Inicio de diálisis tras trasplante renal. ¿Se empieza en peor situación que la de los enfermos renales de novo? / Dialysis after kidney transplant failure: do patients start in a worse condition than the general population with chronic kidney disease?

Introducción: Los pacientes trasplantados renales con disfunción crónica del injerto que precisan reinicio de diálisis constituyen un grupo cada día más prevalente, con características especiales que los diferencia de la población general con enfermedad renal crónica (ERC). El objetivo del presente estudio fue analizar y comparar la situación clínica al inicio de diálisis y su evolución en el primer año endos grupos de enfermos, trasplantados y no trasplantados, de acuerdo con los criterios fijados en las guías K/DOQI. Asimismo, se estudia si la modalidad de terapia renal sustitutiva (TRS) escogida a su retorno a diálisis pudiera condicionar una mejoría clínica de los pacientes trasplantados. Material y métodos: Estudio retrospectivo y observacional en 106 enfermos con ERC estadio 5 seguidos en el Hospital Ramón y Cajal. Dichos enfermos fueron divididos en dos grupos. El primero estaba formado por 50 enfermos con ERC de riñones nativos que comenzaron tratamiento con diálisis entre los años 2000 y 2009. El segundo grupo estaba constituido por 56 enfermos trasplantados con disfunción del injerto que precisaron retorno a diálisis entre los años 1997 y 2009. Se recogieron parámetros de anemia, función renal, metabolismo calcio-fósforo, factores de riesgo cardiovascular y estado nutricional en el momento de comenzar tratamiento con diálisis y un año después. Resultados: Al inicio de diálisis ambos grupos presentan valores similares en los parámetros analizados con excepción (..) (AU)

Background: Patients with renal graft dysfunction constitute an increasingly prevalent group of end-stage kidney disease (ESKD) patients that require dialysis therapy. These patients have special characteristics that set them apart from the ESKD general population. The aim of this study was to analyse the clinical condition and evolution of patients entering dialysis with a failed kidney graft at the time of restarting dialysis and over a year of therapy according to the K/DOQI guidelines, and to compare them with incidental patients with end-stage kidney disease. We also investigated whether the modality of kidney replacement therapy may determine the clinical improvement of transplant patients. Material and Method: This is a retrospective observational study of 106 patients with ESKD followed up in the Ramon y Cajal Hospital. They were classified in two groups. Group one was made up of 50 failed native kidney patients who started dialysis between 2000and 2009. Group two was comprised of 56 transplant patients with graft dysfunction who returned to dialysis between 1997 and 2009. We studied parameters of kidney (..) (AU)

Dialysis after kidney transplant failure: do patients start in a worse condition than the general population with chronic kidney disease?

BACKGROUND: Patients with renal graft dysfunction constitute an increasingly prevalent group of end-stage kidney disease (ESKD) patients that require dialysis therapy. These patients have special characteristics that set them apart from the ESKD general population. The aim of this study was to analyse the clinical condition and evolution of patients entering dialysis with a failed kidney graft at the time of restarting dialysis and over a year of therapy according to the K/DOQI guidelines, and to compare them with incidental patients with end-stage kidney disease. We also investigated whether the modality of kidney replacement therapy may determine the clinical improvement of transplant patients. MATERIAL AND METHOD: This is a retrospective observational study of 106 patients with ESKD followed up in the Ramon y Cajal Hospital. They were classified in two groups. Group one was made up of 50 failed native kidney patients who started dialysis between 2000 and 2009. Group two was comprised of 56 transplant patients with graft dysfunction who returned to dialysis between 1997 and 2009. We studied parameters of kidney function, anaemia, calcium-phosphorus metabolism, cardiovascular risk factors and nutritional status at the time both groups started on dialysis and one year later. RESULTS: Both groups had a similar clinical status at the time they started on dialysis in most of the parameters analysed with the exception of anaemia. This was more severe in transplant patients, despite the fact that transplant patients received a higher dose of erythropoietin than non-transplant patients. One year later the main difference between both groups was the residual kidney function rate, higher in non-transplant patients. There were no significant differences in the parameters analysed in patients with a failed graft according to the modality of kidney replacement therapy. CONCLUSION: Failed transplant patients start dialysis with more severe anaemia than patients entering dialysis for the first time. Twelve months later both groups present a similar clinical condition with the exception of residual kidney function, higher in failed native kidney patients. The method of dialysis treatment after kidney transplant failure did not have a bearing on the clinical improvement of our patients.

¿Una intervención educativa en niños de doce años de Madrid modifica sus conocimientos y hábitos de higiene buco-dental? / An educative intervention in children of twelve years of Madrid could modify its knowledge and habits bucodental hygiene?

Una adecuada educación en higiene buco-dental en niños es deseable para que éstos adquieran desde la infancia unos hábitos saludables que prevengan posibles enfermedades odontológicas en el futuro. En este estudio nos hemos propuesto valorar la eficacia de un programa de intervención en escolares que les proporcione unos conocimientos básicos sobre este aspecto sanitario. Para ello hemos impartido a sesenta niños y niñas de sexto de primaria (de doce años) del colegio Berriz Veracruz una charla educativa, distribuyéndoles dos encuestas, una antes y otra cuatro semanas después del programa educativo, y hemos estudiado los conocimientos y hábitos que sobre salud e higiene buco-dental presentaron antes de la intervención, así como las modificaciones que sufrieron tras la misma. Observamos cambios significativos tanto en la frecuencia como en la técnica de cepillado, en la actitud a tomar ante el sangrado de encías y en el abandono de hábitos nocivos. Por todo ello concluimos que los programas educativos sobre higiene y salud buco-dental son eficaces para modificar positivamente las conductas de niños de esta edad, subrayando el interés que tiene la implantación de los mismos en el ámbito escolar (AU)

The proper education on dental hygiene is desirable for children, so that they acquire from an early age good habits that prevent possible future diseases. Our study focuses on the results of an educational program for school age children that provide basic knowledge about dental hygiene. To do this, we have given an educational workshop to a group of sixth graders from The School Berriz Veracruz. We conducted a survey before and after the survey to monitor the children's dental hygiene habits before and after the workshop. That way we could determine the changes in attitudes upon attending an information workshop on dental hygiene. We noticed significant changes both in the frequency and technique of mouth washing. We also observed changes in attitude toward gums bleeding and abandonment of poor hygiene habits. Thus, we conclude that educational workshops about dental hygiene provide positive results in children's habits. We must highlight the importance of implementing such workshops among school-age children (AU)