Incidencia de la injuria renal aguda en unidad de paciente crítico y su mortalidad a 30 días y un año

Boltansky, A.; Bassa, C.; Melani, Sophia; Sepúlveda, Andrés Grau; Maldonado, Isabel; Postigo, Javiera; Sotta, Esperanza; Vidueira, Paloma; Cavagnaro, Catalina; Cavada, Gabriel; Benavente, C.; Villamizar, Guillermo; Vukusich, Antonio; Irarrázabal, Carlos E.

doi:10.4067/s0034-98872015000900003

Cited by 4 publications

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“…This rate agrees with rates found nationally and internationally. (13)(14)(15)(16) After define sociodemographic and clinical profile of patients, we observed prevalent diagnoses, most common were: risk of infection, risk of inefficient gastrointestinal perfusion, risk of inefficient renal perfusion, excessive fluid volume, risk of electrolytic imbalance, risk of imbalance fluid volume. These results are similar to other Brazilian studies that used Delphi's technique and identified five main diagnosis: decreased cardiac output, inefficient tissue perfusion -renal, impaired fluid volume, excessive fluid volume, and risk of infection.…”

Section: Discussionmentioning

confidence: 99%

Diagnósticos, resultados e intervenções de enfermagem em pacientes com lesão renal aguda

et al. 2017

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Objective: To identify prevalence and correlate diagnosis, results, and nursing interventions in patients with acute renal injury (ARI) who were hospitalized in an intensive care unit (ICU). Methods: This was a cross-sectional study including 98 patients older than 18 years old with ARI who were undergoing hemodialysis treatment in the ICU . The study was carried out in an ICU a large public hospital located in the city of São Paulo, Brazil. For statistics analysis we used the SPSS v21.0 to estimate prevalence, the 95% of confidence interval and sample error of 0.05. Data were collected from March to July 2016 using structured interviews, anamnesis and physical exam of patients using an instrument designed by this study researchers. The main instrument was completed by the principal researcher. Nursing consultation lasted for approximately 30 minutes. Of the total sample, 10% was selected and checked randomly in order to evaluate data quality and atypical values. Two patients previously did a pilot test to verify whether information in the instrument achieved the objective of the study. Results: The 98 participatns were aged ≥60 years (33%), men (60%), and classified as pre-renal injury (54%). Prevalent diagnosis was (100%) risk of infection, risk of inefficient gastrointestinal perfusion, risk of ineffective renal perfusion, risk of electrolyte imbalance, excessive fluid volume, and risk of imbalanced fluid volume. Results (100%) were: severity of infection, access for hemodialysis, tissue perfusionabdominal organs, hydric balance, mobility, removal of toxins and renal function. Prevalent nursing interventions (100%) were: promotion against infection, control of infection, maintenance of access for dialysis, hydroeletrolitic control, urinary elimination control, acid-base control, electrolytic control, hypervolemia control, hydric control, hydric monitoring, respiratory physiotherapy, respiratory and positioning monitoring. Correlations were significant (p< 0.001) between diagnosis and nursing interventions and between nursing interventions and results. Conclusion: Main diagnosis, results and nursing interventions related with loss of renal function originated from changes of renal perfusion, volemia, hydroelectrolytic dysfunctions, and risk of infection. The number of diagnosis showed to be correlated with number of nursing interventions and nursing interventions was correlated with results. ResumoObjetivo: Identificar prevalência de diagnósticos (DE), resultados (RE) e intervenções de enfermagem (IE) em pacientes com lesão renal aguda (LRA) internados em unidade de terapia intensiva (UTI). Correlacionar DE, RE e IE identificados. Métodos: Estudo transversal, conduzido em Unidades de Terapia Intensiva de um hospital público de grande porte da cidade de São Paulo. Foram incluídos, numa amostra intencional, 98 pacientes com LRA em tratamento hemodialítico internados em UTI, maiores de 18 anos. Foi utilizado software SPSS v21.0 para estimação da prevalência, fixando a estimativa no intervalo de confiança ...

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Section: Discussionmentioning

confidence: 99%

Diagnósticos, resultados e intervenções de enfermagem em pacientes com lesão renal aguda

et al. 2017

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“…Mortality also varies widely, ranging from 15 to 60% depending on the associated diseases [ 6 , 7 ]. Approximately 30% of patients discharged from the ICU that required RRT will remain in the most advanced stage of chronic kidney disease (CKD-5) [ 7 – 9 ], which could be related to a lower long-term survival [ 10 – 12 ]. Different studies have established risk factors at the individual level that determine prognosis.…”

Section: Introductionmentioning

confidence: 99%

Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit

Oliveros

Buitrago

2020

j intensive care

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Background: Between 30 and 70% of patients admitted to the intensive care unit (ICU) have acute kidney injury (AKI), and 10% of these patients will require renal replacement therapy (RRT). A significant number of studies have compared the mortality of patients who require RRT versus those who do not require it, finding an increase in mortality rates in the short and medium term; however, few studies have evaluated the long-term survival in a mixture of patients admitted to the ICU. Objective: To evaluate the impact of RRT on 5-year survival in patients with AKI admitted to the ICU Methods: Using administrative databases of insurers of the Colombian health system, a cohort of patients admitted to the ICU between 1 January 2012 and 31 December 2013 was followed until 31 December 2018. ICD-10 diagnoses, procedure codes, and prescribed medications were used to establish the frequencies of the comorbidities included in the Charlson index. Patients were followed for at least 5 years to evaluate survival and establish the adjusted risks by propensity score matching. Results: Of the 150,230 patients admitted to the ICU, 4366 (2.9%) required RRT in the ICU. Mortality rates for patients with RRT vs no RRT evaluated at ICU discharge, 1 year, and 5 years were 35%, 57.4%, and 67.9% vs 7.4%, 17.6%, and 30.1%, respectively. After propensity score matching, the hazard ratio was calculated for patients who received RRT and those who did not (HR, 2.46; 95% CI 2.37 to 2.56; p < 0.001), with a lower difference in years of survival for patients with RRT (mean effect in the treated) of − 1.86 (95% CI − 2.01 to to1.65; p < 0.001). Conclusions: The impact of acute renal failure with the consequent need for RRT in patients admitted to the ICU is reflected in a decrease of approximately one quarter in 5-year survival, regardless of the different comorbidities.

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“…Este tipo de injuria ocurre en aproximadamente el 5 al 25% de los pacientes en la Unidad de Paciente Crítico (UPC) en la mayoría de las series, pero puede llegar hasta 70% dependiendo de la población estudiada (2)(3)(4)(5) . En Chile, se estima que puede llegar hasta el 28,9% (6) . De todos esos pacientes, entre el 5 al 50% van a requerir terapia de reemplazo renal (TRR) (2,3,5) y entre el 70 al 80% se inicia terapia de reemplazo renal continua (TRRC) (7) por su estabilidad hemodinámica y control de solutos (8) .…”

Section: Introductionunclassified

Suspensión de terapia de reemplazo renal continua e independencia de diálisis en falla renal aguda

2020

Rev. Hosp. Clín. Univ. Chile (En línea)

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Renal replacement therapy (RRT) is a crucial form of extracorporeal support in critical patients that develop acute kidney injury. This therapy allows to gain solute and water control when the kidneys are not capable of doing it. Nevertheless, RRT techniques are not without risks, complications and costs. Under this point of view, is fundamental to be conscious of the indications of timing and, most importantly, weaning of the RRT. The unnecesary extension of these techniques can lead to increase morbidity, hospital stay, health care costs and complications. Unfortunately, randomized controlled studies are scarce and this paucity of data has lead to different predictive models based on retrospective studies. Creatinine clearence, urinary output and other novel biomarkers has been used to identify the best moment to safely stop RRT. In this review, we summarize the available evidence about secure weaning of RRT and the potential of novel urinary and serum biomarkers that can be used to guide therapeutic decisions in the future.

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Incidencia de la injuria renal aguda en unidad de paciente crítico y su mortalidad a 30 días y un año

Abstract: Incidence and consequences of acute kidney injury among patients admitted to critical care units (Rev Med Chile 2015; 143: 1114-1120

Cited by 4 publications

References 42 publications

Diagnósticos, resultados e intervenções de enfermagem em pacientes com lesão renal aguda

Diagnósticos, resultados e intervenções de enfermagem em pacientes com lesão renal aguda

Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit

Suspensión de terapia de reemplazo renal continua e independencia de diálisis en falla renal aguda

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