Deterioro cognitivo primario en pacientes en Hemodiálisis
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Fecha
2019
Autores
Castro Ahumada, Eddie Manuel
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Los pacientes con Enfermedad Renal Crónica (ERC) suelen presentar gran variedad de trastornos en el Sistema Nervioso Central y Periférico que han sido ampliamente descritos en la literatura médica. Sin embargo, su abordaje solo es realizado cuando los signos y síntomas son evidentes, esto ocasiona que la intervención sea solamente paliativa. Por tal motivo es necesario establecer el grado de deterioro cognitivo primario (DCP) en pacientes con enfermedad renal crónica en terapia dialítica. Se realizó un estudio metacéntrico (3 IPS), transversal. A los pacientes, previo consentimiento informado, se les aplicó el cuestionario para Evaluación Cognitiva De Montreal (MoCA), así mismo se registraron los datos de últimos paraclínicos (Hemoglobina, Sodio, BUN, Creatinina Sérica), KtV, Fecha de la primera diálisis, enfermedad de base y comorbilidades. Se evaluaron en un total de 62 pacientes en diálisis. El 58.5% fueron hombres. La edad promedio global fue de 53±16 años (mujeres: 47±16 años | hombres: 58±15 años). El tiempo en diálisis fue de 7.5±5 años (mujeres: 7±5 años | hombres: 8±5 años). Solo dos pacientes (3.5%) obtuvieron para no clasificarlos con deterioro cognitivo primario. Se encontró una correlación de efecto mixto entre la Edad y el Tiempo en diálisis, sin embargo, el valor de R² es medianamente débil (31.2%) aunque el valor de significancia indica que esta es muy significativa (p-valor < 0.05), estos resultados indican la necesidad de incluirle al modelo los valores de dosis de diálisis, así como los parámetros de laboratorio, así como las comorbilidades y demás datos clínicos de relevancia. Con los parámetros evaluados hasta el momento, Edad y el Tiempo en diálisis, es posible desarrollar un modelo predictivo de deterioro cognitivo primario en los pacientes con ERC en fase dialítica.
Patients with Chronic Kidney Disease (CKD) usually present a wide variety of disorders in the Central and Peripheral Nervous System that has been widely reported in the medical literature. However, this is the only problem that has occurred when the symptoms and symptoms occur, this is due to the intervention at sea. For this reason, it is necessary to establish the degree of primary cognitive impairment in patients with chronic kidney disease on dialysis therapy. A multicenter study (3 IPS), transversal. To the patients, previous informed consent, the questionnaire for the Cognitive Evaluation of Montreal was applied, as well as the data of the last paraclinical ones (Hemoglobin, Sodium, BUN, Serum Creatinine), KtV, Date of the first dialysis, were registered. Base disease and comorbidities. It was evaluated in a total of 62 patients on dialysis. 58.5% were men. The overall average age was 53 ± 16 years (women: 47 ± 16 years | men: 58 ± 15 years). The time on dialysis was 7.5 ± 5 years (women: 7 ± 5 years | men: 8 ± 5 years). Only two patients (3.5%) obtained not to classify them with primary cognitive impairment. A correlation of the mixing effect between Age and Time in dialysis has been found, however, the value of R² is moderately weak (31.2%), although the value of significance indicates that it is very important (p-value <0.05), These results indicate the need to include the model values of the dialysis dose, as well as laboratory parameters, as well as comorbidities and other relevant clinical data. With the parameters evaluated so far, Age and Time in dialysis, it is possible to develop a predictive model of primary cognitive deterioration in patients with CKD in the dialysis phase.
Patients with Chronic Kidney Disease (CKD) usually present a wide variety of disorders in the Central and Peripheral Nervous System that has been widely reported in the medical literature. However, this is the only problem that has occurred when the symptoms and symptoms occur, this is due to the intervention at sea. For this reason, it is necessary to establish the degree of primary cognitive impairment in patients with chronic kidney disease on dialysis therapy. A multicenter study (3 IPS), transversal. To the patients, previous informed consent, the questionnaire for the Cognitive Evaluation of Montreal was applied, as well as the data of the last paraclinical ones (Hemoglobin, Sodium, BUN, Serum Creatinine), KtV, Date of the first dialysis, were registered. Base disease and comorbidities. It was evaluated in a total of 62 patients on dialysis. 58.5% were men. The overall average age was 53 ± 16 years (women: 47 ± 16 years | men: 58 ± 15 years). The time on dialysis was 7.5 ± 5 years (women: 7 ± 5 years | men: 8 ± 5 years). Only two patients (3.5%) obtained not to classify them with primary cognitive impairment. A correlation of the mixing effect between Age and Time in dialysis has been found, however, the value of R² is moderately weak (31.2%), although the value of significance indicates that it is very important (p-value <0.05), These results indicate the need to include the model values of the dialysis dose, as well as laboratory parameters, as well as comorbidities and other relevant clinical data. With the parameters evaluated so far, Age and Time in dialysis, it is possible to develop a predictive model of primary cognitive deterioration in patients with CKD in the dialysis phase.
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Palabras clave
Deterioro cognitivo primario, Deterioro cognitivo en hemodiálisis, Deterioro cognitivo en enfermedad renal crónica, Primary cognitive deterioration, Cognitive deterioration in hemodialysis, Cognitive deterioration in chronic kidney disease