UN CAMBIO EN LOS PARADIGMAS DE LA INSUFICIENCIA RENAL AGUDA

  • Juan Daniel Ordóñez Universidad de California
Palabras clave: Insuficiencia Renal Aguda, Insuficiencia Renal Crónica, Prognosis, Epidemiología, Acute Renal Failure, Acute Kidney Injury, Chronic Renal Failure, Chronic Kidney Injury, Epidemiology

Resumen

Entre los años 2007 y 2009, varios estudios epidemiológicos sobre la Insuficiencia Renal Aguda (IRA), mostraron que la enfermedad tiene características clínicas y pronóstico distinto y más severo que los considerados previamente. Otras investigaciones, realizadas entre los años 2010 y 2014, confirmaron y extendieron esos hallazgos. Tomados en conjunto y con la perspectiva de los estudios posteriores, el resultado de los iniciales ha cambiado los paradigmas de la In- suficiencia Renal Aguda y el manejo de los pacientes. Los estudios más recientes sugieren que el pronóstico de la enfermedad puede estar mejorando, posiblemente como consecuencia del mejor manejo de la enfermedad. El autor fue coinvestigador y dirigió una de las tres entidades que participaron en los estudios originales.A CHANGE IN THE PARADIGMS OF THE ACUTE RENAL FAILUREABSTRACTBetween the years of 2007 and 2009 several epidemiologic studies on Acute Renal Failure showed that the disease has clinical features and prognosis different from the predominating beliefs at the time. Rather than having a benign prognosis after recovery, Acute Renal Failure has a high mortality and a guarded prognosis, with frequent development of progressive chro- nic Kidney Disease and the need for maintenance hemodialysis after apparent recovery. The recommendation was made that these patients be closely followed by a nehrologist after leaving the Hospital. Several other studies between 2010 and 2014 confirmed and extended these findings. Taken as a whole, and with the added information of later publications, these studies have changed the paradigm of Acute Renal failure and the management of patients with that disease. The most recent studies suggest that the disease prognosis may be improving, in part at least as a consequence of the better and more insightful management of the disease. The author was a co-investigator and directed one of the three entities that participated in the original studies. 

Biografía del autor/a

Juan Daniel Ordóñez, Universidad de California
MD, MPH, FACP, FASN. Profesor Clínico de Medicina Interna, Universidad de California, San Francisco. Jefe de Nefrología, East Bay Medical Centers, The permanente Medical Group of Northern California.

Citas

Los coinvestigadores que participaron en los estudios iniciales, en los pacientes de Kaiser Permanente fueron los siguientes: Investigadores Asociados, Chi-Yuan, Hsu, MD, MSc University of California, San Francisco, California. Glenn Chertow, MD, MPH Stanford University School of Medicine, Palo Alto, California. Alan Go, MD, Kaiser Permanente of Northern California, Oakland, California. University of California, San Francisco, California. Charles McCulloch, PhD University of California, San Francisco, California. Dongie Fan, MSPH Kaiser Permanente of Northern California, Oakland, California. University of California, San Francisco, California. Lowell J Lo, University of California, San Francisco, California. Trabajo presentado para la promoción a Miembro de Número de la Academia Nacional de Medicina. Bogotá, febrero 1 de 2016.

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Publicado
2016-04-30
Sección
Artículos de reflexión