Palabras clave
tolvaptán
enfermedad renal
quiste renal
hipertensión arterial
insuficiencia renal crónica
Cómo citar
Resumen
Contexto: la poliquistosis renal autosómica dominante (PQRAD) es la causa más frecuente de nefropatía hereditaria en el adulto y de enfermedad renal crónica estadio 5 de origen genético, además, es una enfermedad heterogénea con una variabilidad fenotípica con relación a la progresión, por lo que es necesario establecer todas las medidas encaminadas a enlentecer la progresión de la enfermedad renal.
Objetivo: generar recomendaciones basadas en la evidencia para el diagnóstico, seguimiento y tratamiento del paciente con PQRAD, definiendo los pacientes con rápida progresión de la enfermedad, guiar el tratamiento general y específico con el agente tolvaptán, y establecer recomendaciones para el acceso a terapias de reemplazo renal, incluido el trasplante, mediante un consenso de expertos.
Metodología: a partir de la formulación de preguntas de investigación pragmáticas relacionadas con la PQRAD, se realiza la búsqueda de evidencia en las bases de datos Pubmed, Scopus y Ovid en el periodo de enero del 2012 a julio del 2023. Los artículos se seleccionaron por medio de una revisión sistemática y a través de la metodología de consenso Delphi modificado. Luego, se aplicó la escala Oxford para cuantificar el nivel de evidencia del total de artículos científicos seleccionados. Todas las recomendaciones finales fueron categorizadas por grado según la clasificación de las guías NHS.
Resultados: se formularon en total 18 recomendaciones para el diagnóstico, tratamiento y seguimiento de la PQRAD, participaron un panel de 10 expertos temáticos, 1 experto metodológico y 2 revisores externos de forma activa para la elaboración del consenso.
Conclusiones: las recomendaciones basadas en evidencia y experticia clínica adaptadas al contexto colombiano permitirán orientar de manera estandarizada, a nivel nacional y regional, el diagnóstico y el tratamiento de pacientes con PQRAD y orientar sobre el uso y aplicación de tolvaptán.
Citas
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