Age-related markers and predictors of diabetic kidney disease progression in type 2 diabetes patients: a retrospective cohort study.

Background: Diabetic kidney disease (DKD) is characterized by reduced estimated glomerular filtration rate (eGFR) and albuminuria, which play a pivotal role in both diagnosing and determining the disease's progression. This study aimed to assess the trajectory of these markers concerning age in individuals with DKD and identify predictive factors for the decline in eGFR decline, variation in albuminuria, mortality, and progression to renal replacement therapy (RRT). Design: This retrospective cohort encompassed patients with type 2 diabetes (T2D), divided into two age categories: <75 and ⩾75 years old. Methods: Over a 3-year span, the study evaluated eGFR (CKD-EPI) and 24-h albuminuria. Univariate and multivariate analyses were employed to pinpoint factors associated with deteriorating renal function and mortality. Significance was set at p < 0.05, and Kaplan-Meier survival curves were constructed to illustrate renal and overall survival. Results: The analysis comprised 304 patients. Comparable eGFR declines were evident in both age groups during the transition from the first to the second year and from the second to the third year. Nonetheless, a more pronounced rise in albuminuria was evident in the ⩾75 years group during the first to the second year. Multivariate analysis unveiled that systolic blood pressure (SBP) measurements in the first year positively forecasted eGFR decline. Age was associated with heightened albuminuria and mortality, while hospitalizations linked to cardiovascular causes robustly predicted mortality. Hospitalizations due to sepsis and cardiovascular reasons, coupled with first-year SBP measurements, served as predictive indicators for progression to RRT. Conclusion: Both age groups experienced similar declines in eGFR, though the ⩾75 years group displayed a more significant increase in albuminuria during the first to the second year. Age, hospitalizations, and higher blood pressure levels were correlated with exacerbated renal function deterioration and/or elevated mortality in DKD. Timely intervention and tailored management strategies stand as critical components for enhancing outcomes among DKD patients.

Diabetic kidney disease: aging and progression Diabetic kidney disease (DKD) is characterized by a reduced estimated glomerular filtration rate (eGFR) and albuminuria. This study aims to evaluate the follow-up of these renal markers in relation to age among individuals with DKD and identify factors predisposing to eGFR loss, increased albuminuria, mortality, and the need for dialysis. We conducted an observational and retrospective study in Brazil, including patients with type 2 diabetes, divided into two age groups: < 75 and ⩾ 75 years. The patients were followed for three years, and a total of 304 patients were evaluated. We observed a similar decline in eGFR in both age groups from the 1st to the 2nd year and from the 2nd to the 3rd year. However, worsening of albuminuria was more frequent in the ⩾ 75 years old group from the 1st to the 2nd year. Elevated blood pressure levels were associated with eGFR decline. Age was associated with increased albuminuria and mortality. Hospitalizations for cardiovascular causes strongly predicted mortality. Hospitalizations for sepsis and cardiovascular causes, along with higher blood pressure levels, were associated with the need for dialysis. Hence, establish approaches to enhance the health in individuals with DKD is of paramount importance.

Idiopathic partial central diabetes insipidus.

Diabetes insipidus is a rare disorder characterized by the inability to concentrate urine, which results in hypotonic urine and increased urinary volume. It may occur because of antidiuretic hormone deficiency or resistance to its action in the renal tubules. When there is a deficiency in the synthesis of antidiuretic hormones, diabetes insipidus is called central; when there is resistance to its action in the renal tubules, it is said to be nephrogenic. We report a case of idiopathic partial central diabetes insipidus and highlight the management and treatment of the disease.

Idiopathic partial central diabetes insipidus

ABSTRACT Diabetes insipidus is a rare disorder characterized by the inability to concentrate urine, which results in hypotonic urine and increased urinary volume. It may occur because of antidiuretic hormone deficiency or resistance to its action in the renal tubules. When there is a deficiency in the synthesis of antidiuretic hormones, diabetes insipidus is called central; when there is resistance to its action in the renal tubules, it is said to be nephrogenic. We report a case of idiopathic partial central diabetes insipidus and highlight the management and treatment of the disease.

Osteogênese imperfeita: relato de caso de uma família / Osteogenesis imperfecta: case report of a family

A osteogênese imperfeita (OI) é uma doença rara do tecido conjuntivo cuja principal causa é uma mutação dominante nos genes do colágeno tipo I, a proteína mais abundante do osso. As principais manifestações clínicas da doença incluem a ocorrência de fraturas de repetição, encurvamento dos ossos, esclera azulada, dentinogênese imperfeita, perda auditiva, escoliose, aumento da frouxidão ligamentar, deformidade basilar do crânio e baixa estatura. Neste estudo, descrevemos cinco casos de pacientes de uma mesma família com OI tipo I, destacando os aspectos clínicos da doença. Todos os pacientes apresentam esclera azulada e tiveram múltiplas fraturas ao longo da vida. Eles permanecem em seguimento a nível ambulatorial e a maioria faz tratamento com alendronato de sódio, suplementação de cálcio e vitamina D.

Osteogenesis imperfecta is a rare disease of connective tissue in which the most common cause is the dominant mutation in collagen type I, the most abundant protein in the bone. The main clinical manifestations of the disease include the occurrence of repeat fractures, bowing of the bones, blue sclera, dentinogenesis imperfecta, hearing loss, scoliosis, increased ligament laxity, basilar skull deformity and short stature. In this study, we describe five cases of patients with osteogenesis imperfecta type I of the same family, highlighting the clinical aspects of the disease. All patients have blue sclera and had multiple fractures. They remain in follow-up and most of them do treatment with alendronate, supplementation of calcium and vitamin D.