RESUMEN
INTRODUCTION: Glomerulopathy is a group of diseases that affect mainly young adults between the ages of 20 and 40 years. Recently, it has been demonstrated that syndecan-1, a biomarker of endothelial glycocalyx damage, is increased in nephrotic patients with near-normal renal function and it is important to endothelial dysfunction in these patients. Angiopoietin-2 (AGPT2) is an endothelial growth factor that promotes cell derangement. Here we evaluated AGPT2 levels in patients with nephrotic syndrome, near-normal renal function and the possible interaction of AGPT2 with endothelial glycocalyx derangement. METHODS: This was a cross-sectional study performed from January through November 2017. Adult patients (age > 18 years) with nephrotic syndrome and without immunosuppression were included. Blood samples were drawn after a 12 h fast for later measurement of syndecan-1 and AGPT2. Mediation analyses were performed to assess the hypothesized associations of nephrotic syndrome features and AGPT2 with syndecan-1. RESULTS: We included 65 patients, 37 (56.9%) of them female, with primary glomerular disease. Syndecan-1 in nephrotic patients was higher than in control individuals (102.8 ± 36.2 vs. 28.2 ± 9.8 ng/mL, p < 0.001). Correlation of syndecan-1 with the main features of nephrotic syndrome after adjustment for age and estmmated glomerular filtration rate (eGFR) demonstrated that syndecan-1 was significantly associated with 24-h urinary protein excretion, total cholesterol, LDL (low density lipoprotein)-cholesterol, HDL (high-density lipoprotein)-cholesterol, and triglycerides. Angiopoietin-2 was independently associated with serum albumin, 24 h urinary protein excretion, total cholesterol, and LDL-cholesterol, in addition to being strongly associated with syndecan-1 (0.461, p < 0.001). The results of the mediation analyses showed that the direct association between LDL-cholesterol and syndecan-1 was no longer significant after AGPT-2 was included in the mediation analysis. AGPT2 explained 56% of the total observed association between LDL-cholesterol and syndecan-1. CONCLUSION: The association between LDL-cholesterol and glycocalyx derangement in nephrotic patients is possibly mediated by AGPT2.
RESUMEN
Estudo exploratório-descritivo de natureza qualitativa, realizado na Unidade de Terapia Intensiva Neonatal (UTIN) da maternidade-Escola AssisChateaubriand (MEAC) na cidade de Fortaleza - CE, em dezembro de 2008 a fevereiro de 2009. Os objetivos foram identificar o grau de adesão das enfermeiras na utilização da membrana semipermeável na pele do prematuro como fator de proteção e observar os cuidados de Enfermagem durante o manuseio desses bebês. Utilizou-se uma entrevista semi-estruturada contemplando dados de identificação e questões relacionadas à assistência de Enfermagem prestada ao recém-nascido prematuro (RNPT) e a observação livre dos cuidados realizados, entre os quais a aplicação da membrana semipermeável. Os dados foram analisados sendo apresentados em quadro e discussões textuais. A padronização das condutas profissionais e a construção de protocolos para assistencia do cuidado na pele do RNPT acarretarão redução do risco de variações indesejadas nas condutas e consequentemente uma melhor qualidade devida e bem-estar .
This is an exploratory-descriptive study of qualitative nature, carried out in the Neonatal lntensive Care Unit (NICU) e Teaching Maternity Assis Chateaubriand (TMAC) in the" of Fortaleza - CE from December 2008 to February 2009. The objective of this work was to identify the nurses' adhesion: egree in the use of semi permeable membrane in the preterm 5t.:ÚI as protection factor and to observe the Nursing cares while handling these babies. A semi-structured interview was used with eighteen nurses, contemplating identification data and questions regarding the Nursing assistance to the preterm in"8nt in use of semi permeable membrane in NICU and the free observation of the cares performed by them was carried out, cluding the application of semi permeable membrane. The data were analyzed according to the pertinent literature to the theme, being presented in pictures and text discussions. The standardization of the professional conducts and the construcion of protocols to assist the care of the preterm infant skin will result in reduce the risk of undesired variations in the conducts and consequently a better quality of life and well-being. .