Evaluación de la correlación la dosis de diálisis (Kt/V) y el estatus de fragilidad en el paciente crónico dializado
Cargando...
Fecha
2020
Autores
Hernández Agudelo, Sandra Yolima
Maya Altamiranda, Lina Paola
Título de la revista
ISSN de la revista
Título del volumen
Editor
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: la fragilidad es un síndrome multicausal caracterizado por una disminución de fuerza, resistencia y función fisiológica, lo que hace al individuo vulnerable y dependiente, y aumenta su mortalidad. Este síndrome es más frecuente entre las personas mayores y los pacientes con enfermedad renal crónica, particularmente aquellos en diálisis. La dosis de diálisis está estandarizada actualmente para pacientes en hemodialálisis (HD) independientemente de su edad y estado funcional. Sin embargo, se ha postulado que la dosis de diálisis requerida en pacientes mayores, especialmente los frágiles, debe ser menor, ya que podría aumentar su grado de fragilidad. Entonces, el propósito de este estudio fue evaluar si habría una correlación entre la dosis de Kt / V y el grado de fragilidad en un población de pacientes adultos en HD. Material y métodos: un estudio transversal con 82 pacientes en HD en Barranquilla (Colombia) y Lobos (Argentina). Se registraron datos sociodemográficos y de laboratorio, así como dosis de diálisis (Kt / V) y se aplicaron escalas de fragilidad, actividad física, marcha y fuerza de agarre. Entonces estos los datos se correlacionaron mediante una correlación de Spearman y una regresión logística.
Resultados: SFC, aislamiento social, actividad física, velocidad de la marcha y pruebas de fuerza prensil fueron fuera de los rangos de referencia en el grupo estudiado. No se encontró correlación significativa entre la dosis de diálisis y todas las pruebas funcionales mencionadas anteriormente. Sin embargo, fue documentó una correlación significativa e inversa entre la actividad física y el síndrome de fatiga crónica (puntuación -1,41 (IC: -2,1 a -0,7). En conclusión: no hubo correlación significativa documentado entre el valor Kt / V y diferentes parámetros del estado de fragilidad, pero esto el estado se correlacionó de manera significativa e inversa con la actividad física en este grupo. Fragilidad El estado de los pacientes en hemodiálisis fue significativamente mayor en las personas mayores, aunque los jóvenes no estaban exentos de ella.
Introduction: Frailty is a multicausal syndrome characterized by a decrease in strength, resistance and physiological function, which makes the individual vulnerable and dependent, and increases his/her mortality. This syndrome is more prevalent among older individuals, and chronic kidney disease patients, particularly those on dialysis. Dialysis dose is currently standardized for hemodiallysis (HD) patients regardless their age and functional status. However, it has been postulated that the dialysis dose required in older patients, especially frail ones, should be lower, since it could increase their degree of frailty. Then, the purpose of this study was to evaluate if there would be a correlation between the dose of Kt/V and the degree of frailty in a population of adult patients on HD. Material & methods: A cross-sectional study with 82 patients on HD in Barranquilla (Colombia) and Lobos (Argentina) was conducted. Socio-demographic and laboratory data, as well as dialysis doses (Kt/V) were recorded and scales of fragility, physical activity, gait and grip strength were applied. Then these data were correlated by a Spearman’s correlation and a logistic regression. Results: CFS, social isolation, physical activity, gait speed, and prehensile strength tests were outside the reference ranges in the studied group. No significant correlation was found between dialysis dose and all the above mentioned functional tests. However, it was documented a significant and inverse correlation between physical activity and CFS (score -1.41 (CI: -2.1 to -0.7). In conclusion: no significant correlation was documented between Kt/V value and different parameters of the frailty status, but this status correlated significantly and inversely with physical activity in this group. Frailty status in hemodialysis patients was significantly higher in older individuals, although young individuals were not exempt from it
Introduction: Frailty is a multicausal syndrome characterized by a decrease in strength, resistance and physiological function, which makes the individual vulnerable and dependent, and increases his/her mortality. This syndrome is more prevalent among older individuals, and chronic kidney disease patients, particularly those on dialysis. Dialysis dose is currently standardized for hemodiallysis (HD) patients regardless their age and functional status. However, it has been postulated that the dialysis dose required in older patients, especially frail ones, should be lower, since it could increase their degree of frailty. Then, the purpose of this study was to evaluate if there would be a correlation between the dose of Kt/V and the degree of frailty in a population of adult patients on HD. Material & methods: A cross-sectional study with 82 patients on HD in Barranquilla (Colombia) and Lobos (Argentina) was conducted. Socio-demographic and laboratory data, as well as dialysis doses (Kt/V) were recorded and scales of fragility, physical activity, gait and grip strength were applied. Then these data were correlated by a Spearman’s correlation and a logistic regression. Results: CFS, social isolation, physical activity, gait speed, and prehensile strength tests were outside the reference ranges in the studied group. No significant correlation was found between dialysis dose and all the above mentioned functional tests. However, it was documented a significant and inverse correlation between physical activity and CFS (score -1.41 (CI: -2.1 to -0.7). In conclusion: no significant correlation was documented between Kt/V value and different parameters of the frailty status, but this status correlated significantly and inversely with physical activity in this group. Frailty status in hemodialysis patients was significantly higher in older individuals, although young individuals were not exempt from it
Descripción
Palabras clave
Fragilidad, Dosis de diálisis, Hemodiálisis, Frailty, Dialysis dose, Hemodialysis.