RESUMO
Diet can be a helpful tool to enhance the quality of urine and lower the likelihood and recurrence of kidney stones. This study set out to identify the foods and nutrients that are associated with each type of calcium oxalate kidney stone formation. A single-center, cross-sectional study was conducted. Between 2018 and 2021, a sample of 90 cases (13 cases with papillary COM, 27 with non-papillary COM, and 50 with COD kidney stones), as well as a control group of 50 people, were chosen. A food intake frequency questionnaire was completed by the study's participants, and the results were compared between groups. Additionally, a comparison of the 24 h urine analysis between stone groups was made. Processed food and meat derivatives were linked to COM papillary calculi (OR = 1.051, p = 0.032 and OR = 1.013, p = 0.012, respectively). Consuming enough calcium may offer protection against non-papillary COM stones (OR = 0.997; p = 0.002). Similarly, dairy product consumption was linked to COD calculi (OR = 1.005, p = 0.001). In conclusion, a diet high in animal items may increase the risk of developing papillary COM stones. Consuming calcium may be preventive against non-papillary COM calculi, and dairy product consumption may be a risk factor for COD stones.
Assuntos
Cálcio , Cálculos Renais , Humanos , Oxalato de Cálcio , Estudos Transversais , Cálculos Renais/etiologia , Cálculos Renais/prevenção & controle , Cálcio da Dieta , Dieta/efeitos adversosRESUMO
PURPOSE: The COVID19 pandemic has caused a redistribution of hospital resources. Prioritization strategies are needed in order to organize elective surgeries. We compared the new Medically Necessary Time-Sensitive score (MeNTS) and its factors (disease, procedure, and patient factors) between operated and deferred cases, and also to a subjective priority scale in the Urology department. METHODS: The MeNTS score and a subjective prioritization scale were prospective applied to all patients included on the surgical waiting list from March 10 to September 9, 2020. Mann-Whitney U test was used to compare MeNTS scores between operated and non-operated groups. Kruskal-Wallis test was used to compare MeNTS scores between three subjective priority groups. RESULTS: A total of 150 cases were operated while 100 were deferred. Median total MeNTS score in the operated group was 39.5 whereas in the non-operated group it was 38 (p = 0.135). Median disease factors score was 9.5 in the operated group and 11 in the non-operated group(p = 0.033). Median procedure factors score was 10 in both groups (p = 0.02). Median patient factors score was 17 in the operated group and 18 in the non-operated group (p = 0.210). Disease factors displayed a significant difference between the three subjective priority groups. CONCLUSIONS: Total MeNTS score does not show significant differences between operated and non-operated patients. However, we demonstrate a relationship between MeNTS disease factors and the operated group as well as with the subjective priority scale.
Assuntos
COVID-19 , COVID-19/epidemiologia , Procedimentos Cirúrgicos Eletivos , Humanos , Pandemias , Estudos Prospectivos , SARS-CoV-2RESUMO
OBJECTIVE: Complications in donation after circulatory death (DCD) kidney transplants (KT) are barely described, while in some urological complications the cause is unknown. The aim of this study is to describe surgical and urological complications and analyze what donation features could be involved. METHODS: A prospective, single center study was performed from 2016 to 2019 including all KT from controlled cardiac death donors (cDCD). RESULTS: A total of 86 cDCD KT were included in the study. Recipient BMI, residual urine output (RUO) <500 mL/day, delayed graft function (DGF), and wound complication were related to UTI (p = 0.020, p = 0.008, p = 0.016, and p = 0.004, respectively). Features related to early graft nephrectomy were recipient BMI and recipients with diabetes mellitus (DM) (p = 0.025 and p = 0.036, respectively). DM in recipients was significantly associated with hematuria (p = 0.046). Urinary leak (UL) was associated to vascular complication and ureteral stricture (US) (p = 0.029 both). UL and lymphocele were associated to US (p = 0.029 both). Features related to lymphocele were recipient BMI and US (p = 0.028 and p = 0.029, respectively). History of previous transplant, time from cardiac arrest (CA) to cold flush, and DGF, were associated to wound complication (p = 0.040, p = 0.011 and p = 0.016, respectively). CONCLUSIONS: Surgical and urological complications after KT are an important issue to resolve. Our data revealed an association between RUO <500 mL/day, DGF, and wound complication with urinary infection, as well as between recipient DM and hematuria. Recipient BMI and DM were related to early graft nephrectomy. Vascular complications were associated with urinary leak, and lymphocele with US. Finally, wound complication was related to previous transplant, DGF, and time from CA to cold flush. This data revealed interesting associations between donor and recipient features and cDCD KT complications, providing more information to improve prevention and management.
Assuntos
Transplante de Rim , Linfocele , Obtenção de Tecidos e Órgãos , Humanos , Transplante de Rim/efeitos adversos , Função Retardada do Enxerto/epidemiologia , Função Retardada do Enxerto/etiologia , Sobrevivência de Enxerto , Estudos Prospectivos , Linfocele/etiologia , Hematúria/etiologia , Doadores de Tecidos , Fatores de Risco , Estudos RetrospectivosRESUMO
OBJECTIVE: Expansion of the donor pool has been enabled by the use of donation after circulatory death (DCD). The aim of this study is to identify what donation features are able to predict kidney transplant (KT) outcomes from DCD. MATERIALS AND METHODS: A prospective analysis of all DCD KT from June 2016 to November 2019 was conducted. Association between donor and recipient features, and ischemia times with delayed graft function (DGF) and serum creatinine (Cr) at discharge, and at three and twelve months were analysed. RESULTS: A total of 86 KT were performed. The results revealed a relationship between donor age (p = 0.014) and receptors on haemodialysis (p = 0.001) with DGF. There was no association between different ischemia times and DGF. Residual urine output greater than 500mL/day and being on peritoneal dialysis were found to be protective factors for DGF. Correlation analysis illustrated a significant correlation between donor age and Cr at discharge and at 3 months. CONCLUSION: Higher donor age and being on haemodialysis were risk factors for DGF. Likewise, donor age did not show a significant association with 12-month serum Cr. These results demonstrate that donor age is a risk factor for DGF but does not affect long term graft function.