肾脏病学与治疗学杂志

Cadmium is a toxic heavy metal in the contaminated environment which accumulates in different organs of the human and animal. Cd exposure leads to the production of reactive oxygen species present study was performed to evaluate the effect of cadmium on the biochemical criteria (ROS). The related to oxidative stress in kidney, liver and testis of adult male rats and to clarify the protective effect of pre and post treatment with lycopene on these criteria. The results showed that cadmium treatment caused significant elevations in liver and kidney weights, serum creatinine, urea, uric acid, aspartate aminotransferse (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamaglutamyltransferase (GGT), and lactate dehydrogenase (LDH) with significant reductions in weights of testes, epididymis, seminal vesicles and prostate, serum total protein and plasma testosterone. It also markedly increased lipid peroxidation and cadmium concentration in kidney, liver and testis tissues, while significantly decreased superoxide dismutase (SOD), catalase (CAT) activities and reduced glutathione in the tissues of the three organs. Cadmium intoxicated rats showed also considerable increase in the percentages of dead sperms and abnormal sperm rate, while marked decrease in sperm concentration and sperm motility as compared to the control group. Pre-supplementation with lycopene prevented degenerative changes induced by cadmium, reduced oxidative stress and restored the biochemical changes occurring in kidney, liver and testis tissues to near normal group (control). In addition pretreatment with lycopene was more effective than post- treatment in reversing almost all hepatorenal and testicular parameters.

Background: Among the recommendations for the prevention of high cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) enhanced surveillance, detection and awareness of this condition include; which are mainly targeting populations with increased risk. Yet despite a high prevalence of CKD in these patients, there is limited knowledge of the disease in populations at high cardiovascular risk, especially in developing countries. To determine the awareness of CKD in the population of moderate and high cardiovascular risk. Methods: A prevalence study, multicenter was developed; the sample corresponds to adults over 18 with moderate or high cardiovascular risk (defined as Framingham criteria), treated at the outpatient clinic for health institutions in the city of Cartagena from April 2013 to October 2014. Statistical analysis: descriptive univariate and bivariate analyzes were performed using measures of central tendency and dispersion for continuous variables and proportions for qualitative variables. The association between variables was established by The Chi square test and Fisher's exact test. Results: 653 patients were included, the prevalence of CKD was 34.8% and overall awareness of it was 70.9% and 48.2% by the health system and the patient respectively. There was no association between awareness of CKD both the health system and the patient and the level of cardiovascular risk (p=0.916 and p=0.772). In unconscious patients with CKD have a higher proportion of women compared with patients with CKD awareness (95% CI for the difference, 4.3 to 29.7 66.1% vs 49.1%) was found. There was a significant association between CKD awareness, adherence to lifestyle (p ≤ 0.0001) and medication adherence (p=0.041), was determined that unconscious patients had lower compliance healthy lifestyles (22,9% vs 64.5%; 95% CI for the difference, 29.9 to 53.3) and pharmacological (92.4% vs 98.2%; 95% CI for the difference, 2.7 to 11.3) than patients aware for the disease. Conclusions: This study demonstrates the high prevalence of CKD in patients with moderate and high cardiovascular risk, highlighting the inadequate consciousness we have of it in this population.

Hypocomplementemic urticarial vasculitis (HUV) is the rare immune complex vasculitis, affecting small vessels and associated with anti-C1q antibodies, presenting with urticaria and hypocomplementemia. Glomerulonephritis, arthritis, obstructive pulmonary disease, and ocular inflammation are common in HUV. HUV may present as an idiopathic disease or be a part of systemic autoimmune or autoinflammatory condition, like systemic lupus erythematosus, arthritis-hives-angioedema (AHA) syndrome, cryoglobulinemic vasculitis, Schnitzler syndrome, Cogan’s syndrome and Muckle–Wells syndrome. Renal involvement includes proteinuria, sometimes of nephrotic range, hematuria and usually moderately impaired kidney function. Various pathology variants were found in patients with HUV: mesagnial proliferative, membranoproliferative, focal proliferative, membranous, minimal change, crescentic and severe sclerosing proliferative glomerulonephritis. Interstitial nephritis and C1q-associated small vessel vasculopathy are poorly described. Here we present a case of HUV with combined renal damage - crescentic glomerulonephritis, interstitial nephritis and small vessel vasculopathy, successfully treated with immunosuppressant’s, and discuss the differential diagnostics of HUV.

???????? (DKA) ?????????????????????????????????????????????????????? DKA ?? 1% ????????? 40-90%??????????????????????????????????????????????????????????????????????????????????/???????????????? 26 ??????????????????????????????????????????????????????????????????????

????????????????????????????????????????? 2-3 ??????????????????????????????????????????????????????????????????????????????????????????????????????????????? 2 ??????????? 420 ????????????????????????????????????????????????????????????????????????????????????????????? 97 ? (23%) ???????????323 ? (77%) ????????????????????????????????????????????????????? 9 ??2.8%?? 5 ??5.2%?????????????????????????????????????????????????????????????????? ICU ??????????????????

??????????????????? (RN) ??????? (PN) ???????????????????? (eGFR) ?????????????????? 284 ???????? RN (n=195) ? PN (n=89) ????????? eGFR ?????????? (CKD) ??????????? CKD 3b ? (eGFR<45 mL/min/1.73 m2) ?????????????? (CV) ??????????? (OS) ????????? (CSS)????? eGFR ????? RN ? PN ?????????? eGFR ?? CKD 2 ???PN ????? CKD ≥ 3b ??? eGFR ?? CKD 3a ???? RN ?????????????????????????? eGFR ?????????? OS ? CSS ?????????????????? eGFR ?? CKD 2 ?????RN ? CKD ≥ 3b ?????????????????????????????? eGFR ?? CKD 1 ???PN ? RN ?????????? eGFR ?? CKD 2 ???PN ????????? eGFR ?? CKD 3a ???RN ?????????????? eGFR ?????? RN ? PN ??????

Objective: To compare the overall survival (OS) between radical nephrectomy (RN) and nephron-sparing surgery (NSS) by preoperative estimated glomerular filtration rate (eGFR) and tumor size. Methods: Patients with cT1 renal tumors (N0M0) treated by RN or NSS between 1994 and 2014 were included. OS was compared by the surgical technique using Kaplan- Meier curves for the whole population. Then, subgroup analyses for OS were performed by the presence (< 60 ml/min/1.73 m2) or absence (≥ 60 ml/min/1.73 m2) of preoperative chronic kidney disease (CKD) and by cT1a and cT1b disease status. Multivariate analysis was also performed. Results: 440 patients were included. There was no significant difference in OS by the surgical technique, including in patients with CKD. However, the group without CKD had a significantly better OS than the group with CKD. Moreover, compared with RN, the use of NSS was associated with a significantly better OS for patients without CKD, including those with cT1a tumors. There were no significant differences when OS was compared by the surgical technique in patients with CKD or cT1b tumors. Multivariate analysis showed that preoperative eGFR and tumor size were independent risk factors in the total population and the group without CKD, respectively. Conclusion: We have shown that NSS can be beneficial for patients with preoperative non-CKD and stage cT1a tumors. RN and NSS produce comparable OS in patients with unfavorable preoperative renal function or tumor size. Further investigation is needed with larger populations.