2009, Number 3
PDF size: 312.61 Kb.
ABSTRACTObjective: to evaluate the evolution time to Terminal Chronic Renal disease of patients with systemic high blood pressure (SHBP) Design: a retrospective study. Methods: fi les of patients with Terminal Chronic Renal disease attending the Regional General Hospital – 1 (HGR-1) associated to high blood pressure (≥140/90 mmHg) were included in the study, and those associated to another comorbidity, were excluded. Data are expressed in a ± standard error. Results: from 538 fi les, 54 accomplished the selected criteria, 33 (61%) in peritoneal dialysis, 15 (28%) in hemodialysis, 6 (11%) with kidney transplant. The evolution time since the High blood pressure was fi rst diagnosed until the Terminal Chronic Renal disease was of 13 years ± 1.18. The diagnosis was made with a VFG of 12.26 ± 1.2ml/min and the replacement therapy began after 1.2 ± 0.27 years the kidney failure was fi rst diagnosed. 68% of the patients presented no control of the TA. Conclusions: after 13 years, patients developed the renal disease in terminal phase. There is a poor or no follow up to the guidelines to the systemic high blood pressure management. There is no opportune diagnosis and treatment of the Chronic Renal Disease, which can derive in a better quality of life of patients.
Johnson CA, Levey A, Coresh J, Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults. Part I. Deﬁ nition, disease Stages, evaluation, treatment, and risk factors. Am fam Physician. 2004;70: 869-76.
Mezzano AS, Aros EC. Chronic Kidney Disease: Classiﬁ cation, Mechanisms of progression and strategies for Renoprotection. Rev Med. Chile 2005; 133: 338-342.
U.S. Renal data system. USRDS 2003 Annual data Report. Bethesda, MD, National Institutes of Health, 2003;1-560.
Pons R, Torregrosa E, Hernández L, García H, et. al. El coste del tratamiento farmacológico en la enfermedad renal crónica. Nefrología 2006; 26 (3):358-364.
Ministerio de Sanidad. Guía Clínica de Enfermedad Renal Crónica Terminal. 1st Ed. Santiago Misal, 2005;1-40.
Subsecretaría de Prevención y Control de Enfermedades, Coordinación de Vigilancia Epidemiológica. Proyecto de Norma Oficial Mexicana para la prevención, tratamiento y control de la hipertensión arterial, Marzo de 1999.
Masahiko T, Kunitoshi I, Chiho I, Kozen K, et. al. Blood Pressure Predicts Risk of Developing End-Stage Renal Disease in Men and Women. Hypertension 2003;41:1341-1345.
Rodes TJ. Enfermedad Renal Crónica. En: Guardia MJ, coordinador. Medicina Interna de MASSON. 5a ed. Barcelona: Manual Moderno, 1996; 2321-2325.
Aros C, Remuzzi G. The renin-angiotensin system in progression, remission and regression of chronic nephropathies. J Hypertens 2002;20:S45-S53.
Vito M, Campese and Jeanie Park. Use of antagonists of aldosterone in patients with chronic Kidney disease: potential advantages and risks. Journal of Hypertension 2006;24:2157-2159.
National Kidney Foundation KD. Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classiﬁ cation, and Stratiﬁ cation. Am J Kidney Dis 2002;39(suppl 1):S1-266.
Johnson CA, Levey A, Coresh J. Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults. Part I. Deﬁ nition, disease Stages, evaluation, treatment, and risk factors. Am fam Physician. 2004;70:869-76.
Guadalajara JF: Hipertensión Arterial Sistémica En: Gaspar HJ, coordinador. Cardiología. 5ª ed. México: Méndez editores, 2001;593-625.
Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The Seven Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Presure. Arch Intern Med 2003;157:2413-46.
Johnson CA. Creating practice guidelines for chronic kidney disease: An insider’s view. Am fam Physician. 2004;70(5):823-824.