Tânia Torres Rosa

Avaliação da tolerância e nefrotoxicidade do antimonial pentavalente administrado na dose de 40mg Sb v/kg/dia, de 12/12h, por 30 dias na forma cutaneo-mucosa de leishmaniose

The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.

Pentavalent antimonial nephrotoxicity in the rat

Aspects of the renal function were assessed in rats treated with the pentavalent antimonials Glucantime (Meglumine Antimoniate, Rhodia) or Pentostam (Sodium Stibogluconate, Wellcome). In dose of 30 mg of Sbv (Glucantime or Pentostam) by 100 mg of weight by day for 30 days, renal functional changes were observed consisting of disturbances in urine concentrating capacity. Such disturbances were expressed by significantly low values of urine osmolality as compared to the basal values previous to the drugs. The decrease in urine osmolality was associated to a significant increase in urinary flow and in negative free-water clearance. There was no alteration in osmolar clearance and in fractional excretion of sodium. These observations suggest an interference of the drugs in the action of the antidiuretic hormone. The disturbance in urine concentration was reversible after a seven days period without the drugs administration. No significant histopathological alterations were observed in the kidneys of the rats treated with the drugs. On the other hand, the rats treated with a high dose of Pentostam (200 mg/100 grams of weight/day) showed the functional and the histopathological alterations of the acute tubular necrosis.

Função renal em pacientes com leishmaniose muco-cutânea tratados com antimoniais pentavalentes

The renal function in ten patients with mucocutaneous leishmaniasis treated with Glucantime (meglumine antimoniate, Rhodia) or Pentostam (Sodium Stibogluconate, Wellcome) was assessed. During the use of these drugs a defect in concentrating capacity of the kidney was observed expressed as low values of maximun urinary osmolarity and negative maximun clearance of free water in relation to tests made before treatment. The urinary concentrating capacity returned to normal in 5 of the 8 patients studied 15-30 days after the end of treatment. However the maximal urinary osmolarity values where still inferior to those obtained before treatment. In two patients there was a proteinuria above 150 mg/24 hours after antimoniais which disappeared later. The clearance of endogenous creatinine do not alter significatly with the use of these drugs. The results suggest that pentavalent antimoniais can resue in a defect in urine concentrating capacity which is partially reversible after antimonial therapy has ceased.

Prevalence of high serum uric acid is increased in ambulatory subjects with hyperglycemia and dyslipidemia

INTRODUCTION: Serum uric acid has been considered a marker or an element of the clinical and laboratory alterations in the metabolic syndrome. OBJECTIVE: to evaluate the association between levels of serum uric acid (UA) and the following laboratory profile: fasting glucose > 100 mg/dl, triglycerides > 150 mg/dl and high density lipoprotein cholesterol (HDL-C) < 50 mg/dl in women and < 40 mg/dl in men. METHOD: In a cross-sectional survey, blood samples of 4,328 randomized outpatients aged from 20 to 102 years were analyzed. RESULTS: The mean (interquartile range) UA level was higher in men (6.7; 2.4-12.5 mg/dl) and women (5.4; 2.0-12.2 mg/dl) with the laboratorial profile than in those without it (5.9; 0.90-33.8 mg/dl for men and 4.4; 0.8-30.0 mg/dl for women) (p < 0.0001). A significant increase in the prevalence of laboratory profile was observed in men (OR = 2.2 mg/dl; 95% CI: 1.2-3.9 mg/dl) and women (OR = 2.2 mg/dl; 95% CI: 1.4-3.5 mg/dl) with hyperuricemia. CONCLUSION: These results show the association between serum levels of uric acid and metabolic syndrome profile, which corroborates to similar results found in other populations worldwide.