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Función renal, estado de volemia y furosemida en diálisis peritoneal

Authors: Cirera Segura, Francisco; Martín Espejo, Jesús Lucas; Gómez Castilla, Antonia Concepción; Ojeda Guerrero, María Ángeles;

Función renal, estado de volemia y furosemida en diálisis peritoneal

Abstract

El objetivo principal fue comparar la diuresis y la función renal de los pacientes incidentes en diálisis peritoneal y su evolución en función al uso de furosemida. El objetivo secundario fue valorar si la furosemida puede mejorar el estado de volumen. Material y métodos: Se realizó un estudio retrospectivo, comparativo, longitudinal y multicéntrico. La muestra fueron 40 pacientes. En una unidad se utilizaron diuréticos (grupo furosemida) y en otra no (grupo control). Se recogieron variables del estudio al inicio, 6 y 12 meses. El análisis se realizó con el SPSS 19. Resultados: El 57,5% de los pacientes eran hombres. La edad media fue 56,45 + 16,2 años. La etiología más prevalente fue la nefritis intersticial. Ningún paciente presentó efectos secundarios. La diuresis evolucionó igual en ambos grupos, siendo superiores en el grupo furosemida sin significación. No hallamos diferencias significativas a lo largo del estudio para la diuresis, filtrado glomerular, peso, índice masa corporal y ultrafiltración media. El 40% de los pacientes del grupo control presentaron edemas a los 6 meses frente al 17,6% del grupo furosemida. El grupo control utilizó mayor número de intercambios hipertónicos durante el primer año. El grupo furosemida mostró presiones arteriales sistólicas y diastólicas superiores y utilizó más hipotensores aunque sin significación. Conclusiones: La administración de dosis bajas de diuréticos no ha mostrado diferencias significativas para la diuresis y la función renal durante el primer año en diálisis peritoneal. Quizás por las bajas dosis, el uso de diuréticos no mejoró los parámetros relacionados con el estado de volumen.

The main object was to compare diuresis and renal function in peritoneal dialysis incident patients and their evolution according to the use of furosemide. The secondary object was to evaluate whether furosemide can improve the volume status. Material and methods: A multicentre, longitudinal, comparative, retrospective study was carried out. The sample was 40 patients. In one unit diuretics (furosemide group) were used and in another they were not (control group). Study variables were noted at the start, and after 6 and 12 months. The analysis was carried out using SPSS 19. Results: 57.5% of the patients were men. The average age was 56.45 + 16.2 yeas. The most prevalent aetiology was interstitial nephritis. No patients presented side effects. The evolution of diuresis was the same in both groups, and was higher in the furosemide group without significance. We did not find significant differences throughout the study for diuresis, glomerular filtration, weight, body mass index and mean ultrafiltration. 40% of the patients in the control group presented oedemas after 6 months compared to 17.6% in the furosemide group. The control group used a larger number of hypertonic exchanges during the first year. The furosemide group showed higher systolic and diastolic blood pressure and used more hypotensors, although without significance. Conclusions: The administration of low doses of diuretics has not shown significant differences for diuresis and renal functions during the first year on peritoneal dialysis. Perhaps on account of the low doses, the use of diuretics did not improve the parameters related to the volume status.

Keywords

Medical Subject Headings::Diseases::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Nephritis::Nephritis, Interstitial, función renal residual, Peritoneal dialysis, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Renal Replacement Therapy::Renal Dialysis::Peritoneal Dialysis, Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Sulfonamides::Sulfanilamides::Furosemide, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Extracorporeal Circulation::Ultrafiltration, residual renal function, diuretics, diuréticos, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Control Groups, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Vital Signs::Blood Pressure, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass Index, Medical Subject Headings::Check Tags::Male, Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight, Medical Subject Headings::Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Urinary Tract Physiological Phenomena::Urinary Tract Physiological Processes::Diuresis, Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Natriuretic Agents::Diuretics, Diálisis peritoneal, Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Edema

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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Average
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