Evolución clínica de la urgencia o emergencia hipertensiva en el paciente con enfermedad renal crónica con tratamiento sustitutivo en el HGZ No.1 Tlaxcala

Abstract

Hypertension is a condition that is of great clinical interest, epidemiological and social. The incidence of hypertensive emergencies has been declining in line with the advancement of pharmacotherapy measures. The epidemiological transition and the increase in life expectancy have influenced the emergence of chronic degenerative highly demanding of health services. According to the National Health Survey 2000 found a total prevalence of hypertension of 30.7% (15 million adults approx.) It showed that 61% of adults with hypertension were unaware of being carriers of the same. The pathophysiology of hypertension is complex, since there is a significant participation of molecules, tissues and organs. Material, methods and patients: The study was conducted case series, prospective, observational, and analytical. The group of patients were those who present with chronic renal disease replacement therapy DPCA, DPA, DPI, hemodialysis, kidney graft treated at the No.1 HGZ Tlaxcala, in the period July 2010 to October 2010 for urgency or hypertensive emergency . Results: Among females the highest frequency was within the age range between 15 and 20 who had a hypertensive crisis. In males, the results were that the highest frequency in the range of 61 to 65. The modality of dialysis in which more was presented was in Hypertensive Crisis Automated Peritoneal Dialysis, second in Hemodialysis. Likewise we have no greater frequency of patients with hypertensive urgency which corresponds to 84% of patients, and 16% with hypertensive emergency at the time of admission to the Emergency. Within the medical treatment in the emergency admission group are most commonly used antihypertensive ACE inhibitors and AAR II use, being the first use of drugs by doctors, even using up to 5 antihypertensive income, compared to some which uses only antihypertensives. 60% of patients had no hospitalization for medical conditions improve their income, and 40% was discharged to home, with the majority of patients had more than 8 hours in the emergency room for improvement. According to the survey results we can conclude that the clinical course of patients with hypertensive emergency and urgency with chronic renal disease replacement therapy entering the emergency department HGZ Tlaxcala No. 1 IMSS has poor clinical response