RESUMO
resumen está disponible en el texto completo
ABSTRACT Background: Urinary tract infection (UTI) is a common disease in childhood and one of the most common causes of consultation in the pediatric emergency department. Its incidence ranges between 5% and 10% in children under 2 years old. Objective: To generate recommendations on the diagnosis, treatment, and follow-up of UTI in pediatric patients in Colombia. Methods: 15 questions of clinical interest in the diagnosis, treatment, and follow-up of UTI in pediatric patients were formulated. A systematic review of the literature was carried out to identify the clinical practice guidelines (CPG) available in UTI, in order to use this evidence to answer the proposed questions and articulate the recommendations. Local and international tools were used to select and evaluate the CPGs. Information was retrieved from the selected guidelines, preliminary recommendations were compiled, and final recommendations were approved by expert consensus. Finally, the strength and direction of each recommendation was assessed. Results: A total of 4 CPGs were selected: American Academy of Pediatrics, Spanish Ministry of Health, McTaggart, and National Institute for Health and Care Excellence. Final recommendations for the diagnosis, treatment, and follow-up of UTI are presented in this paper. Conclusions: These recommendations will guide the teams to make clinical decisions regarding health care of pediatric patients with UTI in Colombia. This will help to improve health care and to generate policies for timely diagnosis, treatment, and follow-up in these patients.
RESUMO
BACKGROUND: Pediatric kidney transplant patients have an increased risk of developing arterial hypertension, dyslipidemia, carbohydrate intolerance and diabetes mellitus, risk factors associated with increased cardiovascular morbidity and mortality. OBJECTIVE: This study evaluates the frequency of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism in a cohort of pediatric kidney transplant patients during 2006-2016 at the Pablo Tobon Uribe Hospital, in Colombia. MATERIAL AND METHODS: Retrospective descriptive study in which descriptive statistics were used. Additionally, a bivariate analysis was performed to compare patients according to the outcome of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism. RESULTS: From a total of 48 pediatric kidney transplants in the period studied, complete information was obtained from 43 patients at one year of follow-up. There was a post-transplant frequency of hypertension of 86%, dyslipidemia 48%, carbohydrate intolerance 14% and diabetes of 2%. CONCLUSIONS: In the evaluated cohort a high frequency of arterial hypertension and dyslipidemia was found after kidney transplantation. The development of early diagnosis and treatment guidelines is suggested to reduce the impact of these diseases associated with cardiovascular risk in adult life.
INTRODUCCIÓN: Los pacientes pediátricos con trasplante renal tienen un riesgo incrementado de desarrollar hipertensión arterial, dislipidemia, intolerancia a los hidratos de carbono y diabetes mellitus, factores de riesgo que se asocian con una mayor morbilidad y mortalidad cardiovascular. OBJETIVO: Evaluar la frecuencia de hipertensión arterial, dislipidemia y alteración en el metabolismo de los hidratos de carbono en una cohorte de pacientes pediátricos con trasplante renal durante 2006-2016 en el Hospital Pablo Tobon Uribe, en Colombia. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo en el cual se utilizó estadística descriptiva. Adicionalmente se realizó análisis bivariado para comparar pacientes según el desenlace hipertensión arterial, dislipidemia y alteración en el metabolismo de los hidratos de carbono. RESULTADOS: De un total de 48 trasplantes renales pediátricos en el periodo estudiado, se obtuvo información completa de 43 pacientes al año de seguimiento. Se observó una frecuencia postrasplante de hipertensión arterial del 86%, de dislipidemia del 48%, de intolerancia a los hidratos de carbono del 14% y de diabetes del 2%. CONCLUSIONES: En la cohorte evaluada se encontró una alta frecuencia de hipertensión arterial y dislipidemia postrasplante renal. Se sugiere el desarrollo de guías de diagnóstico precoz y tratamiento que permitan disminuir el impacto de estas enfermedades asociadas a riesgo cardiovascular en la vida adulta.