5 research outputs found
Evolution of nutritional biochemical parameters in hemodialysis patients during a one-year follow-up period
La elevada supervivencia actual del paciente en
hemodiálisis (52% hasta 5 años), ha hecho que se
pongan de manifiesto complicaciones crónicas como
la elevada prevalencia de malnutrición en los enfermos,
así como la importancia de la situación nutricional
en la morbi-mortalidad que presentan. La causa
de desnutrición proteico-calórica es multifactorial,
aunque procesos de inflamación crónica asociada a
la técnica de diálisis cobran cada vez más relevancia.
Se han evaluado las variaciones de distintos parámetros
bioquímicos nutricionales (proteínas totales,
albúmina plasmática, transferrina y colesterol total)
de 73 pacientes en hemodiálisis durante un año de
seguimiento. La edad media de los pacientes era de
53,3 ± 18,69 años, con 43 varones y 30 mujeres. El
tiempo en programa de hemodiálisis ha sido de 43 ±
33 meses, con una duración media de la sesión de 246
± 24 minutos y dosis media de hemodiálisis administrada
de 1,37 ± 0,27 (KT/V) (Daurgidas 2ª generación).
Se ha observado un descenso en todos los parámetros
bioquímicos evaluados, con diferencias
estadísticamente significativas: Proteínas totales (p <
0,001), albúmina (p < 0,00001), colesterol total (p <
0,05) y transferrina (p < 0,01). La evolución de los
parámetros bioquímicos nutricionales evaluados
mostró un importante deterioro nutricional de los
pacientes estables con el tratamiento.Current high survival in hemodialysis patients (52% at
5 years) have made the chronic manifestations to emerge
such as the high hyponutrition prevalence of these
patients, as well as the importance of the nutritional status
in their morbimortality. The reason for protein-caloric
hyponutrition is multifactorial, although chronic
inflammatory conditions associated to the dialysis technique
are becoming more and more relevant. The variations
in several nutritional biochemical parameters (total
proteins, plasma albumin, transferrin, and total cholesterol)
have been assessed in 73 hemodialysis patients for
one year. The mean age of the patients was 53.3 ± 18.69
years (43 males and 30 females). The average on hemodialysis
program was 43 ± 33 months, with a mean session
duration of 246 ± 24 minutes, and mean hemodialysis
dose administered of 1.37 ± 0.27 (KT/V) (second generation
Daurgidas). A decrease in all the biochemical parameters
assessed has been observed, with statistically significant
differences: total proteins (p < 0.001), albumin
(p < 0.00001), total cholesterol (p < 0.05), and transferrin
(p < 0.01). The evolution of the nutritional biochemical
parameters assessed showed an important nutritional
deterioration of the patients remaining stable with the
therapy
Resistance of hyperhomocysteinemia in renal patients to treatment with supra-physiological doses of parenteral folic acid
Los pacientes en hemodiálisis presentan un aumento
de homocisteína plasmática (Hcy), debido a la alteración
en la metilación causada por la uremia y déficit de los
cofactores necesarios (vitamina B, ácido fólico). Esto se
correlaciona con un mayor desarrollo de la enfermedad
vascular prematura. El tratamiento, no está consensuado,
siendo escasa la respuesta a la administración oral
de dosis convencionales de ácido fólico. En este trabajo
valoramos la respuesta de la hiperhomocisteinemia de 73
pacientes en programa de hemodiálisis periódica tras la
administración de 50 mg de ácido folínico parenteral
durante 18 meses. La homocisteína plasmática de los
pacientes en el momento de inicio del estudio presentaba
unos valores medios de 22,67 (μmol/l). Durante el primer
año de suplementación mantuvieron el valor medio de 20
μmol/l. A partir del primer año de tratamiento, y hasta
finalizar los 18 meses de observación, los niveles medios
de homocisteína fueron de 19,58 μmol/l. Aunque con el
tiempo de tratamiento encontramos una clara tendencia
al descenso de sus valores plasmáticos, no existieron diferencias
estadísticamente significativas. Los valores de
homocisteína no se normalizaron en ninguno de los
pacientes tratados.Hemodialysis patients present an increase in plasma
homocysteine (Hcy) due to methylation impairment caused
by uremia and the deficiency of the co-factors needed (vitamin
B, folic acid). This correlates with a more common development
of premature vascular disease. There is no consensus
on the therapy, with a poor response to oral
administration of conventional doses of folic acid. In this
work, we assessed the response of hyperhomocysteinemia in
73 regular hemodialysis patients after the administration of
50 mg of parenteral folinic acid for 18 months. Plasma
homocysteine of the patients at the time of the study beginning
presented mean values of 22.67 (μmol/L). During the
first year of supplementation the mean value was kept at 20
μmol/L. From the first year to the end of the 18-months
observation period the mean homocysteine levels were 19.58
μmol/L. Although we found a clear trend towards a decrease
in plasma homocysteine levels during the treatment period,
there were no significant differences. Homocysteine levels
did not come back to normal in none of the patients treated
Impacto del tiempo en hemodiálisis sobre el estado nutricional de los pacientes: índices de diagnóstico y seguimiento
Tesis Univ. Granada. Departamento de Nutrición y Bromatología. Leída el 2 de marzo de 200
Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy—A Hospital-Based Prospective Observational Study
Background: Negative outcomes associated with medications (NOM) and drug-related
problems (DRP) significantly impact individuals with kidney replacement therapy (KRT) given the
complexities of managing kidney disease and associated comorbidities. The present study aims to
assess the frequency of NOMs/DRPs among KRT patients and identify contributing factors. Methods:
A cross-sectional study was conducted at Virgen de las Nieves University Hospital (Granada,
Spain), involving 117 outpatient adults with KRT. Data were collected from February 2021 to July
2023 using electronic records, semi-structured interviews (Dáder Method), and discussions with
nephrology specialists. NOMs/DRPs were identified following treatment guidelines. Binary logistic
regression was used to determine associated factors (p-value < 0.05). Results: Across 117 patients,
2436 NOMs and 3303 DRPs were identified, averaging 20.82 NOMs and 28.23 DRPs per patient.
Prevalent NOMs included untreated conditions (58.95%), quantitative ineffectiveness (35.43%), and
non-quantitative safety problems (5.13%). Dominant DRPs were undertreated conditions (37.63%),
wrong dose/posology/length (33.00%), risk of adverse drug reactions (ADR) (16.14%), and nonadherence
(6.87%). Patients with ADR, undertreated conditions, and anemia were associated with
quantitative ineffectiveness. Risk of ADR and vitamin D deficiency/insufficiency correlated with
non-quantitative safety problems. Conclusions: KRT patients exhibited a substantial prevalence of
NOMs/DRPs. Further research is needed to deepen our understanding of these complexities for
improved patient care.Doctoral Grant (reference number OAICE-143-2020) from the Office of International Affairs and External CooperationUniversity of Costa Rica and the APC
was funded by Fundación para la Investigación Biosantitaria de Andalucía Oriental-Alejandro Otero
(Granada, Spain