Acta Medica Port
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Practice Guideline
Diagnosis of Chronic Kidney Disease in Adults in Portugal: Practical Recommendations from National Clinical and Laboratory Experts.
Chronic kidney disease represents a significant public health issue, affecting approximately 9.8% of the adult population in Portugal. Despite this figure, early diagnosis of this disease in high-risk groups remains limited. Although only two parameters are essential for its diagnosis - estimated glomerular filtration rate (eGFR) and albuminuria - in Portugal, over 50% of stage 3 - 5 patients have not undergone simultaneous assessment of eGFR and albumin-uria. ⋯ This national consensus among the key stakeholders in the chronic kidney disease screening and diagnosis process culminated in the development of four practical guidelines. These guidelines will enable the consistent provision of eGFR and albuminuria measurements, regardless of the attending physician's medical specialty, the laboratory, or geographic location. Additionally, through this collective effort, experts want to raise awareness among national authorities to the need of developing new guidelines, based on scientific evidence and clinical practice, to address the underassessment of albuminuria and eGFR in this disease's management.
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Urinary tract infections are common in pediatrics. Knowledge of local resistance patterns is crucial to guide empirical antibiotic therapy. We aimed to review the pathogens implicated in urinary tract infections, local resistance patterns, and the impact of switching first-line empirical antibiotic regimens. ⋯ E.coli remains the predominant pathogen in pediatric urinary tract infections. Resistance to A-C in our sample was high (33.1%). The switch from A-C to cefuroxime as first-line agent resulted in a decreasing trend in A-C resistance, while cefuroxime resistance remained low and even slightly lower.