Terapia metabólica con yodo 131 en paciente con insuficiencia renal crónica. Caso clínico / Metabolic therapy with iodine 131 in patients with chronic renal failure. clinical case

OBSERVACIÓN CLÍNICA: Varón de 62 años con insuficiencia renal crónica en estadio 5 en programa de diálisis desde el 2012 que es intervenido de carcinoma papilar de tiroides con metástasis ganglionares. Posteriormente el paciente ingresa en la Unidad de Terapia Metabólica de su hospital de referencia donde se le administran 80 milicurios de yodo-131 como tratamiento asociado al quirúrgico. Ante la imposibilidad de practicarle su sesión de diálisis convencional, se le realizan las intervenciones de enfermería requeridas en las distintas etapas de aplicación de las técnicas continuas de depuración extrarrenal (TCDE). PLAN DE CUIDADOS: Se abordan los cuidados orientados a pacientes sometidos a TCDE en tratamiento con I131: material específico, medidas de protección personal y los principales diagnósticos e intervenciones enfermeras. DISCUSIÓN: Las TCDE a pesar de ser propias de pacientes críticos, en un momento dado se pueden extrapolar a otro tipo de pacientes. Las TCDE permiten dializar a este tipo de pacientes en un entorno seguro para el personal, garantizándose la adecuada eliminación de líquidos contaminados. CONCLUSIONES: Las TCDE resultaron ser un tratamiento eficaz para la eliminación del I131, siendo necesaria una única sesión para normalizar los niveles de radiactividad. La coordinación entre servicios permitió garantizar un tratamiento adecuado y eficaz para el paciente

CASE REPORT: 62 year-old male with CKD stage 5 in dialysis program since 2012 who underwent surgery for papillary thyroid carcinoma with lymph node metastasis. Subsequently, the patient was admitted to the Unit of Metabolic Therapy at his reference hospital, where he is administered 80 mill curies of iodine-131 as a treatment associated with the surgery, unable to have his conventional dialysis, nursing interventions required in various stages of implementation of the continuous extrarenal clearance techniques (TCDE) were performed. CARE PLAN: The following care values were addressed targeted to patients undergoing treatment with I131: specific equipment, personal protective measures and major diagnoses and nursing INTERVENTIONS: PROGRESS: TCDE, despite being attributed to very critical patients, they can be extrapolated to other patients in a given time. TCDE allowed these patients to undergo dialysis in a safe environment for staff, ensuring proper disposal of contaminated liquids. CONCLUSIONS: TCDE were an effective treatment for the removal of I131, a single session being necessary to normalize the levels of radioactivity. Coordination between services allowed ensure proper and effective treatment for the patient

[Metabolic therapy with iodine 131 in patients with chronic renal failure. Clinical case]. / Terapia metabólica con yodo 131 en paciente con insuficiencia renal crónica. Caso clínico.

CASE REPORT: 62 year-old male with CKD stage 5 in dialysis program since 2012 who underwent surgery for papillary thyroid carcinoma with lymph node metastasis. Subsequently, the patient was admitted to the Unit of Metabolic Therapy at his reference hospital, where he is administered 80 millicuries of iodine-131 as a treatment associated with the surgery, unable to have his conventional dialysis, nursing interventions required in various stages of implementation of the continuous extrarenal clearance techniques (TCDE) were performed. CARE PLAN: The following care values were addressed targeted to patients undergoing treatment with I(131): specific equipment, personal protective measures and major diagnoses and nursing interventions. PROGRESS: TCDE, despite being attributed to very critical patients, they can be extrapolated to other patients in a given time. TCDE allowed these patients to undergo dialysis in a safe environment for staff, ensuring proper disposal of contaminated liquids. CONCLUSIONS: TCDE were an effective treatment for the removal of I131, a single ssesion being necessary to normalize the levels of radioactivity. Coordination between services allewed ensure proper and effective treatment for the patient.