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LA DERIVACION TEMPRANA AL NEFROLOGO MEJORA LOS RESULTADOS A LARGO PLAZO EN LA ENFERMEDAD RENAL CRONICA
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LA DERIVACION TEMPRANA AL NEFROLOGO MEJORA LOS RESULTADOS A LARGO PLAZO EN LA ENFERMEDAD RENAL CRONICA

(especial para SIIC © Derechos reservados)
La derivación temprana de los pacientes con enfermedad renal crónica al nefrólogo es necesaria para mejorar los resultados a largo plazo en cuanto a morbilidad y mortalidad.
penaporta9.jpg Autor:
José María Peña Porta
Columnista Experto de SIIC

Institución:
Hospital de Barbastro


Artículos publicados por José María Peña Porta
Coautor
Carmen Vicente de Vera Floristán* 
Doctora en Medicina y Cirugía, Hospital Universitario Arnau de Vilanova, Lérida, España*
Recepción del artículo
4 de Febrero, 2008
Aprobación
5 de Junio, 2008
Primera edición
27 de Octubre, 2008
Segunda edición, ampliada y corregida
27 de Enero, 2009

Resumen
La enfermedad renal crónica es una patología creciente en todo el mundo y cada vez es mayor la prevalencia de pacientes en diálisis, lo que ocasiona un costo muy elevado. En los últimos años han cobrado relevancia los adecuados cuidados en la etapa prediálisis. Para ello es fundamental detectar la enfermedad en sus primeras fases, lo que puede permitir adoptar las medidas necesarias para su tratamiento o, en su caso, retrasar su progresión y prevenir las complicaciones asociadas. A pesar de todo siguen siendo muchos los pacientes que son vistos por primera vez por un especialista en nefrología en etapas avanzadas de la enfermedad como consecuencia de su derivación tardía. Los factores que ocasionan este fenómeno son numerosos e implican tanto a los médicos, como a los pacientes y al sistema sanitario. Las consecuencias negativas de la derivación tardía ya han sido demostradas en cuanto a morbilidad, mortalidad y costos, pero todavía no está demostrado cuál es el mejor momento de iniciar la diálisis en función del filtrado glomerular. Es imprescindible la elaboración y difusión de guías clínicas junto con la colaboración entre nefrólogos y médicos generales para disminuir el impacto de la derivación tardía.

Palabras clave
referencia tardía, inicio de diálisis, enfermedad renal crónica


Artículo completo

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Abstract
Chronic kidney disease is increasing worldwide, and its prevalence in patients on hemodialysis keeps growing, causing a steep rise in health care expenditures. In recent years, the importance of appropriate patient care at the pre-dialysis stage, has gained relevance. Therefore, detection of the disease in its early stages is essential, since it would allow for treatment measures to slow its progression and prevent associated complications. In spite of those efforts, a great number of patients consult the nephrologist in advanced stages of renal disease, due to late referrals. This situation, which involves physicians, patients, and the healthcare system, is caused by multiple factors. The negative consequences of late referrals on morbility, mortality and healthcare expenditures were demonstrated, but the best time to start dialysis based on the glomerular filtration rate, has not been determined yet. In order to diminish the impact of late referrals, the development and dissemination of clinical guidelines together with a coordinated action between nephrologists and general practitioners are essential.

Key words
late referral, start of dialysis, chronic kidney disease


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Nefrología y Medio Interno
Relacionadas: Administración Hospitalaria, Atención Primaria, Bioquímica, Diagnóstico por Laboratorio, Educación Médica, Emergentología, Epidemiología, Farmacología, Geriatría, Medicina Interna, Salud Pública



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José María Peña Porta, Hospital de Barbastro, 25199, C/ Vall Fosca 11, Huesca, España
Bibliografía del artículo
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