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Recomendaciones de la Sociedad Latinoamericana de Nefrología e Hipertensión para la atención ambulatoria nefrológica y en el primer nivel de atención durante la pandemia de COVID-19 拉丁美洲肾脏和高血压学会对COVID-19大流行期间肾脏门诊护理和一级护理的建议
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000028
A. Alles, Alfonso M. Cueto-Manzano, Pablo G. Ríos-Sarro, Adriana Robayo, Vicente Sánchez-Polo, R. Silvariño, Laura Solá, A. Vallejos, C. Zúñiga
The current emergency situation due to COVID-19 has originated a redistribution of human and material resources for prevention and management of patients with SARS-CoV-19 infection, with the subsequent decrease in preventive and treatment actions for patients with chronic kidney disease (CKD) (particularly late stage), and/or other chronic all specialist and by the primary the new situation with the pandemic by COVID-19 is highly probable that frequent modification and update of the present recommendations emerge, which in turn be subsequently to the Nephrological community. Meanwhile, the expressed in this document would be of great provide the best possible CKD treatment in
当前的COVID-19紧急情况引发了人力和物力资源的重新分配,以预防和管理SARS-CoV-19感染患者,随后减少了对慢性肾脏疾病(CKD)患者(特别是晚期)的预防和治疗行动。和/或其他慢性专家,首先是COVID-19大流行的新情况,很可能出现频繁修改和更新现有建议的情况,这反过来又会影响肾病学社区。同时,本文所表达的内容将极大地为CKD的最佳治疗提供可能的参考
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引用次数: 0
Hipertensión renovascular: actualización
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000031
R. Silvariño, José Boggia, Sofía San-Román, C. Baccino, Alejandro Crisci, Marcelo Langleib, Óscar Noboa
Renovascular hypertension (RVHT) is a frequent and potentially correctable cause of secondary arterial hypertension (HT). Its incidence varies depending on the clinical setting. Renal artery stenosis (RAS) is found in 1% of patients with mild HT and in up to 10-45% in patients with severe HT or with accelerated evolution. The most frequent causes of RAS are atherosclerotic vascular disease and fibromuscular dysplasia (FMD), which are found in a ratio 9:1 in favor of the atherosclerotic disease. RVHT usually occurs in a context of high cardiovascular comorbidity, coexisting with coronary heart disease (10-14%), peripheral arterial disease (15-25%), cerebrovascular (10%), aortic (25-35%) and advanced chronic kidney disease (CKD) (35%), among others. Diagnostic and therapeutic difficulties arise in different clinical scenarios. Some of the questions un-derlying the approach of these patients are: should I look for RAS in a specific patient? What is the most appropriate form of study? Should I carry out medical and / or interventional treatment in a specific patient? We review these questions from a clinical approach and based on the “state of the art”. Given the preponderant role of atherosclerotic disease due to its frequency, the emphasis will be placed on it. Much more than other pathologies, the RVHT approach must be in a team, integrating the different disciplines in decision-making.
肾血管性高血压(RVHT)是继发性动脉高血压(HT)的常见和潜在的纠正原因。其发病率因临床环境而异。肾动脉狭窄(RAS)在1%的轻度HT患者中发现,在严重HT或加速发展的患者中高达10-45%。RAS最常见的原因是动脉粥样硬化性血管疾病和纤维肌肉发育不良(FMD),两者的比例为9:1,有利于动脉粥样硬化性疾病。RVHT通常发生在高心血管合并症的背景下,并伴有冠心病(10-14%)、外周动脉疾病(15-25%)、脑血管疾病(10%)、主动脉疾病(25-35%)和晚期慢性肾脏疾病(CKD)(35%)等。诊断和治疗的困难出现在不同的临床情况。这些患者的治疗方法背后的一些问题是:我应该在特定患者中寻找RAS吗?什么是最合适的学习形式?我是否应该对特定患者进行医疗和/或介入治疗?我们回顾这些问题,从临床方法和基于“艺术的状态”。鉴于动脉粥样硬化性疾病因其频率而具有优势作用,因此将重点放在其上。与其他病理相比,RVHT方法必须在一个团队中进行,在决策过程中整合不同的学科。
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引用次数: 0
Epidemiology of kidney failure with replacement therapy in Puerto Rico: Report from 2001 to 2017 波多黎各肾衰替代治疗流行病学:2001年至2017年报告
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000019
Johanna K. Corchado-Feliciano, A. Díaz, B. Zayas, Samuel A. Collazo-Meléndez, Jesús D. Vega-Colon, A. Ortiz, Tatiana Correa, Carlos G Rivera-Bermúdez, Ileana E. Ocasio-Meléndez, J. Cangiano
Kidney failure (KF) with replacement therapy (RT) is a major health threat to Latin American population. Studies comparing the Latin American population in different countries have ascertained the growing concern of increased incidence and prevalence. Some factors that contribute to this condition are diabetes, hypertension, and poverty. Objective: The purpose of this study was to report the epidemiology for KF with RT in Puerto Rican population from 2001 to 2017. Materials and methods: Data were provided by the Renal Council of Puerto Rico from 2001 to 2017. Population involved adult male and women residents of Puerto Rico registered as dialysis patients. Methods for reporting data incorporated formulas for calculating incidence, prevalence, and mortality rate per year. Results: The incidence rate demonstrated an increase from 306 per million population (pmp) in 2001 to 419 pmp in 2016. Prevalence rate reported as 892 pmp at the start of the study and 1598 pmp at the end. The mortality rate was reported as 255 pmp in 2001 and progressively increased to 345 pmp in 2017. Conclusions: This study demonstrates the increasing trend of the incidence and prevalence among cases of KF in Puerto Rico. Reporting the above statistical data will help provide an understanding of which health programs and strategies are needed to prevent this condition.
肾衰竭(KF)与替代治疗(RT)是拉丁美洲人口的主要健康威胁。对不同国家的拉丁美洲人口进行比较的研究已经确定了对发病率和流行率增加的日益关注。导致这种情况的一些因素是糖尿病、高血压和贫穷。目的:本研究的目的是报告2001 - 2017年波多黎各人群中KF合并RT的流行病学。材料和方法:数据由波多黎各肾脏委员会2001年至2017年提供。人口涉及登记为透析患者的波多黎各成年男性和女性居民。报告数据的方法包括计算每年发病率、患病率和死亡率的公式。结果:发病率从2001年的306 /百万人口(pmp)上升到2016年的419 /百万人口(pmp)。研究开始时的患病率为892 pmp,研究结束时为1598 pmp。据报告,2001年死亡率为255例,2017年逐步增加到345例。结论:本研究表明波多黎各KF病例的发病率和患病率呈上升趋势。报告上述统计数据将有助于了解需要哪些健康计划和策略来预防这种情况。
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引用次数: 0
Nefritis tubulointersticial aguda asociada a consumo de Anisakis en paciente alérgica 过敏患者急性小管间质肾炎与茴香草摄入相关
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000003
Alejandro Tomás-Latorre, Jose Maria Peña-Porta, Manuel Moros-García, Carlo Bruno-Marta, M. P. Martin-Azara, Hilda M. Villafuerte-Ledesma, Ana Coscojuela-Otto, Almudena Castellano-Calvo, Rafael Álvarez-Lipe
We present the case of a 70-year-old patient with a unique interesting medical history of Anaphylaxis of Anisakis, who presents an acute renal failure with a biopsy compatible with tubulointerstitial nephritis of allergic etiology after fish intake. Despite the fact that no previous case of hypersensitivity nephritis to Anisakis has been published, the clinic, evolution and biopsy were compatible with this suspicion, without being able to find another possible etiology of acute renal failure.
我们报告了一位70岁的患者,他有独特有趣的异尖基过敏史,他在吃鱼后表现出急性肾衰竭,活检符合过敏性病因的小管间质肾炎。尽管以前没有发表过异尖线虫过敏肾炎的病例,但临床、进化和活检都符合这种怀疑,没有发现急性肾衰竭的另一种可能的病因。
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引用次数: 0
Asistencia y educación en nefrología en épocas de COVID-19: transformando amenazas en oportunidades COVID-19时期的肾病护理和教育:将威胁转化为机遇
Pub Date : 2020-12-22 DOI: 10.24875/nefro.m20000008
R. Silvariño, José Boggia
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引用次数: 0
Consenso iberoamericano para uniformar la nomenclatura de la función y las enfermedades renales 伊比利亚-美洲关于肾脏功能和疾病统一命名的共识
Pub Date : 2020-12-22 DOI: 10.24875/nefro.m20000009
Alejandro Ferreiro-Fuentes, Mª Carlota González-Bedat, Raúl Lombardi, Jocemir Ronaldo Lugon, Gianna Mastroianni, Filipe Mira, Guillermo Rosa-Diez, J. E. Sánchez, José Suassuna
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引用次数: 8
Vitamina D en enfermedades respiratorias: desde la influenza hasta el COVID-19 呼吸系统疾病中的维生素D:从流感到COVID-19
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000033
Alonso Cortina-Gutiérrez, Víctor Leal-Martínez, Emilio Abuabara-Franco, Nehomar Pájaro-Galvis, Maria Raad-Sarabia, Jorge-Eduardo Rico-Fontalvo, Rodrigo Daza-Arnedo, Iván de Jesús-Baños
Active vitamin D (1,25-dihydroxycholecalciferol) is a steroid hormone that has multiple functions, including: calcium-phospho-rus metabolism and bone mineralization; but, it also has a fundamental role in the functioning of the immune system, being an essential tool in the response against bacterial infections (including mycobacteria), fungi and viruses. A strong association between hypovitaminosis D and the development of respiratory tract infections such as pneumonia, tuberculosis, influenza virus infection, up to the current pandemic COVID-19 has been demonstrated. Hence the importance of identifying patients with vitamin D deficiency early, in order to correct their levels and prevent infectious processes that increase morbidity and mortality.
活性维生素D(1,25-二羟基胆钙化醇)是一种具有多种功能的类固醇激素,包括:钙磷代谢和骨矿化;但是,它在免疫系统的功能中也起着重要作用,是对抗细菌感染(包括分枝杆菌)、真菌和病毒的重要工具。已证实维生素D缺乏症与肺炎、结核病、流感病毒感染等呼吸道感染的发展之间存在密切关联,直至目前的COVID-19大流行。因此,及早发现维生素D缺乏症患者非常重要,以便纠正其水平并预防增加发病率和死亡率的感染过程。
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引用次数: 0
Vasculitis crioglobulinémica con compromiso renal en pacientes con crioglobulinemia mixta esencial sin relación con infección por virus de la hepatitis C. Descripción de una serie de casos y revisión de la bibliografía 与丙型肝炎病毒感染无关的原发性混合低温球蛋白血症患者的低温球蛋白血症伴肾损害的低温球蛋白血管炎系列病例描述和文献综述
Pub Date : 2020-12-22 DOI: 10.24875/nefro.20000016
R. Silvariño, G. Otatti, P. Iglesias, José Boggia, Sofía San-Román, Óscar Noboa
Cryoglobulinemic vasculitis is a small vessel vasculitis associated with the presence of cryoglobulins. It compromises skin, joints, peripheral nervous system and kidneys. In the kidney the predominant compromise is glomerular, with histopathological manifestations characterized by a membranoproliferative pattern associated with immune complex deposition. The objective of this paper is to describe the clinical presentation, histopathological characteristics, treatment response and prognosis of a series of patients with renal cryoglobulinemic vasculitis associated with mixed cryoglobulinemia, confirmed involvement (nephritic syndrome, rapidly progressive renal failure). The most frequent histopathological pattern was membranoproliferative glomerulonephritis with immune complex deposition. In 2 cases underlying disease (autoimmune, infectious) was found. All received initial treatment based on glucocorticoids, in two therapeutic plasma replacement was performed and in three cyclophosphamide it was administered. As maintenance, the whole received corticosteroids associated with mofetil mycophenolate or rituximab. One patient died shortly after diagnosis. A 24.2-month follow-up was complet-ed, at the end of it, 3 presented partial response and 2 complete response.
冷球蛋白血症性血管炎是一种与冷球蛋白存在相关的小血管血管炎。它会损害皮肤、关节、周围神经系统和肾脏。肾脏的主要病变是肾小球,其组织病理表现为与免疫复合物沉积相关的膜增生性。本文的目的是描述一系列肾冷球蛋白血症性血管炎合并混合冷球蛋白血症,确认受累(肾病综合征,快速进展性肾功能衰竭)患者的临床表现,组织病理学特征,治疗反应和预后。最常见的组织病理学模式是膜增生性肾小球肾炎伴免疫复合物沉积。2例发现基础疾病(自身免疫性、感染性)。所有患者均接受基于糖皮质激素的初始治疗,其中2例进行治疗性血浆置换,3例给予环磷酰胺。作为维持,所有患者接受与霉酚酸酯或利妥昔单抗相关的皮质类固醇治疗。一名患者在确诊后不久死亡。随访24.2个月,结束时部分缓解3例,完全缓解2例。
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引用次数: 0
Estado de los programas de trasplante renal en América Central y el Caribe 中美洲和加勒比地区肾脏移植项目的现状
Pub Date : 2020-12-18 DOI: 10.24875/nefro.18000039
C. Cuero, M. Cerdas, José Juan Castillos, Antonio Enamorado, C. Henríquez, A. Hernández, Guillermo Alvarez, Francisco González, Luis Morales
César Cuero1,2*, Manuel Cerdas1,3, José J. Castillos1,4, Antonio Enamorado1,5, Carlos Henríquez1,6, Agualuz Hernández1,7, Guillermo Álvarez1,8, Francisco González1,9 y Luis Morales1,10 1Grupo Coordinador de trasplante Renal de América Central y el Caribe, Asociación Centroamericana y del Caribe de Nefrología (ACECAN); 2Organización Panameña de Trasplantes, Panamá; 3Hospital México, Caja Costarricense de Seguridad Social, Costa Rica; 4Hospital General de La Plaza de la Salud, República Dominicana; 5Coordinación Nacional de Trasplantes, Cuba; 6Hospital Benjamín Bloom, El Salvador; 7Hospital General de Enfermedades, Instituto Guatemalteco de Seguridad Social, Guatemala; 8Centro de Diagnóstico Medicina Avanzada y Telemedicina (CEDIMAT), República Dominicana; 9Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; 10Instituto Nacional de Ciencias Médicas y Nutrición Manuel Zubirán, Ciudad de México, México ARTÍCULO ORIGINAL
cesar Cuero1,2*, Manuel Cerdas1,3, jose J. Castillos1,4, Antonio Enamorado1,5, Carlos henriquez1,6, Agualuz hernandez 1,7, Guillermo alvarez 1,8, Francisco gonzales 1,9和Luis Morales1,10 1中美洲和加勒比肾脏移植协调小组,中美洲和加勒比肾脏协会(ACECAN);2巴拿马移植组织,巴拿马;3墨西哥医院,哥斯达黎加社会保障基金;4多米尼加共和国健康广场综合医院;5国家移植协调,古巴;萨尔瓦多本杰明·布鲁姆医院;7危地马拉社会保障研究所疾病综合医院,危地马拉;8多米尼加共和国高级医学和远程医疗诊断中心;9乌拉圭蒙得维的亚共和国大学医学院;10国家医学科学和营养研究所Manuel zubiran,墨西哥城,墨西哥
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引用次数: 0
Tuberculosis de la pared torácica en hemodiálisis: a propósito de un caso 血液透析中的胸壁结核:关于一个病例
Pub Date : 2020-12-18 DOI: 10.24875/nefro.20000026
Manon Lecueder, Andrés Urrestarazú, Patricia Domínguez, Martí López, A. Álvarez
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引用次数: 0
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Nefrología Latinoamericana
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