Envíe este artículo por correo electrónico (Inicie sesión)
Enviar un correo electrónico al autor/a (Inicie sesión) Open Journal Systems
Factores asociados a carga sintomática residual en pacientes con diálisis peritoneal: estudio de cohorte / Factors associated with residual symptom burden in patients with peritoneal dialysis: a cohort study
Resumen
Resumen
Introducción: Los pacientes en diálisis peritoneal presentan síntomas residuales que reducen su calidad de vida.
Objetivo: Determinar los factores asociados a la carga sintomática residual en pacientes con diálisis peritoneal continua ambulatoria (DPCA).
Material y métodos: Estudio observacional, longitudinal, prospectivo y analítico. Se incluyeron pacientes con enfermedad renal crónica candidatos a diálisis peritoneal. Se les aplicó el cuestionario Palliative Care Outcome Scale-Symptoms Renal (POS-S Renal) en prediálisis y a los 3 meses de DPCA. Se determinó la carga sintomática residual a los 3 meses de DPCA con un valor ≥ 8 puntos del cuestionario POS-S Renal. Las variables clínicas y bioquímicas codificadas de forma dicotómica fueron comparadas con la carga sintomática residual. Se calcularon el riesgo relativo (RR), los intervalos de confianza del 95% y los modelos de regresión logística.
Resultados: Se incluyeron 70 pacientes. La media de la tasa de filtrado glomerular fue de 4.7 ± 2 ml/min/1.73 m2. La mediana de la puntuación POS-S Renal en prediálisis fue de 30 puntos y a los 3 meses de la DPCA fue de 8 puntos. La carga sintomática leve prediálisis presentó un RR de 0.18.
Conclusiones: La carga sintomática leve prediálisis es un factor protector independiente de la carga sintomática residual a los 3 meses de la DPCA.
Abstract
Background: Patients on peritoneal dialysis have residual symptoms that reduce their quality of life.
Objective: To determine the associated factors of residual symptom burden in patients with continuous ambulatory peritoneal dialysis (CAPD).
Material and mehotds: An observational, longitudinal, prospective and analytical study was carried out in patients with chronic kidney disease, who were candidates for peritoneal dialysis. The Palliative Care Outcome Scale-Symptoms Renal (POS-S Renal) questionnaire was applied in predialysis and 3 months after CAPD. The residual symptom burden was determined three months after CAPD with a value ≥ 8 points of the POS-S Renal questionnaire. The clinical and biochemical variables coded in a dichotomous manner were compared with the residual symptom burden. Relative risk (RR) with 95% confidence intervals and logistic regression models were calculated.
Results: Seventy patients were included. The mean of glomerular filtration rate (GFR) was 4.7 ± 2 ml/min/1.73 m2. The median of the POS-S Renal score in predialysis was 30 points, and 3 months after CAPD was 8 points. The slight symptom burden predialysis presented a RR of 0.18.
Conclusions: The slight symptom burden predialysis is a protective factor independent for residual symptom burden three months after CAPD.
Palabras clave
Referencias
Aldrete-Velasco JA, Chiquete E, Rodríguez-García JA, Rincón-Pedrero R, Correa-Rotter R, Peña-García R, et al. Mortalidad por enfermedad renal crónica y su relación con la diabetes en México. Med Int Mex. 2018;34(4):534-50.
Torres-Toledano M, Granados-García V, López-Ocaña LR. Carga de la enfermedad renal crónica en México. Rev Med Inst Mex Seguro Soc. 2017;55(2):118-23.
Lisowska B. Uremic toxins and their effects on multiple organ systems. Nephron Clin Pract. 2014;128:303-11.
Gapstur R. Symptom burden:a concept analysis and implications for oncology nurses. Oncol Nurs Forum. 2007;34(3):673-80.
Depner T. Uremic toxicity:urea and beyond. Semin Dial. 2001;14(4):246-51.
Meyer T, Hostetter T. Approaches to uremia. J Am Soc Nephrol. 2014;25(10):2151-8.
Steinhauser K, Christakis N, Clipp E, McNeilly M, McIntyre L, Tulsky J. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000;284(19):2476-82.
Li H, Xie L, Yang J, Pang X. Symptom burden amongst patients suffering from end-stage renal disease and receiving dialysis:a literature review. Int J Nurs Sci. 2018;5(4):427-31.
Flythe J, Powell J, Poulton C, Westreich K, Handler L, Reeve B. Patient-reported outcome instruments for physical symptoms among patients receiving maintenance dialysis:a systematic review. Am J Kidney Dis. 2015;66(6):1033-46.
Murphy E, Murtagh F, Carey I, Sheerin N. Understanding symptoms in patients with advanced chronic kidney disease managed without dialysis:use of a short patient-completed assessment tool. Nephron Clin Pract. 2009;111(1):74-80.
Gutiérrez D, Leiva J, Sánchez R, Hernández D, Cuesta A. Spanish modified version of the palliative care outcome scale-symptoms renal:cross-cultural adaptation and validation. BMC Nephrol. 2016;17:1-9.
Thong M, Dijk S, Noordzij M, Boeschoten E, Krediet R, Dekker F. Symptom clusters in incident dialysis patients:associations with clinical variables and quality of life. Nephrol Dial Transplant. 2009;24(1):225-30.
Almutary H, Bonner A, Douglas C. Which patients with chronic kidney disease have the greatest symptom burden?A comparative study of advanced CKD stage and dialysis modality. J Ren Care. 2016;42(2):73-82.
Eknoyan G, Kasiske B, Wheeler D. Kidney Disease:Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150.
Stevens L, Coresh J, Feldman H, Greene T, Lash J, Nelson R. Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol. 2007;18(10):2749-57.
Webster A, Nagler E, Morton R, Masson P. Chronic kidney disease. Lancet. 2009;29(5):524-32.
Paniagua R, Amato D, Vonesh E, Correa R, Ramos A, Moran A, et al. Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis:ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol. 2002;10(Suppl 13):S1307-20.
Moskovitch J, Mount P, Davies M. Changes in symptom burden in dialysis patients assessed using a symptom-reporting questionnaire in clinic. J Palliat Care. 2020;35(1):59-65.
Ducharlet K, Sundarajan V, Philip J, Weil J, Barker N, Langham R. Patient-reported outcome measures and their utility in the management of patients with advanced chronic kidney disease. Nephrology. 2019;24(8):814-8.
Murphy E, Murtagh F, Carey I, Sheerin N. Understanding symptoms in patients with advanced chronic kidney disease managed without dialysis:use of a short patient-completed assessment tool. Nephron Clin Pract. 2009;111(1):74-80.
Murtagh F, Addington-Hall J, Higginson I. The prevalence of symptoms in end-stage renal disease:a systematic review. Adv Chronic Kidney Dis. 2007;14(1):82-99.
Almutary H, Bonner A, Douglas C. Symptom burden in chronic kidney disease:a review of recent literature. J Renal Care. 2013;39(3):140-50.
Amro A, Waldum B, Dammen T, Miaskowski C, Os I. Symptom clusters in patients on dialysis and their association with quality-of-life outcomes. J Ren Care. 2014;40(1):23-33.
Barrett B, Vavasour H, Major A. Clinical and psychological correlates of somatic symptoms in patients on dialysis. Nephron. 1990;55(1):10-5.
Gutiérrez D, Leiva J, Cuesta A. Symptom burden clustering in chronic kidney disease stage 5. Clin Nurs Res. 2019;28(5):583-601.
Da Silva-Gane M, Wellsted D, Greenshields H, Norton S, Chandna S, Farrington K. Quality of life and survival in patients with advanced kidney failure managed conservatively or by dialysis. Clin J Am Soc Nephrol. 2012;7(12):2002-9.
DOI: https://doi.org/10.24875/RMIMSS.M20000015
Enlaces refback
- No hay ningún enlace refback.