Análisis de los factores pronósticos de mortalidad en los pacientes con enfermedad renal crónica en hemodiálisis

• Autores: Sergio Orlando Escalona-González, Mirna León Acebo, Yailé Caballero Mota, Zoraida Caridad González Milán, Yanela Rodríguez Alvarez, Beatriz Ricardo Paez, Katiuska Danay Rodríguez Espinosa
• Localización: Revista cubana de medicina, ISSN-e 1561-302X, ISSN 0034-7523, Vol. 62, Nº. 4, 2023
• Idioma: español
• Títulos paralelos:
  • Analysis of Mortality Prognostic Factors in Patients with chronic Kidney Disease on Hemodialysis
• Enlaces
  • Texto completo
• Resumen
  • español

    RESUMEN Introducción: La enfermedad renal crónica es una de las principales causas de mortalidad en todo el mundo. La estratificación del riesgo a través del análisis de factores pronósticos podría generar un cambio de paradigma. Objetivo: Analizar los factores pronósticos de mortalidad en los pacientes con enfermedad renal crónica en hemodiálisis. Métodos: Se realizó un estudio no experimental, longitudinal de cohorte retrospectivo en los pacientes con enfermedad renal crónica en hemodiálisis en el Hospital General Docente: “Dr. Ernesto Guevara de la Serna” durante el período del 1 de enero de 2017 al 31 de diciembre de 2021. En general, se analizaron los factores pronósticos de mortalidad mediante el análisis multivariado de regresión logística binaria y se determinó el porcentaje correcto de clasificación del modelo de regresión. Resultados: Se analizaron como variables pronosticas de mortalidad la enfermedad cardiovascular [B = 3,831; p = 0,000; Exp (B) = 46,118], Albúmina < 29 g/L [B = 2,839; p = 0,000; Exp (B) = 17,099], urea > 17 mmol/L [B = 1,326; p = 0,027; Exp (B) = 3,767], glucemia < 4 mmol/L [B = 1,600; p = 0,015; Exp (B) = 4,955] y ganancia de peso interdialítica excesiva [B = 2,243; p = 0,001; Exp (B) = 9,420]. El porcentaje global de clasificación del modelo de regresión logística binaria fue de 89,5 %. Conclusiones: Se analizó el modelo predictivo de regresión logística que presentó una buena precisión con los factores de pronósticos asociados a la mortalidad en los pacientes en hemodiálisis.

  • English

    ABSTRACT Introduction: Chronic kidney disease is one of the main causes of mortality worldwide. Risk stratification through the analysis of prognostic factors could generate a paradigm shift. Objective: To analyze the prognostic factors of mortality in patients with chronic kidney disease on hemodialysis. Methods: A non-experimental, longitudinal retrospective cohort study was carried out on patients with chronic kidney disease on hemodialysis at Dr. Ernesto Guevara de la Serna General Teaching Hospital from January 2017 to December 31, 2021. The prognostic factors of mortality were analyzed using multivariate binary logistic regression analysis and the correct percentage of classification of the regression model was determined. Results: Prognostic variables of mortality were analyzed, such as cardiovascular disease [B = 3.831; p = 0.000; Exp (B) = 46.118], albumin < 29 g/L [B = 2.839; p = 0.000; Exp (B) = 17.099], urea > 17 mmol/L [B = 1.326; p = 0.027; Exp (B) = 3.767], blood glucose < 4 mmol/L [B = 1.600; p = 0.015; Exp (B) = 4.955] and excessive interdialytic weight gain [B = 2.243; p = 0.001; Exp(B) = 9.420]. The overall classification percentage of the binary logistic regression model was 89.5%. Conclusions: The logistic regression predictive model was analyzed, which showed good precision with the prognostic factors associated with mortality in hemodialysis patients.

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