Indicadores de mortalidad en el paciente con insuficiencia renal crónica, que contraindican el inicio de terapia de reemplazo: Validación de una escala pronóstica
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La insuficiencia renal crónica terminal (IRCT) en México tiene una prevalencia similar a los reportes internacionales; siendo las principales causas diabetes mellitus, hipertensión arterial sistémica o ambas. Actualmente el número de personas con IRCT tratados con diálisis ha crecido al doble en los últimos diez años. Los pacientes con IRCT son sujetos tanto a los factores de riesgo cardiovascular tradicionales, como a aquéllos relacionados con la enfermedad (inflamación, incremento producto fosfo-cálcico, toxinas urémicas, anemia, sobrecarga de líquidos, calcificaciones vasculares, estrés oxidativo, hiperhomocisteinemia), que conllevan una mortalidad cardiovascular ajustada para sexo, edad y raza 10 a 100 veces mayor que en la población general. Agregándose como predictores de mal pronóstico, desnutrición y nivel so- cioeconómico bajo.
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