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Colegio de Medicina Interna de México.

2013, Número 2

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Med Int Mex 2013; 29 (2)


Actualidades en disfuncion renal aguda y terapia de soporte renal

Carrillo-Esper R, Vázquez-Rangel A, Merino-López M, Peña-Pérez C, Nava-López J, Espinoza de los Monteros-Estrada I, de la Torre-León T, Rosales-Gutiérrez AO, Carrillo-Córdova LD, Carrillo-Córdova DM, Carrillo-Córdova CA

Idioma: Español
Referencias bibliográficas: 48
Paginas: 179-191
Archivo PDF: 417.30 Kb.


RESUMEN

La lesión renal aguda es una complicación frecuente en pacientes hospitalizados. Se diagnostica menos de lo que debiera, a pesar de la evidencia de que aún en su forma leve se asocia con elevadas morbilidad y moralidad y complicaciones cardiovasculares e infecciosas. Son bien conocidos los mecanismos fisiopatológicos que condicionan la lesión renal aguda, en especial los relacionados con la disfunción y lesión de células endoteliales y epiteliales, uniones celulares, transportadores de membrana y moléculas de unión entre otros. Los criterios diagnósticos de la lesión renal aguda se han modificado, en especial una vez desarrollados e incorporados los criterios RIFLE y AKIN, que son fáciles de realizar en la cabecera de la cama del enfermo; su limitación se debe a las modificaciones de la creatinina sérica y de los volúmenes urinarios. Según las modificaciones de la creatinina sérica, son un marcador tardío de lesión renal aguda. Se han desarrollado nuevos biomarcadores útiles para el diagnóstico, estadificación y pronóstico de la lesión renal aguda, entre estos destaca la lipocalina asociada con gelatinasa de neutrófilos. El inicio temprano y las nuevas técnicas de reemplazo renal han incrementado de manera significativa la supervivencia de los enfermos con lesión renal aguda.


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