scholarly journals Síntomas, comorbilidad y estado funcional de los pacientes con enfermedad renal crónica estadio 5 en manejo renal conservador

2021 ◽  
Vol 20 (3) ◽  
pp. 33-54
Author(s):  
Daniel Gutiérrez Sánchez ◽  
Juan P. Leiva-Santos
Keyword(s):  
Chronic Kidney Disease ◽  
Palliative Care ◽  
Kidney Disease ◽  
Barthel Index ◽  
Chronic Kidney Disease Stage ◽  
Functional Decline ◽  
Symptom Burden ◽  
Disease Stage ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Objetivos: Determinar la prevalencia e intensidad de síntomas pacientes con Enfermedad Renal Crónica estadio 5 en manejo renal conservador y analizar su asociación con la comorbilidad y el estado funcional. Método: Estudio descriptivo, correlacional, de corte transversal. Para la evaluación de síntomas se utilizó la versión española modificada de la Palliative care Outcome Scale-Symptoms Renal. La comorbilidad fue evaluada con el índice de comorbilidad de Charlson modificado. Para la evaluación del estado funcional y grado de dependencia se utilizó el índice de Barthel. Resultados: 60 pacientes fueron incluidos en este estudio. Más del 50% de los pacientes presentaron debilidad, dolor, dificultad para dormir, poco apetito y problemas en la boca, encontrándose el dolor y la debilidad entre los síntomas más intensos. Las principales condiciones comórbidas fueron: diabetes, cardiopatía isquémica, enfermedad vascular periférica y neoplasias. La media del índice de Barthel fue 88±14,2. No se encontró asociación entre la comorbilidad y la sintomatología (p=0,43). El deterioro del estado funcional se asoció con la carga de síntomas (p=0.001).Conclusiones: Los pacientes con Enfermedad Renal Crónica estadio 5 en manejo renal conservador sufren una elevada carga de síntomas. La debilidad fue síntoma más frecuente en esta población. La carga sintomática se asoció con el deterioro del estado funcional. Futuros estudios sobre el impacto de los síntomas en estos pacientes, así como las intervenciones necesarias para su óptimo manejo deberían ser considerados. Objective: To determine the prevalence and severity of symptoms of patients with Chronic Kidney Disease Stage 5 managed conservately, and their association with the comorbidities and functional status. Methods: A cross-sectional, descriptive, and correlational design was used. Symptom data were collected using the Spanish modified version of Palliative care Outcome Scale-Symptoms Renal. Comorbidity was collected and scored according to the modified Charlson Comorbidity Index. For the evaluation of functional status, the Barthel index was used.Results: 60 patients were included in this study. More than 50% of patients described weakness, pain, difficulty for sleeping, poor appetite and mouth problems. Diabetes, coronary artery disease, and peripheral vascular disease, and tumor, were the main comorbid conditions of these patients. The mean score of Barthel index was 88±14.2. There was no significant correlation between comorbidities and symptoms (p=0.43). There was a significant correlation between symptoms and functional decline (p=0.001).Conclusions: Patients with Chronic Kidney Disease Stage 5 experience a high level of symptom burden. Weakness was the most prevalent symptom in this sample population. Symptom burden correlated with functional decline. Further longitudinal studies are needed that analyse the impact of symptoms and their management in this population.

Symptom Burden Clustering in Chronic Kidney Disease Stage 5

2017 ◽  
Vol 28 (5) ◽  
pp. 583-601 ◽  
Author(s):  
Daniel Gutiérrez Sánchez ◽  
Juan P. Leiva-Santos ◽  
Antonio I. Cuesta-Vargas
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Severity ◽  
Chronic Kidney Disease Stage ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Statistical Correlation ◽  
Disease Stage ◽  
Validated Questionnaire ◽  
Ckd Stage

Patients with chronic kidney disease (CKD) Stage 5, experience multiple symptoms that negatively affect the health-related quality of life (HRQoL). This study examined the cluster of symptoms and their association with disease severity and comorbidities. The study sample included 123 patients with CKD Stage 5; 60 patients were in the dialysis group and 63 patients in the Conservative Kidney Management group. Symptom data were collected using the Spanish modified version of Palliative Care Outcome Scale–Symptoms (POS-S) Renal, a validated questionnaire to assess symptoms in this population. More than half of the patients described weakness, difficulty sleeping, and feeling depressed. Two symptom clusters were identified. There was no significant statistical correlation between disease severity and symptoms and between comorbidities and symptoms. The tendency of these symptoms to occur together has implications for improving symptom management in this population. Routine symptom assessment can be useful in clinical and research settings.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

1049-P: Preexisting Chronic Kidney Disease Stage 3 Does Not Reduce Glycemic Efficacy of Metformin in U.S. Veterans with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1049-P
Author(s):  
ELVIRA GOSMANOVA ◽  
DARREN E. GEMOETS ◽  
LAURENCE S. KAMINSKY ◽  
CSABA P. KOVESDY ◽  
AIDAR R. GOSMANOV
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage

Sarcopenia is an actual problem in chronic kidney disease of the 5d stage

2020 ◽  
Vol 24 (1) ◽  
pp. 60-66
Author(s):  
I. V. Lavrishcheva ◽  
A. Sh. Rumyantsev ◽  
M. V. Zakharov ◽  
N. N. Kulaeva ◽  
V. M. Somova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Chronic Kidney Disease Stage ◽  
Age Groups ◽  
Disease Stage ◽  
Actual Problem ◽  
European Working ◽  
Low Performance ◽  
6 Minute Walk Test

BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.

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