TASAS DE SUPERVIVENCIA EN PACIENTES CON ENFERMEDAD RENAL. INFLUENCIA DE LA CORRECCION DE LA ANEMIA
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Se han demostrado las ventajas de la corrección de la anemia en pacientes que se encuentran en tratamiento con diálisis. Estos beneficios, relacionados con la elevación de los niveles de hemoglobina, probablemente se manifiesten también en quienes padecen nefropatía crónica. |
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Recepción del artículo: 20 de Noviembre, 2002
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Aprobación: 15 de Enero, 2003
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Resumen
Gran parte de la morbilidad y mortalidad en pacientes con nefropatía terminal bajo tratamiento dialítico es de origen cardiovascular. La anemia es un factor de riesgo de daño cardiovascular, incluida la hipertrofia del ventrículo izquierdo, en pacientes con disfunción renal. La revisión de los resultados de grandes estudios retrospectivos indica que existe una asociación entre el manejo de la anemia y la disminución de las tasas de mortalidad en pacientes que se encuentran en diálisis. Además, según algunas evidencias, el tratamiento con epoetina podría ejercer un efecto protector contra la mortalidad global y por causa cardiovascular. Estos beneficios, que se asocian con aumento de los niveles de hematócrito/hemoglobina, también podrían ser importantes para los pacientes con nefropatía crónica que no requieren diálisis. La hipótesis se fundamenta en los resultados de estudios que demuestran que la corrección de la anemia en pacientes con nefropatía crónica mejora los factores de riesgo cardiovascular y las tasas de mortalidad. En resumen, la corrección de la anemia parece influir sobre los factores de riesgo cardiovascular, hecho reflejado en disminución del riesgo de muerte en pacientes bajo diálisis. La anemia aparece tempranamente en el curso de la nefropatía crónica, y la evidencia apunta a que la intervención precoz para mejorar al máximo los niveles de hemoglobina tiende a reducir las tasas de mortalidad y prevenir complicaciones cardíacas.
Palabras clave
Anemia, eritropoyetina, mortalidad, diálisis, nefropatía crónica.
Clasificación en siicsalud
Artículos originales> Expertos del Mundo>
página www.siicsalud.com/des/des031/03205002.htm
Especialidades
Principal: Nefrología y Medio Interno
Relacionadas: Hematología, Clínica Médica
Enviar correspondencia a:
Dr. Joachim Möcks. Roche Diagnostics GmbH, Sandhofer Strasse 116, D-68305 Mannheim, Germany
Artículo completo
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Extensión:
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SURVIVAL RATES IN KIDNEY DISEASE PATIENTS - THE IMPACT OF ANAEMIA CORRECTION
Abstract
Much of the morbidity and mortality among end-stage renal disease (ESRD) patients receiving dialysis is cardiovascular in origin. Anaemia is a risk factor for cardiovascular damage, including left ventricular growth, in patients with renal dysfunction. Review of the results of large retrospective studies indicates that there is an association between anaemia management and decreased mortality rates in patients already on dialysis. Also, there is some evidence to suggest that epoetin therapy may have a protective effect against overall and cardiovascular mortality. These benefits, which are associated with raised haematocrit/haemoglobin levels, are also likely to be relevant for chronic kidney disease (CKD) patients not requiring dialysis. This hypothesis is supported by the results of studies showing that anaemia correction in CKD patients improves cardiovascular risk factors and mortality rates. In summary, anaemia correction appears to have an impact on cardiovascular disease risk factors, which has translated into reduced mortality risk in dialysis patients. Anaemia develops early in the course of CKD, and evidence suggests that early intervention to optimise haemoglobin levels appears to decrease mortality rates and prevent the development of cardiac abnormalities.
Key words
Anaemia, erythropoietin, mortality, dialysis, chronic kidney disease.
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