Differential diagnosis of sudden neurologic deficits and paraplegia in renal patients with secondary HPPT must consider the possibility of brown tumor.

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Objective: chronic kidney disease (CKD) is an increasing common problem in the world due to the exponential growth of diabetes mellitus, hypertension and other risk factors. The aim of this study is to investigate urinary abnormalities and risk factors for kidney disease in the general population. Methods: this study was performed from data collected during the annual World Kidney Day (WKD) campaigns, in Fortaleza, Ceará, Brazil, between 2009 and 2012. The population sought assistance spontaneously in stands placed in high people-traffic areas. Results: among 2,637 individuals interviewed, the mean age was 50.7±15.7 years and 53% were male. The main risk factors found were sedentarism (60.7%), obesity (22.7%) and smoking (19.8%). Blood pressure (BP) > 140x90 mmHg was found in 877 (33%). Increased BP was found for the first time in 527 cases (19.9%). Cardiovascular diseases were reported in 228 (8.6%). Diabetes was related by 343 (13%). Capillary blood glucose > 200 mg/dL was found in 127 (4.8%) and it was > 200 mg/dL for the first time in 30 (1.13%). Urinalysis was performed in 1,151 people and found proteinuria in 269 (23.3%). Proteinuria was most frequent in hypertension people (77.3% vs. 55.8%, p=0.0001), diabetes mellitus (22.7% vs. 15.2%, p=0.005) and elderly (42.1% vs. 30.7%, p=0.0007). Conclusion: risk factors for CKD are frequent in the general population. Many individuals had hypertension and diabetes and did not know this. It is important to regularly perform actions like WKD in order to early detect potential candidates for CKD.

Introduction: There are scarce data in Brazil concerning the referral of the patients with renal diseases to the nephrologist care. Objective: The aim of the present study was to describe the adequacy of early referral of these patients to a nephrology out-patient clinic. Material and methods: It was a cross-sectional study. Data of the first visit of the patient to the nephrologists were collected. The decision of the nephrologist, regarding the admittance of the patient to the follow-up with the nephrology team was also described. Results: We evaluated 150 patients, with mean age of 49 ± 16 years, and 56% of females. The need of a consultation and follow-up with the renal specialist was found in only 71 patients (47.3%) and all these patients were enrolled in the nephrology unit outpatient clinic for, at least, one visit a year. All the patients with chronic kidney disease stages 3 to 5 were recommended to maintaining visits to the nephrologist, whereas 60% of those with diabetes and/ or hypertension and 50% of those with renal lythiasis were also enrolled in the same program. Approximately 50% of patients originated from public health system units and 70% of private doctors were adequately referred. Conclusion: There was inadequate use of the abilities of the nefrologist as a specialist in the care of the patient with early stages of renal diseases. Other studies are needed to evaluate the efficiency of referral systems to the nephrologists in other areas of Brazil, with the purpose to rationalize supply and demand in the nephrology care.