[Frequency of altered levels of thyroid hormones in patients undergoing peritoneal dialysis]. / Frecuencia de alteración de los niveles de hormonas tiroideas en pacientes sometidos a diálisis peritoneal.

BACKGROUND: There are concomitant conditions that, by themselves, alter the metabolism of thyroid hormones in chronic kidney disease (CKD), in addition to structural and functional alterations of the thyroid gland. It has been shown that there are various abnormalities in CKD that interfere with peripheral hormonal metabolism. OBJECTIVES: To determine the frequency of alteration of thyroid hormones in patients undergoing peritoneal dialysis and to identify if thyroid disease prevails. METHODS: Cross-sectional and descriptive study with peritoneal dialysis patients in a secondary hospital. We took into account the patient age, cause of renal disease, peritoneal dialysis modality and time it was received. Also, serum free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), and stimulating hormone thyroid (TSH). RESULTS: We studied 76 patients, 43 being men with a mean age of 58.3 years, and the average time of peritoneal dialysis was 27.2 months, and resulting continuous ambulatory peritoneal dialysis (n = 61) was the main mode. Of the subjects, 96.1% had at least one alteration in thyroid hormone, 27 had subclinical hypothyroidism, and five had primary hypothyroidism. CONCLUSIONS: A basic thyroid profile must be used in profile screening of patients undergoing peritoneal dialysis.

[What you should know of the arterial blood gases during the watch]. / Lo que debe conocerse de la gasometría durante la guardia.

Gasometry is the measurement of dissolved gases in the blood, by measuring pH, carbon dioxide pressure (pCO(2)), serum bicarbonate (HCO(3-)), and lactate and serum electrolytes: sodium, potassium and chlorine you can make a diagnosis, etiology and treatment in the critically ill patient. The aim is to provide five steps for the interpretation of blood gases by: 1. The definition of acidemia or acidosis, or alkalemia or alkalosis. 2. Defining the metabolic component or respiratory. 3. To determine the anion gap; levels above 15 ± 2 determine other likely causes of excess anions (methanol, uremia, diabetic ketoacidosis, paraldehyde, ionized, lactic acidosis, ethylene glycol and salicylates. 4. Compensation, using the Winter formula. 5. The delta gap, with the formula for determining intrinsic and metabolic alkalosis. When anion gap is normal, is calculated urinary anion gap; the value is negative if the loss is extrarenal, contrary to the positive result is renal etiology.