Introducción: La residencia de nefrología en nuestro país no ha sido evaluada en forma sistemática y considerando que existen diferentes programas de formación y diferentes sedes docentes, ésta puede ser percibida como inadecuada por sus residentes. Por lo que nos propusimos evaluar la percepción de los residentes de nefrología sobre su formación en postgrado Material Y Métodos: Se llevó a cabo un estudio descriptivo de corte transversal sobre médicos que cursaban los dos últimos años de entrenamiento en la especialidad de nefrología durante febrero del 2012 y sobre egresados de los años 2010 y 2011 a nivel nacional. Se utilizó un cuestionario auto-aplicado elaborado en base a estándares internacionales conjuntamente con la Sociedad Peruana de Nefrología, el cual exploraba las áreas de: Tutoría, formación clínica, procedimientos, rotaciones externas, investigación...

Objetivo. Describir los hallazgos oculares en una población en diálisis crónica convencional. Material y Métodos. Se realizó un estudio observacional, descriptivo y transversal en los pacientes en hemodiálisis crónica en el Servicio de Nefrología del Hospital Nacional Dos de Mayo de Lima. Resultados. Se estudió a 31 pacientes con edad promedio de 62,67 ± 12,46 años y 45,16% fueron varones. Como antecedente, 87,1% tenían hipertensión arterial y 45,16%, diabetes mellitus. Los síntomas oculares más frecuentes fueron: visión borrosa (67,74%), lagrimeo (38,71%), prurito (25,81%), ardorocular (16,13%) y astenopia (6,41%). La presión intraocular promedio fue14,5± 5,28mmHg en el ojo derecho y 14,23 ± 4,78mmHg en el ojo izquierdo. Agudeza visual, ceguera en 6,07% de los pacientes y baja visión en 39,39%. Los hallazgos externos más frecuentes fueron: Depósitos córneo-conjunt...

Objetivos. Describir las características de la hipertensión arterial (HTA) y la hipertensión arterial paradójica (HTAP), y sus factores asociados en pacientes en hemodiálisis. Material y Métodos. Se estudió a 203 pacientes. Se definió HTA como antecedente clínico y/o toma de medicamentos para la HTA; presión arterial promedio (PAP): presión arterial medida antes y después de hemodiálisis; HTA no controlada, si PAP >140/90 mmHg. Se definió HTAP como presión diastólica posdiálisis mayor de 10 mmHg que en prediálisis. Se evaluó edad, tiempo en diálisis, etiología de la enfermedad, peso interdialítico, antecedente cardiovascular, analítica individual, tipo y número de antihipertensivos. Se realizó un análisis univariante y multivariante de estas variables. Resultados. La prevalencia de HTA fue 79,8% y la de HTA no controlada, 54,9%. La edadpromedio fue 56,25 ± 1...

Objetivo: Determinar la prevalencia, características de la clínica y factores relacionados a prurito en pacientes de hemodiálisis. Material y métodos: Estudiamos a 188 pacientes de hemodiálisis crónica. Se encuestó a los pacientes para determinar la prevalencia y la clínica de prurito (alteración del sueño, frecuencia, localización, calendario, relación con diálisis y tratamiento). Se evaluó la relación entre los antecedentes de prurito y clínica y de laboratorio (calcio, fósforo, albúmina, ferritina, Kt/V, RCP, hemoglobina y hepatitis). Se realizó un análisis univariante y multivariante de estas variables. Resultados: La prevalencia de prurito fue 37,2%. El sueño fue perturbado en 37,14%, con una intensidadmoderada de acuerdo a una escala visual analógica (6,2 puntos). El prurito tuvo una presentación diaria en el 98,8% de los pacientes; fue localizado en la parte...

“Background: Previous studies have suggested that the pandemic impact on mental health could vary according to gender. We aimed to evaluate the gender influence in the prevalence of depressive and anxiety symptoms in Latin American and the Caribbean (LAC) countries in the first stage of the COVID-19 pandemic. Methods: We conducted a secondary analysis employing the Facebook–COVID-19 Symptom Survey developed by the University of Maryland. We categorized gender as men, women, and non-binary. The outcomes were the presence of anxiety or depressive symptoms, measured with two adapted questions extracted from the Kessler Psychological Distress Scale (K10). We used generalized linear models from the Poisson family, considering the survey’s complex sampling. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95% CI) and explored interactions with ...

Introduction: Community mitigation strategies (CMS) have demonstrated to be effective in the reduction of transmission and incidence of COVID-19, especially in the population with symptoms associated with the disease. The aim of this study was to evaluate the association between the presence of COVID-19 symptoms and adherence to CMS in Latin American adults. Methods: We carried out a secondary analysis of a database developed by the University of Maryland and Facebook social network during the COVID-19 pandemic. We included Latin American adults that used the Facebook platform and participated in a survey conducted from April 23 to May 23, 2020. The principal outcome variable was reported compliance with the three main CMS (physical distancing, use of face masks, and hand washing). The exposure variable included symptoms suspicious for COVID-19 defined as the presence of three or more sy...

“Background: Previous studies have suggested that the pandemic impact on mental health could vary according to gender. We aimed to evaluate the gender influence in the prevalence of depressive and anxiety symptoms in Latin American and the Caribbean (LAC) countries in the first stage of the COVID-19 pandemic. Methods: We conducted a secondary analysis employing the Facebook–COVID-19 Symptom Survey developed by the University of Maryland. We categorized gender as men, women, and non-binary. The outcomes were the presence of anxiety or depressive symptoms, measured with two adapted questions extracted from the Kessler Psychological Distress Scale (K10). We used generalized linear models from the Poisson family, considering the survey’s complex sampling. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95% CI) and explored interactions with ...

Objetivos: Estimar la prevalencia y los factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. Materiales y métodos: Estudio transversal analítico utilizando una encuesta realizada por la Universidad de Maryland, EUA, en Facebook. La variable dependiente fue la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación de variables sociodemográficas, el cumplimiento de estrategias comunitarias de mitigación, los síntomas de la COVID-19, la salud mental y la aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias. Resultados: Se analizaron los datos de 17 162 adultos. La prevalencia general de la IDV fue del 74,9%. Se asociaron a una menor prevalencia de la ID...

Introduction: Patients with acute kidney injury (AKI) in developing countries are described in a profile of young age, with less comorbidities, with unifactorial, and with a lower mortality compared to patients in developed countries. Objective: To assess mortality in patients with acute kidney injury undergoing hemodialysis (HD) and its associated factors in a developing country setting. Methods: Retrospective study. Demographic, clinical, and mortality variables were collected from patients who presented AKI and underwent HD between January 2014 and December 2015 at a national reference hospital in Lima, Peru. Risk ratios (RR) and 95% confidence intervals (95%CI) were estimated through Poisson regressions. Results: Data from 72 patients with AKI that underwent HD were analyzed, 66.7% of them were < 64 years old, and 40.2% of all patients died undergoing HD. Crude analysis showed higher...

El número de médicos en el Perú no garantiza una cobertura adecuada a toda la población (1). La posibilidad de cubrir ésta demanda con la formación de más médicos es bienvenida; sin embargo, se ha cuestionado si este aumento va de la mano con una supervisión de la calidad de su enseñanza (2).

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Objectives. To determine the factors associated with mortality during the first hospitalization of patients admitted to a hemodialysis unit. Materials and methods. Observational and retrospective study of patients admitted to “Dos de Mayo” National Hospital between January 2012 and December 2013. For the survival analysis we used the Kaplan-Meier method. A multivariate logistic regression was performed to evaluate the factors associated with hospital mortality. Results. 216 patients with a mean age of 56.9 ± 15.5 years were studied. 24% of patients (n = 51) died during their hospital stay. The mortality rate was 9.3 deaths/100 person-weeks (95% CI: 7.0 to 12.3). We found a tendency of less risk of death in patients with between 1 and 6 months from chronic kidney disease diagnosis (OR 0.84, 95% CI: 0.32 to 2.26) and in those with more than six months from chronic kidney disease diagn...

Introduction: Clinical work can influence time spent on scientific research among physicians training in Nephrology. Objective: To describe scientific research practices among medical residents and specialists in Nephrology recently graduated in Peru. Material and Methods: We carried out a cross-sectional study on residents of nephrology of the last two years and specialists graduated from the past two years at the national level through a self-administered validated questionnaire. Results: We obtained 40 responses of which 50% were residents. 68% of respondents never conducted research during residency training. None of the respondents who performed some research work published their research. Almost all considered deficient their research training received and studies done in their hospitals. Conclusion: Scientific research practices among nephrology resident training in Peru are defic...

silamud@gmail.com

silamud@gmail.com

We read with interest the Lancet Series on Global Kidney Disease. Valerie Luyckx and colleagues describe the economics and medical management of chronic kidney disease in sub-Saharan Africa.1 We note clear similarities with patients in Peru. Indeed, in Peru, the Ministry of Health (MINSA)—which covers 70% of the population—does not have a comprehensive programme for the management of patients with chronic kidney disease, including renal replacement therapies. However, the Social Security System (Essalud)—which covers 20% of the population—has a chronic kidney disease programme.

Introduction: In Peru there are different hospitals and university programs for training of specialists in nephrology. Objective: To assess the perception of physicians who attend such programs. Methods: We carried out a descriptive cross-sectional national-level study in physicians who were in the last two years of nephrology training during February 2012 and who had graduated from it in 2010 and 2011. A self-applied questionnaire was developed along with the Peruvian Society of Nephrology based on international standards. The questionnaire evaluated: mentoring, clinical training, procedures, external rotations, research and global perception. Results: Forty doctors were surveyed nationwide. 82.5% had tutors, 22.5% of them said their support was poor. A 27.5% described their theoretical formation as deficient. The practical training was perceived as acceptable globally; however, improve...

Background: Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. Methods: We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR <60 mL/min and/or albuminuria >30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidenc...

Introducción: El número de pacientes con enfermedad renal en etapa terminal (ERT) en terapia de reemplazo renal, principalmente hemodiálisis, ha aumentado sustancialmente en todo el mundo. Las enfermedades crónicas no transmisibles que conllevan a ERT, como diabetes e hipertensión, son comunes en adultos mayores. La supervivencia de adultos mayores en hemodiálisis es pobre debido al efecto de varios factores incluyendo la edad, la atención tardía en nefrología y un inadecuado cuidado pre-hemodiálisis. Es importante comprender el patrón de mortalidad relacionado con la ERT en adultos mayores en nuestro país. Metodología: Se analizaron los pacientes adultos mayores con ERT en tratamiento con hemodiálisis, desde enero de 2012 hasta agosto 2017 en un hospital general en Perú. Se analizaron variables individuales y relacionadas con el sistema de salud, utilizando el modelo line...