Renal abnormalities in patients with sickle cell disease
Autor(a) principal: | |
---|---|
Data de Publicação: | 2013 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFC |
Texto Completo: | http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10491 |
Resumo: | ABSTRACT Background - Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal abnormalities among patients with SCD. Methods - This is a cohort study with 26 SCD patients followed in a medical center in Fortaleza, CearÃ, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2), and after a 12h period of water and food deprivation. Fractional excretion of sodium (FENa), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH2O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Aquaporin-2 (AQP2) and renal outer medullary K+ channels (ROMK) were quantified through exosomes search in urine. Results - Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 5 SCD patients (19.2%), who presented urinary pH > 5.5 after CaCl2 test. Urinary osmolality was significantly lower in SCD patients (355Â60 vs. 818Â202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FENa was higher among SCD patients (0.75Â0.3 vs. 0.55Â0.2%, p=0.02). The TTKG was higher in SCD patients (5.5Â2.5 vs. 3.0Â1.5, p=0.001), and TcH2O was lower (0.22Â0.3 vs. 1.1Â0.3L/day, p=0.0001). The search for AQP2 did not show significant difference between SCD patients and control group (102Â6.0 vs. 100Â7.2%, p=0.874), as well as for ROMK (172Â38 vs. 100Â25%, p=0.207). Conclusions - SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water transport, evidencing the occurrence of distal tubular dysfunction. |
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info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisRenal abnormalities in patients with sickle cell diseaseAlteraÃÃes renais em pacientes com doenÃa falciforme 2013-07-26Elizabeth de Francesco Daher18772919353http://lattes.cnpq.br/4855968398515646SÃnia Leite da Silva55600557949http://lattes.cnpq.br/002592822341772886007157334http://lattes.cnpq.br/7234328753543020Geraldo Bezerra da Silva JÃniorUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em CiÃncias MÃdicasUFCBRNEFROLOGIAABSTRACT Background - Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal abnormalities among patients with SCD. Methods - This is a cohort study with 26 SCD patients followed in a medical center in Fortaleza, CearÃ, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2), and after a 12h period of water and food deprivation. Fractional excretion of sodium (FENa), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH2O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Aquaporin-2 (AQP2) and renal outer medullary K+ channels (ROMK) were quantified through exosomes search in urine. Results - Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 5 SCD patients (19.2%), who presented urinary pH > 5.5 after CaCl2 test. Urinary osmolality was significantly lower in SCD patients (355Â60 vs. 818Â202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FENa was higher among SCD patients (0.75Â0.3 vs. 0.55Â0.2%, p=0.02). The TTKG was higher in SCD patients (5.5Â2.5 vs. 3.0Â1.5, p=0.001), and TcH2O was lower (0.22Â0.3 vs. 1.1Â0.3L/day, p=0.0001). The search for AQP2 did not show significant difference between SCD patients and control group (102Â6.0 vs. 100Â7.2%, p=0.874), as well as for ROMK (172Â38 vs. 100Â25%, p=0.207). Conclusions - SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water transport, evidencing the occurrence of distal tubular dysfunction.RESUMO IntroduÃÃo - AlteraÃÃes renais representam uma das complicaÃÃes crÃnicas principais da doenÃa falciforme (DF). O objetivo deste estudo à investigar a ocorrÃncia de alteraÃÃes renais em pacientes com DF. MÃtodos - Foi realizado estudo de coorte com 26 pacientes com DF acompanhados em um ambulatÃrio de Fortaleza, CearÃ, Brasil. Testes de acidificaÃÃo e concentraÃÃo urinÃrias foram realizados usando cloreto de cÃlcio (CaCl2) e apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica. Foram calculados fraÃÃo de excreÃÃo de sÃdio (FENa), transporte transtubular de potÃssio (TTKG) e transporte de Ãgua livre de solutos (TcH2O). O grupo de pacientes com DF foi comparado com um grupo de 15 voluntÃrios sadios (grupo controle). Os transportadores aquaporina-2 (AQP2) e canal de K+ apical (ROMK) foram quantificados pela pesquisa de exossomas na urina. Resultados - A mÃdia de idade e a distribuiÃÃo de gÃnero foi similar entre os dois grupos. DÃficit de acidificaÃÃo urinÃria foi encontrada em 5 pacientes com DF (19,2%), que apresentaram pH urinÃrio > 5,5 apÃs o teste com CaCl2. A osmolaridade urinÃria foi significativamente menor entre os pacientes com DF (355Â60 vs. 818Â202mOsm/kg, p=0,0001, apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica). DÃficit de concentraÃÃo urinÃria foi encontrado em todos os casos de DF (100%). A FENa foi maior entre os pacientes com DF (0,75Â0,3 vs. 0,55Â0,2%, p=0,02). O TTKG tambÃm foi maior nos pacientes com DF (5,5Â2,5 vs. 3,0Â1,5, p=0,001), e o TcH2O foi menor (0,22Â0,3 vs. 1,1Â0,3L/dia, p=0,0001). A pesquisa de AQP2 nÃo mostrou diferenÃa significativa em relaÃÃo ao grupo controle (102Â6,0 vs. 100Â7,2%, p=0,874), bem como a do canal ROMK (172Â38 vs. 100Â25%, p=0,207). ConclusÃo - A DF à associada a importantes alteraÃÃes renais. As principais alteraÃÃes encontradas foram dÃficit de concentraÃÃo e acidificaÃÃo urinÃria. Foi ainda observado aumento no transportenÃo hÃhttp://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10491application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:23:32Zmail@mail.com - |
dc.title.en.fl_str_mv |
Renal abnormalities in patients with sickle cell disease |
dc.title.alternative.pt.fl_str_mv |
AlteraÃÃes renais em pacientes com doenÃa falciforme |
title |
Renal abnormalities in patients with sickle cell disease |
spellingShingle |
Renal abnormalities in patients with sickle cell disease Geraldo Bezerra da Silva JÃnior NEFROLOGIA |
title_short |
Renal abnormalities in patients with sickle cell disease |
title_full |
Renal abnormalities in patients with sickle cell disease |
title_fullStr |
Renal abnormalities in patients with sickle cell disease |
title_full_unstemmed |
Renal abnormalities in patients with sickle cell disease |
title_sort |
Renal abnormalities in patients with sickle cell disease |
author |
Geraldo Bezerra da Silva JÃnior |
author_facet |
Geraldo Bezerra da Silva JÃnior |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Elizabeth de Francesco Daher |
dc.contributor.advisor1ID.fl_str_mv |
18772919353 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4855968398515646 |
dc.contributor.referee1.fl_str_mv |
SÃnia Leite da Silva |
dc.contributor.referee1ID.fl_str_mv |
55600557949 |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/0025928223417728 |
dc.contributor.authorID.fl_str_mv |
86007157334 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/7234328753543020 |
dc.contributor.author.fl_str_mv |
Geraldo Bezerra da Silva JÃnior |
contributor_str_mv |
Elizabeth de Francesco Daher SÃnia Leite da Silva |
dc.subject.cnpq.fl_str_mv |
NEFROLOGIA |
topic |
NEFROLOGIA |
dc.description.sponsorship.fl_txt_mv |
nÃo hà |
dc.description.abstract.por.fl_txt_mv |
ABSTRACT Background - Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal abnormalities among patients with SCD. Methods - This is a cohort study with 26 SCD patients followed in a medical center in Fortaleza, CearÃ, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2), and after a 12h period of water and food deprivation. Fractional excretion of sodium (FENa), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH2O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Aquaporin-2 (AQP2) and renal outer medullary K+ channels (ROMK) were quantified through exosomes search in urine. Results - Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 5 SCD patients (19.2%), who presented urinary pH > 5.5 after CaCl2 test. Urinary osmolality was significantly lower in SCD patients (355Â60 vs. 818Â202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FENa was higher among SCD patients (0.75Â0.3 vs. 0.55Â0.2%, p=0.02). The TTKG was higher in SCD patients (5.5Â2.5 vs. 3.0Â1.5, p=0.001), and TcH2O was lower (0.22Â0.3 vs. 1.1Â0.3L/day, p=0.0001). The search for AQP2 did not show significant difference between SCD patients and control group (102Â6.0 vs. 100Â7.2%, p=0.874), as well as for ROMK (172Â38 vs. 100Â25%, p=0.207). Conclusions - SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water transport, evidencing the occurrence of distal tubular dysfunction. RESUMO IntroduÃÃo - AlteraÃÃes renais representam uma das complicaÃÃes crÃnicas principais da doenÃa falciforme (DF). O objetivo deste estudo à investigar a ocorrÃncia de alteraÃÃes renais em pacientes com DF. MÃtodos - Foi realizado estudo de coorte com 26 pacientes com DF acompanhados em um ambulatÃrio de Fortaleza, CearÃ, Brasil. Testes de acidificaÃÃo e concentraÃÃo urinÃrias foram realizados usando cloreto de cÃlcio (CaCl2) e apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica. Foram calculados fraÃÃo de excreÃÃo de sÃdio (FENa), transporte transtubular de potÃssio (TTKG) e transporte de Ãgua livre de solutos (TcH2O). O grupo de pacientes com DF foi comparado com um grupo de 15 voluntÃrios sadios (grupo controle). Os transportadores aquaporina-2 (AQP2) e canal de K+ apical (ROMK) foram quantificados pela pesquisa de exossomas na urina. Resultados - A mÃdia de idade e a distribuiÃÃo de gÃnero foi similar entre os dois grupos. DÃficit de acidificaÃÃo urinÃria foi encontrada em 5 pacientes com DF (19,2%), que apresentaram pH urinÃrio > 5,5 apÃs o teste com CaCl2. A osmolaridade urinÃria foi significativamente menor entre os pacientes com DF (355Â60 vs. 818Â202mOsm/kg, p=0,0001, apÃs perÃodo de 12h de jejum e privaÃÃo hÃdrica). DÃficit de concentraÃÃo urinÃria foi encontrado em todos os casos de DF (100%). A FENa foi maior entre os pacientes com DF (0,75Â0,3 vs. 0,55Â0,2%, p=0,02). O TTKG tambÃm foi maior nos pacientes com DF (5,5Â2,5 vs. 3,0Â1,5, p=0,001), e o TcH2O foi menor (0,22Â0,3 vs. 1,1Â0,3L/dia, p=0,0001). A pesquisa de AQP2 nÃo mostrou diferenÃa significativa em relaÃÃo ao grupo controle (102Â6,0 vs. 100Â7,2%, p=0,874), bem como a do canal ROMK (172Â38 vs. 100Â25%, p=0,207). ConclusÃo - A DF à associada a importantes alteraÃÃes renais. As principais alteraÃÃes encontradas foram dÃficit de concentraÃÃo e acidificaÃÃo urinÃria. Foi ainda observado aumento no transporte |
description |
ABSTRACT Background - Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal abnormalities among patients with SCD. Methods - This is a cohort study with 26 SCD patients followed in a medical center in Fortaleza, CearÃ, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2), and after a 12h period of water and food deprivation. Fractional excretion of sodium (FENa), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH2O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Aquaporin-2 (AQP2) and renal outer medullary K+ channels (ROMK) were quantified through exosomes search in urine. Results - Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 5 SCD patients (19.2%), who presented urinary pH > 5.5 after CaCl2 test. Urinary osmolality was significantly lower in SCD patients (355Â60 vs. 818Â202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FENa was higher among SCD patients (0.75Â0.3 vs. 0.55Â0.2%, p=0.02). The TTKG was higher in SCD patients (5.5Â2.5 vs. 3.0Â1.5, p=0.001), and TcH2O was lower (0.22Â0.3 vs. 1.1Â0.3L/day, p=0.0001). The search for AQP2 did not show significant difference between SCD patients and control group (102Â6.0 vs. 100Â7.2%, p=0.874), as well as for ROMK (172Â38 vs. 100Â25%, p=0.207). Conclusions - SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water transport, evidencing the occurrence of distal tubular dysfunction. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-07-26 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
status_str |
publishedVersion |
format |
doctoralThesis |
dc.identifier.uri.fl_str_mv |
http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10491 |
url |
http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10491 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Cearà |
dc.publisher.program.fl_str_mv |
Programa de PÃs-GraduaÃÃo em CiÃncias MÃdicas |
dc.publisher.initials.fl_str_mv |
UFC |
dc.publisher.country.fl_str_mv |
BR |
publisher.none.fl_str_mv |
Universidade Federal do Cearà |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFC instname:Universidade Federal do Ceará instacron:UFC |
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Biblioteca Digital de Teses e Dissertações da UFC |
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Biblioteca Digital de Teses e Dissertações da UFC |
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Universidade Federal do Ceará |
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UFC |
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UFC |
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|
repository.mail.fl_str_mv |
mail@mail.com |
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1643295177626877952 |