Prevalencia del síndrome cardiorrenal en pacientes con enfermedad renal crónica en hemodiálisis
Fecha
2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
El síndrome cardiorrenal abarca un estado fisiopatológico en donde una disfunción
del riñón o corazón causa la disfunción del otro. Se ha descrito recientemente la
existencia de 5 tipos de síndrome cardiorrenal, dependiendo de cuál es el órgano que
se altera de forma primaria. La enfermedad renal crónica produce una disfunción
progresiva cardiovascular, lo que se conoce como síndrome cardiorrenal tipo IV. En
este estudio se trata de evaluar la prevalencia de este síndrome mediante
ecocardiografía, según los criterios ecocardiográficos ADQI.
La prevalencia de síndrome cardiorrenal en enfermedad renal crónica terminal en
tratamiento sustitutivo de la función renal es alta, y entre los hallazgos
ecocardiográficos más comunes se encuentran la disfunción diastólica, la hipertrofia
concéntrica del ventrículo izquierdo y la insuficiencia tricuspídea. Todos ellos debidos a
la sobrecarga de volumen y a la presencia de toxinas urémicas específicas como el pcresol
y el sulfato indoxil.
La existencia de afectaciones cardiovasculares en pacientes en hemodiálisis, como
la disfunción diastólica, se asocia a una mayor mortalidad y morbilidad en esta
población, .a una disminución de la calidad de vida y a complicaciones durante la
hemodiálisis.
Cardiorenal syndrome encompass a situation where a primary disorder of one of these organs often results in a secondary dysfunction of other. There are 5 types of cardiorenal syndrome, depending of what organ is afected primarily. In chronic kidney disease, there is a cardiovascular progresive dysfunction, this is known as cardiorenal syndrome type 4. In this research, we asses de prevalence of this syndrome, using echocardiography, according to the ADQI criteria. The prevalence of cardiorenal syndrome in end stage renal disease treated by replacement renal treatment is high. Diastolic dysfunction, concentric left ventricle hypertrophy and tricuspid insufficiency are common findings in echocardiography. All of above come as a result of volume overcharge, hypervolemia and uremic toxins such as p-cresol and indoxil sulfate. The existence of a impaired cardiovascular function in patients treated by hemodyalisis, like diastolic disfunction, is related to a higher mortality and mobidity, a reduced expectancy life and development of complications during hemodyalisis
Cardiorenal syndrome encompass a situation where a primary disorder of one of these organs often results in a secondary dysfunction of other. There are 5 types of cardiorenal syndrome, depending of what organ is afected primarily. In chronic kidney disease, there is a cardiovascular progresive dysfunction, this is known as cardiorenal syndrome type 4. In this research, we asses de prevalence of this syndrome, using echocardiography, according to the ADQI criteria. The prevalence of cardiorenal syndrome in end stage renal disease treated by replacement renal treatment is high. Diastolic dysfunction, concentric left ventricle hypertrophy and tricuspid insufficiency are common findings in echocardiography. All of above come as a result of volume overcharge, hypervolemia and uremic toxins such as p-cresol and indoxil sulfate. The existence of a impaired cardiovascular function in patients treated by hemodyalisis, like diastolic disfunction, is related to a higher mortality and mobidity, a reduced expectancy life and development of complications during hemodyalisis
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Palabras clave
Síndrome cardiorrenal, Diálisis renal, Ecocardiografía, Cantón Guayaquil, Ecuador, Centro de Hemodiálisis INRIDI, Insuficiencia renal crónica, Prevalencia