Variabilidade dos marcadores morfofuncionais e mortalidade após rastreio da doença renal crônica: estudo longitudinal após dez anos
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Doença Renal Crônica, Hematúria, Mortalidade, Programas de Triagem DiagnósticaResumen
Introducción: La enfermedad renal crónica (ERC) es objeto de cribado poblacional por ser grave y frecuente y cumplir con los criterios epidemiológicos establecidos para el cribado de una patología. Este estudio evaluó la variabilidad de los marcadores morfofuncionales y la mortalidad después del cribado de ERC. Métodos: Estudio de cohorte prospectivo desde 2011 hasta 2022. Los participantes en el estudio puntuado (Fase 1) se incluyeron en la fase 2. La variabilidad de los marcadores de ERC se evaluó durante un intervalo de tres meses. Los pacientes con ERC se compararon con los que no tenían ERC y los supervivientes y no supervivientes se compararon mediante Chi-cuadrado, prueba t de Student o ANOVA. Los factores asociados a la supervivencia se ajustaron por factores de confusión mediante un modelo de Regresión de Cox, considerando un IC del 95%. Resultados: En la fase 1, con seiscientos individuos, el diagnóstico de ERC se basó en la tasa de filtración glomerular estimada (TFGe) en 3,5%, el cociente albúmina/creatinina en 3,0% y la presencia de hematuria glomerular (HtG) en 9,5. % de los evaluados. Pacientes con ERC no eran blancos, eran mayores y tenían niveles más altos de colesterol total y LDL. En la fase 2, con 103 participantes, el análisis bivariado mostró que la edad avanzada, menores ingresos, presión arterial más alta, antecedentes de hipertensión arterial, diabetes mellitus, enfermedad coronaria, tabaquismo, niveles más altos de ácido úrico y glucosa se asociaron con la muerte. En el análisis de regresión multivariado, sólo la edad y la HtG fueron predictores de mortalidad. Conclusión: HtG demostró ser un marcador con menor variabilidad en el diagnóstico de ERC y en el resultado de mortalidad. La variabilidad en los marcadores funcionales y estructurales renales refuerza la necesidad de observar el criterio de cronicidad en el diagnóstico de la ERC.
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Derechos de autor 2025 Neimar Fernandes, Edson Magacho, Luciana Dalamura, Luciana Sodré, Natalia Fernandes, Marcus Bastos
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