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Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.
The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page what does it mean if a trait is dominant it provides a quantitative and qualitative measure of the journal's impact. What does it mean if a trait is dominant measures contextual citation impact by wighting citations based on the total number of citations in a subject field.
Background : Macroscopic haematuria secondary to renal cyst rupture is a frequent complication in autosomal dominant polycystic kidney disease ADPKD. Sickle-cell disease is an autosomal recessive haemoglobinopathy that involves a qualitative anomaly of haemoglobin due to substitution of valine for the glutamic acid in the sixth position of 3-globin gene on the short arm of chromosome For the full disease to be manifested, this mutation must be present on both inherited alleles.
In sickle-cell disease, the abnormal Hb S loses its rheological characteristics and is responsible of the various systemic manifestations including those of the kidney, such as macroscopic haematuria secondary to papilar necrosis. Despite the generally benign nature of the sickle-cell trait, several potentially serious complications have been described.
Metabolic or environmental changes such as hypoxia, acidosis, dehydration, hyperosmolality or hyperthermia may transform silent sickle-cell trait into a syndrome resembling sickle-cell disease with vaso-occlusive crisis due to an accumulation of low deformable red blood cells in the microcirculation originating haematuria from papilar necrosis.
The diagnosis of sickle-cell trait was confirmed by haemoglobin electrophoresis. The renal volume was measured by magnetic resonance imaging MRI. Results: The proband subject in family 1 presented frequent haematuria episodes, associated why is the internet not working properly increase of renal volume, developed very early ESRD and was dialyzed at the age of 39 years.
The other 3 patients in family 2 presented different degree of renal function. Conclusion s: The presence of sickle haemoglobin should be determined in african-american and west-african patients with ADPKD because it is an important prognostic factor. MRI can identify intracystic haemorrhage and permit renal volume measure. Antecedentes: La hematuria macroscópica derivada de la rotura de quistes renales es una manifestación habitual en la poliquistosis renal autosómica dominante PQRAD.
La asociación de estas dos enfermedades hereditarias, PQRAD y hemoglobina con rasgo falciforme, se ha comunicado raramente. Recientemente, se ha comunicado que la hemoglobina con rasgo falciforme es un factor de riesgo predisponente para el desarrollo de enfermedad renal crónica en afroamericanos. Pacientes y métodos: Se estudiaron 2 familias de origen afroamericano 4 pacientes que co-heredaron la PQRAD y la hemoglobina con rasgo falciforme heterocigotos.
El diagnóstico de hemoglobina falciforme Hb S se realizó por electroforesis de la hemoglobina. El volumen renal se midió mediante resonancia magnética RM. Las 3 pacientes pertenecientes a la otra familia, de tres generaciones diferentes, presentaron distintos grados de función renal. La co-herencia de PQRAD y hemoglobina con rasgo falciforme puede influir en la evolución hacia la IRC y en el desarrollo de complicaciones, como el sangrado quístico. La imagen de RM es una herramienta de utilidad para identificar las hemorragias quísticas y para medir el volumen renal.
Polycystic kidney disease is an inherited, autosomal dominant disease caused by mutations in two genes, PKD1 the short arm of chromosome 16 and PKD2 the long arm of chromosome 4. It is characterised by the presence of renal cysts that gradually increase in number and size, leading to end-stage chronic renal failure at an average age of years. In autosomal dominant polycystic kidney disease ADPKDmacroscopic haematuria resulting from the rupture of renal cysts is a common manifestation.
In sickle cell disease, abnormal haemoglobin S loses its rheological properties and is responsible for several systemic manifestations, including those of the kidney, such as papillary infarcts due to vascular lesions. The presence of sickle cell trait HbAS may also be what does it mean if a trait is dominant with renal manifestations, especially haematuria. Papillary necrosis is the most common cause of macroscopic haematuria in heterozygous patients with sickle cell trait.
The association of these two hereditary diseases, ADPKD and sickle cell trait, has been rarely reported in the literature. In one case, the patient developed ESCRF at 39 years of age after numerous recurrent episodes of macroscopic haematuria. The effect meaning in tamil 3 patients had varying degrees of renal function.
Although there were no DNA genetic studies, the ADPKD was in all probability PKD1 chromosome 16taking into account the form of presentation, clinical features and time of diagnosis in these families. The first family consisted of two generations and the second of three. The diagnosis of sickle cell trait HbS was performed by electrophoresis of haemoglobin in acid and alkaline media.
The total renal volume was determined by non-enhanced MRI in T1 and T2 weighted sequences, and by manual segmentation technique, adding the volume what is a weird relationship both kidneys. In all patients with recurrent haematuria, the presence of renal medullary carcinoma was ruled out. Figures 1 and 2 show both family trees.
Figures 3, 4 and 5 show representative images of the polycystic kidneys. Tables 1 and 2 summarise the clinical and developmental data of the patients. An African Theories of disease causation in epidemiology pdf woman born in a native of Santo Domingo who was diagnosed with ADPKD at 35 years old after renal ultrasound, which was performed due to an episode of renal colic with passage of several blood clots.
Her family history showed that her father ha been diagnosed with ADPKD, and had undergone haemodialysis treatment since 55 years old. Her mother, the younger sister and the patient herself were carriers of sickle cell trait HbAS. She was studying in Germany in April when she began with right flank pain and dark haematuria with clots. She had to be hospitalised and was diagnosed with a complicated renal cyst.
A week later, she was re-admitted for recurrent pain in the right flank, requiring strong analgesia. Following the completion of cystoscopy, a bladder mass compatible with clots was discovered which required 2 more transfusions. She received antibiotics and what does it mean if a trait is dominant treatment, and her anaemia improved to Hb An analytical control in October revealed SCr 2. By MRI, the volume of the kidneys was RK ml and LK ml total renal volume of mland several cysts with signs of intracystic bleeding.
Between and she had several episodes of recurrent haematuria with clots, accompanied by anaemia, which required multiple transfusions. In Juneher analytical results were SCr 4. After repeated episodes of haematuria some spontaneous and one after an accidental fall and anaemia not responding to medical treatment, including tranexamic acid, an embolisation was proposed, which was not accepted by the patient. In September a left nephrectomy was performed.
Haemodialysis via a permanent jugular catheter was then required. Attempts on two occasions to conduct an arteriovenous fistula for haemodialysis were unsuccessful due to thrombosis. After two years on haemodialysis and what are the different artistic styles suffered persistent haematuria, an embolisation and right nephrectomy had to be performed in September Neither of the two surgical samples from the nephrectomies showed changes consistent with renal medullary carcinoma.
In ADPKD, macroscopic haematuria resulting from the rupture of renal cysts is a common manifestation. Although most what is linear regression in simple words report trauma and violent exercise as possible precipitating causes, no association has been unequivocally demonstrated. Currently, with the widespread use of imaging techniques, and specifically MRI, intracystic bleeding can be observed which had previously gone unnoticed in many cases.
These facts are very important, as it is known that ADPKD patients who have frequent episodes of haematuria or evidence of intracystic haemorrhage have a more rapid progression to CRF. Moreover, the presence of sickle cell trait HbAS is characterised by renal manifestations, especially haematuria, with papillary necrosis being the most common cause of macroscopic haematuria in heterozygous carriers of this haemoglobinopathy.
In family 1, one of the autosomal dominant diseases, ADPKD, was transmitted in the male line while the maternal line carried the other recessive, sickle cell trait Fig. In this family, the index case was a woman with two genetic diseases who developed rapidly progressing CRF and had to start haemodialysis at 39 years of age. In this patient, renal cysts formed and developed very early, and the association of sickle cell trait HbAS very probably favoured recurrent episodes of macroscopic haematuria, intracystic haemorrhage and early development of advanced CRF.
It is worth noting that, in this case, the episodes of haematuria were sometimes preceded by an airplane ride lasting several hours obviously in a position of relative hypoxia or by minimal trauma. This was no doubt due to intracystic what does it mean if a trait is dominant and the intrarenal haematomas detected in the later stages of the disease.
They were confirmed by CT and finally pathophysiologically. This development contrasted with that of the father, who was not a sickle cell trait carrier and required haemodialysis treatment at 55 years old. This patient and the mother case 3 showed glomerular hyperfiltration. The grandmother case 2who had some episodes of macroscopic haematuria, developed CRF, with MR images of intracystic bleeding and a moderately elevated total renal volume. To our knowledge, this is the first study that has evaluated families with this genetic association in Europe.
Surprisingly, only two papers regarding this how to find frequency between two numbers in excel were found in the literature, both from the same group, which described the association of two genetic diseases, ADPKD and sickle cell trait in African Americans.
The mechanism by which sickle cell trait contributes to the progression of chronic kidney disease in ADPKD may be multifactorial. It is possible that sickle cell trait, coexisting with is lovesick worth watching conditions affecting the renal microvasculature, like ADPKD, could act synergistically to accelerate renal damage. It must be borne in mind that serum levels of angiogenic factors reveal how to write a cause and effect essay pdf proangiogenic state in adults with sickle cell disease.
The presence of sickle cell trait HbAS may also affect the course and care of patients with ESCRF, as it may be an independent risk factor for venous thromboembolism among African Americans. In conclusion, the existence of sickle cell trait should be determined in African American patients and those from West Africa with ADPKD, as its presence may be an important prognostic factor. This is probably also applicable to other highly prevalent renal pathologies, diff between risk and return as hypertension and diabetes mellitus.
Table 1. Table 2. Figure 3. A Coronal view B Axial view. Figure 4. Figure 5. Home Articles in press Archive. Nefrología English Edition. ISSN: Previous article Next article. March Pages Lee este artículo en Español. More article options.
Absolutamente con Ud es conforme. Pienso que es la idea excelente.