RESUMEN
Introducción: el método recomendado para la medición de creatinina plasmática (Cr) es el enzimático, que permite obtener la tasa de filtrado glomerular estimado (TFGe) con la fórmula Full-Age-Spectrum (FAS) para todas las edades, al normalizar la TFGe con valores poblacionales de Cr. Objetivos: obtener valores poblacionales de Cr medida con un método enzimático y evaluar la fórmula FAS, en una población pediátrica ambulatoria de la Argentina, puesto que no existen publicaciones al respecto en nuestro país. Material y métodos: estudio descriptivo, retrospectivo, transversal, por muestreo consecutivo. Se consideró la población pediátrica ambulatoria de 2 a 17 años que concurrió una sola vez, entre 07/2018 y 11/2021 al laboratorio del Hospital Municipal (Bahía Blanca, Argentina) con petición médica de Cr. Se evaluó la distribución poblacional de Cr. Se comparó FAS original (FAS-Belga) con FAS normalizada con valores locales de Cr (FAS-Local). Resultados: se estudiaron 2793 individuos. Los varones tuvieron un valor de Cr superior al de las mujeres a los 16 y 17 años. La TFGe fue menor con FAS-Local que con FAS-Belga [mediana (RI) mL/min/1,73 m2 : 107,3 (22,9) vs. 117,0 (26,5); p=0,0001; rbis=0,87 (tamaño del efecto grande)]. Del análisis del gráfico de Bland-Altman y el índice de concordancia Kappa se obtuvo que FAS-Local no fue comparable con FAS-Belga. Conclusiones: los valores poblacionales de Cr, medida con un método enzimático, son los primeros en obtenerse en una población pediátrica ambulatoria argentina. Dichos valores son necesarios para aplicar FAS en la Argentina (AU)
Introduction: the recommended test for the measurement of plasma creatinine (Cr) is the enzymatic method, which allows calculating the estimated glomerular filtration rate (eGFR) with the Full-Age-Spectrum (FAS) equation for all ages, by normalizing the eGFR with population Cr values. Objectives: to obtain population Cr values measured with an enzymatic method and to evaluate the FAS equation in an pediatric outpatient population in Argentina, since there are no reports on this subject in our country. Material and methods: A descriptive, retrospective, cross-sectional, consecutive sampling study. The pediatric outpatient population aged 2 to 17 years who attended only once to the laboratory of the Municipal Hospital (Bahía Blanca, Argentina) between 07/2018 and 11/2021 with medical request for Cr measurement. The population distribution of Cr was evaluated. The original FAS (FAS-Belgian) was compared to FAS normalized with local Cr values (FAS-Local). Results: 2793 individuals were studied. Males had a higher Cr value than females at 16 and 17 years of age. The eGFR was lower with FAS-Local than with FAS-Belgian [median (IQR) mL/min/1.73 m2: 107.3 (22.9) vs. 117.0 (26.5); p=0.0001; rbis=0.87 (large effect size)]. Analysis of the Bland-Altman plot and the Kappa concordance index showed that FAS-Local was not comparable to FAS-Belgian. Conclusions: population Cr values, measured with an enzymatic method, are the first to be obtained in an Argentine pediatric outpatient population. These values are necessary to apply the FAS in Argentina (AU)
Asunto(s)
Humanos , Preescolar , Niño , Adolescente , Creatinina/análisis , Insuficiencia Renal Crónica/diagnóstico , Tasa de Filtración Glomerular , Pruebas de Función Renal , Argentina , Estudios Transversales , Estudios RetrospectivosRESUMEN
BACKGROUND: We analyze the effects of water ingestion before blood extraction on routine hematological parameters. METHODS: Twenty female volunteers -mean 24 y- were included. Blood was collected after a 12â¯h fast period (T0) and 1â¯h after the ingestion of 300â¯ml water (T1). These parameters were analyzed: white blood cell (WBC) count; WBC differential count including lymphocytes (LYM), monocytes (MONO), neutrophils, eosinophils (EOS), and basophils; red blood cell (RBC) count; hematocrit (HCT); hemoglobin (HGB); mean cell volume; mean cell hemoglobin; RBC distribution width; and platelet count (PLT). Statistical significance: Pâ¯<â¯0.05. Mean difference % (MD%) was calculated for each parameter and was compared with reference change value (RCV). A change was considered clinically significant when MD% exceeded the RCV. RESULTS: Significant differences were observed in (medians, T0 vs T1, P): WBC ×109/l (6.51 vs 6.12, 0.002); LYM ×109/l (2.90 vs 2.19, 0.000); MONO ×109/l (0.50 vs 0.48, 0.031); EOS ×109/l (0.17 vs 0.16, 0.003); RBC ×1012/l (4.46 vs 4.40, 0.024); HCT l/l (0.38 vs 0.37, 0.036); HGB g/l (129 vs 129, 0.009). All MDs% were lower than their respective RCV. CONCLUSION: Ingestion of 300â¯ml water 1â¯h before blood extraction does not alter the hematological parameters studied.
Asunto(s)
Ingestión de Líquidos , Ayuno/sangre , Pruebas Hematológicas/métodos , Fase Preanalítica , Agua/farmacología , Adulto , Artefactos , Estudios de Cohortes , Femenino , Humanos , Adulto JovenRESUMEN
El mundo occidental ha sufrido un aumento preocupante en la prevalencia de la obesidad, la cual se asocia al desarrollo de enfermedad cardiovascular (ECV) y enfermedad renal crónica (ERC). Se ha demostrado que la obesidad induce disturbios fisiopatológicos que favorecen la injuria renal y a su vez, el deterioro de la función renal se ha asociado con la aparición de eventos cardiovasculares y mortalidad. El objetivo de este trabajo fue evaluar si un leve deterioro de la función renal se asocia a un riesgo cardiovascular (RCV) aumentado en individuos con sobrepeso u obesidad. De un total de 454 individuos que concurrieron al Servicio de Medicina Preventiva del Hospital Municipal de Bahía Blanca, se incluyeron 205 (45 %) sujetos adultos, de ambos sexos, con sobrepeso u obesidad y sin otros factores de riesgo cardiovascular, de quienes se obtuvieron datos clínicos y bioquímicos. Se estimó la Velocidad de Filtración Glomerular (VFG) con la ecuación abreviada Modification of Diet in Renal Disease y el RCV con el score Reynolds. El 19 % de la población estudiada presentó leve deterioro del Filtrado Glomerular (FG), VFG entre 60 y 89 mL/min/1,73 m², con valores normales de creatinina, observándose en este grupo una mayor proporción de pacientes con RCV aumentado (23 %) comparado con el grupo sin deterioro del FG (14 %), p = 0.153. Se observó asociación significativa entre leve deterioro del FG y edad mayor a 50 años, (p = 0,000). Se concluyó en este estudio, que en estos individuos con exceso de peso es necesario optimizar el screening de ERC, incorporando rutinariamente la estimación de la VFG y completando la evaluación de la función renal con la medición de Albúmina Urinaria y otros estudios por imágenes, para clasificarlos o no en el estadio 2 de ERC, con el fin de prevenir la ERC y la ECV. Los autores declaran no poseer conflictos de interés.
The occidental world has suffered an alarming increase in the prevalence of obesity, which is associated with the development of cardiovascular disease (CVD) and chronic kidney disease (CKD). It has been demonstrated that obesity induces pathophysiologic disturbances that promote renal injury, and at the same time, renal dysfunction has been associated with the onset of cardiovascular events and mortality. The aim of this study was to evaluate if a mild impairment in renal function is associated with an increased cardiovascular risk (CVR) in subjects with overweight or obesity. From a total of 454 individuals who presented at the Preventive Medicine Department of Hospital Municipal de Bahía Blanca, 205 (45 %) adults of both genders with over-weight or obesity and with no other cardiovascular risk factor were enrolled. Clinical and biochemical data were obtained from these individuals. Glomerular Filtration Rate (GFR) was estimated with the abbreviated equation Modification of Diet in Renal Dis-ease, CVR was determined with Reynolds score. Nineteen percent of the studied population had a mild impairment in glomerular filtration (GF), GFR between 60 and 89 mL/min/1.73m², with normal creatinine values, with a higher proportion of patients with increased CVR (23 %) being found in this group as compared to the group with no GF impairment (14 %), p=0.153. A significant association was found between mild impairment of GF and age older than 50 years (p = 0.000). In this study, we concluded that it is necessary to optimize CKD screening in overweight or obese individuals by incorporating the estimation of GFR in routine practice and performing a complete renal function evaluation including urinary albumin measurement and other imaging studies, to determine whether they should be classified or not into stage 2 of CKD with the aim of preventing CKD and CVD. No financial conflicts of interest exist.
RESUMEN
El mundo occidental ha sufrido un aumento preocupante en la prevalencia de la obesidad, la cual se asocia al desarrollo de enfermedad cardiovascular (ECV) y enfermedad renal crónica (ERC). Se ha demostrado que la obesidad induce disturbios fisiopatológicos que favorecen la injuria renal y a su vez, el deterioro de la función renal se ha asociado con la aparición de eventos cardiovasculares y mortalidad. El objetivo de este trabajo fue evaluar si un leve deterioro de la función renal se asocia a un riesgo cardiovascular (RCV) aumentado en individuos con sobrepeso u obesidad. De un total de 454 individuos que concurrieron al Servicio de Medicina Preventiva del Hospital Municipal de Bahía Blanca, se incluyeron 205 (45 %) sujetos adultos, de ambos sexos, con sobrepeso u obesidad y sin otros factores de riesgo cardiovascular, de quienes se obtuvieron datos clínicos y bioquímicos. Se estimó la Velocidad de Filtración Glomerular (VFG) con la ecuación abreviada Modification of Diet in Renal Disease y el RCV con el score Reynolds. El 19 % de la población estudiada presentó leve deterioro del Filtrado Glomerular (FG), VFG entre 60 y 89 mL/min/1,73 m², con valores normales de creatinina, observándose en este grupo una mayor proporción de pacientes con RCV aumentado (23 %) comparado con el grupo sin deterioro del FG (14 %), p = 0.153. Se observó asociación significativa entre leve deterioro del FG y edad mayor a 50 años, (p = 0,000). Se concluyó en este estudio, que en estos individuos con exceso de peso es necesario optimizar el screening de ERC, incorporando rutinariamente la estimación de la VFG y completando la evaluación de la función renal con la medición de Albúmina Urinaria y otros estudios por imágenes, para clasificarlos o no en el estadio 2 de ERC, con el fin de prevenir la ERC y la ECV. Los autores declaran no poseer conflictos de interés.(AU)
The occidental world has suffered an alarming increase in the prevalence of obesity, which is associated with the development of cardiovascular disease (CVD) and chronic kidney disease (CKD). It has been demonstrated that obesity induces pathophysiologic disturbances that promote renal injury, and at the same time, renal dysfunction has been associated with the onset of cardiovascular events and mortality. The aim of this study was to evaluate if a mild impairment in renal function is associated with an increased cardiovascular risk (CVR) in subjects with overweight or obesity. From a total of 454 individuals who presented at the Preventive Medicine Department of Hospital Municipal de Bahía Blanca, 205 (45 %) adults of both genders with over-weight or obesity and with no other cardiovascular risk factor were enrolled. Clinical and biochemical data were obtained from these individuals. Glomerular Filtration Rate (GFR) was estimated with the abbreviated equation Modification of Diet in Renal Dis-ease, CVR was determined with Reynolds score. Nineteen percent of the studied population had a mild impairment in glomerular filtration (GF), GFR between 60 and 89 mL/min/1.73m², with normal creatinine values, with a higher proportion of patients with increased CVR (23 %) being found in this group as compared to the group with no GF impairment (14 %), p=0.153. A significant association was found between mild impairment of GF and age older than 50 years (p = 0.000). In this study, we concluded that it is necessary to optimize CKD screening in overweight or obese individuals by incorporating the estimation of GFR in routine practice and performing a complete renal function evaluation including urinary albumin measurement and other imaging studies, to determine whether they should be classified or not into stage 2 of CKD with the aim of preventing CKD and CVD. No financial conflicts of interest exist.(AU)
RESUMEN
In this study, the expression of extracellular matrix genes by vascular cells from human iliac blood vessels was characterized on the mRNA steady-state level by slot blot and Northern transfer analyses, as well as by in situ hybridization. Endothelial cells were isolated from adult human iliac arteries and veins, as well as from umbilical veins; smooth muscle cells were isolated from adult human iliac arteries and inferior vena cava. The results show that confluent umbilical vein endothelial cells expressed the genes that encode types I, III, IV and VI collagens, as well as fibronectin and laminin. In contrast, the iliac endothelial cells expressed the genes for types IV and V collagens, fibronectin and laminin; mRNA transcripts for types I, III and VI collagens were not detectable. The smooth muscle cells from iliac arteries or inferior vena cava displayed gene expression for types I, III, IV, V and VI collagens, fibronectin and laminin. The results indicate major differences in gene expression for the various types of collagens by human iliac endothelial and smooth muscle cells. Furthermore, the fetal-derived umbilical endothelial cells displayed differential collagen gene expression from that of adult iliac endothelial cells.