Abstract
Clinical as well as renal anatomopathological data of 119 patients with acquired immunodeficiency syndrome from the Hospital of the Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil, were studied. Mean age was 33 +/- 10.4 years (range 18 to 67 years). White (59%) and male (80%) individuals predominated. Ninety percent of patients came from Uberaba or neighborhood. There were 59 (50%) heterosexual, 25 (21%) homosexual, 17 (14%) bisexual and 18 (15%) unknown. Forty three percent were drug abusers. Fourteen (12.2%) of patients had serum creatinine higher than 3mg/dl, ten days before death, 64% of them showed acute tubular necrosis. Seventy one (61%) patients presented hyponatremia and 8 (7%) had hypernatremia. Hypokalemia was detected in 28 (24%) and hyperkalemia in 8 (7%) patients. Twenty four hours urinary protein was detected in 12 patients, 7 of them presenting more than 1g/24h. Two patients showed segmentar focal glomerulosclerosis, one of them with 24h urinary protein level of 5.5 g and serum creatinine 1.5 mg/dl and no edema. The most (56%) patients had tubulointerstitial nephritis. Clinical, laboratory and types of renal disorders in patients with acquired immunodeficiency syndrome are variable. The glomerular diseases were relatively scarce however, tubulointerstitial lesions are quite frequent, mainly interstitial nephritis and acute tubular necrosis. Not always an anatomoclinical correlation could be observed, because many times the electrolyte disorders were frequently observed only functionally.
Highlights
Clinical as well as renal anatomopathological data of 119 patients with acquired immunodeffiency syndrome from the Hospital of the Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil, were studied
Em 71 (61%) pacientes, houve pelo menos um episódio de hiponatremia, sendo que 19 pacientes se apresentaram hiponatrêmicos nas 48 horas antes do óbito
Em relação aos distúrbios hidroeletrolíticos, a alta freqüência de pacientes com hiponatremia (61%) concorda com outros relatos, sendo o distúrbio hidroeletrolítico mais freqüente entre os pacientes com SIDA1 3 12 22 28 34
Summary
O estudo foi realizado no Hospital Escola da Faculdade de Medicina do Triângulo Mineiro (HE/ FMTM), Uberaba, Minas Gerais. Foram padronizadas as seguintes categorias: azotemia, quando o nível de creatinina sangüínea estava entre 1,2mg/dl e 3mg/dl e insuficiência renal estabelecida (IRE), quando acima de 3mg/dl. Os valores da potassemia entre 3 e 5,5mEq/l foram considerados normais. O limite dos valores normais para proteínas na urina de 24h foi até 150mg. Quanto aos valores de depuração de creatinina, considerou-se normais quando estavam entre. Havia 91 (76%) pacientes com idade compreendida entre 20 e 40 anos, sendo que 59 (50%) eram menores de 30 anos. Observou-se que em 36 (30%) pacientes, o diagnóstico sorológico foi feito na última internação, em um período menor que 30 dias antes do óbito, em 32 (27%), entre 1 e 5 meses antes do óbito e em 51 (43%), acima de 5 meses. Tabela 1 - Diagnósticos anatomopatológicos renais em 119 necropsias de pacientes com SIDA
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