Estado nutricional y capacidad funcional del nefrópata terminal en hemodiálisis crónica

Miroslaba Dalas Guiber, Yazmina Fernández Uriarte, Xiomara Castelo Villalón, Dulce María Sanz Guzmán

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Resumen

Justificación: La desnutrición energético-nutrimental es frecuente en los nefrópatas en diálisis crónica, y suele asociarse con un aumento de la morbi-mortalidad de estos pacientes, y una mala respuesta a la terapia sustitutiva renal. El nefrópata desnutrido suele exhibir una menor capacidad funcional, lo que puede repercutir en el afrontamiento de la enfermedad, y la satisfacción de las necesidades de cuidado personal. Objetivos: Evaluar la asociación entre la capacidad funcional y el estado nutricional del nefrópata en diálisis crónica. Material y método: Se realizó un estudio analítico, prospectivo y longitudinal con 23 nefrópatas (Hombres: 65.2%, Blancos: 56.5%; Edad £ 60 años: 73.9%) en diálisis crónica (Tiempo de permanencia: 2.5 años) en el Programa de Hemodiálisis del Servicio de Nefrología, Hospital Clínico quirúrgico “Hermanos Ameijeiras” (La Habana, Cuba) entre los años 2007-2009. La capacidad funcional del enfermo se midió mediante la escala de Karnofsky. El estado nutricional se determinó mediante una versión modificada de la Valoración Subjetiva Global suministrada por el Instituto Nacional de Nefrología (La Habana, Cuba). Resultados: La mortalidad del nefrópata en diálisis transcurridos 2 años de observación fue del 21.7%. La desnutrición afectó al 47.8% de los enfermos. La capacidad funcional estaba limitada en el 39.1% de los pacientes. La capacidad funcional y el estado nutricional se asociaron significativamente. La mortalidad del nefrópata en diálisis crónica al cierre de la ventana de observación fue dependiente de la capacidad funcional: los enfermos fallecidos se destacaron por la limitación de la capacidad funcional. Conclusiones: En el momento actual la mortalidad del nefrópata en diálisis crónica es dependiente de la capacidad funcional.

Palabras clave

Estado nutricional; Diálisis; Capacidad funcional; Mortalidad

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