Examinando por Autor "Terrasa, Sergio"
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Ítem Acute kidney injury in rural workers: An environmental-stress nephropathy(Asociación Colombiana de Nefrología e Hipertensión Arterial, 2023) Musso, Carlos G.; Aroca-Martínez, Gustavo; Avendaño-Echavez, Lil; Cadena-Bonfanti, Andrés; Castillo, Luis; González-Torres, Henry; Conde, Juan C.; Navarro-Quiroz, Elkin; Peña-Vargas, William; Hernandez, Sandra; Velez-Verbel, María de los Ángeles; Perez, Rafael; Sierra, Angélica; Rua, Zenen; Palmera, Jorge; Terrasa, SergioIntroduction: Mesoamerican nephropathy is a tubule-interstitial nephropathy whose etiology is still unknown. However, clinical cases like Mesoamerican nephropathy have been described in other geographically distant and ethnically diverse regions. Still, they all have a common factor: the intensity of heat and rural physical labor. Objective: To study whether this entity could occur among rural workers in a non-Mesoamerican region with similar climatic and working conditions, in the Colombian Caribbean countryside, and to consider how much repetitive dehydration could weigh in its pathogenesis. Methodology: An observational study was carried out, based on field work in a farm in Sitio Nuevo (Colombia) with 28 rural worker volunteers (rice fields), who were measured for weight, blood pressure, and blood and urine samples to measure electrolytes and osmolarity, at 2 times of the day (morning and evening). Results: Of the 28 young men workers evaluated, 5 (18 %) presented a significant increase in serum creatinine during the day (0.8±0.15 vs 1.2±0.17, p<0.001). The volume of water ingested by the workers was highly variable (2,861 ± 1,591 cc). There was a significant increase in serum sodium (p<0.001), and urinary osmolarity (p=0.01) values between morning and afternoon values in these 5 patients. Conclusions: Eighteen percent (18 %) of the workers evaluated developed parameters compatible with acute kidney injury and dehydration during the workday in the Colombian Caribbean countryside.Ítem Osmotic diuresis in chronic kidney disease: its significance and clinical utility(Springer, 2019-06) Musso, Carlos G.; Juarez, Rossina; Terrasa, Sergio; Gonzalez‑Torres, Henry; Aroca‑Martinez, GustavoIntroduction The kidneys contribute to maintain plasma osmolality in normal range by achieving the adequate daily osmolar urine excretion (DOUE). An equation has been described for estimating the expected daily urine volume necessary to excrete the osmolar load required to keep serum osmolality in normal range. According to this equation, a difference between real and expected daily osmolar diuresis (DOD) can be obtained, being normally this difference value zero (± 500 cc). However, a positive DOD difference signifies a reduced urine concentration capability, while a negative DOD difference signifies a reduced urine dilution capability. Therefore, we decided to originally investigate how DOUE, and DOD difference are modified through the different stages of CKD. Materials and methods 61 patients suffering from CKD (stages I–V) secondary to glomerulopathies were studied. Creatinine clearance (CrCl), DOUE, and difference between real and expected DOD were obtained from each patient. Besides, correlation (Spearman) between CrCl and DOUE, and between CrCl and real–expected DOD difference were also obtained. Results Spearman correlation between CrCl and DOUE was positive and significant (Spearman’s ρ = 0.63, p < 0.0001). In addition, CKD patients who were not able to achieve the minimal DOUE required (600 mOsm/day) were mostly those with CrCl < 40 mL/min. Spearman correlation between CrCl and real–expected DOD difference was negative and significant (Spearman’s ρ = − 0.4, p < 0.0013). Additionally, abnormal DOD difference (> 500 cc) was found in CKD patients with CrCl < 80 mL/min/1.73 m2. Conclusion Daily osmolar urine excretion, and difference between real and expected daily osmolar diuresis are simple and significant clinical parameter which can be useful to easily evaluate urine concentration–dilution capability (tubular function) in CKD patients.