ABSTRACT
The incidence of diabetes mellitus has increased dramatically in Puerto Rico. On 1996, it accounted for 56.8% of all new cases admitted for dialysis. By 1998 the number increased to 59.9%, of which, 88.5% were Type 2 diabetic patients. Strategies for the reduction or prevention of renal insufficiency of Type 2 diabetic patients should include: identification of potential chronic complications, review of risk factors related to diabetic nepropathy, and the evaluation of the arterial blood pressure and renal function. The therapeutic actions which have shown reduction of proteinuria and reduction of the progression to end stage renal disease in patients with type 2 diabetes are: strict control of the arterial pressure, the use of converting enzyme inhibitors, low salt diet and control of the protein intake. It is recommended that type 2 diabetic patients with high arterial pressure, micro or macroalbuminuria and increased serum creatinine should be referred to the nephrologist as early as possible.
Subject(s)
Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/prevention & control , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/therapy , Disease Progression , Female , Humans , MaleABSTRACT
The Objective of this study was identify the aspects related with the adherence of medical treatment recommended to the patients that received hemodialysis in the tertiary public hospital. A non experimental transectional correlation design was utilized in this study. Fifty-three patients constituted the population study. A structure interview was utilized to gathered the data. Descriptive statistics and Chi-square tests were utilized to analysis. The response rate was 91.0%. The 75.0% of patients not compliance with the medical treatment. Significant association between compliance variable and educational level was encountered (p < or = 0.05). This study provides important findings to will develops educative intervention in the Renal Unit, directed to improve the adherence of the patient with medical treatment.
Subject(s)
Kidney Diseases/therapy , Patient Compliance , Renal Dialysis , Adult , Aged , Chi-Square Distribution , Education , Female , Humans , Interviews as Topic , Male , Middle Aged , Puerto Rico , Surveys and Questionnaires , Time FactorsABSTRACT
To assess the survival probabilities of patients with end stage renal disease in Puerto Rico, the data from the United States Renal Data System from 1970 through 1994 was analyzed. The Kaplan Meier method was used to determine the survival rate for the following variables: diagnosis, gender, age groups, treatment modality and health regions. The analysis included 7,527 patients reported to the United States Renal Disease System of which 4,295 (57%) patients were reported dead. The median time of survival rate (50%) was 47.7 months. There was significantly lower survival rate (p = 0.0001) for diabetics compared with all the other diagnosis. Age was also a strong predictor of survival (p = 0.0001) and modality treatment (p = 0.0001). We concluded that diabetes, the elderly and the hemodialysis modality, had the lower survival rate in the puerto rican population.
Subject(s)
Kidney Failure, Chronic/mortality , Adult , Age Factors , Aged , Data Interpretation, Statistical , Diabetes Complications , Female , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Middle Aged , Peritoneal Dialysis , Puerto Rico , Renal Dialysis , Sex Factors , Survival Rate , Time FactorsABSTRACT
To assess the survival probabilities of patients with end stage renal disease in Puerto Rico, the data from the United States Renal Data System from 1970 through 1994 was analyzed. The Kaplan Meier method was used to determine the survival rate for the following variables: diagnosis, gender, age groups, treatment modality and health regions. The analysis included 7,527 patients reported to the United States Renal Disease System of which 4,295 (57 percent) patients were reported dead. The median time of survival rate (50 percent) was 47.7 months. There was significantly lower survival rate (p = 0.0001) for diabetics compared with all the other diagnosis. Age was also a strong predictor of survival (p = 0.0001) and modality treatment (p = 0.0001). We concluded that diabetes, the elderly and the hemodialysis modality, had the lower survival rate in the puerto rican population
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Kidney Failure, Chronic/mortality , Age Factors , Data Interpretation, Statistical , Diabetes Mellitus/complications , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Peritoneal Dialysis , Puerto Rico , Renal Dialysis , Sex Factors , Survival Rate , Time FactorsABSTRACT
To describe the characteristics and trends of the incidence and mortality of End-Stage Renal Diseases (ESRD) in Puerto Rico, a descriptive analysis of the data of all patients treated with dialysis between 1970 through 1994 was conducted. A total of 7,256 patients received dialysis treatment for ESRD in Puerto Rico. Of these, 61% were males and 39% were females. Diabetes (41.7%) and glomerulonephritis (18.3) accounted for the largest number of cases followed by circulatory problems (8.3%). Hemodialysis was the predominant treatment modality (76%). The incidence trend was significant for the predictor variable period of time after adjusting by age and gender (Poisson). The mortality trend was significant for the predictor variables, period of time, gender and age (Poisson). A substantial increment in the incidence and mortality of persons receiving dialysis was found, particularly in the diabetics, males and elderly persons. The casual explanations of these findings requires further study.
Subject(s)
Kidney Failure, Chronic/epidemiology , Adult , Aged , Aged, 80 and over , Female , Humans , Incidence , Male , Middle Aged , Morbidity , Puerto Rico/epidemiologyABSTRACT
The purpose of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis or peritoneal dialysis. One-hundred and two patients with CRF were examined for the presence of cutaneous alterations. All patients examined had at least one cutaneous lesion. The most prevalent findings were alterations in the cutaneous pigmentation. Of particular interest was an increased prevalence of hyperpigmented macules on the palms and soles. Other manifestations, seen particularly in the hemodialysis group, included the half-and-half nail, pruritus, and keratotic pits of the palms and soles. Infectious processes were more prevalent in the group undergoing peritoneal dialysis. This study showed that all patients with CRF have some type of cutaneous alteration and that the type of dialysis could have some influence upon the incidence of these changes.
Subject(s)
Kidney Failure, Chronic/complications , Skin Diseases/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Dermatomycoses/epidemiology , Dermatomycoses/etiology , Female , Humans , Hyperpigmentation/epidemiology , Hyperpigmentation/etiology , Kidney Failure, Chronic/therapy , Male , Middle Aged , Nail Diseases/epidemiology , Nail Diseases/etiology , Onychomycosis/epidemiology , Onychomycosis/etiology , Peritoneal Dialysis/adverse effects , Prevalence , Pruritus/epidemiology , Pruritus/etiology , Renal Dialysis/adverse effects , Skin Diseases/epidemiology , Tinea Pedis/epidemiology , Tinea Pedis/etiologyABSTRACT
There is controversy on whether or not patients with End Stage Renal Disease (ESRD) on chronic hemodialysis (HD) should be routinely tested for the presence of HIV-antibody (HIV-Ab) in their blood. Several reports have appeared in the literature reporting incidence from 0 to 11%. A total of 227 patients receiving chronic HD; at the University and San Juan City Hospital, from January to December 1987 were screened for the presence of HIV-Ab by the ELISA method. Those reported as positive were confirmed by the Western Blot method. HIV-Ab presence was reported and confirmed in 9 patients (4%). Five of these patients (2%) were IV drug abusers, 2 (0.9%) homosexual, 1 (0.4%) had history of sexual promiscuity and 1 (0.4%) had been exposed to multiple blood transfusion (MBT) prior to HIV testing of blood. Our prevalence was 7%. However when risk factors other than MBT were excluded the prevalence was 0.4%. The incidence and prevalence of HIV positive cases in our hemodialysis population is comparable to that previously reported.
