ABSTRACT
Antecedentes: La biopsia del aloinjerto renal se realiza habitualmente con el paciente hospitalizado. Objetivo: Evaluar la seguridad y eficacia de un programa de biopsias ambulatorio en receptores de trasplante renal. Métodos: En diciembre de 2011 se inició un programa ambulatorio de biopsias en trasplante renal. Se contraindica la biopsia ambulatoria en los casos siguientes: 1) tratamiento anticoagulante, 2) trombocitopenia < 50 000/mm3, 3) índice de masa corporal > 35 kg/m2, 4) hipertensión arterial no controlada. Se compara la seguridad y eficacia de las biopsias realizadas bajo hospitalización en el período 2007-2011 (n = 124) con las biopsias ambulatorias realizadas durante el período 2011-2013 (n = 219) y las realizadas en este mismo período bajo hospitalización (n = 42). Resultados: Entre diciembre de 2011 y diciembre de 2013 se han indicado 230 biopsias desde la consulta externa y se han realizado 219 (95 %) en régimen ambulatorio. La incidencia de complicaciones mayores (necesidad de transfusión y/o embolización) ha sido de 0,8 % para el período 2007-2011 y de 2,4 % para las realizadas bajo hospitalización del período 2011-2013 (p = 0,475). No se observaron complicaciones mayores en el grupo de pacientes con biopsias realizadas de forma ambulatoria. La tasa de complicaciones menores (hematuria macroscópica, hematoma o fístula que no requirieron transfusión ni embolización) no ha sido distinta entre los grupos (3,2 %, 7,1 % y 2,7 %, respectivamente). La adecuación de la muestra obtenida según los criterios de Banff no ha sido distinta entre los grupos (p = 0,052). Conclusión: La realización ambulatoria de la biopsia de injerto renal es un procedimiento seguro y eficaz (AU)
Background: In many centers patients are hospitalised to perform a renal allograft biopsy. Aim: To evaluate the safety and efficacy of outpatient renal allograft biopsies. Methods: Since December 2011 we perform renal allograft biopsies as an outpatient procedure. Exclusion criteria for performing an outpatient biopsy included: 1.) anticoagulant treatment, 2.) thrombocytopenia <50,000/mm3, 3.) body mass index >35kg/m2 and 4.) uncontrolled hypertension. The number and severity of complications were compared with an historical cohort of 124 biopsies done between 2007 and 2011 when all patients were hospitalised for the procedure and with 42 patients biopsied during hospitalisation between 2011 and 2013. Results: Between 2011 and 2013, 210 (95%) out of 230 biopsies indicated in the outclinic were performed as an outpatient procedure (95%). The incidence of major complications (bleeding requiring blood transfusion and/or embolisation) was 0.8% between 2007 and 2011 and 2.4% in biopsies between 2011 and 2013 in hospitalised patients (p=0.475). No major complications were observed in the outpatient biopsy group. Minor complications (hematuria, hematoma or fistula not requiring transfusion or embolisation) were also not different between groups (3.2%, 7.1% and 2.7%; respectively). Sample size adequacy according to the Banff criteria was not different among groups (p=0.052). Conclusion: Ambulatory renal allograft biopsy is a safe and efficient procedure (AU)
Subject(s)
Humans , Biopsy/methods , Kidney Transplantation/methods , Patient Safety , Ambulatory Care , Preoperative Care/methods , Risk Factors , Biopsy , Postoperative Complications/epidemiology , Cohort Studies , Transplants/pathologyABSTRACT
BACKGROUND: In many centers patients are hospitalised to perform a renal allograft biopsy. AIM: To evaluate the safety and efficacy of outpatient renal allograft biopsies. METHODS: Since December 2011 we perform renal allograft biopsies as an outpatient procedure. Exclusion criteria for performing an outpatient biopsy included: 1.) anticoagulant treatment, 2.) thrombocytopenia <50,000/mm3, 3.) body mass index >35kg/m2 and 4.) uncontrolled hypertension. The number and severity of complications were compared with an historical cohort of 124 biopsies done between 2007 and 2011 when all patients were hospitalised for the procedure and with 42 patients biopsied during hospitalisation between 2011 and 2013. RESULTS: Between 2011 and 2013, 210 (95%) out of 230 biopsies indicated in the outclinic were performed as an outpatient procedure (95%). The incidence of major complications (bleeding requiring blood transfusion and/or embolisation) was 0.8% between 2007 and 2011 and 2.4% in biopsies between 2011 and 2013 in hospitalised patients (p=0.475). No major complications were observed in the outpatient biopsy group. Minor complications (hematuria, hematoma or fistula not requiring transfusion or embolisation) were also not different between groups (3.2%, 7.1% and 2.7%; respectively). Sample size adequacy according to the Banff criteria was not different among groups (p=0.052). CONCLUSION: Ambulatory renal allograft biopsy is a safe and efficient procedure.
Subject(s)
Ambulatory Surgical Procedures , Biopsy, Needle , Kidney Transplantation , Transplants/pathology , Adult , Allografts , Ambulatory Surgical Procedures/adverse effects , Biopsy, Needle/adverse effects , Contraindications , Cutaneous Fistula/epidemiology , Cutaneous Fistula/etiology , Female , Hemorrhage/epidemiology , Hemorrhage/etiology , Hospitalization , Humans , Kidney Diseases/epidemiology , Kidney Diseases/etiology , Male , Middle Aged , Surgery, Computer-Assisted , Ultrasonography, Interventional , Urinary Fistula/epidemiology , Urinary Fistula/etiologyABSTRACT
Introducción: El optimismo disposicional aparece como un recurso personal que determina el estilo de afrontamiento y respuesta adaptativa ante enfermedades crónicas. Los objetivos de este estudio fueron averiguar las relaciones entre el constructor de optimismo disposicional y las estrategias de afrontamiento en pacientes con trasplante renal reciente, y evaluar diferencias en la utilización de estrategias de afrontamiento según el grado de optimismo disposicional. Material y métodos: Consecutivamente se eligen pacientes hospitalizados en el servicio de nefrología tras realizar el trasplante renal. Los instrumentos de evaluación fueron el Life Orientation Test-Revised y el Inventario de Estrategias de Afrontamiento. Los datos son analizados con medidas de tendencia central, análisis correlacional y comparación de medias con la prueba t de Student. Resultados: Participan 66 pacientes con trasplante renal. El estilo de afrontamiento que caracteriza a pacientes con trasplante renal reciente sería la Retirada social y la Evitación de problemas. Las correlaciones entre optimismo disposicional y estrategias de afrontamiento son significativas, en sentido positivo en Resolución de problemas (p < 0,05) y Reestructuración cognitiva (p < 0,01), y en sentido inverso con Autocrítica (p < 0,05). Las diferencias en optimismo disposicional generan diferencias significativas en la dimensión de Autocrítica (t = 2,58; p < 0,01). Conclusiones: Las puntuaciones en optimismo disposicional aportan diferencias en la respuesta de afrontamiento tras el trasplante renal. Además, las estrategias de afrontamiento podrían estar influyendo en la percepción del paciente sobre el bienestar emocional tras el trasplante renal (AU)
Introduction: Dispositional optimism is a personal resource that determines the coping style and adaptive response to chronic diseases. The aim of this study was to assess the correlations between dispositional optimism and coping strategies in patients with recent kidney transplantation and evaluate the differences in the use of coping strategies in accordance with the level of dispositional optimism. Material and method: Patients who were hospitalised in the nephrology department were selected consecutively after kidney transplantation was performed. The evaluation instruments were the Life Orientation Test-Revised, and the Coping Strategies Inventory. The data were analysed with central tendency measures, correlation analyses and means were compared using Students t-test. Results: 66 patients with a kidney transplant participated in the study. The coping styles that characterised patients with a recent kidney transplantation were Social withdrawal and Problem avoidance. Correlations between dispositional optimism and coping strategies were significant in a positive direction in Problem-solving (p<.05) and Cognitive restructuring (p<.01), and inversely with Self-criticism (p<.05). Differences in dispositional optimism created significant differences in the Self-Criticism dimension (t=2.58; p<.01). Conclusions: Dispositional optimism scores provide differences in coping responses after kidney transplantation. Moreover, coping strategies may influence the patient's perception of emotional wellbeing after kidney transplantation (AU)
Subject(s)
Humans , Kidney Transplantation/psychology , Adaptation, Psychological , Kidney Failure, Chronic/surgery , Quality of Life , Sickness Impact Profile , Retrospective StudiesABSTRACT
INTRODUCTION: Dispositional optimism is a personal resource that determines the coping style and adaptive response to chronic diseases. The aim of this study was to assess the correlations between dispositional optimism and coping strategies in patients with recent kidney transplantation and evaluate the differences in the use of coping strategies in accordance with the level of dispositional optimism. MATERIAL AND METHOD: Patients who were hospitalised in the nephrology department were selected consecutively after kidney transplantation was performed. The evaluation instruments were the Life Orientation Test-Revised, and the Coping Strategies Inventory. The data were analysed with central tendency measures, correlation analyses and means were compared using Student’s t-test. RESULTS: 66 patients with a kidney transplant participated in the study. The coping styles that characterised patients with a recent kidney transplantation were Social withdrawal and Problem avoidance. Correlations between dispositional optimism and coping strategies were significant in a positive direction in Problem-solving (p<.05) and Cognitive restructuring (p<.01), and inversely with Self-criticism (p<.05). Differences in dispositional optimism created significant differences in the Self-Criticism dimension (t=2.58; p<.01). CONCLUSIONS: Dispositional optimism scores provide differences in coping responses after kidney transplantation. Moreover, coping strategies may influence the patient’s perception of emotional wellbeing after kidney transplantation.
Subject(s)
Adaptation, Psychological , Kidney Transplantation/psychology , Optimism , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Fundamento y objetivo: El trasplante es una modalidad de tratamiento eficaz para la insuficiencia renal terminal. El objetivo de este estudio fue comparar, al mes y 6 meses postrasplante, la percepción de la calidad de vida relacionada con la salud (CVRS) en pacientes con trasplante renal con valores de la población general. acientes y método: El Cuestionario de Calidad de Vida en Enfermedades Renales fue administrado al mes y 6 meses postrasplante. La comparación con la población general fue realizada con la parte genérica del cuestionario. Se compararon puntuaciones típicas estandarizadas. Resultados: Participaron 72 pacientes, con una mediana de edad de 57 años. A los 6 meses postrasplante, la CVRS en todas sus dimensiones muestra valores similares a los de la población general. Al comparar la CVRS al mes y 6 meses del trasplante, resultan significativas las diferencias en todos las dimensiones, excepto en Salud general y Rol emocional. Conclusiones: A los 6 meses del trasplante hay una mejoría en la CVRS que es semejante a la percibida en la población general (AU)
No disponible
Subject(s)
Humans , Kidney Transplantation/rehabilitation , Renal Insufficiency, Chronic/surgery , Quality of Life , Sickness Impact Profile , Age and Sex Distribution , Follow-Up StudiesABSTRACT
Fundamento y objetivo: El trasplante es una modalidad de tratamiento eficaz para la insuficiencia renal terminal. El objetivo de este estudio fue comparar, al mes y 6 meses postrasplante, la percepción de la calidad de vida relacionada con la salud (CVRS) en pacientes con trasplante renal con valores de la población general. Pacientes y método: El Cuestionario de Calidad de Vida en Enfermedades Renales fue administrado al mes y 6 meses postrasplante. La comparación con la población general fue realizada con la parte genérica del cuestionario. Se compararon puntuaciones típicas estandarizadas. Resultados: Participaron 72 pacientes, con una mediana de edad de 57 años. A los 6 meses postrasplante, la CVRS en todas sus dimensiones muestra valores similares a los de la población general. Al comparar la CVRS al mes y 6 meses del trasplante, resultan significativas las diferencias en todos las dimensiones, excepto en Salud general y Rol emocional. Conclusiones: A los 6 meses del trasplante hay una mejoría en la CVRS que es semejante a la percibida en la población general (AU)
No disponible
Subject(s)
Humans , Kidney Transplantation/rehabilitation , Renal Insufficiency, Chronic/surgery , Quality of Life , Sickness Impact Profile , Age and Sex Distribution , Follow-Up StudiesABSTRACT
BACKGROUND AND OBJECTIVE: Transplantation is an effective treatment for end stage renal failure. The aim of this study was to compare patient's perceived health related quality of life (HRQoL) with population values, at one moth and 6 moths of kidney post-transplantation. PATIENTS AND METHOD: The Questionnaire of Quality of Life in Kidney Disease was administered during the first month and also at the 6 months following transplantation. A comparison with the general population was done with the generic part of the questionnaire. In the statistical analyses, typical standardized scores were used. RESULTS: In this study 72 patients were included with a median age of 57 years. At the 6 month post-transplantation, the patient's HRQoL showed values that were similar to the general population. When we compared the HRQoL at the first month and at the 6 month post-transplantation, the differences of HRQoL were significant in all dimensions, except on the General health and Emotional role. CONCLUSIONS: At 6 moths after transplantation, there was an improvement in the perceived HRQoL that was similar to the general population.
