Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE

Detalhes bibliográficos
Autor(a) principal: Michelle Jacintha Cavalcante Oliveira
Data de Publicação: 2010
Tipo de documento: Dissertação
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=4987
Resumo: Background. There are few studies of renal function evaluation in visceral leishmaniasis (Kala-azar). The aim of this study was to investigate the clinical manifest and the risk factors associated with acute kidney injury (AKI) based on RIFLE criteria in patients with visceral leishmaniasis (VL). Methods. A retrospective study of medical records from patients over 14 years old, without previous kidney disease, with VL, treated at SÃo Josà Infectious Diseases Hospital, from 2002 to 2008. Clinical manifestations and risk factors for AKI (defined by using RIFLE criteria) were studied. A multivariate analysis was performed to analyze the risk factors for AKI. Results. A total of 224 patients were included. The mean age was 36Â15 years and 76.8% were males. AKI was observed in 76 patients (33.9% of cases) and % 52.6 (40) were class F on RIFLE criteria. The main clinical symptoms were dyspnea, edema and jaundice in patients with VL and AKI (p<0.05). Oliguria was observed in 6.5% of patients with AKI. Risk factors associated with AKI were male gender (OR=2.2, 95% CI= 1.0-4.7, p=0.03), age > 40 years (OR = 1.05, 95% CI= 1.02-1.08, p < 0.001) and jaundice (OR=2.9, 95% CI= 1.5-5.8 p=0.002). There was an strong association between amphotericin B use and AKI (OR=18.4, 95% CI=7.9-42.8, p<0.0001), whereas glucantime use was associated with a lower incidence of AKI when compared to amphotericin B users (OR=0.05, 95% CI=0.02-0.12, p<0.0001). Mortality was 13.3% and it was higher in AKI patients (30.2% vs. 4.7%, p<0.0001). RIFLE criteria presented mortality 40%, 20.8% e 35% in R, I and F respective class. Conclusions. The risk factors associated with AKI in patients with VL were male gender, advanced age, jaundice and amphotericin B. The last one was the most important factor of AKI in VL.
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spelling info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisVisceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLEManifestaÃÃes clÃnicas e fatores de risco relacionados à lesÃo renal aguda na Leishmaniose visceral e aplicaÃÃo do critÃrio Rifle2010-05-10Elizabeth de Francesco Daher18772919353http://lattes.cnpq.br/4855968398515646Geanne Matos de Andrade21911258320http://lattes.cnpq.br/9935129797137635Roberto da Justa Pires Neto44778309391http://lattes.cnpq.br/188768532661813902536698475 http://lattes.cnpq.br/7500052524020068Michelle Jacintha Cavalcante OliveiraUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em CiÃncias MÃdicasUFCBRVisceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLECiÃncias da SaÃdeBackground. There are few studies of renal function evaluation in visceral leishmaniasis (Kala-azar). The aim of this study was to investigate the clinical manifest and the risk factors associated with acute kidney injury (AKI) based on RIFLE criteria in patients with visceral leishmaniasis (VL). Methods. A retrospective study of medical records from patients over 14 years old, without previous kidney disease, with VL, treated at SÃo Josà Infectious Diseases Hospital, from 2002 to 2008. Clinical manifestations and risk factors for AKI (defined by using RIFLE criteria) were studied. A multivariate analysis was performed to analyze the risk factors for AKI. Results. A total of 224 patients were included. The mean age was 36Â15 years and 76.8% were males. AKI was observed in 76 patients (33.9% of cases) and % 52.6 (40) were class F on RIFLE criteria. The main clinical symptoms were dyspnea, edema and jaundice in patients with VL and AKI (p<0.05). Oliguria was observed in 6.5% of patients with AKI. Risk factors associated with AKI were male gender (OR=2.2, 95% CI= 1.0-4.7, p=0.03), age > 40 years (OR = 1.05, 95% CI= 1.02-1.08, p < 0.001) and jaundice (OR=2.9, 95% CI= 1.5-5.8 p=0.002). There was an strong association between amphotericin B use and AKI (OR=18.4, 95% CI=7.9-42.8, p<0.0001), whereas glucantime use was associated with a lower incidence of AKI when compared to amphotericin B users (OR=0.05, 95% CI=0.02-0.12, p<0.0001). Mortality was 13.3% and it was higher in AKI patients (30.2% vs. 4.7%, p<0.0001). RIFLE criteria presented mortality 40%, 20.8% e 35% in R, I and F respective class. Conclusions. The risk factors associated with AKI in patients with VL were male gender, advanced age, jaundice and amphotericin B. The last one was the most important factor of AKI in VL.IntroduÃÃo. Hà poucos dados na literatura que relacionam a Leishmaniose visceral (LV) à lesÃo renal aguda (LRA). O objetivo deste estudo à avaliar as manifestaÃÃes clÃnicas e fatores de risco associados à LRA em pacientes com LV e aplicar o critÃrio RIFLE. MÃtodo. Estudo retrospectivo, incluindo pacientes acima de 14 anos, sem doenÃa renal prÃvia, com diagnÃstico de LV, internados no HSJ entre 2002 e 2008. Foram avaliadas manifestaÃÃes clÃnicas e os fatores de risco relacionados à LRA (avaliada atravÃs do critÃrio RIFLE) nesses pacientes, aplicando regressÃo logÃstica multivariada. Resultados. Foram incluÃdos 224 pacientes com idade mÃdia de 36Â15 anos sendo 76,8% do gÃnero masculino. LRA foi observada em 76 pacientes (33,9%) sendo que 52,6% (40) estavam na classe F do critÃrio RIFLE. Dispneia, edema e icterÃcia foram os principais sinais e sintomas associados à LRA (p<0,05). OligÃria foi observada em 6,5% dos pacientes com LRA. Os fatores de risco associados à LRA foram gÃnero masculino (OR=2,2, 95% IC=1,0-4,7, p=0,03), idade acima de 40 anos (OR = 1,05, 95% IC = 1,02-1,08, p<0,001) e icterÃcia (OR=2,9, 95% IC=1,5-5,8, p=0,002). Foi verificada considerÃvel associaÃÃo entre o emprego de anfotericina B e LRA (OR=18,4, 95% IC=7,9-42,8, p<0,0001), contudo o uso de glucantime foi associado a menor ocorrÃncia de LRA (OR=0,05, 95% IC=0,02-0,12, p<0,0001). A mortalidade geral foi 13,3% e foi mais alta nos pacientes que desenvolveram LRA (30,2% vs. 4,7%, p<0,0001). Os percentuais de mortalidade nas classes R, I e F foram respectivamente 40%, 20,8% e 35%. ConclusÃes. Os fatores de risco preditores de LRA em pacientes com LV foram sexo masculino, anfotericina B, idade acima de 40 anos e icterÃcia. Anfotericina B foi o fator mais importante de LRA na LV.http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4987application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:18:12Zmail@mail.com -
dc.title.en.fl_str_mv Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
dc.title.alternative.pt.fl_str_mv ManifestaÃÃes clÃnicas e fatores de risco relacionados à lesÃo renal aguda na Leishmaniose visceral e aplicaÃÃo do critÃrio Rifle
title Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
spellingShingle Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
Michelle Jacintha Cavalcante Oliveira
Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
CiÃncias da SaÃde
title_short Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
title_full Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
title_fullStr Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
title_full_unstemmed Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
title_sort Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
author Michelle Jacintha Cavalcante Oliveira
author_facet Michelle Jacintha Cavalcante Oliveira
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 Geanne Matos de Andrade
dc.contributor.referee1ID.fl_str_mv 21911258320
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/9935129797137635
dc.contributor.referee2.fl_str_mv Roberto da Justa Pires Neto
dc.contributor.referee2ID.fl_str_mv 44778309391
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/1887685326618139
dc.contributor.authorID.fl_str_mv 02536698475
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/7500052524020068
dc.contributor.author.fl_str_mv Michelle Jacintha Cavalcante Oliveira
contributor_str_mv Elizabeth de Francesco Daher
Geanne Matos de Andrade
Roberto da Justa Pires Neto
dc.subject.eng.fl_str_mv Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
topic Visceral leishmaniasis. Kala-azar. Acute kidney injury. Mortality. Risk factors. RIFLE
CiÃncias da SaÃde
dc.subject.cnpq.fl_str_mv CiÃncias da SaÃde
dc.description.abstract.por.fl_txt_mv Background. There are few studies of renal function evaluation in visceral leishmaniasis (Kala-azar). The aim of this study was to investigate the clinical manifest and the risk factors associated with acute kidney injury (AKI) based on RIFLE criteria in patients with visceral leishmaniasis (VL). Methods. A retrospective study of medical records from patients over 14 years old, without previous kidney disease, with VL, treated at SÃo Josà Infectious Diseases Hospital, from 2002 to 2008. Clinical manifestations and risk factors for AKI (defined by using RIFLE criteria) were studied. A multivariate analysis was performed to analyze the risk factors for AKI. Results. A total of 224 patients were included. The mean age was 36Â15 years and 76.8% were males. AKI was observed in 76 patients (33.9% of cases) and % 52.6 (40) were class F on RIFLE criteria. The main clinical symptoms were dyspnea, edema and jaundice in patients with VL and AKI (p<0.05). Oliguria was observed in 6.5% of patients with AKI. Risk factors associated with AKI were male gender (OR=2.2, 95% CI= 1.0-4.7, p=0.03), age > 40 years (OR = 1.05, 95% CI= 1.02-1.08, p < 0.001) and jaundice (OR=2.9, 95% CI= 1.5-5.8 p=0.002). There was an strong association between amphotericin B use and AKI (OR=18.4, 95% CI=7.9-42.8, p<0.0001), whereas glucantime use was associated with a lower incidence of AKI when compared to amphotericin B users (OR=0.05, 95% CI=0.02-0.12, p<0.0001). Mortality was 13.3% and it was higher in AKI patients (30.2% vs. 4.7%, p<0.0001). RIFLE criteria presented mortality 40%, 20.8% e 35% in R, I and F respective class. Conclusions. The risk factors associated with AKI in patients with VL were male gender, advanced age, jaundice and amphotericin B. The last one was the most important factor of AKI in VL.
IntroduÃÃo. Hà poucos dados na literatura que relacionam a Leishmaniose visceral (LV) à lesÃo renal aguda (LRA). O objetivo deste estudo à avaliar as manifestaÃÃes clÃnicas e fatores de risco associados à LRA em pacientes com LV e aplicar o critÃrio RIFLE. MÃtodo. Estudo retrospectivo, incluindo pacientes acima de 14 anos, sem doenÃa renal prÃvia, com diagnÃstico de LV, internados no HSJ entre 2002 e 2008. Foram avaliadas manifestaÃÃes clÃnicas e os fatores de risco relacionados à LRA (avaliada atravÃs do critÃrio RIFLE) nesses pacientes, aplicando regressÃo logÃstica multivariada. Resultados. Foram incluÃdos 224 pacientes com idade mÃdia de 36Â15 anos sendo 76,8% do gÃnero masculino. LRA foi observada em 76 pacientes (33,9%) sendo que 52,6% (40) estavam na classe F do critÃrio RIFLE. Dispneia, edema e icterÃcia foram os principais sinais e sintomas associados à LRA (p<0,05). OligÃria foi observada em 6,5% dos pacientes com LRA. Os fatores de risco associados à LRA foram gÃnero masculino (OR=2,2, 95% IC=1,0-4,7, p=0,03), idade acima de 40 anos (OR = 1,05, 95% IC = 1,02-1,08, p<0,001) e icterÃcia (OR=2,9, 95% IC=1,5-5,8, p=0,002). Foi verificada considerÃvel associaÃÃo entre o emprego de anfotericina B e LRA (OR=18,4, 95% IC=7,9-42,8, p<0,0001), contudo o uso de glucantime foi associado a menor ocorrÃncia de LRA (OR=0,05, 95% IC=0,02-0,12, p<0,0001). A mortalidade geral foi 13,3% e foi mais alta nos pacientes que desenvolveram LRA (30,2% vs. 4,7%, p<0,0001). Os percentuais de mortalidade nas classes R, I e F foram respectivamente 40%, 20,8% e 35%. ConclusÃes. Os fatores de risco preditores de LRA em pacientes com LV foram sexo masculino, anfotericina B, idade acima de 40 anos e icterÃcia. Anfotericina B foi o fator mais importante de LRA na LV.
description Background. There are few studies of renal function evaluation in visceral leishmaniasis (Kala-azar). The aim of this study was to investigate the clinical manifest and the risk factors associated with acute kidney injury (AKI) based on RIFLE criteria in patients with visceral leishmaniasis (VL). Methods. A retrospective study of medical records from patients over 14 years old, without previous kidney disease, with VL, treated at SÃo Josà Infectious Diseases Hospital, from 2002 to 2008. Clinical manifestations and risk factors for AKI (defined by using RIFLE criteria) were studied. A multivariate analysis was performed to analyze the risk factors for AKI. Results. A total of 224 patients were included. The mean age was 36Â15 years and 76.8% were males. AKI was observed in 76 patients (33.9% of cases) and % 52.6 (40) were class F on RIFLE criteria. The main clinical symptoms were dyspnea, edema and jaundice in patients with VL and AKI (p<0.05). Oliguria was observed in 6.5% of patients with AKI. Risk factors associated with AKI were male gender (OR=2.2, 95% CI= 1.0-4.7, p=0.03), age > 40 years (OR = 1.05, 95% CI= 1.02-1.08, p < 0.001) and jaundice (OR=2.9, 95% CI= 1.5-5.8 p=0.002). There was an strong association between amphotericin B use and AKI (OR=18.4, 95% CI=7.9-42.8, p<0.0001), whereas glucantime use was associated with a lower incidence of AKI when compared to amphotericin B users (OR=0.05, 95% CI=0.02-0.12, p<0.0001). Mortality was 13.3% and it was higher in AKI patients (30.2% vs. 4.7%, p<0.0001). RIFLE criteria presented mortality 40%, 20.8% e 35% in R, I and F respective class. Conclusions. The risk factors associated with AKI in patients with VL were male gender, advanced age, jaundice and amphotericin B. The last one was the most important factor of AKI in VL.
publishDate 2010
dc.date.issued.fl_str_mv 2010-05-10
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publisher.none.fl_str_mv Universidade Federal do CearÃ
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