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dc.contributor.advisorBarrera Garavito, Edgar Camilo 
dc.creatorNaranjo-Millán, Julián 
dc.creatorCastellanos-de la Hoz, Juan 
dc.date.accessioned2018-08-03T14:36:01Z
dc.date.available2018-08-03T14:36:01Z
dc.date.created2018-07-13
dc.date.issued2018
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18247
dc.descriptionObjetivo: Determinar factores clínicos asociados al desarrollo de lesión renal aguda (LRA) en el periodo posoperatorio de trasplante hepático en pacientes operados en la FCI-IC. Diseño: El presente será un estudio prospectivo, observacional, analítico de cohorte; incluyendo pacientes mayores de 18 años, receptores de trasplante hepático realizado en la Fundación Cardioinfantil (FCI). Se analizarán dentro de la cohorte disponible de pacientes trasplantados en la FCI entre los años 2005 a 2014, se establecerá mediante análisis multivariados que variables se encuentran asociadas al desarrollo de LRA. Resultados:198 pacientes cumplían con los criterios de inclusión y exclusión, descartándose 94 pacientes por no contar con datos intraoperatorios en la historia clínica. Se encontraron 54 (52%) casos de LRA, con una mediana de sobrevida libre de LRA de 83 días. El modelo de regresión incluyó la presencia de ascitis severa, MELD > 20 y uso de mas de 4 unidades de Crioprecipitado durante la cirugía. La presencia de ascitis severa confiere un HR 0.36 (IC 95%0.14-0.92) independiente del MELD y el uso de crioprecipitado durante la cirugía de trasplante. Discusión: La LRA es una complicación frecuente en el postrasplante hepático. Se ha considerado a la LRA multifactorial, donde influyen factores del recipiente, peri operatorios y posoperatorios. En nuestro estudio se ha encontrado después de ajustar por las probables variables de confusión, como la principal variable asociada la ascitis severa, esto probablemente asociado a fenómenos de precondicionamiento isquémico. Consideramos un hallazgo que se debe tener en consideración en los estudios que se realicen a posteriori.
dc.description.abstractObjective: To determine the clinical variables associated with the development of acute kidney injury (AKI) in the postoperative period of liver transplantation. Design: Prospective, observational, analytical cohort study. Frame of reference: The study was developed at the Fundación Cardioinfantil (FCI), a fourth level hospital. Patients: Patients older than 18 years, liver transplant recipients. Main measurements: Pre-surgical, post-surgical variables and creatinine evolution to determine the incidence of AKI. A Cox regression model was developed to determine which variables are associated with AKI. Results: 198 patients were found; 94 patients were discarded due to the lack of intraoperative data in the history chart. 54 (52%) cases of AKI were found, with a median survival time free of AKI of 83 days. No statistically significant differences in the univariate analyzes between the population with AKI and event-free patients. The regression model included the presence of severe ascites, MELD> 20 and the use of more than 4 units of cryoprecipitate during surgery. The presence of severe ascites confers a HR 0.36 (95% CI 0.14-0.92). Conclusions: In our study it was found after adjusting for the confounding variables, that severe ascites is associated with a decreased rate of AKI, a finding that could be understood studying the ischemic preconditioning phenomena that this population group can have. We consider a finding that should be taken into consideration in the studies that are carried out in the future.
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dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectLesión renal aguda
dc.subjectTrasplante hepático
dc.subjectTerapia de remplazo renal
dc.subject.ddcEnfermedades 
dc.subject.lembEnfermedades renales
dc.subject.lembTrasplantes de hígado
dc.titleFactores asociados a injuria renal aguda en pacientes con trasplante hepático en un hospital de cuarto nivel
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Medicina Interna
dc.publisher.programEspecialización en Medicina Interna
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordAcute renal failure
dc.subject.keywordLiver transplantation
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.


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Atribución-NoComercial-SinDerivadas 2.5 Colombia
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