Insuficiencia renal oculta y factores asociados en pacientes con enfermedades crónicas

espanolIntroduccion: El diagnostico oportuno y la intervencion terapeutica temprana disminuyen la mortalidad prematura asociada con insuficiencia renal cronica. Objetivo: Identificar la prevalencia y factores asociados con insuficiencia renal oculta en pa- cientes con enfermedades cronicas. Metodo: Estudio transversal de 1268 pacientes con diabetes mellitus tipo 2 e hipertension arterial sistemica. Se uso un instrumento de medicion con preguntas sobre factores asociados como artrosis, tratamiento de padecimiento cronico, tabaquismo, ingesta de analgesicos, alcoholismo, indice de masa corporal, actividad fisica y niveles sericos de glucosa, colesterol y trigliceridos. Resultados: La prevalencia de insuficiencia renal oculta fue de 13.2 % (167/1268), 13.4 % en pacientes diabeticos (117/876) y 14.9 % en hipertensos (150/1010). En el analisis multivariado, los factores aso- ciados con insuficiencia renal oculta fueron edad > 60 anos (RMa = 1.96, IC 95 % = 1.22-2.49), sexo femenino (RMa = 2.17, IC 95 % = 1.30-2.82), padecer hipertension arterial sistemica (RMa = 1.96, IC 95 % = 1.22-2.50) y no tener sobrepeso u obesidad (RMa = 0.49, IC 95 % = 0.41-0.8). Conclusiones: La prevalencia de insuficiencia renal oculta fue de 13 %. Los pacientes mayores de 60 anos, con sobrepeso u obesidad e hipertension arterial sistemica deben ser examinados detallada- mente por el medico familiar para la deteccion temprana de insuficiencia renal oculta. EnglishIntroduction: Timely diagnosis and early therapeutic intervention reduce premature mortality associated with chronic renal failure. Objective: To identify the prevalence and factors associated with occult renal failure in patients with chronic diseases. Method: Cross- sectional study of 1268 patients with type 2 diabetes mellitus and systemic arterial hypertension. A measuring instrument with questions about associated factors such as osteoarthritis, treatment of chronic conditions, smoking, analgesic consumption, alcohol- ism, body mass index, physical activity and serum glucose, cholesterol and triglyceride levels was used. Results: The prevalence of occult renal failure was 13.2 % (167/1,268), 13.4 % in diabetic patients (117/876) and 14.9 % in hypertensive patients (150/1,010). In the multivariate analysis, the factors associated with occult renal failure were being older than 60 years (aOR = 1.96, 95 % CI = 1.22-2.49), belonging to the female gender (aOR = 2.17, 95 % CI = 1.30-2.82), suffering from systemic arterial hypertension (aOR = 1.96, 95% CI = 1.22-2.50) and not having overweight/obesity (aOR = 0.49, 95 % CI = 0.41-0.8). Conclusions: The prevalence of occult renal failure was 13 %. Female patients older than 60 years with overweight/obesity and systemic arterial hypertension should be examined in detail by the family doctor for occult renal failure early detection.