreased in patients after renal transplantation and decreasing protein C activity and progressive renal failure was found to be positively correlated in the azathioprine treated groups.

  12. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  13. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  14. Sporotrichosis in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Paulo Gewehr

    2013-01-01

    Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

  15. CT features of renal infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F

    2002-10-01

    Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction.

  16. Acción urológica frente a lesiones renales en el politraumatizado

    Directory of Open Access Journals (Sweden)

    Pedro Luis Pedroso Fernández

    2002-12-01

    Full Text Available Se aborda la problemática de los traumatismos renales tomando en consideración a diferentes autores, así como la experiencia personal del autor del artículo y se plantean pautas, no solamente para la acción inmediata sino también para el seguimiento posterior, con el objetivo de elevar la calidad asistencial en el politraumatizado

  17. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  18. Renal cirsoid arteriovenous malformation masquerading as neoplasia.

    Science.gov (United States)

    Silverthorn, K; George, D

    1988-12-01

    A woman with renal colic and microscopic hematuria had filling defects in the left renal collecting system detected on excretory urography. A nephrectomy, performed because of suspected malignancy, might have been averted by renal angiography.

  19. Tumor Seeding With Renal Cell Carcinoma After Renal Biopsy

    OpenAIRE

    M.F.B. Andersen; Norus, T.P.

    2016-01-01

    Tumor seeding following biopsy of renal cell carcinoma is extremely rare with an incidence of 1:10.000. In this paper two cases with multiple recurrent RRC metastasis in the biopsy tract following biopsy of renal tumor is presented and the current literature is shortly discussed.

  20. Renal blood flow in experimental septic acute renal failure

    NARCIS (Netherlands)

    Langenberg, C.; Wan, L.; Egi, M.; May, C. N.; Bellomo, R.

    2006-01-01

    Reduced renal blood flow (RBF) is considered central to the pathogenesis of septic acute renal failure (ARF). However, no controlled experimental studies have continuously assessed RBF during the development of severe septic ARF. We conducted a sequential animal study in seven female Merino sheep. F

  1. Renal vein oxygen saturation in renal artery stenosis

    DEFF Research Database (Denmark)

    Nielsen, K; Rehling, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Renal vein oxygen-saturation was measured in 56 patients with arterial hypertension and unilateral stenosis or occlusion of the renal artery. Oxygen-saturation in blood from the ischaemic kidney (84.4%, range 73-93%) was significantly higher than that from the 'normal' contralateral kidney (81...

  2. The renal scan in pregnant renal transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  3. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  4. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  5. Renal metabolism of calcitonin

    Energy Technology Data Exchange (ETDEWEB)

    Simmons, R.E.; Hjelle, J.T.; Mahoney, C.; Deftos, L.J.; Lisker, W.; Kato, P.; Rabkin, R.

    1988-04-01

    The kidneys account for approximately two-thirds of the metabolism of calcitonin, but relatively little is known regarding the details thereof. To further characterize this process, we examined the renal handling and metabolism of human calcitonin (hCT) by the isolated perfused rat kidney. We also studied the degradation of radiolabeled salmon calcitonin (sCT) by subcellular fractions prepared from isolated rabbit proximal tubules. The total renal (organ) clearance of immunoreactive hCT by the isolated kidney was 1.96 +/- 0.18 ml/min. This was independent of the perfusate total calcium concentration from 5.5 to 10.2 mg/dl. Total renal clearance exceeded the glomerular filtration rate (GFR, 0.68 +/- 0.05 ml/min), indicating filtration-independent removal. Urinary calcitonin clearance as a fraction of GFR averaged 2.6%. Gel filtration chromatography of medium from isolated kidneys perfused with /sup 125/I-labeled sCT showed the principal degradation products to be low molecular weight forms eluting with monoiodotyrosine. Intermediate size products were not detected. In the subcellular fractionation experiments, when carried out at pH 5.0, calcitonin hydrolysis exclusively followed the activities of the lysosomal enzyme N-acetyl-beta-glucosaminidase. Typically, at pH 7.5, 42% of total degradation occurred in the region of the brush-border enzyme alanyl aminopeptidase and 29% occurred in the region of the cytosolic enzyme phosphoglucomutase. Although 9% of the calcitonin-degrading activity was associated with basolateral membrane fractions, most of this activity could be accounted for by the presence of brush-border membranes.

  6. Citrato y litiasis renal

    Directory of Open Access Journals (Sweden)

    Elisa E. Del Valle

    2013-08-01

    Full Text Available El citrato es un potente inhibidor de la cristalización de sales de calcio. La hipocitraturia es una alteración bioquímica frecuente en la formación de cálculos de calcio en adultos y especialmente en niños. El pH ácido (sistémico, tubular e intracelular es el principal determinante de la excreción de citrato en la orina. Si bien la mayoría de los pacientes con litiasis renal presentan hipocitraturia idiopática, hay un número de causas para esta anormalidad que incluyen acidosis tubular renal distal, hipokalemia, dietas ricas en proteínas de origen animal y/o dietas bajas en álcalis y ciertas drogas, como la acetazolamida, topiramato, IECA y tiazidas. Las modificaciones dietéticas que benefician a estos pacientes incluyen: alta ingesta de líquidos y frutas, especialmente cítricos, restricción de sodio y proteínas, con consumo normal de calcio. El tratamiento con citrato de potasio es efectivo en pacientes con hipocitraturia primaria o secundaria y en aquellos desordenes en la acidificación, que provocan un pH urinario persistentemente ácido. Los efectos adversos son bajos y están referidos al tracto gastrointestinal. Si bien hay diferentes preparaciones de citrato (citrato de potasio, citrato de sodio, citrato de potasio-magnesio en nuestro país solo está disponible el citrato de potasio en polvo que es muy útil para corregir la hipocitraturia y el pH urinario bajo, y reducir marcadamente la recurrencia de la litiasis renal.

  7. Renal calculus disease.

    Science.gov (United States)

    Schulsinger, D A; Sosa, R E

    1998-03-01

    We have seen an explosion in technical innovations for the management of urolithiasis. Today, the endourologist possesses an assortment of minimally invasive tools to treat renal stones. Most patients receive fast, safe and effective treatment in the outpatient setting. Despite the many technical advances, however, anatomical malformations and complex stones still provide significant challenges in diagnosis, access to a targeted stone, fragmentation, and clearance of the resulting fragments. This review examines a variety of urinary stone presentations and treatment strategies for cost-effective management.

  8. [Pulmonary-renal syndrome].

    Science.gov (United States)

    Risso, Jorge A; Mazzocchi, Octavio; De All, Jorge; Gnocchi, César A

    2009-01-01

    The pulmonary-renal syndrome is defined as a combination of diffuse alveolar hemorrhage and glomerulonephritis. The coexistence of these two clinical conditions is due to diseases with different pathogenic mechanisms. Primary systemic vasculitis and Goodpasture syndrome are the most frequent etiologies. Systemic lupus erythematosus, connective tissue diseases, negative anti neutrophil cytoplasmic antibody vasculitis and those secondary to drugs are far less common causes. An early diagnosis based on clinical, radiologic, laboratory and histologic criteria enables early treatment, thus diminishing its high morbidity-mortality rate. Therapy is based on high doses of corticosteroids, immunosuppressants, tumor necrosis factor inhibitors and plasmapheresis.

  9. Role of Erythropoietin in Renal Anemia Therapy

    African Journals Online (AJOL)

    Keywords: Chronic renal failure, Renal anemia, Erythropoietin resistance. Tropical Journal of ... gastrointestinal reaction, which can increase the iron utilization and improve iron reserves, overcoming the reticuloendothelial system iron.

  10. Acute Renal Failure in the Neonate.

    Science.gov (United States)

    Khan, Owais A; Hageman, Joseph R; Clardy, Christopher

    2015-10-01

    Acute renal failure (ARF) in a neonate is a serious condition that impacts 8% to 24% of hospitalized neonates. There is a need for prompt evaluation and treatment to avoid additional complications. In this review, a neonate was found to have renal failure associated with renal vein thrombosis. There are varying etiologies of ARF. Causes of ARF are typically divided into three subsets: pre-renal, renal or intrinsic, and post-renal. Treatment of ARF varies based on the cause. Renal vein thrombosis is an interesting cause of renal or intrinsic ARF and can be serious, often leading to a need for dialysis.

  11. El nivel de la hormona paratiroidea (PTH y no el de fósforo sérico es predictor de la progresión de la enfermedad renal en pacientes mayores con enfermedad renal crónica avanzada

    Directory of Open Access Journals (Sweden)

    Néstor Gabriel Toapanta Gaibor

    2017-03-01

    Conclusiones: En nuestro grupo de pacientes de edad avanzada el deterioro de la función renal es muy lento, especialmente en los pacientes en estadio 5. La albuminuria y la PTH al inicio del seguimiento son factores pronósticos en la evolución de su función renal.

  12. Potencial del Agua del suelo

    Directory of Open Access Journals (Sweden)

    Bustamante Heliodoro

    1986-12-01

    Full Text Available La energía potencial del agua presenta diferencias de un punto del suelo a otro; esas diferencias son las que originan el movimiento del agua de acuerdo a la tendencia universal de la materia en el sentido de moverse de donde la energía potencial es mayor a donde dicha energía es menor. En el suelo el agua en consecuencia se mueve hacia donde su energía decrece hasta lograr su estado de equilibrio. Se desprende entonces que la cantidad de energía potencial absoluta contenida en el agua, no es importante por sí misma, sino por su relación con la energía en diferentes lugares dentro del suelo. El concepto Potencial de agua del suelo es un criterio para esta energía.

  13. Trasplante renal en bloque de donantes pediátricos

    Directory of Open Access Journals (Sweden)

    Pedro Méndez-Chacón

    2005-03-01

    Full Text Available Objetivo: Determinar la aceptación de ambos riñones de donantes pediátricos para utilizarlos como trasplante renal en bloque. Material y Métodos: La edad de los seis donantes varió entre 14 meses y 10 años. La causa de muerte fue el traumatismo encefalocraneano. La edad de los seis receptores osciló entre 15 y 48 años con peso menor de 50 kg. Ambos riñones fueron removidos en bloque. La técnica operatoria de los trasplantes consistió en la anastomosis término lateral del segmento aórtico y vena cava inferior del donante a los vasos ilíacos del receptor; ambos uréteres fueron anastomosados por separado a la vejiga. El implante fue localizado en una de las fosas ilíacas. Resultados: Los injertos en bloque funcionaron inmediatamente. Cuatro de los seis receptores cursaron con función renal adecuada a cuatro años promedio de seguimiento. Uno de los injertos en bloque se perdió por rechazo vascular severo y otro por indisciplina a la medicación inmunosupresora. Las series ecográficas de los riñones revelaron incremento de tamaño hasta en 55% de su dimensión original al tercer mes del trasplante. Conclusión: Se recomienda que los riñones procedentes de donantes menores de tres años de edad sean utilizados como trasplante en bloque y riñones de donantes mayores de tres años como trasplante renal simple. Se demuestra que es posible trasplantar exitosamente riñones en bloque de niños muy pequeños en receptores mayores, según experiencia inédita en nuestro medio.

  14. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  15. Ultrasonography in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Buturovic-Ponikvar, Jadranka E-mail: jadranka.buturovic@mf.uni-lj.si; Visnar-Perovic, Alenka

    2003-05-01

    Many chronic renal diseases lead to the final common state of decrease in renal size, parenchymal atrophy, sclerosis and fibrosis. The ultrasound image show a smaller kidney, thinning of the parenchyma and its hyperechogenicity (reflecting sclerosis and fibrosis). The frequency of renal cysts increases with the progression of the disease. Ultrasound generally does not allow for the exact diagnosis of an underlying chronic disease (renal biopsy is usually required), but it can help to determine an irreversible disease, assess prognosis and avoid unnecessary diagnostic or therapeutic procedures. The main exception in which the ultrasound image does not show a smaller kidney with parenchymal atrophy is diabetic nephropathy, the leading cause of chronic and end-stage renal failure in developed countries in recent years. In this case, both renal size and parenchymal thickness are preserved until end-stage renal failure. Doppler study of intrarenal vessels can provide additional information about microvascular and parenchymal lesions, which is helpful in deciding for or against therapeutic intervention and timely planning for optimal renal replacement therapy option.

  16. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Pippias, Maria; Stel, Vianda S; Abad Diez, José Maria

    2015-01-01

    BACKGROUND: This article summarizes the 2012 European Renal Association-European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). METHODS: Data provided by 45 national or regional renal r...

  17. Observación de la reacción tisular del precinto comercial de poliamida empleado como método de ligadura en pedículo renal y ute rino en conejos Observation of tissular reaction of commercial polyamide seal used as a method of bond in renal and uterine pedicle in rabbits

    Directory of Open Access Journals (Sweden)

    R Rovere

    2007-01-01

    Full Text Available La ligadura constituye el método más corriente para el control local y permanente de las hemorragias. Ha sido usada por más de 4.000 años a través del empleo de distintos materiales, desde el lino, la seda, intestino de oveja o fibras de tendón, hasta los actuales materiales sintéticos, absorbibles (polioglactin 910 y polidioxanona o no absorbibles (polipropileno, poliéster y poliamida. Las grapas y clips vasculares pueden también ser empleados para la hemostasia permanente, los cuales permiten una buena oclusión de los pedículos vasculares, pero lamentablemente su elevado costo limita la utilización en la cirugía veterinaria. Se evaluó la respuesta tisular provocada en los pedículos vasculares sometidos a ligadura con precintos de poliamida en conejos. En seis animales machos se realizó la nefrectomía y se ligó el pedículo con un precinto de poliamida; en los seis restantes se procedió a la ovario-histerectomía con la colocación de un precinto a nivel cervical. La hemostasia provista por el implante se obtiene en forma inmediata y segura tras su aplicación. Las observaciones macroscópicas y los resultados microscópicos en los animales intervenidos muestran que la reacción tisular fue mínima. En los estudios histopatológicos no se observaron necrosis tisular ni un importante grado de inflamación, como tampoco signos de infección. El precinto comercial de poliamida se presenta como una técnica de fácil aplicación, segura, con mínima reacción tisular y de bajo costo para ser empleado en la ligadura de pedículos vasculares en las intervenciones quirúrgicas en la práctica veterinaria.Ligation is the most common localized and permanent method for the control of haemorrhages. It has been used for more than 4000 years through the employment of different materials, from linen, silk, sheep intestine or tendon fibers until the current use of synthetic materials, absorbables (polyglactine and polydioxanone or non

  18. Successful renal transplantation during pregnancy.

    Science.gov (United States)

    Hold, Phoebe M; Wong, Christopher F; Dhanda, Raman K; Walkinshaw, Steve A; Bakran, Ali

    2005-09-01

    Little is known about the implications of performing a renal transplant on a patient who is already pregnant. This case study reports a successful outcome of pregnancy, diagnosed coincidentally following renal transplantation at 13 weeks gestation. The recipient was a 23-year-old woman with chronic kidney disease who received a live-related renal transplant from her father. Pregnancy was discovered at routine ultrasound scanning of the renal allograft at 5 days posttransplant and estimated at 13 weeks gestation. She received ciclosporin monotherapy as immunosuppression throughout the pregnancy, and was given valacyclovir as prophylaxis against cytomegalovirus (CMV) infection. Renal function remained stable throughout the pregnancy, which progressed normally, resulting in the vaginal delivery of a healthy, liveborn male infant at 37 weeks gestation. This case study demonstrates that transplantation during pregnancy can have a successful outcome.

  19. Characterization of complex renal cysts

    DEFF Research Database (Denmark)

    Graumann, Ole; Osther, Susanne Sloth; Osther, Palle Jörn Sloth

    2010-01-01

    Abstract Objective. Complex renal cysts represent a major clinical problem, since it is often difficult to exclude malignancy. The Bosniak classification system, based on computed tomography (CT), is widely used to categorize cystic renal lesions. The aim of this study was to evaluate critically ...... of this "new" classification strategy is, however, still missing. Data on other imaging modalities are too limited for conclusions to be drawn.......Abstract Objective. Complex renal cysts represent a major clinical problem, since it is often difficult to exclude malignancy. The Bosniak classification system, based on computed tomography (CT), is widely used to categorize cystic renal lesions. The aim of this study was to evaluate critically...... available data on the Bosniak classification. Material and methods. All publications from an Entrez Pubmed search were reviewed, focusing on clinical applicability and the use of imaging modalities other than CT to categorize complex renal cysts. Results. Fifteen retrospective studies were found. Most...

  20. Ciprofloxacin-Induced Renal Failure

    Directory of Open Access Journals (Sweden)

    Audra Fuller

    2015-10-01

    Full Text Available Acute renal failure (ARF is a common diagnosis in hospitalized patients, particularly in intensive care units (ICU. Determining the cause and contributing factors associated with ARF is crucial during treatment. The etiology is complex, and several factors often contribute to its development. Medications can cause acute tubular necrosis, acute interstitial nephritis, and crystal-induced or post-obstructive nephropathy. There have been several case reports of ARF secondary to fluoroquinolones. Here we report the development of acute renal failure within a few days of initiating oral ciprofloxacin therapy and briefly describe the different types of renal failure secondary to fluoroquinolone administration. Clinical studies demonstrate that using fluoroquinolones with other potentially nephrotoxic medications requires monitoring of renal function to limit the renal toxicity with these medications. Also, the risk-benefit profile of patients requiring fluoroquinolones should be considered.

  1. Development of the renal arterioles.

    Science.gov (United States)

    Sequeira Lopez, Maria Luisa S; Gomez, R Ariel

    2011-12-01

    The kidney is a highly vascularized organ that normally receives a fifth of the cardiac output. The unique spatial arrangement of the kidney vasculature with each nephron is crucial for the regulation of renal blood flow, GFR, urine concentration, and other specialized kidney functions. Thus, the proper and timely assembly of kidney vessels with their respective nephrons is a crucial morphogenetic event leading to the formation of a functioning kidney necessary for independent extrauterine life. Mechanisms that govern the development of the kidney vasculature are poorly understood. In this review, we discuss the anatomical development, embryological origin, lineage relationships, and key regulators of the kidney arterioles and postglomerular circulation. Because renal disease is associated with deterioration of the kidney microvasculature and/or the reenactment of embryonic pathways, understanding the morphogenetic events and processes that maintain the renal vasculature may open new avenues for the preservation of renal structure and function and prevent the progression of renal disease.

  2. Hypertension in Renal Allograft Recipients

    Directory of Open Access Journals (Sweden)

    Waiser Johannes

    1999-01-01

    Full Text Available Hypertension is a frequent complication after renal transplantation. It contributes to the considerable cardiovascular morbidity and mortality in renal allograft recipients. Additionally, it has a major impact on long-term allograft survival. The pathogenesis of post transplant hypertension is multifactorial. Besides common risk factors, renal allograft recipients accumulate specific risk factors related to the original renal disease, renal transplantation per se and the immunosuppressive regimen. Chronic allograft dysfunction is the main cause of post transplant hypertension. The introduction of calcineurin inhibitors, such as cyclosporine, has increased the prevalence of hypertension. At present, the growing manual of diagnostic and therapeutic tools enables us to adapt better antihypertensive therapy. Tight monitoring, individualization of the immunosuppressive protocol, inclusion of non-pharmacological measures and aggressive antihypertensive treatment should help to minimize the negative implications of post transplant hypertension. Probably, this goal can only be reached by "normalization" of systolic and diastolic blood pressure to below 135/85 mmHg.

  3. Current status of renal biopsy for small renal masses.

    Science.gov (United States)

    Ha, Seung Beom; Kwak, Cheol

    2014-09-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.

  4. Current Status of Renal Biopsy for Small Renal Masses

    Science.gov (United States)

    Ha, Seung Beom

    2014-01-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered. PMID:25237457

  5. Targeting Strategies for Renal Cell Carcinoma: From Renal Cancer Cells to Renal Cancer Stem Cells.

    Science.gov (United States)

    Yuan, Zhi-Xiang; Mo, Jingxin; Zhao, Guixian; Shu, Gang; Fu, Hua-Lin; Zhao, Wei

    2016-01-01

    Renal cell carcinoma (RCC) is a common form of urologic tumor that originates from the highly heterogeneous epithelium of renal tubules. Over the last decade, targeting therapies to renal cancer cells have transformed clinical care for RCC. Recently, it was proposed that renal cancer stem cells (CSCs) isolated from renal carcinomas were responsible for driving tumor growth and resistance to conventional chemotherapy and radiotherapy, according to the theory of CSCs; this has provided the rationale for therapies targeting this aggressive cell population. Precise identification of renal CSC populations and the complete cell hierarchy will accurately inform characterization of disease subtypes. This will ultimately contribute to more personalized and targeted therapies. Here, we summarize potential targeting strategies for renal cancer cells and renal CSCs, including tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors (mTOR), interleukins, CSC marker inhibitors, bone morphogenetic protein-2, antibody drug conjugates, and nanomedicine. In conclusion, targeting therapies for RCC represent new directions for exploration and clinical investigation and they plant a seed of hope for advanced clinical care.

  6. Documento de consenso para la detección y manejo de la enfermedad renal crónica

    Directory of Open Access Journals (Sweden)

    Alberto Martínez-Castelao

    2014-11-01

    Full Text Available La enfermedad renal crónica (ERC es un importante problema de salud pública que puede afectar en sus diferentes estadios a cerca del 10% de la población española y que supone una elevada morbimortalidad, así como un importante consumo de recursos al Sistema Nacional de Salud. Diez sociedades científicas involucradas en el manejo del paciente renal nos hemos puesto de acuerdo para hacer una puesta al día del anterior documento de consenso sobre ERC de 2007. El presente es la edición abreviada del documento general extenso, que puede ser consultado en las páginas Web de cada una de las sociedades firmantes. Contiene los siguientes aspectos: definición, epidemiología y factores de riesgo de la ERC; criterios de diagnóstico, evaluación y estadificación de la ERC, albuminuria y estimación del filtrado glomerular; concepto y factores de progresión; criterios de derivación a nefrología; seguimiento del paciente, actitudes y objetivos por especialidad; prevención de la nefrotoxicidad; detección del daño cardiovascular; actitudes, estilo de vida y tratamiento: manejo de la hipertensión arterial, dislipidemia, hiperglucemia, tabaquismo, obesidad, hiperuricemia, anemia, alteraciones del metabolismo mineral y óseo; seguimiento coordinado por atención primaria-otras especialidades-nefrología; manejo del paciente en tratamiento renal sustitutivo, hemodiálisis, diálisis peritoneal y trasplante renal; tratamiento paliativo de la uremia terminal. Esperamos que sirva de gran ayuda en el manejo multidisciplinar del paciente con ERC, a la vista de las recomendaciones más actualizadas.

  7. Spontaneous renal artery dissection complicating with renal infarction.

    Science.gov (United States)

    Tsai, Tsung-Han; Su, Jung-Tsung; Hu, Sung-Yuan; Chao, Chih-Chung; Tsan, Yu-Tse; Lin, Tzu-Chieh

    2010-12-01

    Spontaneous renal artery dissection (SRAD) is a rare entity. We reported a 30-year-old healthy man presenting with sudden onset of left flank pain. Abdominal plain film and sonography were unremarkable. The contrast-enhanced abdominal computed tomographic (CT) scan demonstrated a dissecting intimal flap of the left distal renal artery (RA) complicating infarction. Selective angiography of the renal artery disclosed a long dissection of left distal RA with a patent true lumen and occlusion of left accessory RA. Conservative treatment with control of blood pressure and antiplatelet agent was prescribed. The patient was discharged with an uneventful condition on day 5.

  8. Renal histology and immunopathology in distal renal tubular acidosis.

    Science.gov (United States)

    Feest, T G; Lockwood, C M; Morley, A R; Uff, J S

    1978-11-01

    Renal biospy studies are reported from 10 patients with distal renal tubular acidosis (DRTA). On the biopsies from 6 patients who had associated immunological abnormalities immunofluorescent studies for immunoglobulins, complement, and fibrin were performed. Interstitial cellular infiltration and fibrosis were common findings in patients with and without immunological abnormalities, and were usually associated with nephrocalcinosis and/or recurrent urinary infection. No immune deposits were demonstrated in association with the renal tubules. This study shows that DRTA in immunologically abnormal patients is not caused by tubular deposition of antibody or immune complexes. The possibility of cell mediated immune damage is discussed.

  9. Potencial del agua del suelo

    OpenAIRE

    Bustamante Heliodoro

    2012-01-01

    La energía potencial del agua presenta diferencias de un punto del suelo a otro; esas diferencias son las que originan el movimiento del agua de acuerdo a la tendencia universal de la materia en el sentido de moverse de donde la energía potencial es mayor a donde dicha energía es menor. En el suelo el agua en consecuencia se mueve hacia donde su energía decrece hasta lograr su estado de equilibrio. Se desprende entonces que la cantidad de energía potencial absoluta contenida en el agua, no es...

  10. Factores asociados a insuficiencia renal postoperatoria en cirugía de revascularización miocárdica

    Directory of Open Access Journals (Sweden)

    Albert F. Guerrero B.

    2016-05-01

    Conclusiones: En quienes se realizó revascularización miocárdica los factores asociados a la presentación de insuficiencia renal postoperatoria fueron comorbilidades que se relacionaron con daño renal progresivo dentro y fuera del contexto de la cirugía. Esto implica que las estrategias para minimizar este evento estarán enfocadas a identificar de manera oportuna a estos pacientes y proporcionarles nefroprotección adecuada.

  11. Insuficiencia renal aguda en pacientes de la Unidad de Cuidados Intensivos, Hospital Regional de Cuilapa, Santa Rosa, Guatemala

    Directory of Open Access Journals (Sweden)

    Ronald J. Ajcalon

    2017-03-01

    Full Text Available La insuficiencia renal aguda, es una condición común en la Unidad de Cuidados Intensivos de Adultos (UCIA y probablemente una consecuencia de la enfermedad crítica que se asocia a resultados clínicos adversos, altos costos y una mortalidad de más del 50%, sobre todo si se requiere tratamiento de reemplazo renal. El objetivo fue determinar la incidencia de insuficiencia renal aguda en pacientes ingresados a la UCIA. El estudio fue prospectivo, longitudinal, observacional, en 101 pacientes ingresados en la UCIA del Hospital Regional de Cuilapa. Se diagnosticaron 101 pacientes durante el periodo de estudio con insuficiencia renal aguda represento el 27.4% del total de pacientes internados (368 en el servicio en un año. La incidencia de mortalidad en pacientes que requieren terapia de reemplazo renal y se encuentran en ventilación mecánica es del 100%. Del total de pacientes estudiados, según la escala Akin, se encontró que el 49.5% de los pacientes correspondían a grado II, aunque el grado I también fue frecuente (29%, y que el 22 % de los pacientes correspondían a grado III. La patología que mayormente se asoció al desarrollo de insuficiencia renal aguda fue sepsis grave con un 31%, seguido de pacientes sometidos a cirugía mayor e hipovolemia con el 21 y 18% respectivamente. Se halló una incidencia aumentada de insuficiencia renal aguda comparado con estadísticas internacionales, cuya etiología fue mayormente causada por procesos sépticos.

  12. Renal involvement in antiphospholipid syndrome.

    Science.gov (United States)

    Sciascia, Savino; Cuadrado, Maria José; Khamashta, Munther; Roccatello, Dario

    2014-05-01

    Antiphospholipid syndrome (APS) is an autoimmune disease defined by the presence of arterial or venous thrombotic events and/or pregnancy morbidity in patients who test positive for antiphospholipid antibodies (aPLs). APS can be isolated (known as primary APS) or associated with other autoimmune diseases, such as systemic lupus erythematosus (SLE; known as secondary APS). The kidney is a major target organ in APS and renal thrombosis can occur at any level within the vasculature of the kidney (renal arteries, intrarenal arteries, glomerular capillaries and renal veins); events reflect the site and size of the involved vessels. Histological findings vary widely, including ischaemic glomeruli and thrombotic lesions without glomerular or arterial immune deposits on immunofluorescence. Renal prognosis is affected by the presence of aPLs in patients with lupus nephritis and can be poor. In patients with SLE and aPLs, biopsy should be performed because inflammatory and thrombotic lesions require different therapeutic approaches. Renal involvement in patients with definite APS is treated by anticoagulation with long-term warfarin. The range of renal manifestations associated with APS is broadening and, therefore, aPLs have increasing relevance in end-stage renal disease, transplantation and pregnancy.

  13. Renal Toxicities of Targeted Therapies.

    Science.gov (United States)

    Abbas, Anum; Mirza, Mohsin M; Ganti, Apar Kishor; Tendulkar, Ketki

    2015-12-01

    With the incorporation of targeted therapies in routine cancer therapy, it is imperative that the array of toxicities associated with these agents be well-recognized and managed, especially since these toxicities are distinct from those seen with conventional cytotoxic agents. This review will focus on these renal toxicities from commonly used targeted agents. This review discusses the mechanisms of these side effects and management strategies. Anti-vascular endothelial growth factor (VEGF) agents including the monoclonal antibody bevacizumab, aflibercept (VEGF trap), and anti-VEGF receptor (VEGFR) tyrosine kinase inhibitors (TKIs) all cause hypertension, whereas some of them result in proteinuria. Monoclonal antibodies against the human epidermal growth factor receptor (HER) family of receptors, such as cetuximab and panitumumab, cause electrolyte imbalances including hypomagnesemia and hypokalemia due to the direct nephrotoxic effect of the drug on renal tubules. Cetuximab may also result in renal tubular acidosis. The TKIs, imatinib and dasatinib, can result in acute or chronic renal failure. Rituximab, an anti-CD20 monoclonal antibody, can cause acute renal failure following initiation of therapy because of the onset of acute tumor lysis syndrome. Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, can result in proteinuria. Discerning the renal adverse effects resulting from these agents is essential for safe treatment strategies, particularly in those with pre-existing renal disease.

  14. Malignancy and chronic renal failure.

    Science.gov (United States)

    Peces, Ramon

    2003-01-01

    Increased incidence of cancer at various sites is observed in patients with end-stage renal disease (ESRD). Certain malignant diseases, such as lymphomas and carcinomas of the kidney, prostate, liver and uterus, show an enhanced prevalence compared with the general population. In particular, renal cell carcinoma (RCC) shows an excess incidence in ESRD patients. A multitude of factors, directly or indirectly associated with the renal disease and the treatment regimens, may contribute to the increased tumor formation in these patients. Patients undergoing renal replacement therapy (RRT) are prone to develop acquired cystic kidney disease (ACKD), which may subsequently lead to the development of RCC. In pre-dialysis patients with coexistent renal disease, as in dialysis and transplant patients, the presence of ACKD may predispose to RCC. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse, are additional risk factors for malignancy. Malignancy following renal transplantation is an important medical problem during the follow-up. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). Another important confounder for risk of malignancy after renal transplantation is the type of immunosuppression. The type of malignancy is different in various countries and dependent on genetic and environmental factors. Finally, previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and post-malignancy screening.

  15. Wegener's granulomatosis with renal involvement: patient survival and correlations between initial renal function, renal histology, therapy and renal outcome.

    Science.gov (United States)

    Andrassy, K; Erb, A; Koderisch, J; Waldherr, R; Ritz, E

    1991-04-01

    Patient survival and renal outcome were followed in 25 patients with biopsy confirmed Wegener's granulomatosis and renal involvement. Fourteen out of 25 patients required dialysis on admission, 11/25 patients did not. All patients were treated with a novel protocol comprising methylprednisolone and cyclophosphamide. The median follow-up observation was 36 months (12-113 months). With the exception of 1 patient (who died from causes not related to Wegener's granulomatosis) all patients are alive. Among the patients initially requiring dialysis (n = 14) 4 are in terminal renal failure after 0, 7, 21 and 38 months respectively. In the nondialysis group (n = 11) only 1 patient subsequently required chronic dialysis 30 months after clinical admission. Renal failure was due to non-compliance with immunosuppressive therapy in at least 2 patients. Percentage of obsolescent glomeruli and the degree of tubulointerstitial lesions, but not active glomerular lesions (crescents, necroses) predicted renal outcome. The major cause of renal functional impairment was relapse of Wegener's granulomatosis usually within 2 years after clinical remission. Therefore prolonged treatment with cyclophosphamide for at least 2 years after clinical remission is recommended. Two patients with initially negative immunohistology had a second renal biopsy which revealed de novo appearance of mesangial IgA deposits.

  16. Evaluación de la calidad de vida de pacientes de insuficiencia renal crónica en diálisis renal

    OpenAIRE

    Cunha Franco, L.; Teles Zatta, L.; Vasconcelos, P.; Alves Barbosa, M.; De Oliveira Rosa, LF.

    2011-01-01

    Objetivo: Evaluar la calidad de vida de las personas con Insuficiencia Renal Crónica (IRC) en hemodiálisis, a través de KDQOL TM-SF. Métodos: Estudio descriptivo, analítico y cuantitativo, utilizando como instrumento para recolectar datos el KDQOL- SF TM, en una muestra de 32 pacientes con insuficiencia renal crónica. Las respuestas a las preguntas del cuestionario se distribuyeron en una escala dicotómica y en escalas tipo Likert, con puntuación que va desde diez hasta tres. Resultad...

  17. Unilateral renal agenesis: case review of ambulatory pediatric nephrology clinics in Cali

    Directory of Open Access Journals (Sweden)

    Consuelo Restrepo de Rovetto

    2010-09-01

    Full Text Available Introduction: Unilateral renal agenesis is a frequent renal malformation with incidence of 1 per 1000 live born children. There are no statistics nor protocols to manage and follow-up these patients. Usually asymptomatic, it can be early detected by prenatal ultrasound, allowing opportune detection and adequate follow up. The goal is to describe main features found in children with renal agenesis at four ambulatory pediatric nephrology clinics in Cali, Colombia: Hospital Universitario del Valle (HUV, Club Noel Children’s hospital and the private practice of two pediatric nephrologists. Methods: This is a retrospective descriptive study in a series of cases with congenital renal agenesis diagnosed between January, 1995 and December 2007, of patients under 18 years of age and based on a review of clinical records. Results: 43 patients were found, 51.2% males, 88% from the department of Valle del Cauca. Prenatal diagnoses were conducted in only 21% of these patients; agenesis was right in 48.8% and left in 51.2%. In 46.5%, association with other pathologies was found: occult spinal bifida, congenital scoliosis, and Klippel-Feil sequence. Compensatory renal hypertrophy was reported in 39.5% of the patients, 42% had episodes of urinary tract infection, 31% vesicoureteral reflux and 10% proteinuria. Four male patients (9.3% developed renal failure. The average follow-up was 6.6 years. Conclusions: Prenatal diagnose was not very frequent in our set of cases. Urinary tract infection and vesicoureteral reflux were common, increasing the risk of renal deterioration. Prolonged follow up is suggested, with unified protocols to prevent renal failure.

  18. Unilateral renal agenesis: case review of ambulatory pediatric nephrology clinics in Cali

    Directory of Open Access Journals (Sweden)

    Consuelo Restrepo de Rovetto

    2010-03-01

    Full Text Available Introduction: Unilateral renal agenesis is a frequent renal malformation with incidence of 1 per 1000 live born children. There are no statistics nor protocols to manage and follow-up these patients. Usually asymptomatic, it can be early detected by prenatal ultrasound, allowing opportune detection and adequate follow up. The goal is to describe main features found in children with renal agenesis at four ambulatory pediatric nephrology clinics in Cali, Colombia: Hospital Universitario del Valle (HUV, Club Noel Children’s hospital and the private practice of two pediatric nephrologists.Methods: This is a retrospective descriptive study in a series of cases with congenital renal agenesis diagnosed between January, 1995 and December 2007, of patients under 18 years of age and based on a review of clinical records.Results: 43 patients were found, 51.2% males, 88% from the department of Valle del Cauca. Prenatal diagnoses were conducted in only 21% of these patients; agenesis was right in 48.8% and left in 51.2%. In 46.5%, association with other pathologies was found: occult spinal bifida, congenital scoliosis, and Klippel-Feil sequence. Compensatory renal hypertrophy was reported in 39.5% of the patients, 42% had episodes of urinary tract infection, 31% vesicoureteral reflux and 10% proteinuria. Four male patients (9.3% developed renal failure. The average follow-up was 6.6 years.Conclusions: Prenatal diagnose was not very frequent in our set of cases. Urinary tract infection and vesicoureteral reflux were common, increasing the risk of renal deterioration. Prolonged follow up is suggested, with unified protocols to prevent renal failure.

  19. Hyperparathyroidism of Renal Disease

    Science.gov (United States)

    Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

    2016-01-01

    Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1.73 m2). Since the 1990s, improving medical management with vitamin D analogs, phosphate binders, and calcimimetic drugs has expanded the treatment options for patients with rHPT, but some patients still require a parathyroidectomy to mitigate the sequelae of this challenging disease. PMID:27479950

  20. Citrato y litiasis renal

    OpenAIRE

    2013-01-01

    El citrato es un potente inhibidor de la cristalización de sales de calcio. La hipocitraturia es una alteración bioquímica frecuente en la formación de cálculos de calcio en adultos y especialmente en niños. El pH ácido (sistémico, tubular e intracelular) es el principal determinante de la excreción de citrato en la orina. Si bien la mayoría de los pacientes con litiasis renal presentan hipocitraturia idiopática, hay un número de causas para esta anormalidad que incluyen acidosis tubular rena...

  1. Angio-embolization of a renal pseudoaneurysm complicating a percutaneous renal biopsy: a case report.

    Science.gov (United States)

    Rafik, Hicham; Azizi, Mounia; El Kabbaj, Driss; Benyahia, Mohammed

    2015-01-01

    We report the treatment of a bleeding renal pseudoaneurysm by angio-embolization. A 21 years old woman developed macroscopic haematuria following renal biopsy. Renal angio-scan showed a 1.4 cm renal pseudoaneurysm in the left kidney. The presence of pseudoaneurysm was confirmed by selective renal angiography. Successful embolization was performed using gelatine sponge particles.

  2. Successful management of neonatal renal venous thrombosis.

    Science.gov (United States)

    Piscitelli, Antonio; Galiano, Rossella; Piccolo, Vincenzo; Concolino, Daniela; Strisciuglio, Pietro

    2014-10-01

    Renal vein thrombosis is the most common vascular condition involving the newborn kidney and it can result in severe renal damage. We report a newborn with renal vein thrombosis treated with continuous infusion of unfractionated heparin who had normal total renal function after 3 years of follow up, despite reduction of the functional contribution of the affected kidney.

  3. Diagnosis and treatment of renal artery stenosis.

    NARCIS (Netherlands)

    Plouin, P.F.; Bax, L.

    2010-01-01

    A reduction in the diameter of the renal arteries can lead to hypertension, renal dysfunction and/or pulmonary edema. About 90% of patients with renal artery stenosis have atherosclerosis, and 10% have fibromuscular dysplasia. Atherosclerotic renal artery stenosis is a common condition that typicall

  4. Renal acidification defects in medullary sponge kidney

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1988-01-01

    Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X-ray examination. Nine...... of renal calculi in medullary sponge kidney, have considerable therapeutic implications....

  5. Renal acidification defects in medullary sponge kidney

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1988-01-01

    patients had some form of renal acidification defect; 8 had the distal type of renal tubular acidosis, 2 the complete and 6 the incomplete form. One patient had proximal renal tubular acidosis. These findings, which suggest that renal acidification defects play an important role in the pathogenesis...

  6. Renal allograft rejection. Unusual scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Desai, A.G.; Park, C.H.

    1986-11-01

    During sequential renal imagining for evaluation of clinically suspected rejection, focal areas of functioning renal tissue were seen in two cases of renal transplant in the midst of severe and irreversible renal allograft rejection. A probable explanation for this histopathologically confirmed and previously unreported finding is discussed.

  7. FISIOPATOLOGÍA DE LA INSUFICIENCIA RENAL AGUDA.NUEVAS CLAVES PARA UN VIEJO DILEMA

    Directory of Open Access Journals (Sweden)

    Carlos G. Musso

    2008-01-01

    Full Text Available Insuficiencia renal aguda (IRA es el término con el cual se designa a la reducción abrupta y sostenida del filtrado glomerular, de la cual resulta la retención de productos de desecho del metabolismo corporal. Clásicamente se dividen los mecanismos de la IRA en pre-renal, parenquimatoso, y obstructivo.En el caso de la IRA parenquimatosa, ésta pareciera ser el resultado de la sumatoria de las múltiples variables: necrosis y apoptosis tubular, alteración de la barrera de filtración, retrodifusión del filtrado glomerular, vasoconstricción intra-renal, contracción del mesangio, obstrucción intratubular, inflamación intersticial, activación de enzimas proteolíticas, entre otros.Por este motivo se postula que sólo una mirada de perspectiva multicausal de este síndrome pareciera ser la estrategia adecuada para conseguir su entendimiento cabal y tendiente a la resolución del mismo.

  8. Renal Cancer in the Elderly.

    Science.gov (United States)

    González León, Tania; Morera Pérez, Maricela

    2016-01-01

    The increase of the aging population corresponds with the rise of renal cancer in elderly patients. The distinction between functional and chronological age, quality of life, and survival estimate are important issues, among others, that should be considered in the management of renal cancer in elderly patients. We made this review with the purpose of synthesizing the most updated criteria regarding indications and outcomes of the different therapeutic options in the management of elderly patients with renal cancer, beginning from the physiologic considerations that characterize them, their capacity to tolerate different therapeutic possibilities, and the prognosis of the patients' risks and comorbidity assessment.

  9. Renal rickets-practical approach

    Directory of Open Access Journals (Sweden)

    Manisha Sahay

    2013-01-01

    Full Text Available Rickets/osteomalacia is an important problem in a tropical country. Many cases are due to poor vitamin D intake or calcium deficient diets and can be corrected by administration of calcium and vitamin D. However, some cases are refractory to vitamin D therapy and are related to renal defects. These include rickets of renal tubular acidosis (RTA, hypophosphatemic rickets, and vitamin D dependent rickets (VDDR. The latter is due to impaired action of 1α-hydroxylase in renal tubule. These varieties need proper diagnosis and specific treatment.

  10. Blunt Renal Trauma in a Pre-Existing Renal Lesion

    Directory of Open Access Journals (Sweden)

    G.V. Soundra Pandyan

    2006-01-01

    Full Text Available A 70-year-old male presented with direct trauma to his loin with gross hematuria, as an isolated case of blunt renal trauma (BRT due to a traffic accident. A pre-existing renal lesion (PERL was strongly suspected by his past history of gross macroscopic hematuria and monotrauma to the kidney without other associated injuries. Spiral CT scan with contrast and a retrograde pyelogram (RGP confirmed an occult complex renal cyst. The gold standard of CT diagnosis in this situation is stressed. Computed tomography is particularly useful in evaluating traumatic injuries to kidneys with pre-existing abnormalities. The decision on the initial course of conservative management, ureteral retrograde stenting to drain extravasation, and its final outcome are discussed. Radical nephroureterectomy was carried out by a transperitoneal approach with an early vascular control of the renal pedicle. A brief review of recent literature has been undertaken.

  11. Management of renal disease in pregnancy.

    Science.gov (United States)

    Podymow, Tiina; August, Phyllis; Akbari, Ayub

    2010-06-01

    Although renal disease in pregnancy is uncommon, it poses considerable risk to maternal and fetal health. This article discusses renal physiology and assessment of renal function in pregnancy and the effect of pregnancy on renal disease in patients with diabetes, lupus, chronic glomerulonephritis, polycystic kidney disease, and chronic pyelonephritis. Renal diseases occasionally present for the first time in pregnancy, and diagnoses of glomerulonephritis, acute tubular necrosis, hemolytic uremic syndrome, and acute fatty liver of pregnancy are described. Finally, therapy of end-stage renal disease in pregnancy, dialysis, and renal transplantation are reviewed.

  12. del alcoholismo

    Directory of Open Access Journals (Sweden)

    Rodrigo Arias Duque

    2005-01-01

    Full Text Available Desde el punto de vista farmacológico, es importante comprender qué es el alcohol y cómo actúa en el organismo. No existe una causa simple, sino una interacción complicada de factores neuroquímicos, fisiológicos, psicológicos y sociales que originan y desarrollan esta grave enfermedad fármaco-dependiente. La acción psicofisiológica y farmacodinámica del alcohol es fundamentalmente depresiva, por la reducción de la transmisión sináptica en el sistema nervioso humano. Es un hecho conocido que el consumo excesivo de alcohol causa una disfunción aguda y crónica del cerebro, produciendo trastornos en el sistema nervioso central, presentando alteraciones en la memoria y en las funciones intelectuales como cálculo, comprensión y aprendizaje. A nivel hepático tiene lugar, en su mayoría, el metabolismo del alcohol, produciéndose un hígado graso alcohólico, aumentando el tamaño, terminando en necrosis e inflamación grave del hígado; esto se llama hepatitis alcohólica, y si se sigue consumiendo alcohol se desarrollará la cirrosis. El alcohol también ha estado relacionado con alteraciones del miocardio; se ha constatado en animales de experimentación sanos que tanto la velocidad de contracción del músculo cardiaco y su máxima tensión disminuyen en presencia del alcohol, como consecuencia, la fuerza de cada contracción y el aumento de presión en el ventrículo izquierdo son menores, perdiendo eficacia el corazón como bomba.

  13. Amiloidosis renal hereditaria por depósito de apolipoproteína AI: un reto diagnóstico

    Directory of Open Access Journals (Sweden)

    Kelly del Rocío Samillán-Sosa

    2015-05-01

    La amiloidosis por depósito de Apo AI progresa a enfermedad renal crónica terminal en el plazo de de 3 a 15 años. Se diferencia clínicamente de la amiloidosis AL por su menor afectación extrarrenal y su mejor pronóstico. El trasplante renal ofrece una supervivencia del injerto aceptable y el trasplante hepato-renal se podría tener en cuenta en pacientes con disfunción significativa de ambos órganos.

  14. Insuficiencia renal aguda en pacientes de la Unidad de Cuidados Intensivos, Hospital Regional de Cuilapa, Santa Rosa, Guatemala

    OpenAIRE

    Ronald J. Ajcalon

    2017-01-01

    La insuficiencia renal aguda, es una condición común en la Unidad de Cuidados Intensivos de Adultos (UCIA) y probablemente una consecuencia de la enfermedad crítica que se asocia a resultados clínicos adversos, altos costos y una mortalidad de más del 50%, sobre todo si se requiere tratamiento de reemplazo renal. El objetivo fue determinar la incidencia de insuficiencia renal aguda en pacientes ingresados a la UCIA. El estudio fue prospectivo, longitudinal, observacional, en 101 pacientes ing...

  15. [Spontaneous renal artery dissection with renal infarction: a case report].

    Science.gov (United States)

    Oki, Takashi; Adachi, Hiroyuki; Tahara, Hideo; Kino, Sigeo

    2011-11-01

    A 58-year-old woman visited our hospital with nausea and right flank pain. At first abdominal ultrasonography was performed, suggesting a right renal infarction. Computed tomography (CT) study of the abdomen with intravenous contrast was performed to determine the cause of the symptoms. The scan revealed poor enhancement in the lower half of the right kidney. She was diagnosed with a right renal infarction. She was initially treated with anticoagulant therapy, but 5 days later, she complained of nausea. This time, CT demonstrated exacerbation of a right renal infarction with renal artery dissection. Based on this finding, we performed a right nephrectomy. The result of pathology was segmental arterial mediolysis. She was discharged 12 days after the surgery and is doing well at 6 months after discharge. Spontaneous renal artery dissection is a rare disease. It constitutes approximately 0.05% of arteriographic dissections. In addition, spontaneous renal artery dissection shows nonspecific symptoms. Together, these two factors may cause a delay in diagnosis.

  16. An unusual cause of acute renal failure: renal lymphoma.

    Science.gov (United States)

    Ozaltin, Fatih; Yalçin, Bilgehan; Orhan, Diclehan; Sari, Neriman; Caglar, Melda; Besbas, Nesrin; Bakkaloglu, Aysin

    2004-08-01

    Renal involvement is a common finding in non-Hodgkin's lymphoma (NHL). Acute renal failure at initial presentation due to lymphomatous infiltration of the kidneys has been described infrequently. We report a 17-year-old male who presented with acute renal failure due to massive lymphomatous infiltration of the kidneys, which necessitated hemodialysis. The diagnosis of B-cell NHL was established by tru-cut biopsy of the kidneys and the patient had an excellent response to high-dose chemotherapy with no major complication. The presence of extrarenal involvement in the testes and the retroperitoneal lymph nodes made the diagnosis of primary renal lymphoma debatable. However, considering the delay in diagnosis and the high proliferative rate of B-cell NHL, we might postulate that the disease had originated primarily in the kidneys. We recommend that in NHL cases with severe renal involvement, full-dose chemotherapy should be instituted with meticulous clinical and laboratory follow-up in order to improve clinical and renal failure status rapidly and to avoid further dissemination of NHL.

  17. Sinvastatina e lesão renal aguda isquêmica em ratos Simvastatina y lesión renal aguda isquémica en ratas Simvastatin and acute ischemic renal injury in rats

    Directory of Open Access Journals (Sweden)

    Claudia Akemi Shibuya Teshima

    2012-01-01

    Full Text Available OBJETIVOS: O estudo visou verificar a ação renoprotetora da sinvastatina em modelo animal de isquemia/reperfusão por 30 minutos. MÉTODOS: A isquemia foi obtida por meio do clampeamento dos pedículos renais bilaterais por 30 minutos, seguida de reperfusão. Ratos Wistar, machos foram usados pesando entre 250-300g, distribuídos nos seguintes grupos: SHAM (controle, sem clampeamento renal; Isquemia (isquemia renal por 30 minutos; Isquemia+Estatina (sinvastatina 0,5 mg/kg, via oral durante três dias. A função renal (clearance de creatinina, método de Jaffé, a osmolalidade urinária, os peróxidos urinários foram avaliados. RESULTADOS: Os resultados mostraram que a estatina melhorou a função renal, a osmolalidade urinária e reduziu a excreção de PU. CONCLUSÃO: Em síntese, o estudo confirmou o efeito renoprotetor da estatina, com ação antioxidante de proteção renal.OBJETIVOS: El estudio tuvo como objetivo verificar la acción renoprotectora de la simvastatina en modelo animal de isquemia/reperfusión por 30 minutos. MÉTODOS: La isquemia se obtuvo por medio del pinzamiento de los pedículos renales bilaterales por 30 minutos, seguida de la reperfusión. Fueron usadas ratas Wistar, machos que pesaban entre 250-300g, distribuidos en los siguientes grupos: SHAM (control, sin pinzamiento renal; Isquemia (isquemia renal por 30 minutos; Isquemia+Estatina (simvastatina 0,5 mg/kg, via oral durante tres días. Fueron evaluadas la función renal (clearance de creatinina, método de Jaffé, la osmolaridad urinaria y los peróxidos urinarios. RESULTADOS: Los resultados mostraron que la estatina mejoró la función renal, la osmolaridad urinaria y redujo la excreción de PU. CONCLUSIÓN: En síntesis, el estudio confirmó el efecto renoprotector de la estatina, con acción antioxidante de protección renal.OBJECTIVES: The study aimed to verify the protective renal action of simvastatin in an animal model of ischemia / reperfusion for 30

  18. Incidencia de sexo, edad y raza en perros con proteinuria post-renal: estudio retrospectivo de 162 casos.

    Directory of Open Access Journals (Sweden)

    Barrera-Chacón, R

    2009-05-01

    Full Text Available ResumenExisten varias patologías que están relacionadas con proteinuria post-renal en el perro. En ocasiones, el desarrollo de algunas de estas patologías puede estar influenciado por ciertos factores como edad, sexo y raza del paciente; estos parámetros fueron considerados en este estudio. Con el objetivo de conocer la influencia de dichos factores en la aparición de proteinuria pos-renal se revisaron 162 análisis de orina de pacientes procedentes del Hospital Clínico Veterinario de la UEx.

  19. Soporte social percibido y calidad de vida de personas con enfermedad renal crónica sometidas a trasplante renal

    Directory of Open Access Journals (Sweden)

    Judith Medellín Olaya

    2014-07-01

    Full Text Available Objetivo: Establecer la relación entre el soporte social y la calidad de vida percibida de personas con enfermedad renal crónica sometidas a trasplante renal. Método: Estudio descriptivo correlacional, de corte transversal y abordaje cuantitativo. Participaron 210 personas con trasplante renal que asistieron a su control mensual en una institución privada prestadora de servicios de salud. Se aplicaron los instrumentos Calidad de vida versión paciente de Betty Ferrell, Soporte social percibido de Hilbert y el Formato de caracterización sociodemográfica para persona con enfermedad crónica del Grupo de Cuidado al Paciente Crónico de la Universidad Nacional de Colombia. El análisis de asociación se realizó mediante la determinación de los coeficientes de correlación de Pearson y de Spearman, utilizando el programa SPSSS Versión 17.0 Resultados: Las características sociodemográficas de las personas con enfermedad renal crónica sometidas a trasplante renal fueron: mayoría hombres, edades entre 18 y 60 años, estado civil casados, estrato socioeconómico 2, nivel educativo bachillerato, ocupación trabajadores independientes. La percepción de calidad de vida en general fue alta, especialmente en la dimensión física. El soporte social percibido en la mayoría de los casos fue alto, reportándose los mayores puntajes en las dimensiones guía y en la interacción social, mientras que los menores, en la interacción personal. No se identificó correlación estadísticamente significativa entre calidad de vida y soporte social percibido en personas con enfermedad renal crónica sometidas a un trasplante renal. Conclusión: Para este estudio, la calidad de vida en personas sometidas a trasplante renal no se relacionó con el soporte social percibido, aspecto que puede estar relacionado con factores que requieren ser explorados mediante abordajes cualitativos que reconozcan elementos propios de la experiencia de cronicidad y que hacen

  20. Daño renal congénito asociado a reflujo vesicoureteral CONGENITAL RENAL DAMAGE ASSOCIATED WIHT VESICOURETERAL REFLUX

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2005-03-01

    Full Text Available Se realizó uretrocistografía miccional a 71 niños (48 varones en los que el estudio ultrasonográfico materno-fetal había detectado una dilatación pélvica renal y esta alteración se confirmó en el ultrasonido renal posnatal. Se encontró reflujo vesicoureteral (RVU en 16 (22,5 % y unidades renales refluentes (URR en 23 (16 %. El estudio gammagráfico estático (Tc 99 m-DMSA demostró alteración de la función renal diferencial en 6 pacientes, 1 con RVU de grado II y 5 con RVU de grados IV y V. El grado de afectación funcional varió de ligero hasta esencialmente afuncional. En uno de estos pacientes había el antecedente de una infección urinaria en el período neonatal y en los 5 restantes no existía historia de infección urinaria. Estos datos apoyan el criterio de que en el RVU, sobre todo en los grados IV y V, el riñón puede afectarse antes del nacimiento.Miction uretrocystography was performed in 71 children (48 boys, among whom the maternofetal ultrasonographic study had detected a pelvic renal dilation that was confirmed in the postnatal renal ultrasound. Vesicoureteral reflux (VUR was found in 16 (22.5 % and renal reflowing units (RRU in 23 (16 %. The static gammagraphic study (Tc 99m-DMSA showed alteration of the differential renal function in 6 patients, 1 with degree II VUR and 5 with degree IV and V VUR. The degree of functional affectation varied from mild to essentially nonfunctional. One of these patients had history of urinary infection in the neonatal period, whereas the other five did not. These data support the criterion that in VUR, mainly in IV and V degrees, the kidney may be affected before birth.

  1. O ITINERÁRIO DA DOENÇA RENAL CRÔNICA: DO PRENÚNCIO À DESCOBERTA

    Directory of Open Access Journals (Sweden)

    Vera Lucia Fortunato Fortes

    2013-01-01

    Full Text Available Estudio exploratorio, descriptivo, con enfoque cualitativo, cuyo objetivo fue comprender el significado del descubrimiento de la enfermedad renal crónica y la necesidad de la máquina de hemodiálisis. Estudio realizado con veinte pacientes de dos servicios de hemodiálisis de una ciudad del interior de RS, Brasil. La recolección de los datos ocurrió entre septiembre y diciembre de 2007, mediante entrevista semiestructurada. El análisis temático origino las categorías: historiando la enfermedad renal crónica; del silencio de la enfermedad al cuadro clínico clásico; descubrimiento y sus efectos inmediatos; la vida después del descubrimiento; aceptación de la dependencia de una máquina. Hay necesidad de adaptación en el cotidiano de la vida del paciente renal crónico, pues la hemodiálisis provoca alteraciones físicas y sociales, exigiendo apoyo del equipo para enfrentamiento de la enfermedad. El profesional no debe abdicar del conocimiento, seguridad y habilidades técnicas, como condiciones indispensables a la atención.

  2. Taurine and the renal system

    Science.gov (United States)

    2010-01-01

    Taurine participates in a number of different physiologic and biologic processes in the kidney, often reflected by urinary excretion patterns. The kidney is key to aspects of taurine body pool size and homeostasis. This review will examine the renal-taurine interactions relative to ion reabsorption; renal blood flow and renal vascular endothelial function; antioxidant properties, especially in the glomerulus; and the role of taurine in ischemia and reperfusion injury. In addition, taurine plays a role in the renal cell cycle and apoptosis, and functions as an osmolyte during the stress response. The role of the kidney in adaptation to variations in dietary taurine intake and the regulation of taurine body pool size are described. Finally, the protective function of taurine against several kidney diseases is reviewed. PMID:20804616

  3. Stages of Renal Cell Cancer

    Science.gov (United States)

    ... cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell ... diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other ...

  4. Renal Disease and Adult Vaccination

    Science.gov (United States)

    ... Resources for Healthcare Professionals Renal Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  5. Renal infarction complicating fibromuscular dysplasia.

    Science.gov (United States)

    Gavalas, M; Meisner, R; Labropoulos, N; Gasparis, A; Tassiopoulos, A

    2014-01-01

    Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects the renal and extracranial carotid arteries. We present 3 cases of renal infarction complicating renal artery FMD in 42-, 43-, and 46-year-old females and provide a comprehensive review of the literature on this topic. In our patients, oral anticoagulation therapy was used to treat all cases of infarction, and percutaneous angioplasty was used nonemergently in one case to treat refractory hypertension. All patients remained stable at 1-year follow-up. This is consistent with outcomes in previously published reports where conservative medical management was comparable to surgical and interventional therapies. Demographic differences may also exist in patients with renal infarction and FMD. A higher prevalence of males and a younger age at presentation have been found in these patients when compared to the general population with FMD.

  6. Drugs in pregnancy. Renal disease.

    Science.gov (United States)

    Marsh, J E; Maclean, D; Pattison, J M

    2001-12-01

    The management of pregnant women with renal impairment presents a major challenge to obstetricians, nephrologists, and ultimately paediatricians. As renal failure progresses there is an increase in both maternal and fetal complications. Often these women have intercurrent medical conditions and, prior to conception, are receiving a broad range of prescribed medications. A successful obstetric outcome relies upon careful pre-pregnancy counselling and planning, obsessive monitoring during pregnancy, and close liaison between different specialist teams. Experience is mounting in the management of pregnant transplant recipients, but the introduction of newer immunosuppressive agents which have great promise in prolonging graft survival present new problems for those recipients of a kidney transplant who are planning to conceive. We review drug prescription for pregnant patients with renal impairment, end-stage renal failure, or a kidney transplant.

  7. Transcatheter embolisation of renal angiomyolipoma.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-01

    Angiomyolipomas (AML) are rare benign renal tumours which are associated with aneurysms that can cause haemorrhage. Embolisation of AML greater than 4 cm with a variety of embolic agents is now the first-line treatment in these cases.

  8. Cryoablation for Small Renal Masses

    Directory of Open Access Journals (Sweden)

    J. L. Dominguez-Escrig

    2008-01-01

    Full Text Available Advances in imaging techniques (CT and MRI and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA, high-intensity focused ultrasound (HIFU, and cryoablation (CA. In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

  9. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Noordzij, Marlies; Kramer, Anneke; Abad Diez, José M

    2014-01-01

    BACKGROUND: This article provides a summary of the 2011 ERA-EDTA Registry Annual Report (available at www.era-edta-reg.org). METHODS: Data on renal replacement therapy (RRT) for end-stage renal disease (ESRD) from national and regional renal registries in 30 countries in Europe and bordering the .......6-47.0], and on dialysis 39.3% (95% CI 39.2-39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2-87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6-95.0) for kidneys from living donors....

  10. Pregnancy in renal transplant recipients.

    Science.gov (United States)

    Fuchs, Karin M; Wu, Danny; Ebcioglu, Zeynep

    2007-12-01

    Women with renal disease face increasing infertility and high-risk pregnancy as they approach end-stage renal disease due to uremia. Renal transplantation has provided these patients the ability to return to a better quality of life, and for a number of women who are of child bearing age with renal disease, it has restored their fertility and provided the opportunity to have children. But, although fertility is restored, pregnancy in these women still harbors risk to the mother, graft, and fetus. Selected patients who have stable graft function can have successful pregnancies under the supervision of a multidisciplinary team involving maternal fetal medicine specialists and transplant nephrologists. Careful observation and management are required to optimize outcome for mother and fetus.

  11. Antibiotic managment in renal failure.

    Science.gov (United States)

    Winter, R E

    1976-06-01

    This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

  12. Markers of renal function tests

    Directory of Open Access Journals (Sweden)

    Shivaraj Gowda

    2010-04-01

    Full Text Available Background: The markers of renal function test assess the normal functioning of kidneys. These markers may be radioactive and non radioactive. They indicate the glomerular filtration rate, concentrating and diluting capacity of kidneys (tubular function. If there is an increase or decrease in the valves of these markers it indicates dysfunction of kidney. Aim: The aim of this review is to compare and analyze the present and newer markers of renal function tests which help in diagnosis of clinical disorders. Material & Methods: An extensive literature survey was done aiming to compare and compile renal function tests makers required in diagnosis of diseases. Results: Creatinine, urea, uric acid and electrolytes are makers for routine analysis whereas several studies have confirmed and consolidated the usefulness of markers such as cystatin C and β-Trace Protein. Conclusion: We conclude that further investigation is necessary to define these biomarkers in terms of usefulness in assessing renal function.

  13. Mucormycosis (zygomycosis) of renal allograft.

    Science.gov (United States)

    Gupta, Krishan L; Joshi, Kusum; Kohli, Harbir S; Jha, Vivekanand; Sakhuja, Vinay

    2012-12-01

    Fungal infection is relatively common among renal transplant recipients from developing countries. Mucormycosis, also known as zygomycosis, is one of the most serious fungal infections in these patients. The most common of presentation is rhino-cerebral. Isolated involvement of a renal allograft is very rare. A thorough search of literature and our medical records yielded a total of 24 cases with mucormycosis of the transplanted kidney. There was an association with cytomegalovirus (CMV) infection and anti-rejection treatment in these patients and most of these transplants were performed in the developing countries from unrelated donors. The outcome was very poor with an early mortality in 13 (54.5%) patients. Renal allograft mucormycosis is a relatively rare and potentially fatal complication following renal transplantation. Early diagnosis, graft nephrectomy and appropriate antifungal therapy may result in an improved prognosis for these patients.

  14. Acute renal dysfunction in liver diseases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  15. On renal pathophysiology in preeclampsia

    OpenAIRE

    2014-01-01

    Preeclampsia is a complication of pregnancy which can suddenly change from a relatively mild phenotype into a life-threatening situation. One of the organs that is always involved during preeclampsia is the kidney. The placenta plays an important role in the renal pathophysiology of preeclampsia. The placenta produces excessive amounts of anti-angiogenic factors which are associated with systemic endothelial dysfunction. Although the underlying mechanisms of renal injury during preeclampsia r...

  16. [Heterolateral renal dystopia (2 cases)].

    Science.gov (United States)

    Anastasov, G; Peneva, S; Mushmov, D; Salambashev, L

    1982-01-01

    The authors observed two cases with crossed renal dystopia, to which venous urography, renal scintigraphy, echographic and gamma-chamber investigations were performed. The venous urography, in case of the appropriate symptomatics, is stressed to be able to establish the presence of heterolateral dystopia by as far as the distributional function of the anomaly is concerned--the gamma-chamber investigation is with the highest information value.

  17. [Unusual elements in renal calculi].

    Science.gov (United States)

    Rodríguez-Miñón Cifuentes, J L; Salvador, E; Traba Villameytide, M L

    2006-01-01

    A group of 54 renal calculi were spontaneously passed renal stone after a nephritic colic. Two groups of calculi were found: papillary and non-papillary calculi. All calculi were analyzed by infrared spectroscopy and electronic microscopy scan (EMS) and EDAX. When the stones were analyzed with EDAX, elements such as C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn were detected. The possible origin of these elements is discussed in this work.

  18. How renal cells handle urea.

    Science.gov (United States)

    Bagnasco, S M

    2000-01-01

    The urine concentration process requires an osmolality gradient along the renal cortico-medullary axis, with highest values in the renal papilla. NaCl and urea are the major solutes in the renal inner medulla, concentrations of urea up to 500-600 mM are found in the rat renal papilla. Urea can diffuse across cell membranes and contributes to balance intracellular and extracellular osmotic equilibrium. However, urea has perturbing effects on enzyme activity, and in concentrations above 300 mM is toxic for renal cultured cells. There is increasing evidence that urea can induce cellular responses distinct from those due to NaCl and other non-permeable solutes, including upregulation of immediate-early genes (IEGs). Urea transport by epithelial and endothelial cells is important for intra-medullary urea recycling and preservation of high urea concentration in the inner medulla. Trans-cellular movement of urea in cells expressing urea transporters may influence intracellular levels of this solute and modulate urea-induced signaling pathways. Regulation of urea transporters expression and activity can therefore be viewed as one aspect of cellular adaptation to urea. We have identified tonicity-responsive transcription as one mechanism regulating expression of the urea transporter UT-A. The short-term and long-term effects of variable extracellular urea concentration on the function of renal cells remain still unclear.

  19. Renal transepithelial transport of nucleosides.

    Science.gov (United States)

    Nelson, J A; Vidale, E; Enigbokan, M

    1988-01-01

    Previous work from this and other laboratories has suggested that the mammalian kidney has unique mechanisms for handling purine nucleosides. For example, in humans and in mice, adenosine undergoes net renal reabsorption whereas deoxyadenosine is secreted [Kuttesch and Nelson: Cancer Chemother. Pharmacol. 8, 221 (1982)]. The relationships between these renal transport systems and classical renal organic cation and anion, carbohydrate, and cell membrane nucleoside transport carriers are not established. To investigate possible relationships between such carriers, we have tested effects of selected classical transport inhibitors on the renal clearances of adenosine, deoxyadenosine, 5'-deoxy-5-fluorouridine (5'-dFUR), and 5-fluorouracil in mice. The secretion of deoxyadenosine and 5'-dFUR, but not the reabsorption of adenosine or 5-fluorouracil, was prevented by the classical nucleoside transport inhibitors, dipyridamole and nitrobenzylthioinosine. Cimetidine, an inhibitor of the organic cation secretory system, also inhibited the secretion of 5'-dFUR, although it did not inhibit deoxyadenosine secretion in earlier studies [Nelson et al.: Biochem. Pharmacol. 32, 2323 (1983)]. The specific inhibitor of glucose renal reabsorption, phloridzin, failed to inhibit the reabsorption of adenosine or the secretion of deoxyadenosine. Failure of the nucleoside transport inhibitors and phloridzin to prevent adenosine reabsorption suggests that adenosine reabsorption may occur via a unique process. On the other hand, inhibition of the net secretion of deoxyadenosine and 5'-dFUR by dipyridamole and nitrobenzylthioinosine implies a role for the carrier that is sensitive to these compounds in the renal secretion (active transport) of these nucleosides.

  20. Gadobutrol in Renally Impaired Patients

    Science.gov (United States)

    Michaely, Henrik J.; Aschauer, Manuela; Deutschmann, Hannes; Bongartz, Georg; Gutberlet, Matthias; Woitek, Ramona; Ertl-Wagner, Birgit; Kucharczyk, Walter; Hammerstingl, Renate; De Cobelli, Francesco; Rosenberg, Martin; Balzer, Thomas; Endrikat, Jan

    2017-01-01

    Objective The aim of this study was to assess the potential risk of gadobutrol-enhanced magnetic resonance imaging (MRI) in patients with moderate to severe renal impairment for the development of nephrogenic systemic fibrosis (NSF). Materials and Methods We performed a prospective, international, multicenter, open-label study in 55 centers. Patients with moderate to severe renal impairment scheduled for any gadobutrol-enhanced MRI were included. All patients received a single intravenous bolus injection of gadobutrol at a dose of 0.1 mmol/kg body weight. The primary target variable was the number of patients who develop NSF within a 2-year follow-up period. Results A total of 908 patients were enrolled, including 586 with moderate and 284 with severe renal impairment who are at highest risk for developing NSF. The mean time since renal disease diagnosis was 1.83 and 5.49 years in the moderate and severe renal impairment cohort, respectively. Overall, 184 patients (20.3%) underwent further contrast-enhanced MRI with other gadolinium-based contrast agents within the 2-year follow-up. No patient developed symptoms conclusive of NSF. Conclusions No safety concerns with gadobutrol in patients with moderate to severe renal impairment were identified. There were no NSF cases. PMID:27529464

  1. Physical Activity and Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Vincenzo Bellizzi

    2014-07-01

    Full Text Available Renal transplantation is burdened by high cardiovascular risk because of increased prevalence of traditional and disease-specific cardiovascular risk factors and, consequently, patients are affected by greater morbidity and mortality. In renal transplanted patients, healthy lifestyle and physical activity are recommended to improve overall morbidity and cardiovascular outcomes. According to METs (Metabolic Equivalent Task; i.e. the amount of energy consumed while sitting at rest, physical activities are classified as sedentary (<3.0 METs, of moderate-(3.0 to 5.9 METs or vigorous-intensity (≥6.0 METs. Guidelines suggest for patients with chronic kidney disease an amount of physical activity of at least 30 minutes of moderate-intensity activity five times per week (min 450 MET-minutes/week. Data on physical activity in renal transplanted patients, however, are limited and have been mainly obtained by mean of non-objective methods. Available data suggest that physical activity is low either at the start or during renal transplantation and this may be associated with poor patient and graft outcomes. Therefore, in renal transplanted patients more data on physical activity obtained with objective, accelerometer-based methods are needed. In the meanwhile, physical activity have to be considered as an essential part of the medical care for renal transplanted recipients.

  2. Renal tubular acidosis.

    Science.gov (United States)

    Rothstein, M; Obialo, C; Hruska, K A

    1990-12-01

    Renal tubular acidosis refers to a group of disorders that result from pure tubular damage without concomitant glomerular damage. They could be hereditary (primary) or acquired (secondary to various disease states like sickle cell disease, obstructive uropathy, postrenal transplant, autoimmune disease, or drugs). The hallmark of the disorder is the presence of hyperchloremic metabolic acidosis with, or without, associated defects in potassium homeostasis, a UpH greater than 5.5 in the presence of systemic acidemia, and absence of an easily identifiable cause of the acidemia. There are three physiologic types whose basic defects are impairment of or a decrease in acid excretion, i.e., type 1 (dRTA); a failure in bicarbonate reabsorption, i.e., type 2 (pRTA); and deficiency of buffer or impaired generation of NH4+, i.e., type 4 RTA. Several pathophysiologic mechanisms have been postulated for these various types. pRTA is the least common of all in the adult population. It rarely occurs as an isolated defect. It is frequently accompanied by diffuse proximal tubule transport defects with aminoaciduria, glycosuria, hyperphosphaturia, and so forth (Fanconi syndrome). dRTA is associated with a high incidence of nephrolithiasis, nephrocalcinosis, osteodystrophy, and growth retardation (in children). Osteodystrophy also occurs in pRTA to a lesser degree and is believed to be secondary to hypophosphatemia. Patients with type 4 RTA usually have mild renal insufficiency from either diabetes mellitus or interstitial nephritis. Acute bicarbonate loading will result in a high fractional excretion of bicarbonate greater than 15% (FEHCO3- greater than 15%) in patients with pRTA, but FEHCO3- less than 3% in patients with dRTA. Type I patients will also have a low (U - B) PCO2 with bicarbonate loading. They are also unable to lower their urine pH to less than 5.5 with NH4Cl loading. The treatment of these patients involves avoidance of precipitating factors when possible, treatment

  3. Compromiso renal en pacientes HIV+ Renal abnormalities in HIV infected patients

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    María Marta Pernasetti

    2010-06-01

    Full Text Available Varias complicaciones nefrológicas pueden ocurrir durante la infección por el virus de la inmunodeficiencia humana (HIV especialmente en estadios avanzados de la enfermedad o relacionadas con otras infecciones o drogas. Poco conocida es la prevalencia de alteraciones renales subclínicas de pacientes HIV+ surgidas como complicación o relacionadas a la infección y/o tratamiento. Realizamos un corte transversal de pacientes asintomáticos HIV+ referidos en forma consecutiva al consultorio de nefrología para la detección de alteraciones nefrológicas. Se estudiaron 52 pacientes adultos mediante exámenes de sangre y orina, ultrasonido y biopsia renal. Edad media 39.9 ± 10.6 años, 88% varones, tiempo de diagnóstico de la infección: 53.2 ± 41.2 (2-127 meses. El 71% tenían síndrome de inmunodeficiencia adquirida (HIV-sida y el 77% recibían con antirretrovirales. La carga viral al momento del estudio fue 7043 ± 3322 copias y el recuento de CD4+ 484 ± 39 cel/mm³. El 30.7% presentó alteraciones del sedimento urinario: albuminuria: 16.6%, hematuria microscópica: 11.5%, hipercalciuria: 10.8% y cristaluria 6%. La media del filtrado glomerular fue 102.2 ± 22.9 ml/min (rango: 34-149. El 41% presentó anormalidades que corresponderían a enfermedad renal crónica (estadios 1 a 3. Los pacientes con alteraciones tenían mayor edad, con duración más prolongada de la infección. Las anomalías renales no se asociaron con mayor prevalencia de HIV-sida. Dos pacientes fueron biopsiados, con hallazgos de nefritis túbulo-intersticial crónica con cristales y glomerulonefritis por IgA. No hubo hallazgos de nefropatía por HIV. El amplio espectro y la alta prevalencia de anormalidades nefrológicas subclínicas encontradas sugieren que los pacientes asintomáticos HIV+ deberían realizar evaluaciones nefrológicas de rutina.Several renal complications may occur during HIV infection, especially in advanced stages related to HIV, to other infectious

  4. Renal artery injury during robot-assisted renal surgery.

    Science.gov (United States)

    Lee, Jae Won; Yoon, Young Eun; Kim, Dae Keun; Park, Sung Yul; Moon, Hong Sang; Lee, Tchun Yong

    2010-07-01

    Laparoscopic partial nephrectomy (LPN) is becoming the standard of care for incidentally diagnosed, small renal tumors. With its seven degrees of freedom and three-dimensional vision, the DaVinci robotic surgical system has been used to assist in LPNs. The main disadvantage of robot-assisted surgery, however, is the lack of tactile feedback. We present a case of renal artery injury during robot-assisted renal surgery. Robot-assisted partial nephrectomy (RPN) was planned for 47-year-old man with a 3.5-cm right renal mass. After standard bowel mobilization, renal hilar dissection was performed. In the attempt to complete the dissection posteriorly, however, there was sudden profuse bleeding. The intraperitoneal pressure immediately increased to 20 mm Hg, and an additional suction device was inserted through the 5-mm liver retractor port. On inspection, there was an injury at the takeoff of the posterior segmental artery. A decision was made to convert to robot-assisted laparoscopic radical nephrectomy. The main renal artery and renal vein were controlled with Hem-o-Lok clips. The estimated blood loss was 2,000 mL. Four units of packed red blood cells were transfused intraoperatively. The post-transfusion hemoglobin level was 12.6 g/dL. There were no other perioperative complications. The surgeon should keep in mind that the robotic arms are very powerful and can easily injure major vessels because of lack of tactile feedback. A competent and experienced tableside surgeon is very important in robot-assisted surgery because the unsterile console surgeon cannot immediately react to intraoperative complications.

  5. Culturas del Mundo

    DEFF Research Database (Denmark)

    Benwell, Ann Fenger; Costa, Alberto; Waehle, Espen

    2006-01-01

    ’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39......’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39...

  6. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2012-12-01

    Full Text Available Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

  7. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    Directory of Open Access Journals (Sweden)

    Fady T. Botros

    2012-01-01

    Full Text Available Heme oxygenases (HO-1; HO-2 catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n=7 and hemin-treated rats (n=6 were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115±5 mmHg versus 112±4 mmHg and 331±16 versus 346±10 bpm. However, RBF was significantly higher (9.1±0.8 versus 7.0±0.5 mL/min/g, P<0.05, and renal vascular resistance was significantly lower (13.0±0.9 versus 16.6±1.4 [mmHg/(mL/min/g], P<0.05. Likewise, glomerular filtration rate was significantly elevated (1.4±0.2 versus 1.0±0.1 mL/min/g, P<0.05, and urine flow and sodium excretion were also higher (18.9±3.9 versus 8.2±1.0 μL/min/g, P<0.05 and 1.9±0.6 versus 0.2±0.1 μmol/min/g, P<0.05, resp.. The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models.

  8. Scintigraphic assessment of renal function in a case of renal dystopia; Szintigraphische Funktionsberechnung bei renaler Lageanomalie

    Energy Technology Data Exchange (ETDEWEB)

    Pilgrim, S. [Gemeinschaftspraxis fuer Nuklearmedizin, Luebeck (Germany)

    1998-06-01

    In patients with renal dystopia radionuclide urography in commonly used technique may yield inaccurate results concerning split renal function. In a case of unilateral pelvic kidney a simple strategy to avoid this methodical error is demonstrated. (orig.) [Deutsch] Am Fallbeispiel eines Patienten mit einseitiger Beckenniere wird dargestellt, dass bei einer Lageanomalie und Anwendung der renalen Funktionsszintigraphie in ueblicher Technik eine deutliche Fehleinschaetzung der seitengetrennten Funktionsanteile resultieren kann. Ein einfaches Verfahren zur Vermeidung dieses Bestimmungsfehlers wird aufgezeigt. (orig.)

  9. Impaired Renal Function

    Directory of Open Access Journals (Sweden)

    Kentaro Ide

    2011-01-01

    Full Text Available Patients requiring liver transplantation (LT frequently experience renal insufficiency (RI, which affects their survival. Although calcineurin inhibitor-sparing immunosuppressive regimens (CSRs are well known to prevent RI, the immune state in recipients receiving CSR remains to be intensively investigated. Among 60 cases of living-donor LT at our institute, 68% of the patients had none to mild RI (non-RI group and 32% of the patients had moderate to severe RI (RI group. The RI group received a CSR comprising reduced dose of tacrolimus, methylprednisolone, and mycophenolate mofetil, while the non-RI group received a regimen comprising conventional dose of tacrolimus and methylprednisolone. One year after LT, the mean estimated glomerular filtration rate (eGFR in the RI group had significantly improved, although it was still lower than that of the non-RI group. Serial mixed lymphocyte reaction assays revealed that antidonor T-cell responses were adequately suppressed in both groups. Thus, we provide evidence that CSR leads to improvement of eGFR after LT in patients with RI, while maintaining an appropriate immunosuppressive state.

  10. Renale Osteogystrophie - radiologische Diagnostik

    Directory of Open Access Journals (Sweden)

    Kainberger F

    2001-01-01

    Full Text Available Die renale Osteodystrophie (ROD kann definiert werden als die Summe morphologischer Knochenveränderungen infolge des gestörten Kalzium-Phosphat-Stoffwechsels bei chronischer Niereninsuffizienz. Speziell in Österreich mit einer im internationalen Vergleich hohen Rate an Nierentransplantationen ist das radiologische Vollbild dieser Erkrankung heute nur mehr in seltenen Fällen zu sehen. Grundsätzliches Ziel der bildgebenden Diagnostik ist nicht so sehr die Primärdiagnose, sondern die gezielte Planung von Prophylaxe oder Therapie klinisch relevanter Komponenten. Als bildgebende Verfahren stehen neben konventionell-radiologischen Aufnahmetechniken die Osteodensitometrie und, zum Nachweis von Veränderungen der Nebenschilddrüsen, die Sonographie sowie die Szintigraphie zur Verfügung. Es werden vier empirisch abgeleitete radiologische Bildmuster, basierend auf den wichtigsten zugrundeliegenden Stoffwechselkomponenten, beschrieben: die malazische, die hyperparathyreote, die porotische und die hyperphosphatämische Form. Die Ziele der bildgebenden Untersuchung sind heute sowohl auf eine qualitative, als vor allem auch auf eine quantitative Diagnostik ausgerichtet.

  11. Renal failure in patients with multiple myeloma.

    Science.gov (United States)

    Almueilo, Samir H

    2015-01-01

    Renal dysfunction is encountered in 20-25% of patients with multiple myeloma (MM) at the time of diagnosis. There is often a precipitating event. Several biochemical and clinical correlations with renal failure in MM have been reported. Renal failure in MM is associated with worse outcome of the disease. We retrospectively analyzed the medical records of 64 patients with MM admitted to our institution during the period January 1992 to December 2012. Abnormal renal function was observed in 24 (37.5%) patients and 17 (26.6%) of them had renal failure; 14 of the 17 (82.4%) of patients with renal failure had Stage III MM. Urine Bence- Jones protein was positive in ten (58.8%) patients with renal failure versus ten (21.3%) patients without renal failure (P = 0.004). Potential precipitating factors of renal failure were determined in nine patients. Renal function normalized in 11 patients with simple measures, while six patients required hemodialysis; one remained dialysis dependent till time of death. Early mortality occurred in five (29.4%) patients with renal failure as compared with two (4.3%) patients in the group without renal failure (P = 0.005). In conclusion, renal failure is associated with a higher tumor burden and Bence-Jones proteinuria in patients with MM. It is reversible in the majority of patients; however, early mortality tends to be higher in patients with persistent renal failure.

  12. Influence of low-protein dietetic foods consumption on quality of life and levels of B vitamins and homocysteine in patients with chronic renal failure Influencia del consumo de alimentos dietéticos bajos en proteína sobre la calidad de vida y los niveles de vitaminas B y homocisteína en pacientes con insuficiencia renal crónica

    OpenAIRE

    Sánchez, C; Aranda, P.; E. Planells; Galindo, P.; A. Pérez de la Cruz; M. Larrubia; J. Llopis

    2010-01-01

    Objective: The aim of the study was to determine whether the consumption of low protein dietetic foods® improved the quality of life and nutritional status for vitamins B and homocysteine in patients with chronic renal failure. Methodology: This nutritional-intervention involved 28 men and 21 women, divided into two groups. The control-group consumed a low-protein diet prescribed, and the experimental-group consumed a diet in which some commonly used foods were replaced by low-protein dieteti...

  13. Renal dysfunctions in glomerulonephropathy with rapidly declined renal failure.

    Science.gov (United States)

    Futrakul, N; Pochanugool, C; Sitprija, V; Singkhwa, V; Futrakul, P; Yenrudi, S; Sensirivatana, R; Watana, D; Poshyachinda, M

    1996-07-01

    Eight patients aged between 5 and 26 years developed rapid deterioration of renal function and became oliguric/anuric with duration ranging from 1 to 21 days. The initial functional assessment revealed severe degree of glomerular, tubular, and vascular dysfunctions. The magnitude of renal dysfunction was quantified and expressed in terms of a clinical score. The degree of glomerular and tubular dysfunctions were inversely proportional to the renal plasma flow and peritubular capillary blood flow (PTCB), respectively. Similar findings have been observed in a variety of severe glomerulonephropathies. In this aspect, it is likely that the reduction of peritubular capillary blood flow and tubulointerstitial disease are interrelated. Further evidence to support the primary role of reduction of PTCB in inducing tubulointerstitial disease is provided by the following: (a) Reduction of PTCB is documented in mesangial proliferative nephrosis with steroid resistance prior to the detection of tubulointerstitial disease. (b) Ischemic insult can induce tubulointerstitial disease in experimental setting of renal artery occlusion in animal, (c) Improved tubular function can be achieved following the increase in PTCB with the enhanced renal perfusion therapy.

  14. Renal cell carcinoma in functional renal graft: Toward ablative treatments.

    Science.gov (United States)

    Tillou, Xavier; Guleryuz, Kerem; Collon, Sylvie; Doerfler, Arnaud

    2016-01-01

    The occurrence of a kidney transplant tumor is a rare but serious issue with a double risk: the return to dialysis and the development of metastatic cancer. Publications on this topic are mainly case reports. The purpose of this review was to report an exhaustive literature review of functional graft renal cell carcinomas to highlight the impact of tumors on the renal graft outcomes. 201 de novo renal carcinomas in functional renal grafts from 69 publications were included. Incidence was estimated at 0.18%. Graft tumors were mostly asymptomatic (85.9%). Whatever the discovery circumstances of graft tumors, they were mostly documented by graft ultrasounds supplemented by CT-scanning or MR imaging. Nephron sparing surgery (95 patients) was the first treatment performed followed by radiofrequency ablation (38 patients) and cryotherapy (10 patients). The most common tumor graft histology was clear cell carcinoma (46.4%), followed by papillary carcinoma (43.7%). Specific mortality was 2.9% with 6 deaths. Renal graft cell carcinoma is a rare pathology with a low specific death. When possible, conservative treatment should be the first choice. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Crisis de esclerodermia renal normotensiva

    Directory of Open Access Journals (Sweden)

    M. Villaverde

    2003-01-01

    Full Text Available Paciente de sexo masculino de 60 años con esclerosis sistémica que evolucionó con crisis de esclerodermia renal normotensiva. Tenía compromiso poliarticular, esofágico, pulmonar y cutáneo. Antes de internarse en nuestro hospital recibió tratamiento con altas dosis de corticoides, lo que probablemente precipitó el daño renal que presentó en su evolución, caracterizado por falla renal, anemia hemolítica microangiopática sin elevación de la presión arterial. La ausencia de hipertensión se observa sólo en el 10% de los casos de esclerodermia renal. Recibió tratamiento con enalapril y hemodiálisis. Evolucionó en forma desfavorable, sin respuesta a la terapeútica y falleció a los siete días de internado.A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10% of these cases have normal blood pressure. The patient was treated with enalapril and hemodyalisis. There was no favourable response to this treatment and he died seven days after admission.

  16. Caracterización de la función renal en perros

    Directory of Open Access Journals (Sweden)

    Pedro Pablo Martínez Padua

    2012-06-01

    Full Text Available Mediante filtración, reabsorción y excreción, los riñones mantienen la homeostasis en los organismos vivos. Los perros con lesiones renales tienen afectados estos procesos, que alteran la homeostasis. Ello da como resultado cuadros de insuficiencia renal. Se evaluaron parámetros que estiman la filtración, reabsorción y excreción renal en tres grupos de perros, referentes a concentración sérica de creatinina, relación proteína-creatinina urinaria, clearance de creatinina, excreción fraccionada (EF de calcio, fósforo, sodio y magnesio, así como el perfil sérico de estos electrolitos. El grupo G1 estuvo conformado por diez perros sin alteración en los parámetros de función renal; quince perros con compromiso de función renal fueron distribuidos en dos grupos (G2 y G3, respectivamente, basados en las fases descritas por el IRIS 2009. Los grupos se compararon por el test de Kruskal-Wallis, seguido por el test de Dunn. Perros del G3 mostraron aumento de las concentraciones séricas de fósforo, sodio y magnesio, comparados con los G1 y G2. Perros de G1 y G2 presentaron disminución de la excreción fraccionada de los electrolitos, que difirieron de los perros del G3. Estos resultados sugieren que perros con afectación de la función renal presentan alteraciones que dependen de la gravedad y de la fase de la enfermedad. Estas alteraciones se evidenciaron en la EF de electrolitos en los diferentes grupos; adicionalmente, el Mg y el Na mostraron ser más sensibles al detectar precozmente el compromiso de la función renal.

  17. Insuficiència cardíaca i fallida renal : quan tot s'ajunta

    OpenAIRE

    Zamora, Elisabet

    2008-01-01

    Un dels problemes que coexisteixen amb la insuficiència cardíaca és la insuficiència renal. Els autors d'aquest article proposen un mètode alternatiu per poder detectar de manera més precisa la presència d'aquesta fallida renal en els pacients amb insuficiència cardíaca, ja que els mètodes habituals, basats únicament en la determinació de la creatinina en sang, són menys sensibles.

  18. Obesidad y enfermedad renal crónica en niños y adolescentes

    OpenAIRE

    Pérez Clemente, Lourdes María

    2015-01-01

    La obesidad y la enfermedad renal crónica forman parte de las grandes epidemias del siglo XXI. El objetivo fue confirmar que los niños obesos tienen un riesgo mayor de enfermedad renal crónica que los que no lo son. Se realizó un estudio observacional, analítico y transversal que incluyó a niños y adolescentes con obesidad exógena. Para comparar los resultados obtenidos en los obesos se seleccionó un grupo de niños normopesos. Se determinaron variables emográficas, antropométricas, clínica...

  19. Púrpura Schönlein Henoch con compromiso renal. Reporte de un caso

    OpenAIRE

    Cynthia Aguilera M.; Camila Bustos C.; Nicole Bascur P.

    2013-01-01

    INTRODUCCIÓN: El Púrpura Schönlein Henoch es una vasculitis sistémica que afecta principalmente a la piel, articulaciones, sistema gastrointestinal y renal. Es una de las vasculitis más comunes en la infancia. El compromiso renal se da en aproximadamente el 40% de los casos, y en la mayoría se presenta con hematuria, sin embargo, también puede manifestarse como proteinuria, síndrome nefrótico y nefrítico. PRESENTACIÓN DEL CASO: Se presenta el caso de una paciente de 6 años que consulta en Ser...

  20. Severe perioperative bleeding in renal cell carcinoma after elective pericardiocentesis associated left ventricular puncture: case report

    OpenAIRE

    Javier Lasala; Miguel Alejandro Patino; Gabriel Mena; Shital Vachhani; Teresa Moon; Thao Bui; January Tsai

    2016-01-01

    Resumen En los Estados Unidos se estimó que, durante el 2015, unos 61 560 pacientes serían diagnosticados con cáncer renal y que 14 080 morirían por esta enfermedad. Presentamos el caso de un paciente con carcinoma de células renales y trombo tumoral de vena cava inferior que sufrió una hemorragia perioperatoria grave y coagulopatía después de una esternotomía de emergencia. También abordamos aspectos relevantes del cuidado anestésico perioperatorio incluyendo consideraciones y manejo de c...

  1. Púrpura Schönlein Henoch con compromiso renal. Reporte de un caso

    OpenAIRE

    Cynthia Aguilera M.; Camila Bustos C.; Nicole Bascur P.

    2013-01-01

    INTRODUCCIÓN: El Púrpura Schönlein Henoch es una vasculitis sistémica que afecta principalmente a la piel, articulaciones, sistema gastrointestinal y renal. Es una de las vasculitis más comunes en la infancia. El compromiso renal se da en aproximadamente el 40% de los casos, y en la mayoría se presenta con hematuria, sin embargo, también puede manifestarse como proteinuria, síndrome nefrótico y nefrítico. PRESENTACIÓN DEL CASO: Se presenta el caso de una paciente de 6 años que consulta en Ser...

  2. Índice de resistividade renal como preditor da revascularização renal para hipertensão renovascular Índice de resistividad renal como predictor de la revascularización renal para hipertensión renovascular Renal resistance index predicting outcome of renal revascularization for renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Simone N. Santos

    2010-04-01

    exitosa, ni todos los pacientes (pt expresan mejora clínica y algunos pueden empeorar. OBJETIVO: El presente estudio está destinado a evaluar el valor del índice de resistividad renal (IR como predictor de los efectos de la revascularización renal. MÉTODOS: Entre enero de 1998 y febrero de 2001, 2933 pacientes se sometieron al ultrasonido Doppler dúplex renal. Un total de 106 de estos pacientes expresaron EAR significativa y fueron sometidos a angiografía y revascularización renal. Se midió la presión arterial (PA antes y después de la intervención, en intervalos de hasta 2 años y las medicaciones prescriptas fueron registradas. Antes de la revascularización, el IR se midió en 3 locales del riñón, con la obtención de un promedio de estas mediciones. RESULTADOS: De los 106 pacientes, 81 tuvieron IR 80. La EAR se corrigió solamente por angioplastia (PTA en 25 pts, PTA + stent en 56 pts y quirúrgicamente en 25 pts. De los pacientes que se beneficiaron de la revascularización renal; 57 de los 81 pacientes con IR 80. Usando un modelo de regresión logística múltiple, el IR estuvo significativamente asociado a la evolución de la PA (p = 0,001, ajustado de acuerdo con los efectos de la edad, sexo, PAS, PAD, duración de la hipertensión, el tipo de revascularização, número de fármacos en uso, nivel de creatinina, presencia de DM, hipercolesterolemia, volumen sistólico, enfermedad arterial periférica y coronaria y tamaño renal (OR 99,6-95%CI para OR 6,1-1.621,2. CONCLUSIÓN: La resistividad intrarrenal arterial, medida por ultrasonido Doppler dúplex, desempeña un rol importante en la predicción de los efectos post revascularização renal para EAR.BACKGROUND: Renal artery stenosis (RAS is a potentially correctable cause of hypertension and ischemic nephropathy. Despite successful renal revascularization, not all patients (pt overcome it and some get worse. OBJECTIVE: This study was designed to assess the value of renal resistance index (RI in

  3. Fluoride-induced chronic renal failure.

    Science.gov (United States)

    Lantz, O; Jouvin, M H; De Vernejoul, M C; Druet, P

    1987-08-01

    Renal fluoride toxicity in human beings is difficult to assess in the literature. Although experimental studies and research on methoxyflurane toxicity have shown frank renal damage, observations of renal insufficiency related to chronic fluoride exposure are scarce. We report a case of fluoride intoxication related to potomania of Vichy water, a highly mineralized water containing 8.5 mg/L of fluoride. Features of fluoride osteosclerosis were prominent and end-stage renal failure was present. The young age of the patient, the long duration of high fluoride intake, and the absence of other cause of renal insufficiency suggest a causal relationship between fluoride intoxication and renal failure.

  4. Renal infarction secondary to ketamine abuse.

    Science.gov (United States)

    Chen, Chin-Li; Chen, Jin-Li; Cha, Tai-Lung; Wu, Sheng-Tang; Tang, Shou-Hung; Tsao, Chih-Wei; Meng, En

    2013-07-01

    Renal infarction is an uncommon condition that resulted from inadequate perfusion of the kidney and is easily missed diagnosed due to its nonspecific clinical presentations. Major risk factors for renal infarction are atrial fibrillation, previous embolism, and ischemic and valvular heart disease. Progressive decrease in renal function or even death can occur if renal infarction is not diagnosed accurately and promptly. Ketamine abuse may cause variable urinary tract injury. However, renal infarction caused by ketamine abuse has never been reported. To our knowledge, this is the first documented case of renal infarction following nasal insufflation of ketamine.

  5. Diffuse FDG renal uptake in lymphoma.

    Science.gov (United States)

    Navalkissoor, Shaunak; Szyszko, Teresa; Gnanasegaran, Gopinath; Nunan, Thomas

    2010-10-01

    In patients presenting with acute renal failure and known/suspected lymphoma, the diagnosis of diffuse renal involvement is important, as there is potential for rapid resolution with chemotherapy. Although FDG is excreted through the kidneys and focal renal disease may be difficult to identify, diffuse renal FDG is more easily recognized and is always abnormal. We report a patient presenting with acute renal failure and suspected lymphoma. F-18 FDG PET/CT study demonstrated diffuse increased FDG uptake in bilaterally enlarged kidneys. Following 1 cycle of chemotherapy, the renal function normalized. An interim F-18 FDG PET/CT demonstrated normal size and FDG uptake within both kidneys.

  6. CHRONIC RENAL FAILURE TODAY

    Directory of Open Access Journals (Sweden)

    Svetislav Kostić

    2004-07-01

    Full Text Available The syndrome of chronic renal failure (CRF is already known for more than 150 years. Current research in this domain changed our understanding in epidemiology, aetiology, prevention of disease progression, classifications, definition, and adequate treatment of comorbid conditions in predialytic period. With data collection and registration on CRF patients it is obvious an increase in prevalence and incidence of patients with CRF in the world. The diabetic nephropathy is the most common disease leading in 40% of cases to terminal CRF. In the follow up of these patients the most important goal is slowing down the disease progression with low protein diet (0,6-0,8 g/kg BW/day and vigorous blood pressure control (target values: 120-135/75-85 mmHg. The adequate therapy of anaemia and secondary hyperparathyroidism including predialytic use of erythopoietin and vitamin D significantly slow down the progression of CRF and postpones the beginning of dialytic treatment. Numerous comorbid conditions present in predialytic period fasten the progression of CRF. The most common are of cardiovascular origin (congestive heart failure and coronary artery disease. Those cardiovascular comorbid conditions have an impact on CRF progresion as well as on the outcome in dialytic therapy. The most common causes of cardiovascular comorbidity are hypertension, anemia and secondary hyperparathyroidism, all of which should be treated in predialytic period. Of special concern is use of nephrotoxic drugs, particularly nephrotoxic antibioticsaminoglycosides. The optimal timing of creation of permanent vascular access and vaccination against hepatitis B in predialytic period are cost-effective and have an impact on quality of dialysis.

  7. Renal atrophy after stereotactic body radiotherapy for renal cell carcinoma.

    Science.gov (United States)

    Yamamoto, Takaya; Kadoya, Noriyuki; Takeda, Ken; Matsushita, Haruo; Umezawa, Rei; Sato, Kiyokazu; Kubozono, Masaki; Ito, Kengo; Ishikawa, Yojiro; Kozumi, Maiko; Takahashi, Noriyoshi; Katagiri, Yu; Onishi, Hiroshi; Jingu, Keiichi

    2016-05-26

    Renal atrophy is observed in an irradiated kidney. The aim of this study was to determine dose-volume histogram parameters and other factors that predict renal atrophy after 10-fraction stereotactic body radiotherapy (SBRT) for primary renal cell carcinoma (RCC). A total of 14 patients (11 males, 3 females) who received SBRT for RCC at Tohoku University Hospital between April 2010 and February 2014 were analyzed. The median serum creatinine level was 1.1 mg/dl and two patients had a single kidney. Nine patients were implanted with fiducial markers. The median tumor diameter was 30 mm. SBRT was delivered at 70 Gy in 10 fractions for 7 tumors, at 60 Gy in 10 fractions for 2 tumors, and at 50 Gy in 10 fractions for 5 tumors with 6 and/or 15 MV X-ray using 5 to 8 multi-static beams. Renal atrophy was assessed using post-SBRT CT images after 12-24 months intervals. Correlations were examined by Spearman rank correlation analysis. Differences between two groups were evaluated by the Mann-Whitney test, and pairwise comparisons were made by the Wilcoxon signed-rank test. The median tumor volume shrunk from 14.8 cc to 10.6 cc (p = 0.12), and the median irradiated kidney volume changed from 160.4 cc to 137.1 cc (p atrophy (p = 0.02). Significant renal atrophic change was observed. Dose distribution of SBRT at 20-30 Gy had a strong correlation with renal atrophy when irradiation was performed in 10 fractions.

  8. Ossifying renal tumor of infancy.

    Science.gov (United States)

    Schelling, Johannes; Schröder, Annette; Stein, Raimund; Rösch, Wolfgang H

    2007-06-01

    A renal ossifying tumor of infancy is a rare event with few cases having been published, and the etiology has not yet been established. We report on two new cases of this unusual neoplasm. A 2-year-old boy presented with intermittent painless gross hematuria. After several diagnostic procedures, an open pyelolithotomy was performed and the histological diagnosis of renal tumor of infancy was finally made. The history of the second case is very similar. An 8-week-old infant presented with gross hematuria. As in the first case, an open pyelolithotomy was performed and a tumor entirely covered with blood clots was found in the renal pelvis and completely removed. A histological diagnosis of renal ossifying tumor of infancy was made. Using the literature available, the histological criteria and biological behavior are discussed, together with the diagnostic and therapeutic algorithm for this tumor. In infants with gross hematuria and a calcified (non-)invasive mass in the pelvi-calceal system, renal ossifying tumor should be considered in the differential diagnosis. MRI or CT scan offers a good diagnostic guide.

  9. HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  10. Gastrointestinal complications in renal transplantation

    Directory of Open Access Journals (Sweden)

    Kamal Jeet Singh

    2004-01-01

    Full Text Available Objective: Gastrointestinal complications are responsible for substantial morbidity and mortality among renal allograft recipients. We retrospectively analyzed incidence of these complications and their impact on the patient outcome. Materials & Methods: Between 1998 to Aug 2002, 558 live related renal transplants were performed at our center. The immunosuppression used consisted mainly of cyclosporine, azathioprine and prednisolone, though varied in some patients. These patients were followed for any occurrence of significant gastrointestinal problems. Results: Out of the of 538 renal transplant recipients studied, gastro esophageal ulcerations were seen in 3% patients. Acute pancreatitis was observed in twelve (2.2% patients and four patients had acute intestinal obstruction secondary to fecal impaction. Infectious complications included acute diarrheas in 18% of patients. Three patients developed abdominal tuberculosis. Acute rejection episodes were encountered in 26% of the patients. During these episodes, 58% of patients experienced prolonged ileus. Most of these complications (66% occurred within first one-year post transplant. Three patients presenting with acute intestinal obstruction required laparotomy (two- bands, one-intussusception. There were four mortalities -two patients had severe pancreatitis, one patient had massive upper GI bleed and one succumbed due to perforation peritonitis. Conclusions: Gastrointestinal complications account for significant morbidity and mortality in renal transplant recipients. Paralytic ileus secondary to acute vascular rejection is quite common and resolves spontaneously with recovery of renal function.

  11. [Renal toxicity of antiviral drugs].

    Science.gov (United States)

    Frasca', Giovanni M; Balestra, Emilio; Tavio, Marcello; Morroni, Manrico; Manarini, Gloria; Brigante, Fabiana

    2012-01-01

    Highly effective and powerful antiviral drugs have been introduced into clinical practice in recent years which are associated with an increased incidence of nephrotoxicity. The need of combining several drugs, the fragility of the patients treated, and the high susceptibility of the kidney are all factors contributing to renal injury. Many pathogenetic mechanisms are involved in the nephrotoxicity of antiviral drugs, including drug interaction with transport proteins in the tubular cell; direct cytotoxicity due to a high intracellular drug concentration; mitochondrial injury; and intrarenal obstruction or stone formation due to the low solubility of drugs at a normal urinary pH. As a result, various clinical pictures may be observed in patients treated with antiviral drugs, ranging from tubular dysfunction (Fanconi syndrome, renal tubular acidosis, nephrogenic diabetes insipidus) to acute renal failure (induced by tubular necrosis or crystal nephropathy) and kidney stones. Careful attention should be paid to prevent renal toxicity by evaluating the glomerular filtration rate before therapy and adjusting the drug dosage accordingly, avoiding the combination with other nephrotoxic drugs, and monitoring renal parameters on a regular basis while treating patients.

  12. Protocol biopsies for renal transplantation

    Directory of Open Access Journals (Sweden)

    Rush David

    2010-01-01

    Full Text Available Protocol biopsies in renal transplantation are those that are procured at predetermined times post renal transplantation, regardless of renal function. These biopsies have been useful to study the natural history of the transplanted kidney as they have detected unexpected - i.e. "subclinical" pathology. The most significant subclinical pathologies that have been detected with protocol biopsies have been acute lesions, such as cellular and antibody mediated rejection, and chronic lesions, such as interstitial fibrosis and tubular atrophy, and transplant glomerulopathy. The potential benefit of early recognition of the above lesions is that their early treatment may result in improved long-term outcomes. Conversely, the identification of normal histology on a protocol biopsy, may inform us about the safety of reduction in overall immunosuppression. Our centre, as well as others, is attempting to develop non-invasive methods of immune monitoring of renal transplant patients. However, we believe that until such methods have been developed and validated, the protocol biopsy will remain an indispensable tool for the complete care of renal transplant patients.

  13. Advanced renal disease, end-stage renal disease and renal death among HIV-positive individuals in Europe

    DEFF Research Database (Denmark)

    Ryom, L; Kirk, O; Lundgren, Jens

    2012-01-01

    Many studies have focused on chronic kidney disease in HIV-positive individuals, but few have studied the less frequent events, advanced renal disease (ARD) and end-stage renal disease (ESRD). The aim of this study was to investigate incidence, predictors and outcomes for ARD/ESRD and renal death...

  14. del Norte

    Directory of Open Access Journals (Sweden)

    Heydi Robles

    2005-01-01

    Full Text Available Este artículo muestra los resultados de una investigación sobre la ansiedad causada por el aprendizaje de idiomas. Está centrado en la ansiedad relacionada con la habilidad de producción oral. El objetivo del estudio era identificar los factores externos que producen ansiedad en el desarrollo de la competencia oral en un grupo de estudiantes de Psicología. Para lograr su objetivo, la investigación utilizó diarios, cuestionarios, grabaciones (opiniones personales, presentaciones orales breves y entrevistas. Con respecto de los factores externos que producen ansiedad en relación con las actividades, los resultados muestran que todas las actividades orales producen un alto grado de ansiedades en los estudiantes, especialmente las actividades no programadas. También muestran una falta de participación en clase con un fuerte rechazo a las actividades orales. Entre las posibles causas de reticencia puede estar el hecho de que los estudiantes no quieren ser objeto de burla. Además, la habilidad de producción oral no fue estimulada en los niveles anteriores del programa de inglés. Es vital mencionar que los alumnos son conscientes de sus carencias en algunos aspectos del idioma como vocabulario, gramática y fluidez.

  15. Idiopathic Renal Infarction Mimicking Appendicitis

    Science.gov (United States)

    Lisanti, Francesco; Scarano, Enrico

    2017-01-01

    Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%–0.007%). Usually, it manifests in patients aged 60–70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis. Here we highlight the extremely ambiguous presentation of renal infarct and the importance for clinicians to be aware of this condition, particularly in patients without clear risk factors, as it usually has a good prognosis after appropriate anticoagulant therapy. PMID:28203466

  16. Renal Myxoma, an Incidental Finding

    Directory of Open Access Journals (Sweden)

    Parth Thakker

    2017-07-01

    Full Text Available Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm. Immunohistochemical staining for CD-10, Desmin, HMB-45, and Pankeratin were negative.

  17. Renal secondary hyperparathyroidism in dogs.

    Science.gov (United States)

    Stillion, Jenefer R; Ritt, Michelle G

    2009-06-01

    The parathyroid glands secrete parathyroid hormone (PTH), which is important for maintaining calcium homeostasis. Parathyroid gland hyperplasia and subsequent hyperparathyroidism can occur secondary to chronic renal failure in dogs, resulting in significant alterations in calcium metabolism. Renal secondary hyperparathyroidism is a complex, multifactorial syndrome that involves changes in circulating levels of calcium, PTH, phosphorus, and 1,25-dihydroxycholecalciferol (calcitriol). An increased PTH level can have deleterious effects, including soft tissue mineralization, fibrous osteodystrophy, bone marrow suppression, urolithiasis, and neuropathy. Dietary phosphorus restriction, intestinal phosphate binders, and calcitriol supplementation may slow the progression of renal disease and decrease PTH concentrations in animals with secondary hyperparathyroidism; however, the prognosis for these animals is guarded to poor.

  18. Primary renal primitive neuroectodermal tumor.

    Science.gov (United States)

    Goel, V; Talwar, V; Dodagoudar, C; Singh, S; Sharma, A; Patnaik, N

    2015-01-01

    Primitive Neuroectodermal Tumor of the kidney is a rare entity. Very few cases of primary renal PNET have been reported to date. Most literature about rPNET is isolated case reports. We report a case of rPNET in a 39-year-old male with a pre-operative diagnosis of renal cell carcinoma with renal vein thrombosis. The patient underwent radical nephrectomy with thrombolectomy, and histopathological examination revealed a highly aggressive tumor composed of monotonous sheets of round cells. Tumor cells were positive for CD 99 and FLI-1, hence confirming the diagnosis of Primitive Neuroectodermal Tumor. Post-surgery, patient was given VAC/IE-based adjuvant chemotherapy. In view of highly aggressive nature of this tumor, prompt diagnosis and imparting effective chemotherapy regimen to the patient is required, and it is important to differentiate PNET from other small round-cell tumors because of different therapeutic approach.

  19. Scimitar syndrome with renal agenesis

    Directory of Open Access Journals (Sweden)

    Hasan Kahraman

    2012-01-01

    Full Text Available Partial pulmonary venous connection anomaly is relatively uncommon form of congenital heart diseases. The quite rare combination of this anomaly with hypoplasia of the right lung and dextroposition of the heart is designated as scimitar syndrome. Most cases are presented in infantile period and adult presentation is exceedingly rare. Our patient, a 38-year-old man, was admitted to a doctor with flu-like complaint and because of abnormalities on chest X-ray he was sent to our clinic. He did not have any chronic complaints such as shortness of breath and fatigue. After investigation, scimitar syndrome was diagnosed. Left renal agenesis was determined with abdominal examination. Best of our knowledge in literature we did not detect any case both with Scimitar syndrome and renal agenesis, and we wanted to report the asymptomatic adult Scimitar syndrome case with left renal agenesis.

  20. Sorafenib in renal cell carcinoma.

    Science.gov (United States)

    Davoudi, Ehsan Taghizadeh; bin-Noordin, Mohamed Ibrahim; Javar, Hamid Akbari; Kadivar, Ali; Sabeti, Bahare

    2014-01-01

    Cancer is among most important causes of death in recent decades. Whoever the renal cell carcinoma incidence is low but it seems it is more complicated than the other cancers in terms of pathophysiology and treatments. The purpose of this work is to provide an overview and also deeper insight to renal cell carcinoma and the steps which have been taken to reach more specific treatment and target therapy, in this type of cancer by developing most effective agents such as Sorafenib. To achieve this goal hundreds of research paper and published work has been overviewed and due to limitation of space in a paper just focus in most important points on renal cell carcinoma, treatment of RCC and clinical development of Sorafenib. The information presented this paper shows the advanced of human knowledge to provide more efficient drug in treatment of some complicated cancer such as RCC in promising much better future to fight killing disease.

  1. Emphysematous prostatitis in renal transplant

    Directory of Open Access Journals (Sweden)

    Krishnaswamy Sampathkumar

    2007-01-01

    Full Text Available Urinary tract infections are common following renal transplant. The spectrum varies from asymptomatic bacteriuria to septicemia. Gas-producing infections of the urinary tract are rare but tend to have a grave prognosis when they do occur. We report a 57-year-old gentleman who underwent a renal transplant 20 months earlier. He presented to us with fever and dysuria. Clinical examination revealed a febrile and ill-looking patient with severe graft tenderness. An emergency pelvic CT scan revealed presence of emphysematous prostatitis, cystitis and pyelitis. Urine and blood cultures grew E. coli . Endoscopic abscess drainage was done and antibiotics given but he succumbed to his illness due to multiorgan failure within 48h. This is the first reported case of emphysematous prostatitis in a renal allograft recipient.

  2. Pseudoporphyria secondary to renal failure

    Directory of Open Access Journals (Sweden)

    Lilianna Kulczycka-Siennicka

    2017-04-01

    Full Text Available Introduction . Pseudoporphyria is a rare disease associated with chronic renal failure. Symptoms of pseudoporphyria may develop in response to UV exposure and medications. The literature reports cases of pseudoporphyria in patients infected with hepatis C virus, HIV and undergoing dialysis therapy. Objective . Presentation of the case of a patient with pseudoporphyria and uraemic pruritus, and overview of therapeutic management. Case report . A 64-year-old male patient, who had been on dialysis for chronic renal failure secondary to type 2 diabetes for the past 11 years, presented with tense bullae located on sun-exposed skin which had persisted for the previous 5 months. The patient was diagnosed with pseudoporphyria, and treatment was prescribed including N-acetylcysteine, chloroquine, paroxetine and mianserin. An improvement in the patient’s clinical condition and a regression of pruritus were achieved. Conclusions . Patients with renal failure may develop symptoms of pseudoporphyria requiring differentiation from porphyria cutanea tarda.

  3. Calidad de vida relacionada con la salud en pacientes con enfermedad renal crónica

    Directory of Open Access Journals (Sweden)

    Lilian Barros-Higgins

    2015-10-01

    Full Text Available Antecedentes. La calidad de vida relacionada con la salud se puede afectar en personas con enfermedad renal crónica. Objetivo. Determinar la calidad de vida relacionada con la salud de los pacientes con enfermedad renal crónica (ERC y su relación con variables sociodemográficas y datos clínicos. Materiales y métodos. Estudio analítico de corte transversal realizado en 80 personas con diagnóstico de enfermedad renal crónica. Participaron los pacientes que asistieron a la Unidad Renal y al servicio de hospitalización durante los meses de estudio. Se aplicó el cuestionario Kidney Disease Quality of Life (KDQOL-SF, valorando ocho dimensiones genéricas de la calidad de vida relacionada con la salud y tres específicas relacionadas con la enfermedad renal. Se compararon las variables socio demográficas y las relacionadas con la enfermedad con las dimensiones del KDQOOL-36. Resultados. El 23.5% de la población estudiada tenía entre 61 y 70 años y 51.3% eran hombres. Se obtuvieron promedios bajos en las dimensiones carga de la enfermedad renal (40.3, salud física (33.4 y salud mental (43.5 del componente genérico. Se encontró una correlación significativa de la edad con las dimensiones efectos de la enfermedad renal en la vida diaria (0.238, p=0.03 y el componente genérico salud física (-0.242, p=0.03. Un trabajo remunerado se correlacionó positivamente con los componentes genéricos salud física (0.499, p=0.001 y salud mental (0.375, p=0.001 y la carga de la enfermedad renal se correlacionó negativamente con el tiempo de diagnóstico de enfermedad renal (-0.241, p=0.02. Conclusión. La enfermedad renal crónica tiene una carga sobre la calidad de vida de los pacientes en términos de salud física, salud mental y carga de la enfermedad.

  4. [Scintigraphic assessment of function in renal dystopia].

    Science.gov (United States)

    Pilgrim, S

    1998-06-01

    In patients with renal dystopia radionuclide urography in commonly used technique may yield inaccurate results concerning split renal function. In a case of unilateral pelvic kidney a simple strategy to avoid this methodical error is demonstrated.

  5. Pediatric renal transplantation: Results and prognostic factors

    Directory of Open Access Journals (Sweden)

    Po-Cheng Huang

    2013-04-01

    Conclusion: For pediatric patients, we found that renal transplantation is now a safe and effective surgical procedure for children with end-stage renal disease. Acute rejection and male gender were identified as prognostic factors for poor graft survival.

  6. Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

    DEFF Research Database (Denmark)

    Hornum, Mads; Feldt-Rasmussen, Bo

    2017-01-01

    or estimates of renal function in these patients, in order to accurately and safely dose immunosuppressive medication and perform and adjust the treatment and prophylaxis of renal dysfunction. This is a short overview and discussion of relevant studies and possible caveats of estimated glomerular filtration...... rate methods for use in renal and non-renal TX....

  7. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  8. Novel EYA1 variants causing Branchio-oto-renal syndrome.

    Science.gov (United States)

    Klingbeil, Kyle D; Greenland, Christopher M; Arslan, Selcuk; Llamos Paneque, Arianne; Gurkan, Hakan; Demir Ulusal, Selma; Maroofian, Reza; Carrera-Gonzalez, Andrea; Montufar-Armendariz, Stefany; Paredes, Rosario; Elcioglu, Nursel; Menendez, Ibis; Behnam, Mahdiyeh; Foster, Joseph; Guo, Shengru; Escarfuller, Sebastian; Cengiz, Filiz Basak; Duman, Duygu; Bademci, Guney; Tekin, Mustafa

    2017-07-01

    Branchio-oto-renal (BOR) syndrome is an autosomal dominant genetic disorder characterized by second branchial arch anomalies, hearing impairment, and renal malformations. Pathogenic mutations have been discovered in several genes such as EYA1, SIX5, and SIX1. However, nearly half of those affected reveal no pathogenic variant by traditional genetic testing. Whole Exome sequencing and/or Sanger sequencing performed in 10 unrelated families from Turkey, Iran, Ecuador, and USA with BOR syndrome in this study. We identified causative DNA variants in six families including novel c.525delT, c.979T > C, and c.1768delG and a previously reported c.1779A > T variants in EYA1. Two large heterozygous deletions involving EYA1 were detected in additional two families. Whole exome sequencing did not reveal a causative variant in the remaining four families. A variety of DNA changes including large deletions underlie BOR syndrome in different populations, which can be detected with comprehensive genetic testing. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Challenges in renal transplantation].

    Science.gov (United States)

    Thuret, R; Kleinclauss, F; Terrier, N; Karam, G; Timsit, M O

    2016-11-01

    To describe kidney transplantation surgical techniques and to propose strategies in high-risk recipients. Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov/) and Embase (http://www.embase.com/) database using the following keywords, alone or in association, "renal transplantation; peripheral arterial disease; obesity; third and fourth transplantation; robotic-assisted kidney transplant; anticoagulant therapy; dual kidney transplant". Articles were selected according to methods, language of publication and relevance. The reference lists were used to identify additional historical studies of interest. Both prospective and retrospective series, in French and English, as well as review articles and case-reports were selected. A total of 1949 articles were analyzed for arterial disease and anticoagulant therapy, 1083 for obesity, 663 for dual kidney transplants, 458 for third and subsequent procedures and 84 for robotic-assisted kidney transplantation. After careful selection, 304 publications were eligible for our review. Surgical assessment of future recipients is a pivotal step to anticipate technical difficulties, to interrupt clopidogrel or direct oral anticoagulants and to propose a revascularization procedure when necessary. Lack of data regarding obese recipients does not allow us to conclude about best surgical care or optimal timing but suggest that an early global management of obesity in chronic kidney disease patients is mandatory to improve access to a successful transplantation. In neurologic bladder and congenital anomalies, urodynamics and bladder function must be assessed prior to the onset of oliguria to intend an early treatment. Urinary diversion may be performed prior to or after transplantation with similar survival outcome and comparable rates of infections. Because of a rigorous selection of donors, the French dual kidney transplant program provides satisfactory outcomes, but fails in convincing surgical

  10. Renal infarction associated with adrenal pheochromocytoma.

    Science.gov (United States)

    Thewjitcharoen, Yotsapon; Atikankul, Taywin; Sunthornyothin, Sarat

    2013-09-01

    The coexistence of pheochromocytoma and renal artery stenosis had been reported occasionally from the possible mechanism of catecholoamine-induced vasospasm and extrinsic compression of renal artery in some reported cases. However, renal infarction caused by pheochromocytoma is an uncommon phenomenon. Herein, we report an interesting case of adrenal pheochromocytoma associated with renal artery thrombosis, which should be included in the differential diagnosis of pheochromocytoma patients who present with abdominal pain.

  11. Hypogonadism and renal failure: An update

    OpenAIRE

    Nannan Thirumavalavan; Wilken, Nathan A.; Ranjith Ramasamy

    2015-01-01

    The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles ...

  12. Impact of Pregnancy on Underlying Renal Disease

    OpenAIRE

    Baylis, Chris

    2003-01-01

    Normal pregnancy involves marked renal vasodilation and large increases in glomerular filtration rate (GFR). Studies in rats reveal that the gestational renal vasodilation is achieved by parallel reductions in tone in afferent and efferent arterioles so GFR rises without a change in glomerular blood pressure. There is some evidence from animal studies that increased renal generation of nitric oxide (NO) may be involved. Although chronic renal vasodilation has been implicated in causing progre...

  13. Hypogonadism and renal failure: An update

    OpenAIRE

    Nannan Thirumavalavan; Nathan A Wilken; Ranjith Ramasamy

    2015-01-01

    The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles ...

  14. [Intrascrotal metastasis in a renal cell carcinoma].

    Science.gov (United States)

    Calleja Escudero, J; Pascual Samaniego, M; Martín Blanco, S; de Castro Olmedo, C; Gonzalo, V; Fernández del Busto, E

    2004-04-01

    The present article reports a case of intrascrotal metastasis of renal adenocarcinoma. This is an unusual case. A 66-year-old male patient undewent right radical nephrectomy and cavotomy for renal cell carcinoma with renal vein infiltration and thrombus in cava. Six months later the patient present with a nodulous enlargement intrascrotal and roots of penis. And he died 15 moths after nephrectomy. Usually intrascrotal metastases are a late event in the course after detection of a renal carcinoma.

  15. Chronic Renal Failure, Cachexia, and Ghrelin

    OpenAIRE

    Laviano, A.; Krznaric, Z.; Sanchez-Lara, K.; Preziosa, I.; Cascino, A; Rossi Fanelli, F.

    2010-01-01

    Protein energy wasting is frequently observed in patients with advanced chronic renal failure and end-stage renal disease. Anorexia and reduced food intake are critical contributing factors and negatively impact on patients' survival. Ghrelin is a prophagic peptide produced by the stomach and acting at the hypothalamic level to increase the activity of orexigenic neurons. In patients with chronic renal disease, plasma levels are increased as a likely effect of reduced renal clearance. Neverth...

  16. Transplante renal na anemia falciforme

    OpenAIRE

    Friedrisch, Joao Ricardo; Barros, Elvino José Guardão; Manfro, Roberto Ceratti; Bittar,Christina Matzenbacher; Silla, Lucia Mariano da Rocha

    2003-01-01

    Embora a anemia falciforme e as síndromes falciformes freqüentemente causem várias alterações funcionais renais, não é comum a insuficiência renal terminal. Nestes casos, o transplante renal é uma alternativa que se acompanha de resultados comparáveis aos obtidos em receptores sem hemoglobinopatias. Esta estratégia terapêutica tem sido, no entanto, pouco relatada para portadores de hemoglobinopatia SC. Este relato descreve a evolução de dois pacientes portadores de hemoglobinopatia SC que for...

  17. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  18. Contemporary treatment of renal tumors

    DEFF Research Database (Denmark)

    Nisen, Harry; Järvinen, Petrus; Fovaeus, Magnus

    2017-01-01

    questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals. Hospital volume was defined as low (LVH: ...% thermoablations. For RN and PN, the percentages of open, laparoscopic and robotic approaches were 47%, 40%, 13% and 47%, 20%, 33%, respectively. The mean complication rate (Clavien–Dindo 3–5) was 4.9%, and 30 day mortality (TDM) was 0.5%. The median length of hospital stay was 4 days. Training with a simulator...

  19. Diagnostic management of renal colic.

    Science.gov (United States)

    Nicolau, C; Salvador, R; Artigas, J M

    2015-01-01

    Renal colic is a common reason for presentation to emergency departments, and imaging has become fundamental for the diagnosis and clinical management of this condition. Ultrasonography and particularly noncontrast computed tomography have good diagnostic performance in diagnosing renal colic. Radiologic management will depend on the tools available at the center and on the characteristics of the patient. It is essential to use computed tomography techniques that minimize radiation and to use alternatives like ultrasonography in pregnant patients and children. In this article, we review the epidemiology, clinical and radiologic presentations, and clinical management of ureteral lithiasis.

  20. [Renal cholesteatoma: keratin accumulation tumor].

    Science.gov (United States)

    González Castillo, P; Mora, M J; Mañas, A; Extramiana, J; Manzarbeitia, F; Pérez, M J; Paniagua, P; Pamplona, M

    1992-01-01

    Presentation of 6 cases of renal cholesteatoma in 4 male and 2 female patients ranging between 30 and 67 years of age. The most consistent clinical data was a history of relapsing nephritic colic of long-evolution. The average time to diagnose was 19 years. In 50% cases an association to malignant neoplastic pathology was found. The clinical diagnosis was based on the urography and the histopathological examination of the material passed with the urine. Renal exeresis was performed in 5 cases. One was treated in a conservative fashion. Also the etiology causes, diagnostic procedure and other therapeutic possibilities were reviewed.

  1. Acute renal infarction secondary to atrial fibrillation - mimicking renal stone picture.

    Science.gov (United States)

    Salih, Salih Bin; Al Durihim, Huda; Al Jizeeri, Ahmed; Al Maziad, Ghassan

    2006-06-01

    Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation.

  2. [Bacteria isolated from urine and renal tissue samples and their relation to renal histology].

    Science.gov (United States)

    Gökalp, A; Gültekin, E Y; Bakici, M Z; Ozdeşlik, B

    1988-01-01

    The bacteria from the urine and renal biopsy specimens of 40 patients undergoing renal surgery were isolated and their relations with renal histology investigated. The urine cultures were positive in 14 patients, the same organisms being isolated from the renal tissue in 7 cases. In 6 patients with negative urine cultures, bacteria were isolated from renal tissues. Of the 28 cases pathologically diagnosed as chronic pyelonephritis, bacteria were isolated from the renal tissue in 13 cases, the urine cultures being positive in only 11 cases. E. coli was the most commonly encountered bacteria in both the urine and renal tissues.

  3. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    Science.gov (United States)

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.

  4. Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

    DEFF Research Database (Denmark)

    Kneifel, M; Scholze, A; Burkert, A;

    2006-01-01

    It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...... of large arteries S1 and small arteries S2 in renal transplant recipients (each p renal allograft (p ...-Wallis test between groups). It is concluded that impairment of renal allograft function is associated with an increased arterial stiffness in renal transplant recipients....

  5. Comparación entre las ecuaciones CKD-EPI y MDRD para la estimación del filtrado glomerular en pacientes con enfermedad renal crónica Comparison between CKD-EPI and MDRD-equations to estimate glomerular filtration rate in chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Guillermo J. Rosa-Diez

    2011-08-01

    Full Text Available La ecuación MDRD para la estimación del índice de filtrado glomerular (IFG, es la estrategia más utilizada para evaluar pacientes con enfermedad renal crónica (ERC. Sin embargo, puede subestimar el IFG con el riesgo de asignar al paciente a estadios más avanzados de ERC. La nueva ecuación CKD-EPI, mejoraría la exactitud y precisión de las estimaciones. Sus autores sugieren que reemplace a la anterior. No habiendo comparaciones de estas ecuaciones aplicadas en un gran número de pacientes en nuestro país, nuestro objetivo fue realizarla en una amplia cohorte de pacientes. Se evaluó la concordancia de asignación en estadios de ERC entre ambas ecuaciones, tomando como referencia los datos surgidos de MDRD. Se calculó la media de las diferencias de los IFG obtenidos empleando ambas ecuaciones y se aplicó el análisis estadístico de Bland-Altman. Se estudió una cohorte de 9 319 pacientes con una media de creatinina sérica de 1.60 ± 1.03 mg/dl, 67% de sexo femenino y edad media 58 ± 20 años. En el grupo total, CKD-EPI presentó una media de IFG 0.61 ml/min/1.73 m² mayor que MDRD (p: NS. En los estadios 2 y 3A las medias del IFG fueron respectivamente 6.95 ± 4.76 y 3.21 ± 3.31, y la concordancia de 81 y 74%. El porcentaje de pacientes con un IFG menor de 60 ml/min/1.73 m², se redujo de 76.3% (MDRD a 70.1% (CKD-EPI. Por lo tanto, la nueva ecuación CKD-EPI disminuye el número de pacientes con IFG debajo de 60 ml/min/1.73 m² y asigna estadios de IFG más elevado a un número mayor de pacientes.The MDRD equation to estimate glomerular filtration rate (GFR is the most widely used strategy to assess chronic kidney disease. Nonetheless, for the individual patient the true GFR can be underestimated with the risk of diagnosing a more elevated CKD stage. This novel CKD-EPI equation would improve accuracy and precision of estimations, and several authors recommend this new equation replace the former. In our country there is only a

  6. Qualidade de vida da criança com insuficiência renal crônica Cualidad de vida de niños con insuficiencia renal crónica Life quality of children with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Mirna Albuquerque Frota

    2010-09-01

    Full Text Available O estudo objetivou avaliar a qualidade de vida de crianças com insuficiência renal crônica e identificar os domínios mais relevantes. É descritivo, com abordagem qualitativa e quantitativa, para a qual se utilizou a aplicação do Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI. Realizado no Instituto do Rim, em Fortaleza-CE-Brasil, com 13 crianças com diagnóstico de insuficiência renal crônica. Os dados foram analisados por meio da técnica de análise temática e do programa estatístico EXCEL. Emergiram as categorias: Dor no momento da diálise; Hospitalização; Limitações da doença e tratamento; Expectativa do transplante; e Apoio/aproximação familiar. A análise dos dados indicou que 61,53% das crianças possuem qualidade de vida regular, enquanto 38,46% têm essa qualidade prejudicada. As dimensões mais representativas foram: Lazer e Família, sendo Autonomia a dimensão mais comprometida. A qualidade de vida de criança com insuficiência renal crônica é considerada satisfatória, apesar das limitações.El objetivo del estudio fue evaluar la cualidad de vida de niños con insuficiencia renal crónica e identificar los dominios más importantes. Es descriptivo, con abordaje cualitativo y cuantitativo, donde se utilizó la aplicación del Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI. Realizado en el Instituto del Riñón, en Fortaleza-CE-Brasil, con 13 niños con diagnóstico de insuficiencia renal crónica. Los datos fueron analizados a través de la técnica de análisis temática y del programa EXCEL. Emergieron las categorías: Dolor en el momento de la diálisis; Hospitalización; limitaciones de la enfermedad y tratamiento; expectativa del trasplante; y apoyo/aproximación familiar. El análisis de los datos indicó que 61,53% de los niños poseen una cualidad de vida regular, mientras 38,46% tienen esta cualidad perjudicada. Las dimensiones más representativas fueron: entretenimiento y familia

  7. Absence of loss of heterozygosity of BRCA1 in a renal tumor from a BRCA1 germline mutation carrier

    OpenAIRE

    Alanee, Shaheen; Shah, Sohela; Murali, Rajmohan; Rau-Murthy, Rohini; Kasmintan A Schrader; Offit, Kenneth

    2013-01-01

    BRCA1 functions as a tumor suppressor gene and germline and somatic mutations in this gene have been shown to be associated with many types of cancer. We report the first tumor study of renal cell carcinoma in a carrier of the deleterious BRCA1 mutation-c.68_69delAG.

  8. Fast renal decline to end-stage renal disease

    DEFF Research Database (Denmark)

    Krolewski, Andrzej S.; Skupien, Jan; Rossing, Peter

    2017-01-01

    A new model of diabetic nephropathy in type 1 diabetes emerged from our studies of Joslin Clinic patients. The dominant feature is progressive renal decline, not albuminuria. This decline is a unidirectional process commencing while patients have normal renal function and, in the majority, progre...... for markers predictive of the rate of renal decline yield findings that may make detection of fast decliners feasible. Identifying such patients will be the foundation for developing effective individualized methods to prevent or delay onset of ESRD in diabetes....... progression as rate of eGFR declines > 5 ml/min/year, a value exceeded by 80% of patients in Joslin's type 1 diabetes ESRD cohort. The extraordinary range of slopes within the rapid progression category prompted us to partition it into “very fast,” “fast” and “moderate” decline. We showed, for the first time......, that very fast and fast decline from normal eGFR to ESRD within 2 to 10 years constitutes 50% of the Joslin cohort. In this review we present data about frequency of fast decliners in both diabetes types, survey some mechanisms underlying fast renal decline, discuss methods of identifying patients at risk...

  9. Hypogonadism and renal failure: An update

    Directory of Open Access Journals (Sweden)

    Nannan Thirumavalavan

    2015-01-01

    Full Text Available The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

  10. Hypogonadism and renal failure: An update.

    Science.gov (United States)

    Thirumavalavan, Nannan; Wilken, Nathan A; Ramasamy, Ranjith

    2015-01-01

    The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

  11. Maternal drugs and neonatal renal failure

    Directory of Open Access Journals (Sweden)

    M Sahay

    2014-01-01

    Full Text Available Maternal use of drugs during pregnancy may cause irreversible renal failure in the newborn. This report highlights the adverse effect of telmisartan during the last trimester of pregnancy. The neonate presented with oliguric renal failure and the renal histology showed proximal tubular dysgenesis.

  12. Impact of pregnancy on underlying renal disease.

    Science.gov (United States)

    Baylis, Chris

    2003-01-01

    Normal pregnancy involves marked renal vasodilation and large increases in glomerular filtration rate (GFR). Studies in rats reveal that the gestational renal vasodilation is achieved by parallel reductions in tone in afferent and efferent arterioles so GFR rises without a change in glomerular blood pressure. There is some evidence from animal studies that increased renal generation of nitric oxide (NO) may be involved. Although chronic renal vasodilation has been implicated in causing progression of renal disease in nonpregnant states by glomerular hypertension, there are no long-term deleterious effects of pregnancies on the kidney when maternal renal function is normal because glomerular blood pressure remains normal. When maternal renal function is compromised before conception, there are no long-term adverse effects on renal function in most types of renal disease, providing that the GFR is well maintained before conception. When serum creatinine exceeds approximately 1.4 mg/dL, pregnancy may accelerate the renal disease increases and when serum creatinine >2 mg/dL, the chances are greater than 1 in 3 that pregnancy will hasten the progression of the renal disease. The available animal studies suggest that glomerular hypertension does not occur despite diverse injuries. Thus, the mechanisms of the adverse interaction between pregnancy and underlying renal disease remain unknown.

  13. [The Dutch guideline 'Renal cell carcinoma'].

    NARCIS (Netherlands)

    Osanto, S.; Bex, A.; Hulsbergen- van de Kaa, C.A.; Soetekouw, P.M.M.B.; Stemkens, D.

    2012-01-01

    The Dutch guideline 'Renal Cell Carcinoma' has been revised on the basis of new literature. With the assistance of the Netherlands Cancer Registry an assessment was made of the current care for patients with renal cell carcinoma. Renal cell carcinoma is a type of cancer for which knowledge of the ge

  14. Renal function after solid organ transplantation

    NARCIS (Netherlands)

    Broekroelofs, Jan

    2000-01-01

    The studies described in this thesis focus on the problem of renal chronic function loss following solid organ transplantation form a nephrologist point of view. Nephrologists have been and are still confionted with renal function loss in native kidney diseases. The last 3 decades chronic renal func

  15. Enfermedad Renal Crónica y trasplante renal: experiencias y superación de una estudiante de medicina

    Directory of Open Access Journals (Sweden)

    Ana Julia Carrillo Algarra

    2015-12-01

    Full Text Available Las personas con enfermedad renal crónica (ERC en estado terminal ven el trasplante como esperanza de vida e independencia, les evita ir tres veces por semana a hemodiálisis o tener presente el horario para sus recambios. Describen este cambio como positivo, por tanto interesa comprender cómo vive esa transformación Kate, estudiante de último año de medicina a quien sorpresivamente le diagnostican ERC, el efecto que tiene este suceso en su confianza en la medicina occidental, que la lleva a buscar refugio en medicinas alternativas. El relato rememora la experiencia y evolución del tratamiento de Kate, cómo describe ella el cambio de vida, las implicaciones de ser paciente en las diferentes terapias de sustitución renal, sus experiencias antes, durante y después del trasplante y lo que este significa teniendo en cuenta que ella conoce los procedimientos y las posibles complicaciones.

  16. Automated renal histopathology: digital extraction and quantification of renal pathology

    Science.gov (United States)

    Sarder, Pinaki; Ginley, Brandon; Tomaszewski, John E.

    2016-03-01

    The branch of pathology concerned with excess blood serum proteins being excreted in the urine pays particular attention to the glomerulus, a small intertwined bunch of capillaries located at the beginning of the nephron. Normal glomeruli allow moderate amount of blood proteins to be filtered; proteinuric glomeruli allow large amount of blood proteins to be filtered. Diagnosis of proteinuric diseases requires time intensive manual examination of the structural compartments of the glomerulus from renal biopsies. Pathological examination includes cellularity of individual compartments, Bowman's and luminal space segmentation, cellular morphology, glomerular volume, capillary morphology, and more. Long examination times may lead to increased diagnosis time and/or lead to reduced precision of the diagnostic process. Automatic quantification holds strong potential to reduce renal diagnostic time. We have developed a computational pipeline capable of automatically segmenting relevant features from renal biopsies. Our method first segments glomerular compartments from renal biopsies by isolating regions with high nuclear density. Gabor texture segmentation is used to accurately define glomerular boundaries. Bowman's and luminal spaces are segmented using morphological operators. Nuclei structures are segmented using color deconvolution, morphological processing, and bottleneck detection. Average computation time of feature extraction for a typical biopsy, comprising of ~12 glomeruli, is ˜69 s using an Intel(R) Core(TM) i7-4790 CPU, and is ~65X faster than manual processing. Using images from rat renal tissue samples, automatic glomerular structural feature estimation was reproducibly demonstrated for 15 biopsy images, which contained 148 individual glomeruli images. The proposed method holds immense potential to enhance information available while making clinical diagnoses.

  17. Renal functional reserve and renal recovery after acute kidney injury.

    Science.gov (United States)

    Sharma, Aashish; Mucino, Marìa Jimena; Ronco, Claudio

    2014-01-01

    Renal functional reserve (RFR) represents the capacity of the kidney to increase glomerular filtration rate (GFR) in response to certain physiological or pathological stimuli or conditions. Once baseline GFR is determined, RFR can be assessed clinically after an oral protein load or intravenous amino acid infusion. In clinical practice, baseline GFR displays variable levels due to diet or other factors. RFR is the difference between peak 'stress' GFR induced by the test (p.o. or i.v.) and the baseline GFR. In clinical scenarios where hyperfiltration is present (high baseline GFR due to pregnancy, hypertension or diabetic nephropathy, in solitary kidney or kidney donors), RFR may be fully or partially used to achieve normal or supranormal renal function. Since commonly used renal function markers, such as GFR, may remain within normal ranges until 50% of nephrons are lost or in patients with a single remnant kidney, the RFR test may represent a sensitive and early way to assess the functional decline in the kidney. RFR assessment may become an important tool to evaluate the ability of the kidney to recover completely or partially after a kidney attack. In case of healing with a defect and progressive fibrosis, recovery may appear complete clinically, but a reduced RFR may be a sign of a maladaptive repair or subclinical loss of renal mass. Thus, a reduction in RFR may represent the equivalent of renal frailty or susceptibility to insults. The main aim of this article is to review the concept of RFR, its utility in different clinical scenarios, and future perspective for its use.

  18. Cyclosporine-induced renal dysfunction in human renal allograft recipients.

    Science.gov (United States)

    Kiberd, B A

    1989-12-01

    Cyclosporine-treated renal allograft recipients frequently suffer CsA-related nephrotoxicity and hypertension. This study demonstrates that glomerular filtration rate is reduced acutely by 13% (P less than 0.02) and renal vascular resistance increased by 30% (P less than 0.05), immediately after patients take their CsA dose. The reduction in GFR is directly related to their trough CsA level (r = 0.82; P less than 0.01). The lower the trough CsA level the greater the fall in GFR after the CsA dose. Plasma renin activity does not increase after the CsA dose (pre-CsA 0.6 +/- 0.2 ng/L/sec vs. post-CsA 0.4 +/- 0.1 ng/L/sec; P = NS), and therefore cannot be responsible for the reduction in renal function. Short-term nifedipine treatment is effective in preventing the acute reduction in GFR (P less than 0.05). This occurred despite no apparent effect of nifedipine in altering trough or post-dose CsA levels. Furthermore nifedipine was effective in lowering both the mean arterial blood pressure (109 mmHg to 94 mmHg; P less than 0.01) and the elevated renal vascular resistance (25% reduction; P less than 0.02) observed in these patients. These results suggest that nifedipine may be a suitable agent for limiting acute CsA nephrotoxicity and for treating CsA-associated hypertension in renal allograft recipients.

  19. Renal cell carcinoma with areas mimicking renal angiomyoadenomatous tumor/clear cell papillary renal cell carcinoma.

    Science.gov (United States)

    Petersson, Fredrik; Grossmann, Petr; Hora, Milan; Sperga, Maris; Montiel, Delia Perez; Martinek, Petr; Gutierrez, Maria Evelyn Cortes; Bulimbasic, Stela; Michal, Michal; Branzovsky, Jindrich; Hes, Ondrej

    2013-07-01

    We present a cohort of 8 renal carcinomas that displayed a variable (5%-95% extent) light microscopic appearance of renal angiomyoadenomatous tumor/clear cell papillary renal cell carcinoma (RAT/CCPRCC) without fulfilling the criteria for these tumors. All but 1 case predominantly (75%-95% extent) showed histopathologic features of conventional clear cell renal cell carcinoma. In 5 of 7 cases with mostly conventional clear renal cell carcinoma (CRCC) morphology, a diagnosis of CRCC was supported by the molecular genetic findings (presence of von Hippel-Lindau tumor suppressor [VHL] mutation and/or VHL promoter methylation and/or loss of heterozygosity [LOH] for 3p). Of the other 2 cases with predominantly characteristic CRCC morphology, 1 tumor did not reveal any VHL mutation, VHL promoter methylation, or LOH for 3p, and both chromosomes 7 and 17 were disomic, whereas the other tumor displayed polysomy for chromosomes 7 and 17 and no VHL mutation, VHL promoter methylation, or LOH for 3p. One tumor was composed primarily (95%) of distinctly RAT/CCPRCC-like morphology, and this tumor harbored a VHL mutation and displayed polysomy for chromosomes 7 and 17. Of the 5 cases with both histomorphologic features and molecular genetic findings of CRCC, we detected significant immunoreactivity for α-methylacyl-CoA racemase in 2 cases and strong diffuse immunopositivity for cytokeratin 7 in 3 cases. Despite the combination of positivity for α-methylacyl-CoA racemase and cytokeratin 7 in 2 cases, there was nothing to suggest of the possibility of a conventional papillary renal cell carcinoma with a predominance of clear cells.

  20. Biomarcadores de daño renal temprano asociados al consumo de tabaco

    OpenAIRE

    Sanz Parras, Francisco José

    2016-01-01

    [ES] El tabaco es un factor de riesgo (FR) asociado a la progresión de patologías como el cáncer, las enfermedades pulmonares y las enfermedades cardiovasculares. En las últimas décadas se ha observado un incremento del daño renal en individuos fumadores con patologías como la diabetes, la hipertensión, la enfermedad renal crónica. Sin embargo, existe poca evidencia de la asociación entre el consumo de tabaco y la producción de daño renal en individuos sanos. Por otra parte, el diagnóstico de...

  1. Pescados procesados: ¿son todos recomendables para pacientes renales?

    Directory of Open Access Journals (Sweden)

    María Isabel Castro-González

    2009-01-01

    Full Text Available Es indispensable un buen manejo nutricional en pacientes renales. La dieta debe incluir proteína de buena calidad con cantidades limitadas de fósforo (P y potasio (K. Los ácidos grasos n-3 (AGPIn-3 de los pescados proporcionan beneficios contra la progresión del daño renal. El objetivo fue evaluar el contenido de proteína (PR, (P, (K, calcio (Ca y AGPIn-3 en pescados procesados como una opción para pacientes renales. Se analizó atún en agua (AA, en aceite (AAC, sardina en tomate (ST, en chipotle (SC y salmón ahumado (SA. (SA presentó la mayor concentración de (PR, (P y (K y la menor cantidad de (AGPIn-3. Las sardinas presentaron el doble de la concentración de (P y (K en comparación con los atunes, así como (Ca en elevada concentración. Atunes y sardinas tuvieron altas concentraciones de AGPIn-3 (4256-5213 mg/100g; las relaciones P:AGPIn-3 y K: P:AGPIn-3 fueron muy bajas (0.03 a 0.06, para atunes y sardinas, respectivamente; (AA y (AC aportaron (10.1 y 11.1 mg(P/g(PR; (ST (26.4 y (SC(19.1. AGPIn-3/g(PR fue similar para atunes y sardinas (302-424. Se detectó diferencia significativa para (P y (K entre tipos de pescados. Se recomienda incluir de manera individualizada (AA y (AC en la dieta de pacientes renales, no así el consumo de sardina y salmón.

  2. Chemical Renal Denervation in the Rat

    Energy Technology Data Exchange (ETDEWEB)

    Consigny, Paul M., E-mail: paul.consigny@av.abbott.com; Davalian, Dariush, E-mail: dariush.davalian@av.abbott.com [Abbott Vascular, Innovation Incubator (United States); Donn, Rosy, E-mail: rosy.donn@av.abbott.com; Hu, Jie, E-mail: jie.hu@av.abbott.com [Abbott Vascular, Bioanalytical and Material Characterization (United States); Rieser, Matthew, E-mail: matthew.j.rieser@abbvie.com; Stolarik, DeAnne, E-mail: deanne.f.stolarik@abbvie.com [Abbvie, Analytical Pharmacology (United States)

    2013-12-03

    Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10{sup −5} M through 10{sup −2} M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

  3. Comparison of the effectiveness and renal safety of tenofovir versus entecavir in patients with chronic hepatitis B.

    Science.gov (United States)

    López Centeno, Beatriz; Collado Borrell, Roberto; Pérez Encinas, Montserrat; Gutiérrez García, Maria Luisa; Sanmartin Fenollera, Patricia

    2016-06-01

    Objetivo: Comparar la efectividad y seguridad renal del tratamiento con tenofovir frente al entecavir en pacientes con hepatitis B cronica. Métodos: Estudio retrospectivo en pacientes con hepatitis B que iniciaron tratamiento con tenofovir o entecavir entre enero 1998-2013. La variable principal de la efectividad fue definida como DNA viral estudio existen diferencias significativas entre ambos tratamientos respecto a su efectividad, mostrandose el tenofovir superior. En cuanto a la seguridad renal, no hemos encontrado diferencias significativas, pero dos casos de suspension de tratamiento por toxicidad renal con tenofovir nos llevan a concluir que la decision de tratamiento en los pacientes con alteraciones en la funcion renal deberia incluir un analisis individualizado de cada caso.

  4. Guidelines on renal cell cancer

    NARCIS (Netherlands)

    Mickisch, G; Carballido, J; Hellsten, S; Schuize, H; Mensink, H

    2001-01-01

    Objectives., On behalf of the European Association of Urology (EAU), Guidelines for Diagnosis, Therapy and. Follow Up of Renal. Cell Carcinoma Patients were established. Criteria for recommendations were evidence based and included aspects of cost-effectiveness and clinical feasibility. Method: A sy

  5. Renal targeting of kinase inhibitors

    NARCIS (Netherlands)

    Dolman, M. E. M.; Fretz, M. M.; Segers, Gj. W.; Lacombe, M.; Prakash, J.; Storm, G.; Hennink, W. E.; Kok, R. J.

    2008-01-01

    Activation of proximal tubular cells by fibrotic and inflammatory mediators is an important hallmark of chronic kidney disease. We have developed a novel strategy to intervene in renal fibrosis, by means of locally delivered kinase inhibitors. Such compounds will display enhanced activity within tub

  6. Renal targeting of kinase inhibitors

    NARCIS (Netherlands)

    Dolman, M. E. M.; Fretz, M. M.; Segers, Gj. W.; Lacombe, M.; Prakash, J.; Storm, G.; Hennink, W. E.; Kok, R. J.

    2008-01-01

    Activation of proximal tubular cells by fibrotic and inflammatory mediators is an important hallmark of chronic kidney disease. We have developed a novel strategy to intervene in renal fibrosis, by means of locally delivered kinase inhibitors. Such compounds will display enhanced activity within

  7. Acute leukaemia following renal transplantation.

    Science.gov (United States)

    Subar, M; Gucalp, R; Benstein, J; Williams, G; Wiernik, P H

    1996-03-01

    Four renal transplant patients on immunosuppressive therapy who presented with acute myeloid leukaemia are described. In two cases, azathioprine may have played an important role as a cofactor in leukaemogenesis. In a third case, the alkylating agent cyclophosphamide may have contributed. All patients were treated for leukaemia with full doses of cytotoxic chemotherapy and, in each case, a functioning renal allograft was preserved throughout the treatment despite attenuation of immunosuppressive therapy. Three patients achieved complete remission. Of the three, one is surviving at 2 years and two expired during the pancytopenic phase of their treatment with no active leukaemia present, and with intact renal function. As increasing expertise in the field of organ transplantation allows patients to survive longer, such patients' exposure to immunosuppressive and potentially leukaemogenic drugs is prolonged. The risk of secondary neoplasia has been previously documented in this population. Two of the four cases reported here suffered from polycystic kidney disease as their underlying condition. While this report suggests that the leukaemias are related to renal transplantation, we cannot rule out an association with the underlying disease which led to the transplant. This report further suggests that the leukaemia that develops in such patients may respond to standard therapy, and that such treatment does not compromise the transplanted kidney.

  8. Novel genes in renal aging

    NARCIS (Netherlands)

    Noordmans, Gerda Anke

    2015-01-01

    Renal aging is characterized by structural changes and functional decline. These changes make the elderly more vulnerable to chronic kidney disease, hypertension, and cardiovascular disease. Furthermore, they also make it more difficult to cope with stress factors, such as dehydration, toxicity, and

  9. Renal replacement therapy in yemen.

    Science.gov (United States)

    Sheiban, A K; Yehia, A; Mohamed, Y A; Hajar, A R

    1996-01-01

    In this report we present the current status of dialysis and transplantation in Yemen. The reported incidence of end stage renal disease (ESRD) in one region of Yemen was estimated as 385 per million population (PMP) per year. The total population of Yemen is also estimated as 16,000,000. Peritoneal dialysis was started in 1980, while hemodialysis was started in 1981. At present there are around 36 hemodialysis machines distributed in the large cities of Yemen. Intermittent peritoneal dialysis is commonly used; however, continuous ambulatory peritoneal dialysis has been out of practice since 1992. Renal transplantation has not yet been started in Yemen; however, at present there are 327 transplant patients being followed up in it. The majority of patients had their grafts from living non related donors abroad. In our experience, such transplantations were associated with high morbidity and mortality, in addition to acquisition of serious, potentially lethal extra-renal medical problems. We believe that there is a wide shortage of renal services in Yemen. Establishing a National Kidney Foundation to organize these services may be helpful.

  10. On renal pathophysiology in preeclampsia

    NARCIS (Netherlands)

    Penning, Maria Elisabeth (Marlies)

    2014-01-01

    Preeclampsia is a complication of pregnancy which can suddenly change from a relatively mild phenotype into a life-threatening situation. One of the organs that is always involved during preeclampsia is the kidney. The placenta plays an important role in the renal pathophysiology of preeclampsia. Th

  11. Fibrate therapy and renal function.

    Science.gov (United States)

    Sica, Domenic A

    2009-09-01

    Fibrates are a class of lipid-lowering medications primarily used as second-line agents behind statins. The adverse-effect profile of fibrates has been marked by a puzzling yet reversible rise in serum creatinine values with their use. It is not known whether this finding represents a true change in renal function. One proposed explanation for this phenomenon is that fibrates increase the production of creatinine, in which case a rise in serum creatinine values would not represent a true deterioration in renal function. An alternative theory is that fibrates reduce the production of vasodilatory prostaglandins, which would lead to a true change in renal function in patients who experience a rise in serum creatinine values. Routine serum creatinine monitoring is advisable in fibrate-treated patients, particularly in those with preexisting renal disease. A 30% increase in serum creatinine values in the absence of other causes of serum creatinine change warrants discontinuation of fibrate therapy. Serum creatinine values can take several weeks to return to their baseline values following discontinuation of a fibrate.

  12. Emphysema in the renal allograft

    Energy Technology Data Exchange (ETDEWEB)

    Potter, J.L.; Sullivan, B.M.; Fluornoy, J.G.; Gerza, C.

    1985-04-01

    Two diabetic patients in whom emphysematous pyelonephritis developed after renal transplantation are described. Clinical recognition of this unusual and serious infection is masked by the effects of immunosuppression. Abdominal radiographic, ultrasound, and computed tomography findings are discussed. The clinical presentation includes urinary tract infection, sepsis, and acute tubular malfunction of the allograft in insulin-dependent diabetics.

  13. Del Derecho laboral al Derecho del trabajo

    OpenAIRE

    Jaramillo Jassir, Ivan Daniel

    2011-01-01

    El Derecho Laboral hijo de la revolución industrial, calificado como el acontecimiento jurídico del siglo XX, reduce su ámbito de estudio al trabajo subordinado. Los cambios del sistema de producción superan la centralidad del contrato de trabajo subordinado a tiempo indeterminado, situación que demanda ampliación del ámbito de aplicación subjetivo y objetivo de la materia, dando paso al Derecho del Trabajo que se ocupa del trabajo en todas sus modalidades como fuente de ingreso para satisfac...

  14. [Renal cell carcinoma secondary to tuberculous nephritis].

    Science.gov (United States)

    El Mejjad, Amine; Fekak, Hamid; Debbagh, Adili; Joual, Abdenbi; Bennani, Saad; El Mrini, Mohamed

    2005-04-01

    The combination of renal tuberculosis and renal cancer is rare. The authors report the case of a patient who was followed for multifocal pulmonary, hepatic and renal tuberculosis. The diagnosis of associated renal tumour was raised in the presence of suggestive radiological images. Tumourectomy was performed after tuberculostatic therapy, and histological examination revealed renal cell carcinoma associated with caseo-follicular tuberculous granulomas. The outcome was favourable after a follow-up of 2 years. The objective of this study is to analyse the pathogenesis, diagnostic features and treatment modalities of this exceptional combination.

  15. TCM Researches on Chronic Renal Tubulointerstitial Lesions

    Institute of Scientific and Technical Information of China (English)

    LI Hang; XIONG Jing; ZHOU Quan-rong

    2008-01-01

    @@ Researches in recent years show that progressive deterioration of the renal function caused by kidney diseases mainly relies on the severity of renal tubulointerstitial lesions (RTIL).Therefore,imp-ortance should be attached to RTIL.With its very complicated pathogenesis,RTIL is manifested as the local in flammation in renal interstitium at early stage,followed by secretion of cellular factor and then phenotype variation,apoptosis and excessive pro-liferation of renal tubular epithelial cell(RTEC),as well as increase in synthesis and decrease in degradation of extracellular matrix(ECM),causing excessive deposition of ECM and eventually-renal interstitial fibrosis(RIF).ws.

  16. Sonographic Findings in Fetal Renal Vein Thrombosis.

    Science.gov (United States)

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  17. Malformaciones müllerianas. Síndrome de hemivagina obstruida y anomalía renal ipsilateral (OHVIRA)

    OpenAIRE

    Cyrus Dean Mario Afrashtehfar; Adrián Piña-García; Kelvin Ian Afrashtehfar

    2014-01-01

    Las malformaciones de los conductos de Müller son un grupo de entidades raras y poco diagnosticadas que ocasionan síntomas inespecíficos en adolescentes y pueden acompañarse de problemas de infertilidad y resultados obstétricos adversos. Estas malformaciones ocurren durante la gestación como consecuencia del desarrollo anormal de los conductos de Müller en diferentes etapas del proceso de formación del aparato reproductor femenino. El síndrome de hemivagina obstruida y anomalía renal ipsilate...

  18. La Exploración Funcional en la Insuficiencia Renal Crónica.

    OpenAIRE

    Palma Álvarez, Alfonso

    2017-01-01

    Hasta hace muy poco tiempo, la actitud del clínico ante la Insuficiencia Renal Crónica (IRC) era pasiva y, con resignado conformismo, era testigo y acompañante del triste e inexorable sino, que en un breve plazo y preñado de complicaciones, conduce al “exitus”, ante su indignada impotencia. Ahora el panorama ha cambiado, es cierto que el inexorable destino se cumple, pero se ha conseguido prolongar la vida considerablemente y lo que es aún m&aa...

  19. Metastatic renal cell carcinoma management

    Directory of Open Access Journals (Sweden)

    Flavio L. Heldwein

    2009-06-01

    Full Text Available PURPOSE: To assess the current treatment of metastatic renal cell carcinoma, focusing on medical treatment options. MATERIAL AND METHODS: The most important recent publications have been selected after a literature search employing PubMed using the search terms: advanced and metastatic renal cell carcinoma, anti-angiogenesis drugs and systemic therapy; also significant meeting abstracts were consulted. RESULTS: Progress in understanding the molecular basis of renal cell carcinoma, especially related to genetics and angiogenesis, has been achieved mainly through of the study of von Hippel-Lindau disease. A great variety of active agents have been developed and tested in metastatic renal cell carcinoma (mRCC patients. New specific molecular therapies in metastatic disease are discussed. Sunitinib, Sorafenib and Bevacizumab increase the progression-free survival when compared to therapy with cytokines. Temsirolimus increases overall survival in high-risk patients. Growth factors and regulatory enzymes, such as carbonic anhydrase IX may be targets for future therapies. CONCLUSIONS: A broader knowledge of clear cell carcinoma molecular biology has permitted the beginning of a new era in mRCC therapy. Benefits of these novel agents in terms of progression-free and overall survival have been observed in patients with mRCC, and, in many cases, have become the standard of care. Sunitinib is now considered the new reference first-line treatment for mRCC. Despite all the progress in recent years, complete responses are still very rare. Currently, many important issues regarding the use of these agents in the management of metastatic renal cancer still need to be properly addressed.

  20. Nutrición artificial en la insuficiencia renal aguda Artificial nutrition in acute renal failure

    Directory of Open Access Journals (Sweden)

    F. J. Jiménez Jiménez

    2005-06-01

    Full Text Available El soporte nutricional en los pacientes críticos que presentan insuficiencia renal aguda ha sido motivo de cambio en los últimos años. Ello es debido al empleo cada vez más frecuente y precoz de las técnicas de depuración extrarenal. Las modificaciones en la pauta de soporte nutricional y metabólico destinadas a evitar la progresión del fracaso renal, recomendadas clásicamente, no tendrían indicación en estas situaciones salvo en los casos no tratados con alguna de las técnicas depurativas. El aporte proteico, por lo tanto, deberá ser adecuado a la situación clínica, no recomendándose ya el empleo de las formulaciones de aminoácidos compuestas exclusivamente por aminoácidos esenciales. La administración de glucosa no sería diferente a la recomendada en otras situaciones. La infusión de lípidos tendría un límite máximo de 1 gr/Kg/día. El empleo de dietas estándar, por tanto, no plantea problemas si los pacientes están siendo tratados con técnicas de depuración. No obstante, la relación entre el flujo de substratos a través de las membranas de diálisis y su efecto sobre la demanda de nutrientes está aún sin establecer de manera clara. Es probable que se requiera un incremento del aporte de nutrientes con el fin de contrarrestar la pérdida obligada por las técnicas de depuración. A la inversa, queda también por estudiar el papel de dichas técnicas como vía adecuada para el soporte nutricional en los pacientes críticos.Nutritional support in critically ill patients that present with acute renal failure has been a matter of change in recent years. This is due to the increasing and earlier use of extrarenal depuration techniques. Modifications in nutritional and metabolic support regimen aimed at preventing renal failure progression, classically recommended, would not have an indication in these situations but in cases not treated with one of these depurative techniques. Thus, protein intake should be

  1. RENAL FUNCTION DERANGEMENT IN HELLP SYNDROME

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    Anusha Harihara Gopalan

    2017-04-01

    Full Text Available BACKGROUND HELLP is the acronym for haemolysis, elevated liver enzymes and low platelet count. HELLP syndrome is a form of severe preeclampsia with an incidence of 0.2-0.6% of all pregnancies. The aim of our study is to evaluate the trend of renal dysfunction in HELLP syndrome patients. MATERIALS AND METHODS This is a cross-sectional observational study conducted in Department of Obstetrics and Gynaecology, Institute of Maternal and Child Health, Government Medical College, Kozhikode, during the period of 12 months from January 2013 to December 2013. All patients with HELLP syndrome were included in the study and their renal function tests monitored. RESULTS Results were renal dysfunction prevalence in HELLP syndrome patients is 77%. The renal impairment recovered by 6 days on an average. All had normal renal function tests at the time of discharge. Patients with renal function derangement had a mean duration of hospital stay and transfusion requirements more than the patients without renal function derangement, which was statistically significant (p value 0.036. Haemodialysis required for one out of 60 patients. One maternal mortality due to acute renal failure. CONCLUSION As the prevalence of renal dysfunction is high, some amount of renal impairment maybe a part of the HELLP syndrome disease spectrum itself. Though the incidence of progression to acute renal failure and dialysis is less, this is the important cause of morbidity and mortality in HELLP syndrome patients.

  2. Renal denervation for resistant hypertension.

    Science.gov (United States)

    Coppolino, Giuseppe; Pisano, Anna; Rivoli, Laura; Bolignano, Davide

    2017-02-21

    Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition. We sought to evaluate the short- and long-term effects of renal denervation in individuals with resistant hypertension on clinical end points, including fatal and non-fatal cardiovascular events, all-cause mortality, hospital admissions, quality of life, blood pressure control, left ventricular hypertrophy, cardiovascular and metabolic profile, and kidney function, as well as the potential adverse events related to the procedure. We searched the following databases to 17 February 2016 using relevant search terms: the Cochrane Hypertension Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and ClinicalTrials.gov SELECTION CRITERIA: We considered randomised controlled trials (RCTs) that compared renal denervation to standard therapy or sham procedure to treat resistant hypertension, without language restriction. Two authors independently extracted data and assessed study risks of bias. We summarised treatment effects on available clinical outcomes and adverse events using random-effects meta-analyses. We assessed heterogeneity in estimated treatment effects using Chi² and I² statistics. We calculated summary treatment estimates as a mean difference (MD) or standardised mean difference (SMD) for continuous outcomes, and a risk ratio (RR) for dichotomous outcomes, together with their 95% confidence intervals (CI). We found 12 eligible studies (1149

  3. Factores asociados y consecuencias clínicas de la anemia post trasplante renal

    Directory of Open Access Journals (Sweden)

    Mónica Freiberg

    2013-04-01

    Full Text Available Un porcentaje considerable de pacientes presentan anemia post trasplante renal. Su origen es multifactorial y sus principales etiologías dependen de la etapa post trasplante que se considere. Estudiamos en un grupo de 134 pacientes los factores asociados con anemia tardía (6 meses post trasplante y sus implicaciones clínicas a mediano plazo. En el análisis de regresión múltiple, la duración de la oliguria post trasplante y el número de episodios de rechazo fueron las variables significativamente asociadas con esta complicación. La supervivencia del órgano mostró una diferencia significativa a los 36 meses entre los grupos (83% en los anémicos versus 96% de los no anémicos p < 0.01. No observamos diferencias en mortalidad o eventos cardiovasculares. Concluimos que la presencia de anemia al sexto mes post trasplante renal está independiente y significativamente asociada con factores que condicionan la masa renal funcionante que explicarían además la menor supervivencia del injerto renal observada en estos pacientes.

  4. Análisis de la utilidad de la olfatogustometría mediante BAST-24 en la población diabética y su relación con la función renal

    OpenAIRE

    Gascón Rubio, María Cristina

    2014-01-01

    157 p. : il., graf. Realizamos un estudio descriptivo observacional del sentido del olfato mediante el test BAST-24 de la población diabética. Valoramos su función renal mediante determinaciones analíticas.

  5. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-10-01

    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

  6. HBsAg as predictor of outcome in renal transplant patients HBsAg como predictor de evolución en trasplantados renales

    Directory of Open Access Journals (Sweden)

    Ezequiel Ridruejo

    2004-10-01

    Full Text Available Chronic liver infections related to hepatitis B and C viruses are a common problem in renal transplant patients with a prevalence of 1.5 to 50% in different countries. There is no uniform agreement regarding their influence on the incidence of acute rejection, graft outcome and survival of renal transplant patients. We retrospectively evaluated the influence of antiHBc, antiHCV and HBsAg positive status; gender; age over 50 years of age at the time of transplantation; pre and postransplantation alaninaminotransferase (ALT elevation; acute rejection; type of graft; number of transplants; and maintenance and induction immunosuppression treatment on the incidence of acute rejection and both graft and patient survival in the population transplanted in our center between 1991 and 1998. The univariate analysis showed that antiHCV, HBsAg and antiHBc status, more than one renal transplant and one or more episodes of acute rejection were associated with diminished graft survival; and being over the age of 50 at the time of transplantation was also associated with diminished patient survival. In the multivariate analysis HBsAg positive and one or more episodes of rejection were associated with a diminished graft survival, and none of the variables studied was associated with diminished patient survival. In conclusion antiHCV and HBsAg positive status was associated with an increased risk of losing the transplanted kidney, and HBsAg positivity was associated with an increased risk of death, but this was not a statistically significant association.Las hepatitis virales crónicas causadas por los virus B y C son un problema común en los pacientes trasplantados renales. No hay un consenso en cuanto a su influencia en la evolución del injerto y la sobrevida de los pacientes trasplantados renales. Evaluamos en forma retrospectiva la influencia de la positividad de antiHBc, antiHCV y HBsAg; sexo; edad mayor de 50 años al momento del trasplante; elevación de

  7. ¿Deben realizarse las ecografías renal y vesical en pacientes con mamelones preauriculares? Should renal and vesical ultrasound be performed in patients with preauricular tags?

    Directory of Open Access Journals (Sweden)

    Marcela Tombesi

    2008-06-01

    Full Text Available Introducción: Los niños con malformaciones menores del pabellón auricular son estudiados habitualmente con ecografías renal y vesical, existiendo controversias en cuanto a la validez de esta práctica. Objetivo: Determinar si la prevalencia de malformaciones del tracto urinario es mayor entre niños con mamelones preauriculares aislados que entre aquellos que no los presentan. Población, material y métodos: Entre Junio de 1996 y Junio de 2006, 92 niños con mamelones preauriculares fueron estudiados con ecografía renal y vesical. Se incluyeron en la evaluación a niños sanos con mamelón preauricular aislado. Se excluyeron aquellos con hoyuelos preauriculares, una o más malformaciones menores asociadas, síndromes de malformaciones congénitas múltiples o anomalías mayores identificadas previamente. Ochenta y ocho niños cumplieron con los criterios de inclusión. Para la comparación estadística se utilizó un grupo control histórico de 300 lactantes sanos sin mamelón, estudiados en forma no concurrente con el grupo estudio y que mostró un prevalencia del 1% de malformaciones urinarias. Se realizó una prueba de hipótesis exacta para una proporción utilizando un nivel de significación del 5%, con el software Epidat 3.1. Resultados: Tres de los 88 niños (3,4% con mamelones preauriculares aislados presentaron malformaciones renales : ectopia renal derecha e hidroureteronefrosis, detectada prenatalmente; agenesia renal izquierda, existiendo antecedentes familiares de malformaciones renales y un quiste cortical simple. No se detectaron diferencias estadísticamente significativas con el grupo considerado control histórico (p = 0.11. Conclusión: La prevalencia de malformaciones renales fue similar entre los niños sanos con y sin mamelones preauriculares aislados, por lo que la indicación rutinaria de ecografías renal y vesical no sería necesaria.Introduction: The renal and vesical ultrasound in every patient with

  8. α1B-Adrenoceptors mediate adrenergically-induced renal vasoconstrictions in rats with renal impairment

    Institute of Scientific and Technical Information of China (English)

    Md Abdul Hye KHAN; Munavvar Abdul SATTAR; Nor Azizan ABDULLAH; Edward James JOHNS

    2008-01-01

    Aim: This study examined whether α1B-adrenoceptors are involved in mediating adrenergically-induced renal vasoconstrictor responses in rats with pathophysi-ological and normal physiological states. Methods: Male Wistar Kyoto and spon-taneously hypertensive rats were induced with acute renal failure or experimental early diabetic nephropathy by cisplatin or streptozotocin, respectively. Cisplatin-induced renal failure was confirmed by impaired renal function and pronounced tubular damage. Experimental early diabetic nephropathy was confirmed by hyperglycemia, changes in physiological parameters, and renal function. The hemodynamic study was conducted on anesthetized rats after 7 d of cisplatin (renal failure) and 4 weeks of streptozotocin (experimental early diabetic nephropathy). Results: In the rats with renal failure and experimental early dia-betic nephropathy, there were marked reductions in their baseline renal blood flow (P0.05) in the renal failure and experimental early diabetic nephropathy rats, respectively, as compared to their non-renal failure and non-diabetic nephropathy controls. In the rats with renal impairment, chloroethylclonidine caused either accentuation or attenuation (all P0.05). Conclusion: This study demonstrated the presence of functional α1B-adrenoceptors that mediated the adrenergically-induced renal vaso-constrictions in rats with renal impairment, but not in rats with normal renal function.

  9. Preoperative diagnosis of renal oncocytoma: case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Wang Linhui; Wang Zhixiang; Sun Yinghao

    2008-01-01

    To differentiate renal oncocytoma from renal carcinoma, the clinical data of four patients with incidentally found renal oncocytomas were studied in this report. And additional Immunohistochemistry examinations were done to confirm diagnosis. Renal oncocytomas were found incidentally in four patients during medical examination. No characteristic changes were found in laboratory tests. Radiology examination provided the location and possibility of renal oncocytoma. History, laboratory test and radiology exanimation indicated the diagnosis of renal oncocytoma, but the final identify of renal oncocytoma need pathology examination.

  10. Daño renal en pacientes con infección por el VIH y tratamiento antirretroviral de gran actividad

    OpenAIRE

    Palacio Tamarit, María del

    2013-01-01

    En la era del tratamiento antirretroviral de gran actividad (TARGA), gracias a la disminución de la mortalidad y del riesgo de progresión a SIDA, las complicaciones derivadas de la cronificación de la infección por el VIH y del tratamiento antirretroviral han cobrado relevancia. Entre los eventos no SIDA, la afectación renal puede aparecer hasta en el 12% de los pacientes. Este está producido por el efecto propio de la replicación del VIH y la inmunoactivación asociada, por factores propios d...

  11. Beneficios del descanso peritoneal

    Directory of Open Access Journals (Sweden)

    Jesús Lucas Martín Espejo

    Full Text Available Introducción: Valorar si el descanso peritoneal, de al menos un día semanal, ha supuesto mejoras en la rehabilitación de los pacientes y el impacto clínico que puede suponer. Nos planteamos además cuantificar el beneficio económico. Material y Método: Se realizó un estudio longitudinal, retrospectivo, descriptivo. De los pacientes atendidos en nuestra unidad desde el 1 de enero de 2014 al 31 de diciembre de 2014, se estudiaron los pacientes que cumplieran todo el año de seguimiento y que no procedieran de otras técnicas de depuración como la hemodiálisis o trasplante renal. La muestra de estudio estuvo compuesta por 40 pacientes, de los que 21 tuvieron prescrito al menos 1 día semanal de descanso peritoneal y 19 pacientes sin descanso. Se recogieron las siguientes variables al inicio del periodo de estudio y a los 12 meses: Variables demográficas, variables relacionadas con el estado de volumen, datos clínicos relacionados con la técnica, se pasó una encuesta de satisfacción a todos los pacientes estudiados, y se recogieron los importes del coste mensual de cada tipo de tratamiento. Resultados: Las diferencias iniciales entre los grupos, eran esperables ya que son los valores en los cuales se ha basado la prescripción del día de descanso. La exposición a la glucosa, al comienzo y al final fue menor en el grupo con descanso. Al año, no se encontró diferencias en los parámetros estudiados. Una encuesta de satisfacción nos reveló a que dedican los pacientes el día de descanso y los que no lo tienen a que lo dedicarían. Conclusiones: El descanso peritoneal no ha supuesto una peor evolución de los parámetros clínicos estudiados al año de seguimiento, cumpliendo las recomendaciones de adecuación de diálisis de las guías clínicas. La exposición a la glucosa, aun sin llegar a ser significativa por la duración del estudio, ha sido menor en el grupo con descanso. El día de descanso ha facilitado a los pacientes

  12. Renal relevant radiology: renal functional magnetic resonance imaging.

    Science.gov (United States)

    Ebrahimi, Behzad; Textor, Stephen C; Lerman, Lilach O

    2014-02-01

    Because of its noninvasive nature and provision of quantitative measures of a wide variety of physiologic parameters, functional magnetic resonance imaging (MRI) shows great potential for research and clinical applications. Over the past decade, application of functional MRI extended beyond detection of cerebral activity, and techniques for abdominal functional MRI evolved. Assessment of renal perfusion, glomerular filtration, interstitial diffusion, and parenchymal oxygenation turned this modality into an essential research and potentially diagnostic tool. Variations in many renal physiologic markers can be detected using functional MRI before morphologic changes become evident in anatomic magnetic resonance images. Moreover, the framework of functional MRI opened a window of opportunity to develop novel pathophysiologic markers. This article reviews applications of some well validated functional MRI techniques, including perfusion, diffusion-weighted imaging, and blood oxygen level-dependent MRI, as well as some emerging new techniques such as magnetic resonance elastography, which might evolve into clinically useful tools.

  13. Renal replacement therapy in sepsis-induced acute renal failure

    Directory of Open Access Journals (Sweden)

    Rajapakse Senaka

    2009-01-01

    Full Text Available Acute renal failure (ARF is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

  14. [Extracorporeal renal replacement therapies in acute renal failure].

    Science.gov (United States)

    Schaefer, R M; Barenbrock, M; Teschner, M; Bahner, U

    2000-05-15

    The most serious forms of acute renal failure (ARF) are nowadays encountered in the intensive care unit (ICU), where up to 25% of new patients are reported to develop ARF. Lethality rates may reach 50 to 90% when the ARF is part of a multiple organ dysfunction syndrome. A multitude of extracorporeal procedures have been introduced into intensive care medicine. Applied with adequate skills and experience, most of these techniques will suffice to replace excretory renal function. However, because of low efficacy arterio-venous procedures (CAVH and CAVHD) have been abandoned for the veno-venous, pump-driven techniques (CVVH and CVVHD). Up to now, there is no consensus whether continuous or intermittent renal replacement therapy is more advantageous. In many cases, oliguric patients with circulatory instability will be treated by CVVH, even though there is no prospective study to show that in terms of outcome continuous treatment is superior to intermittent hemodialysis. It is equally conceivable to treat such patients with daily, prolonged (intermittent) hemodialysis. Apparently, the dose of replacement therapy, be it continuous filtration (36 to 48 l/24 h) or intermittent hemodialysis (daily 3 to 4 h) with a target BUN of less than 50 mg/dl, is more important than the modality of treatment. Moreover, there is good evidence that the use of biocompatible membranes (no complement- or leukocyte activation) is preferable and that with high-volume hemofiltration bicarbonate-containing replacement fluids should be used. However, despite all the technical advances, we firmly believe that the skills and the experience of those physicians and nurses who actually perform renal replacement therapy in the ICU are more important than the modality of treatment applied.

  15. Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Radiology (Germany); Ditting, Tilmann, E-mail: tilmann.ditting@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Sobotka, Paul A., E-mail: sobotka@alumni.stanford.edu [Ohio State University (United States); Veelken, Roland, E-mail: roland.veelken@uk-erlangen.de; Schmieder, Roland E., E-mail: roland.schmieder@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Uder, Michael, E-mail: michael.uder@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Radiology (Germany); Ott, Christian, E-mail: christian.ott@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany)

    2013-08-01

    PurposeRenal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.MethodsFifty-three patients with treatment-resistant hypertension (office BP {>=} 140/90 mmHg and 24-h ambulatory BP monitoring ({>=}130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.ResultsBaseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV -15 {+-} 23 vs. MV -16 {+-} 20 mmHg; diastolic: OV -10 {+-} 12 vs. MV -8 {+-} 11 mmHg, both p = NS) as well as 6 months (systolic: OV -18 {+-} 18 vs. MV -17 {+-} 22 mmHg; diastolic: OV -10 {+-} 10 vs. -10 {+-} 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.ConclusionIn patients with multiple renal arteries, RDN of one renal artery-namely, the dominant one-is sufficient to induce BP reduction in treatment-resistant hypertension.

  16. Expresión de renina en oncocitomas renales = Renin expression in renal oncocytomas

    Directory of Open Access Journals (Sweden)

    Franco Tavera, Óscar Andrés

    2010-12-01

    Full Text Available Introducción: algunos tumores renales han sido asociados con secreción de hormonas, incluyendo renina. Nuestro objetivo fue investigar la frecuencia de expresión de esta hormona en un tumor renal epitelial infrecuente, el oncocitoma, y si esta expresión se asocia con hipertensión arterial sistémica (HTA.Métodos: examinamos una serie de 13 oncocitomas (provenientes de igual número de pacientes usando un anticuerpo monoclonal para detectar la hormona por inmunohistoquímica, y su asociación con HTA. Las características de la inmunotinción se evaluaron microscópicamente. Obtuvimos, de los archivos de historias, las características clínicas y de la presión arterial sistémica antes y después de la resección tumoral.Resultados: ocho de los 13 tumores (61,5% tenían inmunorreactividad para renina, en todos ellos difusa. En tres casos la inmunomarcación fue como un punto paranuclear (dot-like y en otros tres estaba en la porción apical del citoplasma de las células neoplásicas. En tres de los ocho casos con expresión de renina (37,5% y en tres de los cinco sin dicha expresión (60,0% se detectó HTA (p = 0,59. Después de la resección tumoral ninguno de los pacientes con expresión de renina e HTA mostró remisión de esta.Conclusión: la renina se expresa frecuentemente en oncocitomas renales pero es clínicamente inactiva. Serán necesarios más estudios para conocer las implicaciones de esta expresión en la presentación clínica, el diagnóstico y la histogénesis.

  17. Acute pancreatitis, acute hepatitis and acute renal failure favourably resolved in two renal transplant recipients.

    Science.gov (United States)

    Voiculescu, Mihai; Ionescu, Camelia; Ismail, Gener; Mandache, Eugen; Hortopan, Monica; Constantinescu, Ileana; Iliescu, Olguta

    2003-03-01

    Renal transplantation is often associated with severe complications. Except for acute rejection, infections and toxicity of immunosuppressive treatment are the most frequent problems observed after transplantation. Infections with hepatic viruses (HBV, HDV, HCV, HGV) and cytomegalic virus (CMV) are the main infectious complications after renal transplantation. Cyclosporine toxicity is not unusual for a patient with renal transplantation and is even more frequent for patients with hepatic impairment due to viral infections. The subjects of this report are two renal transplant recipients with acute pancreatitis, severe hepatitis and acute renal failure on graft, receiving immunosuppressive therapy for maintaining renal graft function

  18. Renal rescue of dopamine D2 receptor function reverses renal injury and high blood pressure

    OpenAIRE

    Konkalmatt, Prasad R.; Asico, Laureano D.; Zhang, Yanrong; Yang, Yu; Drachenberg, Cinthia; Zheng, Xiaoxu; Han, Fei; Pedro A. Jose; Armando, Ines

    2016-01-01

    Dopamine D2 receptor (DRD2) deficiency increases renal inflammation and blood pressure in mice. We show here that long-term renal-selective silencing of Drd2 using siRNA increases renal expression of proinflammatory and profibrotic factors and blood pressure in mice. To determine the effects of renal-selective rescue of Drd2 expression in mice, the renal expression of DRD2 was first silenced using siRNA and 14 days later rescued by retrograde renal infusion of adeno-associated virus (AAV) vec...

  19. del cambio

    Directory of Open Access Journals (Sweden)

    Alejandro Canales

    2006-01-01

    Full Text Available El artículo analiza las propuestas y los compromisos en materia de cobertura y de financiamiento en el periodo 2000-2006. En particular, revisa las modificaciones y los ajustes de los tres principales documentos en los que se expresaron las iniciativas: el de la Asociación Nacional de Universidades e Instituciones de Educación Superior, el del equipo de la transición y el programa sectorial. Los resultados muestran que las cifras de atención a la demanda educativa e inversión quedaron lejos de las metas autoimpuestas por el gobierno federal y que será necesario realizar mayores esfuerzos para atender tales desafíos.

  20. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.