ABSTRACT
Inflammatory bowel disease (IBD) is a chronic disease connected to the immune system, with a predilection for the gastrointestinal tract. However, a large proportion of the patients have extraintestinal manifestations (EIM), and the ocular system is affected in some patients. The clinical presentation of ocular pathology is broad, ranging from asymptomatic cases to blindness, leading to high morbidity. Ocular complications can be primary and, in general, are associated with episodes of acute flare-ups that subside with immunological management of the digestive disease. Secondary complications arise from the primary ones and as adverse effects of immunological treatment. In addition, on many occasions, the ocular manifestation may appear prior to the presentation of digestive symptoms. The presence of a multidisciplinary team that includes a gastroenterologist and an ophthalmologist is important in order to achieve early diagnosis of ocular complications, thereby preventing, treating, and avoiding unfavorable and irreversible long-term ocular sequelae.
ABSTRACT
Resumen Introducción: la urolitiasis es una enfermedad frecuente de la cual en Colombia se han publicado estudios previos; sin embargo, estos no comparan las características sociodemográficas y clínicas de los pacientes con las comorbilidades y los factores predisponentes de litiasis como hiperuricemia, hipertensión arterial (HTA), obesidad y enfermedad renal crónica (ERC). Objetivos: caracterizar clínica y metabólicamente los pacientes con diagnóstico de urolitiasis atendidos en una clínica de cuarto nivel de Barranquilla, Colombia, en el año 2019. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal en 49 pacientes con base en el estudio de fichas clínicas Resultados: el 53,1 % de los participantes eran hombres y las medianas de edad y de índice de masa corporal (IMC) fueron 58 años y 26,4 kg/m2, respectivamente. Algunas de las comorbilidades identificadas fueron, en orden de frecuencia, HTA (69,4 %), ERC (36,7 %), infección de vías urinarias recurrente (24,5 %), hiperuricemia (44,9 %), hipercalcemia (16,3 %) e hiperfosfatemia (12,2 %). Los tipos de cristal encontrados fueron oxalato (20,4 %), urato (12,2 %), mezcla de oxalato y urato (4,1 %), fosfato (4,1 %), hipercalciuria e hiperoxaluria (38,8 %), hiperuricosuria e hipocalciuria (18,4 %) y hipofosfaturia o hipofosfaturia (4,1 %). Asimismo, la hiperuricemia se asoció a edad (p=0,028), ERC (p=0,026), medicamentos antihipertensivos (p=0,022), posición del cálculo en cáliz renal (p=0,012), hiperparatiroidismo (p=0,007), depuración de creatinina (p=0,046) e hipercalciuria (p=0,049). El IMC ≥30 se asoció con ERC estadio 5 (p=0,025), diálisis (p=0,025) e hiperoxaluria (p=0,021). Conclusiones: en la población analizada se evidenció una frecuencia significativa de ERC, hiperuricemia, obesidad e HTA.
Abstract Introduction: Urolithiasis is a disease with high frequency and our environment is no exception. Previous studies have been published in Colombia, however, these do not compare the sociodemographic and clinical characteristics of patients with comorbidities and predisposing factors for lithiasis such as they are hyperuricemia, high blood pressure, obesity, and chronic kidney disease (CKD). Objectives: To characterize clinically and metabolically the patients diagnosed with urolithiasis in a fourth-level clinic in the city of Barranquilla in 2019. Methods: Observational, descriptive, cross-sectional study. In 49 patients, based on the study of clinical records Results: The median age was 58 years, the male sex in 53.1 %. The median body mass index was 26.4 Kg / m2. High blood pressure was identified in 69.4 %, chronic kidney disease (CKD) in 36.7 %, recurrent urinary tract infection in 24.5 %. Hyperuricemia in 44.9 %, hypercalcemia in 16.3 % and hyperphosphatemia in 12.2 %. The crystal types were oxalate in 20.4 %, urate in 12.2 %, mixture of the previous ones in 4.1 % and in the same proportion phosphate. Hypercalciuria and hyperoxaluria in 38.8 %, hyperuricosuria and hypocalciuria in 18.4 %, while hyperphosphaturia or hypophosphaturia in 4.1 %. Hyperuricemia was associated with age (p = 0.028), CKD (p = 0.026), antihypertensive drugs (p = 0.022), the position of the stone in the renal calyx (p = 0.012), hyperparathyroidism (p = 0.007), creatinine clearance (p = 0.046) and hypercalciuria (p = 0.049). BMI ≥30 was associated with stage 5 CKD (p = 0.025), dialysis (p = 0.025), and hyperoxaluria (p = 0.021). Conclusions: A significant frequency of CKD, hyperuricemia, obesity and hypertension was evidenced in patients with urolithiasis.
