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        "titulo" => "ENCUESTA SOBRE LOS CENTROS DE HEMODIÁLISIS EXTRAHOSPITALARIA EN ESPAÑA"
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      "titulo" => "Acute Renal failure in the transretinoic syndrome"
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      "titulo" => "Utility of Cystatin-C in hospitalized patients. Comparing with different methods of assessing renal function."
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        "titulo" => "ENCUESTA SOBRE LOS CENTROS DE HEMODIÁLISIS EXTRAHOSPITALARIA EN ESPAÑA"
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        "resumen" => "Background: Many guides and scientific recommendations about hemodialysis (HD) treatment have been developed. However, its impact and application is unknown. The aim of this study is to describe how Spanish Extrahospitalary Hemodialysis Centers work. Methods: A transversal, descriptive study was conducted by means of a survey. An 83-items questionnaire tackled different aspects involving patients and HD characteristics, Dialysis Unit organization and anemia management. Results: One hundred surveys were distributed and 91% were answered, corresponding to 6599 patients (M 4015/F 2584). Fifteen % were younger of 50 years and 45.2% older of 70 years. Seventy seven % had arteriovenous fistulas, 8.1% had polytetrafluoroethylene grafts and 14.8% had catheters. The mean number of patients per center was 72.3 (11-212). Seventy eight % were divided in 3 shifts, with a mean relationship of 38.9 patients/physician, 4.7 patients/nurse and 9 patients/auxiliary personnel. HD characteristics were: 60.1% of the HD sessions were longer than 4 hours, 97.2% were on a 3 days/week schedule&#59; 95.4% used a conventional technique&#59; 49.1% were performed with high-flux membranes, 89.6% with synthetic membranes, and 11.7% used Qb higher than 400 mL/min: On the other hand, 8.8% of the patients were HVC+, 0.68% were AgHBs+, and 0.09 were HIV+. There were HCV+ patients in 79% of Dialysis Units, 50% of them with complete isolation, while patients with hepatitis B were attended in 13.8%, and VIH+ in 3.4% of the Units, the latter always with complete isolation. Water treatment was done with simple osmosis in 46.6% of the cases, with water collection in 86.8% with pyrogen filter in the monitors in 48.9%. Surveillance of the controls was performed by the physician in 94.3% of the cases, and by technicians or nurses in the rest. Mean Hb was 11.9(1.4) g/dL, being higher of 11 g/dL in 80.2% of the patients. Ferritin higher than 100 µg/L was found in 92.4% and transferrin saturation higher than 20% in 81.9% of patients. The percentage treated with erithropoyetic stimulant agents was 90.6%. Conclusions: All information collected is relevant in order to know what is done and how to improve it.. It will be useful to evaluate the impact of the publication of the new Guides of HD Centers of SEN on medical practice in this area. "
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        "resumen" => "Introducción: Existen múltiples guías y recomendaciones científicas sobre el tratamiento de HD, pero se desconoce su grado de aplicación y repercusión. El Grupo de Trabajo de Hemodiálisis Extrahospitalaria se planteó describir una serie de puntos relevantes de la forma de trabajo de los centros extrahospitalarios. Material y métodos: Se realizó un estudio transversal y descriptivo, mediante un cuestionario de 83 preguntas en forma de encuesta, que abordaba distintos aspectos de los pacientes (pac), de características la HD (pauta, tratamiento de agua, medidas de aislamiento de virus), de la organización y el manejo de la anemia Resultados: Se distribuyeron encuestas a 100 centros, de los que respondieron el 91%. El número total de pacientes fue 6599 (H 4015 vs. M 2584). El 15.7% eran menores de 50 y el 45.2% mayores de 70 años. Los accesos vasculares prevalentes eran: 77% fístulas nativas, 8.1% prótesis y el 14.8% catéteres. La media de pacientes por centro fue 72.3 (rango 11-212), en el 78% divididos 3 turnos, con una media 38.9 pac/médico, 4.7 pac/enfermera y 9 pac/auxiliar. El 60.1% se dializaban más de 4 horas, con una frecuencia de 3 días/semana en el 97.2%, por una técnica convencional el 95.4%, con membranas de alta permeabilidad el 49.1% y sintéticas el 89.6%, el 11.7% utilizaban Qb superiores a 400 mL/min. El 8.8% de los pacientes eran VHC+, 0.68% virusB+ y 0.09 VIH+. El 79% de los centros dializaban pacientes portadores del virus C (con aislamiento completo el 50%), mientras que los individuos virus B+ se atendían en el 13.8% y los HIV + en el 3.4% de los centros, siempre con aislamiento completo. El tratamiento de agua fue ósmosis simple en el 46.6%, con almacenamiento de agua, 86.8% y filtro de pirógenos en los monitores, 48.9%. La supervisión de los controles la realizaba el médico en el 94.3% y en el resto sólo lo supervisaban el técnico o el personal de enfermería. La hemoglobina media fue 11.9 (1.4) g/L, siendo superior a 11 g/L en el 80.2% de los pacientes, con una ferritina >100 µg/L el 92.4% y una saturación >20% el 81.9%. El % de tratados con agentes estimuladores de la eritropoyesis era el 90.6%. Conclusiones: Toda la información obtenida es relevante para conocer qué se hace y cómo mejorarlo. Además, proporciona una herramienta para evaluar el impacto de la publicación de la Guía de Centros de HD de la SEN sobre la práctica médica en este sector. "
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