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Enfermedad arterial periférica en pacientes con enfermedad renal en estadio terminal: observaciones del Estudio de

Sanjay Rajagopalan¹, Santo Dellegrottaglie, Anna L Furniss

¹Division of Cardiovascular Medicine, 473 W 12th Ave, Ohio State University, Columbus, OH 43202, USA. Sanjay.Rajagopalan@osumc.edu

|October 25, 2006

Resumen

La enfermedad arterial periférica (EAP) afecta a casi el 25% de los pacientes en hemodiálisis, aumentando su riesgo de muerte, eventos cardiovasculares y hospitalizaciones. La PAD también reduce significativamente la calidad de vida relacionada con la salud de los pacientes.

Área de la Ciencia:

Nefrología Nefrología.
Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
Salud Pública La salud pública.

Sus antecedentes:

Los pacientes con enfermedad renal en estadio terminal (ESRD) se enfrentan a riesgos elevados de complicaciones cardiovasculares.
La enfermedad arterial periférica (EAP) es una preocupación significativa en esta población.
Comprender la prevalencia y el impacto de la EAP es crucial para mejorar los resultados de los pacientes.

Objetivo del estudio:

Para determinar la prevalencia de la EAP en una cohorte internacional de pacientes en hemodiálisis.
Investigar la asociación entre la EAP y el pronóstico, incluidas las tasas de mortalidad y hospitalización.
Evaluar el impacto de la EAP en la calidad de vida relacionada con la salud (QVLA) en pacientes en hemodiálisis.

Principales métodos:

Análisis de los datos del estudio prospectivo internacional de resultados de diálisis y patrones de práctica (DOPPS) en el que participaron 29.873 pacientes en hemodiálisis.
Regresión logística para identificar correlatos de PAD.
Modelos de regresión de Cox para evaluar la asociación entre la EAP y los riesgos de mortalidad/hospitalización.
Cuestionarios HRQOL para evaluar los resultados informados por los pacientes.

Principales resultados:

La EAP se diagnosticó en el 25,3% de los pacientes, con notables variaciones geográficas.
Los correlatos significativos de la EAP incluyeron la edad, el sexo masculino, la diabetes, la hipertensión, el tabaquismo y la duración de la hemodiálisis.
El diagnóstico de PAD se relacionó con un aumento de la mortalidad por todas las causas (HR = 1.36), la mortalidad cardíaca (HR = 1.43) y la hospitalización (HR = 1.19).
Los pacientes con EAP experimentaron puntajes de salud física significativamente más bajos en los cuestionarios HRQOL (P<0.0001).

Conclusiones:

La enfermedad arterial periférica es muy prevalente entre los pacientes en hemodiálisis.
La EAP se asocia de forma independiente con un riesgo significativamente mayor de mortalidad, morbilidad y hospitalización cardiovascular.
La EAP tiene un impacto negativo en la calidad de vida relacionada con la salud de los pacientes sometidos a hemodiálisis.

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