Enfoque multidisciplinario en la atención de  pacientes con enfermedad renal crónica. Una revisión narrativa

Jessica Bravo-Zúñiga

doi:10.20453/rmh.v34i1.4451

Jessica Bravo-Zúñiga Hospital Nacional Edgardo Rebagliati, EsSalud, Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú https://orcid.org/0000-0003-2528-6271

DOI: https://doi.org/10.20453/rmh.v34i1.4451

Palabras clave: insuficiencia renal, enfermedad crónica, grupo de atención al paciente

Resumen

La enfermedad renal crónica (ERC) es un importante problema de salud pública. En el Perú al momento no existe un programa nacional de salud renal. Existe evidencia que el modelo multidisciplinario de atención en ERC mejora la calidad de atención y ha mostrado que enlentece la progresión de ERC y disminuye la mortalidad por todas las causas. Aunque aún hay puntos controversiales, como, por ejemplo, desde que nivel de tasa de filtración glomerular se debería iniciar el manejo multidisciplinario, es una práctica que ha mejorado la atención y el seguimiento de los pacientes renales. Sin embargo, se requiere para su implementación recursos financieros y profesionales y una capacidad organizativa del sistema de salud, que quizás en nuestro país se convierte en un reto.

Referencias

Francis ER, Kuo CC, Bernabe-Ortiz A, Nessel L, Gilman RH, Checkley W, et al. Burden of chronic kidney disease in resource-limited settings from Peru: a population-based study. BMC Nephrol. 2015 jul 24; 16:114.

Herrera-Añazco P, Atamari-Anahui N, Flores-Benites V. Número de nefrólogos, servicios de hemodiálisis y tendencia de la prevalencia de enfermedad renal crónica en el Ministerio de Salud de Perú. Rev Peru Med Exp Salud Publica. 2019 ene-mar; 36:62-7.

Bravo-Zúñiga J, Gálvez-Inga J, Carrillo-Onofre P, Chávez-Gómez R, Castro-Monteverde P. Early detection of chronic renal disease: coordinated work between primary and specialized care in an ambulatory renal network of Peru. J Bras Nefrol. 2019; 41(2):176-84.

Arana LL, Escobar MG, Rodríguez AS, Martínez MCN, Rivero MM, Rivero BR. La interdisciplinariedad: una necesidad contemporánea para favorecer el proceso de enseñanza aprendizaje. Medisur. 2016 abr-jun; 14(3):320-327.

Ander-Egg E. Interdisciplinariedad en Educación. Magisterio del Río de la Plata. Bs. As. Argentina. 1996. [Citado el 14 de octubre de 2021]. Disponible en: https://docplayer.es/98039806-Ander-egg-e-1994-interdisciplinariedad-en-educacion-magisterio-del-rio-de-la-plata-bs-as-argentina.html

Lewis R, Dixon J. Rethinking management of chronic diseases. BMJ 2004 Jan 24; 328(7433):220-2.

Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. Int J Integr Care. 2009 Jun 17; 9:e82.

Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. BMJ. 2012 Sep 3; 345:e5205.

Damery S, Flanagan S, Combes G. The effectiveness of interventions to achieve co-ordinated multidisciplinary care and reduce hospital use for people with chronic diseases: study protocol for a systematic review of reviews. Syst Rev. 2015 May 8; 4:64.

Ducharme A, Doyon O, White M, Rouleau JL, Brophy JM. Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial. CMAJ. 2005 Jul 5; 173(1):40-5.

Sidhom MA, Poulsen MG. Multidisciplinary care in oncology: medicolegal implications of group decisions. Lancet Oncol. 2006 Nov 1; 7(11):951-4.

Epping-Jordan JE, Pruitt SD, Bengoa R, Wagner EH. Improving the quality of health care for chronic conditions. Qual Saf Health Care. 2004 Aug; 13(4):299-305.

Jessup RL. Interdisciplinary versus multidisciplinary care teams: do we understand the difference? Aust Health Rev. 2007 Aug; 31(3):330-1.

Saxena N, Rizk DV. The interdisciplinary team: the whole is larger than the parts. Adv Chronic Kidney Dis. 2014 Jul;21(4):333-7.

Beaulieu M, Levin A. Analysis of multidisciplinary care models and interface with primary care in management of chronic kidney disease. Semin Nephrol. 2009 Sep; 29(5):467-74.

Coulter A, Ellins J. Effectiveness of strategies for informing, educating, and involving patients. BMJ. 2007 Jul 5; 335(7609):24-7.

Coleman MT, Newton KS. Supporting Self-management in Patients with Chronic Illness. AFP. 2005 Oct 15; 72(8):1503-10.

Calderón RB, Depine S. Sustainable and tenable renal health model: a Latin American proposal of classification, programming, and evaluation. Kidney Int Suppl. 2005 Aug; (97):S23-30. doi: 10.1111/j.1523-1755.2005.09704.x.

Burgos-Calderón R, Depine SÁ, Aroca-Martínez G. Population Kidney Health. A New Paradigm for Chronic Kidney Disease Management. Int J Environ Res Public Health. 2021 Jun 24; 18(13):6786.

IETSI EsSALUD, Instituto de Evaluación de Tecnologías en Salud e Investigación. [Citado el 13 de noviembre de 2021]. Disponible en: http://www.essalud.gob.pe/ietsi/guias_pract_clini.html

National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 Feb; 39(2 Suppl 1):S1-266.

Tangri N, Kitsios GD, Inker LA, Griffith J, Naimark DM, Walker S, et al. Risk prediction models for patients with chronic kidney disease: a systematic review. Ann Intern Med. 2013 Apr 16; 158(8):596-603.

Tangri N, Stevens LA, Griffith J, Tighiouart H, Djurdjev O, Naimark D, et al. A predictive model for progression of chronic kidney disease to kidney failure. JAMA. 2011 Apr 20; 305(15):1553-9.

Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013 Jun 4; 158(11):825-30.

Spry L. Building the chronic kidney disease management team. Adv Chronic Kidney Dis. 2008 Jan; 15(1):29-36.

Van Zuilen AD, Wetzels JFM, Bots ML, Van Blankestijn PJ, MASTERPLAN Study Group. MASTERPLAN: study of the role of nurse practitioners in a multifactorial intervention to reduce cardiovascular risk in chronic kidney disease patients. J Nephrol. 2008 Jun; 21(3):261-7.

Collister D, Pyne L, Cunningham J, Donald M, Molnar A, Beaulieu M, et al. Multidisciplinary Chronic Kidney Disease Clinic Practices: A Scoping Review. Can J Kidney Health Dis. 2019; 6:2054358119882667.

Shi Y, Xiong J, Chen Y, Deng J, Peng H, Zhao J, et al. The effectiveness of multidisciplinary care models for patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol. 2018 Feb; 50(2):301-12.

Cho EJ, Park HC, Yoon HB, Ju KD, Kim H, Oh YK, et al. Effect of multidisciplinary pre-dialysis education in advanced chronic kidney disease: Propensity score matched cohort analysis. Nephrology (Carlton). 2012; 17(5):472-9.

Nicoll R, Robertson L, Gemmell E, Sharma P, Black C, Marks A. Models of care for chronic kidney disease: A systematic review. Nephrology (Carlton). 2018 May; 23(5):389-96.

Goovaerts T, Jadoul M, Goffin E. Influence of a Pre-Dialysis Education Programme (PDEP) on the mode of renal replacement therapy. Nephrol Dial Transplant. 2005 Sep 1; 20(9):1842-7.

Bravo-Zúñiga J, Saldarriaga EM, Chávez-Gómez R, Gálvez-Inga J, Valdivia-Vega R, Villavicencio-Carranza M, et al. Effectiveness of adherence to a renal health program in a health network in Peru. Rev Saúde Pública. 2020 Aug 14; 54:80.