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Factores asociados a lesión renal aguda en pacientes sometidos a cirugía cardiaca en la Fundación Cardioinfantil
dc.contributor.advisor | Hernández Leiva, Edgar | |
dc.creator | Peña Peña, Adwar | |
dc.creator | Ortiz García, César Augusto | |
dc.creator.degree | Especialista en Medicina Interna | |
dc.date.accessioned | 2017-02-07T12:28:47Z | |
dc.date.available | 2017-02-07T12:28:47Z | |
dc.date.created | 2017-02-01 | |
dc.date.issued | 2017 | |
dc.description | Introducción: La lesión renal aguda (LRA) es una de las principales complicaciones de la cirugía cardíaca, además, es un factor de riesgo independiente para la muerte postoperatoria precoz y tardía en esta población. Conocer los factores que llevan al desarrollo de lesión renal aguda ayudarían a disminuir esta complicación. Métodos: Estudio de casos y controles. El objetivo de este estudio fue evaluar los factores asociados con el desarrollo de lesión renal aguda, en pacientes sometidos a cirugía cardiaca, con la hipótesis de que el péptido natriurético cerebral (BNP), la hemoglobina baja, el EuroSCORE y la creatinina sérica elevada, están asociados con la aparición de LRA en el postoperatorio. Resultados: Se analizaron 491 pacientes, 141 mujeres (28.72%), de ellos 35 (7.13%) cumplían criterios para LRA en el período posoperatorio. Los pacientes con LRA tenían una media de creatinina mayor en el periodo preoperatorio (p<0.001) y tenían un EuroSCORE tanto logístico como estándar mayor (p<0.001). Los factores asociados a LRA fueron: BNP pμ/mL > 300 OR 3.9 IC95% (1.6-9.5), presencia de arritmia previa OR 5.4 IC95% (2.2-3.5), EuroSCORE estándar OR 1.2 IC95% (1.0.1.3), cirugía valvular OR 2.7 IC95% (0.8-7.6). Conclusión: El BNP preoperatorio elevado, la presencia de arritmia previa, el hecho de que se trate de una cirugía valvular y el EuroSCORE están asociados a aumento de riesgo para desarrollo en deterioro de la función renal y requerimiento de terapia de reemplazo renal en pacientes postoperatorios de cirugía cardiovascular. | spa |
dc.description.abstract | Introduction: Acute Kidney Injury (AKI) is one of the major complications of cardiacsurgery. AKI has been shown as an independent risk factor for both, early and latepostoperative death in this population. The knowledge of the factors that lead to acute renal injury would help to reduce this complication. Methods: Case control study. The objective of this study was to evaluate the factorsassociated with acute renal injury in patients undergoing cardiac surgery, with the hypothesis that Brain Natriuretic Peptide (BNP), low hemoglobin, and an elevated EuroSCORE and serum creatinine, are associated with the occurrence of AKI in the postoperative period. Results: A total of 491 patients were analyzed, 141 women (28. 72%), 35 of them (7. 13%)met criteria for AKI in the postoperative period. Patients with AKI had a higher meancreatinine level in the preoperative period (p< 0. 001) and had a greater EuroSCORE(p< 0. 001). Univariate analysis showed that preoperative BNP was higher (p< 0. 001) andhematocrit was lower in the AKI group (p < 0. 004). Factors associated with LRA were: BNP pμ / ml> 300 OR 3. 9 IC95% (1. 6-9. 5), presence of previous arrhythmia OR 5. 4 95% CI (2. 2-13. 5), EuroSCORE standard OR 1. 2 IC95% (1. 0-1. 3), surgery Valvular OR 2. 7 IC95% (0. 8-7. 6). Conclusion: Elevated preoperative BNP, the presence of previous arrhythmia, a valvularsurgery and EuroSCORE are associated with increased risk for impaired renal function and requirement for renal replacement therapy in postoperative cardiovascular surgery patients. | eng |
dc.format.mimetype | application/pdf | |
dc.identifier.doi | https://doi.org/10.48713/10336_12893 | |
dc.identifier.uri | http://repository.urosario.edu.co/handle/10336/12893 | |
dc.language.iso | spa | |
dc.publisher | Universidad del Rosario | spa |
dc.publisher.department | Facultad de Medicina | spa |
dc.publisher.program | Especialización en Medicina Interna | spa |
dc.rights.accesRights | info:eu-repo/semantics/openAccess | |
dc.rights.acceso | Abierto (Texto completo) | spa |
dc.rights.cc | Atribución-NoComercial-SinDerivadas 2.5 Colombia | spa |
dc.rights.licencia | EL 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. | spa |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | |
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dc.source.instname | instname:Universidad del Rosario | spa |
dc.source.reponame | reponame:Repositorio Institucional EdocUR | spa |
dc.subject | Lesión renal aguda | spa |
dc.subject | EuroSCORE | spa |
dc.subject | Circulación extracorpórea | spa |
dc.subject | Cirugía cardiaca | spa |
dc.subject.ddc | Enfermedades | |
dc.subject.decs | Enfermedades Renales | spa |
dc.subject.decs | Cirugía Torácica | spa |
dc.subject.keyword | Acute kidney injury | eng |
dc.subject.keyword | EuroSCORE | eng |
dc.subject.keyword | Cardiac surgery | eng |
dc.subject.keyword | Extracorporeal circulation | eng |
dc.title | Factores asociados a lesión renal aguda en pacientes sometidos a cirugía cardiaca en la Fundación Cardioinfantil | spa |
dc.type | masterThesis | eng |
dc.type.hasVersion | info:eu-repo/semantics/acceptedVersion | |
dc.type.spa | Trabajo de grado | spa |
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