ABSTRACT
Acquired tubulopathies are frequently underdiagnosed. They can be characterized by the renal loss of specific electrolytes or organic solutes, suggesting the location of dysfunction. These tubulopathies phenotypically can resemble Bartter or Gitelman syndrome). These syndromes are infrequent, they may present salt loss resembling the effect of thiazides (Gitelman) or loop diuretics (Bartter). They are characterized by potentially severe hypokalemia, associated with metabolic alkalosis, secondary hyperaldosteronism, and often hypomagnesemia. Tubular dysfunction has been described as nephrotoxic effects of platinum-based chemotherapy. We present 4 cases with biochemical signs of tubular dysfunction (Bartter-like/Gitelman-like phenotype) related to chemotherapy.
ABSTRACT
Objetivo: Obtener la prevalencia de hipertensión arterial sistémica en niños en el Hospital General de Zacatecas (HGZ). Identificar género, edad, etiología, diagnóstico, métodos confirmatorios y terapéutica. Además, comparar resultados con la literatura médica. Métodos: Estudio retrospectivo descriptivo de prevalencias que analizó 5 941 expedientes digitales de servicios de cardiología y nefrología pediátrica del HGZ, de agosto 2013 a agosto 2015, en el sistema de cómputo hospitalario, denominado SIGHO. Se seleccionó pacientes con diagnóstico de Hipertensión Arterial Sistémica (HAS), revisándoles género, edad, etiología, método de confirmación diagnóstica, y tratamiento indicado, mediante el computador central y administrativo del hospital, para identificar las consultas y pacientes con los filtros específicos. El análisis de datos se estableció por medio del Software SPSS.19® para Windows. Resultados: De 5 941 consultas totales, 3 277 de Cardiopediatría y 2 664 de nefropediatría. Con solo 40 pacientes con HAS, 0,67%; 25 de ellos masculinos, 62,5%; una frecuencia asentada entre edades de 1-4 años, con 45%. En su etiología la mayoría presentaron coartación de aorta con 57,5%, insuficiencia renal crónica en un 27,5%, solo 1 niño con tumor renal, 1 con HAS renovascular y 1 con HAS primaria, equivalente 2,5%, y se clasifico 3 pacientes con HAS secundaria sin especificar, 7,5%. Conclusiones: Resalta la baja prevalencia de HAS pediátrica, de 0,67%, en casi 6 000 consultas, comparativamente con la literatura universal de 1,5-3%; y a casuística con coartación aortica en 57,5% e insuficiencia renal crónica en 27,5%, y otras patologías renales en menor frecuencia, invirtiendo causas primero la coartación de aorta y después problemas parenquimatosos renales.
Aim: To obtain the prevalence of hypertension in children in the General Hospital of Zacatecas (HGZ). Identify gender, age, etiology, diagnosis, and therapeutic methods Confirmatory. In addition, to compare results with the medical literature. Methods: Retrospective study that analyzed 5 941 digital records of pediatric cardiology and pediatric nephrology of HGZ, from August 2013 to August 2015, in the hospital computer system, called SIGHO. Patients were selected with diagnosis of systemic hypertension (HAS), reviewing gender, age, etiology, methods of diagnostic confirmation and treatment indicated by the central and administrative computer of the hospital for identify queries and patients with specific filters. Data analysis was established by the SPSS.19® Software for Windows. Results: Of 5 941 total views, 3 277 and 2 664 of pediatric cardiology and pediatric nephrology. With only 40 patients with HAS, 0,67%; 25 of them male, 62,5%; main frequency seated between the ages of 1-4 years, with 45%. In its etiology most they had aortic coarctation with 57,5%, chronic renal failure in 27,5%, only 1 child with renal tumor, 1 with HAS by the renal vasculature and 1 with HAS primary, equivalent to 2,5% and 3 patients was classified with HAS secondary unspecified 7,5%. Conclusions: Highlight the low prevalence of pediatric hypertension, 0,67%, almost 6,000 consultations, compared with world literature 1,5-3%; Casuistry with coarctation in 57,5% and chronic renal failure in 27,5%, and other renal diseases less frequently, investing causes aortic coarctation first and then parenchymal kidney problems.