Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30
Filtrar
1.
G Ital Nefrol ; 26(4): 523-9, 2009.
Artículo en Italiano | MEDLINE | ID: mdl-19644841

RESUMEN

The presence of operational and organizational differences in the use of ultrasonography in Italian nephrology units has prompted this survey on a nationwide scale. The survey was carried out by questionnaire and included questions about the activity and equipment of each nephrology unit, dedicated personnel and relevant training, and the fields of ultrasonography application. Seventy-five percent of the contacted care units replied to the questionnaire. Twenty-six percent of these performed their ultrasound examinations outside the care unit, sharing equipment with other units. The mean lifetime of ultrasound devices was longer (5.8 years) than allowed by the electro-medical equipment regulations. In spite of an increasing number of nephrologists with ultrasonographic expertise, in each care unit the percentage of physicians performing ultrasound examinations was very low. The number of operators who learned this methodology directly at surgeries using ultrasound devices was higher than that of operators who attended training courses and obtained the relevant certificates. In addition to the kidneys and urinary tract, other body districts investigated included abdominal organs, parathyroids, vascular access for hemodialysis treatment, and the bone-joint system. Moreover, ultrasonography was widely used for surgical procedures in nephrology. However, in spite of the widespread application of ultrasound imaging, the use of radiology was unexpectedly high (80%). Finally, the questionnaire results evidenced the particular care of nephrologists towards follow-up for situations of nephrological interest, such as acquired renal cysts, vascular access visualization, and monitoring of parathyroids.


Asunto(s)
Riñón/diagnóstico por imagen , Nefrología , Instituciones de Salud , Humanos , Italia , Encuestas y Cuestionarios , Ultrasonografía/estadística & datos numéricos
2.
G Ital Nefrol ; 25(3): 354-7, 2008.
Artículo en Italiano | MEDLINE | ID: mdl-18473307

RESUMEN

A 47-year-old man with a medical history of nephrolithiasis of the right kidney presented with abdominal pain at the level of the right hip. Ultrasonography showed an anechoic area with irregular contours in the lower pole of the right kidney, where a previous ultrasound scan had signalled the presence of a large cyst. Abdominal computed tomography revealed the presence of a fluid area within the lower pole of the right kidney. Subsequent ultrasonography showed progressive reduction of the anechoic area, which was associated with gradual reduction of the pain. The case was diagnosed as spontaneous rupture of a renal cyst. Renal cyst rupture is an infrequent, usually self-limiting event that may engender diagnostic dilemmas.


Asunto(s)
Enfermedades Renales Quísticas/diagnóstico por imagen , Nefrolitiasis/complicaciones , Humanos , Enfermedades Renales Quísticas/complicaciones , Masculino , Persona de Mediana Edad , Radiografía , Rotura Espontánea , Sensibilidad y Especificidad , Ultrasonografía
3.
G Ital Nefrol ; 25(4): 441-8, 2008.
Artículo en Italiano | MEDLINE | ID: mdl-18663691

RESUMEN

Ultrasound (US) evaluation of the urinary tract in nephrological settings provides the right assessment of many clinical pictures. Actually it allows a realtime differentiation between parenchymal lesions, obstructions or tumoral masses. On the contrary the differential diagnosis of parenchymal nephropathies appears more difficult due to the fact that different histological pictures may present similar ultrasound findings. The echo-color-Doppler is a valid integration of the conventional US B-mode technique thanks to the measurement of some indirect parameters such as the resistance index (RI) and the pulsatility index (PA). It has been showed that the IR results higher in patients with tubulo- interstitial or vascular nephropathies than in those with glomerular ones. It is still debated the relationship between IR and the progression of the renal damage. In the recent years the RIs have gained importance as vascular compliance surrogates: actually their rise has been observed both in cases of vascular damages and in systemic atherosclerosis or associated with other features of renal damage. More studies based on sophisticated US techniques are warranted in order to make the US as golden standard for the diagnosis of parenchymal nephropathies.


Asunto(s)
Enfermedades Renales/diagnóstico por imagen , Ultrasonografía Doppler , Progresión de la Enfermedad , Humanos , Enfermedades Renales/patología
4.
G Ital Nefrol ; 24(1): 66-9, 2007.
Artículo en Italiano | MEDLINE | ID: mdl-17342696

RESUMEN

A 72-year-old woman presented with chronic renal failure and diffuse abdominal pain. On ultrasonography the right kidney showed an uncommon site, whereas the left kidney presented a pseudo mass on its lower pole. MRI detected a multiple anatomic anomaly: dislocation of the right kidney, renal fusion, malrotation of the left kidney. This anatomic anomaly is called ''sigmoid kidney'': it can be asymptomatic or result in genitourinary diseases.


Asunto(s)
Riñón/anomalías , Riñón/diagnóstico por imagen , Anciano , Femenino , Humanos , Ultrasonografía
5.
G Ital Nefrol ; 23(2): 217-20, 2006.
Artículo en Italiano | MEDLINE | ID: mdl-16710827

RESUMEN

The classic presentation of acute renal colic is the onset of severe flank pain associated to homolateral groin irradiation. Very often these patients present typical clinical diagnosis patterns. We present a case of nephrolithiasis with atypical characteristics. The exact diagnosis has been possible only after the release of the stone.


Asunto(s)
Cálculos Renales/diagnóstico , Humanos , Masculino , Persona de Mediana Edad
6.
G Ital Nefrol ; 22(2): 159-61, 2005.
Artículo en Italiano | MEDLINE | ID: mdl-15875279

RESUMEN

Microhematuria is nearly always due to renal parenchymal or genito-urinary damage, with few exceptions. We report a case of microhematuria due to vascular anomaly. The diagnosis was realized making use of several imaging techniques.


Asunto(s)
Enfermedad de Fabry/complicaciones , Hematuria/etiología , Hematuria/diagnóstico , Humanos , Masculino , Persona de Mediana Edad
7.
J Nephrol ; 13(6): 444-9, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-11132761

RESUMEN

BACKGROUND: Hemodialysis (HD) patients with functional iron deficiency (FID) often develop resistance to recombinant human erythropoietin (rHuEpo). In these patients, iron therapy may be a hazard, leading to iron overload and consequently to hemosiderosis. Recent studies suggest that intravenous ascorbic acid (IVAA) may circumvent rHuEpo resistance. The aim of our study was to show the effects of IVAA on FID and whether this results in a better correction of anemia in HD patients with stable hemoglobin (Hb) concentration and FID. METHODS: Twenty-seven HD patients with serum ferritin >300 microg/l, transferrin saturation (TS) <20% and hemoglobin (Hb) <10 g/dL were selected andrandomly divided into two groups to enter a cross-over trial with IVAA. In group I IV vitamin C 500 mg was administered three times a week for three months and discontinued in the next three months of the study. Vitamin C was not given the first three months in group II (control group, first three months of the study), who then received 500 mg IV three times a week for the next three months. RESULTS: Hb and TS% significantly increased (baselines vs 3 months, Hb 9.2 +/- 0.2 vs 10.0 +/- 0.3 g/dL, TS% 17.5 +/- 0.6 vs 25.7 +/- 1.7, respectively p < 0.01 and p <0.001) in group I after three months; ferritin fell significantly from 572 +/- 40 to 398 +/- 55 microg/L (p<0.004). Ten patients completed the study: mean Hb and TS% fell significantly (3 months vs final, Hb 9.9 +/- 0.3 vs 8.9 +/- 0.2 g/dL, TS% 25.1 +/- 1.2 vs 19.1 +/- 1.1, respectively p < 0.01 and p <0.001), while mean ferritin did not change. Mean Hb, ferritin and TS% remained unchanged in group II after three months. Hb and TS% mean values rose significantly (3 months vs final, Hb 9.0 +/- 0.2 vs 9.9 +/- 0.2 g/dl, TS% 18.4 +/- 1.0 vs 27.0 +/- 1.0, respectively p < 0.005 and p <0.001), and ferritin markedly decreased from 450 +/- 50 to 206 +/- 24 microg/L (p < 0.001) at the end of the study. The rHuEpo dose was kept unchanged throughout the study. Differences were analyzed after three months. Mean Hb rose (0.8 +/- 0.2 g/dL) in group I but dropped (-0.1 +/- 0.1 g/dL) (p< 0.009) in group II. Ferritin dropped in both groups (group I vs group II, -173 + /-48 vs - 33 +/- 21 microg/L) (p < 0.01) while TS% increased (group I vs group II, 8.2 +/- 1.5 vs 0.4 +/- 0.7) (p < 0.001). CONCLUSION: IVAA may partially correct FID and consequently help rHuEpo hyporesponsive anemia.


Asunto(s)
Anemia Ferropénica/tratamiento farmacológico , Ácido Ascórbico/administración & dosificación , Diálisis Renal/efectos adversos , Adulto , Anciano , Anemia Ferropénica/etiología , Estudios Cruzados , Esquema de Medicación , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intravenosas , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Probabilidad , Diálisis Renal/métodos , Estadísticas no Paramétricas , Resultado del Tratamiento
12.
G Ital Nefrol ; 23(5): 508-11, 2006.
Artículo en Italiano | MEDLINE | ID: mdl-17123264

RESUMEN

We report a case of situs ambiguous associated with particular vascular anomalies resulting in secondary arterial hypertension. Renal ultrasonography performed in this case has oriented diagnosis.


Asunto(s)
Riñón/anomalías , Riñón/diagnóstico por imagen , Situs Inversus/diagnóstico por imagen , Adolescente , Femenino , Humanos , Hipertensión/etiología , Situs Inversus/complicaciones , Ultrasonografía
13.
Kidney Int ; 69(3): 538-45, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16395261

RESUMEN

The current implementation into nephrology clinical practice of guidelines on treatment of cardiovascular (CV) risk factors in chronic kidney disease (CKD) is unknown. We designed a cross-sectional analysis to evaluate the prevalence and treatment of eight modifiable CV risk factors in 1058 predialysis CKD patients (stage 3: n=486; stage 4: n=430, stage 5: n=142) followed for at least 1 year in 26 Italian renal clinics. The median nephrology follow-up was 37 months (range: 12-391 months). From stages 3 to 5, hypertension was the main complication (89, 87, and 87%), whereas smoking, high calcium-phosphate product and malnutrition were uncommon. The prevalence of proteinuria (25, 38, and 58%), anemia (16, 32, and 51%) and left ventricular hypertrophy (51, 55, and 64%) significantly increased, while hypercholesterolemia was less frequent in stage 5 (49%) than in stages 4 and 3 (59%). The vast majority of patients received multidrug antihypertensive therapy including inhibitors of renin-angiotensin system; conversely, diuretic treatment was consistently inadequate for both frequency and dose despite scarce implementation of low salt diet (19%). Statins were not prescribed in most hypercholesterolemics (78%), and epoietin treatment was largely overlooked in anemics (78%). The adjusted risk for having a higher number of uncontrolled risk factors rose in the presence of diabetes (odds ratio 1.29, 95% confidence interval 1.00-1.66), history of CV disease (odds ratio 1.48, 95% confidence interval 1.15-1.90) and CKD stages 4 and 5 (odds ratio 1.75, 95% confidence interval 1.37-2.22 and odds ratio 2.85, 95% confidence interval 2.01-4.04, respectively). In the tertiary care of CKD, treatment of hypertension is largely inadequate, whereas therapy of anemia and dyslipidemia is frequently omitted. The risk of not achieving therapeutic targets is higher in patients with diabetes, CV disease and more advanced CKD.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Renales/complicaciones , Enfermedades Renales/terapia , Anciano , Anciano de 80 o más Años , Antihipertensivos/uso terapéutico , Enfermedades Cardiovasculares/epidemiología , Enfermedad Crónica , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipercolesterolemia/etiología , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Hipertensión/etiología , Hipertrofia Ventricular Izquierda/epidemiología , Hipertrofia Ventricular Izquierda/etiología , Italia/epidemiología , Enfermedades Renales/epidemiología , Enfermedades Renales/fisiopatología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Guías de Práctica Clínica como Asunto , Prevalencia , Proteinuria/epidemiología , Proteinuria/etiología , Factores de Riesgo , Índice de Severidad de la Enfermedad
14.
Kidney Int ; 50(6): 1990-2001, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8943482

RESUMEN

Interleukin 6 (IL-6) is produced by human mesangial and tubular cells, and its urinary levels has been proposed as a marker of mesangial proliferation and tubulointerstitial damage. Epidermal growth factor (EGF) is expressed within the Henle's loop and the distal tubule and has been shown to accelerate recovery from renal injury. In the present study we have defined renal gene and protein expression of IL-6 and EGF in 10 normal, 10 nonproliferative glomerulonephritis (NPGN) and 30 IgA nephropathy (IgAN) human kidneys by RT-PCR, in situ hybridization and immunohistochemical techniques. Moreover, urinary IL-6 and EGF levels were measured in 41 patients with IgAN and in 20 normal subjects (N). In normal kidneys, EGF was localized in Henle's loop and distal convoluted tubule whereas IL-6 was mainly located in the proximal tubule and, less, within the glomerulus. In IgAN patients, EGF was decreased whereas IL-6 expression was upregulated. These modifications paralleled the degree of tubulointerstitial damage. Moreover, IgAN patients as a whole exhibited a reduction of EGF and an increase of IL-6 urinary concentration (EGF values: N, 12.96 +/- 1.15; IgAN Grades 1-2, 20.05 +/- 2.64; Grades 3-4 7.60 +/- 1.70: Grade 5, 3.14 +/- 0.71, ng/mg urinary creatinine. IL-6 values: N, 2.04 +/- 0.51; IgAN Grades 1-2, 3.26 +/- 0.38; Grades 3-4, 5.67 +/- 0.92; Grade 5, 27.20 +/- 9.70 pg/mg urinary creatinine), that correlated with the degree of histological lesions, the presence of hypertension and serum creatinine level. Interestingly, patients with the highest urinary IL-6/EGF ratio showed a worse evolution in a three year follow-up. In conclusion, our data show that: (1) renal IL-6 and EGF expression are strictly correlated to the degree of tubulointerstitial damage; and (2) urinary IL-6/EGF ratio might be a valuable prognostic marker for the progression of the renal damage in IgAN.


Asunto(s)
Factor de Crecimiento Epidérmico/orina , Glomerulonefritis por IGA/orina , Interleucina-6/orina , Riñón/patología , Adolescente , Adulto , Factor de Crecimiento Epidérmico/genética , Femenino , Glomerulonefritis por IGA/patología , Humanos , Interleucina-6/genética , Masculino , Persona de Mediana Edad , Pronóstico , ARN Mensajero/análisis
15.
Nephron ; 61(3): 302-3, 1992.
Artículo en Inglés | MEDLINE | ID: mdl-1323774

RESUMEN

It was the purpose of this study to evaluate the spread of HCV infection among the staff at Dialysis Units and among relatives of anti-HCV-positive hemodialysis patients. 122 health-care workers and 52 relatives were screened for presence of anti-HCV Ab. The control groups consisted of 100 health-care workers from other wards and 30 relatives of anti-HCV-negative subjects. 2.45% of the health-care staff and 5.8% of the relatives were found to be anti-HCV Ab carriers. None of the subjects in the control groups were positive. In conclusion, the results of this study indicate that there is a real possibility of HCV spread through occupational exposure although the corresponding percentage in less than that presumably due to within-the-family contagion by the virus.


Asunto(s)
Unidades de Hemodiálisis en Hospital , Hepatitis C/transmisión , Exposición Profesional/estadística & datos numéricos , Adulto , Niño , Salud de la Familia , Femenino , Hepacivirus/inmunología , Anticuerpos Antihepatitis/sangre , Hepatitis C/inmunología , Humanos , Masculino , Personal de Hospital
16.
Miner Electrolyte Metab ; 15(4): 246-53, 1989.
Artículo en Inglés | MEDLINE | ID: mdl-2761492

RESUMEN

We have considered just some of the many factors which may affect myocardial function, assessed by means of echocardiography, in uremic patients. Our findings support the view of a multifactorial genesis of the cardiac involvement in uremic patients.


Asunto(s)
Cardiomiopatía Hipertrófica/etiología , Uremia/complicaciones , Adulto , Anciano , Calcio/metabolismo , Cardiomiopatía Hipertrófica/metabolismo , Cardiomiopatía Hipertrófica/fisiopatología , Carnitina/sangre , Ecocardiografía , Femenino , Humanos , Hierro/metabolismo , Metabolismo de los Lípidos , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/fisiología , Fósforo/metabolismo , Uremia/metabolismo , Uremia/fisiopatología , Vitamina D/fisiología
17.
Nephron ; 27(3): 152-4, 1981.
Artículo en Inglés | MEDLINE | ID: mdl-7219645

RESUMEN

The mortality rate of 67 sequential cases of acute renal failure (ARF) accompanied by jaundice was compared with the mortality rate of 168 patients without jaundice. The mortality rate in the group of jaundiced patients was 57%, significantly greater (p less than 0.05) than the 42% mortality in patients without jaundice. The mortality rate correlated with serum bilirubin levels; patients with serum bilirubin greater than 20 mg% had a mortality rate of 85%, whereas patients with levels lower than 10 mg% had a mortality rate of only 33%. Average blood pressures were significantly lower (p less than 0.01) in patients with jaundice than in those without. The data indicate that: (1) ARF accompanied by jaundice carries a worse prognosis; (2) reduced blood pressure which accompanies this condition may be an aggravating factor, and (3) serum bilirubin levels may be used as a prognostic index.


Asunto(s)
Lesión Renal Aguda/complicaciones , Bilirrubina/sangre , Ictericia/complicaciones , Lesión Renal Aguda/mortalidad , Presión Sanguínea , Humanos , Ictericia/sangre , Ictericia/mortalidad , Pronóstico
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA