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Asociación entre la variabilidad de la ultrafiltración y los resultados clínicos en pacientes en hemodiálisis
Seok Hui Kang1, So Young Park2, Yu Jeong Lim3
1Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Renal failure
|February 12, 2026
Resumen
La alta variabilidad del volumen de ultrafiltración en pacientes en hemodiálisis se asocia con un mayor riesgo de mortalidad y demencia. Esta variabilidad puede servir como un indicador pronóstico clave para los resultados del paciente.
Área de la Ciencia:
- Nefrología; Epidemiología Clínica
Sus antecedentes:
- Los pacientes en hemodiálisis (HD) de mantenimiento se enfrentan a riesgos asociados con el manejo de fluidos.; El volumen de ultrafiltración (UFV) es un parámetro crítico en la HD, pero su variabilidad ha sido poco estudiada.
Objetivo del estudio:
- Investigar la asociación entre la variabilidad de la UFV y los resultados clínicos en una gran cohorte de pacientes en hemodiálisis (HD) de mantenimiento.; Determinar si la variabilidad de la UFV predice la mortalidad, los eventos cardiovasculares y la demencia.
Principales métodos:
- Análisis retrospectivo de una cohorte poblacional (n=50,583) de los datos nacionales de evaluación de la calidad de HD y reclamaciones de seguros de salud de Corea.; Variabilidad de la UFV cuantificada utilizando la desviación estándar residual de modelos de regresión lineal individuales durante seis mediciones.; Pacientes estratificados en cuartiles según la variabilidad de la UFV; tasas de supervivencia y eventos analizadas mediante regresión de Cox multivariante.
Principales resultados:
- Se observó una asociación graduada entre el aumento de los cuartiles de variabilidad de la UFV y la disminución de las tasas de supervivencia a 5 años.; La mayor variabilidad de la UFV (Q4) se asoció significativamente con un mayor riesgo de mortalidad por todas las causas (el índice de riesgo más alto).; El aumento de la variabilidad de la UFV se correlacionó con un mayor riesgo de eventos cardiovasculares y fibrilación auricular, y la menor variabilidad (Q1) mostró el menor riesgo de demencia.
Conclusiones:
- Existe una asociación significativa entre la alta variabilidad de la UFV y los resultados clínicos adversos, incluida la mortalidad y la demencia.; La variabilidad de la UFV es un indicador pronóstico suplementario potencial para pacientes en HD de mantenimiento.; La optimización de la consistencia de la UFV puede mejorar los resultados de los pacientes en hemodiálisis.
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