Análisis clínicos y de laboratorio de pacientes en diálisis en un hospital de referencia en la Amazonía

DOI: https://doi.org/10.46642/efd.v27i289.2380

Resumen

Introducción: Los cambios hormonales y minerales caracterizan un gran desafío en el tratamiento de pacientes renales crónicos en hemodiálisis. Objetivo: Analizar las características clínicas y sociales y la evolución de la hormona paratiroidea, calcio total, fósforo y vitamina D en pacientes en diálisis en los años 2017 y 2018. Métodos: La muestra estuvo constituida por 105 historias clínicas de pacientes en hemodiálisis en un hospital de referencia. en Santarém, Pará. Se recolectó información sociodemográfica y clínica en 2017, así como información de laboratorio para los años 2017 y 2018. Los datos fueron tabulados y analizados según estadística descriptiva e inferencial, adoptando p<0,05. Resultados: Se encontró mayor frecuencia en el sexo masculino, mayores de 47 años, casados, morenos y con índice de masa corporal normal. Las etiologías subyacentes más frecuentes fueron hipertensión arterial sistémica, diabetes mellitus y glomerulonefritis crónica. En 2017 el calcio total tuvo mayor proporción de valores adecuados, así como la vitamina D en 2017 y 2018. El fósforo y la hormona paratiroidea tuvieron predominio de valores alterados en 2017 y 2018. Conclusión: Además de la alta frecuencia de alteraciones para el fósforo y la hormona paratiroidea durante todo el período analizado, hubo una asociación positiva entre la alteración del fósforo para la alteración del calcio total y la edad <55 años para la alteración de la hormona paratiroidea.

Palabras clave: Insuficiencia renal crónica, Diálisis renal, Indicadores de salud

Referencias

Abrita, RR, Pereira, BS, Fernandes, NS, Abrita, R., Huaira, RMNH, Bastos, MG, e Fernandes, NMS (2018). Evaluation of prevalence, biochemical profile, and drugs associated with chronic kidney disease-mineral and bone disorder in 11 dialysis centers. Brazilian Journal of Nephrology, 40(1), 26-34. https://doi.org/10.1590/2175-8239-jbn-3527

Alvarenga, L.A., Andrade, B.D., Moreira, M.A., Nascimento, R.P., Macedo, I.D., e Aguiar, A.S. (2017). Nutritional profile of hemodialysis patients concerning treatment time. Brazilian Journal of Nephrology, 39(3), 283-286. http://dx.doi.org/10.5935/0101-2800.20170052

Beto, J., Bhatt, N., Gerbeling, T., Patel, C., e Drayer, D. (2019). Overview of the 2017 KDIGO CKD-MBD Update: Practice Implications for Adult Hemodialysis Patients. Journal of Renal Nutrition, 29(1), 2-15. https://doi.org/10.1053/j.jrn.2018.05.006

Bhan, I., Dobens, D., Tamez, H., Deferio, JJ, Li, YC, Warren, HS, Ankers, E., Wenger, J., Tucker, JK, Trottier, C., Pathan, F., Kalim, S., Nigwekar, SU, e Thadhani, R. (2015). Nutritional vitamin D supplementation in dialysis: a randomized trial. Clinical Journal of the American Society of Nephrology, 10(4), 611-619. https://doi.org/10.2215/CJN.06910714

Brasil (2016). Protocolo Clínico e Diretrizes Terapêuticas: Distúrbio Mineral e Ósseo na Doença Renal Crônica. Ministério da Saúde.

Castro, M.C.M. (2016). Variability in quality of care among dialysis units in the state of São Paulo and the ordinance number 389/2014 of the Health Ministry of Brazil. Brazilian Journal of Nephrology, 38(1), 62-69. https://doi.org/10.5935/0101-2800.20160010

Castro Júnior, DF, Soares, LP, Barbosa, RP, Tenório Filho, NJ, Vasconcelos, GG, de Bessa, NF, e Herrera, SDSC (2017). Prevalência de hipertensão arterial sistêmica e diabetes melitus em pacientes com doença renal crônica em ambulatório de cardiologia. Revista Cereus, 9(3), 2-20. http://ojs.unirg.edu.br/index.php/1/article/view/1744

Cozzolino, M., Foque, D., Ciceri, P., e Galassi, A. (2017). Phosphate in chronic kidney disease progression. In G. La Manna, e C. Ronco (Orgs.), Contributions to Nephrology (vol. 190, p. 71–82). S. Karger AG. https://doi.org/10.1159/000468915

Damasiewicz, M.J., e Nickolas, T.L. (2018). Rethinking bone disease in kidney disease. JBMR Plus, 2(6), 309-322. https://doi.org/10.1002/jbm4.10117

Douthat, WG, Castellano, M., Berenguer, L., Guzmán, MA, Arteaga, J., Chiurchiu, CR, Massari, PU, Garay, G., Capra, R., e de la Fuente, JL (2013). High prevalence of secondary hyperparathyroidism in chronic kidney disease patients on dialysis in Argentina. Nefrología (Madrid), 33(5), 657-666. http://dx.doi.org/10.3265/Nefrologia.pre2013.May.12009

Felsenfeld, A.J., Levine, B.S., e Rodriguez, M. (2015). Pathophysiology of calcium, phosphorus, and magnesium dysregulation in chronic kidney disease. Seminars in dialysis, 28(6), 564-577. https://doi.org/10.1111/sdi.12411

Fernández-Martín, JL, Dusso, A., Martínez-Camblor, P., Dionisi, MP, Floege, J., Ketteler, M., London, G., Locatelli, F., Górriz, JL, Rutkowski, B., Bos, WJ, Tielemans, C., Martin, PY, Wüthrich, RP, Pavlovic, D., Benedik, M., Rodríguez-Puyol, D., Carrero, JJ, Zoccali, C., e Cannata-Andía, JB (2019). Serum phosphate optimal timing and range associated with patients survival in haemodialysis: the COSMOS study. Nephrology Dialysis Transplantation, 34(4), 673-681. https://doi.org/10.1093/ndt/gfy093

Goltzman, D., Mannstadt, M., e Marcocci, C. (2018). Physiology of the calcium-parathyroid hormone-vitamin D axis. In A. Giustina, e J.P. Bilezikian (Orgs.), Frontiers of Hormone Research (vol. 50, p. 1–13). S. Karger AG. https://doi.org/10.1159/000486060

Hill, NR, Fatoba, ST, Oke, JL, Hirst, JA, O’Callaghan, CA, Lasserson, DS, e Hobbs, FDR (2016). Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PloS One, 11(7), e158765. https://doi.org/10.1371/journal.pone.0158765

Instituto Brasileiro de Geografia e Estatística [IBGE] (2020). Pesquisa Nacional por Amostra de Domicílios Contínua: características gerais dos domicílios e dos moradores: 2019. IBGE. https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101707

Iwasaki, Y., Kazama, J.J., e Fukagawa, M. (2017). Molecular abnormalities underlying bone fragility in chronic kidney disease. BioMed Research International, 1-11. https://doi.org/10.1155/2017/3485785

Jesus, N.M., Souza, G.F., Mendes-Rodrigues, C., Almeida Neto, O.P., Rodrigues, D.D.M., e Cunha, C.M. (2019). Quality of life of individuals with chronic kidney disease on dialysis. Brazilian Journal of Nephrology, 41(3), 364-374. https://doi.org/10.1590/2175-8239-jbn-2018-0152

Levin, A., Stevens, P., Bilous, RW, Coresh, J., de Francisco, ALM, De Jong, PE, Griffith, KE, Hemmelgarn, BR, Iseki, K., Lamb, EJ, Levey, AS, Riella, M., Shlipak, MG, Wang, H., White, CT, e Winearl, CG (2013). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl, 3(1), 1-150. http://dx.doi.org/10.1038/kisup.2012.73

Ketteler, M., Block, GA, Evenepoel, P., Fukagawa, M., Herzog, CA, McCann, L., Moe, MS, Shroff, R., Tonelli, MA, Toussaint, ND, Vervloet, MG, e Leonard, MB (2018). Diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder: Synopsis of the kidney disease: improving global outcomes 2017 clinical practice guideline update. Annals of Internal Medicine, 168(6), 422-430. https://doi.org/10.7326/M17-2640

Kirsztajn, GM, Salgado Filho, N., Draibe, SA, Netto, MVP, Thomé, FS, Souza, E., e Bastos, MG (2014). Fast reading of the KDIGO 2012: guidelines for evaluation and management of chronic kidney disease in clinical practice. Brazilian Journal of Nephrology, 36(1), 63-73. https://doi.org/10.5935/0101-2800.20140012

Kooman, J.P., Van der Sande, F.M., e Leunissen, K.M.L. (2017). Kidney disease and aging: a reciprocal relation. Experimental gerontology, 87, 156-159. https://doi.org/10.1016/j.exger.2016.02.003

Levorato, C.D., Mello, L.M. de, Silva, A.S. da, e Nunes, A.A. (2014). Fatores associados à procura por serviços de saúde numa perspectiva relacional de gênero. Ciência & Saúde Coletiva, 19(4), 1263-1274. https://doi.org/10.1590/1413-81232014194.01242013

Ma, X., Zhang, C., Su, H., Gong, X., e Kong, X. (2018). Increasing body mass index predicts rapid decline in renal function: a 5 year retrospective study. Hormone and Metabolic Research, 50(7), 556-561. https://doi.org/10.1055/a-0599-6360

Melamed, ML, Chonchol, M., Gutiérrez, OM, Kalantar-Zadeh, K., Kendrick, J., Norris, K., Scialla, JJ, e Thadhani, R. (2018). The role of vitamin D in CKD stages 3 to 4: report of a scientific workshop sponsored by the National Kidney Foundation. American Journal of Kidney Diseases, 72(6), 834-845. https://doi.org/10.1053/j.ajkd.2018.06.031

Moreira, R., Fontes, W., e Barboza, T. (2014). Difficulties of the man in primary healthcare: the speech of nurses. Esc Anna Nery Rev Enferm, 18(4), 615-621. https://doi.org/10.5935/1414-8145.20140087

Neves, P.D.M.M., Sesso, R.C.C., Thomé, F.S., Lugon, J.R., e Nascimento, M.M. (2020). Censo Brasileiro de Diálise: análise de dados da década 2009-2018. Brazilian Journal of Nephrology (AHEAD), 42(2). https://doi.org/10.1590/2175-8239-jbn-2019-0234

Nunes, F.M., Sotero, R.F.T.M., Magalhães, T.A., de Quadros, A.C.V.C., e Oliva, H.N.P. (2019). Prevalência de lesões em órgãos-alvo em diabéticos tipo 2. Revista da Sociedade Brasileira de Clínica Médica, 17(2), 85-89. http://www.sbcm.org.br/ojs3/index.php/rsbcm/article/view/613/364

Saddadi, F., Rasoolzadeh, A., Ganji, M., e Miri, M. (2017). Impact of FGF23 level on calcium and phosphorus levels in post-renal transplantation. Journal of renal injury prevention, 6(2), 99. https://doi.org/10.15171/jrip.2017.19

Schiller, A., Apetrii, M., Onofriescu, M., Siriopol, D., Veisa, G., Schiller, O., Bob, F., Timar, R., Mihaescu, A., Kanbay, M. e Covic, A. (2015). Prognostic significance of 25‐hydroxivitamin D entirely explained by a higher comorbidity burden: Experience from a South‐Eastern European Dialysis Cohort. Hemodialysis International, 19(2), 249-255. https://doi.org/10.1111/hdi.12226

Silva, BC, Sanjuan, A., Costa-Hong, V., Reis, L., Graciolli, F., Consolim-Colombo, F., Bortolotto, LA, Moyses, RMA, e Elias, RM (2016). Factors associated with subendocardial ischemia risk in patients on hemodialysis. Brazilian Journal of Nephrology, 38(3), 320-326. https://doi.org/10.5935/0101-2800.20160049

Silva, CA, Rodrigues, MSC, Dias, MRF, Moreira, JSB, Reis, AD, Ferreira, MC, Cordeiro, KS, Dias, LPP, e Martins, ICVS (2020). Perfil Clínico e Bioquímico de Pacientes em Hemodiálise com Hiperparatireoidismo Secundário. Rev. bras. ciênc. saúde, 24(1), 63-70. https://doi.org/10.22478/ufpb.2317-6032.2020v24n1.47385

Souza Júnior, EV, Costa, EL, Matos, RA, Cruz, JS, Maia, TF, Nunes, GA, Boery, RNSO, e Boery, EN (2019). Epidemiologia da morbimortalidade e custos públicos por insuficiência renal. Rev. enferm. UFPE on line, 13(3), 647-654. https://doi.org/10.5205/1981-8963-v13i3a236395p647-654-2019

Stumm, EMF, Kirchner, RM, Azevedo Guido, L., Benetti, ERR, Belasco, AGS, Sesso, RCC., e Barbosa, DA (2017). Intervenção educacional de enfermagem para redução da hiperfosfatemia em pacientes em hemodiálise. Revista Brasileira de Enfermagem, 70(1), 31-38. http://dx.doi.org/10.1590/0034-7167-2016-0015

Thomé, F.S., Sesso, R.C., Lopes, A.A., Lugon, J.R., e Martins, C.T. (2019). Brazilian chronic dialysis survey 2017. Brazilian Journal of Nephrology, 39(3), 261-266. http://dx.doi.org/10.5935/0101-2800.20170049

Tomich, GM, Milhomem, BM, Araújo, CS, Sousa, PPS, Azevedo Coelho, T., Ginani, GF, e Oliveira, RA (2015). Hiperparatireoidismo secundário à doença renal crônica em pacientes em diálise no Pará-Brasil. Semina: Ciências Biológicas e da Saúde, 36(2), 67-74. http://www.uel.br/revistas/uel/index.php/seminabio/article/view/23174

Valencia, C.A.R., e Arango, J.V.A. (2016). Vitamin D (25 (OH) D) in patients with chronic kidney disease stages 2-5. Colombia Médica, 47(3), 160-166. https://doi.org/10.25100/cm.v47i3.2148

Vervloet, M.G., Sezer, S., Massy, Z.A., Johansson, L., Cozzolino, M., e Fouque, D. (2017). The role of phosphate in kidney disease. Nature Reviews Nephrology, 13(1), 27. http://dx.doi.org/10.1038/nrneph.2016.164

Waziri, B., Musenge, E., Duarte, R., Dickens, C., Dix-Peek, T., Rekhviashvili, V., Paget, G., e Naicker, S. (2019). Associations of plasma fibroblast growth factor 23 and other markers of chronic kidney disease—Mineral and bone disorder with all-cause mortality in South African patients on maintenance dialysis: A 3-year prospective cohort study. PloS One, 14(5). https://doi.org/10.1371/journal.pone.0216656

Wheeler, D.C., e Winkelmayer, W.C. (2017). KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) foreword. Kidney International Supplements, 7(1), 1-59. https://kdigo.org/wp-content/uploads/2017/02/2017-KDIGO-CKD-MBD-GL-Update.pdf

World Health Organization (2000). Obesity: preventing and managing the global epidemic. WHO. https://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/

World Health Organization (2016). Global report on diabetes. WHO. https://apps.who.int/iris/bitstream/handle/10665/204871/9789241565257_eng.pdf?sequence=1

Winter, D.E.A. (2016). Sobrevida e fatores de risco de mortalidade em pacientes sob hemodiálise. HU Revista, 42(4), 267-275. https://periodicos.ufjf.br/index.php/hurevista/article/view/2483

Zambello, A., Soares, A., Tauil, C., Donzelli, C., Fontana, F., e Chotolli, W. (2018). Metodologia da pesquisa e do trabalho científico. Thiago Mazucato (org.). FUNEPE. http://funepe.edu.br/arquivos/publicacoes/metodologia-pesquisa-trabalho-cientifico.pdf

Zanesco, C., de Brito Pitilin, E., Rossetto, M., e de Resende, D.T. (2019). Avaliação da qualidade de vida de pacientes renais crônicos em hemodiálise – um estudo transversal. Revista de Pesquisa: Cuidado é Fundamental, 11(1), 186-191. http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/6934

Biografía del autor/a

Denilson Soares Gomes Junior,

http://lattes.cnpq.br/1936851909878855

Bruna Jacó Lima Samselski,

http://lattes.cnpq.br/8709376208088691

Daniela Freitas de Oliveira,

http://lattes.cnpq.br/8080049300144696

Brenda dos Santos Coutinho,

http://lattes.cnpq.br/6456311220408048

Emanuel Pinheiro Esposito,

http://lattes.cnpq.br/4046885474500580

Luiz Fernando Gouvêa-e-Silva,

http://lattes.cnpq.br/2109467799397782

Es fútbol, no una guerra
Publicado
2022-06-06
Cómo citar
Gomes Junior, D. S., Samselski, B. J. L., Oliveira, D. F. de, Coutinho, B. dos S., Esposito, E. P., & Gouvêa-e-Silva, L. F. (2022). Análisis clínicos y de laboratorio de pacientes en diálisis en un hospital de referencia en la Amazonía. Lecturas: Educación Física Y Deportes, 27(289), 112-126. https://doi.org/10.46642/efd.v27i289.2380
Número
Vol. 27 Núm. 289 (2022)
Sección
Artículos de Investigación

Derechos de autor 2022 Lecturas: Educación Física y Deportes

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