Clinical results of a kidney protection program in patients with chronic kidney disease stage 5 at medellín, colombia. Preliminary Report
PDF (Español)

Keywords

Chronic renal disease
renal protection
survival
dialysis
Cockcroft -Gault
utility.

How to Cite

1.
González Sánchez DA, Ayala Ramírez D, Aguirre D, Mercado Juri Álvaro, Rodelo Ceballos J, Ustariz JM. Clinical results of a kidney protection program in patients with chronic kidney disease stage 5 at medellín, colombia. Preliminary Report. Rev. Colomb. Nefrol. [Internet]. 2016 Nov. 18 [cited 2024 May 20];3(2):99-106. Available from: https://revistanefrologia.org/index.php/rcn/article/view/242

Abstract

Introduction: Chronic kidney disease remains a major cause of morbidity and mortality in our environment. A proper medical intervention of risk factors slow disease progression to dialysis. The usefulness of renal protection programs in our country has not been evaluated.

Objective: To describe the clinical and medical results obtained in patients with chronic kidney disease stage 5 belonging to renal protection program.

Materials and Methods: A total of 4727 patients belong to renal protection program at the Medellin General Hospital-Savia Salud started in November 2013 and followed up until December 31, 2015. Those patients with GFRe < 15 cc/min by Cockcroft-Gault were included taking into account the guidelines and policies of high cost in Colombia. We excluded patients with a history of renal transplantation.

Results: A total of 112 patients were included in the analysis, with an average age of 71.8 years and an average follow-up of 343.2 days. Diabetic nephropathy was the leading cause of chronic kidney disease with 36.6 %. The mortality rate was 6.25% (7 deaths), median dialysis-free days was 694 days IQR (199 -> 694) and average reduction in GFRe by MDRD was -2.88 ml/min/year.

Conclusions: Renal protection programs are a useful tool in the management of patients with advanced chronic kidney disease and help slow the progression to dialysis.

https://doi.org/10.22265/acnef.3.2.242
PDF (Español)

References

1. Tomado de https://cuentadealtocosto.org/site/index.php/patologias 9-patologias/35-enfermedad-renal-cronica-erc/?template=cuentadealtocostocontenido

2. Eknoyan G, Lameire N, Eckardt KU, et al. Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Inter Suppl. 2013; 3: 1-150.

3. Levey A, Coresh J, et al. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Clasification and Stratification. American Journal of Kidney Diseases. 2002; 39(2 Suppl 1): S1-S266.

4. León-García D, Ordóñez IE, Muñoz JE, et al. Guía para el manejo de la enfermedad renal crónica (ERC) basada en la evidencia. Colombia: Fedesalud. Ministerio de la Protección Social. Programa de Apoyo a la Reforma de Salud.

5. Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130(6): 461-70.

6. Sarnak MJ. Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003; 108(17): 2154-69.

7. Rosset S, Tzur S, Behar DM, et al. The population genetics of chronic kidney disease: insights from the MYH9-APOL1 locus. Nat Rev Nephrol. 2011 Jun; 7(6): 313-26.

8. James PA, Oparil S, Carter BL, et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults. Jama. 2013; 1097(5):1-14.

9. Bakris GL, Cleveland WH, Charleston J, et al. Intensive Blood-ressure Control in Hypertensive Chronic Kidney Disease. N Engl J Med. 2010; 363: 918-29.

10. Group AC. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2008; 358(24): 2560-72.

11. Zoungas S, Chalmers J, Neal B, et al. Follow-up of Blood-Pressure Lowering and Glucose Control in Type 2 Diabetes. N Engl J Med. 2014; 371(15): 1392-1406.

12. De Brito-Ashurst I, Varagunam M, Raftery MJ, et al. Bicarbonate Supplementation Slows Progression of CKD and Improves Nutritional Status. J Am Soc Nephrol. 2009; 20(9): 2075-84.

13. Li L, Yang C, Zhao Y, et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15: 122.

14. Borghi C, Rosei EA, Bardin T, et al. Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens. 2015; 33(9): 1729-41.

15. Acuña Merchán L, Sánchez Quintero P, Soler Vanoy L, et al. Situación de la enfermedad renal crónica en Colombia 2014. Resolución 4700/2008.

16. Otero A, de Francisco A, Gayoso P, et al. Prevalence of chronic renal disease in Spain: results of the EPIRCE study. Nefrología. 2010; 30(1): 78-86.
No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.

Dimensions


PlumX


Downloads

Download data is not yet available.