Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Abstract

Background: Chronic kidney disease (CKD) represents a worldwide public health problem, Mexico has a prevalence of 12.2%, of which 52,000 patients are in renal replacement therapy and 80% are treated at the Mexican Social Security Institute, it is associated with early mortality with a higher incidence after 40 years of age. The literature mentions severe metabolic acidosis, severe hyperkalemia and hyperphosphatemia, water overload and uremic syndrome as frequent causes of dialysis urgency. However, the most frequent dialysis emergency in our setting has not been studied.Objective: To establish the most frequent cause of dialysis emergencies and to identify the precipitating factor in patients with chronic kidney disease admitted to the emergency department of Hospital General Zone (HGZ) 50, Mexico.Methods: Analytical and retrospective study, the sample was obtained by calculating the finite sample (Murray's formula) of patients admitted to the emergency department over a period of one year, as well as descriptive statistics (measures of trend, central, ranges, frequencies, proportions, chi-square to establish associations), SPSS software was used. Results. Data were collected from 148 patients.Results: Severe metabolic acidosis was identified as the main cause of dialysis urgency (29.1%) and the main precipitating factor was the presence of infections at any level (33.8%). Conclusion:Refractory metabolic acidosis is the main dialysis emergency in our patients, it is important to perform gasometry on admission in the ED, the main precipitating factor is the presence of infection, so initiating timely treatment and immediately requesting renal replacement therapy, as well as providing sanitary and preventive measures will have a positive impact on reducing morbidity and mortality.