Evaluación de cambios bioquímicos en pacientes con enfermedad renal crónica de 18 a 65 años sometidos a hemodiálisis, en Hospital General del Norte de Guayaquil "Los Ceibos", 2017 a 2019.

Abstract

Introduction The present research is focused on the evaluation of biochemical changes in patients with chronic renal failure who are treated with hemodialysis in a period of 3 years (2017 to 2019), with the purpose of being able to determine the complications and their relation with the percentage of urea reduction. Materials and Methods A descriptive, retrospective, longitudinal, cohort study was conducted that aims to measure the variables and describe the parameters affected in the patients in our study. The data collection was carried out by reviewing the medical records and results of laboratories that are registered in the AS400 medical system used by the General Hospital of the North of Guayaquil, of which a detailed review was carried out in order to obtain data, mainly from the laboratory, which allows us to evaluate the biochemical changes of patients with chronic renal failure undergoing hemodialysis for a period of 3 years (2017 to 2019), these data were recorded in a spreadsheet in the Microsoft Excel program. Results From our sample of 37 patients on hemodialysis, there were 5 types of complications in 2019. 21 (56.8%) had itching (see Table 1 and Figure 1), 3 (8.1%) nausea and vomiting (see Table 2 and Figure 2), 22 (59.5%) headache (see Table 3 and Figure 3), 27 (73%) hypotension (see Table 4 and Figure 4) and 6 (16.2%) precordial pain (see Table 5 and Figure 5). The average PRU of hemodialysis for each patient throughout 2019 as a group presented a minimum of 55.1, a maximum of 89.6% and an average of 75,432% (± 8,765%). Discusion From our sample of 37 patients, mainly five complications could be observed: pruritus, nausea and vomiting, headache, hypotension and precordial pain. The most frequent were pruritus, headache, and hypotension. Between 20 to 25 of the 37 patients suffered each of these three. This differs from other studies in two ways. The first is that we did not find itching as a post-dialytic complication in other studies, which may be as much because the patients do not present it as because the authors do not report it (3). Conclusion The percentage of urea reduction does not present a significant relationship with the presence or absence of complications after hemodialysis in patients with chronic kidney disease.