Eduardo S. López Hernández

Multiple kidney cysts in thin basement membrane disease with proteinuria and kidney function impairment.

Background Some patients with thin basement membrane disease (TBMD) develop proteinuria, hypertension and different degrees of CKD, besides the persistent microhaematuria characteristic of the disease. Little is known about factors associated with this unfavourable outcome. Methods We reviewed clinical, pathological and radiological features of 32 patients with biopsy-proven TBMD. Patients were divided in two groups: those with persistent normal kidney function and negative or minimal proteinuria (n = 16) and those with persistent proteinuria >0.5 g/day (n = 16). Results Patients with proteinuria had a worse kidney function at baseline than those with negative proteinuria. Global or segmental glomerulosclerosis, together with interstitial fibrosis, was found in 37% of patients with proteinuria. All proteinuric patients were treated with renin–angiotensin system blockers. At the end of follow-up (198 months in proteinuric patients and 210 months in patients with negative proteinuria) the prevalence of hypertension was 68% in proteinuric patients (12% at baseline), compared with 12 and 6%, respectively, in non-proteinuric patients. A slow decline of renal function was observed in proteinuric patients, although no patient developed end-stage kidney disease. Ultrasound studies showed bilateral kidney cysts in nine patients (56%) with proteinuria. Cysts were bilateral and countless in six patients, and bilateral but with a limited number of cysts in the three remaining patients. No cysts were found in patients with negative proteinuria. Conclusions Some patients with TBMD develop hypertension, proteinuria and CKD. Multiple bilateral kidney cysts were found in a majority (56%) of these patients. Further studies are needed to investigate the pathogenesis and the influence on long-term outcome of this TBMD-associated multiple kidney cysts.

Dos glomerulonefritis en un mismo paciente con infección por virus de la hepatitis C

Membranoproliferative glomerulonephritis (GN) may be pathogenically associated with infection due to the hepatitis C virus (HCV) as many clinical cases have shown. The potential relationship between the HCV and IgA GN, by contrast, has been suggested only in isolated cases. IgA nephropathy recurs in up to 50% of cases after renal transplantation, but it is uncommon for it to appear as a de novo GN. We report the case of a patient with chronic infection due to the HCV and liver disease, who developed two different glomerular diseases during its progression: membranoproliferative GN in his native kidneys, a process that caused terminal renal failure and de novo IgA GN in the transplanted kidney. The potential pathogenic relationship of both glomerular processes with infection due to the HCV is discussed.

APORTACIONES DEL CUERPO ACADÉMICO DE EDUCACIÓN AMBIENTAL, CULTURA Y SUSTENTABILIDAD AL DECENIO DE LA EDUCACIÓN PARA EL DESARROLLO SOSTENIBLE 2005-2014

El factor humano tiene unas caracteristicas que lo ubican por encima de otras especies, entre ellas su capacidad intelectual y la utilizacion de ella en la confeccion, fabricacion y empleo de multiples objetos y herramientas para la modificacion del medio, la generacion de la cultura y el desarrollo de sus sociedades. Diversos factores que han colocado al hombre en el planeta como el principal provocador de la crisis ambiental.

Gestión sustentable de pilas e intervenciones educativas para mitigar sus efectos en la salud humana y el ambiente.

El trabajo se realizo dentro del Programa Ambiental para el Desarrollo Sustentable de la Universidad Juarez Autonoma de Tabasco (Lopez-Hernandez y Priego, 2007), para planear alternativas sobre residuos solidos altamente contaminantes como las pilas (dispositivo pequeno en el que la energia quimica se transforma en electrica. Tiene multiples aplicaciones como fuente de energia en pequenos aparatos. (RAE, 2011). El manejo incorrecto de estos residuos es un problema socio-ambiental con efectos mundiales. Se requieren nuevos enfoques en el manejo para la disposicion final al termino de su vida util. Por lo anterior, se plantea contribuir a resolver la problematica relacionada con su alto consumo, extendida por la facilidad de utilizarlas en diversos artefactos. Una vez convertidas en basura generan residuos toxicos como Zn, Li, Ni, Cd, Ag y Hg. (Castro Diaz, 2003). Asi, se persiguio elaborar una propuesta educativa para el manejo, gestion y disposicion de pilas. Establecer recomendaciones para reducir, y prevenir sustentablemente los efectos que provocan en la salud y el ambiente. A partir de la recopilacion bibliografica sobre tratamientos para estos peligrosos, se hizo una clasificacion de tipos, clases y uso de pilas. Se definieron los componentes toxicos segun el Diario Oficial de la Federacion (2006). Se investigaron los efectos nocivos al ambiente y la salud. Se disenaron actividades de educacion ambiental basadas con objetivos, tecnicas de manejo (generacion, separacion, transporte, almacenamiento, tratamiento y disposicion final). Se plantearon alternativas para una disposicion final sustentable como los rellenos sanitarios para residuos de manejo especial y/o peligroso, como las pilas agotadas.