RESUMO
BACKGROUND: The objective of this study was to evaluate renal function and to explore the relationship between some risk factors in kidney donors 12.37 ± 7.60 years after donation. PATIENTS AND METHODS: In a cross-sectional study conducted in a transplant unit, 77 nephrectomized subjects were assessed ≥5 years after donation to evaluate their renal function and the presence or absence of hypertension, dyslipidemia, and microalbuminuria. RESULTS: Twenty donors had an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). Nine donors showed urinary albumin excretion of >20 µg/min (11.68%). Subjects with an EGFR of <60 mL/min were predominantly male and hypertensive and showed higher body mass index (BMI), higher uric acid, higher total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), and logarithm of triglycerides/HDL-C (log TG/HDL-C) ratios than donors with an EGFR of >60 mL/min. Hypertensive donors were older and had higher BMI, higher UA serum values, higher TC/HDL-C and log TG/HDL-C ratios and microalbuminuria than nonhypertensive donors (P < .005). A multivariate analysis was conducted and, after final adjustment, a filtration rate of <60 mL/min was 3.05 times higher in men than women, increased 10% for each 1-unit increase in BMI and was positively associated with log (TG/HDL-C). The frequency of hypertension increased by 10% for each 1-unit increase in BMI and was positively associated with microalbuminuria. CONCLUSION: In this sample of kidney donors from a single transplant unit, ≥5 years after donation, male sex and high BMI were positively associated with the presence of kidney failure.
Assuntos
Hipertensão/complicações , Transplante de Rim , Doadores Vivos , Insuficiência Renal/complicações , Albuminúria/complicações , Índice de Massa Corporal , Brasil , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangueRESUMO
PURPOSE: To investigate clinical performance of a low-shrinkage silorane-based composite resin when used for repairing conventional dimethacrylate-based composite restorations. BACKGROUND: Despite the continued development of resin-based materials, polymerization shrinkage and shrinkage stress still require improvement. A silorane-based monomer system was recently made available for dental restorations. This report refers to the use of this material for making repairs and evaluates the clinical performance of this alternative treatment. MATERIALS AND METHODS: One operator repaired the defective dimethacrylate-based composite resin restorations that were randomly assigned to one of two treatment groups: control (n=50) repair with Adper SE Plus (3M/ESPE) and Filtek P60 Posterior Restorative (3M/ESPE), and test (n=50) repair with P90 System Adhesive Self-Etch Primer and Bond (3M/ESPE) and Filtek P90 Low Shrink Posterior Restorative (3M/ESPE). After one week, restorations were finished and polished. Two calibrated examiners (Kw≥0.78) evaluated all repaired restorations, blindly and independently, at baseline and one year. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alpha, Bravo, or Charlie, according to modified US Public Health Service criteria. Mann-Whitney and Wilcoxon tests were used to compare the groups. RESULTS: Of the 100 restorations repaired in this study, 93 were reexamined at baseline. Dropout from baseline to one-year recall was 11%. No statistically significant differences were found between the materials for all clinical criteria, at baseline or at one-year recall (p>0.05). No statistically significant differences were registered (p>0.05) for each material when compared for all clinical criteria at baseline and at one-year recall. CONCLUSIONS: The hypothesis tested in this randomized controlled clinical trial was accepted. After the one-year evaluations, the silorane-based composite exhibited a similar performance compared with dimethacrylate-based composite when used to make repairs.
Assuntos
Resinas Compostas/química , Materiais Dentários/química , Reparação de Restauração Dentária/métodos , Metacrilatos/química , Resinas de Silorano/química , Adolescente , Adulto , Cor , Colagem Dentária/métodos , Cárie Dentária/classificação , Adaptação Marginal Dentária , Polimento Dentário/métodos , Sensibilidade da Dentina/classificação , Seguimentos , Humanos , Pessoa de Meia-Idade , Polimerização , Estudos Prospectivos , Recidiva , Propriedades de Superfície , Adulto JovemRESUMO
Microalbuminuria (MA) is a well recognized marker of cardiovascular complications in hypertension, but whether MA can predict adverse outcome in this clinical condition is still a subject for debate. The fact that in hypertensive cohorts those patients who showed an increase in albumin excretion rate also manifested an increased incidence of morbid events indicates that the presence of MA in hypertension may carry an increased cardiovascular risk. However, the prognostic significance of MA remains controversial because no results of prospective studies performed in hypertensive subjects without diabetes mellitus are available. Several factors can affect the prevalence of MA in hypertension, including severity of the disease, selection procedures, concomitant risk factors, degree of obesity, age, and sex distribution. This accounts for the large differences in the prevalence of MA that can be found in the literature, with prevalence rates going from a low of 4.7% to a high of 40%. There is still conflict over whether MA in hypertension is due to increased intraglomerular pressure or to glomerular damage. The data from the literature suggest that in subjects with mild hypertension the main determinant of albumin excretion rate is the haemodynamic load. In subjects with more severe hypertension and hypertensive complications, the augmented urinary albumin leak is probably the consequence of a systemic microvascular disturbance which involves the glomeruli. In this respect, the insulin resistance state often associated to high blood pressure appears as one of the main pathogenetic factors. Whether management of hypertensive populations may be improved by monitoring of albumin excretion rate and whether antihypertensive drugs which are more effective in decreasing urinary albumin can be more beneficial in patients with MA remains to be determined.
Assuntos
Albuminúria/etiologia , Hipertensão/urina , Albuminúria/epidemiologia , Albuminúria/fisiopatologia , Anti-Hipertensivos/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Prevalência , PrognósticoRESUMO
The occurrence of alterations was verified in some parameters of the asymptomatic individuals' renal function infected by the virus of the human immunodeficiency (HIV). Forty seven individuals were studied, taking place renal functional tests, as: creatinine clearance, clearance of free water, clearance osmolar, reabsorption tubular proximal and distal of sodium and potassium and urinary pH. The results revealed significant differences (p < 0.05) in the urinary pH, larger in the group with HIV (6.36 +/- 0.41), that in the controls (6.02 +/- 0.41); in the clearance of free water, that indicated reabsorption of larger water in the group with HIV (1.00 +/- 0.64 ml/min) and in the clearance osmolar, that was 2.00 +/- 0.83 ml/min in the group with HIV and 1.57 +/- 0.48 ml/min. The remaining of the indicators of renal function was not shown statistically different between an and other group. It was ended that those differences are significant, in spite of the absolute values they be inside of the normality, because could be associated to late evolutionary alterations of the disease, such as the increase of the frequency of infections of the urinary treatment and the dilution hyponatremia. More studies are necessary for if they confirm those hypotheses.
Assuntos
Infecções por HIV/fisiopatologia , Rim/fisiopatologia , Adulto , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/imunologia , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Urina/química , Água/metabolismoRESUMO
Verificou-se a ocorrência de alterações em alguns parâmetros da função renal de indivíduos infectados pelo virus da imunodeficiência humana (HIV), assintomáticos. Foram estudados 47 indivíduos, realizando-se provas funcionais renais: depuração de creatinina endógena, depuração de água livre, depuração osmolar, reabsorção tubular proximal e distal de sódio, excreção fracional de sódio e potássio e pH urinário. Os resultados revelaram diferenças significantes (p < 0,05) no pH urinário, maior no grupo HIV (6,36 ± 0,41), do que nos controles (6,02 ± 0,41); na depuração de água livre, que indicou reabsorção de água maior no grupo HIV (1,00 ± 0,64ml/min), do que nos controles (0,53 ± 0,48ml/min) e na depuração osmolar, que foi 2,00 ± 0,83ml/min no grupo HIV e 1,57 ± 0,48ml/min nos controles. O restante dos indicadores de função renal estudados não se mostraram diferentes estatisticamente entre um e outro grupo. Concluiu-se que essas diferenças são significativas, apesar de os valores absolutos estarem dentro da normalidade, pois podem estar associadas a alterações evolutivas tardias da doença, tais como o aumento na frequência de infecções do trato urinário e a hiponatremia dilucional. Mais estudos são necessários para se confirmarem essas hipóteses.
The occurrence of alterations was verified in some parameters of the asymptomatic individuals' renal function infected by the virus of the human immunodeficiency (HIV). Forty seven individuals were studied, taking place renal functional tests, as: creatinine clearance, clearance of free water, clearance osmolar, reabsorption tubular proximal and distal of sodium and potassium and urinary pH. The results revealed significant differences (p < 0.05) in the urinary pH, larger in the group with HIV (6.36 +/- 0.41), that in the controls (6.02 +/- 0.41); in the clearance of free water, that indicated reabsorption of larger water in the group with HIV (1.00 +/- 0.64 ml/min) and in the clearance osmolar, that was 2.00 +/- 0.83 ml/min in the group with HIV and 1.57 +/- 0.48 ml/min. The remaining of the indicators of renal function was not shown statistically different between an and other group. It was ended that those differences are significant, in spite of the absolute values they be inside of the normality, because could be associated to late evolutionary alterations of the disease, such as the increase of the frequency of infections of the urinary treatment and the dilution hyponatremia. More studies are necessary for if they confirm those hypotheses.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por HIV/fisiopatologia , Rim/fisiopatologia , Água/metabolismo , Concentração de Íons de Hidrogênio , Infecções por HIV/imunologia , Urina/químicaRESUMO
Foi avaliada a função renal de 11 pacientes com leishmaniose cutâneo-mucosa tratados com antimonial pentavalente na dose de 40mg SbV/kg/dia aplicada de 12/12 horas, em esquema contínuo, durante trinta dias. No estudo, um paciente apresentou insuficiência renal reversível e dois desenvolveram alterações enzimáticas hepáticas e eletrocardiográficas sendo o esquema terapêutico interrompido. Nos demais pacientes observou-se efeitos nefrotóxicos tais como diminuição da taxa de filtração glomerular, diminuição da capacidade de concentração urinária, avaliada por um jejum hídrico de 16 horas e aumento na fração de excreção de sódio. No exame do sedimento urinário observou-se um aumento no número de leucócitos e cilindros. Os resultados encontrados neste estudo sugerem que o tratamento com antimonial pentavalente na dose de 40mg SbV/kg/dia foi menos tolerado em virtude de seus efeitos tóxicos, não parecendo apresentar índice de cura superior ao esquema atualmente preconizado de 20mg SbV/kg/dia.
The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.
Assuntos
Adolescente , Adulto , Animais , Humanos , Pessoa de Meia-Idade , Antimônio/administração & dosagem , Antimônio/efeitos adversos , Antiprotozoários/administração & dosagem , Antiprotozoários/efeitos adversos , Compostos Organometálicos/administração & dosagem , Leishmania braziliensis , Leishmaniose Mucocutânea/tratamento farmacológico , Meglumina/administração & dosagem , Meglumina/efeitos adversos , Rim/efeitos dos fármacos , Compostos Organometálicos/efeitos adversos , Avaliação de Medicamentos , Tolerância a Medicamentos , Leishmaniose Mucocutânea/fisiopatologia , Estudos Prospectivos , Rim/fisiopatologia , Fatores de TempoRESUMO
The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.
Assuntos
Antimônio/administração & dosagem , Antimônio/efeitos adversos , Antiprotozoários/administração & dosagem , Antiprotozoários/efeitos adversos , Rim/efeitos dos fármacos , Leishmania braziliensis , Leishmaniose Mucocutânea/tratamento farmacológico , Meglumina/administração & dosagem , Meglumina/efeitos adversos , Compostos Organometálicos/administração & dosagem , Compostos Organometálicos/efeitos adversos , Adolescente , Adulto , Animais , Avaliação de Medicamentos , Tolerância a Medicamentos , Humanos , Rim/fisiopatologia , Leishmaniose Mucocutânea/fisiopatologia , Antimoniato de Meglumina , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
The effect of an 8 hour-period of water deprivation on fluid and electrolyte renal excretion was investigated in male Wistar rats infected with the strain Sao Felipe (12SF) of Trypanosoma cruzi, in comparison with age and sex matched non-infected controls. The median percent reductions in the urinary flow (-40 per cent v -63 per cent) and excretion of sodium (-57 per cent v - 79 per cent) were smaller in chagasic than in control rats, respectively. So, chagasic rats excereted more than controls. On the other hand, the median percent decrement in the clearance of creatinine was higher in chagasic (-51 per cent) than in controls (-39 per cent). Thus, chagasic rats showed some disturbed renal hydroelectrolytic responses to water deprivation, expressed by smaller conservation, or higher excretion of water and sodium in association with smallerglotmerular filtration rate. This fact denoted an elevation in the fractional excretion of sodium and water.
Assuntos
Animais , Masculino , Ratos , Doença de Chagas/fisiopatologia , Privação de Água/fisiologia , Desequilíbrio Hidroeletrolítico/fisiopatologia , Doença Crônica , Ratos WistarRESUMO
The effect of an 8 hour-period of water deprivation on fluid and electrolyte renal excretion was investigated in male Wistar rats infected with the strain São Felipe (12SF) of Trypanosoma cruzi, in comparison with age and sex matched non-infected controls. The median percent reductions in the urinary flow (-40% v-63%) and excretion of sodium (-57% v -79%) were smaller in chagasic than in control rats, respectively. So, chagasic rats excreted more than controls. On the other hand, the median percent decrement in the clearance of creatinine was higher in chagasic (-51%) than in controls (-39%). Thus, chagasic rats showed some disturbed renal hydroelectrolytic responses to water deprivation, expressed by smaller conservation, or higher excretion of water and sodium in association with smaller glomerular filtration rate. This fact denoted an elevation in the fractional excretion of sodium and water.
Assuntos
Doença de Chagas/fisiopatologia , Privação de Água/fisiologia , Desequilíbrio Hidroeletrolítico/fisiopatologia , Animais , Doença Crônica , Masculino , Ratos , Ratos WistarRESUMO
Estudou-se a funcao renal de ratos tratados com Glucantime (Antimoniato de Meglumine, Rhodia) e Pentostam (estibogloconato de Sodio, Wellcome) na dose de 30 mg de "Sb POT v" por 100g de peso por dia, durante 30 dias. Observou-se um disturbio na concentracao urinaria, que foi reversivel 7 dias apos cessada a administracao das drogas. O estudo histopatologico do rim, por meio da microscopia optica, nao evidenciou alteracoes significativas. Por outro lado, ratos tratados com altas doses dos antimoniais (220mg de "Sb POT v" por 100g de peso por dia) mostraram alteracoes funcionais e histopatologicas renais compativeis com necrose tubular aguda
Assuntos
Ratos , Animais , Rim/efeitos dos fármacos , Meglumina/toxicidade , Compostos Organometálicos/toxicidade , Capacidade de Concentração Renal/efeitos dos fármacos , Concentração Osmolar , Ratos Wistar , Sódio/metabolismo , Água/metabolismoRESUMO
Aspects of the renal function were assessed in rats treated with the pentavalent antimonials Glucantime (Meglumine Antimoniate, Rhodia) or Pentostam (Sodium Stibogluconate, Wellcome). In dose of 30 mg of Sbv (Glucantime or Pentostam) by 100 mg of weight by day for 30 days, renal functional changes were observed consisting of disturbances in urine concentrating capacity. Such disturbances were expressed by significantly low values of urine osmolality as compared to the basal values previous to the drugs. The decrease in urine osmolality was associated to a significant increase in urinary flow and in negative free-water clearance. There was no alteration in osmolar clearance and in fractional excretion of sodium. These observations suggest an interference of the drugs in the action of the antidiuretic hormone. The disturbance in urine concentration was reversible after a seven days period without the drugs administration. No significant histopathological alterations were observed in the kidneys of the rats treated with the drugs. On the other hand, the rats treated with a high dose of Pentostam (200 mg/100 grams of weight/day) showed the functional and the histopathological alterations of the acute tubular necrosis.
Assuntos
Antiprotozoários/toxicidade , Rim/efeitos dos fármacos , Meglumina/toxicidade , Compostos Organometálicos/toxicidade , Animais , Capacidade de Concentração Renal/efeitos dos fármacos , Masculino , Antimoniato de Meglumina , Concentração Osmolar , Ratos , Ratos Endogâmicos , Sódio/metabolismo , Água/metabolismoAssuntos
Gluconato de Antimônio e Sódio/efeitos adversos , Antimônio/efeitos adversos , Antiprotozoários/efeitos adversos , Gluconatos/efeitos adversos , Capacidade de Concentração Renal/efeitos dos fármacos , Rim/fisiopatologia , Leishmaniose Mucocutânea/tratamento farmacológico , Meglumina , Compostos Organometálicos , Antimônio/uso terapêutico , Gluconato de Antimônio e Sódio/uso terapêutico , Antiprotozoários/uso terapêutico , Ensaios Clínicos como Assunto , Feminino , Humanos , Leishmaniose Mucocutânea/fisiopatologia , Masculino , Antimoniato de MegluminaRESUMO
The inhibition of osmotic stimulated water flow in the isolated toad bladder by 0.1 mM sodium stibogluconate (pentavalent antimony) is described. Pentavalent antimony on the serosal surface significantly inhibited oxytocin-induced water flow but when the drug was added to the mucosal surface only the effect of low oxytocin concentrations was reduced. The phosphodiesterase inhibitor pentoxifylline, when present on the serosal side, blocks the effect of pentavalent antimony on stimulated water flow. No effect was detected when indomethacin was present on the serosal side. It is suggested that phosphodiesterase activation might play a role in the mechanism of pentavalent antimonial inhibition of oxytocin-induced water flow in the isolated toad bladder. The effect obtained when sodium stibogluconate on the serosal side was replaced with antimony pentachloride (SbCl5) supports the view that the metal in the molecule is responsible for the inhibition of the effect of oxytocin.
Assuntos
Gluconato de Antimônio e Sódio/farmacologia , Gluconatos/farmacologia , Ocitocina/antagonistas & inibidores , Bexiga Urinária/metabolismo , Água/metabolismo , Animais , Bufo marinus , Ocitocina/farmacologia , Pentoxifilina/farmacologia , Inibidores de Fosfodiesterase/metabolismo , Bexiga Urinária/efeitos dos fármacosRESUMO
Dosou-se aldosterona em soro e saliva de individuos normais, atraves de radioimunoensaio com extracao previa, obtendo-se os valores medios de 9,5ng/100ml e 8,8ng/ 100ml, respectivamente. O estudo da correlacao entre estes valores revelou um coeficiente de 0,82. A vantagem de obter valores de aldosterona salivar e a possibilidade de estudos em circunstancias em que o stress da puncao venosa interfere na analise dos resultados e em situacoes em que se necessitam colheitas sanguineas seriadas (p.ex., ritmo hormonal)