Palabras clave
enfermedad renal crónica
diálisis peritoneal
monitoreo continuo de glucosa
hiperglucemia
hipoglucemia
Cómo citar
Resumen
Contexto: los pacientes con diabetes mellitus (DM) y enfermedad renal diabética (ERD) enfrentan una mayor morbimortalidad por enfermedades cardiovasculares. El control glucémico es un reto debido a las múltiples variaciones metabólicas durante la terapia dialítica y una monitorización cuidadosa es clave para prevenir complicaciones en esta población.
Objetivo: el objetivo de este estudio fue describir el comportamiento de la glucemia, determinado por el monitoreo continuo de glucosa (MCG) en la población renal diabética en terapia de diálisis peritoneal (DP), describir las variables del monitoreo continuo de glucosa y su correlación con la modalidad de diálisis peritoneal, con las concentraciones de diálisis a base de glucosa; así como con las variables analíticas y nutricionales.
Metodología: estudio de cohorte prospectivo. Se incluyeron pacientes con DM tipo 1 y 2 con ERD terminal en DP.
Resultados: se incluyeron 46 pacientes con enfermedad renal crónica (ERC) en DP, con una mediana de edad de 63 años (RIQ?=?54,3-69,8), de los cuales el 65?% fueron de sexo masculino. El 93?% tenía DM tipo 2, con una mediana de tiempo de diagnóstico de 20 años; el 76,1?% se encontraban bajo terapia de diálisis peritoneal ambulatoria continua (CAPD, según sus siglas en inglés) y el 23,9?% estaba bajo terapia de diálisis peritoneal automatizada (APD, según sus siglas en inglés). La mediana de hemoglobina glicada (HbA1C) fue del 7,5?% (RIQ?=?7-8.3) y la mediana del indicador de control de glucosa (GMI, según sus siglas en inglés) fue del 7,2?% (RIQ?=?6,7-7,6). La mediana de tiempo en rango (TIR, según sus siglas en inglés), tiempo sobre rango (TSR) y tiempo por debajo de rango (TBR, según sus siglas en inglés) fue del 60,5?%, 34,0?% y 0,5?%, respectivamente.
Conclusiones: se observó una tendencia a la hiperglucemia en pacientes sometidos a DP, principalmente en aquellos con soluciones de diálisis con mayor concentración de glucosa.
Citas
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