Caracterización clínica y epidemiológica de pacientes diagnosticados con nefropatía por IgA en una clínica de la ciudad de Barranquilla durante el periodo 2008 – 2014
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Fecha
2015
Autores
Llinas Rincón, Jhonny Rafael
Theran Marimon, Yekaterina
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: La nefropatía IgA (NIgA) está reconocida como la causa más común
de enfermedad glomerular, con un curso evolutivo variable: desde cuadros de
microhematuria y proteinuria aislada, hasta el fracaso renal agudo (FRA) o la
insuficiencia renal, rápidamente progresiva. Su comienzo como FRA es
relativamente frecuente en el contexto de necrosis tubular aguda (NTA).
Objetivos: Describir las características sociodemográficas, epidemiológicas y
clínicas de la población con nefropatía por IgA en la región caribe colombiana en el
periodo entre 2008 – 2014.
Materiales y Métodos: Para este estudio, se tomaron las historias clínicas y las
biopsias de patología de 132 pacientes con diagnóstico de nefropatía por IgA y
datos de la red de Nefrólogos del Caribe (NEFRORED), considerando como criterio
de inclusión a los pacientes que contaban con diagnóstico histopatológico, y
diagnóstico clínico y como criterio de exclusión, a los que no contaban con estos
requisitos. Para la muestra de estudio se seleccionaron 29 pacientes, los cuales se
les caracterizó clínica y epidemiológicamente con base en su patología, clasificando
estas variables y distribuyéndolas por, edad y sexo, por cuadro clínico, y por la
evolución de su enfermedad.
Resultados: Los pacientes se distribuyeron por edad así: un número de 6 pacientes
que constituye el 20.6% pertenecientes al grupo etario igual o menor de 20 años;
un número de 9 pacientes que constituye el 31.0% pertenecientes al grupo entre 21
a 29 años de edad; un número de 7 pacientes que constituye el 24.1%,
pertenecientes al grupo entre 30 y 39 años; un número de dos pacientes que
constituye un 6.8% pertenecientes al grupo entre 40 y 49; un número de 4 pacientes
que constituye el 13.7% pertenecientes al grupo de 50 a 59, y finalmente, un solo
paciente que constituye el 3.4% perteneciente al grupo entre 60 y 69 años de edad.
7 pacientes cursaron con síndrome nefrítico como presentación clínica de la
enfermedad, es decir el 24%, y 22 pacientes no presentaron síndrome nefrítico, sino
manifestaciones clinicas aisladas, para un 76%, de un total de 29 pacientes; de los
7 pacientes que presentaron síndrome nefrítico, 4 mostraron microhematuria y tres
macrohematuria.
Conclusiones: El estudio presentado ofrece información relevante sobre una
patología que es muy común en nuestro medio, y que tiene en cuenta a la
población de todas las edades, abarcando asi, la presentación de la enfermedad
desde diferentes escenarios, y pudiendo asi corroborar datos teóricos mediante la
practica investigativa.
En el estudio se pudo corroborar dato teóricos como la edad de presentación mas
frecuente, que es entre los 20 y 30 años, el predominio del sexo masculino , la
presencia de manifestaciones clinicas como síndrome nefrítico, macrohematuria y
microhematuria, proteinuria, y por ultimo como fue la evolución de la enfermedad,
evidenciando la evolución satisfactoria en la mayoría de los pacientes, y en
algunos la presencia de enfermedad renal crónica.
Background: IgA nephropathy (IgA) is recognized as the most common cause of glomerular disease, with a variable evolutionary course: from microhematuria and isolated proteinuria to acute renal failure (ARF) or rapidly progressive renal failure. Its onset as ARF is relatively frequent in the context of acute tubular necrosis (ATN). Objective: Describe the sociodemographic, epidemiological and clinical characteristics of the population with IgA nephropathy in the Colombian Caribbean region in the period between 2008 - 2014. Materials and Methods: For this study, the clinical histories and pathology biopsies of 132 patients with a diagnosis of IgA nephropathy and data from the Caribbean Nephrologists Network (NEFRORED) were taken, considering as inclusion criteria the patients with a histopathological diagnosis, and clinical diagnosis and as exclusion criteria, those who did not have these requirements. For the study sample, 29 patients were selected, who were characterized clinically and epidemiologically based on their pathology, classifying these variables and distributing them by age and sex, by clinical picture, and by the evolution of their disease. Results: The patients were distributed by age as follows: a number of 6 patients that constitutes 20.6% belonging to the age group equal to or less than 20 years; a number of 9 patients that constitutes 31.0% belonging to the group between 21 and 29 years of age; a number of 7 patients that constitutes 24.1%, belonging to the group between 30 and 39 years old; a number of two patients that constitutes 6.8% belonging to the group between 40 and 49; a number of 4 patients that constitutes 13.7% belonging to the group between 50 and 59, and finally, a single patient that constitutes 3.4% belonging to the group between 60 and 69 years of age. 7 patients presented with nephritic syndrome as the clinical presentation of the disease, that is, 24%, and 22 patients did not present nephritic syndrome, but isolated clinical manifestations, for 76% of a total of 29 patients; Of the 7 patients who presented nephritic syndrome, 4 showed microhematuria and three macrohematuria. Conclusions: The study presented offers relevant information on a pathology that is very common in our environment, and that takes into account the population of all ages, thus covering the presentation of the disease from different scenarios, and thus being able to corroborate theoretical data through the investigative practice. In the study it was possible to corroborate theoretical data such as the most frequent age of presentation, which is between 20 and 30 years, the predominance of the male sex, the presence of clinical manifestations such as nephritic syndrome, macrohematuria and microhematuria, proteinuria, and finally as was the evolution of the disease, evidencing the satisfactory evolution in most of the patients, and in some the presence of chronic kidney disease
Background: IgA nephropathy (IgA) is recognized as the most common cause of glomerular disease, with a variable evolutionary course: from microhematuria and isolated proteinuria to acute renal failure (ARF) or rapidly progressive renal failure. Its onset as ARF is relatively frequent in the context of acute tubular necrosis (ATN). Objective: Describe the sociodemographic, epidemiological and clinical characteristics of the population with IgA nephropathy in the Colombian Caribbean region in the period between 2008 - 2014. Materials and Methods: For this study, the clinical histories and pathology biopsies of 132 patients with a diagnosis of IgA nephropathy and data from the Caribbean Nephrologists Network (NEFRORED) were taken, considering as inclusion criteria the patients with a histopathological diagnosis, and clinical diagnosis and as exclusion criteria, those who did not have these requirements. For the study sample, 29 patients were selected, who were characterized clinically and epidemiologically based on their pathology, classifying these variables and distributing them by age and sex, by clinical picture, and by the evolution of their disease. Results: The patients were distributed by age as follows: a number of 6 patients that constitutes 20.6% belonging to the age group equal to or less than 20 years; a number of 9 patients that constitutes 31.0% belonging to the group between 21 and 29 years of age; a number of 7 patients that constitutes 24.1%, belonging to the group between 30 and 39 years old; a number of two patients that constitutes 6.8% belonging to the group between 40 and 49; a number of 4 patients that constitutes 13.7% belonging to the group between 50 and 59, and finally, a single patient that constitutes 3.4% belonging to the group between 60 and 69 years of age. 7 patients presented with nephritic syndrome as the clinical presentation of the disease, that is, 24%, and 22 patients did not present nephritic syndrome, but isolated clinical manifestations, for 76% of a total of 29 patients; Of the 7 patients who presented nephritic syndrome, 4 showed microhematuria and three macrohematuria. Conclusions: The study presented offers relevant information on a pathology that is very common in our environment, and that takes into account the population of all ages, thus covering the presentation of the disease from different scenarios, and thus being able to corroborate theoretical data through the investigative practice. In the study it was possible to corroborate theoretical data such as the most frequent age of presentation, which is between 20 and 30 years, the predominance of the male sex, the presence of clinical manifestations such as nephritic syndrome, macrohematuria and microhematuria, proteinuria, and finally as was the evolution of the disease, evidencing the satisfactory evolution in most of the patients, and in some the presence of chronic kidney disease
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Palabras clave
Nefropatía, Insuficiencia renal, Características patogénicas, Proteinuria, IgA, Mesangio, Etiología, Nephropathy, Renal failure, Pathogenic characteristics, Proteinuria, mesangium, Etiology, IgA