RESUMEN
30 to 40% of the adult population worldwide has been diagnosed with hypertension, among these patients 5 to 10% of them could have a possibly curable condition. In order to recognize this special population, the clinician must perform a complete work up and be aware of the main underlying causes of secondary hypertension. Often this could be a goal difficult to accomplish. The purpose of this article is to discuss the most frequent causes of secondary hypertension and offer a diagnostic approach for these patients. Clinicians should never forget that drug-related hypertension is a common cause that is discovered only with the help of a good medical history.
Asunto(s)
Humanos , Hipertensión/prevención & control , Hipertensión Renovascular/etiología , Feocromocitoma , Síndromes de la Apnea del Sueño , Monitoreo Ambulatorio de la Presión Arterial , Hiperaldosteronismo , Hipertensión/diagnóstico , Hipertensión/etiología , Hipertensión Renovascular/diagnóstico , Antihipertensivos/uso terapéuticoRESUMEN
INTRODUCTION: Plasmapheresis is an extracorporeal procedure that allows the plasma to be separated from the figurative elements of the blood, removing specific elements involved in pathological processes. OBJECTIVE: To show the experience of the Regional Hospital of Talca (HRT) in the use of Plasmapheresis from 2017 to March 2019. METHODS: Corresponds to a retrospective study of all patients undergoing plasmapheresis from January 2017 to March 2019 (27 months). The clinical profile of this group of patients is analyzed, emphasizing in the nephrological etiologies and showing the clinical evolution of the diseases submitted to this procedure and aspects such as number of sessions, complications and associated therapies. RESULTS: In this period 14 patients have required plasmapheresis in our center, 9 cases for renal causes (64.2%) and 5 for non-renal causes (35.7%). A deceased was recorded during the acute stage of the disease (7.14%), in the context of a negative antineutrophil cytoplasmic antibody (ANCA) in patient with pulmonary-renal syndrome. 78% of those who needed plasmapheresis for renal etiologies are on hemodialysis at the end of the work. The clinical improvement experienced in the majority of the cases studied allows us to attribute a beneficial effect of plasmapheresis.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Plasmaféresis , Enfermedades Renales/terapia , Púrpura Trombocitopénica Trombótica/terapia , Procedimientos Quirúrgicos Vasculares , Estudios Retrospectivos , Crioglobulinemia/terapia , Enfermedades Renales/etiologíaRESUMEN
La mejor terapia para la insuficiencia renal crónica es el transplante renal. Para los pacientes de provincia esta alternativa está limitada por factores como la ruralidad y concentración de centros de trasplantes en Santiago. El presente trabajo muestra la experiencia inicial del Hospital Regional de Talca en transplante renal. Se evalúan los primeros 10 meses del programa que reúne los primeros 17 transplantados consecutivos. Estos se hicieron en 12 pacientes masculinos y 5 femeninos, con seguimiento promedio de 6 meses y una creatinina promedio de 1,4 mg por ciento. La mayor parte de los órganos son de origen local, con un tiempo de isquemia fría de 22,75 horas e isquemia caliente de 32 min. Este programa aunque de corta evolución demuestra que los hospitales en regionespueden hacer programas que no sean absolutamente dependiente de la obtención de órganos en los centros capitalinos. Los resultados funcionales junto con el 100 por ciento de sobrevida tanto de los pacientes como de los órganos son destacables, pero éstos deberán ser revaluados con mayor tiempo de evolución y mayor número de enfermos