RESUMEN
Microalbuminuria is a considerable good indicator of atherogenic disease and cardiovascular risk. In the arterial hypertension, the main centre organ is the kidney. Structural and functional changes that happen in the hypertensive nephropathy are going to cause alterations m the albumin urinary excretion. The authors have done a revision of the main factors which can origin the existence of microalbuminuria in patients with arterial hypertension, and they conclude that this is an useful biochemist indicator in order to evaluate the degree of renal disease in these patients.
Asunto(s)
Albuminuria/etiología , Hipertensión/complicaciones , Enfermedades Renales/diagnóstico , Albuminuria/diagnóstico , Biomarcadores , Humanos , Hipertensión/orina , Enfermedades Renales/etiología , Enfermedades Renales/orina , Análisis Multivariante , Pronóstico , Factores de RiesgoRESUMEN
Besides diabetic patients are controlled with glycosylated hemoglobins not exceeding 7% and the normalization of blood pressure with some hypotensive drugs, it has been noted the important role of protein restriction in diet in order to retard nephropathy progression. For some years, various aldose reductase inhibitors (ARIs) have been used, which avoid the accumulation of sorbitol in tissues as well as complications. Platelet antiaggregants are also used for the treatment of diabetic nephropathy, but at a lower level.
Asunto(s)
Nefropatías Diabéticas/terapia , Aldehído Reductasa/antagonistas & inhibidores , Dieta con Restricción de Proteínas , Inhibidores Enzimáticos/uso terapéutico , Humanos , Hipolipemiantes/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéuticoRESUMEN
Diabetic nephropathy is the third cause of renal failure after pyelonephritis and glomerulonephritis. Lately, many efforts have been made for the early identification (on the silent stage) of patients with a high risk of developing this disease. On these initial stages, therapeutic attitude has changed very much, emphasizing nowadays the importance of glucose levels control, avoiding maintained conditions of hyperglycemia and maintaining blood pressure within the limits, by using the therapeutic store available, basically calcium antagonists and angiotensin-converting enzyme inhibitors.
Asunto(s)
Nefropatías Diabéticas/terapia , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Glucemia/análisis , Presión Sanguínea , Bloqueadores de los Canales de Calcio/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Nefropatías Diabéticas/sangre , Nefropatías Diabéticas/tratamiento farmacológico , Diuréticos/uso terapéutico , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/prevención & control , Hipoglucemiantes/uso terapéuticoRESUMEN
The Churg-Strauss's allergic granulomatosis is an entity considered by some authors as a simple clinical problem within the context of vasculitis, but that given its anatomopathological and clinical characteristics (different from other vasculitis), must be studied as a separate syndrome. Its incidence depends on the strictness in the application of the diagnosis criteria and its pathogenic is unknown. Although the most frequent pathology is respiratory, we review the affectation of other organs and systems (circulatory, digestive, urogenital, locomotive, nervous system, skin, etc.), stressing the relevance of its knowledge for a correct diagnosis. The current therapy is based in seeking an useful drug, which added of the patients. of the patients.
Asunto(s)
Síndrome de Churg-Strauss/patología , Síndrome de Churg-Strauss/diagnóstico , Síndrome de Churg-Strauss/terapia , Diagnóstico Diferencial , HumanosRESUMEN
Urinary kallikrein (reliable reflexion of its renal excretion) is studied in a large group of diabetic patients with and without nephropathy (again subdivided following Mogensen stages) and in hypertense non-diabetic patients. It is observed that the urinary excretion of kallikrein is independent of the type of diabetes (insulin or non-insulin dependent). There exists a clear difference in the behaviour of this enzyme, in diabetic patients with and without nephropathy, increasing in the former and decreasing in the latter (p less than 0.001). The decrease in urinary kallikrein is parallel to the existence of diabetic nephropathy with arterial hypertension. Urinary kallikrein in hypertense non-diabetic patients who are not treated with diuretics (furosemide) has a behaviour as in normal controls, but it is much higher in patients treated with captopril, being this finding of great importance since it can suggest new therapeutic approaches to diabetic nephropathy.