Dietary evaluation of sodium intake in patients with chronic kidney disease.

Introduction: Introduction: high sodium intake is a risk factor for diseases such as systemic arterial hypertension, stroke, left ventricular hypertrophy, and chronic kidney disease (CKD). Objective: to evaluate the correlation between estimated sodium intake by dietary intake and 24-hour urinary excretion in patients with non-dialysis CKD. Material and Methods: a cross-sectional study with 151 individuals. Demographic, socioeconomic, clinical and lifestyle data were evaluated. Sodium was dosed in 24-hour urine and estimated by 24-hour Food Recall (R24h). To evaluate the association between demographic, anthropometric, nutritional and laboratory variables with sodium excretion in 24-hour urine, variance analysis (ANOVA) or Kruskal-Wallis test were used. The correlation between 24-hour urinary sodium excretion and dietary sodium intake was performed by Spearman's correlation coefficient. Results: mean age was 60.8 ± 11.8 years, 51.7 % were women. Hypertensive patients, 88.9 %; diabetics, 45.0 %; and 39.1 % were in stage 3B of CKD. Median sodium excretion in 24-hour urine was 112.2 mmol/L and R24h intake was 833.8 mg/day. Individuals belonging to the highest tertile of sodium excretion (T3) presented lower PTH values, and those with lower tertile (T1), higher serum HDL-c levels (p < 0.05). There was no statistical correlation between dietary sodium intake and 24-hour urine excretion (p-value = 0.241). Conclusion: the non-correlation between sodium obtained by 24-hour urinary excretion and dietary intake demonstrates the fragility of the estimation of sodium excretion through the dietary survey.

Introducción: Introducción: la ingesta elevada de sodio es un factor de riesgo para enfermedades como la hipertensión arterial sistémica, el accidente cerebrovascular, la hipertrofia ventricular izquierda y la enfermedad renal crónica (ERC). Objetivo: evaluar la correlación entre la ingesta estimada de sodio y la excreción urinaria de 24 horas en pacientes con ERC sin diálisis. Métodos: estudio transversal con 151 individuos. Se evaluaron datos demográficos, socioeconómicos, clínicos y de estilo de vida. El sodio se cuantificó en orina de 24 horas y se estimó en Food Recall (R24h) de 24 horas. Para evaluar la asociación entre variables demográficas, antropométricas, nutricionales y de laboratorio con la excreción de sodio en orina de 24 horas, se utilizó el análisis de varianza (ANOVA) o la prueba de Kruskal-Wallis. La correlación entre la excreción urinaria de sodio de 24 horas y la ingesta de sodio en la dieta se realizó mediante el coeficiente de correlación de Spearman. Resultados: la edad media fue de 60,8 ± 11,8 años, el 51,7 % eran mujeres. Los pacientes hipertensos eran el 88,9 %; los diabéticos, el 45,0 %, y el 39,1 % se encontraban en estadio 3B de ERC. La mediana de excreción de sodio en orina de 24 horas fue de 112,2 mmol/L y la ingesta de R24h fue de 833,8 mg/día. Los individuos pertenecientes al tercil más alto de excreción de sodio (T3) presentaron valores de PTH más bajos y aquellos con niveles más bajos de tercil (T1), mayores niveles séricos de HDL-c (p < 0,05). No hubo correlación estadística entre la ingesta de sodio en la dieta y la excreción de orina durante 24 horas (valor p = 0,241). Conclusión: la ausencia de correlación entre el sodio obtenido por excreción urinaria de 24 horas y la ingesta dietética demuestra la fragilidad de la estimación de la excreción de sodio a través de la encuesta dietética.

Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report.

Clinical presentations of the novel coronavirus (SARS-CoV-2) infection are quite varied, ranging from asymptomatic conditions to potentially fatal disease. The kidney is one of the affected targets of coronavirus disease (COVID-19) complications, and renal dysfunction is a significant prognostic factor for mortality. This report describes a series of clinical complications in a previously healthy child who developed nephritic syndrome with a concomitant SARS-CoV-2 infection. These complications include acute kidney injury that progressed to chronicity, multisystemic inflammatory syndrome, Kawasaki-like syndrome, and thrombotic microangiopathy.

The Prevalence of Nondiabetic Renal Diseases in Patients with Diabetes Mellitus in the University Hospital of Ribeirão Preto, São Paulo.

OBJECTIVE: To evaluate the prevalence of nondiabetic renal diseases (NDRDs) in renal biopsies of patients with diabetes mellitus (DM) in the University Hospital of Ribeirão Preto, São Paulo. Research Design and Methods. We conducted a retrospective study including kidney biopsies performed in diabetic patients between 1987 and 2013. We evaluated 79 biopsies during this period. The primary variable was the prevalence of NDRD in patients with DM. The secondary variables were the presence of systemic arterial hypertension (SAH), hematuria, time since diagnosis of DM, serum creatinine, and proteinuria levels. The cases were divided into the following groups: isolated diabetic nephropathy (DN-group I), isolated nondiabetic renal diseases (NDRD-group II), associated NDRD/DN (group III), and associated NDRD+NDRD/DN (group IV). RESULTS: Most of the patients (58.22%) presented only alterations arising from DN. NDRDs were present in 41.77% of the patients. Membranous glomerulonephritis (30.3%) and IgA nephropathy (24.24%) were the most prevalent NDRDs. We found no differences between female and male patients with NDRD when assessing the secondary variables. A time since diagnosis of five years or less revealed a statistical difference (p = 0.0005) in the comparison between the isolated DN (group I) and the NDRD+NDRD/DN (group IV). The other secondary variables were not significant in the comparison of the groups. CONCLUSIONS: We concluded that the prevalence of NDRD is 41.77%. Membranous glomerulonephritis was the most prevalent NDRD in our study. We also conclude that the probability of the presence of NDRD with or without concomitant DN is greater for patients who had biopsies with a time since diagnosis of five years or less. A time since diagnosis of ten years or more does not allow the exclusion of the presence of NDRD.