Keywords
How to Cite
Abstract
Introducción: la hemodiálisis crónica tiene como objetivo reemplazar la función renal y proporciona una extensión de la esperanza de vida; sin embargo, en esta ocurren complicaciones que pueden llegar a ser graves e incluso fatales, por lo que conocerlas puede permitir hacer una mejor evaluación pronóstica y establecer un enfoque de intervención adecuado. Estos factores pueden ser identificados al realizar la anamnesis y la exploración física, y, con mayor precisión, mediante biomarcadores renales, cardíacos y pruebas de imagen.
Objetivos: identificar los biomarcadores sanguíneos válidos para detectar insuficiencia cardíaca e insuficiencia renal asociada con enfermedad renal y hemodiálisis.
Materiales y métodos: se realizó una revisión sistemática de la literatura en agosto de 2018 en las bases de datos Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct y Lilacs. La pregunta guía fue ¿Cuáles son los biomarcadores de sangre utilizados para detectar la insuficiencia cardíaca y la insuficiencia renal? Se encontraron 537 publicaciones, de las cuales se excluyeron 94 por estar repetidas, 383 después de leer títulos y resúmenes, 32 después de leer los textos completos y 10 en la síntesis cuantitativa y cualitativa.
Resultados: Se incluyeron 18 documentos en la muestra final, los cuales presentan pruebas de laboratorio y de imagen, instrumentos para evaluar el riesgo de insuficiencia renal y cardíaca, así como el manejo clínico de la progresión de la insuficiencia renal y cardíaca. Todos los estudios correlacionaron el riesgo de mortalidad y resultado de la muerte.
Conclusión: las pruebas de laboratorio son importantes para identificar la insuficiencia renal y cardíaca y deben utilizarse para mejorar el manejo clínico del tratamiento de hemodiálisis de personas con enfermedad renal crónica a fin de mejorar la calidad y la esperanza de vida.
References
Reilly RF, Perazella MA. Nefrologia em 30 dias. 2nd ed. Artmed; 2015.
Mazur-Laskwska M, Bała-Błądzińska A, Zegartowska P, Dumnicka P, Ząbek-Adamska A, Kapusta M, et al. Serum pregnancyassociated plasma protein A correlates with inflammation and malnutrition in patients treated with maintenance hemodialysis. Folia Med Cracov. 2015 [cited 2019 Apr 21]. Available from:https://reference.medscape.com/medline/abstract/26774806.
Reis MLCA. Síndrome cardiorrenal. Arco Arquivos Centro-Oeste de Cardiologia. 2011[cited 2019 Apr 20];(4):20-3. Available from: http://sociedades.cardiol.br/co/revista_arco/2011/Revista04/08-revisao-sindrome.pdf.
Sociedade Brasileira de Nefrologia (SBN). Tratamento: Hemodiálise. SBN; 2018 [cited 2019 Apr 20]. Available from: https://sbn.org.br/publico/tratatamentos/hemodialise/.
Barberato SH, Bucharles SGE, Barberato MFA, Pecoits-Folho R. Associação entre Parâmetros Clínicos e Ecodopplercardiográficos com Morte Súbita em Pacientes de Hemodiálise. Arq Bras Cardiol. 2016. https://dx.doi.org/10.5935/abc.20160098.
Aldemar-Castro A. Revisão Sistemática e Meta-análise. Metodologia. 2001 [cited 2019 Feb 3]. Available from: http://www.usinadepesquisa.com/metodologia/wp-content/uploads/2010/08/meta1.pdf.
Galvão TF, Pansani TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: a recomendação PRISMA. Epidemiol. Serv. Saúde. 2015;24(2):335-42. http://dx.doi.org/10.5123/S1679-49742015000200017.
Oxford Centre for Evidence-Based Medicine (CEBM). The Oxford 2011 Levels of Evidence. Oxford: CEMB; 2011 [cited 2019 Feb 19]. Available from: https://www.cebm.net/wp-content/uploads/2014/06/CEBM-Levels-of-Evidence-2.1.pdf.
Malta M, Cardoso LO, Bastos FI, Magnanini MMF, da Silva CMFP. Iniciativa STROBE: subsídios para a comunicação de estudos observacionais. Rev Saúde Pública. 2010;44(3):559-65. http://dx.doi.org/10.1590/S0034-89102010000300021.
Pacheco RL, Garcia CM, Hosni ND, Latorraca COC, Martimbianco ALC, Logullo P, et al. Guidelines para publicações de estudos científicos. Parte 3: como publicar ensaios clínicos. Diagn Tratamento. 2017 [cited 2019 May 29]. Available from: http://docs.bvsalud.org/biblioref/2017/11/875481/rdt_v22n4_169-175.pdf.
Lacson Jr E, Xu J, Suri RS, Nesrallah G, Lindsay R, Garg AX, et al. Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis. J Am Soc Nephrol. 2012;23(4):687-95. http://dx.doi.org/10.1681/ASN.2011070674.
Floege J, Gillespie IA, Kronenberg F, Anker SD, Gioni I, Richards S, et al. Development and validation of a predictive mortality risk score from a European hemodialysis cohort. Kidney Int. 2015;87(5):996-1008. http://dx.doi.org/10.1038/ki.2014.419.
Janda K, Krzanowski M, Gajda M, Dumnicka P, Fedak D, Lis GJ, et al. Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. BMC Nephrol. 2015;16:78. http://dx.doi.org/10.1186/s12882-015-0067-8.
Vashistha T, Streja E, Molnar MZ, Rhee CM, Moradi H, Soohoo M, et al. Red Cell Distribution Width and Mortality in Hemodialysis Patients. Am J Kidney Dis. 2016;68(1):110-21. http://dx.doi.org/10.1053/j.ajkd.2015.11.020.
Toledo FR, Antunes AA, Vannini FCD, Silveira LVA, Martin LC, Barretti P, et al. Validity of malnutrition scores for predicting mortality in chronic hemodialysis patients. Int Urol Nephrol. 2013; 45(6):1747-53. http://dx.doi.org/10.1007/s11255-013-0482-3.
Akgul A, Bilgic A, Sezer S, Arat Z, Ozdemir FN, Haberal M. Low Total Plasma Homocysteine Level in Relation to Malnutrition, Inflammation, and Outcome in Hemodialysis Patients. J Ren Nutr. 2008;18(4):338-46. http://dx.doi.org/10.1053/j.jrn.2007.11.007.
Rocco MV, Lockridge Jr RS, Beck GJ, Eggers PW, Gassman JJ, Greene T, et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 2011;80(10):1080-91. http://dx.doi.org/10.1038/ki.2011.213.
Rivara MB, Chen CH, Nair A, Cobb D, Himmelfarb J, Mehrotra R. Indication for Dialysis Initiation and Mortality in Patients With Chronic Kidney Failure: A Retrospective Cohort Study. Am J Kidney Dis. 2017;69(1):41-50. http://dx.doi.org/10.1053/ j.ajkd.2016.06.024.
Karlsson F, Modica A, Mooe T. Association of Level of Kidney Function and Platelet Aggregation in Acute Myocardial Infarction. Am J Kidney Dis. 2009;54(2):262-9. http://dx.doi.org/10.1053/j.ajkd.2009.04.023.
Desjardins L, Liabeuf S, Oliveira RB, Louvet L, Kamel S, Lemke HD, et al. Uremic toxicity and sclerostin in chronic kidney disease patients. Nephrol Ther. 2014;10(6):463-70. http://dx.doi.org/10.1016/j.nephro.2014.04.002.
Aranalde GI, Girino C, Suita GR. Utilidad del NT-probnp como marcador analítico de hipertrofia ventricular izquierda en pacientes dialíticos. Rev. Med. Rosario. 2016 [cited 2019 Apr 21]. Available from: http://www.circulomedicorosario.org/Upload/Directos/Revis- ta/aa4158Aranalde.pdf.
Thomé FS, Senger M, Garcez C, Garcez J, Chemello C, Manfro RC. Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients. Braz J Med Biol Res. 2005;38(5):89-794. http://dx.doi.org/10.1590/S0100-879X2005000500018.
Sanchez-Perales C, Vázquez-Ruiz-de Castroviejob E, García-Cortésa MJ, Biechya MM, Gil-Cunqueroa KM, Borrego-Hinojosa J, et al. Las calcificaciones valvulares al inicio de diálisis predicen la aparición de eventos cardiovasculares en la evolución. Nefrología. 2015;35(2):125.226. http://dx.doi.org/10.1016/j.nefro.2015.05.017.
Martin RSS, Martin LC, Franco RJS, Barretti P, Caramori JCT, Castro JH, et al. Ventricular Hypertrophy and Cardiovascular Mortality in Hemodialysis Patients With Low Educational Level. Arq Bras Cardiol. 2012;98(1):52-61. http://dx.doi.org/10.1590/S0066-782X2012005000004.
Barberato SH, Bucharles SGE, de Souza AM, Costantini CO, CostantiniII; CRF, Pecoits-Filho R. Associação entre Marcadores de Inflamação e Aumento do Átrio Esquerdo em Pacientes de Hemodiálise. Arq Bras Cardiol. 2013;100(2):141-6. https://doi.org/10.5935/ abc.20130027.
Morsch C, Gonçalves LP, Barros E. Índice de gravidade da doença renal, indicadores assistenciais e mortalidade em pacientes em hemodiálise. Rev Assoc Med Bras. 2005;51(5):296-300. https://doi.org/10.1590/S0104-42302005000500023.
Quiroga B, Vega A, Abad S, Villaverde M, Reque J, López-Gómez JM. Creatine-kinase and dialysis patients, a helpful tool for stratifying cardiovascular risk? Nefrología 2016;3:51-6. https://doi.org/10.1016/j.nefroe.2016.01.010.
Li Y, Zhou C, Zhou X, Song L, Hui R. PAPP-A in cardiac and non-cardiac conditions. Clin Chim Acta. 2013;417:67-72. http://dx.doi.org/10.1016/j.cca.2012.12.006.
Pinon P, Kaski JC. Inflamación, aterosclerosis y riesgo cardiovascular: PAPP-A, Lp-PLA2 y cistatina C. ¿Nuevas aportaciones o información redundante?. Rev Esp Cardiol. 2006;59(3):247-58. http://dx.doi.org/10.1157/13086083.
Ujszaszi A, Molnar MZ, Czira ME, Novak M, Mucsi I. Renal function is independently associated with red cell distribution width in kidney transplant recipients: a potential new auxiliary parameter for the clinical evaluation of patients with chronic kidney disease. Br J Haematol. 2013;161(5):715-25. http://dx.doi.org/10.1111/bjh.12315.
Mucsi I, Ujszaszi A, Czira ME, Novak M, Molnar MZ. Red cell distribution width is associated with mortality in kidney transplant recipients. Int Urol Nephrol. 2014;46(3):641-51. http://dx.doi.org/10.1007/s11255-013-0530-z.
Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50(1):40-7. http://dx.doi.org/10.1016/j.jacc.2007.02.067.
Lu YA, Fan PC, Lee CC, Wu VCC, Tian YC, Yan CW, et al. Red cell distribution width associated with adverse cardiovascular outcomes in patients with chronic kidney disease. BMC Nephrology. 2017;18(1):361. http://dx.doi.org/10.1186/s12882-017-0766-4.
Hsieh YP, Chang CC, Kor CT, Yang Y, Wen YK, Chiu PF. The Predictive Role of Red Cell Distribution Width in Mortality among Chronic Kidney Disease Patients. PLOS ONE. 2016;11(12):e0162025. http://dx.doi.org/10.1371/journal.pone.0162025.
Canadas-Garre M, Anderson K, McGoldrick J, Maxwell AP, McKnight, AJ. Proteomic and metabolomic approaches in the search for biomarkers in chronic kidney disease. J Proteomics. 2019;193:93-122. http://dx.doi.org/10.1016/j.jprot.2018.09.020.
Ahmed KAA, Al-Attab WM. Prognostic performance of combined use of high- sensitivity troponin T and creatine kinase MB isoenzyme in high cardiovascular risk patients with end-stage renal disease. Kidney Res Clin Pract. 2017;36(4):358-67. http://dx.doi.org/10.23876/j.krcp.2017.36.4.358.
Odum EP, Wakwe VC. Clinical Significance of Creatine Kinase-MB Elevation in Patients with Chronic Kidney Disease before Initiation of Hemodialysis. Cardiology and Angiology: Na International Journal. 2017;6(4):1-7. https://doi.org/10.9734/CA/2017/38020.
Chen M, Arcari L, Engel J, Freiwald T, Platschek S, Zhou H, et al. Aortic stiffness is independently associated with interstitial myocardial fibrosis by native T1 and accelerated in the presence of chronic kidney disease. Int J Cardiol Heart Vasc. 2019;24:100389. http://dx.doi.org/10.1016/j.ijcha.2019.100389.
Niizuma S, Iwanaga Y, Yahata T, Miyazaki S. Renocardiovascular Biomarkers: from the Perspective of Managing Chronic Kidney Disease and Cardiovascular Disease. Front Cardiovasc Med. 2017;4:10. http://dx.doi.org/10.3389/fcvm.2017.00010.
Manousopoulos K, Lykka A, Michas F, Kostogianni K, Koroboki E, Dimitriou A, et al. Association of short-term variability indices with common carotid artery intima-media thickness in chronic kidney disease patients. Journal of Hipertension. 2018;36:e70. http://dx.doi.org/10.1097/01.hjh.0000539159.96280.38.
Zhao Y, Dong Y, Wang J, Sheng L, Chai Q, Zhang H, et al. Longitudinal association of carotid endothelial shear stress with renal function decline in aging adults with normal renal function: A population-based cohort study. Sci Reps. 2019;9:2051. https://doi.org/10.1038/s41598-018-38470-x.
Sud M, Naimark DMJ. Cardiovascular disease in chronic kidney disease in 2015. Curr Opin Nephrol Hypertens. 2016;25(3):203-7. http://dx.doi.org/10.1097/MNH.0000000000000213.
Dai L, Golembiewska E, Lindholm B, Stenvinkel P. End-Stage Renal Disease, Inflammation and Cardiovascular Outcomes. Contrib Nephrool. 2017;191:32-43. http://dx.doi.org/10.1159/000479254.
Ataklte F, Song R, Upadhyay A, Ramachandran VS, Xanthakis V. Abstract 14106: Association of Mildly Reduced Estimated Glomerular Filtration Rate With Clinical and Subclinical Cardiovascular Disease and Chronic Kidney Disease: The Framingham Heart Study. Circulation. 2019 [cited 2019 May 20];140:A14106. Available from: https://www.ahajournals.org/doi/abs/10.1161/ circ.140.suppl_1.14106.
McCullough PA, Chan CT, Weinhadl ED, Burkart JM, Bakris GL. Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease. Am J Kidney Dis. 2016;68(5S1):S5-14. http://dx.doi.org/10.1053/j.ajkd.2016.05.025.
Netti GS, Rotondi M, Di Lorenzo A, Papantonio D, Teri A, Schirone M, et al. Nocturnal haemodialysis is associated with a reduced occurrence of low triiodothyronine serum levels in haemodialysed patients. Clin Kidney J. 2020;13(3):450-60. http://dx.doi.org/10.1093/ckj/sfaa003.
Graham-Brown MPM, Churchward DR, Hull KL, Preston R, Pickering WP, Eborall HC, et al. Cardiac Remodelling in Patients Undergoing in-Centre Nocturnal Haemodialysis: Results from the MIDNIGHT Study, a Non-Randomized Controlled Trial. Blood Purif. 2017;44(4):301-10. http://dx.doi.org/10.1159/000481248.
Roumeliotis A, Roumeliotis S, Chan C, Pierratos A. Cardiovascular Benefits of Extended-Time Nocturnal Hemodialysis. Curr Vasc Pharmacol. 2020. http://dx.doi.org/10.2174/1570161118666200401112106.
Gan SWS, Chan CT. CKD as CAD Equivalent: Inflammatory Milieu and Vascular Oxidative Stress. In: Rangaswami J, Lerma E, Ronco C, editors. Cardio-Nephrology. 2017 [cited 2020 May 26]. https://doi.org/10.1007/978-3-319-56042-7_6.
Shafiee MA, Chamanian P, Shaker P, Shahideh Y, Broumand B. The Impact of Hemodialysis Frequency and Duration on Blood Pressure Management and Quality of Life in End-Stage Renal Disease Patients. Healthcare (Basel). 2017;5(3):52.http://dx.doi.org/10.3390/ healthcare5030052.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2020 Revista Colombiana de Nefrología