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Kidney disease is a syndrome characterized by decreased glomerular filtration, which causes the kidney's inability to excrete nitrogenous products and to maintain fluid and electrolyte homeostasis. It is associated with a high risk of death and/or major complications, in addition to the high cost it generates for health services. The criteria for starting renal replacement therapy in patients with dialysis emergency are widely documented in international literature, however, at the ISSSTE Morelia Hospital they are affected by various factors, mainly: lack of supplies and lack of personnel and this is reflected in the morbidity and mortality of patients.
Observational, analytical, cross-sectional, retrospective study from July 1, 2022 to April 30, 2023. Adult patients with chronic kidney disease who meet the criteria for dialysis urgency. Age between 18-65 years. Both genders.
Newly admitted patients were included in the study: 21 patients on peritoneal dialysis and 38 patients on hemodialysis in the period from July 1, 2022 to April 30, 2023. Of the 21 patients who were indicated for peritoneal dialysis, 15 were admitted to peritoneal dialysis mainly due to cardiac complications and in the morning shift (shift in which percutaneous catheters for peritoneal dialysis are placed) the rest received peritoneal dialysis after 12 hours and up to 26 hours after admission. , due to lack of surgical space and refractory shock that contraindicated hemodialysis. Of the patients who were admitted to hemodialysis: 27 of them had therapy initiated within the first 6 hours of their admission, 7 had the temporary catheter placed between 4 and 6 hours after their admission and the hemodialysis session was delayed further. 12 hrs due to lack of space in the unit; The remaining 4 had the catheter placement delayed for 6 to 8:30 hours, predominantly on weekend night shifts, thereby delaying the hemodialysis session from up to 15 hours 30 minutes to 19 hours from their admission to the emergency room.
Los dias de estancia hospitalaria promedio de los pacientes atendidos dentro de las primeras 6 horas fue de 2. Los sustituidos despues de 12hr su estancia promedio fue de 5 dias, lo que aumenta el riesgo de infecciones nosocomiales y la morbilidad; por otra parte, aumenta exponencialmente los costos al sistema de salud. En cuanto a la mortalidad no hubo significancia estadistica, posiblemente por el tamaño de la muestra.