Aspectos genéticos e ambientais na etiologia da nefrolitíase
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Resumo
Objetivo: Avaliar os fatores genéticos e ambientais associados à Nefrolitíase (NL). Métodos: Revisão integrativa, delineada pela estratégia PICO, o levantamento foi feito nas bases MEDLINE e PUBMED. Utilizaram-se os descritores: "Nephrolitiasis", "Genetics", "Diet" e "Exercises”. Os critérios de inclusão foram: artigos na íntegra, nos últimos 5 anos, com metodologia de acordo com o objetivo proposto. Foram apurados 92 artigos e 23 foram selecionados. Resultados: Observou-se que o Índice de Massa Corporal (IMC) elevado e a alta ingestão de cálcio e proteínas aumentam o risco de NL, enquanto a dieta DASH (Abordagem dietética para interromper a hipertensão), frutas e vegetais, reduzem o risco. O consumo de bebidas alcoólicas ora foi apontado como protetor, ora como fator de risco. Foram relacionados à NL as doenças tireoidianas, cardiovasculares, metabólicas e acidose tubular renal e os genes e polimorfismos: rs1056628 e C1562T: gene MMP9, rs6776158 e rs7627468: gene CaSR, rs35747824: gene PDILT, rs6667242 e rs1256328: gene ALPL, rs1544935 em KCNK5, rs7328064 em DGKH, rs13041834 em BCAS1, rs182089527: gene PDE1A, e os genes alfa-2-MRAP, TCF7L2, GSTM1, GSTT1. Considerações finais: Considera-se que tanto os fatores genéticos quanto os ambientais influenciam de maneira significativa o desenvolvimento da NL.
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