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Diálise e Terapias de Substituição da Função Renal
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Abstract(s)
A doença renal crónica é uma patologia com elevada prevalência global e impacto na
mortalidade e morbilidade. A progressão para insuficiência renal exige a implementação
de terapias de substituição da função renal, como hemodiálise, diálise peritoneal e
hemodiafiltração. Este trabalho tem como objetivo analisar as características destas
modalidades, comparando a sua eficácia, complicações, impacto na qualidade de vida e
outcomes cardiovasculares, bem como discutir a relevância do transplante renal
enquanto opção terapêutica.
A pesquisa foi feita entre maio e novembro de 2024, utilizando, preferencialmente,
artigos de revisão, revisões sistemáticas e meta-análises publicadas nos últimos 10 anos,
com recurso à base de dados PubMed, guidelines da KDIGO e UKKA, e a obra de base
médica “Harrison’s Principles of Internal Medicine”.
Os resultados revelaram que cada modalidade apresenta vantagens e limitações que
influenciam a escolha terapêutica. A hemodiálise é eficaz na remoção de toxinas
urémicas, mas está associada a fadiga e alterações cardiovasculares. A diálise peritoneal
destacou-se pela maior autonomia e benefícios na interação social, mas é limitada por
complicações infeciosas. A hemodiafiltração online apresentou resultados promissores
na redução da mortalidade cardiovascular, apesar de ser menos acessível. O transplante
renal, apesar de ser a melhor opção terapêutica para os doentes elegíveis, enfrenta
limitações devido à escassez de órgãos e critérios rigorosos de elegibilidade.
Conclui-se que uma abordagem personalizada, centrada nas características clínicas e
preferências do doente, é essencial para maximizar os resultados e melhor a qualidade
de vida dos pacientes.
Chronic kidney disease is a condition with high global prevalence and an impact on mortality and morbidity. Progression to renal failure requires the implementation of renal replacement therapies, such as hemodialysis, peritoneal dialysis, and hemodiafiltration. This study aims to analyze the characteristics of these modalities, comparing their efficacy, complications, impact on quality of life, and cardiovascular outcomes, as well as discussing the relevance of kidney transplantation as a therapeutic option. The research was carried out between May and November 2024, preferably using review articles, systematic reviews, and meta-analyses published in the last 10 years. The sources included the PubMed database, KDIGO and UKKA guidelines, and the medical textbook “Harrison’s Principles of Internal Medicine.” The results showed that each modality has advantages and limitations that influence therapeutic choice. Hemodialysis is effective in removing uremic toxins, but is associated with fatigue and cardiovascular alterations. Peritoneal dialysis stood out for its greater autonomy and benefits in social interaction, but is limited by infectious complications. Online hemodiafiltration demonstrated promising results in reducing cardiovascular mortality, despite being less accessible. Kidney transplantation, while the best therapeutic option for eligible patients, faces limitations due to organ scarcity and strict eligibility criteria. In conclusion, a personalized approach centered on the patient’s characteristics and preferences is essential to maximize outcomes and improve patient’s quality of life.
Chronic kidney disease is a condition with high global prevalence and an impact on mortality and morbidity. Progression to renal failure requires the implementation of renal replacement therapies, such as hemodialysis, peritoneal dialysis, and hemodiafiltration. This study aims to analyze the characteristics of these modalities, comparing their efficacy, complications, impact on quality of life, and cardiovascular outcomes, as well as discussing the relevance of kidney transplantation as a therapeutic option. The research was carried out between May and November 2024, preferably using review articles, systematic reviews, and meta-analyses published in the last 10 years. The sources included the PubMed database, KDIGO and UKKA guidelines, and the medical textbook “Harrison’s Principles of Internal Medicine.” The results showed that each modality has advantages and limitations that influence therapeutic choice. Hemodialysis is effective in removing uremic toxins, but is associated with fatigue and cardiovascular alterations. Peritoneal dialysis stood out for its greater autonomy and benefits in social interaction, but is limited by infectious complications. Online hemodiafiltration demonstrated promising results in reducing cardiovascular mortality, despite being less accessible. Kidney transplantation, while the best therapeutic option for eligible patients, faces limitations due to organ scarcity and strict eligibility criteria. In conclusion, a personalized approach centered on the patient’s characteristics and preferences is essential to maximize outcomes and improve patient’s quality of life.
Description
Keywords
Diálise Peritoneal Doença Renal Crónica Hemodiafiltração Online Hemodiálise Qualidade de Vida