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espanolLa resiliencia consiste en una serie de habilidades personalizadas que sirven para afrontar situaciones adversas y superarlas, e incluso salir fortalecido. La resiliencia en pacientes con insuficiencia renal cronica (IRC) tratados con hemodialisis (HD) se ha evaluado con cuestionarios generales, no especificos para esta poblacion. Objetivo Evaluar las propiedades psicometricas de un cuestionario de resiliencia en pacientes tratados con HD cronica. Metodo Se incluyeron 280 pacientes con IRC (edad 18 a 85 anos, 44% mujeres) tratados con HD al menos dos meses en seis unidades de hemodialisis en Mexico, que respondieron los inventarios de depresion y ansiedad de Beck, un inventario de distorsiones cognitivas y la escala de medicion de resiliencia con mexicanos (RESI-M). Resultados Por duplicidad en mas de un factor, se eliminaron dos de 43 reactivos en el analisis factorial exploratorio. Se confirmaron cinco factores que explicaron 63.4% de la varianza total, con alfa de Cronbach de .96 (el alfa en los cinco factores va de .85 a .95). El analisis confirmatorio mostro un modelo estructural teorico que se ajusta aceptable, equilibrada y parsimoniosamente a los datos empiricos. Los cinco factores se correlacionan positivamente entre ellos y negativamente con los sintomas de ansiedad, depresion y los pensamientos distorsionados. Discusion y conclusion La escala RESI-M es valida y confiable para evaluar resiliencia en pacientes tratados con HD cronica. Los factores de resiliencia evaluados con la RESI-M son un blanco terapeutico potencial para disminuir los sintomas depresivos y ansiosos en estos pacientes. EnglishIntroduction: resilience consists of a series personalized skills to cope with adverse situations and overcome them, and even emerge strengthened. Resilience in patients with chronic renal insufficiency (CRI) treated with hemodialysis (HD) has been evaluated with general questionnaires that are not specific for this population. Objective: to evaluate the psychometric properties of a resilience questionnaire in patients treated with chronic HD. Method: the study included 280 patients with CRI (aged 18 to 85, 44% women) treated with HD for at least two months in six hemodialysis units in Mexico, who completed Beck’s depression and anxiety inventories, an inventory of cognitive distortions, and the Mexican Resilience Measurement Scale (RESI-M). Results: owing to the duplication of more than one factor, two of the 43 items were eliminated in the exploratory factor analysis. We confirmed five factors that explained 63.4% of the total variance, with a Cronbach’s alpha of .96 (the alpha ranges in the five factors from .85 to .95). The confirmatory analysis showed a theoretical structural model that fits the empirical data in an acceptable, balanced, and parsimonious way. The five factors correlate positively with each other and negatively with anxiety and depression symptoms and distorted thoughts. Discussion and conclusion: the RESI-M scale is valid and reliable for assessing resilience in patients treated with chronic HD. Resilience factors evaluated with RESI-M are a potential therapeutic target to reduce depression and anxiety symptoms in these patients.

This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P

This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P 0.05). Concurrent acute and gradual ECG changes during HDF are identified by the 3DECG, which could be useful as a preventive and prognostic method.