Asociación entre óxido nítrico e hipotensión en pacientes sometidos a hemodiálisis crónica del Hospital Universitario de Maracaibo
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Fecha
2018-07-15
Autores
Silva, Anderson
Martínez, María Sofía
Parra, Gustavo
Palmar, Jim
Linares, Sergia
Bermúdez, Valmore
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Editor
Sociedad Latinoamericana de Hipertención
Resumen
La hipotensión es la manifestación clínica más
frecuente de inestabilidad hemodinámica durante
el procedimiento de hemodiálisis (HD).
El origen de este trastorno hemodinámico es multifactorial,
sin embargo recientemente se ha planteado que el
Óxido Nítrico (ON) juega un rol determinante, dado a que
se ha demostrado que los niveles séricos se incrementan
significativamente durante el proceso de HD, por ello el
objetivo de esta investigación fue determinar la asociación
entre los niveles séricos de ON e hipotensión durante
HD crónica en pacientes de la Unidad de HD del Hospital
Universitario de Maracaibo. Para ello se realizó un estudio
no experimental, de campo, descriptivo y transversal, que
incluyó 10 individuos con antecedente de hipotensión en
HD y 10 paciente controles, a los cuales se les determinó
la concentración sérica de ON pre-diálisis, durante el episodio
hipotensivo intradiálisis al grupo caso, mientras que
la medición al grupo control se efectuó al minuto 107 de
dicho procedimiento. La media de edad de la población
estudiada fue 49,15±16,88 años. No se encontraron diferencias
entre las medias de PAS, PAD Y PAM prediálisis
de los grupos estudiados, más si existieron diferencias
intradiálisis. Asimismo se observaron diferencias significativas
entre la media de ON intradiálisis de controles y
casos (24,80±3,35 μM vs 31,89±4,06 μM respectivamente,
p=0,0445), mas no se encontraron diferencias en los
valores prediálisis (27,30±5,50 μM vs 29,70±9,44 μM,
respectivamente; p=0,496). Se concluyó que los individuos
hipotensos poseen niveles de ON significativamente
mayores durante un episodio hipotensivo, con respecto a
los controles.
Hypotension is the most common clinical manifestation of hemodynamic instability during hemodialysis (HD) procedure. The origin of this hemodynamic disorder is multifactorial, but recently nitric oxide (NO) has been shown an important role on its pathophysiology since increased ON seric levels during HD have been demonstrated. Therefore the aim of this research was to determinate the association between seric levels of NO and hypotension during chronic HD in patients of the HD Unit of the University Hospital of Maracaibo. A non-experimental, descriptive and cross-sectional study was developed, which included 10 individuals with a history of hypotension in HD patients and 10 controls. Seric ON levels pre-dialysis were determinated, likewise during intradialysis hypotensive episode on the study group, and on the minute 107 of HD for the control group. The mean age of the study population was 49.15 ± 16.88 years. No differences were found between means of SBP, DBP and MBP predialysis of the study groups, but intradialysis differences were found. Also significant differences were observed between ON intradialysis means of cases and controls (24,80±3,35 μM vs 31,89±4,06 μM respective, p=0,0445), but no differences were found in the predialysis values (27,30±5,50 μM vs 29,70±9,44 μM, respective; p=0,496). It was concluded that individuals with hypotension have significantly higher ON levels during a hypotensive episode, compare with controls subjects.
Hypotension is the most common clinical manifestation of hemodynamic instability during hemodialysis (HD) procedure. The origin of this hemodynamic disorder is multifactorial, but recently nitric oxide (NO) has been shown an important role on its pathophysiology since increased ON seric levels during HD have been demonstrated. Therefore the aim of this research was to determinate the association between seric levels of NO and hypotension during chronic HD in patients of the HD Unit of the University Hospital of Maracaibo. A non-experimental, descriptive and cross-sectional study was developed, which included 10 individuals with a history of hypotension in HD patients and 10 controls. Seric ON levels pre-dialysis were determinated, likewise during intradialysis hypotensive episode on the study group, and on the minute 107 of HD for the control group. The mean age of the study population was 49.15 ± 16.88 years. No differences were found between means of SBP, DBP and MBP predialysis of the study groups, but intradialysis differences were found. Also significant differences were observed between ON intradialysis means of cases and controls (24,80±3,35 μM vs 31,89±4,06 μM respective, p=0,0445), but no differences were found in the predialysis values (27,30±5,50 μM vs 29,70±9,44 μM, respective; p=0,496). It was concluded that individuals with hypotension have significantly higher ON levels during a hypotensive episode, compare with controls subjects.
Descripción
Palabras clave
Hipotensión, Hemodiálisis, Óxido Nítrico, hipertensión, Enfermedad renal crónica, Hypotension, Hemodialysis, Nitric Oxide, Hypertension, Chronic kidney disease