SUMMARY Objective. The present study was designed to determine the degree of fulfilment of the therapeutic objectives recommended in the clinical guidelines in patients with chronic kidney disease (CKD) in a nephrology outpatient clinic and the treatment that the patients were receiving to control these objectives. Methods. A descriptive, cross-sectional study was performed in unselected patients with CKD (stages 1-5) who attended the nephrology outpatient clinic of the Hospital General Universitario Gregorio Marañón for follow up between 1st January and 1st April 2006. Results. Data from 600 patients with a mean age of 62.8 years (56.5% male) were collected. The distribution of patients according to the stage (S) of CKD was as follows: S1: 11.5%, S2: 18%, S3: 36.7%, S4: 27.5% and S5: 6.3%. The target blood pressure (BP) < 130/80 mmHg was reached in 35.5%. The target diastolic blood pressure was controlled in 70%. However, systolic blood pressure increasing significantly with age and the degree of renal failure was controlled only in 42%. Total cholesterol was ≤175mg/dl in 33.3% of patients, LDL-cholesterol was ≤100 mg/dl in 40.6% of patients (53.6% with statins) and HDL-cholesterol was ≥50 mg/l in 64.1% of patients. Triglyceride level was related to renal function (p=0.04). Most of the patients (94%) had hemoglobin (Hb) levels ≥11g/dl, because of a significant increase in the percentage of patients treated with erythropoiesis-stimulating agents as the degree of renal function is reduced. Target levels of calcium-phosphorus (CaXP) product ( <55 mg2 dl2 were maintained in all the stages at expense of decreased ca and increased p relation to decrease glomerular filtrate target 8 4-9 5 mg dl was reached 85 cases 2 patients s3 37 s4 54 s5 receiving calcitriol phosphorus levels adequate 80 but parathyroid hormone pth only 28 6 35-70 pg ml 14 70-110 s-5 115-300 conclusions: anemia is best controlled factor factors related renal function degree control blood pressure bp has improved recent years however it still poor particularly systolic getting worse with failure age difficult reach despite cholesterol unlike triglyceride do not depend on require an increse use or doses cholesterol-lowering drugs

RESUMEN Objetivo. El presente estudio se diseñó para determinar el grado de cumplimiento de los objetivos terapéuticos recomendados por las guías de actuación clínica en los pacientes con ERC en una consulta externa de nefrología y el tratamiento que recibían los pacientes para el control de los mismos. Métodos. Se realizó un estudio descriptivo y transversal con pacientes no seleccionados con ERC (estadios 1-5) que acudieron a revisión a la consulta ambulatoria de nefrología del Hospital General Universitario Gregorio Marañón entre el 1 de enero y el 1 de abril del 2006. Resultados Se recogieron los datos de 600 pacientes con una edad media de 62,8 años (56,5% varones). La distribución de los pacientes según los estadios (E) de ERC fue: E1:11,5%, E2:18%, E3:36,7%, E4:27,5% y E5:6,3%. El objetivo de presión arterial (PA) <130 80 mmhg se alcanzó en el 35 5 la pa diastólica estaba controlada 70 sin embargo sistólica que aumenta significativamente con edad y grado de insuficiencia renal únicamente controló 42 33 3 los pacientes presentaba cifras colesterol-total 8804 175mg dl 40 6 ldl-colesterol 100 mg 53 estatinas 64 1 hdl-colesterol 8805 50 l nivel triglicéridos relacionó función p="0.04)." mayor parte 94 tenía hb 11g gracias a un aumento significativo tratados agentes estimulantes eritropoyesis conforme disminuye caxp mantuvo objetivo <55 mg2 dl2 en todos los estadios a expensas de disminución del ca y aumento p relación con la filtrado glomerular el objetivo entre 8 4-9 5 mg dl se alcanzaba 85 casos 2 pacientes e3 37 e4 54 e5 recibían calcitriol niveles fósforo fueron adecuados 80 pero sólo 28 6 e-3 mantuvo cifras pth 35-70pg ml 14 e-4 70-110pg e-5 115-300 pg conclusiones: factores relacionados función renal anemia es mejor controlado grado control pa aunque ha mejorado últimos años sigue siendo pobre sobre todo sistólica que empeora insuficiencia edad difícil alcanzar pesar adecuadas colesterol al contrario triglicéridos no dependen requieren incrementar uso o dosis fármacos hipocolesterolemiantes