Dialisis Dr Kaji ESM IPN

Dr. Julio Kaji Kiyono Nefrología Hospital Regional “1º De Octubre” ISSSTE Septiembre 2010 T R A T A M I E N T O S D E S U S T I T U C I Ó N D E L A F U N C I Ó N R E N A L: D I Á L I S I S Y H E M O D I Á L I S I S

TRATAMIENTOS DE SUSTITUCIÓN USRDS : USA Data System Registry; JSDT : Japanese Society for DialysisTherapy; ANZDATA: Asian-Pacific, New Zealand and Australian Re-gistry (Datos de 2000). CAUSAS MAS FRECUENTES DE IRC USRDS JSDT ANZDATA Incidencia (%) Diabetes 41,7 33,8 18,6 Angionefroesclerosis 25,7 6,5 9,7 Glomerulonefritis 10,5 38,2 34,5 Otras 22.1

TRATAMIENTOS DE SUSTITUCIÓN (J, Am. Soc. Nephrol. 1996; 7:198-207) Adequacy of Dialysis and Nutrition in Continuous Peritoneal Dialysis: Association with Clinical Outcomes1 CANADA-USA (CANUSA) Peritoneal Dialysis Study Group Características del grupo de estudio Pacientes 680 100% Causa de IRC Diabetes Hipertensión Glomerulonefritis Enfermedad Poliquística Renal Otras Co-morbilidades Diabetes mellitus Cardiopatía isquémica 202 95 16 0 47 134 151 258 29.7 14.0 23.5 6.9 19.7 22 37.9

Effects of Increased Peritoneal Clearances on Mortality Rates in Peritoneal Dialysis: ADEMEX, a Prospective, Randomized, Controlled Trial TRATAMIENTOS DE SUSTITUCIÓN Paniagua R. et al J Am Soc Nephrol 13: 1307–1320, 2002 Características Basales de los dos grupos de estudio Grupo control Grupo de estudio Nº de Pacientes 484 481 Causa de IRC Diabetes Hipertensión Glomerulonefritis Enfermedad Poliquística Renal Co-morbilidades Diabetes mellitus Hipertensión 211 (44%) 52 (11%) 28 (6%) 19 (4%) 217 (45%) 322 (66%) 194 (40%) 50 (10%) 31 (6%) 23 (5%) 201 (42%) 311 (65%)

TRATAMIENTOS DE SUSTITUCIÓN BASES FISIOLOGI C A S DE LOS SISTEMAS DE DIALISIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN CRITERIOS CLÍNICOS Y PARACLINICOS DIALISIS PERITONEAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN COMPONENTES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN TIPOS DE DIALISIS PERITONEAL ,[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GLUCOSA COMO AGENTE OSMÓTICO HABITUAL FISIONEAL

TRATAMIENTOS DE SUSTITUCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object],OTRAS ALTERNATIVAS

TRATAMIENTOS DE SUSTITUCIÓN Impact of non-glucose solutions on glucose load Holmes et al, PDI 2000 2.5 L Physioneal 1.36% 2.5 L Physioneal 1.36% 2.5 L Physioneal 1.36% 2.5 L Physioneal 3.86% Glucose absorbed = 123 g/day 2.5 L Physioneal 1.36% 2.5 L Nutrineal 2.5 L Physioneal 2.5 L Extraneal Glucose absorbed = 72 g/da 2.5 L Physioneal 1.36% 2.5 L Physioneal 2.5 L Physioneal 2.5 L Extraneal Glucose absorbed = 70 g/day

CRITERIOS CLÍNICOS Y PARACLINICOS HEMODIALISIS TRATAMIENTOS DE SUSTITUCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN DIALIZADORES

TRATAMIENTOS DE SUSTITUCIÓN COMPONENTES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTOS DE SUSTITUCIÓN HEMODIÁLISIS

TREINTA AÑOS DE LA TECNOLOGÍA EN HEMODIALISIS TRATAMIENTOS DE SUSTITUCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dialisis Dr Kaji ESM IPN

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