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Previous issue date: 2016-03-29 / Introduction: Kidney transplantation is the most effective therapy for chronic renal patients; complications as the delayed graft function (DGF) are common, generating long-term consequences for the prognosis of kidney transplant. The impact of total body volume immediate pre renal transplant in outcome of transplantation is unknown, as well as the influence of the dialysis modality pre transplantation in the occurrence of DGF. The body volume can be measured by bioimpedance, which helps to quantify body water, its distribution and consequent classification in euvolemic, hypovolemic or hypervolemic. Objective: To evaluate volume status by bioelectrical impedance method in patients on dialysis undergoing kidney transplantation and relate to the need for dialysis post operatively. Methods: A prospective longitudinal observational study included chronic renal patients, who underwent a kidney transplant at the Hospital S?o Lucas, Pontifical Catholic University of Rio Grande do Sul between October 2014 and December 2015. The evaluation of the body composition was performed using the body composition monitor - BCM (Fresenius Medical Care), pre renal transplantation, immediately before going to the operating room, and patients were followed during the first week of recovery. DGF was defined as the need of dialysis during the first week after transplantation. Student's t test to compare continuous variables and categorical we used the chi-square test or Fisher's exact test. The significance level was set at alpha = 0.05 and we used the statistical package SPSS version 17 for Windows. This study was approved by the ethics committee of the institution protocol number 826 866. Results: We studied 36 kidney transplant patients (50.3 +14.4 years; 22 male), classified according to body volume, mostly were hypervolemic (16, 44.4%), and euvolemic (15, 41.7 %). DGF was seen in 25 (69.4%) patients, hyperkalemia was the main indication for dialysis (19, 59.2%) and 27 (75%) were discharged with a gain of renal function. The volemic status showed no significant association with the occurrence of DGF (P = 0.610), while peritoneal dialysis (PD) was associated with reduced need for dialysis in the first week after surgery (P = 0.006). Conclusions: Preoperative volemic status in patients undergoing renal transplantation has no association with the incidence of DGF, the volume status was similar between modalities (PD patients and hemodialysis). The data suggest that DP before transplantation decreases the chances of occurrence of DGF. / Introdu??o: O transplante renal ? a terapia mais eficaz para o paciente renal cr?nico, por?m pode apresentar complica??es como a fun??o retardada do enxerto (DGF), gerando consequ?ncias a longo prazo no progn?stico dos transplantados renais. O impacto da volemia pr?-transplante renal no desfecho imediato do transplante ? desconhecido, assim como a influ?ncia da modalidade de di?lise pr?-transplante na ocorr?ncia de DGF. O volume corporal pode ser avaliado por bioimped?ncia, o que auxilia na quantifica??o da ?gua corp?rea, sua distribui??o e consequente classifica??o em euvol?mico, hipovol?mico ou hipervol?mico. Objetivo: Avaliar, pelo m?todo de bioimped?ncia el?trica, o estado vol?mico pr?-transplante de pacientes submetidos ao transplante renal e relacionar com a necessidade de di?lise no p?s-operat?rio. M?todos: Estudo observacional prospectivo e longitudinal, incluiu pacientes renais cr?nicos submetidos a transplante renal no Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul no per?odo entre outubro de 2014 e dezembro de 2015. A avalia??o da composi??o corporal foi realizada utilizando o monitor de composi??o corporal - BCM (Fresenius Medical Care), no pr?-operat?rio do transplante renal, imediatamente antes da ida ao bloco cir?rgico, e os pacientes foram acompanhados durante a primeira semana de recupera??o. DGF foi definida como a necessidade de di?lise na primeira semana p?s transplante. Foi aplicado o teste t de Student para compara??o de vari?veis cont?nuas e para as categ?ricas usou-se o teste do qui quadrado ou teste exato de Fisher. O n?vel de signific?ncia adotado foi de alfa=0,05 e para as an?lises empregou-se o pacote estat?stico SPSS vers?o 17 para Windows. Este estudo foi aprovado pelo Comit? de ?tica da institui??o atrav?s do Parecer n?826.866. Resultados: Foram estudados 36 pacientes transplantados renais (50,3 +14,4 anos; 22 masculinos), classificados de acordo com a volemia, em sua maioria como hipervol?micos (16, 44,4%) e euvol?micos (15, 41,7%). DGF foi vista em 25 (69,4%) pacientes, sendo a hipercalemia a principal indica??o de di?lise (19, 59,2%) e 27 (75%) tiveram alta hospitalar com ganho de fun??o renal. A volemia n?o foi associada ? ocorr?ncia de DGF (P=0,610), por?m a di?lise peritoneal (DP) foi relacionada com menor necessidade de di?lise na primeira semana de p?s-operat?rio (P=0,006). Conclus?es: A volemia pr?-operat?ria dos pacientes transplantados renais n?o foi associada ? incid?ncia de DGF, o estado vol?mico foi similar entre os pacientes em DP e hemodi?lise. Os dados sugerem que fazer DP antes do transplante diminui as chances da ocorr?ncia de DGF.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6850 |
| Date | 29 March 2016 |
| Creators | Tanscheit, Vivian Cunha |
| Contributors | Figueiredo, Ana Elizabeth Prado Lima |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, -8624664729441623247, -969369452308786627 |
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