Factores de riesgo de peritonitis en pacientes pediátricos con insuficiencia renal crónica en diálisis peritoneal. Hospital del Niño Dr. Francisco de Ycaza Bustamante
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2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La insuficiencia renal crónica es el resultado de la disminución progresiva e irreversible de la función renal, las nefronas se hacen insuficientes para seguir produciendo la homeostasis del cuerpo efectuándose un fallo renal y cuadro multisistémico. Unos de los tratamientos utilizados es la diálisis peritoneal, que se encarga de utilizar la membrana natural, el peritoneo, como filtro. Existen varios tipos de diálisis, la más utilizada en niños es la diálisis peritoneal automatizada por su mayor adherencia, cuya complicación mas frecuente es la peritonitis, inflamación e infección del peritoneo. El presente estudio tuvo como objetivo identificar los factores de riesgo para desarrollar peritonitis en pacientes pediátricos con insuficiencia renal crónica que se encuentran con este tratamiento, determinar los factores demográficos, el tiempo de permanencia del catéter, el número de recambios, la hipoalbuminemia y la hipohemoglobinemia son factores de riesgo para desencadenar esta complicación. Se estudiaron 101 pacientes pediátricos seleccionados en el período de enero del 2006 hasta 30 de junio del 2012. 101 con insuficiencia renal crónica y fueron sometidos a diálisis peritoneal automatizada en el servicio de Nefrología del Hospital “Dr. Francisco de Ycaza Bustamante”. La mayor afluencia de pacientes con peritonitis fue de la zona urbano marginal 10 (59%) femenino y 9 (41%) masculino. El tiempo de permanencia del catéter tuvo significancia estadística de p<0.02. Los valores de albúmina, hemoglobina, factores demográficos y número de recambios de catéter no tuvieron significancia estadística. Se concluyó que el factor de riesgo encontrado en el presente estudio con significancia estadística fue el tiempo de permanencia del catéter. Su modificación puede ayudar a disminuir la presencia de peritonitis.
Chronic renal failure is the result of the progressive and irreversible decline in renal function; the nephrons are insufficient to continue producing affected body homeostasis and renal failure multisystem disease. Now one of the treatments is peritoneal dialysis, which uses a natural membrane, the peritoneum, as a filter. There are several types of dialysis; the most widely used automated peritoneal dialysis for their greater adherence in children, whose most frequent complication is peritonitis, inflammation and infection of the peritoneum. This study aimed to identify risk for developing peritonitis in pediatric patients with chronic kidney disease who are used this treatments, identify demographic factors associated with this disease; identify the time of the catheter as a risk factor, knowing the number of recharge and the presentation of peritonitis, establish the statistical significance of the values of albumin and hemoglobin in pediatric patient with peritonitis in peritoneal dialysis in the Hospital del Niño “Dr. Francisco de Ycaza Bustamante”. Reviews the records of all patients enrolled in the period January 2006 to June 30th, 2012. Studied 101 pediatric patients admitted with chronic renal failure and underwent automated peritoneal dialysis. The largest influx of patients with peritonitis was marginal urban area 10 (59%) female y 9 (41%) male. The dwell time of the catheter had statically significance p<0.02. Albumin levels, hemoglobin, demographic factors an number of replacements catheter not statistically significant. It was concluded that the risk factor in this study found statistically significant was the time of the catheter. Your modification may help reduce the presence of peritonitis.
Chronic renal failure is the result of the progressive and irreversible decline in renal function; the nephrons are insufficient to continue producing affected body homeostasis and renal failure multisystem disease. Now one of the treatments is peritoneal dialysis, which uses a natural membrane, the peritoneum, as a filter. There are several types of dialysis; the most widely used automated peritoneal dialysis for their greater adherence in children, whose most frequent complication is peritonitis, inflammation and infection of the peritoneum. This study aimed to identify risk for developing peritonitis in pediatric patients with chronic kidney disease who are used this treatments, identify demographic factors associated with this disease; identify the time of the catheter as a risk factor, knowing the number of recharge and the presentation of peritonitis, establish the statistical significance of the values of albumin and hemoglobin in pediatric patient with peritonitis in peritoneal dialysis in the Hospital del Niño “Dr. Francisco de Ycaza Bustamante”. Reviews the records of all patients enrolled in the period January 2006 to June 30th, 2012. Studied 101 pediatric patients admitted with chronic renal failure and underwent automated peritoneal dialysis. The largest influx of patients with peritonitis was marginal urban area 10 (59%) female y 9 (41%) male. The dwell time of the catheter had statically significance p<0.02. Albumin levels, hemoglobin, demographic factors an number of replacements catheter not statistically significant. It was concluded that the risk factor in this study found statistically significant was the time of the catheter. Your modification may help reduce the presence of peritonitis.
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PERITONITIS, INSUFICIENCIA RENAL CRÓNICA, DIÁLISIS PERITONEAL, PEDIATRÍA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTÓN GUAYAQUIL, ECUADOR