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Objectives: To compare mortality in patients with COVID-19 and renal failure and need for hemodialysis from a general hospital in Lima, Peru and data from the world literature, and according to geographic areas in the world. Methods: Secondary research: evaluative review. PubMed was the database used for the bibliographic search. The keywords "renal failure", "COVID 19" and "mortality" were used and the filters meta-analysis and systematic reviews. Thirteen articles were included. Results: The frequency of acute renal failure (AKI) and COVID-19 ranged between 8.4 and 26% and in Lima, Peru it was 22.6%; the hemodialysis (HD) rates in patients with COVID-19 was 2.97%, continuous renal replacement therapy (CRRT) was reported in AKI: Asia 1.4%, Europe 5.7% and North America 4.0% and in Lima, Peru 44.1% had CKD V on HD and 12.9% received HD for the first time (ARF 9.7% and CKD 3.2%); the OR for mortality in patients with COVID-19 and AKI ranged from 11.05 to 23.9 and mortality in patients with COVID-19 and ARF was in Asia 33.3%, Europe 29.4%, North America 7.4% and in Lima, Peru 81% (66.7% without HD and 100% with HD); in Lima, Peru, 33.3% had CKD, with an overall mortality of 23.7% (15.5% without HD and 100% with HD), and 44.1% had CKD V on HD with a mortality of 16.3%. Conclusion: Mortality in patients with COVID-19 and acute kidney failure and hemodialysis in Lima, Peru was higher compared to data in the world literature. [ABSTRACT FROM AUTHOR]

Paciente de 78 años, polimedicada e incluida en el servicio de Sistema Personalizado de Dosificación de Medicamentos (SPD). Al acudir a retirar su medicación nos informa que desde hace unos meses sufre cansancio, debilidad, mareos y confusión. Se realiza una revisión de la medicación, centrada en la dosificación de los medicamentos de metabolismo o eliminación renal, en función del valor de Filtrado Glomerular estimado de la paciente (FGe). Se realiza derivación al Médico de Atención Primaria (MAP) mediante un informe, en el que se recomienda la reducción de dosis de losartán y manidipino según el valor de FGe de la paciente. El MAP redujo la dosis de los antihipertensivos. Se efectuó seguimiento del caso, que permitió observar que la paciente dejó de presentar los síntomas descritos inicialmente.

78-year-old patient, polymedicated and enrolled in the medication compliance aids service. When she went to pick up her medication, she informed us that for a few months she has been suffering from fatigue, weakness, dizziness and confusion. A medication review is performed, focused on the dosage of renal metabolism or elimination medications, based on the patient’s estimated Glomerular Filtration Rate (eGFR). A referral was made to the Primary Care Physician (PCP) through a report, in which the dose reduction of losartan and manidipine was recommended according to the patient’s eGFR. The PCP reduced the dose of antihypertensives. A follow-up of the case was carried out, which allowed to observe that the patient stopped presenting the symptoms initially described. [ABSTRACT FROM AUTHOR]

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Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Clinical manifestations in patients infected with coxsackievirus B are highly variable, with most cases being asymptomatic or mild, and fewer cases presenting with symptoms of severe disease. Multiorgan involvement associated with coxsackievirus B5 is very rare. CLINICAL CASE: A 20-year-old male patient admitted to the emergency department with jaundice, high fever, abdominal pain, and sepsis; initially treated as leptospirosis. His clinical status rapidly deteriorated to circulatory shock, pancreatitis, and acute renal failure with proteinuria. He subsequently developed acute respiratory failure, possibly due to cardiac failure secondary to viral myocarditis. He required vasoactive support, noninvasive mechanical ventilation, and admission to the intensive care unit. Coxsackie B5 virus was the most likely cause, diagnosed by IgM antibody titer nine days after admission. CONCLUSIONS: The reported case is rare because of multiorgan involvement by Coxsackie B5 virus, which is a common cause of myocarditis and pericarditis and other organ involvement. It is a multiorgan failure of unknown cause; viral infection should be suspected. Coxsackievirus has a wide clinical variability, ranging from asymptomatic infection to life-threatening disease requiring intensive supportive care to sustain life. [ABSTRACT FROM AUTHOR]

Introducción: En el trasplante renal de donante vivo, la percepción de la situación de enfermedad y la vivencia personal influyen de forma significativa en la adaptación emocional y el afrontamiento de la persona. Objetivo: Conocer el significado que atribuyen las personas con trasplante renal de donante vivo a su enfermedad y a su tratamiento, y detectar si existen cambios antes y después trasplante. Material y Método: Estudio cualitativo fenomenológico. Participaron 7 personas con enfermedad renal que recibieron un trasplante renal de donante vivo preventivo. Se obtuvieron los datos mediante entrevistas semiestructuradas y observación cualitativa. Resultados: Del análisis temático de las entrevistas emergieron tres temas: sin sentimiento de enfermedad (no se sentían enfermos ni a nivel físico ni psicológico); sin necesidad de trasplantarse (la enfermedad no les alteró su vida, pero confiaron en los profesionales y aceptaron la cirugía); y trasplantarse para mantener el mismo modo de vida (para evitar la diálisis y recuperar actividades). Conclusiones: El significado de la enfermedad y del trasplante renal cambian según la etapa (pre o post trasplante) en la que esté el paciente: la identificación de la enfermedad está relacionada con la presencia de sintomatología, con la sintomatología física y con las rutinas de toma de medicación diarias y visitas de seguimiento; y el trasplante renal, significa evitar la diálisis, hacer la misma vida, superar un reto y recuperar la condición física.

Introduction: Acute liver failure (ALF) is a rare disease with high mortality. Acute kidney injury (AKI) following ALF is frequent. We assessed AKI impact on long-term kidney function among ALF survivors. Methods: Observational cohort study including consecutive adult (age ≥16 years) patients with ALF or acute liver injury (ALI) admitted to a Portuguese tertiary center intensive care unit (ICU) between October 2013 and February 2020. KDIGO criteria were used to define AKI and chronic kidney disease (CKD). Primary outcome was the estimated glomerular filtration rate (eGFR), defined by the Chronic Kidney Disease Epidemiology Collaboration formula, at least 1 year after index ICU admission. Results: Among 104 patients with ALF (n = 74) or ALI (n = 30), mean (SD) age was 43.7 (18.0) years, and 44 were male. Among all patients (n = 104), following adjustment for age and SOFA score, AKI during the first 7 ICU days (n AKI = 57 and n renal replacement therapy [RRT] = 32) was independently associated with all-cause mortality (adjusted HR [95% CI] 11.61 [1.49–90.34]; p = 0.019). Among hospital survivors with long-term kidney function available (n = 56), median (interquartile range) >1 year eGFR was 95.3 (75.0–107.7) mL/min/1.73 m2 (mean [SD] follow-up of 3.1 [1.6] years). Among these hospital survivors, following adjustment for baseline eGFR, AKI during the first 7 ICU days (n AKI = 19 and n RRT = 10) was not associated with >1 year eGFR (p = 0.15). At least 1 year after index ICU admission, 5 patients developed CKD, none RRT-dependent. Conclusions: Among ALF or ALI survivors, AKI was not associated with significant long-term loss of kidney function.

Cyanide poisoning frequently complicates major burn injuries with inhalation syndrome. The established treatment protocol recommends a standard dose of 70 mg/kg of hydroxocobalamin for adults, with the option to administer a second dose, not exceeding a maximum of 140 mg/kg. Our objective is to chronicle the case of a patient for whom an escalated dosage, exceeding the approved limit, was imperative to reverse the intoxication. The unconventional decision to administer such high doses proved life-saving, albeit not conforming to the medication’s technical specifications. Notably, side effects observed were not markedly worse than those associated with the standard dose, except for the occurrence of moderate kidney failure. It is worth noting that this renal complication is also documented with standard doses and did not necessitate renal replacement therapy. [ABSTRACT FROM AUTHOR]

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La vasculitis asociada a ANCA denominada así por la presencia de anticuerpos anticitoplasma del neutrófilo es una enfermedad rara, crónica, inflamatoria con características clínicas inespecíficas y un diagnóstico por lo general tardío. Conlleva a que esta condición autoinmune se asocie con alta mortalidad y morbilidad. En el presente caso clínico se reporta una paciente femenina adulta mayor con más de un año de signos y síntomas caracterizadas por dolor pleurítico, pérdida de peso, neuropatía periférica, lesiones púrpuricas palpables secundaria a vasculitis asociada a ANCA. Por medio de tratamiento inmunosupresor con el uso inicial de esteroides intravenosos en bolos a altas dosis y ciclofosfamida por la vía oral, la paciente presenta rápida mejoría y control de su cuadro clínico. Se realizó una revisión de la literatura en cuanto a epidemiología, fisiopatología, hallazgos patológicos, manifestaciones clínicas, así como los hallazgos de laboratorio, las diferentes estrategias de tratamiento y la sobrevida de dicha enfermedad.

La Organización Panamericana de la Salud (OPS), señala que alrededor del 10% de la población mundial padece enfermedad renal crónica (ERC). En este sentido, el trabajo de investigación planteó como objetivo analizar las variables asociadas a la manifestación de ERC en los pacientes que asistieron a la Unidad de Diálisis del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), durante el último trimestre del 2022. Se realizó un estudio analítico en el cual fueron evaluadas las variables: presencia de diabetes, hipertensión arterial (HTA) y hábito de fumar. Se aplicaron dos encuestas para la obtención de los datos, una para la población enferma y otra para individuos control. La población enferma arrojó HTA 61,29%, diabetes 35,48%, hábito tabáquico 29,03%, antecedentes de ERC 19,35%, cáncer 22,58% y las 16,13%, en contraposición con los individuos controles que reflejaron HTA 5,40%, diabetes 5,40%, tabaquismo 2,70%, antecedentes de ERC 8,11%, cáncer 2,70% y cardiopatías 2,70%, HTA: OR 27,70, diabetes: OR 16,04, tabaquismo: OR 14,73, cardiopatías: OR 6,92, antecedentes de enfermedad renal crónica: OR 2,72 y cáncer: OR 10,5, así pues, estos datos evidenciaron que la hipertensión arterial y la diabetes son los factores de riesgo más prevalentes en la manifestación de la ERC en la población estudiada, debido a que fueron los factores de riesgo con mayor presencia en los individuos estudiados con ERC. Estos hallazgos sugieren la importancia de la prevención y detección temprana de estos factores de riesgo para retrasar la progresión de la enfermedad y prevenir complicaciones graves.

A doença renal crônica (DRC) é uma das doenças mais comuns em gatos, com prevalência estimada de 1,6 a 20%. Os gatos mais afetados são os idosos, com mais de 12 anos de idade. Possui caráter progressivo e afeta a função dos rins de forma irreversível. São diversos os fatores que podem acabar predispondo a esta enfermidade, como baixa ingestão hídrica e o consumo excessivo de rações secas, mas grande parte das vezes não é possível estabelecer a origem do problema. Os sinais clínicos são inespecíficos e o diagnóstico é feito com base na história clínica, exame físico e exames complementares, como hemograma, urinálise, bioquímica sérica e ultrassonografia. O tratamento da DRC tem como objetivo controlar os sintomas e visa melhorar a qualidade de vida do animal.

Introducción: la vasculitis asociada a anticuerpo anti-citoplasma de neutrófilo (ANCA) afecta los vasos de pequeño tamaño. Existen pocos reportes en pacientes hospitalizados. El objetivo del estudio fue describir las características demográficas, clínico-patológicas, complicaciones, recaídas y desenlaces. Propósito: describir la experiencia en el diagnóstico, manejo y desenlaces de esta patología durante 6 años. Materiales y métodos: estudio descriptivo retrospectivo de corte transversal. Muestreo no probabilístico por conveniencia desarrollado en el Hospital Universitario Clínica San Rafael Bogotá, Colombia, entre 2017-2022. Resultados: se incluyeron 23 pacientes. El 60,9 % hombres con edad media de 50 años. El principal síntoma fue hemoptisis (21,7 %). El 47,6 % se comportó como una glomerulonefritis rápidamente progresiva, y el 21,7 % presentó compromiso pulmonar. La positividad de pANCAS, cANCAS, ANAS, anti-MPO y anti-PR3 fue del 73,9 %, 13 %, 47,6 %, 31,6 % y 8,3 %, respectivamente. Se realizó biopsia en 21 pacientes con un promedio de 22 glomérulos, documentando 70 % de patrón pauciinmune. Se hizo recambio plasmático en el 73,9 % y el esquema más utilizado fue el CYCLOPS (78,3 %). Ningún paciente falleció. El 73,9 % requirió diálisis, de los cuales el 60,9 % egresó en diálisis. Se observó una recuperación de la función renal entre 6 y 12 meses en 21,7 % y 26,1 %. La recaída al año se presentó en el 27,3 %. Conclusión: Es fundamental conocer las manifestaciones clínicas, las pruebas diagnósticas y el tratamiento de esta entidad, en especial, porque si se realiza de manera eficaz, se pueden modificar la mortalidad y las complicaciones. Los pacientes que recibieron un tratamiento oportuno presentaron un elevado porcentaje de recuperación renal a pesar del severo compromiso en la biopsia renal.

Introduction: chronic kidney failure is a disorder in which kidney functions decrease progressively and irreversibly. Due to this decrease, the kidneys lose their ability to eliminate waste, concentrate urine, and maintain adequate levels of electrolytes in the blood. Objective: to update knowledge for the establishment of early diagnosis in the treatment of anemia in patients with chronic renal failure Method: a bibliographic search of scientific articles and information was carried out in the MEDLINE, Scopus, Redalyc and Latindex databases, to In turn, it is complemented with medical literature found on digital platforms such as Google Scholar. Of 68 articles identified, 16 publications were selected that met the inclusion, exclusion and PRISMA Statement criteria. Results: the diagnosis of anemia should focus on the blood count, reticulocytes, iron status, vitamin B12 and folic acid, while therapy is based on the use of iron, erythropoiesis-stimulating agents and in certain cases erythropoietin. Conclusions: providing early and optimal treatment to patients with chronic renal failure reduces the risk of developing hypoproliferative normocytic normochromic anemia.

Introduction: Hyperuricemia has been proposed as an independent factor in the development and progression of chronic kidney disease (CKD). However, the effect of uric acid-lowering therapies on delaying CKD progression is still uncertain. Therefore, this systemic review aims to assess the effect of uric acid-lowering therapies on renal outcomes in pre-dialysis CKD patients. Methods: PubMed, Cochrane Library, and Lilacs databases were searched until April 24, 2021, for randomized clinical trials of CKD patients on uric acid-lowering treatment with xanthine-oxidase (XO) inhibitors. The weighted mean difference (WMD) or standard mean difference (SMD) with confidence interval (CI) were pooled using a random-effects model. Results: Among 567 studies found, eighteen met the inclusion criteria (n = 2463 participants). Compared to the patient's control group, the WMD for the glomerular filtration ratio (GFR) and serum creatinine changes of the treated group was 2.02 ml/min/1.73 m2 (95%CI 0.41 to 3.63, P = 0.014) and −0.19 mg/dl (95%CI −0.34 to −0.04, I2 = 86.2%, P = 0.011), respectively. Subgroup analyses showed that the difference in follow-up time and CKD population type in the studies may explain the controversy about the role of uric acid-lowering therapies in CKD progression. The GFR and creatinine outcomes analysis by types of XO inhibitors showed no difference between the control and treated groups. Uric acid-lowering therapies were strongly associated with decreased serum uric acid and urinary protein–creatinine ratio and urinary albumin–creatinine ratio. Conclusions: These findings suggest that uric acid-lowering treatment may slow CKD progress and reduce protein and albumin excretion. However, larger and properly powered randomized clinical trials with specific CKD populations are needed to confirm these findings. Resumen: Antecedentes: La hiperuricemia se ha propuesto como un factor independiente en el desarrollo y la progresión de la enfermedad renal crónica (ERC). Sin embargo, el efecto de las terapias para reducir el ácido úrico en el retraso de la progresión de la ERC aún es incierto. Por lo tanto, esta revisión sistémica tiene como objetivo evaluar el efecto de los tratamientos para reducir el ácido úrico sobre los resultados renales en pacientes con ERC antes de la diálisis. Métodos: Se realizaron búsquedas en las bases de datos de PubMed, Cochrane Library y Lilacs hasta el 24 de abril de 2021 en busca de ensayos clínicos aleatorizados de pacientes con ERC en tratamiento para reducir el ácido úrico con inhibidores de la xantina-oxidasa (XO). La diferencia de medias ponderada (DMP) o la diferencia de medias estándar (DME) con el intervalo de confianza (IC) se agruparon mediante un modelo de efectos aleatorizados. Resultados: Entre los 567 estudios encontrados, 18 cumplieron los criterios de inclusión (n = 2.463 participantes). En comparación con los pacientes del grupo control, la DMP para la tasa de filtración glomerular (TFG) y los cambios en la creatinina sérica del grupo tratado fueron de 2,02 ml/min/1,73 m2 (IC del 95%: 0,41 a 3,63, P = 0,014) y −0,19 mg/dl (IC del 95%: −0,34 a −0,04, I2 = 86,2%, P = 0,011), respectivamente. Los análisis de subgrupos mostraron que la diferencia en el tiempo de seguimiento y el tipo de población con ERC en los estudios puede explicar la controversia sobre el papel de las terapias para reducir el ácido úrico en la progresión de la ERC. El análisis de resultados de TFG y de creatinina por tipos de inhibidores de la XO no mostró diferencias entre el grupo control y el grupo tratado. Las terapias para reducir el ácido úrico se asociaron fuertemente con una disminución del ácido úrico sérico y de la relación proteína-creatinina urinaria y la relación albúmina-creatinina urinaria. Conclusión: Estos hallazgos sugieren que el tratamiento para reducir el ácido úrico puede retrasar el progreso de la ERC y reducir la excreción de proteínas y de albúmina. Sin embargo, se necesitan ensayos clínicos aleatorizados más grandes y con el poder estadístico adecuado con una población específica con ERC para confirmar estos hallazgos.

Introducción: la mortalidad materna según la OMS, se define como el Número de mujeres que mueren durante el embarazo o en los 42 días siguientes a la terminación de este. Objetivos: Determinar el número de muertes maternas y sus causas en el Hospital General Docente Ambato durante el año 2022. Definir cada uno de los problemas de salud que ocasionan el aumento de la mortalidad materna. Establecer de manera general factores de riesgo y soluciones a los mismos como aporte a fin de reducir la tasa de muertes maternas en la ciudad. Método: Se realizó la selección del Hospital General Docente Ambato, apoyándonos por el servicio de estadística. La muestra fue de 17441. Resultados: Durante el año 2022, ingresaron a hospitalización un total de 17441 pacientes distribuidos en las distintas áreas o especialidades de la unidad de salud, de los cuales el 31,78% son usuarias del área de Gineco-Obstetricia, se registró que el 0,087% fueron en el área de Gineco – Obstetricia en relación con el resto de áreas. Conclusiones: Se determinó que el número de muertes maternas en el hospital General Docente Ambato durante el año 2022 fue de 0,087% en el área de Gineco-Obstetricia. Se definió cada problema de salud que aumentan mortalidad materna como hemorragia posparto, laceraciones perineales, lesiones del esfínter, separación de la sínfisis del pubis, etc. Se estableció que los factores de riesgo son sepsis, ruptura uterina espontánea, distocia fetal, desproporción fetopelviana, distocia de hombro, insuficiencia renal materna, enfermedad renal terminal.

Objective: Arteriovenous fistula (AVF) operations are the most common method to facilitate hemodialysis in patients with chronic renal failure. The longevity of AVF is vital in patients undergoing hemodialysis. We investigated the effect of Transit Time Flow Meter (TTFM) use on AVF patency. Methods: 108 patients (42 in the study group, 66 in the control group) who underwent AVF formation for the first time in the last five years were included in the study. In the measurements made with TTFM, if the pulsatility index (PI) was >5 and the mean flow value was <30 mL/min, AVFs were considered insufficient. Results: Age, gender, lowdensity lipoprotein values (LDL), non-dominant extremity, and accompanying peripheral artery disease in the study group of patients were similar, and smoking in the study group and hypertension in the control group were the most common risk factors. PI and mean flow rates with TFTM in the study group were within the normal range. No statistically significant difference was found in the AVF patency rates when we compared the different periods between groups. However, when evaluating the AVF patency of the groups in the whole period, it was determined that the patency of the patients in the study group was better than the control, and this finding was statistically significant. Conclusion: Intraoperative use of TTFM helps detect AVF dysfunction. This method provides a longer vascular patency time. Increases patient comfort by prolonging the function and life of the AVF. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the clinical course and radiological involvements in different kidney diseases during the COVID-19 infection. Materials and Methods: The present study was conducted on 107 patients with COVID-19 having different kidney disease courses. Thirty patients with chronic kidney disease (CKD), 38 patients with maintenance hemodialysis (MHD), and 39 patients with renal transplantation (RT) were compared. Data on demographic characteristics, blood markers, in-hospital mortality and morbidities, and thorax CT scores were obtained. Results: RT patients were younger than the CKD groups (47.0 ± 11.4 vs. 71.8 ± 11.5 years, respectively; < 0.001) and MHD patients (67.7 ± 10.2 years, p < 0.001). C-reactive protein, procalcitonin, D-dimer, and ferritin values were significantly lower in RT patients (p < 0.05). The acute kidney injury rate was lower in RT patients than in CKD (p = 0.007), and the rate of sepsis development was low compared to MHD and CKD groups (p = 0.004). The requirement for mechanical ventilation (p = 0.013) and the mortality rate were significantly lower in RT patients than in MHD patients (p = 0.008). Concerning total thorax CT score, there was no difference in MHD patients compared to other groups, whereas it was found to be lower in RT patients than in CKD (p = 0.002). Conclusion: The prognosis of COVID-19 infection varies in different kidney diseases regarding morbidity, mortality, and radiologic involvement. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and aimsThe advent of direct-acting antiviral agents promises to change the management of hepatitis C virus infection (HCV) in patients with chronic kidney disease (CKD), a patient group in which the treatment of hepatitis C was historically challenging. We investigated the safety and efficacy of all-oral, interferon-free direct-acting antiviral agents for the treatment of hepatitis C in a 'real-world' cohort of patients with CKD.MethodsWe performed an observational single-arm multi-centre study in a large (n=198) cohort of patients with stage 1-3 CKD who underwent antiviral therapy with DAAs for the treatment of HCV. The primary end-point was sustained virologic response (serum HCV RNA

Background: We aimed to describe the thiamine status in hospitalized hypervolemic heart failure (HF) and/or renal failure (RF) patients treated with furosemide and to investigate whether there was a difference in furosemide-related thiamine deficiency between patients with RF and HF. Methods: Patients who were diagnosed as hypervolemia and treated with intravenous furosemide (at least 40 mg/day) were included in this prospective observational study. Whole blood thiamine concentrations were measured 3 times during hospital follow-up of patients. Results: We evaluated 61 hospitalized hypervolemic patients, of which 22 (36%) were men and 39 (64%) were women, with a mean age of 69.00 ± 10.39 (45–90) years. The baseline and post–hospital admission days 2 and 4 mean thiamine levels were 51.71 ± 20.66 ng/ml, 47.64 ± 15.43 ng/ml and 43.78 ± 16.20 ng/ml, respectively. Thiamine levels of the hypervolemic patients decreased significantly during the hospital stay while furosemide treatment was continuing (p = 0.029). There was a significant decrease in thiamine levels in patients who had HF (p = 0.026) and also, thiamine was significantly lower in HF patients who had previously used oral furosemide before hospitalization. However, these findings were not present in patients with RF. Conclusions: Thiamine substantially decreases in most hypervolemic patients receiving intravenous furosemide treatment during the hospital stay. Thiamine levels were significantly decreased with furosemide treatment in especially HF patients, but the decrease in thiamine levels did not detected at the same rate in RF patients. Diuretic-induced thiamine loss may be less likely in RF patients, probably due to a reduction in excretion. Resumen: Antecedentes: Nos propusimos describir el estado de la tiamina en pacientes hospitalizados con insuficiencia cardíaca (IC) y/o insuficiencia renal (IR) hipervolémica tratados con furosemida, e investigar si había una diferencia en la deficiencia de tiamina relacionada con la furosemida entre los pacientes con IR y con IC. Métodos: En este estudio observacional prospectivo se incluyeron pacientes con diagnóstico de hipervolemia y tratados con furosemida intravenosa (al menos 40 mg/día). Se midieron las concentraciones de tiamina en sangre total 3 veces durante el seguimiento hospitalario de los pacientes. Resultados: Se evaluaron 61 pacientes hipervolémicos hospitalizados, de los cuales 22 (36%) eran hombres y 39 (64%) eran mujeres, con una edad media de 69,00±10,39 (45-90) años. Los niveles medios de tiamina en la línea de base y tras el ingreso hospitalario en los días 2 y 4 fueron de 51,71±20,66 ng/ml, 47,64±15,43 ng/ml y 43,78±16,20 ng/ml, respectivamente. Los niveles de tiamina de los pacientes hipervolémicos hipervolemia disminuyeron significativamente durante la estancia en el hospital mientras se mantenía el tratamiento con furosemida furosemida (p = 0,029). Hubo una disminución significativa de los niveles de tiamina en los pacientes que tenían IC (p = 0,026) y también, la tiamina fue significativamente menor en los pacientes con IC que habían habían utilizado previamente furosemida oral antes de la hospitalización. Sin embargo, estos hallazgos no se presentes en los pacientes con IC. Conclusiones: La tiamina disminuye sustancialmente en la mayoría de los pacientes hipervolémicos que reciben tratamiento con furosemida intravenosa durante la estancia hospitalaria. Los niveles de tiamina se redujeron significativamente con el tratamiento con furosemida, especialmente en los pacientes con IC, pero la disminución de los niveles de tiamina no se detectó al mismo ritmo en los pacientes con IC. La pérdida de tiamina inducida por los diuréticos inducida por los diuréticos puede ser menos probable en los pacientes con insuficiencia cardiaca, probablemente debido a una reducción de la excreción.

Background and objective: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Methods: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012−2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR

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Introducción: el síndrome cardiorrenal se define como la coexistencia de desórdenes entre el corazón y el riñón en la que la alteración de uno causa la disfunción del otro, de forma aguda o crónica. Objetivo: determinar la frecuencia de síndrome cardiorrenal y las características sociodemográficas y clínicas en pacientes hospitalizados con falla cardiaca. Metodología: se realizó un estudio observacional y descriptivo que incluyó pacientes con falla cardiaca que fueron hospitalizados entre el 2018 y el 2021 en un hospital en Boyacá, Colombia. Se incluyeron las variables demográficas, clínicas, diagnósticas y los antecedentes, para la evaluación y el análisis de la información. Resultados: se incluyó a 347 pacientes, donde la frecuencia del síndrome cardiorrenal fue del 10?%, 20,17?% de zona urbana, 16,13?% de sexo masculino, 21,61?% con hipertensión arterial, 9,79?% con diabetes mellitus y 8,64?% con enfermedad pulmonar obstructiva crónica. Las características clínicas fueron: 12,10?% cursaron con insuficiencia cardiaca preservada, 10,08?% con insuficiencia cardiaca reducida y 12,68?% eran del cuadrante de Stevenson estadio C, todos con síndrome cardiorrenal. Conclusiones: el síndrome cardiorrenal es una afectación de origen multicausal, la presentación clínica depende del órgano causante de la disfunción y, típicamente, los pacientes con esta entidad clínica han cursado con alguna descompensación que genera ingresos a hospitalización, cambios en la calidad de vida, peor pronóstico y mortalidad.

O objetivo deste trabalho foi avaliar a leptospirose canina no contexto da saúde pública pelos cães atuarem como sentinelas da doença. Para isso, foi realizado um levantamento epidemiológico de dez (10) animais suspeitos, que foram atendidos na região de Seropédica, Rio de Janeiro. O histórico do animal, local onde vivia, se teve contato com roedores e a possibilidade do contato com águas contaminadas, eram os parâmetros iniciais para se chegar na suspeita da doença. Ao mesmo tempo, parâmetros observados no exame clínico e alterações laboratoriais em hemograma e em alguns marcadores bioquímicos foram utilizados como critérios para se chegar ao diagnóstico prévio, visto que, para a confirmação precisaria da sorologia. Considerando que a leptospirose canina é uma zoonose de alta letalidade e a existência de casos subclínicos, o estudo epidemiológico tem grande importância nesse contexto, fazendo parte de uma das ferramentas do diagnóstico clínico da doença na ausência do teste sorológico confirmatório.

Introdução: A depressão surge como reacção psicológica aos prejuízos e incapacidades trazidas pela doença e como forma do indivíduo expressar emoções, em função de um evento adverso e ameaçador. Objectivo: Avaliar a ocorrência da depressão nos pacientes com insuficiência renal crónica em hemodialise no sentido de influenciar na mudança de atitudes e auxiliar na adesão ao tratamento. Métodos: descritivo que serviu para fornecer uma caracterização precisa das variáveis envolvidas e comparativa: que serviu para comparar as diferenças e semelhanças entre as variáveis independentes (relativamente ao género) em 60 pacientes, de acordo com o horário da realização do tratamento. Recorreu-se ao uso das técnicas de observação, entrevista, inquérito por questionário, estatística descritiva bem como a técnica de interpretação de conteúdo. Resultados: Com a finalidade de um maior entendimento da relação entre IRC e depressão, foi aplicado o inventário de depressão de Beck. Pela aplicação da escala de normalização percebe-se que dentre os 60 participantes, verificou-se a prevalência da ocorrência de depressão em 88% dos pacientes. Em mulheres, foi possível observar a prevalência dos graus leve (23,3%), moderado 20% e grave (36.7%), enquanto em homens, foi observado (23,3%) grau leve, foram verificados 20% no grau moderado e os mesmos valores no nível grave. Conclusão: A depressão é um dos quadros clínicos mais frequentes entre os pacientes com insuficiência renal crónica em hemodiálise, tornando-se numa doença de difícil recuperação, este problema não afecta apenas os adultos, mas também a população infantil e está relacionado com situações de dificuldade de lidar com a própria infecção, bem como os problemas advindas da insuficiência renal crónica como problemas de forro psicológicos, problemas financeiros, problemas familiares e problemas laborais.

Objetivo: comparar o perfil de atendimento aos pacientes críticos em hemodiálise antes e durante a pandemia pela COVID-19. Método: estudo observacional realizado em um hospital de São Paulo - Brasil. Participaram pacientes críticos em hemodiálise internados em 2019 e 2020. Os dados foram coletados de documentos das sessões de hemodiálise e prontuários. Foram utilizados os testes de Qui-quadrado, Mann-Whitney, Shapiro-Wilk e Exato de Fisher para as comparações (p

Objetivo: comparar el perfil de atención de los pacientes críticos en hemodiálisis antes y durante la pandemia de COVID-19. Método: estudio observacional realizado en un hospital de San Pablo, Brasil. Participaron pacientes críticos en hemodiálisis hospitalizados en 2019 y 2020. Los datos se recolectaron de documentos de sesiones de hemodiálisis e historias clínicas. Para las comparaciones se utilizaron las pruebas de chi-cuadrado, Mann-Whitney, Shapiro-Wilk y exacta de Fisher (p

Background: chronic kidney disease is a public health problem worldwide. It is important to educate patients undergoing hemodialysis treatment so that they develop the ability to face the disease and improve their quality of life. Objective: to determine the level of resilience in patients treated in the hemodialysis unit of the General Teaching Hospital "Dr. Ernesto Guevara de la Serna”, in Las Tunas. Methods: an observational, prospective and cross-sectional study was carried out in 95 patients with terminal chronic renal failure, in the hemodialysis unit declared in the objective, during September-December 2019. The variables: level of resilience, age, state marital status, educational level, religion, length of stay in the hemodialysis unit, were evaluated. The resilience scale developed and validated by Wagnild & Young and the perceived social support scale were used. Descriptive statistics were used for data analysis. Results: the age group corresponding to early adulthood predominated (between 31 and 45 years with 48.4 %) and those who had been on hemodialysis for more than 24 months (64.2 %). The highest percentage of patients presented a low level of resilience (55.8 %). Almost half had higher education (48.4 %). They showed statistical significance with the level of resilience: the level of education, religiosity, time in the hemodialysis unit and social support; not so marital status and age. Conclusions: the level of resilience in patients with terminal chronic renal failure on hemodialysis was characterized.

La insuficiencia renal crónica (IRC) contribuye a la morbilidad y mortalidad por enfermedades no transmisibles. En Paraguay la tasa de años de vida ajustados por discapacidad para insuficiencia renal (AVAD-IR) aumentó más del 50%, incrementando sustancialmente la tasa de mortalidad. El objetivo de este estudio fue determinar la prevalencia de IRC presuntiva (IRCp) aplicando la fórmula MDRD-4 en Villarrica, Paraguay, año 2022. El estudio fue poblacional de corte transversal en residentes adultos, aparentemente sanos, de entre 19 y 70 años, tanto hombres como mujeres que aceptaron participar mediante consentimiento informado. Se diseñó un muestreo multietápico y se registró una muestra final de 520 participantes. La prevalencia reportada fue de 9,6 %(IC95%: 7,4 - 12,5 %) siendo IRCp oculta en el 54% de los casos. La población de estudio fue mayormente joven con una edad media de 44 años, con sobrepeso siendo IMC promedio de 28,1 Kg/m2 y predominaron las mujeres en un 62%. Se reportó alta frecuencia de antecedentes urológicos (40%) y sistémicos (33%). Se asoció al IRCp: edad > a 65 años(OR:3,6), sexo mujer(OR: 2,4), IMC > a 25 kg/m2(OR: 2,7), antecedente de enfermedad sistémica(OR:3,1) y medicación actual(OR: 3,5). La prevalencia reportada fue consistente con la del consorcio internacional de investigadores GBD-CKD que refirió una prevalencia del 9,1 % para enfermedad renal según su carga mundial. Por lo tanto, el monitoreo de factores de riesgo asociados debe abordarse de manera exhaustiva tanto en el diagnóstico como en promoción a la salud a fin de garantizar calidad en salud pública.

Introducción: La Enfermedad Renal se considera un problema de salud pública asociado a los estilos de vida de la población. El progreso de la enfermedad a estadio terminal requiere tratamiento de hemodiálisis, condición de salud que genera cambios a nivel social, económico, emocional y físico. Objetivo: Describir los significados que asigna la persona con enfermedad renal crónica al tratamiento de hemodiálisis. Material y Método: Investigación cualitativa, con enfoque en la teoría fundamentada. Al estudio se vincularon 18 personas mayores de 18 años de edad y en tratamiento de hemodiálisis. La recolección de la información se hizo a través de entrevistas en profundidad hasta conseguir la saturación teórica. El análisis de los datos se llevó a cabo en el programa ATLAS.ti9. Resultados: Se hallaron cuatro categorías: perdiendo la función renal, modificando los estilos de vida, cambiando la forma de vivir con la hemodiálisis y viviendo con hemodiálisis, estas categorías, simbolizan los significados al tratamiento de hemodiálisis. Conclusión: El tratamiento con hemodiálisis cambia el pronóstico de la enfermedad renal crónica, disminuyendo la morbilidad y la mortalidad. La persona durante el tratamiento debe adaptarse y enfrentar cambios físicos, fisiológicos, emocionales, sociales y familiares

A 61-year-old male, who presented with generalized abdominal pain, associated with distention and defense. He reports that the pain started approximately 6 hours prior to the consultation. Relevant medical history includes a history of arterial hypertension and atrial fibrillation. Upon arrival to the emergency room, relevant laboratory findings included a creatinine value of 2.31 mg/dL and elevated lactate values. Despite management, and without other relevant findings on physical examination, the patient persisted with severe abdominal pain. Due to clinical suspicion of mesenteric ischemia, an abdominal angio-tomography was performed, showing multiple arterial thrombosis involving the superior and inferior mesenteric artery and other vascular structures. The patient was transferred to a tertiary hospital and taken to the operating room, but due to the great vascular compromise he died during the procedure. [ABSTRACT FROM AUTHOR]

Chronic renal disease (CRD) is an important public health problem. There is no a national renal health program in Peru. There is evidence that the multidisciplinary model of care in patients with CRD delays progression and reduces all-cause mortality. Although there is no agreement on certain topics, such as at which glomerular filtration rate should the multidisciplinary team work, it is clear that outcomes are improved. Human and financial resources are needed to implement this approach. [ABSTRACT FROM AUTHOR]

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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Scientia Medica is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective was to identify and analyze the renal complications associated with SARS-Cov-2 infection in intensive care patients. This is an integrative literature review, carried out in the databases VHL Regional Portal, Latin American and Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF) and PubMed/Medline. The searches covered the period from 2019 to 2022 and the languages Portuguese, English and Spanish. Data were obtained from databases, from which 42 articles were selected that addressed the topic. The results showed that kidney disease is associated with several comorbidities. Age and hypertension were associated with these comorbidities and significance in Covid-19 positive patients. In addition, people over 70 and with hypertension, diabetes, COPD or CKD were more likely to die from the disease compared with patients who did not. From the above, it is possible to conclude that discussing kidney changes in intensive care patients in times of a pandemic encourages us to develop and reflect on methods to promote health, both in the prevention and in critical care of the disease, with an emphasis on this risk group. [ABSTRACT FROM AUTHOR]

Introducción. El síndrome de Alport es una alteración heterocigótica que afecta las cadenas alfas del colágeno tipo IV, manifestándose clínicamente de forma variable principalmente por hematuria persistente. Existen diferentes manifestaciones clínicas en esta patología, encontrando casos de enfermedad renal crónica. Es crucial establecer medidas que permitan la detección oportuna disminuyendo las complicaciones. Objetivo. Describir la relación e importancia entre el síndrome de Alport y las alteraciones renales, resaltar las manifestaciones clínicas y manejo terapéutico. Métodos. Se realizó una búsqueda de la literatura en las bases de datos de PubMed y Scielo orientada hacia artículos actualizados y relevantes en inglés o español publicados en los últimos 5 años. Se evaluó a relación entre el síndrome de Alport y la patología renal permitiendo describir importancia clínica, diagnóstico y tratamiento. Resultados. Diferentes estudios evidencian la relación directa entre el síndrome de Alport y la disfunción renal asociado a procesos inflamatorios crónicos. El tratamiento no está estandarizado, pero se encuentra dirigido al bloqueo del sistema renina-angiotensina aldosterona. Se deben continuar los estudios evaluando el desenlace de la afectación renal asociada a esta patología. Conclusiones. El síndrome de Alport es una causa importante de disfunción renal, primordialmente si no se asocia a un tratamiento; por lo cual, es importante realizar un diagnóstico oportuno mediante la sospecha inicial, diagnóstico diferencial y abordaje adecuado partiendo del reconocimiento clínico de esta entidad asociada con el deterioro de la función renal

A agenesia renal (AR) é um defeito congênito raro em gatos, que consiste na ausência total de um rim, refletindo uma falha completa na nefrogênese associada a má formação do feto. A agenesia unilateral pode ocorrer como anormalidade isolada ou como um componente de distúrbios sindrômicos. O diagnóstico pode ser feito através de exames de imagens como ultrassonografia e ou radiografia abdominal e através de procedimento cirúrgico de laparotomia exploratória. O presente relato tem como objetivo de descrever o caso de um gato da raça Ragdoll, fêmea de nove meses de idade, que, inicialmente, apresentava queixa de vômitos e polaciúria e, após exames complementares, constatou-se a ausência do rim esquerdo.

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Introduction: A case of severe rhabdomyolysis associated with multisystem inflammatory syndrome related to COVID-19 (MIS-C). Case of report: is presented in a one-year 10-month-old boy who presented digestive symptoms, myalgia, weakness, fever, and dark urine. COVID-19 IgM (-) IgG (+) serological test, COVID-19 PCR negative. Initial creatine kinase (CK) presented non-dosable values, with the highest reported level being 517,600 U/L. The creatinine value remained normal throughout the hospitalization. He received human immunoglobulin 2 g/Kg, Methylprednisolone 10 mg/Kg/d, and acetylsalicylic acid to manage MIS-C. Aggressive hydration and urine alkalinization were provided to manage rhabdomyolysis. Conclusion: Positive evolution with discharge after ten days. Few reported cases of rhabdomyolysis are associated with MIS-C and none with such high CK values. Based on the possible complications, performing CK dosing in all patients with MIS-C is suggested routinely. [ABSTRACT FROM AUTHOR]

Introducción: la enfermedad renal crónica subclínica (ERCs), realizando cribado en población de riesgo, está escasamente caracterizada en Chile, su conocimiento contribuiría al mejor manejo y tratamiento precoz, atenuando sus consecuencias. Objetivo: describir las características epidemiológicas y clínicas de la población con ERCs en Chile. Materiales y métodos: estudio descriptivo transversal en una población de 1.032 sujetos provenientes de tres regiones de Chile; Coquimbo (n=902), Metropolitana (n=70) y De Los Ríos (n=60), provenientes de programa cardiovascular, otros programas de APS y familiares directos de pacientes en diálisis. Se aplicó consentimiento informado, encuesta, examen físico (presión arterial, peso y talla) y se realizaron exámenes de laboratorio (creatininemia y albuminuria/creatininuria). Se definió ERC por guía KDOQI-2012 y Velocidad de Filtración Glomerular según MDRD. Albuminuria mediante relación albúminuria/creatinininuria de primera micción (mg/g). VFG

Copyright of JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde is the property of JBES: Brazilian Journal of Health Economics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)