O padrão inflamatório e anemia em hemodiálise

Detalhes bibliográficos
Autor(a) principal: Santos, Carlos Abaeté de los
Data de Publicação: 2004
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional PUCRS
Texto Completo: http://hdl.handle.net/10923/4603
Resumo: The aim of this study was to analyze the association between inflammation and anemia in patients submitted to chronic haemodialysis (HD) in a high-complexity university hospital. The prevalence of the inflammatory pattern (IP) in patients submitted to hemodialysis, in distinct complexity centers, was observed. The characteristics of individuals in HD with functional iron deficiency(FID) and infflammatory iron blockade(IIB) were evaluated. Changes in clinic and laboratory aspects of the IP were studied before and after ultrapure water introduction in HD. This was a cross-sectional study. IP means a serum iron < 60 mg/dL, a total iron binding capacity < 250μg/dL and a ferritin > 100 ng/dL. The prevalence of the IP was compared in 284 individuals submitted to chronic HD in 4 distinct complexity hospitals. To study properly the IP patient´s clinic and laboratory characteristics, the data were derived from individuals submitted to dialysis exclusively in a high complexity university hospital. These patients were initially divided in 2 groups (GA and GB), according to the N high sensitivity C-reactive protein(CRP) serum levels. Subsequently, patients from GB were also divided in 2 other groups (GB1 and GB2), according to the absence or presence of proved infection or inflammation. Prevalence of the IP was augmented in high complexity hospitals. When the IP patients were divided in 2 groups according to CRP levels, nearly 1/4 had normal CRP determinations. Individuals with normal CRP levels had no identified infection or inflammation, had no temporary access and less hospitalizations were required. hematocrit(Htc), hemoglobin(Hgb) and iron(Fe) were augmented, they received less blood transfusions and the mortality rate was significantly decreased. This pattern corresponds to FID. In the individuals with increased CRP levels, the need for temporary catheters increased. Infections and inflammations were more frequently seen and the prevalence of patients admitted to the hospital was augmented. Htc, Hgb and Fe determinations were significantly decreased. Blood transfusions and mortality were increased. These patients belong to the IIB group. When patients with elevated CRP and no specific infection or inflammation were analyzed, it was seen that everyone was dialyzed before ultra pure water implementation. After its introduction CRP levels became within normal limits.
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spelling Santos, Carlos Abaeté de losAntonello, Ivan Carlos Ferreira2013-08-07T19:05:59Z2013-08-07T19:05:59Z2004http://hdl.handle.net/10923/4603The aim of this study was to analyze the association between inflammation and anemia in patients submitted to chronic haemodialysis (HD) in a high-complexity university hospital. The prevalence of the inflammatory pattern (IP) in patients submitted to hemodialysis, in distinct complexity centers, was observed. The characteristics of individuals in HD with functional iron deficiency(FID) and infflammatory iron blockade(IIB) were evaluated. Changes in clinic and laboratory aspects of the IP were studied before and after ultrapure water introduction in HD. This was a cross-sectional study. IP means a serum iron < 60 mg/dL, a total iron binding capacity < 250μg/dL and a ferritin > 100 ng/dL. The prevalence of the IP was compared in 284 individuals submitted to chronic HD in 4 distinct complexity hospitals. To study properly the IP patient´s clinic and laboratory characteristics, the data were derived from individuals submitted to dialysis exclusively in a high complexity university hospital. These patients were initially divided in 2 groups (GA and GB), according to the N high sensitivity C-reactive protein(CRP) serum levels. Subsequently, patients from GB were also divided in 2 other groups (GB1 and GB2), according to the absence or presence of proved infection or inflammation. Prevalence of the IP was augmented in high complexity hospitals. When the IP patients were divided in 2 groups according to CRP levels, nearly 1/4 had normal CRP determinations. Individuals with normal CRP levels had no identified infection or inflammation, had no temporary access and less hospitalizations were required. hematocrit(Htc), hemoglobin(Hgb) and iron(Fe) were augmented, they received less blood transfusions and the mortality rate was significantly decreased. This pattern corresponds to FID. In the individuals with increased CRP levels, the need for temporary catheters increased. Infections and inflammations were more frequently seen and the prevalence of patients admitted to the hospital was augmented. Htc, Hgb and Fe determinations were significantly decreased. Blood transfusions and mortality were increased. These patients belong to the IIB group. When patients with elevated CRP and no specific infection or inflammation were analyzed, it was seen that everyone was dialyzed before ultra pure water implementation. After its introduction CRP levels became within normal limits.O objetivo deste trabalho foi estudar inflamação e anemia em pacientes realizando hemodiálise crônica (HD) em hospital de referência. Estabeleceu-se a prevalência do padrão inflamatório(PI) em centros de diversas complexidades quanto à gravidade de pacientes atendidos, descreveu-se o perfil dos indivíduos com Deficiência Funcional do Ferro(DFF) e Bloqueio Inflamatório do Ferro(BIF), e avaliou-se a evolução clínica e laboratorial do padrão inflamatório com a introdução de água ultrapura em hemodiálise. O estudo foi transversal e descritivo. O PI correspondeu a ferro sérico < 60 mg/dL, capacidade ferropéxica < 250 μg/dL e ferritina > 100 ng/dL. A prevalência deste padrão foi estudada em 284 pacientes que realizavam HD em quatro hospitais de diferentes complexidades. Para estudar as características clínicas e laboratoriais dos pacientes com PI foram exclusivamente utilizados os dados dos pacientes de um centro de referência, divididos inicialmente em 2 grupos (GA e GB), de acordo com o nível sérico de proteína C reativa ultra-sensível(PCR). Posteriormente, os doentes do GB também foram divididos em 2 subgrupos (GB1 e GB2), de acordo com ausência ou presença de infecção ou inflamação clinicamente identificada. A prevalência do PI foi aumentada em hospitais de referência e maior complexidade. Aproximadamente um quarto dos pacientes com PI tinham PCR normal. Estes não apresentaram infecção ou inflamação explícitas, não portavam acessos temporários, e hospitalizaram menos. Tinham níveis de hematócrito (Htc), hemoglobina(Hgb) e ferro(Fe) mais elevados, receberam significativamente menos transfusões, e a taxa de mortalidade foi menor. Preenchiam os requisitos que os definiam como DFF. Nos pacientes com PCR aumentado houve necessidade de maior quantidade de acessos temporários, mais infecção-inflamação, e a prevalência de hospitalizações foi maior. Os níveis de Htc, Hgb e Fe foram significativamente menores. A quantidade de transfusões de sangue e a taxa de mortalidade foram maiores. Estes pacientes parecem se enquadrar no perfil BIF. Quando se analisou exclusivamente os com aumento do PCR, sem infecção ou inflamação específica, verificou-se que as dosagens foram obtidas antes da instalação do sistema de tratamento para obtenção de água ultrapura. Nestes pacientes, após a introdução de água ultrapura houve normalização dos níveis de PCR.Made available in DSpace on 2013-08-07T19:05:59Z (GMT). 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dc.title.pt_BR.fl_str_mv O padrão inflamatório e anemia em hemodiálise
title O padrão inflamatório e anemia em hemodiálise
spellingShingle O padrão inflamatório e anemia em hemodiálise
Santos, Carlos Abaeté de los
DIÁLISE RENAL
ANEMIA
INFLAMAÇÃO
DESNUTRIÇÃO
ERITROPOIETINA
MEDICINA
title_short O padrão inflamatório e anemia em hemodiálise
title_full O padrão inflamatório e anemia em hemodiálise
title_fullStr O padrão inflamatório e anemia em hemodiálise
title_full_unstemmed O padrão inflamatório e anemia em hemodiálise
title_sort O padrão inflamatório e anemia em hemodiálise
author Santos, Carlos Abaeté de los
author_facet Santos, Carlos Abaeté de los
author_role author
dc.contributor.author.fl_str_mv Santos, Carlos Abaeté de los
dc.contributor.advisor1.fl_str_mv Antonello, Ivan Carlos Ferreira
contributor_str_mv Antonello, Ivan Carlos Ferreira
dc.subject.por.fl_str_mv DIÁLISE RENAL
ANEMIA
INFLAMAÇÃO
DESNUTRIÇÃO
ERITROPOIETINA
MEDICINA
topic DIÁLISE RENAL
ANEMIA
INFLAMAÇÃO
DESNUTRIÇÃO
ERITROPOIETINA
MEDICINA
description The aim of this study was to analyze the association between inflammation and anemia in patients submitted to chronic haemodialysis (HD) in a high-complexity university hospital. The prevalence of the inflammatory pattern (IP) in patients submitted to hemodialysis, in distinct complexity centers, was observed. The characteristics of individuals in HD with functional iron deficiency(FID) and infflammatory iron blockade(IIB) were evaluated. Changes in clinic and laboratory aspects of the IP were studied before and after ultrapure water introduction in HD. This was a cross-sectional study. IP means a serum iron < 60 mg/dL, a total iron binding capacity < 250μg/dL and a ferritin > 100 ng/dL. The prevalence of the IP was compared in 284 individuals submitted to chronic HD in 4 distinct complexity hospitals. To study properly the IP patient´s clinic and laboratory characteristics, the data were derived from individuals submitted to dialysis exclusively in a high complexity university hospital. These patients were initially divided in 2 groups (GA and GB), according to the N high sensitivity C-reactive protein(CRP) serum levels. Subsequently, patients from GB were also divided in 2 other groups (GB1 and GB2), according to the absence or presence of proved infection or inflammation. Prevalence of the IP was augmented in high complexity hospitals. When the IP patients were divided in 2 groups according to CRP levels, nearly 1/4 had normal CRP determinations. Individuals with normal CRP levels had no identified infection or inflammation, had no temporary access and less hospitalizations were required. hematocrit(Htc), hemoglobin(Hgb) and iron(Fe) were augmented, they received less blood transfusions and the mortality rate was significantly decreased. This pattern corresponds to FID. In the individuals with increased CRP levels, the need for temporary catheters increased. Infections and inflammations were more frequently seen and the prevalence of patients admitted to the hospital was augmented. Htc, Hgb and Fe determinations were significantly decreased. Blood transfusions and mortality were increased. These patients belong to the IIB group. When patients with elevated CRP and no specific infection or inflammation were analyzed, it was seen that everyone was dialyzed before ultra pure water implementation. After its introduction CRP levels became within normal limits.
publishDate 2004
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Porto Alegre
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Porto Alegre
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