Atención de enfermería en adultos jóvenes con insuficiencia renal aguda: Revisión narrativa / Nursing care in young adults with acute kidney failure: Narrative review

El daño renal está reconocido como la reducción de la función renal, el cual se ve generalmente reflejado por una caída en la diuresis. A nivel mundial, el porcentaje de personas que padece daño renal va en aumento, esto debido a múltiples aspectos. En este sentido, se reconoce que el personal de enfermería es quien idóneamente tiene un gran rol en la educación de la población, para la prevención del daño renal agudo, previniendo con ello el daño renal crónico. De esta manera, en el escrito se abordan aspectos generales más relevantes, de la hidratación, la alimentación, la actividad física, el consumo de alcohol, la automedicación y la prevención de infecciones de las vías urinarias, como parte de los aspectos modificables y en los que las personas tienen directa injerencia en sus acciones, con la debida información, con los que el personal de enfermería puede reforzar sus recursos en materia de educación a la población. De la misma manera, se muestran estudios de diseño cuasiexperimental, como una manera de resaltar que puede medirse el impacto de la educación en la población en una época en donde requerimos tener mayor evidencia de la efectividad de las intervenciones que realicemos.

Renal insufficiency it is recognized as the reduction of the renal function, reflected by the decreased urine output. Worldwide, the amount of people whom have renal insufficiency it is growing, by many reasons. Because of this, is recognized that nursing staff is the best option at the population education, in order to prevent acute renal insufficiency, preventing with this, chronical renal insufficiency. In this document, it is possible to review, the most important general aspects of hydration, feeding, physical activity, alcohol consumption, self-medication and prevention of urinary tract infections, as part of modifiable aspects that people handle as part of their personal health actions, with the proper information, with which nursing staff can strengthen their resources in health education to the population. In this way, this paper shows some quasi-experimental studies, as a way to highlight that it is possible to measure the impact of population education, in a moment that the health system requires more evidence of the effectiveness of the interventions.

Production of low potassium kale with increased glucosinolate content from vertical farming as a novel dietary option for renal dysfunction patients.

The production of low potassium vegetables arose out of the dietary needs of patients with renal dysfunction. Attempts have been made to reduce potassium content in vegetables and fruits; however, induced potassium deficiency has often resulted in decreased yields. Here, we investigated a new method of producing low potassium kale and present the characteristics of the resulting produce. By substituting potassium nitrate with calcium nitrate in the nutrient solution 2 weeks before harvesting, the potassium content of kale was reduced by 70% without a deterioration in yield and semblance qualities. Despite no relationships being detected between potassium deficiency and anti-oxidative properties, the total glucosinolate content, an indicator of the anti-cancer effect of cruciferous vegetables, was significantly increased by potassium deficiency in kale. This study demonstrates a novel method of producing low potassium kale for patients with renal failure, without a reduction in yield but with beneficial increase in glucosinolates.

Dietary intake of cod protein beneficially affects concentrations of urinary markers of kidney function and results in lower urinary loss of amino acids in obese Zucker fa/fa rats.

Obesity increases the risk for developing kidney disease, and protection of kidneys through changes in diet should be investigated. Fish intake has been associated with reduced risk of developing kidney disease; therefore, we wanted to investigate whether cod protein intake could prevent or delay the development of kidney damage in an obese rat model that spontaneously develops proteinuria and focal segmental glomerulosclerosis. The aim of the study was to investigate any effects of cod protein intake on established markers of kidney function, amino acid composition, protein utilisation and growth in obese Zucker fa/fa rats in the early stage of decreased renal function. Male obese Zucker fa/fa rats (HsdOla:Zucker-Lepr) were fed cod muscle proteins in an amount corresponding to 25 % of dietary protein, with the remaining protein from a casein/whey mixture (COD diet). A control group was fed a diet with a casein/whey mixture as the only protein source (CAS diet). The intervention started when rats were 9-10 weeks old, and the rats were fed these diets for 4 weeks. At the end of the study, rats fed the COD diet had lower urine concentration of cystatin C, T-cell immunoglobulin mucin-1 (TIM-1), amino acids, carbamide, uric acid and ammonium and higher concentrations of creatine, trimethylamine N-oxide, 1-methylhistidine and 3-methylhistidine, lower kidney concentration of TIM-1 and showed better growth when compared with the CAS group. To conclude, cod protein may have the potential to delay the development of kidney damage in young obese Zucker rats and to improve protein utilisation and growth.

Lipid peroxidation diminishing perspective of isolated theaflavins and thearubigins from black tea in arginine induced renal malfunctional rats.

BACKGROUND: Recently oxidative stress induced maladies have amplified owing to sedentary lifestyle and monotonous diet. Introduction of plant based biomolecules may be a suitable strategy to cope with the lipid peroxidation. In this context, black tea polyphenols (theaflavin & thearubigins) are in fame among the scientific community as cost effective therapeutic agents owing to their safety, economics, structural diversity and ability to modulate various lipid peroxidation responses by halting the expression of different metabolic targets. METHODS: The mandate of present investigation was to first time check the synergism among the isolated theaflavins & thearubigins against lipid peroxidative indicators both in vitro and in vivo. Purposely, theaflavins and thearubigins were isolated from black tea through solvent partition methods by using different solvents (Aqueous ethanol, Aqueous methanol & Water) and time intervals (30, 60 & 90 min) and subjected to in vitro characterization through different antioxidant indices to access the in vitro lipid peroxidation shooting effect of these bioactive moieties. Moreover, individual theaflavins contents also estimate through HPLC. For evaluation of in vivo antioxidant effect, renal malfunction was induced through arginine and forty rats were divided in four groups (10 each after power analysis) and 04 types of diets were given i.e. T0 (control diet without supplementation), T1 (Basic experimental Diet+ theaflavins supplementation @ 1 g), T2 (Basic experimental Diet+ Thearubigins supplementation @ 1 g) & T3 (Basic experimental Diet+ Supplementation of theaflavins+ thearubigins @ 0.5 + 0.5 g, respectively) for the period of 56 days. Alongside, a control study was also carried out for comparison by involving normal rats fed on arginine free diet. The body weight, lipid profile, glycemic responses, Renal function test, liver function test, antioxidant indices and hematological parameters were estimated at the termination of study. RESULTS: The results indicated that theaflavins and thearubigins isolation was significantly affected by time of extraction and solvent. In this context, aqueous ethanol at 60 min extraction interval caused maximum extraction. Likewise, theaflavins isolate exhibited more antioxidant activity as compared to thearubigins. Moreover, the theaflavins and thearubigins based experimental diets imparted significant reduction in Lipid profile, glucose content, renal function tests and TBARS with enhancement in insulin, HDL and hematological parameters. In this context, theaflavin based diet caused maximum reduction in lipid profile and TBARS better as compared to thearubigins and theaflavins + thearubigins based. However, theaflavin+ thearubigins based diet caused highest glucose, urea & creatinine decline and maximum insulin increase & antioxidant indices as compared to other nutraceuticals. CONCLUSIONS: It was deduced that theaflavins & thearubigins have strong antioxidative potential both in in vitro as well as in vivo to tackle the menace associated with lipid peroxidation.

Effects of dietary milled seed mixture on fatty acid status and inflammatory markers in patients on hemodialysis.

BACKGROUND: Plant seeds have gained interest for their health benefits due to their fatty acid content. The objective of this study was to determine the effects of dietary consumption of milled sesame/pumpkin/flax seed mixture on glycemic control, serum lipids, phospholipid fatty acid status, and inflammatory factors in patients on hemodialysis. METHODS: Thirty patients with well nutrition status (18 male, 12 female) were enrolled in the study. Participants consumed 30 g of milled sesame/pumpkin/flax (6 g/6 g/18 g, resp.) seeds mixture added to their habitual diet. RESULTS: Total n-6 and n-3 polyunsaturated fatty acids and levels of linoleic, dihomo-gamma-linolenic (DGLA), arachidonic, alpha-linolenic (ALA), eicosapentaenoic, docosapentaenoic, and docosahexaenoic (DHA) acid were increased after 12 weeks of supplementation. A significant decrease of the serum triglyceride level (P < 0.001), glucose, insulin, calculated IR HOMA (P < 0.05), and inflammatory markers (TNF-alpha, IL-6, and hs-CRP, P < 0.001) was observed after seed mixture treatment. The serum levels of CRP and TNF-alpha negative correlate with ALA, DHA, and DGLA. CONCLUSION: Results of this study indicated that dietary milled sesame/pumpkin/flax seed mixture added to a habitual diet lowered triglyceride and CRP, TNF-alpha, IL-6 levels, affect glycemic control and improved fatty acid profile and pruritus symptoms in hemodialysis patients.

Cys34-cysteinylated human serum albumin is a sensitive plasma marker in oxidative stress-related chronic diseases.

The degree of oxidized cysteine (Cys) 34 in human serum albumin (HSA), as determined by high performance liquid chromatography (HPLC), is correlated with oxidative stress related pathological conditions. In order to further characterize the oxidation of Cys34-HSA at the molecular level and to develop a suitable analytical method for a rapid and sensitive clinical laboratory analysis, the use of electrospray ionization time-of-flight mass spectrometer (ESI-TOFMS) was evaluated. A marked increase in the cysteinylation of Cys34 occurs in chronic liver and kidney diseases and diabetes mellitus. A significant positive correlation was observed between the Cys-Cys34-HSA fraction of plasma samples obtained from 229 patients, as determined by ESI-TOFMS, and the degree of oxidized Cys34-HSA determined by HPLC. The Cys-Cys34-HSA fraction was significantly increased with the progression of liver cirrhosis, and was reduced by branched chain amino acids (BCAA) treatment. The changes in the Cys-Cys34-HSA fraction were significantly correlated with the alternations of the plasma levels of advanced oxidized protein products, an oxidative stress marker for proteins. The binding ability of endogenous substances (bilirubin and tryptophan) and drugs (warfarin and diazepam) to HSA purified from chronic liver disease patients were significantly suppressed but significantly improved by BCAA supplementation. Interestingly, the changes in this physiological function of HSA in chronic liver disease were correlated with the Cys-Cys34-HSA fraction. In conclusion, ESI-TOFMS is a suitable high throughput method for the rapid and sensitive quantification of Cys-Cys34-HSA in a large number of samples for evaluating oxidative stress related chronic disease progression or in response to a treatment.

Low and medium but not high doses of green tea polyphenols ameliorated dextran sodium sulfate-induced hepatotoxicity and nephrotoxicity.

Our previous study indicated that a diet containing a high dose (1%) of green tea polyphenols (GTPs) disrupted liver and kidney function via a reduction in antioxidant enzyme and heat shock protein (HSP) levels in both colitis and non-treated ICR mice. In the present study, we assessed the effects of 0.01%, 0.1%, and 1% dietary GTPs on liver and kidney physiological functioning in dextran sulfate sodium (DSS)-exposed and normal mice. GTPs at 0.01% and 0.1% significantly suppressed DSS-increased serum aspartate 2-oxoglutarate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In contrast, GTPs at 1% increased kidney weight, serum creatinine levels, and thiobarbituric acid-reactive substances (TBARs) in both the kidney and the liver in normal mice, as compared with DSS-exposed mice. GTPs at 0.01% and 0.1% remarkably upregulated the expression of heme oxygenase-1 (HO-1) and heat shock protein 70 (HSP70) mRNA in the liver and kidney of mice exposed to DSS, whereas GTPs at 1% abolished it. Our results indicate that low and medium doses of GTPs have beneficial effects on DSS-induced hepatotoxicity and nephrotoxicity via upregulation of self-protective enzymes, while these effects disappeared at a high dose.

Manejo nutricional en un paciente crítico con insuficiencia renal aguda con hemodiálisis / Nutritional management in clinically ill patients with acute renal failure on hemodialysis

Paciente de sexo masculino, de 13 años de edad. Ingreso al servicio de la Unidad de Cuidados Intensivos Pediátricos (UCIP) del Hospital Nacional Daniel Alcides Carrión presentando un cuadro de cefalea con antecedente de craneofaringioma, operado en Noviembre del 2011. Portador de un Sistema de Derivación Ventrículo Peritoneal (SDVP). Se le realizaba hemodiálisis incendiario debido a la Insuficiencia Renal Aguda como complicación de la patología presente. Sala: Unidad de Cuidados Intensivos Pediátricos ; Edad: 13 años; Sexo: Maculino; Fecha de ingreso al hospital: 27/06/2012; Fecha de ingreso a servicio: 27/06/2012; Diagnóstico Médico: Síndrome de Derivación Ventrículo Peritoneal. Diabetes insípida, Hipopituitarismo. Sepsis severa. Insuficiencia renal aguda con hemodiálisis.

Male patient, 13 years old. Patient was admitted in the Pediatric Intensive Care Unit (PICU) of the Daniel Alcides Carrion National Hospital presenting headache with a history of craniopharyngioma surgery in November 2011. Patient carries a System Peritoneal Ventricule (SDVP). He has been undergoing a hemodialysis every 2 days due to acute renal failure as a complication of this disease. Room: Pediatric Intensive Care Unit. ; Age: 13 years ; Gender: Male; Hospital admission date: 6/27/2012