Publication: Daño real inducido por la hematuria de origen glomerular
Loading...
Files
Official URL
Full text at PDC
Publication Date
2017-09-18
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
La enfermedad renal crónica (ERC) es una patología con una prevalencia en aumento por lo que ha sido reconocida como un problema de salud pública a nivel mundial. Aunque han sido identificados algunos factores de riesgo implicados en la progresión de la ERC, como la proteinuria, la hipertensión arterial, y los niveles de fósforo, factor de crecimiento fibroblástico 23 [FGF-23] y parathormona séricos, aún se desconoce gran parte de su patogenia. Por otro lado, la biopsia renal se considera el mejor método para diagnosticar enfermedades renales. La biopsia renal nos permite estimar el pronóstico basándose en una gradación de la actividad o cronicidad de las lesiones histológicas encontradas, para así guiar el tratamiento. Sin embargo, dado que la biopsia renal es un procedimiento invasivo, ésta se debe reservar para casos justificados en los que el beneficio de los hallazgos de la biopsia sea superior a los riesgos. Por ello, es necesario conocer de forma precisa los mecanismos implicados en la progresión de la enfermedad renal crónica para poder controlar sus factores de riesgo. La hematuria se define como la presencia de sangre en la orina en cantidades superiores a lo normal (ie. > 3 hematíes por campo), dado que en condiciones fisiológicas no existen hematíes en la orina. La hematuria glomerular es aquella producida por la extravasación de los hematíes desde el capilar glomerular al espacio urinario. Esta se diagnostica por la presencia de hematíes con contornos irregulares en la orina, por ello la hematuria glomerular es un signo de disfunción de la barrera de filtración glomerular...
Chronic kidney disease (CKD) is a global public health problem, because of its growing prevalence and cost. Although, several risk factors of CKD progression has been identified (such as proteinuria, high blood pressure, serum phosphate, parathyroid hormone [PTH] and fibroblastic growth factor-23 [FGF-23] levels), its real pathogenesis remains unknown. Kidney biopsy is considered as the gold-standard for renal disease’s diagnosis, being able to assess kidney disease prognosis based on the activity or chronicity of histological findings, and so provide useful therapy guidance. However, kidney biopsy is an invasive procedure, therefore should be reserved for selected patients with high risk of CKD progression. Consequently, a better understanding of CKD progression markers is necessary. Haematuria is defined by the presence of more than 3 red blood cells (RBCs) per high-power field in the urine. There are not RBCs in the urine under physiological circumstances. Glomerular haematuria is secondary to RBCs egression from glomerular capillary to urinary space and it is recognized by the presence of dysmorphic RBCs in the urinalysis. Therefore, glomerular haematuria is a sign of glomerular filtration barrier dysfunction. Haematuria has been classically considered as a benign hallmark of some glomerular diseases, usually not mentioned in large epidemiological studies and little is known about its role on CKD progression. However, recent evidences suggested the glomerular haematuria could have negative prognostic implications over renal function...
Chronic kidney disease (CKD) is a global public health problem, because of its growing prevalence and cost. Although, several risk factors of CKD progression has been identified (such as proteinuria, high blood pressure, serum phosphate, parathyroid hormone [PTH] and fibroblastic growth factor-23 [FGF-23] levels), its real pathogenesis remains unknown. Kidney biopsy is considered as the gold-standard for renal disease’s diagnosis, being able to assess kidney disease prognosis based on the activity or chronicity of histological findings, and so provide useful therapy guidance. However, kidney biopsy is an invasive procedure, therefore should be reserved for selected patients with high risk of CKD progression. Consequently, a better understanding of CKD progression markers is necessary. Haematuria is defined by the presence of more than 3 red blood cells (RBCs) per high-power field in the urine. There are not RBCs in the urine under physiological circumstances. Glomerular haematuria is secondary to RBCs egression from glomerular capillary to urinary space and it is recognized by the presence of dysmorphic RBCs in the urinalysis. Therefore, glomerular haematuria is a sign of glomerular filtration barrier dysfunction. Haematuria has been classically considered as a benign hallmark of some glomerular diseases, usually not mentioned in large epidemiological studies and little is known about its role on CKD progression. However, recent evidences suggested the glomerular haematuria could have negative prognostic implications over renal function...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 02-02-2016