Causas de exclusión de donantes renales vivos en el servicio de trasplante de un hospital de tercer nivel del noroeste de México

Objetivo: Identificar las causas de exclusión de los donantes renales vivos en un centro hospitalario de tercer nivel en el noroeste de México. Materiales y métodos: Estudio de tipo observacional, transversal, descriptivo, retrospectivo. Se realizó la evaluación de los expedientes clínicos de los candidatos vivos para donación renal, que abarcó el periodo comprendido entre el 1 de enero de 2019 y el 31 de diciembre de 2021. Resultados: De los 30 expedientes seleccionados, solo se eligieron 2 (6,6 %) donadores, es decir, existió un índice de rechazo de 28 (93,3 %) de los potenciales candidatos. La edad promedio fue de 40,7 años; al dividirlos en grupos de edad, se observó que el 7,44 % fueron ≤39 años; el 5,31 %, ≥50 años; y el 4,25 %, de 40 a 49 años. Dentro de las principales patologías que originaron el rechazo del donador vivo se encuentran las enfermedades crónicas, como afección renal desconocida, obesidad, diabetes mellitus, hipertensión arterial sistémica y cardiopatías, que representaron el 60,7 %. El deseo de donar es más frecuente entre consanguíneos que en no consanguíneos. En el caso de los consanguíneos, es decir, hermanos, padres, hijos, tíos, etc., el 64,2 % fue rechazado; en los no consanguíneos, el 34,7 %, que incluía a esposos y amigos. Conclusiones: Los resultados obtenidos sobre el índice de masa corporal (IMC) mostraron que el sobrepeso y la obesidad fueron las principales causas de exclusión, circunstancia que es particular en nuestro país respecto a su perfil epidemiológico. La cantidad de donantes vivos en nuestro centro se redujo porque la mayor parte de la población no es sana, padece obesidad y ello repercute al momento de presentarse como candidato a donante.

Objective: To identify the causes for exclusion of living kidney donors at a third-level hospital in northwestern Mexico. Materials and methods: An observational, cross-sectional, descriptive and retrospective study, in which the medical records of candidates for living kidney donation were evaluated from January 1, 2019 to December 31, 2021. Results: Out of the 30 selected records, only 6.6 % (2) were chosen as donors, i.e., the rejection rate of the potential candidates was 93.3 % (28). The average age was 40.7 years; when divided into age groups, it was observed that 7.44 % were ≤ 39 years, 5.31 % were ≥ 50 years and 4.25 % were in the 40-49 age range. The main pathologies that caused the rejection of living donors were chronic diseases such as unknown renal disease, obesity, diabetes mellitus, systemic hypertension and heart diseases, which accounted for 60.7 %. The desire to donate was more frequent among blood relatives than non-blood relatives. In the case of blood relatives, i.e., siblings, parents, children, uncles, aunts, etc., 64.2 % were rejected, while 34.7 % of non-blood relatives, including spouses and friends, were rejected. Conclusions: Based on the body mass index (BMI), the results showed that overweight and obesity were the main causes of exclusion, a situation that is consistent with the Mexican epidemiological profile. The number of living donors at our center has been reduced because most of the population is not healthy and has obesity, which affects the willingness to be a candidate for living kidney donation.

COVID-19 pandemic: stress level and quality of life in contaminated and non-contaminated cases / Pandemia do COVID-19: nível de estresse e qualidade de vida em casos contaminados e não contaminados

Introdução: A pandemia de coronavírus (COVID-19) impactou não apenas a saúde física, em decorrência da síndrome respiratória aguda grave causada pelo vírus, mas também impactou a saúde mental, as áreas econômica e a social. Além disso, o foco do cenário pandêmico foi a contingência do COVID-19, o que propiciou o aparecimento ou o agravamento de outras doenças. Dessa forma, os escopos originados da pandemia tornaram-se potenciais desencadeantes de quadros de estresse e de interferência na qualidade de vida da população. Proposição: avaliar o índice de estresse percebido e a qualidade de vida da população em dois grupos de pessoas: primeiro, as que tiveram diagnóstico confirmado de COVID-19 e, segundo indivíduos que não contraíram a doença. Materiais e Métodos: Participaram da pesquisa 66 indivíduos, entre 18 e 60 anos, sendo 33 de pessoas sem contaminação e 33 pessoas que tiveram diagnóstico confirmado. Os participantes responderam dois questionários: O questionário de estresse percebido (QEP), para avaliar o estresse e outro questionário para avaliação da qualidade de vida (SF-36). Resultados: A análise mostrou que o QEP dos indivíduos não contaminados foi menor (0,64 + 0,04); em comparação aos indivíduos que tiveram o resultado positivo para doença (0,73 + 0,02) (p = 0,0484), diferença estatisticamente significativa, o que mostra que os casos positivos têm percepção que estão mais estressados. Na análise do SF-36, apenas o domínio Capacidade Funcional apresentou diferença estatisticamente significativa, sendo que os voluntários que não tiveram a doença apresentaram um maior valor (93,3 + 2,0), que os contaminados (73,0 + 3,6) (p < 0,0001), o que sugere melhor qualidade de vida aos primeiros. Conclusão: O estudo apresenta resultados que indicam que a pandemia impactou negativamente a saúde da população, pois os participantes diagnosticados com COVID-19 tiveram maior estresse percebido e menor qualidade de vida, em comparação aos não contaminados.

Introduction: The coronavirus pandemic (COVID-19) has not only impacted physical health, as result of the severe acute respiratory syndrome caused by the virus, but has also impacted mental health, the economic and social areas. In addition, the focus of pandemic scenario was the COVID-19 contingency, which led to the appearance or worsening of other diseases. Besides the scopes originated from the pandemic became potential triggers of stress and interference in the population's quality of life. Proposition: to evaluate the perceived stress index and the population's quality of life in two groups of people: first, those who had a confirmed diagnosis of COVID-19 and, second, individuals who did not contract the disease. Materials and Methods: 66 individuals participated in the research, between 18 and 60 years old, being 33 people without contamination and 33 people who had a confirmed diagnosis. Participants answered two questionnaires: The Perceived Stress Questionnaire (QEP) to assess stress and another questionnaire to assess quality of life (SF-36). Results: The analysis of the results showed that the QEP of non-contaminated individuals was lower (0.64 + 0.04) than that of individuals who tested positive for the disease (0.73 + 0.02) (p = 0.0484), statistically significant difference, which shows that positive cases are perceived to be more stressed. In the analysis of SF-36, only the Functional Capacity domain showed statistically significant difference, and the volunteers who did not have the disease presented higher value (93.3 + 2.0) than contaminated individuals (73.0 + 3.6) (p < 0.0001), suggesting better quality of life. Conclusion: The study presents results that indicate the pandemic negatively impacted the health of the population, as participants diagnosed with COVID-19 had greater perceived stress and lower quality of life, compared to non-contaminated ones.