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Publication
Estudo comparativo das taxas de filtração glomerular obtidas através da cistatina C e creatinina no acompanhamento da função renal em pacientes com bexiga neurogénica por infecção pelo HTLV-I
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| DM_37707 | 1.95 MB | Adobe PDF |
Advisor(s)
Abstract(s)
A avaliação da função renal é imprescindível na prática clínica para a garantia da
homeostase. A busca de marcadores sensíveis aos primeiros indícios de lesão renal é um
importante desafio da medicina laboratorial, especialmente em grupos mais suscetíveis,
tais como diabéticos, portadores de doenças cardiovasculares e doenças neurológicas,
dentre elas, a mielopatia por HTLV-I. Na mielopatia associada ao HTLV/paraparesia
espástica tropical (HTLV-associated myelopathy/tropical spastic paraparesis –
HAM/TSP) observa-se disfunção vesical com origem no comprometimento da medula
toracolombar resultando, na maioria das vezes, em bexiga neurogénica. Diante deste
contexto, é recomendado avaliar periodicamente a função renal do portador sintomático
de HTLV-I com bexiga neurogénica a fim de melhorar o manejo urológico e preservar a
função renal.
Este trabalho objetivou comparar os resultados de cistatina C e da creatinina sérica,
através da avaliação de dados retrospectivos em prontuário eletrónico, de pacientes
adultos portadores de HAM/TSP com diagnóstico de bexiga neurogénica atendidos no
Hospital SARAH Salvador (Bahia, Brasil) no período de 2002 a 2018. Este estudo
realizou análise comparativa das taxas de filtração glomerular (TFG) obtidas através da
cistatina-C e creatinina usando as fórmulas CKD-EPI recomendadas pelo guideline de
doenças renais crónicas da KDIGO. Conclui-se que os resultados de TFG não
demonstraram concordância entre si e ressalta-se que os resultados obtidos pela cistatina
apresentam resultados inferiores de TFG antecipando as condutas clínicas de manejo do
paciente.
The evaluation of renal function is essential in clinical practice to guarantee homeosta sis. The search for markers sensitive to the first signs of kidney injury is an important challenge for laboratory medicine, especially in more susceptible groups, such as dia betics, patients with cardiovascular diseases and neurological diseases, among them, HTLV-I myelopathy. In myelopathy associated with HTLV/tropical spastic paraparesis (HTLV-associated myelopathy/tropical spastic paraparesis - HAM/TSP) bladder dys function is observed, originating in the involvement of the thoraco-lumbar spinal cord, resulting, in most cases, in neurogenic bladder. Given this context, it is recommended to periodically assess the renal function of the symptomatic HTLV-I carrier with neuro genic bladder in order to improve urological management and preserve renal function. This study aimed to compare the results of cystatin C and serum creatinine, through the evaluation of retrospective data in electronic medical records, of adult patients with HAM/TSP diagnosed with neurogenic bladder treated at Hospital SARAH Salvador (Bahia, Brazil) in the period of 2002 to 2018. This study performed a comparative analysis of glomerular filtration rates (GFR) obtained through cystatin-C and creatinine using the CKD-EPI formulas recommended by the KDIGO chronic kidney disease guideline. It is concluded that the GFR results did not show agreement with each other and it is noteworthy that the results obtained by cystatin show lower GFR results in anticipation of the clinical management of the patient.
The evaluation of renal function is essential in clinical practice to guarantee homeosta sis. The search for markers sensitive to the first signs of kidney injury is an important challenge for laboratory medicine, especially in more susceptible groups, such as dia betics, patients with cardiovascular diseases and neurological diseases, among them, HTLV-I myelopathy. In myelopathy associated with HTLV/tropical spastic paraparesis (HTLV-associated myelopathy/tropical spastic paraparesis - HAM/TSP) bladder dys function is observed, originating in the involvement of the thoraco-lumbar spinal cord, resulting, in most cases, in neurogenic bladder. Given this context, it is recommended to periodically assess the renal function of the symptomatic HTLV-I carrier with neuro genic bladder in order to improve urological management and preserve renal function. This study aimed to compare the results of cystatin C and serum creatinine, through the evaluation of retrospective data in electronic medical records, of adult patients with HAM/TSP diagnosed with neurogenic bladder treated at Hospital SARAH Salvador (Bahia, Brazil) in the period of 2002 to 2018. This study performed a comparative analysis of glomerular filtration rates (GFR) obtained through cystatin-C and creatinine using the CKD-EPI formulas recommended by the KDIGO chronic kidney disease guideline. It is concluded that the GFR results did not show agreement with each other and it is noteworthy that the results obtained by cystatin show lower GFR results in anticipation of the clinical management of the patient.