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Aten. prim. (Barc., Ed. impr.) ; 48(9): 596-603, nov. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-157680

RESUMO

Objetivo. Estimar la prevalencia de insuficiencia renal (IR) oculta en DM2, comparando 2 fórmulas de estimación de filtrado glomerular (EFG): Modification of Diet in Renal Disease 4 (MDRD-4) y Crockcoft-Gault (CG) y las variables clínicas asociadas. Diseño Analítico transversal multicéntrico. Emplazamiento. Dos áreas básicas de atención primaria a Terres de l’Ebre. Participantes. Un total de 493 DM2 con médico asignado en las áreas incluidas y edad >18 años. Pérdidas de 9 y 11 casos en cada fórmula debido a falta de variables necesarias para EFG. Mediciones principales. Estimación del filtrado glomerular mediante las 2 fórmulas, valores de creatinina plasmática, clasificación de pacientes con IR establecida, IR oculta y sin IR, posibles variables clinicopatológicas asociadas a la IR. Resultados. Un 45,2% fueron hombres, con una media de edad 70,4 años y un tiempo de evolución de diabetes de 7,5 años. La prevalencia de IR oculta con MDRD-4 fue del 18%, y del 22,6% con CG. Los casos detectados por CG y no por MDRD-4 fueron mayores y con peso menor. En ambas fórmulas, los pacientes con IR oculta presentaron más patologías crónicas, hipertensión y eventos cardiovasculares (CV) que los sin IR. Los factores de riesgo asociados a IR oculta fueron el ser mujer y el incremento de la edad y del colesterol LDL. Conclusiones. La prevalencia de IR oculta fue del 20% en DM2 e, independientemente de la fórmula, se observó un peor control de factores CV, lo que les hace ser un grupo de mayor riesgo de sufrir un evento (AU)


Objective. To estimate the prevalence of occult renal failure (RF) in DM2, by comparing two formulas for estimating glomerular filtration rate (GFR): Modification of Diet in Renal Disease 4 (MDRD-4) and Cockcroft-Gault (CG), as well as their associated clinical variables. Design. Multicentre analytical cross-sectional. Location. Two basic Primary Care areas in Terres de l’Ebre, in North-Eastern Spain. Participants. A total of 493 DM2 patients with age >18 years with an assigned doctor in the areas studied. There was a loss of 9 and 11 cases in each formula due to lack of variables necessary for the GFR. Main measurements. Estimated GFR using the two formulas, plasma creatinine values, classification of patients with established RF, occult RF and without RF, and possible clinical-pathological variables associated with RF. Results. Of the total, 45.2% were men, the mean age was 70.4 years, and mean time since onset of diabetes of 7.5 years. The prevalence of occult RF with MDRD-4 was 18%, and 22.6% with CG. The cases detected by GC and not by MDRD-4 were higher, and with lower weight. In both formulas, occult RF patients had more chronic diseases, hypertension, and cardiovascular events (CV) than those without RF. Risk factors associated with occult RF were female, increasing age, and LDL cholesterol. Conclusions. The prevalence of occult RF was 20% in DM2, independently of the formula. A poorer control of cardiovascular risk factors was observed, which makes them a group at higher risk of suffering a CV event (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Insuficiência Renal/complicações , Insuficiência Renal/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Creatinina/análise , Fatores de Risco , Barreira de Filtração Glomerular , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Estudos Transversais/métodos
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