Asociación entre dosis de Hemodiálisis (Kt/V) y Mortalidad en pacientes Covid 19 con Enfermedad Renal Cronica Terminal en el Hospital Regional Docente de Trujillo periodo 2020 -2021
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Date
2024-01-17
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Universidad Nacional de Trujillo
Abstract
En el mundo, existe variabilidad acerca de la mortalidad de pacientes con enfermedad renal crónica asociado al covid 19 con hemodiálisis y a los factores desencadenantes como son sus complicaciones intradialiticas que al no corregirse a tiempo generan riesgos en la vida de los pacientes.
El Kt / V se define como el aclaramiento de urea ( K ) del dializador multiplicado por la duración de la diálisis ( t , en minutos) dividido por el volumen de distribución de urea en el cuerpo ( V, en ml), que es aproximadamente igual al agua corporal total, corregido por el volumen perdido durante la ultrafiltración 7 En la práctica común se prescribe la diálisis tres veces por semana con sesiones de 3 o 4 horas de duración. Las sesiones de mayor duración o más frecuentes se utilizan actualmente en pacientes de mayor tamaño corporal, pacientes con hipertensión arterial severa que no responden al máximo tratamiento antihipertensivo y pacientes con sobrecarga de volumen e hipotensión intradiálisis que impiden la eliminación de líquido
Las directrices de la National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recomiendan un objetivo de Kt/V de 1,2 a 1,4 por sesión de hemodiálisis para los pacientes tratados tres veces por semana.
Los objetivos del tratamiento sustitutivo renal son: aumentar la supervivencia, reducir la morbilidad y mejorar su calidad de vida, estos objetivos incluyen la reducción de complicaciones médicas que se logran gracias a la eliminación de los solutos mediante la diálisis.
El presente estudio es realizado, con la finalidad de conocer las múltiples formas representativas del Covid 19 y su mortalidad en pacientes con enfermedad crónica renal con hemodiálisis, y adoptar medidas de prevención que se puedan ajustar a la realidad medica de nuestro país.
ABSTRACT In the world, there is variability regarding the mortality of patients with chronic kidney disease associated with covid 19 with hemodialysis and the triggering factors such as its intradialytic complications that, if not corrected in time, generate risks in the lives of patients. The Kt/V is defined as the urea clearance (K) of the dialyzer multiplied by the duration of dialysis (t, in minutes) divided by the volume of distribution of urea in the body (V, in ml), which is approximately equal to total body water, corrected for the volume lost during ultrafiltration 7 In common practice, dialysis is prescribed three times a week with sessions lasting 3 or 4 hours. Longer or more frequent sessions are currently used in patients with larger body size, patients with severe arterial hypertension who do not respond to maximum antihypertensive treatment, and patients with volume overload and intradialytic hypotension that prevent fluid removal. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend a Kt/V target of 1.2 to 1.4 per hemodialysis session for patients treated three times per week. The objectives of renal replacement treatment are: to increase survival, reduce morbidity and improve quality of life. These objectives include the reduction of medical complications that are achieved thanks to the elimination of solutes through dialysis. The present study is carried out with the purpose of knowing the multiple representative forms of Covid 19 and its mortality in patients with chronic kidney disease with hemodialysis, and adopting prevention measures that can be adjusted to the medical reality of our country.
ABSTRACT In the world, there is variability regarding the mortality of patients with chronic kidney disease associated with covid 19 with hemodialysis and the triggering factors such as its intradialytic complications that, if not corrected in time, generate risks in the lives of patients. The Kt/V is defined as the urea clearance (K) of the dialyzer multiplied by the duration of dialysis (t, in minutes) divided by the volume of distribution of urea in the body (V, in ml), which is approximately equal to total body water, corrected for the volume lost during ultrafiltration 7 In common practice, dialysis is prescribed three times a week with sessions lasting 3 or 4 hours. Longer or more frequent sessions are currently used in patients with larger body size, patients with severe arterial hypertension who do not respond to maximum antihypertensive treatment, and patients with volume overload and intradialytic hypotension that prevent fluid removal. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend a Kt/V target of 1.2 to 1.4 per hemodialysis session for patients treated three times per week. The objectives of renal replacement treatment are: to increase survival, reduce morbidity and improve quality of life. These objectives include the reduction of medical complications that are achieved thanks to the elimination of solutes through dialysis. The present study is carried out with the purpose of knowing the multiple representative forms of Covid 19 and its mortality in patients with chronic kidney disease with hemodialysis, and adopting prevention measures that can be adjusted to the medical reality of our country.
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Keywords
SARS CoV 2, Hemodiálisis, Mortalidad