970 resultados para Renal injury
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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OBJETIVO: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina. MÉTODOS: Foram analisados 50 pacientes consecutivos submetidos à cirurgia de revascularização do miocárdio. A função renal foi avaliada com a dosagem sérica de cistatina C e de creatinina no pré-operatório, no primeiro e no quinto dia de pós-operatório. Foram utilizadas as fórmulas de Cockcroft-Gault (CG) e Modification of Diet in Renal Disease (MDRD) para calcular a taxa de filtração glomerular estimada (TFG) através da creatinina, e a fórmula de Larsson para a TFG estimada através da cistatina C (TFG-Cis). RESULTADOS: A creatinina e o TFG através das fórmulas de CG e MDRD não mostraram diferença significativa nos momentos estudados. Após a agressão renal pela cirurgia, houve um aumento da cistatina C no 1º e 5º pós-operatório, sendo que no 5º pós-operatório com diferença estatisticamente significativa (P < 0,01). Houve uma queda da TFG estimada pela cistatina C de 105,2 ± 41,0 ml/min, no pré-operatório, para 89,5 ± 31,5 ml/min no 5º dia pós-operatório (P < 0,012). CONCLUSÃO: A cistatina C e a TFG-Cis apresentaram mudanças significativas no pós-operatório de cirurgia de revascularização do miocárdio quando comparadas a creatinina e a respectiva TFG estimada pelas fórmulas de Cockcroft-Gault e MDRD
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INTRODUÇÃO: A doença renal crônica (DRC) é decorrente de uma lesão renal e perda progressiva e irreversível da função dos rins. A hemodiálise substitui parcialmente essa função, com o objetivo de corrigir as alterações metabólicas na DRC. Para acompanhar a adequação da diálise, é determinado o Kt/V - índice de depuração da ureia por sessão de hemodiálise. O exercício físico de moderada intensidade tem se mostrado de fundamental importância para melhorar os efeitos adversos ao tratamento dialítico. OBJETIVOS: Avaliar o Kt/V em indivíduos com DRC submetidos ao exercício físico isotônico de baixa intensidade durante a hemodiálise. MATERIAIS E MÉTODOS: Analisados dados de 15 voluntários de ambos os sexos, submetidos à hemodiálise três vezes por semana. Após duas horas do início da diálise, foi aplicado um protocolo de exercícios isotônicos de baixa intensidade de membros superiores e inferiores com duração de 30 minutos, por um período de três meses. Os valores do Kt/V foram comparados no período de três meses anteriores sem exercício e após três meses de exercício. RESULTADOS: A média dos valores do Kt/V nos três meses sem exercício foi de 1,13 ± 0,11 e após aplicação do programa de exercícios foi de 1,29 ± 0,12 (p < 0,05). CONCLUSÃO: O programa de exercício físico isotônico de baixa intensidade em pacientes com DRC, aplicados durante a sessão de diálise mostrou a melhora da eficiência dialítica.
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The contamination of water by metal compounds is a worldwide environmental problem. Concentrations of metals are widely related to biochemical values which are used in disease diagnosis due to environmental toxicity. The acute combined effects of cadmium and nickel on biochemical parameters were determined and compared with those of Cd2+ or Ni2+ alone in rats. Male adult rats were given drinking solutions of CdCl2 [Cd(II) cation, 100 mg/liter] or NiSO4 [Ni(II) cation, 100 mg/liter]. For the combined treatment, the animals (Ni+Cd) received both Ni(II)) cation (100 mg/liter) and Cd(II) cation (100 mg/liter). Nickel treatment induced increased alanine transaminase (ALT) activity and hepatotoxicity, but not renal injury. In contrast, cadmium exposure produced hepatic, renal and myocardial damage, characterized by increased creatinine, total and direct bilirubin concentrations and increased ALT and lactate dehydrogenase (LDH) activities. The combined effect Ni-Cd is less toxic than cadmium alone, suggesting antagonism between these toxicants. The toxicity of nickel and cadmium, alone and in combination, decreased Cu-Zn superoxide dismutase (SOD) activity and increased lipoperoxide formation. (C) 1998 Elsevier B.V. Ltd. All rights reserved.
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Background: Granulocyte colony-stimulating factor (G-CSF) and Erythropoietin (EPO) are known to stimulate the growth and differentiation of progenitor cells to prevent acute renal injury. This study aimed to assess the use of growth factors to mobilize stem cell in a mouse model of adriamycin-induced chronic kidney disease. Methods: All animals were injected with adriamycin for kidney injury and allocated into three treatment groups (G-CSF, EPO and G-CSF + EPO), and a control group (adriamycin alone). Results: Number of atrophic sites, glomerulosclerosis rate and interstitial fibrosis severity score were assessed in all groups. In all treatment groups, histologic parameters did not significantly differ, but were lower than in the control group (P<.001). Scal and CD34 expressions among treatment groups showed no statistically significant difference, but were higher than in the control group (P<.0001). CD105 expression was higher in EPO and G+EPO as compared to G-CSF and the control group (P<.0001), with no statistically significant difference between the latter two groups (P = NS). Conclusion: G-CSF and EPO had a histologic protective effect, while treatment with EPO + G-CSF had no additive effects in a model of adriamycin-induced chronic kidney disease. © 2013 Societá Italiana di Nefrologia.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Bases Gerais da Cirurgia - FMB
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Pós-graduação em Anestesiologia - FMB
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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OBJECTIVE: Pneumoperitoneum during laparoscopy results in transient oliguria and decreased glomerular filtration and renal blood flow. The presence of oliguria and elevated serum creatinine is suggestive of acute renal injury. Serum cystatin C has been described as a new marker for the detection of this type of injury. In this study, our aim was to compare the glomerular filtration rate estimated using cystatin C levels with the rate estimated using serum creatinine in patients with normal renal function who were undergoing laparoscopic surgery. METHODS: In total, 41 patients undergoing laparoscopic cholecystectomy or hiatoplasty were recruited for the study. Blood samples were collected at three time intervals: first, before intubation (T1); second, 30 minutes after the establishment of pneumoperitoneum (T2); and third, 30 minutes after deflation of the pneumoperitoneum (T3). These blood samples were then analyzed for serum cystatin C, creatinine, and vasopressin. The Larsson formula was used to calculate the glomerular filtration rate based on the serum cystatin C levels, and the Cockcroft-Gault formula was used to calculate the glomerular filtration rate according to the serum creatinine levels. RESULTS: Serum cystatin C levels increased during the study (T1 = T2
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Although enzymuria tends to be associated to renal injury, there are no studies that have evaluated the presence of the enzyme gamma-glutamyl transpeptidase (GGT) spectrophotometry in the urine using a non-nephrotoxic agent (Nerium oleander) in order to evaluate the possibility of false positive results. The urinary GGT/urinary creatinine concentration ratio (uGGT/uCr) of 10 healthy dogs was calculated and posteriorly confronted with data from clinical evaluation, hematological and serum biochemical profiles, creatinine clearance (CrC), urinalysis, urine protein/creatinine ratio (UPC), electrocardiogram, systemic blood pressure (SBP) and light and electron microscopy. The results for kidney histology, SBP, UPC and CrC were not significantly different in any of the time-points analyzed. However, uGGT/uCr was significantly higher when measured 4 hours and 24 hours after administration of N. oleander. The measurement of the urinary GGT enzyme, as performed in many studies, yielded false positive results in dogs poisoned by a non-nephrotoxic agent.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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A spayed crossbred female dog was presented due to progressive weight loss, emesis and anorexia over the preceding month. A complete blood count, urinalysis, serum biochemical panel, and ultrasound were initially performed. Computed tomography urography was performed as a complementary exam. Based on ultrasound and CT findings an exploratory celiotomy was performed to remove hyperdense structures that could be the cause of the hydronephrosis and hydroureter in both kidneys. An extensive granulomatous reaction was found near the caudal pole to the left kidney. A nylon cable tie adhering firmly to this tissue was removed during surgical excision. On the dorsal surface of the bladder an extensive granulomatous reaction that had entrapped the right ureter was also noted. Another nylon cable tie was removed and the ureter was released. Eight months postoperatively, the dog was in good general physical condition, showing appetite and vigour. Abdominal ultrasonography showed improvement of the hydronephrosis in both kidneys. The urea ratio was normal, but the creatinine level was slightly elevated, suggesting a guarded prognosis. Thus, bilateral hydronephrosis as observed in the present study should be considered as a major complication after elective ovariohysterectomy.