RESUMO
A elevada prevalência da doença renal crónica e a relevância social do seu tratamento exigem um aprofundamento do conhecimento sobre a população doente, tendo em conta a sua complexidade holística. O estudo pretendeu analisar os níveis de complexidade no processo de intervenção social com pessoas com doença renal crónica numa perspetiva de gênero e de escolaridade. A amostra integrou 584 doentes com idades compreendidas entre os 19 e os 93 anos, maioritariamente do sexo masculino, casados e com o 1.º ciclo ensino básico. Os participantes, com diagnóstico de doença renal crónica, foram avaliados através de um protocolo que inclui um questionário sociodemográfico e a Matriz de Complexidade Associada ao Processo de Intervenção Social com Doentes Renais Crónicos (MCAPIS_DRC). Encontrou-se uma associação estatisticamente significativa entre os três níveis de complexidade avaliados e as variáveis sexo (p = 0,002, phi = 0,146) e escolaridade (p > 0,001, phi = 0,277). Verificou-se, igualmente, uma interação entre a escolaridade e o índice de complexidade consoante o sexo (F(5, 572) = 6,647 p = < 0,001, Æp2 = 0,113). As mulheres apresentaram maiores pontuações no índice e as pessoas com maiores níveis de escolaridade pontuam menos no índice. A evidência permite ter uma abordagem diferenciadora na avaliação e intervenção social, priorizando grupos e situações problema.
The high prevalence of chronic kidney disease and the social relevance of its treatment require a deeper knowledge concerning this sick population, taking into account its overall complexity. The study aimed to analyze the levels of complexity in the social intervention process with people with chronic kidney disease from a gender and educational perspective. The sample included 584 patients aged between 19 and 93 years, mostly male, married and with the 1st cycle of primary education completed. Participants, diagnosed with chronic kidney disease, were assessed using a protocol that includes a sociodemographic questionnaire and The Matrix of Complexity Associated with the Process of Social Intervention with Chronic Kidney Disease Patients (MCAPIS_DRC). A statistically significant association was found between the three levels of complexity assessed and the variables gender (p=0.002, phi=0.146) and education (p>0.001, phi=0.277). There was also an interaction between education and the complexity index according to sex (F (5, 572) =6.647 p=<0.001, Æp2=0.113). Women had higher scores on the index and people with higher levels of education scored less on the index. The evidence allows for a different approach in the assessment and social intervention if this condition, prioritizing problematic groups and situations.
RESUMO
INTRODUCTION: Kidney transplantation (KT) is a surgery performed worldwide and has some complications. The objective of this study is to evaluate our surgical complications, comparing the outcomes with those KTs without surgical complications. PATIENTS AND METHODS: An observational cross-sectional study of all surgical complications among 3102 kidney transplants performed between June 1980 and April 2018. RESULTS: Of 3102 kidney transplantations, 490 (15.8%) had the following complications: surgical complications (n = 527); urinary (n = 184; 5.9%); vascular (n = 140; 4.5%); wound-related (n = 78; 2.5%); lymphocele (n = 56; 1.8%); and others (n = 69; 2.2%). The most common complications were ureteral obstruction (n = 85; 2.7%) and urinary fistula (n = 72; 2.3%). The immunosuppression regimen did not influence the surgical complications rate. Surgical complications mainly occurred in male (71.4% vs 66.7%) and heavier (67.6 ± 13.9 vs 65.9 ± 13.5 kg) recipients (P < .05). The hospitalization time was also different (26.3 ± 30.6 vs 15.0 ± 38.8 days, P < .05). Serum creatinine values were different until the second year. After that, the renal function was approximately the same. Nearly 26.1% of complicated kidney transplants had delayed graft function (vs 14.8%, P < .001). Only 23.9% of complicated kidney transplants needed transplant nephrectomy (vs 6.2%, P < .001). The survival of kidneys with surgical complications was lower (64.2 ± 4.5 vs 94.09 ± 2.6 months, P < .001). DISCUSSION/CONCLUSION: Kidney transplant surgical complications occur over time, especially urinary and vascular complications, remaining a problem that leads to prolonged hospitalization and decreased graft survival.