Impacto das diferentes modalidades de diálise peritoneal automatizada sobre o perfil inflamatório de idosos portadores de doença renal crônica

• Ano de defesa: 2022
• Autor(a) principal: Studart, Marcia Maria Muniz de Queiroz
• Orientador(a): Moraes, Clayton Franco
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Doença renal crônica; Diálise peritoneal automatizada; Diálise peritoneal intermitente noturna; Diálise peritoneal contínua por cicladora; Inflamação na diálise peritoneal; Inflamação em idosos
• Palavras-chave em Inglês: Chronic kidney disease; Automated peritoneal dialysis; Intermittent nocturnal peritoneal dialysis; Continuous cycling peritoneal dialysis; Inflammation in peritoneal dialysis; Inflammation in the elderly
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3193

Chronic kidney disease (CKD) is considered a public health problem worldwide. Although CKD affects all ages, it is more prevalent in the elderly. The inflammation, systemic and intraperitoneal, that occurs in peritoneal dialysis is associated with higher morbidity and mortality in this population, in addition to early failure of the dialysis technique. The aim of the present study is to evaluate the impact of different automated peritoneal dialysis modalities, Nocturnal Intermittent Peritoneal Dialysis (NIPD) and Continuous Cycler Peritoneal Dialysis (CCPD), on inflammatory markers in elderly CKD patients and associate with the type of peritoneal transport, residual renal function, and adequacy of dialysis. This is a prospective, cross-sectional, analytical study, carried out in a dialysis clinic located in the city of Brasília-DF. Elderly patients aged 60 years or older on automated peritoneal dialysis participated in the study. Patients on peritoneal dialysis for less than 5 years were included, and those with neoplasms, those with acute adverse events in the last 60 days prior to data collection, those on manual peritoneal dialysis (CAPD), and those who refused to sign the informed consent form were excluded. The patients included in the study underwent the fast Peritoneal Equilibrium Test (fast-PET), as well as the collection of dialysate and blood samples for dosage of the inflammatory cytokines IL-6 and TGF-beta 1, by immunoenzymatic assay, blood collection for evaluation of dialysis adequacy and inflammation, such as CBC, potassium, phosphorus, serum albumin, C-reactive protein, urea, creatinine and alkaline reserve, by standard laboratory techniques with automatic analysis. To measure the association between the data, the Mann-Whitney U-test was used for variables with 2 categories or the Kruskal-Wallis test for variables with 3 or more categories. To measure the correlation between the data, Spearman's rô was used. The results of the study do not allow us to state that the NIPD modality of automated peritoneal dialysis confers less intraperitoneal and systemic inflammation compared to the CCPD modality in elderly PD patients. Residual renal function, age and time on therapy are the main determinants of inflammation, and both modalities enable good dialysis adequacy.