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1.
Rev Assoc Med Bras (1992) ; 66(9): 1258-1263, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027455

RESUMO

INTRODUCTION: This study aims to determine the incidence of de novo nephritic syndrome (NS) in COVID-19 patients and identify its associated factors. METHODS: All ward patients with COVID-19 pneumonia were investigated. After determining the inclusion and exclusion criteria, the study population was identified. The urine dipstick test and urine protein creatinine ratio (UPCR) measurements were performed. Patients with de novo NS findings, nasopharyngeal swab, and urine RT-PCR tests were performed simultaneously. RESULTS: This descriptive cross-sectional study was conducted with 21 patients with COVID-19. The mean age of the patients was 42.2±8.8 years, and 71.4% of them were male. The mean duration of follow-up was 28.4±9.3 days. The urine RT-PCR test was positive in one patient (4.8%). Improvements were observed in hematuria by 71.4%, and proteinuria by 85.7% at the end of the follow-up. A significant decrease in the measured UPCR was found in comparison to the baseline(P=0.000). Also, improvements were recorded in the complete blood counts, inflammatory parameters, ferritin, and coagulation tests, compared to the baseline. There was a positive correlation between baseline UPCR and ferritin, and a negative correlation between baseline UPCR and sodium values. CONCLUSION: COVID-19-induced de novo nephritic syndrome may occur mainly due to tubulointerstitial involvement and often results in spontaneous remission. However, why these findings were not present in all patients who had no comorbidities is not clear.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Nefropatias/etiologia , Pandemias , Pneumonia Viral , Adulto , Infecções por Coronavirus/complicações , Creatinina , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/complicações
2.
Cleve Clin J Med ; 87(10): 619-631, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004323

RESUMO

COVID-19 is primarily considered a respiratory illness, but the kidney may be one of the targets of SARS-CoV-2 infection, since the virus enters cells through the angiotensin-converting enzyme 2 receptor, which is found in abundance in the kidney. Information on kidney involvement in COVID-19 is limited but is evolving rapidly. This article discusses the pathogenesis of acute kidney injury (AKI) in COVID-19, its optimal management, and the impact of COVID-19 on patients with chronic kidney disease, patients with end-stage kidney disease on dialysis, and kidney transplant recipients.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus , Efeitos Psicossociais da Doença , Nefropatias , Pandemias , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Humanos , Nefropatias/classificação , Nefropatias/epidemiologia , Nefropatias/terapia , Nefropatias/virologia , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia
3.
San Salvador; s.n; s.n; sept. 2020. 109 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1119530

RESUMO

Objetivo: Determinar el comportamiento clínico epidemiológico de los pacientes que presentan el síndrome cardio-renal tipo IV en la consulta externa del Servicio de Nefrología del Hospital España de Chinandega, Nicaragua 2018. Diseño: Fue un estudio descriptivo de corte transversal, donde se revisaron los expedientes en la consulta de Nefrología del Hospital España en Chinandega, el instrumento de recolección fue una ficha. La muestra fue no probabilística a conveniencia, estuvo constituida por 184 pacientes que fueron diagnosticados con enfermedad renal crónica y presentaban ecocardiograma, 139 de ellos presentaron diagnóstico de SCR tipo IV. Resultados: El hallazgo ecocardiográfico más frecuente entre los pacientes diagnosticados con SCR tipo IV fue; valvulopatía con un 100%, y la patología más frecuente fue la anemia en un 81.6% con p=0.005. Conclusiones: Los pacientes con síndrome cardio-renal tipo IV presentaron las siguientes patologías y alteraciones; anemia, hipertensión arterial, diabetes mellitus II, y dislipidemia, los hallazgos ecocardiográficos fueron; valvulopatía, hipertrofia ventrículo izquierdo, cardiopatía dilatada, disfunción diastólica, y disfunción sistólica


Assuntos
Humanos , Doença Crônica , Nefropatias , Saúde Pública , Epidemiologia Descritiva , Estudos Transversais
4.
Urologiia ; (4): 151-156, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-32897030

RESUMO

The results of the analysis of domestic and foreign literature on complications of various approaches for nephrectomy are presented in the review. Along with open nephrectomy, complications of various minimally-invasive approaches are described, including laparoscopic, retroperitoneoscopic and robot-assisted nephrectomy. Recently, a large number of publications have been dedicated to donor nephrectomy, which is associated with the growing trend for these procedures in many clinics throughout the world using different approaches. The most of studies show that complications are more common for open nephrectomy (up to 30.4%) compared to laparoscopic (5.0-25.8%), retroperitoneoscopic (up to 17.1%) and robot-assisted (0-15%) nephrectomy. Unlike open procedure, minimally-invasive approaches have specific complications; however, most of the complications are identical for various methods. Retroperitoneoscopic access is associated with a minimal risk of damage to the abdominal organs.


Assuntos
Nefropatias , Transplante de Rim , Laparoscopia , Humanos , Nefrectomia , Coleta de Tecidos e Órgãos
6.
Adv Exp Med Biol ; 1255: 195-202, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32949401

RESUMO

In this chapter, we discussed some of the specific uses of scRNA-seq in exploring viral infections and diseases of the kidney and pancreas. This review, however, is by no means exhaustive, and indeed this technology has advanced the study of pulmonary and cardiac diseases, transplant immunology, cancer, and many others as well. Nevertheless, the above reviewed studies do illustrate the utility and resolution of scRNA-seq in understanding exact cellular compositions, discovering heterogeneity within cellular expression patterns, and uncovering clues that may eventually lead to the development of more targeted and personalized therapies. Additionally, the increasing availability of whole tissue cellular atlases in both health and disease as a result of scRNA-seq studies provides an important resource to better understand complicated molecular signaling patterns and events that are similar and different between human diseases.


Assuntos
Nefropatias/genética , Pancreatopatias/genética , Análise de Sequência de RNA , Análise de Célula Única , Viroses/genética , Humanos
7.
Kyobu Geka ; 73(9): 686-689, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32879273

RESUMO

We experienced a surgical case of Stanford type A acute aortic dissection with abdominal aortic aneurysm (AAA) associated with ectopic kidney. Computerized tomography did not detect any ulcer-like projections, but 3 days later, it appeared, and emergency surgery was performed. Second-stage surgery was selected and done later to repair AAA. The right kidney was an ectopic pelvic kidney. The renal arteries had branched off from the left common iliac artery, and the renal artery lumen narrowed. With a 4 Fr catheter, cold Ringer's solution was given to protect the kidneys during surgery. The patient showed no deterioration of kidney function and made good progress. After rehabilitation, the patient had no complications and was discharged from the hospital.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Nefropatias , Aorta Abdominal , Humanos , Rim , Artéria Renal/cirurgia , Resultado do Tratamento
8.
Nat Commun ; 11(1): 4467, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948751

RESUMO

Recent studies have reported that upregulation of disulfide-bond A oxidoreductase-like protein (DsbA-L) prevented lipid-induced renal injury in diabetic nephropathy (DN). However, the role and regulation of proximal tubular DsbA-L for renal tubulointerstitial fibrosis (TIF) remains unclear. In current study, we found that a proximal tubules-specific DsbA-L knockout mouse (PT-DsbA-L-KO) attenuated UUO-induced TIF, renal cell apoptosis and inflammation. Mechanistically, the DsbA-L interacted with Hsp90 in mitochondria of BUMPT cells which activated the signaling of Smad3 and p53 to produce connective tissue growth factor (CTGF) and then resulted in accumulation of ECM of BUMPT cells and mouse kidney fibroblasts. In addition, the progression of TIF caused by UUO, ischemic/reperfusion (I/R), aristolochic acid, and repeated acute low-dose cisplatin was also alleviated in PT-DsbA-L-KO mice via the activation of Hsp90 /Smad3 and p53/CTGF axis. Finally, the above molecular changes were verified in the kidney biopsies from patients with obstructive nephropathy (Ob). Together, these results suggest that DsbA-L in proximal tubular cells promotes TIF via activation of the Hsp90 /Smad3 and p53/CTGF axis.


Assuntos
Fibrose/genética , Predisposição Genética para Doença/genética , Glutationa Transferase/genética , Glutationa Transferase/metabolismo , Nefropatias/genética , Idoso , Animais , Apoptose , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Nefropatias Diabéticas , Modelos Animais de Doenças , Feminino , Fibrose/patologia , Proteínas de Choque Térmico HSP90/metabolismo , Humanos , Inflamação , Rim/lesões , Nefropatias/patologia , Túbulos Renais Proximais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mitocôndrias/metabolismo , Transdução de Sinais , Proteína Smad3/metabolismo , Proteína Supressora de Tumor p53/metabolismo
9.
Medicine (Baltimore) ; 99(38): e22181, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957343

RESUMO

BACKGROUND: By now, the incidence of chronic kidney disease (CKD) is increasing. The development of various CKD is attributed to the continuous aggravation of renal interstitial fibrosis (RIF) in the process of end-stage renal disease (ESRD). Oral treatment of traditional Chinese medicine (TCM) is one of the therapies for RIF. Randomized controlled trials (RCTs) of TCM treatment RIF have been reported, but its effectiveness and safety have yet been systematically investigated. Therefore, through the systematic analysis and meta-analysis, our study will summarize the effectiveness and safety of oral treatment RIF of TCM, in order to provides scientific reference for clinical practice. METHODS: This protocol follows Preferred Reporting Items for Systematic Evaluation and Meta-Analysis. RCTs will be only selected. Such databases as the PubMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Excerpt Medical Database (Embase), WanFan Data, Chinese Biomedical Literature Database (CBM), WHO International Clinical Trials Registry Platform will be searched from the inception to June, 2020 to collect the RCTs about taking TCM orally in treating RIF. The literature according to the inclusion and exclusion criteria, data-extracted and the methodological quality evaluated will be performed independently by 2 reviewers. The clinical outcomes including renal function indices (Scr, BUN, 24-hour urinary protein quantity) and Indicators of RIF (TGF-ß1, Notch1, Jagged-1). The risk of bias included in the RCTs will be evaluated by the bias risk assessment tool provided in the Cochrane System Evaluation Manual 5.1.0. Review Manager 5.3 provided by the Cochrane collaboration network will be used to process the data. RESULTS AND CONCLUSION: Some more targeted and practical results about the efficacy of taking TCM orally in RIF have been provided by our study. The available evidence suggests that the therapeutic effects of combining TCM with Western medicine therapies is much better for RIF than Western medicine therapies only.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Nefropatias/tratamento farmacológico , Projetos de Pesquisa , Fibrose , Humanos , Medicina Tradicional Chinesa , Metanálise como Assunto , Revisões Sistemáticas como Assunto
10.
J Bras Nefrol ; 42(2 suppl 1): 32-35, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877496

RESUMO

INTRODUCTION: The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. METHODS: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. RESULTS: We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. DISCUSSION: Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Nefropatias/terapia , Pneumonia Viral/epidemiologia , Terapia de Substituição Renal/normas , Adolescente , Assistência Ambulatorial , Brasil/epidemiologia , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Higiene/normas , Transplante de Rim , Máscaras , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Isolamento de Pacientes , Pediatria , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Terapia de Substituição Renal/métodos , Sociedades Médicas , Avaliação de Sintomas , Transporte de Pacientes
11.
J Bras Nefrol ; 42(2 suppl 1): 36-40, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877497

RESUMO

During the Covid-19 pandemic, the issue is how to maintain adequate care for people with other diseases. In this document, the SBN Rare Diseases Committee (COMDORA) gives some guidelines on the care of patients with rare kidney diseases. These patients should follow the recommendations for the general population, bearing in mind that, as they have chronic kidney disease, they are included in the risk group for more serious outcomes if they develop Covid-19. Non-essential decision-making procedures should be postponed. In stable cases under appropriate treatment, we must choose to contact our patients remotely, using teleconsultations and home exam collections (if possible). In the presence of a symptom or sign of decompensation of the underlying disease, or infection with Sars-cov-2, advise the patient to seek medical assistance. The patient should not be waiting to get worse. Changes to the prescription should only be made on a scientific basis. Dosage suspension or change is not recommended, even in cases in which the patient needs to go to a center to receive his medication; in this case, the infusion center must follow the recommendations of the Ministry of Health. If the patient develops Covid-19 and uses any drugs, check the need for dose adjustment of the routine medications. Avoid the use of antimetabolics and anti-CD20 in patients with Covid-19, as they reduce viral clearance and predispose to bacterial infections. Contact between the patient and the medical team is essential; changes are recommended only with specialized medical guidance.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Nefropatias/terapia , Pneumonia Viral/epidemiologia , Doenças Raras/terapia , Brasil , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Interações Medicamentosas , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Avaliação de Sintomas
12.
Life Sci ; 259: 118379, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32890604

RESUMO

With the increasing application of medical imaging contrast materials, contrast-induced nephropathy has become one of the leading causes of iatrogenic renal insufficiency. The underlying mechanism is associated with renal medullary hypoxia, direct toxicity of contrast agents, oxidative stress, apoptosis, immune/inflammation and epigenetic regulation in contrast-induced nephropathy. Up to date, there is no effective therapy for contrast-induced nephropathy, and thus risk predication and effective preventive strategies are keys to reduce the occurrence of contrast-induced nephropathy. It was found that the proper use of contrast medium, personalized hydration, and high-dose statins may reduce the occurrence of contrast-induced nephropathy, while antioxidants have not shown significant therapeutic benefits. Additionally, the role of remote ischemia preconditioning and vasodilators in the prevention of contrast-induced nephropathy needs further study. This review aims to discuss the incidence, pathogenesis, risk prediction, and preventive strategies for contrast-induced nephropathy.


Assuntos
Meios de Contraste/efeitos adversos , Nefropatias/induzido quimicamente , Humanos , Rim/efeitos dos fármacos , Nefropatias/prevenção & controle , Estresse Oxidativo/efeitos dos fármacos
19.
Medicine (Baltimore) ; 99(35): e21574, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871873

RESUMO

The prevalence of the metabolic syndrome (MS) is increasing in China, but there are disparities between urban and rural populations, and across different regions.To examine the prevalence and risk factors of MS in the rural area of Qianjiang (Southwest China).From March 2016 to June 2018, 6 townships in the Qianjiang District of Chongqing Municipality were selected for a cross-sectional study of the residents in rural areas. Demographics and medical history were collected using a questionnaire. Anthropometry and blood pressure were obtained by physical examination. Blood lipids, fasting plasma glucose, and 2-h postprandial glucose were measured.A total of 2949 (1067 males and 1882 females) were included. The mean age was 63.8 ±â€Š10.7 years. The prevalence of MS in the study population was 16.8% (496/2949). The prevalence of MS was 7.4% in men, 22.2% in women, 15.7% in Han, 18.1% in Tujia, and 14.8% in Miao. According to age, the prevalence of MS was 10.6%, 17.0%, and 18.3% in the 30-50, 50-69, and ≥ 70 years groups. The multivariable analysis showed that female sex (OR = 33.36, 95%CI: 17.0-65.53), dyslipidemia (OR = 4.71, 95%CI: 1.73-12.82), kidney diseases (OR = 2.32, 95%CI: 1.37-3.94), waistline (OR = 1.39, 95%CI: 1.33-1.46), high-density lipoprotein cholesterol (OR = 0.12, 95%CI: 0.06-0.23), triglycerides (OR = 1.52, 95%CI: 1.31-1.76), alanine aminotransferase (OR = 0.98, 95%CI: 0.97-1.00), γ-glutamyltransferase (OR = 1.00, 95%CI: 1.00-1.01), and glycated hemoglobin (OR = 1.31, 95%CI: 1.08-1.59) were independently associated with MS.The prevalence of MS was 16.8% in Qianjiang. Female sex, kidney diseases, alanine aminotransferase, and γ-glutamyltransferase were independent risk factors for MS.


Assuntos
Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , População Rural/tendências , Idoso , Alanina Transaminase/sangue , Antropometria , Glicemia/análise , Pressão Sanguínea/fisiologia , China/epidemiologia , HDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/epidemiologia , Jejum/sangue , Feminino , Humanos , Nefropatias/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue , gama-Glutamiltransferase/sangue
20.
Medicine (Baltimore) ; 99(36): e22038, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899061

RESUMO

The effectiveness of diethylenetriamine pentaacetic acid scan is regularly monitored for the assessment of any potential modifications in treatment responses or kidney functions in the pediatric population.This study attempts to compare the usefulness of diethylenetriamine pentaacetic acid and ultrasound imaging of renal disorders among paediatric patients.A retrospective observational study was conducted by enrolling 106 children. The demographic details such as: participant's age, gender, and the history of renal disease of each patient were recorded. Patients were administered radiopharmaceuticals in a fixed dose and were later subjected to computed tomography (CT) scan. The obtained data was analysed using descriptive statistics.Findings indicated increased sensitivity for CT (61.20%); whereas, a major decrease in specificity (23.68%) was observed. Comparison of Single-photon emission CT (SPECT) and CT findings revealed the increased sensitivity (90.90%) for ultrasound; whereas, there was a slight decrease in the specificity (40%) for SPECT. However, SPECT findings show 91% sensitivity among patients with 71.42% positive predictive value. Moreover, an increase in sensitivity for CT (61.20%), followed by a major decrease in specificity (23.68%) was observed.Ultrasonography has been proved to be the safest and the most effective method for the diagnosis and the treatment of most renal disorders, due to the higher predictive value of SPECT scans. It is thus suggested that patients with ureteral calculi should be diagnosed with renal scintigraphy and unenhanced helical computerized tomography.


Assuntos
Nefropatias/diagnóstico por imagem , Ácido Pentético/administração & dosagem , Cintilografia/métodos , Ultrassonografia/métodos , Cálculos Ureterais/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Nefropatias/fisiopatologia , Masculino , Medicina Nuclear/métodos , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos/administração & dosagem , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
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