Inicio de tratamiento renal sustitutivo en la provincia de Cáceres en 2004. Importancia del inicio programado

• S. Gallego ^[1] ; I. Castellano ^[1] ; P.J. Labrador ^[1] ; M. Gil ^[1] ; J.R. Gómez-Martino ^[1] ; A. Covarsí ^[1]
  1. [1] Universidad Autónoma de Madrid

     Universidad Autónoma de Madrid

     Madrid, España

     
• Localización: Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante, ISSN-e 1886-2845, Vol. 26, Nº. 4, 2005, págs. 173-180
• Idioma: español
• Títulos paralelos:
  • The initiation of renal replacement therapy in the province of Cáceres in 2004. The importance of scheduling initiation
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• Resumen

  • Aim. To analyze clinical and analytical characteristics of patients who started renal replacement therapy (RRT) during 2004 in the province of Cáceres. The results show that a planned beginning means a better clinical evolution than a unplanned one. Patients and methods. A retrospective study was carried out, including all patients who started renal replacement therapy (RRT) during 2004 (58 patients in the Health Area in Cáceres). 29 patients (50%) the first dialysis was planned, whereas it was unplanned for the rest of them (29) depending on whether the first dialysis was planned or an emergency. Demographic, clinical and analytical data were collected, so as previous erythropoyetin and iron treatment and the mortality rate in the following six months. Results. Diabetic nephropathy was more usual for the former group, while the diabetic nephropathy and glomerulonephritis was more common for the latter. Haemodialysis as RRT was a major option for the unplanned than for planned group (93.1 vs 79.3%). 89.7% of the patients in the planned group had a vascular or peritoneal access available when starting RRT, whereas in the unplanned group only the 7% had it. Patients in unplanned group showed lower levels of haemoglobin and haematocrit (p < 0,001), worse calcium-phosphorus metabolism control, lower serum albumin (2.9 vs 3.4) (p < 0,001), and lower creatinine clearance. Finally, the period of hospitalization was longer for the unplanned group (p < 0,001), and higher their 6-months-mortality rate. Conclusions. Half of the patients that started RRT by 2004 in the province of Cáceres did it as an emergency. This situation was associated to worse clinical and biochemistry conditions, an unavailable vascular or peritoneal access, no possibility for choosing the starting technique and a higher rate of hospitalization; all of them meaning higher costs.