[Distal renal tubular dysfunction in seriously undernourished pediatric patients].
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.
Barbella-Szarvas
Sobeida
S
Unidad de Investigación en Gastroenterología y Nutrición Pediátrica, Universidad de Carabobo, Valencia, Venezuela. sobeida2001@yahoo.fr
Domínguez
Luis
L
Castro-Kolster
Cruz
C
Callegari
Carlos
C
Marcano
Grace
G
Villanueva
Crisley
C
D000138:Acidosis / Q000209:etiology / Q000378:metabolism; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007686:Kidney Tubules, Distal / Q000503:physiopathology*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D011446:Prospective Studies; D012720:Severity of Illness Index