Choosing not to dialysis in chronic renal failure in stage V (Renal Failure). Evolution of the characteristics of patients between 1992-1995 y 2000-2003
Elección de no diálisis en insuficiencia renal crónica en estadio V (Fallo Renal). Evolución de las características de los pacientes entre 1992-1995 y 2000-2003.
Manuel García García, Juan Carlos Martinez Ocaña, Angel Rodriguez Jornet, Jaume Almirall Daly, Esther Ponz Clemente, José Ibeas López, Tha
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Evolution of the characteristics of patients between 1992-1995 y 2000-2003" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "574" "paginaFinal" => "580" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Manuel García García, Juan Carlos Martinez Ocaña, Angel Rodriguez Jornet, Jaume Almirall Daly, Esther Ponz Clemente, José Ibeas López, Tha" "autores" => array:1 [ 0 => array:1 [ "nombre" => "Manuel García García, Juan Carlos Martinez Ocaña, Angel Rodriguez Jornet, Jaume Almirall Daly, Esther Ponz Clemente, José Ibeas López, Tha" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Elección de no diálisis en insuficiencia renal crónica en estadio V (Fallo Renal). Evolución de las características de los pacientes entre 1992-1995 y 2000-2003." ] ] "pdfFichero" => "P-E-S-A4736-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436173" "palabras" => array:1 [ 0 => "Insuficiencia renal crónica estadio V, manejo no dialítico, manejo conservador, cuidados paliativos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec436174" "palabras" => array:1 [ 0 => "Chronic renal failure, non-dialytic management, conservative management, palliative care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "BACKGROUND. The incidence of chronic renal failure increase with the age. The selection of patient to dialysis has been increasing in spite of the high comorbidity. Moreover, in our clinical practice the aged patient is not contraindicated to dialysis. However, in the nephrology clinical practice not all the patients start the treatment with dialysis. OBJECTIVE The aim of our study has been to compare the characteristics of the patients who had not been dialyzed between the periods 1992-1995 and 2000-2003 to analyze the trend of the nephrology clinical practice. MATERIAL AND METHODS. Comparative study of the characteristics and the evolution of patients with chronic renal failure in stage V, (renal failure) not incorpored to dialysis in one hospital during four years between the periods the 1992-1995 ( period A) and 2000-2003 (period B). RESULTS. Start dialysis (period A versus period B): 116 patients, age 59.9+15.5 years vs. 229 patients, age 64.0+15.8 years (p <0 05 non-dialysis period a versus b : 38 patients age 77 5 9 3 years vs 37 81 7 6 2 p <0 01 renal function: serum creatinina 7 4 2 mg dl vs 5 3 1 p <0 001 mdrd estimate glomerular filtration 6 9 2 4 mg dl ml min 1 73 m2 vs 10 0 3 p <0 001 primary renal disease: unknown etiology 31 5 vs 24 3 nephroangiosclerosis 23 6 32 4 diabetes 28 9 21 functional status: dependent patients 34 2 83 8 p <0 001 the principal reason for non-dialysis were: personal decision: 26 3 vs 35 1 dementia 15 8 29 7 brief life expectancy because of serious co-existing diseases 13 21 and chronic illness with inability themselves care 44 comorbid conditions: 2 0 5 p <0 05 survival: 55 168 days vs 236 p <0 001 conclusion most of the patients that don t begin dialysis are elderly together with a poor functional capacity and more autonomy in their decisions identification renal failure stage v was detected early last period than following one conservative management non-dialyzed uremic is significative nephrology clinical practice due to survival those persons</0> </0> </0> </0> </0> </0> </0>" ] "es" => array:1 [ "resumen" => "Introducción: La insuficiencia renal crónica (IRC) es una patología que aumenta su incidencia con la edad. La aceptación de pacientes para diálisis ha ido aumentando en los últimos años a pesar del incremento de la comorbilidad, no considerándose la edad como contraindicación para el tratamiento sustitutivo renal. No obstante, en la práctica clínica nefrológica hay pacientes que no son incluidos en diálisis. Objetivo: Comparar las características de los pacientes con IRC no incluidos en diálisis en los períodos 1992-1995 y 2000-2003 para analizar las tendencias evolutivas de la práctica clínica nefrológica. Material y método: Estudio comparativo de las características basales y la evolución de los pacientes con IRC en estadio de fallo renal (estadio V) en quienes se decidió la elección de No-Diálisis atendidos en un sólo hospital durante 4 años entre los períodos de 1992-1995 (período A) y 2000-2003 (período B). La elección de No-Diálisis fue por decisión del paciente si era autónomo o de sus representantes llegales en caso contrario. Resultados: SI-Diálisis: (período A versus período B): n:116 pacientes, edad: 59,9 + 15,5 años vs n: 229 pacientes, edad: 64,0 + 15,8 años (p < 0,05). NO-Diálisis: (período A versus período B): n: 38 pacientes, 24,6% de la IRC que inició diálisis, edad: 77,5 + 9,3 años vs n: 37 pacientes, 13,9% de la IRC que inició diálisis, edad: 81,7 + 6,2 años (p < 0,01). Funcionalismo renal: creatinine sérica 7,4 + 2,4 mg/dl vs 5,3 + 1,2 mg/dl (p < 0,001); filtrado glomerular estimado por MDRD abreviado: 6,9 + 2,4 ml/min/1,73 m2 vs 10,0 + 2,3 ml/min/1,73 m2 (p < 0,001). Enfermedad renal primaria principales: etiologia no aclarada 31,5% vs 24,3%, nefroangiosclerosis 23,6% vs 32,4%, diabetes 28,9 vs 21,6. Los motivos principales de la elección de no diálisis fueron: decisión personal 26,3% vs 35,1%, incompetencia mental persistente 15,8% vs 29,7%, pronóstico mortal a corto plazo 13,1% vs 21,7% y deterioro crónico severo con incapacidad de cuidarse 44,7% vs 13,5%. Autonomia funcional: pacientes deppendientes 34,2% vs 83,8% (p < 0,001). Comorbilidades: 2,3 + 1,0 vs 3,0 + 1,5 procesos (p < 0,05), insuficiencia cardíaca 36,8% vs 48,8%, enfermedad cerebro-vascular 47,3% vs 51,3%, artropatía invalidante 13,1% vs 43,2%. Supervivencia media 55 + 168 días vs 168 + 236 días (p <0 001 conclusión: los pacientes que no inician diálisis en últimos años son más viejos tienen peor capacidad física y autónomos su de decisión la identificación con irc estadio v se hace forma precoz el seguimiento es prolongado último período manejo nefrológico conservador una práctica clínica nefrológica significativa debido a mayor supervivencia estos</0>" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000005/v0_201502091551/X2013251407021880/v0_201502091551/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000005/v0_201502091551/X2013251407021880/v0_201502091551/en/P-E-S-A4736-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021880?idApp=UINPBA000064" ]
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