Hiperparatiroidismo Secundário Renal : avaliação da sua relevância clínica
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2011
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Em medicina felina, o diagnóstico de doença renal crónica (DRC) é bastante comum, especialmente nos dias de hoje em que os gatos vivem mais tempo e as doenças do foro geriátrico são mais frequentes. O hiperparatiroidismo secundário renal (HSR) que é uma das complicações dos pacientes insuficientes renais crónicos, com efeitos directos no seu prognóstico, evolução clínica e na sua qualidade de vida, é no entanto, aparentemente, submonitorizada.
A dissertação que se segue teve como principais objectivos avaliar a relevância dada a nível nacional à monitorização de HSR, e por outro estimar a frequência de casos de hiperparatiroidismo secundário a uma insuficiência renal crónica em felinos numa clínica de referência na zona de Oeiras durante um período de 4 meses durante o qual foi realizado o estágio curricular (1 de Setembro a 31 de Dezembro de 2010).
Constatou-se que a requisição de hormona paratiroideia intacta (PTHi) nos 4 meses decorrentes do período de estágio curricular foi residual, e que o cálcio e o fósforo não fazem parte dos perfis renais de 40% dos laboratórios de análises clínicas incluídas neste estudo.
No entanto, dos 5 casos clínicos de doença renal crónica diagnosticados, todos apresentavam hiperfosfatemia e 2 foram diagnosticados com hiperparatiroidismo secundário renal, sugerindo uma frequência elevada.
Os resultados indicam que a monitorização do HSR, neste momento, apenas é feita de forma indirecta, sendo por isso impossível avaliar fidedignamente a real importância desta doença, em termos de consequências clínicas, prognóstico e sucesso nas terapias instituídas.
In feline medicine, chronic kidney disease is a common disease, especially nowadays when cats live longer and geriatric diseases are more frequent. Renal secondary hyperparathyroidism (RSH) which is a complication of chronic kidney disease, with direct effects on prognosis, clinical and quality of life, is however, apparently uncontrolled. The thesis that follows had as main objectives assess the relevance given to the monitoring of RSH, and estimate the frequency of hyperparathyroidism secondary to chronic renal failure in cats at a reference clinic in the area of Oeiras over a period of four months, during which the externship was conducted (September 1 to December 31, 2010). It was found that the request for intact parathyroid hormone (iPTH) in the 4 months of the externship period was residual, and that calcium and phosphorus are not part of the kidney profiles of 40% of clinical laboratories included in this study. However, of five clinical cases diagnosed with chronic kidney disease (CKD), all had hyperphosphatemia, and 2 were diagnosed with RSH, suggesting a high frequency. The results indicate that monitoring of RSH at this point is only made indirectly, and it is therefore impossible to assess, reliably, the real importance of this disease in terms of clinical consequences, prognosis and success of the therapy instituted.
In feline medicine, chronic kidney disease is a common disease, especially nowadays when cats live longer and geriatric diseases are more frequent. Renal secondary hyperparathyroidism (RSH) which is a complication of chronic kidney disease, with direct effects on prognosis, clinical and quality of life, is however, apparently uncontrolled. The thesis that follows had as main objectives assess the relevance given to the monitoring of RSH, and estimate the frequency of hyperparathyroidism secondary to chronic renal failure in cats at a reference clinic in the area of Oeiras over a period of four months, during which the externship was conducted (September 1 to December 31, 2010). It was found that the request for intact parathyroid hormone (iPTH) in the 4 months of the externship period was residual, and that calcium and phosphorus are not part of the kidney profiles of 40% of clinical laboratories included in this study. However, of five clinical cases diagnosed with chronic kidney disease (CKD), all had hyperphosphatemia, and 2 were diagnosed with RSH, suggesting a high frequency. The results indicate that monitoring of RSH at this point is only made indirectly, and it is therefore impossible to assess, reliably, the real importance of this disease in terms of clinical consequences, prognosis and success of the therapy instituted.
Descrição
Orientação : Luís Miguel Caeiro Chambel ; co-orientação : Pedro Faísca
Palavras-chave
VETERINÁRIA, FELÍDEOS, DOENÇAS RENAIS, DOENÇAS CRÓNICAS, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINARY MEDICINE, FELIDS, KIDNEY DISEASES, CHRONIC DISEASES, GATOS, CATS, HIPERPARATIROIDISMO, HYPERPARATHYROIDISM