RESUMEN
En este estudio presentamos todos los resultados derivados del procesamiento de los datos del registro de los pacientes de diálisis peritoneal que iniciaron tratamiento sustitutivo en Andalucía entre enero de 1999 y diciembre de 2008. Toda la información procede del Sistema de Información de la Coordinación Autonómica de Trasplante de Andalucía (SICATA). Se presentan datos demográficos, distribución por provincias, las causas de insuficiencia renal y motivo de elección de la diálisis peritoneal como técnica de tratamiento renal sustitutivo, la situación con respecto al trasplante, datos en relación con el catéter y técnica de diálisis peritoneal, las salidas del programa y sus causas, las peritonitis del año 2008, su evolución y resultado de los cultivos. Presentamos también en el informe datos evolutivos 1999-2008 en cuanto a inclusiones, diabetes, tratamiento con diálisis peritoneal automática e incidencia de peritonitis. Analizamos, por otra parte, la supervivencia global de los pacientes y de la técnica diálisis peritoneal, la comorbilidad al inicio del tratamiento y su impacto en la supervivencia (AU)
In this study we show the results derived from the processing of the data of the Registry of the patients on peritoneal dialysis that initiated renal replacement therapy in Andalucía between January of 1999 and December of2008. All the information comes from the base of the Registry of Renal Patients of the Andalucia´s Health Service. The results show demographic data, distribution by provinces, etiology of the end stage renal disease, reason for election of the peritoneal dialysis, inclusion or not in list of renal transplant, catheter data, with draws and their causes, and peritonitis data of 2008. We also analyze in the report, from 1999-2008: anual incidence, diabetes, automatic peritoneal dialysis and peritonitis incidence. Finally we have studied patient and technique survival and factors affecting mortality on peritoneal dialysis, the initial comorbid conditions and its impact in the patient´s survival (AU)
Asunto(s)
Humanos , Insuficiencia Renal Crónica/epidemiología , Diálisis Peritoneal/estadística & datos numéricos , Peritonitis/epidemiología , Comorbilidad , Tasa de Supervivencia , Registros de Enfermedades/estadística & datos numéricos , Distribución por Edad y SexoAsunto(s)
Granulomatosis con Poliangitis/complicaciones , Derrame Pericárdico/etiología , Derrame Pleural/etiología , Glomeruloesclerosis Focal y Segmentaria/etiología , Granulomatosis con Poliangitis/diagnóstico , Granulomatosis con Poliangitis/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , FumarRESUMEN
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Asunto(s)
Masculino , Persona de Mediana Edad , Humanos , Derrame Pleural/etiología , Granulomatosis con Poliangitis/complicaciones , Glomeruloesclerosis Focal y Segmentaria/etiología , Incidencia , Tabaquismo , Granulomatosis con Poliangitis/diagnóstico , Granulomatosis con Poliangitis/epidemiologíaRESUMEN
El propósito de este estudio ha sido analizar la experiencia clínica con icodextrina en nuestra comunidad, especialmente la incidencia de efectos secundarios y la repercusión en el peso y lípidos plasmáticos a medio plazo al disminuir la carga de glucosa. La muestra estaba formada por 51 pacientes; edad57 ± 18 años (18-86), 30 mujeres y 21 hombres; tiempo icodextrina 10,3 ± 7meses (0-41); 21 en DPCA y 30 con cicladora. Además de los datos clínicosen relación con los efectos secundarios, se observó la evolución de diversos parámetros bioquímicos en el período basal (antes de icodextrina) y a los 6, 12 y18 meses. En 12 pacientes se estudiaron la ultrafiltración y aclaramientos decreatinina y urea en el dializado de 24 horas y tras un intercambio de icodextrina trina. Resultados: Todos los efectos secundarios observados fueron dermatológicos, presentándose en 4 de los 51 pacientes (7,8%); dos de ellos sufrieron (..) (AU)
The aim of this study was to analyse our experience with icodextrin in Andalusia, Spain. The study includes 51 patients (30 women and 21 men) on peritoneal dialysis (21 on CAPD and 30 on Automated Peritoneal Dialysis) treated withicodextrin for 10.3 ± 7 months (0-41 months). Their mean age was 57 ± 18 years(18-86 years). We have recorded the appearance of side effects, and the evolution of several biochemical parameters at baseline and after 6, 12 ans 18 months from initiation of icodextrin. We also studied drainage fluid from 12 patients after an icodextrin exchange. Results: There were side effects (all cutaneous) in 4 out of 51 patients (7,8%).Two of the affected suffered from cutaneous hypersensitivity reactions, and icodextrin had to be suspended; the other two had exfoliative dermatitis affecting hands and feet that disappeared without have to withdraws icodextrin. Biochemical parameters: Serum sodium levels decreased from baseline to six months (138 ± 6 mEq/l vs 136 ± 3 mEq/l; p = 0.006), and then persisted at the same levels throughout the rest of the study period. There was a slight but (..) (AU)
Asunto(s)
Humanos , Soluciones para Diálisis/farmacocinética , Diálisis Peritoneal/métodos , Insuficiencia Renal Crónica/terapia , Ultrafiltración/métodos , Hiponatremia/epidemiología , Aumento de Peso , Factores de RiesgoRESUMEN
El propósito de este estudio ha sido analizar la experiencia clínica con icodextrina en nuestra comunidad, especialmente la incidencia de efectos secundarios y la repercusión en el peso y lípidos plasmáticos a medio plazo al disminuir la carga de glucosa. La muestra estaba formada por 51 pacientes; edad57 ± 18 años (18-86), 30 mujeres y 21 hombres; tiempo icodextrina 10,3 ± 7meses (0-41); 21 en DPCA y 30 con cicladora. Además de los datos clínicos en relación con los efectos secundarios, se observó la evolución de diversos parámetros bioquímicos en el período basal (antes de icodextrina) y a los 6, 12 y18 meses. En 12 pacientes se estudiaron la ultrafiltración y aclaramientos de (..) (AU)
The aim of this study was to analyse our experience with icodextrin in Andalusia, Spain. The study includes 51 patients (30 women and 21 men) on peritoneal dialysis (21 on CAPD and 30 on Automated Peritoneal Dialysis) treated with icodextrin for 10.3 ± 7 months (0-41 months). Their mean age was 57 ± 18 years(18-86 years). We have recorded the appearance of side effects, and the evolu(18-86 years). We have recorded the appearance of side effects, and the evolution of several biochemical parameters at baseline and after 6, 12 ans 18 months from initiation of icodextrin. We also studied drainage fluid from 12 patients after an icodextrin exchange. Results: There were side effects (all cutaneous) in 4 out of 51 patients (7,8%).Two of the affected suffered from cutaneous hypersensitivity reactions, and icodextrin had to be suspended; the other two had exfoliative dermatitis affecting hands and feet that disappeared without have to withdraws icodextrin. Biochemical parameters: Serum sodium levels decreased from baseline to six months (138 ± 6 mEq/l vs 136 ± 3 mEq/l; p = 0.006), and then persisted at the same levels throughout the rest of the study period. There was a slight but (..) (AU)
Asunto(s)
Humanos , Soluciones para Diálisis/farmacocinética , Diálisis Peritoneal/métodos , Insuficiencia Renal Crónica/terapia , Ultrafiltración/métodos , Hiponatremia/epidemiología , Aumento de Peso , Factores de RiesgoRESUMEN
UNLABELLED: The aim of this study was to analyse our experience with icodextrin in Andalusia, Spain. The study includes 51 patients (30 women and 21 men) on peritoneal dialysis (21 on CAPD and 30 on Automated Peritoneal Dialysis) treated with icodextrin for 10.3 +/- 7 months (0-41 months). Their mean age was 57 +/- 18 years (18-86 years). We have recorded the appearance of side effects, and the evolution of several biochemical parameters at baseline and after 6, 12 ans 18 months from initiation of icodextrin. We also studied drainage fluid from 12 patients after an icodextrin exchange. RESULTS: There were side effects (all cutaneous) in 4 out of 51 patients (7.8%). Two of the affected suffered from cutaneous hypersensitivity reactions, and icodextrin had to be suspended; the other two had exfoliative dermatitis affecting hands and feet that disappeared without have to withdraws icodextrin. Biochemical parameters: Serum sodium levels decreased from baseline to six months (138 +/- 6 mEq/l vs 136 +/- 3 mEq/l; p = 0.006), and then persisted at the same levels throughout the rest of the study period. There was a slight but significant decreased of serum HDL-cholesterol at six months vs baseline (55 +/- 26 mg/dl vs 51 +/- 20 mg/dl, p = 0.04), and a further decrease at twelve months vs six months (42 +/- 15 mg/dl vs 51 +/- 13 mg/dl, p = 0.054). There were no significant variations of glucose, osmolality, cholesterol, LDL-cholesterol (tendency to increase), triglycerides, beta 2 m and weight (tendency to increase; p = 0.08). In relation with the icodextrin exchange: average ultrafiltration 296 +/- 119 ml (ranging from 104 to 480 ml), creatinine clearance 1.9 +/- 0.5 litres (20.5% of daily creatinine clearance), urea clearance 2.08 +/- 0.5 litres (18.7% of daily urea clearance), total protein losses 3.2 +/- 0.9 g, albumin losses 1.4 +/- 0.5 g; urea and creatinine clearances were negatively correlated with ratios D/P4 of urea and creatinine of PET and positively correlated with ratio G4/G0. In conclusion, side effects are scarce with the use of icodextrin. As described in other studies, there is a trend to a slight decrease in serum sodium. The long-term use of icodextrin does not-prevent weight gain or deterioration of patients on peritoneal dialysis, despite the diminution of glucose load.