Evolución de la Hipertensión arterial sistémica a enfermedad renal crónica. Estudio retrospectivo
Authors: Muñoz Cortés G. , Trejo Tapia F. , Mejía Rodríguez O. , Belio Caro F. , Salinas González A. , Estrada Andrade M. E. , Rodríguez Ayala E. 
Published: May 2018

<p class="MsoNormal" style="margin: 0pt; mso-layout-grid-align: none;"><strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-bidi-font-family: Garamond-Bold;"><span style="font-family: Times New Roman;">Objetivo: </span></span></strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">evaluar el tiempo de evolución a Enfermedad Renal Crónica Terminal (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">ERFT</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">) en pacientes con Hipertensión Arterial Sistémica (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">HAS</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">). </span><strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-bidi-font-family: Garamond-Bold;"><span style="font-family: Times New Roman;">Diseño: </span></span></strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">estudio retrospectivo/retrolectivo. </span><strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-bidi-font-family: Garamond-Bold;"><span style="font-family: Times New Roman;">Métodos: </span></span></strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-bidi-font-family: Garamond;">se revisaron</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;"> expedientes, se incluyeron pacientes del Instituto Mexicano del Seguro Social (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">IMSS</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">) que acuden al Hospital General Regional-1 (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">HGR</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">-1) con Enfermedad Renal Crónica en Fase Terminal (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">ERFT</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">) asociada con hipertensión (≥ 140/90 mmHg), se excluyeron a aquellos con otra comorbilidad asociada. Los datos se expresan en media ± error estándar. </span><strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond-Bold; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;"><span style="font-family: Times New Roman;">Resultados: </span></span></strong><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">de 538 expedientes, 54 cumplieron los criterios de selección, 33 (61%) en diálisis peritoneal, 15 (28%) en hemodiálisis, seis (11%) con trasplante renal. El tiempo de evolución desde el diagnóstico de hipertensión hasta la <span style="font-size: 7pt;">ERFT</span><span style="font-size: 7pt;"> </span>fue de 13 ± 1.188 años. El diagnóstico se realizó con una Velocidad de Filtrado Glomerular (</span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">VFG </span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">de 12.26 ± 1.2 ml/min y la terapia de reemplazo se inició 1.2 ± 0.27 años después del diagnóstico de la falla renal. 68% de los hipertensos presentaba descontrol de la <span style="font-size: 7pt;">TA</span>. <strong><span style="font-family: Garamond-Bold; mso-bidi-font-family: Garamond-Bold;">Conclusiones</span></strong><strong><span style="font-family: Garamond-Bold; mso-bidi-font-family: Garamond-Bold;">: </span></strong>los pacientes desarrollaron la <span style="font-size: 7pt;">ERFT</span></span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;"> </span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">en 13 años. Existe un pobre apego a las guías para el manejo de la <span style="font-size: 7pt;">HAS</span>. No se está realizando un diagnóstico y tratamiento oportunos de </span><span style="font-size: 7pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">ERC</span><span style="font-size: 10pt; color: #231f20; font-family: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">, lo cual evita al paciente una mejor calidad de vida.</span></p>