RESUMO
This study was conducted to test the hypothesis that normotensive, normoalbuminuric IDDM patients with glomerular hyperfiltration may present functional or structural cardiac abnormalities. Eleven normoalbuminuric and normotensive IDDM patients with normal glomerular filtration rate and 11 patients with hyperfiltration were compared with a group of 17 age and sex matched controls. Glomerular filtration rate was measured by the 51Cr-EDTA technique and hyperfiltration was defined as a glomerular filtration rate higher than 134 ml/min/1.73 m2. Phonocardiogram, M-mode and pulsed Doppler two-dimensional echocardiograms were performed to evaluate resting left ventricular dimensions, systolic and diastolic function. Left ventricular dimensions, fractional shortening, mean velocity of fiber shortening, early and late diastolic peak filling velocity, deceleration time, mitral flow velocity integral, and isovolumic relaxation time were similar (ANOVA P > 0.05) in normal controls, diabetic patients with normal glomerular filtration rate, and diabetic patients with hyperfiltration. In conclusion, the results of our controlled observations indicate that normoalbuminuric and normotensive IDDM patients who have normal glomerular filtration rate or hyperfiltration have no Doppler-echocardiographic evidence of functional and structural abnormalities.
Assuntos
Albuminúria , Diabetes Mellitus Tipo 1/fisiopatologia , Nefropatias Diabéticas/fisiopatologia , Diástole , Taxa de Filtração Glomerular , Sístole , Função Ventricular Esquerda , Adulto , Fatores Etários , Análise de Variância , Estudos de Coortes , Ecocardiografia Doppler , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de ReferênciaRESUMO
OBJETIVO. Avaliar a influência no curso clínico e a prevalência de distúrbios hidroeletrolíticos, ácido-básicos e da funçäo renal em pacientes portadores da síndrome da imunodeficiência adquirida (SIDA). Casuística e Métodos. A partir de um protocolo preestabelecido, revisaram-se os prontuários da primeira internaçäo de todos os pacientes admitidos durante o primeiro semestre de 1989. RESULTADOS. Noventa e nove pacientes foram estudados. A prevalência de hiponatremia, no momento da baixa, foi de 45% e durante a internaçäo, de 80,7% dos pacientes avaliados. Hipopotassemia esteve presente em 23,1% dos pacientes e acidose metabólica e insuficiência renal em 20,1 e 28,4%, respectivamente. O risco relativo para mortalidade em pacientes com hipopotassemia foi 4,4. Acidose metabólica e insuficiência renal aguda apresentaram riscos relativos de 12,9 e 21,4. Estes fatores, hipopotassemia (p < 0,01), acidose metabólica (p < 0,001) e insuficiência renal aguda (p < 0,001), estiveram significativamente associados à mortalidade. DISCUSSÄO E CONCLUSOES. Conclui-se que existe uma elevada prevalência das alteraçöes avaliadas nos pacientes com SIDA e que o desenvolvimento de hipopotassemia, acidose metabólica e insuficiência renal aguda está significativamente associado à mortalidade nestes pacientes
Assuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Acidose/epidemiologia , Injúria Renal Aguda/epidemiologia , Hipopotassemia/epidemiologia , Hiponatremia/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Acidose/complicações , Brasil/epidemiologia , Fatores de Risco , Injúria Renal Aguda/complicações , Hipopotassemia/complicações , Hiponatremia/complicaçõesRESUMO
BACKGROUND: A variety of metabolic and renal disturbances have been described in patients with Acquired Immunodeficiency Syndrome (AIDS) but their influence on the clinical outcome has not been reported. The present study was undertaken in order to evaluate the prevalence of fluid and electrolyte, acid-base, and renal function disturbances in AIDS patients. The influence of these abnormalities on the clinical outcome was studied as well. MATERIAL AND METHODS: Following to a previously established protocol, the charts of all patients hospitalized during the first semester of 1989 were reviewed. RESULTS: The prevalence of hyponatremia was 45% and 80.7% at admission and during hospitalization respectively of 99 patients. Hypokalemia was present in 23.1% of the patients. Metabolic acidosis and renal failure were 20.1% and 28.4% prevalent. The relative risk for mortality in patients with hypokalemia was 4.4. Metabolic acidosis and acute renal failure had relative risks of 12.9 and 21.4. CONCLUSIONS: There is an elevated prevalence of fluid and electrolyte, acid-base and renal function disturbances in these patients. The presence of hypokalemia, metabolic acidosis, and renal failure are significantly associated with mortality in AIDS.