Accesos para diálisis: estableciendo prioridades en los procedimientos bajo pandemia DE SARS-COV-2/COVID-19

Palabras clave: acceso vascular, diálisis renal, diálisis peritoneal, fístula arteriovenosa, trombosis, bacteriemia, catéteres venosos centrales.

Resumen

Introducción: la pandemia de la enfermedad COVID-19, causada por el SARS-CoV-2, obliga a los sistemas sanitarios a reorganizar la atención en salud con el fin de disminuir el riesgo de exposición de los pacientes, en especial, aquellos de edad avanzada y/o comorbilidades, como son los pacientes con enfermedad renal crónica (ERC) en terapia de reemplazo renal (TRR).

Objetivos: emitir recomendaciones en el paciente con ERC que requiere acceso para diálisis durante la pandemia del COVID-19. Con estas conductas minimizar el riesgo de contaminación por SARS-CoV-2 en el paciente con ERC y en el personal de salud durante el proceso de implante de acceso para diálisis.

Metodología: se revisaron los lineamientos actuales del paciente en ERC con necesidad de acceso para diálisis y los cambios que se deben realizar bajo pandemia: 1) Una búsqueda exhaustiva de los artículos más relevantes y de las guías internacionales en la creación de acceso para diálisis antes de la pandemia. 2) Dichas guías se ajustaron a los elementos relacionados con la pandemia teniendo en cuenta: a) la  necesidad individual de cada paciente de realizarse el procedimiento; b) la posible tasa de éxito del procedimiento; c) el concepto clínico emitido por el grupo tratante, y d) las circunstancias actuales de la institución donde se realizará el procedimiento.

Resultados: se describen brevemente los lineamientos actuales que rigen los accesos para diálisis. Se estratifica el nivel de urgencia y los cambios sugeridos por las sociedades médicas internacionales. Se emiten adecuadas y prácticas recomendaciones frente al manejo de los pacientes con ERC que requieren TRR bajo el marco de la pandemia actual.

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Publicado
2020-05-18
Cómo citar
1.
Velez JH, Cadavid LG, Alarcon JC, Ramírez R, Villanueva I, Galeano J, Gómez R, Villegas MV. Accesos para diálisis: estableciendo prioridades en los procedimientos bajo pandemia DE SARS-COV-2/COVID-19. Rev. Colomb. Nefrol. [Internet]. 18 de mayo de 2020 [citado 23 de noviembre de 2020];7(Supl.2). Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/423