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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">In the SEN &#40;Spanish Society of Nephrology&#41; Clinical Guidelines on Haemodialysis Centres&#44; chapter 7 corresponding to the standardisation of criteria for the treatment of outpatients&#44; it is considered that Dialysis Units must have a procedure for admitting and transferring patients that establishes&#44; amongst others&#44; &#8220;the definition of acceptable and non-acceptable characteristics of the patients by the organisation and suitability criteria for admission&#46;&#8221;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">One of the most important aspects to monitor in patients who transfer from one centre to another as outpatients is their viral serology&#46; Although this aspect is of maximum importance&#44; many centres&#44; in their excessive zeal&#44; request that the viral serology of patients transferred to their centre is no more than one month old &#40;this includes HCV&#44; HBV and HIV&#46;&#41;</p><p class="elsevierStylePara">This attitude has several consequences&#46; On one hand&#44; it damages both the issuing centre -since a great number of them are haemodialysis centres that do not have the facilities to perform these tests urgently- and the patients themselves&#44; since some have not been able to travel since they are not admitted for this reason&#46;</p><p class="elsevierStylePara">There are also unnecessary costs involved&#46;</p><p class="elsevierStylePara">Centre guidelines recommend that the viral serology of patients transferring from one centre to another be no more than three months old&#46;<span class="elsevierStyleSup">1</span> In our opinion&#44; centres should only request that the viral serology for haemodialysis patients does not surpass the standard monitoring period stated in the SEN virus guidelines and the guidelines for centres for stable haemodialysis patients&#46;<span class="elsevierStyleSup">3</span></p><p class="elsevierStylePara">Both guides recommend that the HCV-Ab be performed every six months &#40;recommendable&#41; or every three months &#40;desirable&#41;&#59; the HB-Ag to be tested on a yearly basis in patients with HB Ac negative and HIV annually&#46;</p><p class="elsevierStylePara">With respect to the HIV virus&#44; the guidelines for action against viral diseases state&#58; &#8220;All patients starting haemodialysis treatment must have a serology study performed for HIV to treat this disease&#46; Furthermore&#44; when a patient is permanently transferred from another Unit&#44; they must be tested for this virus&#46; Further serological studies are not required&#46; However they may be considered on a sixmonthly or yearly basis in patients who are at risk&#46;&#8221; It may be the case that the confusion originates in the recommendation that each patient starting haemodialysis and any patient being transferred to another Unit must be tested for HIV&#46; There is a difference between a new patient&#44; who is unknown&#44; starting dialysis for the first time in any centre and a patient who is part of a chronic haemodialysis programme in a Unit with adequate serology monitoring&#44; and who is probably in isolation&#44; transferring to another centre as an outpatient&#46; In the case of HIV&#44; the last test performed in the year is probably sufficient&#46; This virus also has low infectivity and the isolation of the patient is not required&#46; Therefore&#44; in theory&#44; strict observation of the universal precaution measures which are obligatory in any Dialysis Unit should be adequate&#44;<span class="elsevierStyleSup">4-6</span> as well as the real cause of nosocomial infections&#46;</p><p class="elsevierStylePara">In terms of determining HB-Ag&#44; guidelines recommend annual tests for each haemodialysis patient &#40;in particular&#44; in those who do not respond to vaccine against HBV&#41; and in all patients referred from another Unit&#44; with particular reference to the vaccination times and Acute Units&#46;</p><p class="elsevierStylePara">It seems reasonable to admit a patient from another stable Unit&#44; with an HB-Ag test carried out in the last three months or with HB-Ac&#44; even if they do not HB-Ag&#46; In such cases the serology is vital&#44; since this requires strict isolation in independent Units&#46; This is also the case with Ac against HCV&#46; Guidelines recommend that these are determined at least every six months&#46; The guidelines also indicate that it is desirable that this be determined every three months&#46;</p><p class="elsevierStylePara">To conclude&#44; in our opinion&#44; viral tests requested for stable haemodialysis patients transferring to another centre for their holidays should not exceed the recommendations stipulated by the guidelines relating to virus monitoring&#46;</p><p class="elsevierStylePara">Having an analysis of the viral serology taken in the last month does not rule out the possibility of nosocomial transmission&#44; since the patients may be in the window period&#44; which may last up to six months following communication&#46; Real prevention of viral infections in Haemodialysis Units is achieved by ensuring strict compliance with universal precautions in each patient undergoing dialysis in the Unit&#44; 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Viral serology in haemodialysis outpatients What is reasonable to request?
SEROLOGIA VÍRICA EN LOS PACIENTES TRANSEUNTES EN HEMODIALISIS ¿QUE ES RAZONABLE SOLICITAR?
María Dolores Arenasa
a Hospital Perpetuo Socorro Alicante, Alicante, España,
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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">In the SEN &#40;Spanish Society of Nephrology&#41; Clinical Guidelines on Haemodialysis Centres&#44; chapter 7 corresponding to the standardisation of criteria for the treatment of outpatients&#44; it is considered that Dialysis Units must have a procedure for admitting and transferring patients that establishes&#44; amongst others&#44; &#8220;the definition of acceptable and non-acceptable characteristics of the patients by the organisation and suitability criteria for admission&#46;&#8221;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">One of the most important aspects to monitor in patients who transfer from one centre to another as outpatients is their viral serology&#46; Although this aspect is of maximum importance&#44; many centres&#44; in their excessive zeal&#44; request that the viral serology of patients transferred to their centre is no more than one month old &#40;this includes HCV&#44; HBV and HIV&#46;&#41;</p><p class="elsevierStylePara">This attitude has several consequences&#46; On one hand&#44; it damages both the issuing centre -since a great number of them are haemodialysis centres that do not have the facilities to perform these tests urgently- and the patients themselves&#44; since some have not been able to travel since they are not admitted for this reason&#46;</p><p class="elsevierStylePara">There are also unnecessary costs involved&#46;</p><p class="elsevierStylePara">Centre guidelines recommend that the viral serology of patients transferring from one centre to another be no more than three months old&#46;<span class="elsevierStyleSup">1</span> In our opinion&#44; centres should only request that the viral serology for haemodialysis patients does not surpass the standard monitoring period stated in the SEN virus guidelines and the guidelines for centres for stable haemodialysis patients&#46;<span class="elsevierStyleSup">3</span></p><p class="elsevierStylePara">Both guides recommend that the HCV-Ab be performed every six months &#40;recommendable&#41; or every three months &#40;desirable&#41;&#59; the HB-Ag to be tested on a yearly basis in patients with HB Ac negative and HIV annually&#46;</p><p class="elsevierStylePara">With respect to the HIV virus&#44; the guidelines for action against viral diseases state&#58; &#8220;All patients starting haemodialysis treatment must have a serology study performed for HIV to treat this disease&#46; Furthermore&#44; when a patient is permanently transferred from another Unit&#44; they must be tested for this virus&#46; Further serological studies are not required&#46; However they may be considered on a sixmonthly or yearly basis in patients who are at risk&#46;&#8221; It may be the case that the confusion originates in the recommendation that each patient starting haemodialysis and any patient being transferred to another Unit must be tested for HIV&#46; There is a difference between a new patient&#44; who is unknown&#44; starting dialysis for the first time in any centre and a patient who is part of a chronic haemodialysis programme in a Unit with adequate serology monitoring&#44; and who is probably in isolation&#44; transferring to another centre as an outpatient&#46; In the case of HIV&#44; the last test performed in the year is probably sufficient&#46; This virus also has low infectivity and the isolation of the patient is not required&#46; Therefore&#44; in theory&#44; strict observation of the universal precaution measures which are obligatory in any Dialysis Unit should be adequate&#44;<span class="elsevierStyleSup">4-6</span> as well as the real cause of nosocomial infections&#46;</p><p class="elsevierStylePara">In terms of determining HB-Ag&#44; guidelines recommend annual tests for each haemodialysis patient &#40;in particular&#44; in those who do not respond to vaccine against HBV&#41; and in all patients referred from another Unit&#44; with particular reference to the vaccination times and Acute Units&#46;</p><p class="elsevierStylePara">It seems reasonable to admit a patient from another stable Unit&#44; with an HB-Ag test carried out in the last three months or with HB-Ac&#44; even if they do not HB-Ag&#46; In such cases the serology is vital&#44; since this requires strict isolation in independent Units&#46; This is also the case with Ac against HCV&#46; Guidelines recommend that these are determined at least every six months&#46; The guidelines also indicate that it is desirable that this be determined every three months&#46;</p><p class="elsevierStylePara">To conclude&#44; in our opinion&#44; viral tests requested for stable haemodialysis patients transferring to another centre for their holidays should not exceed the recommendations stipulated by the guidelines relating to virus monitoring&#46;</p><p class="elsevierStylePara">Having an analysis of the viral serology taken in the last month does not rule out the possibility of nosocomial transmission&#44; since the patients may be in the window period&#44; which may last up to six months following communication&#46; Real prevention of viral infections in Haemodialysis Units is achieved by ensuring strict compliance with universal precautions in each patient undergoing dialysis in the Unit&#44; 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Article information
ISSN: 20132514
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2021 July 73 41 114
2021 June 76 21 97
2021 May 74 14 88
2021 April 143 34 177
2021 March 134 25 159
2021 February 100 22 122
2021 January 82 13 95
2020 December 77 10 87
2020 November 83 16 99
2020 October 52 13 65
2020 September 83 7 90
2020 August 70 14 84
2020 July 71 9 80
2020 June 67 12 79
2020 May 51 10 61
2020 April 68 8 76
2020 March 67 13 80
2020 February 78 8 86
2020 January 82 19 101
2019 December 64 13 77
2019 November 58 10 68
2019 October 45 6 51
2019 September 40 12 52
2019 August 39 13 52
2019 July 39 20 59
2019 June 26 6 32
2019 May 32 4 36
2019 April 48 20 68
2019 March 18 15 33
2019 February 12 11 23
2019 January 25 10 35
2018 December 37 22 59
2018 November 61 12 73
2018 October 53 14 67
2018 September 30 9 39
2018 August 27 10 37
2018 July 16 9 25
2018 June 16 11 27
2018 May 28 10 38
2018 April 22 5 27
2018 March 20 12 32
2018 February 17 7 24
2018 January 17 3 20
2017 December 30 13 43
2017 November 19 3 22
2017 October 18 8 26
2017 September 25 9 34
2017 August 19 4 23
2017 July 22 10 32
2017 June 18 4 22
2017 May 19 4 23
2017 April 23 5 28
2017 March 19 6 25
2017 February 16 4 20
2017 January 11 5 16
2016 December 46 6 52
2016 November 48 5 53
2016 October 49 3 52
2016 September 85 3 88
2016 August 150 2 152
2016 July 123 5 128
2016 June 83 0 83
2016 May 92 0 92
2016 April 78 0 78
2016 March 71 0 71
2016 February 63 0 63
2016 January 73 0 73
2015 December 98 0 98
2015 November 67 0 67
2015 October 60 0 60
2015 September 54 0 54
2015 August 51 0 51
2015 July 46 0 46
2015 June 40 0 40
2015 May 41 0 41
2015 April 10 0 10
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?