Kidney biomarkers in tropical infections: an update.

Neglected tropical diseases affect over 1 billion people, and cause 170,000 deaths each year. They result in disability, stigma and disfigurement, and also push families into poverty. Tropical infections can involve the kidney, presenting as a wide variety of ways, varying from transient urinary abnormalities to severe acute kidney injury (AKI). It is important to assess renal function in patients with tropical infections for earlier detection of AKI, appropriate treatment and prevention of Chronic Kidney Disease (CKD) outcome in some of them. There was an exponential increase in research on new kidney biomarkers that were earlier and specific for renal damage but few in the scope of tropical infections. In this review, we focus on kidney biomarkers that are being studied in some of the most prevalent tropical infections such as visceral leishmaniasis, leptospirosis, malaria, schistosomiasis and leprosy. Further studies are needed to evaluate the usefulness of renal biomarkers in the early diagnosis of renal diseases associated with tropical infections.

Influência da modalidade dialítica na cognição: uma revisão integrativa / Influence of the dialysis modality in cognition: an integrative review

A doença renal crônica é uma condição clínica caracterizada pela queda progressiva da função renal, interferindo na homeostase de todo o corpo, incluindo o sistema nervoso central. Nesses pacientes, o comprometimento cognitivo é um achado comum, em comparação com a população geral, e mais frequente nos pacientes em diálise. O objetivo deste estudo foi identificar, por meio de revisão integrativa, se há diferença entre a modalida- de dialítica (hemodiálise e diálise peritoneal) e a presença de comprometimento cognitivo nesses pacientes. Foi feito levan- tamento bibliográfico nas plataformas PubMed® e Bireme, com buscas padronizadas de 2014 até abril de 2019, utilizando-se pa- lavras-chave. Para a seleção e a avaliação dos estudos científicos levantados, foram estabelecidos critérios, contemplando os seguintes aspectos: autor, ano/local, grau de recomendação/ nível de evidência científica, amostra, faixa etária, média de idade em anos, métodos de avaliação, resultados e conclusão. Dos 561 artigos encontrados, 365 foram excluídos pela data de publicação, 87 foram excluídos pelo título, 17 pelo resumo, 49 pela leitura do artigo, 36 eram repetidos e oito foram selecio- nados para o estudo. Os pacientes em diálise peritoneal apre- sentaram menor comprometimento cognitivo e menor risco para demência que os pacientes em hemodiálise.

Chronic kidney disease is a clinical condition characterized by progressive decline in renal function, interfering with whole-bo- dy homeostasis, including the central nervous system. Cognitive impairment is a common finding in these patients, compared to the general population, besides being more frequent in dialysis patients. The objective of this study was to identify, through an integrative review, if there is difference between the dialysis mo- dality (hemodialysis and peritoneal dialysis) and the presence of cognitive impairment in these patients. A bibliographic search on the PubMed® and Bireme platforms, with standard searches from 2014 to April 2019, using keywords, was conducted. For the selection and evaluation of scientific studies found in the sear- ch, criteria have been established, considering the following as- pects: author, year/location, grade of recommendation/level of evidence, sample, age, mean age in years, evaluation methods, results, and conclusion. Among 561 articles found, 365 were ex- cluded based on the date of publication, 87 based on the title, 17 on the abstract, 48 on the article reading, 36 were repeated, and eight were selected for the study. Patients on peritoneal dialysis have less cognitive impairment and lower risk for dementia than patients on hemodialysis.