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Introducción: La disfunción renal aguda es una complicación grave y frecuente en Unidades de Cuidados Intensivos, que se asocia al empleo de terapias continuas de reemplazo renal, donde la actuación de enfermería es determinante para su aplicación exitosa. Objetivo: Describir el rol de enfermería en el uso de terapias de reemplazo renal continuo en una Unidad de Cuidados Intensivos Quirúrgicos. Métodos: Estudio cuantitativo, descriptivo de corte transversal, en la Unidad de Cuidados Intensivos del Centro Nacional de Cirugía de Mínimo Acceso, La Habana, Cuba, desde 2016 hasta 2019. Universo de 10 pacientes con terapias de reemplazo renal continuo, se revisaron en historias clínicas las variables edad, sexo, duración del hemofiltro, duración de la terapia, acceso venoso, valores de creatinina y urea. Se utilizó el programa IBM SPSS para Windows para calcular distribuciones de frecuencias absolutas, porcentajes, media, mediana, desviación típica, valor mínimo y máximo. Resultados: La mediana de edad fue 73 años, el hemofiltro con duración media de 14,70 horas, tiempo medio de terapia 77 horas, valores medios de creatinina 206,9 É¥mol/l y urea 22,4 mmol/l. Se utilizó anticoagulación sistémica. Conclusiones: El rol de enfermería fue decisivo en el uso exitoso de terapias de reemplazo renal continuo en la Unidad de Cuidados Intensivos Quirúrgicos estudiada. La insuficiencia renal aguda fue la causa de inicio de las terapias, predominaron los pacientes adultos mayores sin diferencias en relación al sexo. Se mantuvo la terapia por más de 72 horas en varios pacientes, se debe lograr una mayor longevidad de los filtros(AU)

Introduction: Acute renal dysfunction is a serious and frequent complication in Intensive Care Units, associated with the use of continuous renal replacement therapies, where nursing action is decisive for successful application. Objective: To describe the involvement of nursing in the use of continuous renal replacement therapies in a Surgical Intensive Care Unit. Methods: A quantitative, descriptive, cross-sectional study of 10 patients with continuous renal replacement therapies in the Intensive Care Unit was carried out at the National Center for Minimal Invasive Surgery, Havana, Cuba, from 2016 to 2019. The medical records were reviewed for the variables age, sex, hemofilter duration, duration of therapy, venous access, creatinine and urea values. The IBM SPSS program for Windows was used to calculate absolute frequency distributions, mean, percentages, median, standard deviation, minimum and maximum value. Results: The median age was 73 years, hemofilter had a mean duration of 14.70 hours, mean therapy time 77 hours, mean creatinine values 206.9 µmol /l and urea 22.4 mmol /l. Systemic anticoagulation was used. Conclusions: The nursing involvement was decisive in the successful use of continuous renal replacement therapies in the Surgical Intensive Care Unit studied. Acute renal failure was the cause of initiation of therapies; older patients predominated with no differences in relation to sex. The therapy was kept for more than 72 hours in several patients; a greater longevity of the filters should be achieved(AU)

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Hotspots of chronic kidney disease of unknown etiology (CKDu) have been identified throughout the globe, of which the Mesoamerican nephropathy in Central America is the most conspicuous example. It affects mainly agricultural workers, heat exposure during extenuating shifts leading to sudden dehydration and subsequent acute kidney injury (AKI) episodes is the main hypothesis, with other factors such as environmental and social determinants playing an underlying role. Recent reports have suggested that Mexico and the United States may have newly identified CKDu hotspots. Studies from Tierra Blanca, a rural region in Mexico, have shown that the prevalence of probable CKD is high (25%) among the population, of which almost half of the identified cases had no known risk factor (such as diabetes or hypertension). Studies in Hispanic agricultural workers from California and Florida have shown that heat stress and dehydration is frequent and is correlated with AKI episodes after a work shift (33% of workers in one shift). Because recurrent AKI is an established risk factor for CKD, these studies strengthen the evidence that suggests an association between this occupational exposure and CKD. Whether the etiology responsible for the entities described is the same as in other CKDu hotspots in the world remains unknown. The development of preventative and intervention strategies is the most urgent priority to address this issue.

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Estudamos a freqüência de insuficiência renal aguda (IRA) entre 240 pacientes internados com sintomas da infecçäo pelo HIV, encontrando 34 episódios em 33 pacientes (13,75). Sua freqüência foi maior nas crianças que nos demais pacientes da série (respectivamente, 34,4 por cento x 12,7 por cento, p < 0,05). O número de sobreviventes 1 mês após a instalaçäo da IRA foi baixo (5 casos, 15,2 por cento). Nenhum dos 21 doentes com quadro séptico associado sobreviveu por mais de 1 mês após o surgimento da IRA, enquanto 5 dos 12(41,7 por cento) näo sépticos ultrapassaram este período (p < 0,01), obtendo alta. Conclui-se que IRA foi importante causa de morbidade entre os pacientes com infecçäo pelo HIV, estando as crianças sob maior risco de desenvolvê-la. O prognóstico após a IRA é ruim, especialmente quando associada à sepsis

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