Resumo Objetivo: Verificar a relação entre a presença de proteinúria como marcador de lesão renal em idosos sem histórico de hipertensão arterial sistêmica e doenças cardiovasculares. Um estudo transversal foi desenvolvido de Janeiro de 2014 a Dezembro de 2019, por meio de campanhas de prevenção a doenças renais promovidas pela Universidade Federal do Ceará, na cidade de Fortaleza. Métodos: A amostra foi composta por 417 idosos. Um questionário foi usado para caracterizar indivíduos e avaliar doenças prévias, e foram utilizadas tiras reagentes de urinálise para avaliar proteinúria. Resultados: Diferenças estatisticamente significativas (p < 0,05) e tamanhos de efeito moderados foram encontrados para níveis de pressão arterial (IC 0,53-0,93), pressão arterial sistólica e pressão arterial diastólica (IC 0,21-0,61). Também foram encontradas diferenças significativas na glicemia capilar entre grupos (p = 0,033), mas com um tamanho de efeito baixo (0,02–0,42). O grupo com comorbidades apresentou 2,94 vezes mais probabilidade de ter proteinúria do que aqueles sem comorbidades (OR 2,94; IC 1,55-4,01; p < 0,05). No grupo sem doença cardiovascular/hipertensão, foi encontrada uma associação estatisticamente significativa para diabetes anterior e proteinúria (p = 0,037), apresentando risco 2,68 vezes maior de proteinúria naqueles com diabetes mellitus (OR 2,68; IC 1,05-6,85). Também foi encontrada uma associação significativa entre faixas etárias, com o grupo mais velho apresentando risco 2,69 vezes maior de desenvolver proteinúria (75 a 90 em comparação com 60 a 74 anos) (IC 1,01-7,16; p = 0,045). Conclusão: Mesmo sem hipertensão arterial sistêmica ou doença cardiovascular, o diabetes e a idade avançada podem ser considerados fatores de alto risco para proteinúria.
Objective: To verify the relationship between the presence of proteinuria as a renal injury marker in elderly without history of systemic arterial hypertension and cardiovascular diseases. A cross-sectional study was developed from January 2014 to December 2019, through kidney disease prevention campaigns promoted by the Federal University of Ceará in the city of Fortaleza. Methods: The sample consisted of 417 elderlies. A questionnaire was used to characterize individuals and assess previous diseases, and urinalysis reagent strips were used to assess proteinuria. Results: Statistically significant differences (p < 0.05) and moderate effect sizes were found for blood pressure levels (CI 0.53-0.93), systolic blood pressure, and diastolic blood pressure (CI 0.21-0.61). Significant differences in capillary glycemia were also found between groups (p = 0.033), but with a low effect size (0.02–0.42). The group with comorbidities was 2.94 times more likely to have proteinuria than those without comorbidities (OR 2.94, CI 1.55-4.01; p < 0.05). In the group without cardiovascular disease/high blood pressure, a statistically significant association was found for previous diabetes and proteinuria (p = 0.037), presenting 2.68 times higher risk of proteinuria in those with diabetes mellitus (OR 2.68, CI 1.05-6.85). Significant association was also found between age groups, with the older group having 2.69 times higher risk of developing proteinuria (75 to 90 compared to 60 to 74 years) (CI 1.01-7.16; p = 0.045). Conclusion: Even without systemic arterial hypertension or cardiovascular disease, diabetes and older age can be considered high risk factors for proteinuria.
BACKGROUND AND AIMS High-intensity exercise modalities such as Crossfit have increased the number of practitioners due to the benefits such as weight loss. However, high-intensity exercise can induce renal and endothelial damage. The objective was to verify the main acute effects of high-intensity exercise on renal and endothelial function of Crossfit athletes. METHOD The study was conducted by evaluating 10 high-performance Crossfit athletes, performing pre- and 24-h post-competition test collection. The athletes were evaluated using biomarkers for kidney injury, such as lipocalin associated with neutrophil gelatinase (NGAL), creatine kinase (CK), albumin, creatinine and estimated glomerular filtration rate (eGFR). Endothelial damage was evaluated using serum enzymatic markers, intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1) and Syndecan-1. In addition, athletes' physical and social evaluation questionnaires measuring body composition data and socioeconomic conditions were used. Statistical analysis was performed with Shapiro-Wilk and Student t test for parametric values and Wilcoxon for non-parametric data. Pearson and Spearman tests were used for data with normality and non-normality, respectively. RESULTS There was a significant increase in creatinine (1.03 ± 0.24 versus 1.36 ± 0.34 mg/ dL, P = .001) and CK [median 302.40 (115.75–474.00) versus 2048.80 (542.75–3391.25) U/L, P = .005] 24 h after the activity, and reduced eGFR (91.55 ± 21.15 versus 66.45 ± 20.6 mL/min/1.73 m², P = .000). The values of ICAM-1, VCAM-1, Syndecan-1 and NGAL did not show statistically significant variations. There was a strong positive correlation between syndecan-1 and CK (P = .000, r = 0.953). CONCLUSION The study showed that high performance exercise performed by athletes does not cause significant acute changes in renal function, but its intensity was able to cause muscle damage and endothelial changes in the participants.
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