Aspectos clínicos e epidemiológicos e análise de fatores de risco para pielonefrite após transplante renal
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Data
2007
Autores
Carpinelli, Catia Cristina [UNIFESP]
Orientadores
Camargo, Luis Fernando Aranha [UNIFESP]
Tipo
Dissertação de mestrado
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Objetivo: Fazer a descricao clinica e epidemiologica da Pielonefrite apos transplante renal bem como analisar os fatores de risco associados. Metodos: O estudo foi do tipo caso-controle, retrospectivo e descritivo. Os casos foram identificados conforme relacao cedida pelo Departamento de Anatomia Patologica da UNIFESP a partir de biopsias com diagnostico de Pielonefrite Histologica (P.H), das duas instituicoes referidas anteriormente no periodo de 1995 a 2003. Resultados: Trinta e dois pacientes foram incluidos na analise final, sendo dezenove casos com cultura positiva associada a data da biopsia e 13 casos com culturas negativas ou nao colhidas. Considerando algumas variaveis e o grupo com cultura positiva e negativa foi observado que nao houve significancia estatistica na comparacao entre os casos, com excecao do relato de disuria. Realizamos tal analise com o objetivo de mostrar que nao ocorreu alteracao no comportamento entre os grupos quando consideramos em ambos a Pielonefrite histologica. A Pielonefrite tem grande impacto na sobrevida do enxerto porque de acordo com nosso estudo a taxa de perda do enxerto e/ou evolucao para hemodialise foi de 21,8 por cento Na analise multivariada a utilizacao de duplo J, reoperacao em 30 dias e o diagnostico de NTA representaram risco para o desenvolvimento de Pielonefrite. Conclusoes: O diagnostico histologico teve grande importancia quando analisamos em conjunto com os dados clinicos, epidemiologicos e laboratoriais. A presenca da cultura positiva e importante, porem a ausencia nao exclui o diagnostico de Pielonefrite com a presenca da biopsia
Purpose: To describe clinical and epidemiological aspects as well as risk factors for Pyelonephritis after renal transplant. Methods: The study was designed as a case-control, retrospective and descriptive study. The cases were identified by the Department of Pathological Anatomy of UNIFESP starting from biopsies with diagnosis of Histological Pyelonephritis from the Hospital do Rim e Hipertensão and Hospital São Paulo from 1995 to 2003. Results: Thirty two patients were included in the final analysis. Nineteen cases had positive cultures associated and 13 cases had negative cultures. No clinical and pathological characteristics were observed between these patients, except for higher prevalence of dysuria in culture-negative patients. Conclusions: Pyelonephritis had a great impact on graft survival since the rate of graft loss or evolution for hemodialysis was 21,8% In the multivariate analysis the previous use of ureteral stents, reoperation within 30 days and the diagnosis of NTA represented risk for the development of Pyelonephritis. The histological diagnosis had great importance when we analyzed together with the clinical`s data, epidemic and laboratories.
Purpose: To describe clinical and epidemiological aspects as well as risk factors for Pyelonephritis after renal transplant. Methods: The study was designed as a case-control, retrospective and descriptive study. The cases were identified by the Department of Pathological Anatomy of UNIFESP starting from biopsies with diagnosis of Histological Pyelonephritis from the Hospital do Rim e Hipertensão and Hospital São Paulo from 1995 to 2003. Results: Thirty two patients were included in the final analysis. Nineteen cases had positive cultures associated and 13 cases had negative cultures. No clinical and pathological characteristics were observed between these patients, except for higher prevalence of dysuria in culture-negative patients. Conclusions: Pyelonephritis had a great impact on graft survival since the rate of graft loss or evolution for hemodialysis was 21,8% In the multivariate analysis the previous use of ureteral stents, reoperation within 30 days and the diagnosis of NTA represented risk for the development of Pyelonephritis. The histological diagnosis had great importance when we analyzed together with the clinical`s data, epidemic and laboratories.
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Citação
CARPINELLI, Catia Cristina. Aspectos clínicos e epidemiológicos e analise de fatores de risco para pielonefrite apos transplante renal. 2007. 61 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2007.