Guía de práctica clínica sobre la detección y el manejo de la enfermedad renal crónica / Clinical practice guideline on the detection and management of chronic kidney disease

Objetivos: Esta GPC sobre Enfermedad Renal Crónica (ERC) responde a preguntas clínicas concernientes a su detección precoz, derivación a atención especializada y manejo, tanto mediante tratamiento farmacológico como con medidas higiénico dietéticas, estilos de vida e intervenciones educativas. Así como informar al paciente y cuidadores para facilitar la toma de decisiones compartidas. En esta GPC no se abordan los siguientes aspectos: Tratamiento de las causas específicas o modificables de ERC, tratamiento sustitutivo renal y tratamiento de las complicaciones de la ERC (anemia, acidosis metabólica, insuficiencia cardiaca, enfermedad renal ósea, insuficiencia renal aguda). ERC en población pediátrica.

A Spanish version for the new ERA-EDTA coding system for primary renal disease.

BACKGROUND: The European Renal Association and the European Dialysis and Transplant Association (ERA-EDTA) have issued an English-language new coding system for primary kidney disease (PKD) aimed at solving the problems that were identified in the list of "Primary renal diagnoses" that has been in use for over 40 years. PURPOSE: In the context of Registro Español de Enfermos Renales (Spanish Registry of Renal Patients, [REER]), the need for a translation and adaptation of terms, definitions and notes for the new ERA-EDTA codes was perceived in order to help those who have Spanish as their working language when using such codes. METHODS: Bilingual nephrologists contributed a professional translation and were involved in a terminological adaptation process, which included a number of phases to contrast translation outputs. Codes, paragraphs, definitions and diagnostic criteria were reviewed and agreements and disagreements aroused for each term were labelled. Finally, the version that was accepted by a majority of reviewers was agreed. RESULTS: A wide agreement was reached in the first review phase, with only 5 points of discrepancy remaining, which were agreed on in the final phase. CONCLUSIONS: Translation and adaptation into Spanish represent an improvement that will help to introduce and use the new coding system for PKD, as it can help reducing the time devoted to coding and also the period of adaptation of health workers to the new codes.

Adaptación en español del nuevo sistema de codificación de enfermedad renal primaria de la European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) / A Spanish version for the new ERA-EDTA coding system for primary renal disease

Antecedentes: La European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) ha publicado, en lengua inglesa, una nueva lista de códigos de enfermedad renal primaria (ERP), con el fin de solventar los problemas detectados en la «Lista de diagnóstico renal primario» que se venía utilizando desde hacía más de 40 años. Objetivos: En el seno del Registro Español de Enfermos Renales (REER) se consideró conveniente traducir y adaptar los términos, definiciones y notas de los nuevos códigos de la ERA-EDTA para facilitar su uso por parte de quienes usan como lengua de trabajo el español. Métodos: Se realizó un proceso de traducción profesional y adaptación terminológica que contó con la participación de nefrólogos bilingües con varias fases de contraste del resultado de la traducción, en las que se revisaron los códigos, literales, definiciones y criterios diagnósticos y se marcaron los acuerdos y discrepancias surgidos para cada término. Finalmente se acordó la versión aceptada por la mayoría de los revisores. Resultados: El acuerdo en la primera fase de revisión fue amplio, con solo 5 puntos de discrepancia que se acordaron en la fase final. Conclusiones: La traducción y adaptación al español representa una mejora para la introducción y uso del nuevo sistema de codificación de ERP, ya que puede contribuir a reducir el tiempo dedicado a la codificación y también el período de adaptación de los profesionales a los nuevos códigos (AU)

Background: The European Renal Association and the European Dialysis and Transplant Association (ERA-EDTA) have issued an English-language new coding system for primary kidney disease (PKD) aimed at solving the problems that were identified in the list of “Primary renal diagnoses” that has been in use for over 40 years. Purpose: In the context of Registro Español de Enfermos Renales (Spanish Registry of Renal Patients, [REER]), the need for a translation and adaptation of terms, definitions and notes for the new ERA-EDTA codes was perceived in order to help those who have Spanish as their working language when using such codes. Methods: Bilingual nephrologists contributed a professional translation and were involved in a terminological adaptation process, which included a number of phases to contrast translation outputs. Codes, paragraphs, definitions and diagnostic criteria were reviewed and agreements and disagreements aroused for each term were labelled. Finally, the version that was accepted by a majority of reviewers was agreed. Results: A wide agreement was reached in the first review phase, with only 5 points of discrepancy remaining, which were agreed on in the final phase. Conclusions: Translation and adaptation into Spanish represent an improvement that will help to introduce and use the new coding system for PKD, as it can help reducing the time devoted to coding and also the period of adaptation of health workers to the new codes (AU)

El afrontamiento como predictor de la calidad de vida en diálisis: un estudio longitudinal y multicéntrico / Coping mechanisms as a predictor for quality of life in patients on dialysis: a longitudinal and multi-centre study

Introducción: Ante el impacto negativo que supone el inicio de la diálisis, es necesario identificar factores psicológicos que afecten a la calidad de vida y salud emocional. Objetivos: Conocer las formas de afrontamiento más utilizadas a lo largo del primer año de tratamiento y analizar su influencia en la calidad de vida y salud emocional. Material y métodos: Estudio longitudinal sobre 98 pacientes incidentes en hemodiálisis y diálisis peritoneal. Se realizaron entrevistas al mes, a los 6 y los 12 meses del inicio de la diálisis, para completar cuestionarios: MOS-SF36, PNA (afectividad) y Formas de Afrontamiento. Resultados: El tipo de estrategias más usadas fueron la Búsqueda de información, Resolución de problemas, Reestructuración cognitiva, Delegación y Expresión regulada de las emociones (p < 0,001). Los afrontamientos de Aproximación se utilizaron más que los de Evitación (p < 0,01); estas diferencias no se modificaron a lo largo del tiempo. La Evitación al inicio fue predictora de mayor afectividad negativa (p < 0,001) y peor componente mental de MOS-SF36 al cabo de un año (p < 0,001). La Evitación a los 6 meses moduló la relación entre afecto negativo al primer mes y al año (p < 0,01). La Aproximación en el primer mes fue predictora de afectividad positiva al cabo de un año (p < 0,001). Conclusiones: Las estrategias de Evitación y Aproximación son factores que influyen en el bienestar psicológico de los pacientes en diálisis. Los pacientes que utilizan estrategias de Evitación al inicio de diálisis están a riesgo de empeorar su bienestar psicológico. Es importante para los profesionales identificar precozmente las estrategias de evitación (AU)

Introduction: Given the negative impacts of dialysis, we must assess and comprehend the psychological factors that affect quality of life and emotional health in dialysis patients. Objectives: We sought to evaluate the most commonly used coping mechanisms during the first year of treatment and to analyse the influence of these strategies on quality of life and emotional health. Material and Method: Longitudinal study of 98 incident patients on haemodialysis and peritoneal dialysis. We interviewed patients at 1, 6, and 12 months after starting dialysis using the MOS-SF36, PNA (affectivity), and Coping Strategies questionnaires. Results: The most commonly used strategies were Information search, Problem solving, Cognitive restructuring, Delegation, and Regulated expression of emotions (P<.001). Adaptive coping strategies were used more frequently than Avoidance coping strategies (P<.01); these differences did not vary over time. Initially, Avoidance was a predictor for a stronger negative emotion (P<.001) and a worse score for the mental component of the MOS-SF36 survey after one year (P<.001). At 6 months, avoidance modulated the relationship between negative emotions after one month and one year (P<.01). Adaptive coping during the first month was a predictor for positive emotion at the end of one year (P<.001). Conclusions: Avoidance and Adaptive mechanisms are coping strategies that influence the psychological well-being of patients on dialysis. Patients who use Avoidance strategies at the start of dialysis are at risk for worsening their psychological state of health. It is important for health care professionals to be able to identify Avoidance strategies at an early stage of dialysis treatment (AU)

Coping mechanisms as a predictor for quality of life in patients on dialysis: a longitudinal and multi-centre study.

INTRODUCTION: Given the negative impacts of dialysis, we must assess and comprehend the psychological factors that affect quality of life and emotional health in dialysis patients. OBJECTIVES: We sought to evaluate the most commonly used coping mechanisms during the first year of treatment and to analyse the influence of these strategies on quality of life and emotional health. MATERIAL AND METHOD: Longitudinal study of 98 incident patients on haemodialysis and peritoneal dialysis. We interviewed patients at 1, 6, and 12 months after starting dialysis using the MOS-SF36, PNA (affectivity), and Coping Strategies questionnaires. RESULTS: The most commonly used strategies were Information search, Problem solving, Cognitive restructuring, Delegation, and Regulated expression of emotions (P<.001). Adaptive coping strategies were used more frequently than Avoidance coping strategies (P<.01); these differences did not vary over time. Initially, Avoidance was a predictor for a stronger negative emotion (P<.001) and a worse score for the mental component of the MOS-SF36 survey after one year (P<.001). At 6 months, avoidance modulated the relationship between negative emotions after one month and one year (P<.01). Adaptive coping during the first month was a predictor for positive emotion at the end of one year (P<.001). CONCLUSIONS: Avoidance and Adaptive mechanisms are coping strategies that influence the psychological well-being of patients on dialysis. Patients who use Avoidance strategies at the start of dialysis are at risk for worsening their psychological state of health. It is important for health care professionals to be able to identify Avoidance strategies at an early stage of dialysis treatment.

Estimación de la tasa de filtración glomerular para el ajuste posológico de los fármacos. Reina la confusión / Estimating glomerular filtration rate in order to adjust drug doses: confusion abounds

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