Resumo

BARBELLA-SZARVAS, Sobeida et al. Dystal renal tubular dysfunction in seriously undernourished pediatric patients. Invest. clín [online]. 2010, vol.51, n.1, pp.5-16. ISSN 0535-5133.

Seriously undernourished patients have a bigger tendency to metabolic acidosis than euthrophic individuals. The objective of the present work was to realize a study of the renal tubular function in 30 severely undernourished children. The investigation was a prospective, descriptive and transversal study. A test of overload with 5% sodium bicarbonate was realized to 30 seriously undernourished children whose primari etiology was marasmus, kwashiorkor or with mixed conditions, with ages of 6 months to 5 years, from both sexes, hemodynamically stable, with metabolic acidosis, hiperchloremia and positive urinary anion gap. The relation calcium/creatinine and the index uric acid/creatinine were determined. The absolute and relatives frequencies, average values and standard deviations were calculated. Infants represented 80% of the evaluated patients. The clinical forms kwashiorkor and mixed forms, of chronic evolution prevailed. Distal tubular renal acidosis was observed in 12 patients (40%) after the test overload with 5% bicarbonate. The average values of the relation calcium/creatinine of children < 2 years was 0.362 ± 0.414 and of children > 2 years was 0.265 ± 0.222. The uric acid/creatinine index was 0.57 ± 0.28. Metabolic acidosis is frequent in serious infantile undernourishment, which, according to the results observed, obeys to distal renal tubular dysfunction. The interpretation of the relation calcium/creatinine and the uric acid/creatinine index is difficult, becoming necessary to increase the investigations in these patients.

Palavras-chave : Serious undernourishment; metabolic acidosis; tubular dysfunction renal distal; hipercalciuria; hiperuricosuria.

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