Palabras clave
hospitalización
mortalidad
hemodiálisis
factor de riesgo
Cómo citar
Resumen
Contexto: los pacientes con enfermedad renal crónica (ERC) en hemodiálisis tienen una tasa de hospitalizaciones y mortalidad mayor que la población general, por lo que es prioritario investigar la contribución de diversos factores de riesgo. La alteración de la hemoglobina es común en ERC y se relaciona con complicaciones cardiovasculares, que son la principal causa de muerte, aunque no existe un consenso sobre cuáles serían los valores adecuados de hemoglobina en ERC, ni sobre su impacto en la hospitalización y mortalidad.
Objetivo: determinar si los valores de hemoglobina alterada se relacionan con la hospitalización y la mortalidad de pacientes con enfermedad renal crónica en hemodiálisis.
Metodología: estudio observacional de una cohorte retrospectiva de 214 pacientes que iniciaron hemodiálisis entre el 2019 y el 2022. Al inicio de la hemodiálisis, la hemoglobina se clasificó como entre alterada (?10 o >12 g/dl) y referencial (>10 a 12 g/dl), y se relacionó con hospitalización y mortalidad en análisis bivariado con la prueba de chi-cuadrado de Pearson y el análisis multivariado con el modelo de regresión de Cox, con un nivel de p <0,05.
Resultados: se incluyó a 214 pacientes con ERC en hemodiálisis, de los que fueron hospitalizados 55 (48,2?%) pacientes con hemoglobina alterada vs. 16 (16,0?%) con hemoglobina referencial (p <0,001) y fallecieron 41 (36,0?%) pacientes con hemoglobina alterada vs. 5 (5,0?%) con hemoglobina referencial (p <0,001). En el resto de los pacientes no se reportaron hospitalizaciones ni mortalidad durante el tiempo del estudio. El riesgo relativo de hospitalización de los pacientes con hemoglobina alterada fue de 3,02 (IC 95?%?=?1,85-4,91) y el riesgo relativo de mortalidad de los pacientes con hemoglobina alterada fue de 7,19 (IC 95?%?=?2,96-17,49). En el análisis multivariado, la hemoglobina alterada, la hipoalbuminemia y la hiperfosfatemia se relacionaron con mayor riesgo de mortalidad y hospitalización.
Conclusiones: la hemoglobina alterada incrementó el riesgo de hospitalización y mortalidad de pacientes en hemodiálisis.
Citas
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