Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract Introduction: The nursing process is the method that allows us to administer care to people with chronic diseases through the disease stages, that is, assessment, diagnostic reasoning, nursing care plan and evaluation. Objective: Evaluate a nursing care plan for an older adult with type 2 diabetes mellitus and osteoporosis with a focus on therapeutic health education. Methodology: Observational, descriptive, and longitudinal clinical case study of a 63-year-old patient with diabetes mellitus and osteoporosis; the Marjory Gordon instrument was used for assessment, and standardized language was used for diagnostic reasoning, planning, execution and evaluation. Under bioethical principles, this is a minimal risk research, and the privacy and data of the elderly are protected. Results: Alteration was found in the pattern of perception/maintenance of health, nutritional/metabolic, exercise activity and coping with stress; with the establishment of activities to control glucose, priority was given to prescribed diet, exercise, adherence to treatment and coping with stress. Acceptance of the disease, learning to take capillary glucose and glycemic control was achieved, as well as adherence to the prescribed diet and exercise. Conclusions: Therapeutic health education achieved adherence to pharmacological and non-pharmacological treatment, as well as the acceptance of the health status, which allows acquiring self-control of the disease. Continuous and long-term follow-up is important due to the pathological progress, age and general deterioration of the patient.

Abstrato Introdução. O processo de enfermagem é o método que nos permite administrar a assistência a pessoas com doenças crônicas por meio dos estágios da doença, ou seja, avaliação, raciocínio diagnóstico, plano de assistência de enfermagem e avaliação. Objetivo: Avaliar um plano de cuidados de enfermagem para um adulto mais velho com diabetes mellitus tipo 2 e osteoporose com foco na educação terapêutica em saúde. Metodologia: Estudo de caso clínico observacional, descritivo e longitudinal de uma paciente de 63 anos com diabetes mellitus e osteoporose; para a avaliação foi utilizado o instrumento Marjory Gordon para raciocínio diagnóstico, planejamento, execução e avaliação, para raciocínio diagnóstico, planejamento, execução e avaliação, foi utilizada a linguagem padronizada. De acordo com os princípios bioéticos, essa é uma pesquisa de risco mínimo, e a privacidade e os dados dos idosos são protegidos. Resultados: Foi encontrada alteração no padrão de percepção/manutenção da saúde, nutricional/metabólico, atividade física e enfrentamento do estresse; com o estabelecimento de atividades para controlar a glicose, a prioridade foi dada à dieta prescrita, aos exercícios, à adesão ao tratamento e ao enfrentamento do estresse. Houve aceitação da doença, aprendizado da medição da glicose capilar e controle glicêmico, além de adesão à dieta e aos exercícios prescritos. Conclusões: A educação terapêutica em saúde conseguiu a adesão ao tratamento farmacológico e não farmacológico, bem como a aceitação do estado de saúde, que permite adquirir o autocontrolo da doença, sendo importante a monitorização contínua e a longo prazo da evolução patológica, da idade e da deterioração geral do paciente.

Resumen Introducción: El proceso de enfermería es el método que nos permite administrar los cuidados a personas con enfermedades crónicas a través de sus etapas: valoración, razonamiento diagnóstico, plan de cuidados de enfermería y evaluación. Objetivo: Evaluar un plan de cuidados de enfermería a una adulta mayor con diabetes mellitus tipo 2 y osteoporosis con enfoque a la educación para la salud terapéutica. Metodología: Estudio de caso clínico, observacional, descriptivo y longitudinal, a paciente de 63 años con diabetes mellitus y osteoporosis; para la valoración se empleó el instrumento de Marjory Gordon, para el razonamiento diagnóstico, planeación, ejecución y evaluación se utilizó el lenguaje estandarizado de enfermería. Bajo los principios bioéticos es una investigación de riesgo mínimo, se protege la privacidad y datos del adulto mayor. Resultados: Se encontró alteración en el patrón percepción / mantenimiento de la salud, nutricional / metabólico, actividad ejercicio y afrontamiento del estrés; estableciendo actividades para el control de su glucosa, se priorizó en dieta prescrita, ejercicio, adherencia al tratamiento y afrontamiento al estrés. Se logró aceptación de la enfermedad, aprendizaje de toma de glucosa capilar y control glucémico, además del apego a dieta y ejercicio prescrito. Conclusiones: La educación para la salud terapéutica logró el apego al tratamiento farmacológico y no farmacológico, así como la aceptación del estado de salud le permite adquirir el autocontrol de su enfermedad, es importante el seguimiento continuo y a largo plazo por el avance patológico, edad y deterioro general de la paciente.

Abstract Introduction: Vascular and neuropathic complications of diabetes cause diabetic foot, being the main risk factor for non-traumatic amputations. Objective: To analyze the available scientific evidence on lifestyle and self-care of patients at risk of diabetic foot. Methodology: Literature review using the preferred reporting items for systematic reviews and meta-analyses methodology; published in EBSCO host, Google academic, PubMed, Scielo and Elsevier; in English and Spanish from 2016 to 2022. Nursing articles were included, mentioning two or more variables of interest: diabetes mellitus, lifestyle, diabetic foot, and self-care; duplicates, no access, and gray literature were eliminated. From a total of 1,080 articles, 14 were included that met the inclusion criteria. Checklists were used to assess the quality of the manuscripts used. Results: Systematic reviews, observational, experimental and qualitative studies showed evidence that self-care can be influenced by culture, context and knowledge deficit, being this a risk factor for the development of diabetic foot. An association was found between the risk of diabetic foot with years of diagnosis, inadequate self-care of the feet and advanced age. Conclusion: The association between the self-care deficit and the risk of diabetic foot in the elderly was evidenced. It is recommended to broaden the search and include people under 40 years of age in order to establish effective preventive measures and reduce the risk of diabetic foot.

Abstrato Introdução: As complicações vasculares e neuropáticas da diabetes causam o pé diabético, sendo o principal fator de risco para amputações não traumáticas. Objetivo: Analisar a evidência científica disponível sobre o estilo de vida e o autocuidado dos doentes em risco de pé diabético. Metodologia: Revisão da literatura utilizando a metodologia preferred reporting items for systematic reviews and meta-analyses; publicada no EBSCO host, Google Scholar, PubMed, Scielo e Elsevier; em inglês e espanhol de 2016 a 2022. Foram incluídos artigos de enfermagem que mencionavam duas ou mais variáveis de interesse: diabetes mellitus, estilo de vida, pé diabético e autocuidado; foram removidos os duplicados, sem acesso e literatura cinzenta. De um total de 1.080 artigos, 14 que preencheram os critérios de inclusão foram incluídos. Foram utilizadas listas de verificação para avaliar a qualidade dos manuscritos utilizados. Resultados: Revisões sistemáticas, estudos observacionais, experimentais e qualitativos mostraram evidências de que o autocuidado pode ser influenciado pela cultura, contexto e défices de conhecimento, que são factores de risco para o desenvolvimento da doença do pé diabético. Foram encontradas associações entre o risco de pé diabético e os anos de diagnóstico, o autocuidado inadequado dos pés e a idade avançada. Conclusão: Verificou-se a associação entre défices de autocuidado e o risco de doença do pé diabético em idosos. Recomendamos o alargamento da pesquisa a pessoas com menos de 40 anos de idade, de forma a estabelecer medidas preventivas eficazes e reduzir o risco de doença do pé diabético.

Resumen Introducción: Las complicaciones vasculares y neuropáticas de la diabetes causan el pie diabético, siendo el principal factor de riesgo para amputaciones no traumáticas. Objetivo: Analizar la evidencia científica disponible sobre el estilo de vida y autocuidado de los pacientes con riesgo de pie diabético. Metodología: Revisión de la literatura mediante la metodología preferred reporting items for systematic reviews and meta-analyses; publicada en EBSCO host, Google académico, PubMed, Scielo y Elsevier; en inglés y español desde 2016 a 2022. Se incluyeron artículos de enfermería, que mencionaran dos o más variables de interés: diabetes mellitus, estilo de vida, pie diabético y autocuidado; se eliminaron duplicados, sin acceso abierto y literatura gris. De un total de 1,080 artículos se incluyeron 14 que reunieron los criterios de inclusión. Se emplearon listas de verificación para evaluar la calidad de los manuscritos utilizados. Resultados: Las revisiones sistemáticas, estudios observacionales, experimentales y cualitativos mostraron evidencias de que el autocuidado puede verse influenciado por la cultura, contexto y déficit de conocimientos, siendo este factor de riesgo para el desarrollo de pie diabético. Se encontró asociación entre el riesgo de pie diabético con años de diagnóstico, autocuidado inadecuado de los pies y edad avanzada. Conclusión: Se evidenció asociación entre déficit de autocuidado y riesgo de pie diabético en el adulto mayor. Se recomienda ampliar la búsqueda e incluir personas menores de 40 años para establecer medidas preventivas eficaces y reducir el riesgo de pie diabético.

Resumo Introdução: É importante identificar fatores de risco para progressão da doença renal policística autossômica dominante (DRPAD). Entretanto, são escassos os estudos que avaliam esse assunto utilizando amostra brasileira. Portanto, o objetivo deste estudo foi identificar fatores de risco para desfechos renais e óbito em coorte brasileira de pacientes com DRPAD. Métodos: Os pacientes tiveram o primeiro atendimento médico entre janeiro/2002 e dezembro/2014, sendo acompanhados até dezembro/2019. Associações entre variáveis clínicas e laboratoriais com desfecho primário (redução sustentada de pelo menos 57% na TFGe em relação ao valor basal, necessidade de diálise ou transplante renal) e desfecho secundário (óbito por qualquer causa) foram analisadas pelo modelo de regressão múltipla de Cox. Entre 80 pacientes com DRPAD, foram excluídos aqueles menores de 18 anos, com TFG <30 mL/min/1,73 m2 e/ou aqueles com dados ausentes. Foram acompanhados 70 pacientes. Resultados: Fatores independentemente associados aos desfechos renais foram: comprimento renal total – Razão de Risco (HR) ajustada com intervalo de confiança de 95% (IC 95%): 1,137 (1,057–1,224), taxa de filtração glomerular – HR (IC 95%): 0,970 (0,949–0,992) e nível sérico de ácido úrico - HR (IC 95%): 1,643 (1,118–2,415). Diabetes mellitus – HR (IC 95%): 8,115 (1,985–33,180) e TFG – HR (IC 95%): 0,957 (0,919–0,997) foram associados ao desfecho secundário. Conclusões: Esses achados corroboram a hipótese de que comprimento renal total, TFG e nível sérico de ácido úrico podem ser importantes preditores prognósticos de DRPAD em uma coorte brasileira, o que pode ajudar a selecionar pacientes que necessitam de acompanhamento mais próximo. Introdução . (DRPAD) Entretanto Portanto Métodos janeiro2002 janeiro 2002 janeiro/200 dezembro2014 dezembro 2014 dezembro/2014 dezembro2019 2019 dezembro/2019 redução 57 basal causa Cox 8 1 anos 30 <3 mLmin173 mLmin mL min 73 mL/min/1,7 m eou ausentes 7 Resultados (HR 95 IC 95%) 1137 137 1,13 1,057–1,224, 10571224 1,057–1,224 , 057 224 (1,057–1,224) 0970 0 970 0,97 0,949–0,992 09490992 949 992 (0,949–0,992 1643 643 1,64 1,118–2,415. 11182415 1,118–2,415 118 2 415 (1,118–2,415) 8115 115 8,11 1,985–33,180 198533180 985 33 180 (1,985–33,180 0957 957 0,95 0,919–0,997 09190997 919 997 (0,919–0,997 Conclusões próximo (DRPAD janeiro200 200 janeiro/20 dezembro201 201 dezembro/201 5 3 < mLmin17 mL/min/1, 9 113 13 1,1 1057122 1,057–1,22 05 22 (1,057–1,224 097 97 0,9 0,949–0,99 0949099 94 99 (0,949–0,99 164 64 1,6 1118241 1,118–2,41 11 41 (1,118–2,415 811 8,1 1,985–33,18 19853318 98 (1,985–33,18 095 0,919–0,99 0919099 91 (0,919–0,99 janeiro20 20 janeiro/2 dezembro20 dezembro/20 mLmin1 mL/min/1 1, 105712 1,057–1,2 (1,057–1,22 09 0, 0,949–0,9 094909 (0,949–0,9 16 6 111824 1,118–2,4 4 (1,118–2,41 81 8, 1,985–33,1 1985331 (1,985–33,1 0,919–0,9 091909 (0,919–0,9 janeiro2 janeiro/ dezembro2 dezembro/2 mL/min/ 10571 1,057–1, (1,057–1,2 0,949–0, 09490 (0,949–0, 11182 1,118–2, (1,118–2,4 1,985–33, 198533 (1,985–33, 0,919–0, 09190 (0,919–0, dezembro/ mL/min 1057 1,057–1 (1,057–1, 0,949–0 0949 (0,949–0 1118 1,118–2 (1,118–2, 1,985–33 19853 (1,985–33 0,919–0 0919 (0,919–0 105 1,057– (1,057–1 0,949– 094 (0,949– 111 1,118– (1,118–2 1,985–3 1985 (1,985–3 0,919– 091 (0,919– 10 1,057 (1,057– 0,949 (0,949 1,118 (1,118– 1,985– 198 (1,985– 0,919 (0,919 1,05 (1,057 0,94 (0,94 1,11 (1,118 1,985 19 (1,985 0,91 (0,91 1,0 (1,05 (0,9 (1,11 1,98 (1,98 (1,0 (0, (1,1 1,9 (1,9 (1, (0 (1 (

Abstract Introduction: Identifying risk factors for autosomal dominant polycystic kidney disease (ADPKD) progression is important. However, studies that have evaluated this subject using a Brazilian sample is sparce. Therefore, the aim of this study was to identify risk factors for renal outcomes and death in a Brazilian cohort of ADPKD patients. Methods: Patients had the first medical appointment between January 2002 and December 2014, and were followed up until December 2019. Associations between clinical and laboratory variables with the primary outcome (sustained decrease of at least 57% in the eGFR from baseline, need for dialysis or renal transplantation) and the secondary outcome (death from any cause) were analyzed using a multiple Cox regression model. Among 80 ADPKD patients, those under 18 years, with glomerular filtration rate <30 mL/min/1.73 m2, and/or those with missing data were excluded. There were 70 patients followed. Results: The factors independently associated with the renal outcomes were total kidney length – adjusted Hazard Ratio (HR) with a 95% confidence interval (95% CI): 1.137 (1.057–1.224), glomerular filtration rate – HR (95% CI): 0.970 (0.949–0.992), and serum uric acid level – HR (95% CI): 1.643 (1.118–2.415). Diabetes mellitus - HR (95% CI): 8.115 (1.985–33.180) and glomerular filtration rate - HR (95% CI): 0.957 (0.919–0.997) were associated with the secondary outcome. Conclusions: These findings corroborate the hypothesis that total kidney length, glomerular filtration rate and serum uric acid level may be important prognostic predictors of ADPKD in a Brazilian cohort, which could help to select patients who require closer follow up. Introduction (ADPKD However sparce Therefore Methods 200 2014 2019 sustained 57 baseline transplantation cause model 8 1 years 30 <3 mLmin173 mLmin mL min 73 mL/min/1.7 m2 m andor excluded 7 Results (HR 95 (95 CI CI) 1137 137 1.13 1.057–1.224, 10571224 1.057–1.224 , 057 224 (1.057–1.224) 0970 0 970 0.97 0.949–0.992, 09490992 0.949–0.992 949 992 (0.949–0.992) 1643 643 1.64 1.118–2.415. 11182415 1.118–2.415 . 118 2 415 (1.118–2.415) 8115 115 8.11 1.985–33.180 198533180 985 33 180 (1.985–33.180 0957 957 0.95 0.919–0.997 09190997 919 997 (0.919–0.997 Conclusions 20 201 5 3 < mLmin17 mL/min/1. 9 (9 113 13 1.1 1057122 1.057–1.22 05 22 (1.057–1.224 097 97 0.9 0949099 0.949–0.99 94 99 (0.949–0.992 164 64 1.6 1118241 1.118–2.41 11 41 (1.118–2.415 811 8.1 1.985–33.18 19853318 98 (1.985–33.18 095 0.919–0.99 0919099 91 (0.919–0.99 mLmin1 mL/min/1 ( 1. 105712 1.057–1.2 (1.057–1.22 09 0. 094909 0.949–0.9 (0.949–0.99 16 6 111824 1.118–2.4 4 (1.118–2.41 81 8. 1.985–33.1 1985331 (1.985–33.1 0.919–0.9 091909 (0.919–0.9 mL/min/ 10571 1.057–1. (1.057–1.2 09490 0.949–0. (0.949–0.9 11182 1.118–2. (1.118–2.4 1.985–33. 198533 (1.985–33. 0.919–0. 09190 (0.919–0. mL/min 1057 1.057–1 (1.057–1. 0949 0.949–0 (0.949–0. 1118 1.118–2 (1.118–2. 1.985–33 19853 (1.985–33 0.919–0 0919 (0.919–0 105 1.057– (1.057–1 094 0.949– (0.949–0 111 1.118– (1.118–2 1.985–3 1985 (1.985–3 0.919– 091 (0.919– 10 1.057 (1.057– 0.949 (0.949– 1.118 (1.118– 1.985– 198 (1.985– 0.919 (0.919 1.05 (1.057 0.94 (0.949 1.11 (1.118 1.985 19 (1.985 0.91 (0.91 1.0 (1.05 (0.94 (1.11 1.98 (1.98 (0.9 (1.0 (1.1 1.9 (1.9 (0. (1. (0 (1

Abstract This research aimed to analyze the relationship between insulin resistance, overweight and obesity. A population of 2,574 patients diagnosed with obesity and overweight was obtained, considering a sample of 334 patients. A descriptive, documentary, retrospective, cross-sectional, and correlational study was conducted. For data collection, the medical records recorded in the IBM AS400 operating system for the Ecuadorian Social Security Institute's medical care were used. The total result of the patients belonged to the female sex with a percentage of 77.84%, urban residence (73.65%), and higher education (60.5%). 52.8% of the individuals registered a BMI > 30kg/m2. Young adult patients with higher education, male sex, and urban sector registered the highest insulin resistance prevalence, 61.7%. In the bivariate analysis, patients with morbid obesity presented a higher risk of insulin resistance (PR: 1.5; 95% CI: 1. 29, 1.77). A significant relationship was established between family history of type 2 diabetes mellitus and the risk of developing insulin resistance (p<0.001; PR: 1.32; 95% CI: 1.12: 1.56). The values of hyperglycemia, hyperinsulinemia, hyperuricemia, and elevated AST and ALT were significantly related to HOMA-IR > 3. It was concluded that insulin resistance is a frequent entity in overweight and obese patients, with a higher prevalence identified in the male gender, which predisposes to the progression of chronic diseases.

Resumen El objetivo de esta investigación fue analizar la relación de resistencia a la insulina, sobrepeso y obesidad. Con una población de 2574 pacientes con diagnóstico de obesidad y sobrepeso, se obtuvo una muestra de 334 pacientes. Se realizó un estudio de tipo descriptivo, documental, retrospectivo, transversal y correlacional. Para la recolección de datos se empleó las historias clínicas registradas en el sistema operativo AS400 de IBM, de atención médica del Instituto Ecuatoriano de Seguridad Social. El resultado total de los pacientes perteneció al sexo femenino con un porcentaje del 77.84 %, residencia urbana (73.65 %) e instrucción superior (60.5 %). El 52.8 % de los individuos registró un IMC >30kg/m2. Los pacientes adultos jóvenes de instrucción superior, sexo masculino y sector urbano registraron la mayor prevalencia de resistencia a la insulina, siendo ésta del 61.7 %. En el análisis bivariado los pacientes con obesidad mórbida presentaron mayor riesgo de resistencia a la insulina (RP:1.5; IC95 %:1. 29; 1.77). Se estableció una relación significativa entre el antecedente familiar de diabetes mellitus tipo 2 y el riesgo de presentar resistencia a la insulina (p<0.001; RP: 1.32; IC 95 %: 1.12: 1.56). Los valores de hiperglucemia, hiperinsulinemia e hiperuricemia, así como de AST Y ALT elevadas registraron una relación significativamente con HOMA-IR >3. Se concluye que la resistencia a la insulina es una entidad frecuente en pacientes con sobrepeso y obesidad, identificándose una mayor prevalencia en el género masculino, misma que predispone a la progresión de enfermedades crónicas.

Abstract Mean arterial pressure is an indirect indicator of the degree of organ perfusion, which could vary in diabetics and non-diabetics. The objective of this research was to determine the differences and risk of alterations in the mean arterial pressure of adults with and without diabetes mellitus-2 of the Peruvian population according to data from the family health demographic survey. An observational, analytical, retrospective and cross-sectional study was carried out. The data came from the demographic and family health survey-2022 (ENDES-2022). Diabetic and non-diabetic adults were included. The variables were mean arterial pressure, diabetes mellitus-2, sex, and the variables age, alcohol consumption, educational level, and body mass index were included for multivariate analysis. Pearson's Chi-square test, student's T test for independent samples, crude Odds Ratio and adjusted by binary logistic regression were performed. The mean arterial pressure in diabetics was 94.81 and 93.52 mmHg in the first and second measurements, and in non-diabetics it was 89.18 and 88.02 mmHg. High mean arterial pressure was more frequent in diabetics than in non-diabetics. In the logistic model, including the variables sex and age, diabetics had a risk twice as high as non-diabetics for alterations in mean arterial pressure in both the first and second measurements. In conclusion, diabetes mellitus-2 increases mean arterial pressure and represents a risk factor for elevated mean arterial pressure in the Peruvian population.

Resumen La presión arterial media es un indicador indirecto del grado de perfusión orgánica, la cual podría variar en pacientes con y sin diabetes mellitus-2. El objetivo fue determinar las diferencias y riesgo de alteraciones en la presión arterial media de adultos con y sin diabetes mellitus-2 de la población peruana según datos de la encuesta demográfica de salud familiar. Se realizó un estudio observacional, analítico, retrospectivo y transversal;. Los datos provinieron de la encuesta demográfica y de salud familiar-2022 (ENDES-2022), se incluyó adultos diabéticos y no diabéticos. Las variables fueron: presión arterial media, diabetes mellitus-2, sexo y se incluyeron las variables: edad, consumo de alcohol, nivel educativo e índice de masa corporal para el análisis multivariado. Se realizó la prueba de Chi-cuadrado de Pearson, la prueba T student para muestras independientes, Odds Ratio crudo y ajustado mediante regresión logística binaria. El promedio de presión arterial media en diabéticos fue de 94,81 y 93,52 mmHg en la primera y segunda medición y en no diabéticos de 89,18 y 88,02 mmHg. La presión arterial media alta fue más frecuente en diabéticos que en no diabéticos; En el modelo logístico, incluyendo las variables sexo y edad, los diabéticos tuvieron un riesgo 2 veces mayor que los no diabéticos de alteraciones en la presión arterial media tanto en la primera como en la segunda medición. En conclusión, la diabetes mellitus-2 incrementa la presión arterial media y representa un factor de riesgo para la elevación de la presión arterial media en la población peruana.

RESUMEN Introducción: las enfermedades del pie relacionadas a la diabetes mellitus representan una de las causas de mayor morbilidad e incapacidad en las personas con diabetes mellitus tipo 2, siendo la causa más frecuente de ingreso hospitalario en dicho grupo. Objetivo: describir las características clínicas de los pacientes con enfermedad del pie relacionadas a la diabetes mellitus del Hospital Nacional 2022-2023. Metodología: se seleccionaron 113 pacientes portadores de diabetes mellitus tipo 2 con pie diabético mayores de 18 años. Se evaluaron las variables demográficas, medidas antropométricas, características de la enfermedad, comorbilidades y características clínicas del pie. Resultados: de los 113 estudiados 42 pacientes (37 %) correspondieron al sexo femenino y 71 (63 %) al sexo masculino, promedio de edad fue de 65 años DE 12,191. 75 pacientes (66 %) presentaron pie diabético, con lesión Wagner grado 4. El 81 % (92) tenía hipertensión arterial, sedentarismo 65 % (84), en menor frecuencia pacientes con sobrepeso 38 % (43), obesidad 25 % (38), tabaquismo 23 % (26) y dislipidemia 18 % (20). Conclusión: las características clínicas de los pacientes con diabetes tipo 2 con lesión en el pie coinciden con otros trabajos obtenidos a nivel mundial. Es muy importante prestar atención a este grupo de riesgo, mediante medidas preventivas y realizar el tratamiento precoz para disminuir las complicaciones.

ABSTRACT Introduction: foot diseases related to diabetes mellitus represent one of the causes of greatest morbidity and disability in people with type 2 diabetes mellitus, being the most frequent cause of hospital admission in said group. Objective: to describe the clinical characteristics of patients with foot disease related to diabetes mellitus at Hospital Nacional 2022-2023. Methodology: 113 patients with type 2 diabetes mellitus with diabetic foot over 18 years of age were selected. Demographic variables, anthropometric measurements, disease characteristics, comorbidities, and clinical characteristics of the foot were evaluated. Results: of the 113 studied, 42 patients (37 %) were female and 71 (63 %) were male, average age was 65 years SD 12,191. 75 patients (66 %) presented diabetic foot, with Wagner grade 4 lesion. 81 % (92) had high blood pressure, sedentary lifestyle 65 % (84), less frequently overweight patients 38 % (43), obesity 25% (38) ), smoking 23 % (26) and dyslipidemia 18 % (20). Conclusion: the clinical characteristics of patients with type 2 diabetes with foot injury coincide with other works obtained worldwide. It is very important to pay attention to this risk group, through preventive measures and carry out early treatment to reduce complications.

RESUMEN Introducción: el riesgo de aparición del infarto agudo de miocardio está relacionada con varias comorbilidades, muchas de las cuales son prevenibles y tratables. El infarto agudo de miocardio tiene un impacto relevante en términos de mortalidad y número de hospitalizaciones. Objetivos: determinar las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Metodología: el diseño del estudio fue observacional, descriptivo de corte transversal, sobre las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes mayores de edad atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Resultados: se analizaron 102 expedientes de pacientes con diagnóstico de infarto agudo de miocardio con elevación del segmento ST con una media de 64 ± 12 años; el 68 % (n = 69) correspondió al sexo masculino, con una edad promedio de 62 años, y en relación a las mujeres el promedio fue de 64 años. El motivo de consulta principal fue el dolor precordial y la cara miocárdica más afectada de acuerdo con el electrocardiograma inicial fue la cara anteroseptal. La mortalidad intrahospitalaria fue del 16 %, el 68 % correspondió a varones. La comorbilidad más frecuente fue la hipertensión arterial. Conclusión: La hipertensión arterial es la patología más prevalente. Asimismo, son habituales la obesidad, el tabaquismo y la diabetes mellitus. Las comorbilidades están en relación directa con la edad y prevalecen en mayores de 60 años. El infarto agudo de miocardio con elevación del segmento ST es más frecuente en el sexo masculino.

ABSTRACT Introduction: the risk of acute myocardial infarction is related to several comorbidities, many of which are preventable and treatable. Acute myocardial infarction has a relevant impact in terms of mortality and number of hospitalizations. Objectives: the design of the study was observational, descriptive, cross-sectional, on the clinical characteristics of ST-segment elevation myocardial infarction, in adult patients treated at the Centro Médico Nacional-Hospital Nacional, during the period 2021-2023. Methodology: the design of the study was observational, descriptive, cross-sectional, on the clinical-epidemiological characteristics of acute myocardial infarction with ST segment elevation in adult patients treated at the National Medical Center-National Hospital, during the period 2021-2023. Results: 102 records of patients with a diagnosis of ST-segment elevation myocardial infarction with a mean age of 64 ± 12 years were analyzed; 68 % (n = 69) were male, with an average age of 62 years, and in relation to women the average was 64 years. The main reason for consultation was precordial pain and the most affected myocardial aspect according to the initial electrocardiogram was the anteroseptal aspect. In-hospital mortality was 16 %, 68 % of which were men. The most frequent comorbidity was arterial hypertension. Conclusion: high blood pressure is the most prevalent pathology. Likewise, obesity, smoking and diabetes mellitus are common. Comorbidities are directly related to age and prevail in those over 60 years of age. ST-segment elevation myocardial infarction is more common in males.

RESUMEN Introducción: los pacientes con enfermedad renal crónica con requerimiento de terapia sustitutiva renal (hemodiálisis) son frecuentes en el Paraguay, lo que afecta la calidad de vida de los que la padecen. Objetivo: conocer la calidad de vida de los pacientes con enfermedad renal crónica en tratamiento hemodialítico en el Departamento de Nefrología del Centro Médico Nacional-Hospital Nacional en el período 2022-2023. Metodología: observacional, descriptivo, de corte transversal realizado en el Departamento de Nefrología del Centro Médico Nacional-Hospital Nacional de Paraguay. Se incluyeron en el estudio 189 pacientes en que acudieron para tratamiento hemodialítico entre los años 2022-2023. La muestra fue censal. Para determinar la calidad de vida se utilizó el cuestionario Kidney Disease Quality of Life - 36 ítems. Los datos fueron analizados con el programa Epiinfo. Resultados: la edad media de los pacientes fue de 53 años, varones 58.2 %. El 98 % refirió la presencia de algún tipo de comorbilidad concomitante, las más frecuentes fueron diabetes Mellitus 43 % e hipertensión arterial 86 %. La media de meses en tratamiento hemodialítico fue de 20 meses. El cuestionario, Kidney Disease Quality of Life - 36 ítems, arrojó puntajes promedios menores a 50 en el componente mental (65.08) y en el componente físico (71.95) así como en la subescala carga de la enfermedad (55.55). Conclusión: la mayoría de los pacientes con enfermedad renal crónica con tratamiento hemodialítico en el Hospital Nacional evidencian una baja calidad de vida.

ABSTRACT Introduction: patients with chronic kidney disease requiring renal replacement therapy (hemodialysis) are common in Paraguay, which affects the quality of life of those who suffer from it. Objective: to know the quality of life of patients with chronic kidney disease undergoing hemodialysis treatment in the Departmento de Nefrología of the Centro Médico Nacional-Hospital Nacional in the period 2022-2023. Methodology: observational, descriptive, cross-sectional carried out in the Nephrology Department of the Centro Médico Nacional-Hospital Nacional of Paraguay. 189 patients who came for hemodialysis treatment between 2022-2023 were included in the study. The sample was census. To determine quality of life, the Kidney Disease Quality of Life questionnaire - 36 items was used. The data were analyzed with the Epi Info program. Results: the average age of the patients was 53 years, 58.2 % men. 98 % reported the presence of some type of concomitant comorbidity, the most frequent being diabetes mellitus 43 % and arterial hypertension 86 %. The average number of months on hemodialysis treatment was 20 months. The questionnaire, Kidney Disease Quality of Life - 36 items, showed average scores less than 50 in the mental component (65.08) and in the physical component (71.95) as well as in the burden of the disease subscale (55.55). Conclusion: the majority of patients with chronic kidney disease with hemodialysis treatment at the National Hospital show a low quality of life.

RESUMEN El estudio de la regularidad de la Frecuencia Cardiaca, a través del Holter de 24 horas se hace desde la década de los años 60 y es bastante efectivo. Sin embargo, desde los años noventa comenzaron a efectuarse estudios cortos de Holter en pacientes sospechados de tener fallas autonómicas de control de la frecuencia cardiaca, especialmente en pacientes con comorbilidades tales como Hipertensión, Diabetes Mellitus, Aterosclerosis etc. De aquí la importancia de realizar un test de Holter de diez minutos, divididos en dos tiempos de 5 minutos, primero en decúbito dorsal y luego en bipedestación, especialmente en pacientes de más de cincuenta años o con comorbilidades presentes. Los resultados se presentan luego en gráficos de Poincare, que incluye el programa operativo del dispositivo, que permite un vistazo de la elipse con sus dos ejes, que representan las acciones simpáticas y parasimpáticas sobre la frecuencia cardiaca. Una variabilidad anormal de la frecuencia cardiaca debe ser luego estudiada más profundamente a fin de reafirmar el diagnóstico y ulteriores pasos en el tratamiento.

ABSTRACT The variability of Cardiac Frequency is a valuable monitor of the autonomic function and is currently used as tool for study of changes of regularity through Holter 24 hours. From nighties, several researchers have been oriented to stablish relationship between VCF and autonomic failure, especially in patients with comorbidities, such as Hypertension, Diabetes Mellitus, atherosclerosis etc. Actually is well known that a lost or VCF or a minor variability, even in short traces of Holter in 10 minutes, means an autonomic failure, of baroreflex and quimioreflex resources. Hence, the importance of performing test of ten minutes Holter, five in decubitus position and five in standing, to patients of more than fifty years old, or less if comorbidities are presents, to design a Poincare diagram, which is special to indicate in quick view the prevalence of Sympathetic o Vagal action on cardiac frequency; that conduces to a more deep study of Autonomic failure, such tilt test, extended holter of 24 hours, and others medicals images resources.

RESUMEN Introducción: la diabetes mellitus es una patología prevalente y por ello la implementación de estrategias prácticas para su diagnóstico son importantes desde la Atención Primaria. Objetivo: determinar los parámetros laboratoriales de los pacientes de la Unidad de Salud Familiar del barrio Chaipe (Encarnación, Paraguay) con moderado a muy alto riesgo de diabetes mellitus tipo 2 según la prueba de FINDRISK. Metodología: estudio prospectivo, observacional, descriptivo, transversal. Se incluyeron pacientes mayores de 18 años que acudieron a consultar en la Unidad de Salud Familiar del barrio Chaipe desde setiembre del 2022 a febrero del 2023. Se aplicó la prueba de FINDRISK para seleccionar a aquellos con moderado a muy alto riesgo de diabetes mellitus tipo 2 para las determinaciones laboratoriales. Resultados: la muestra estuvo conformada por 142 pacientes, con rango de edad menor a 45 años y predominio del sexo femenino. El 42,96 % tenía índice de masa corporal aumentado y 62,68 % circunferencia abdominal de riesgo. El 52,11 % no realizaba actividad física y el 27,46 % no consumía frutas y verduras diariamente. El 25,35 % eran hipertensos, el 11,97 % presentó en alguna oportunidad glicemia elevada y el 56,34 % tenía familiares con diabetes mellitus. El 4,93 % presentó glicemia ≥ 126 mg/dl y el 10,56 % valores de hemoglobina glicosilada (HBA1C) ≥ 6,5 %. El 14,08 % presentó colesterol total ≥ 200 mg/dl y 19,72 % triglicéridos ≥ 150 mg/dl. El 26,65 % presentó 3 o más criterios para síndrome metabólico y se encontró una relación significativa con el riesgo de diabetes mellitus. Conclusiones: se encontró una proporción significativa de pacientes con parámetros laboratoriales de glicemia, HBA1C, colesterol y triglicéridos aumentados.

ABSTRACT Introduction: diabetes mellitus is a prevalent pathology and therefore the implementation of practical strategies for its diagnosis are important from Primary Care. Objective: to determine the laboratory parameters of patients from the United Family Healthcare of the Chaipe neighborhood (Encarnación, Paraguay) with moderate to very high risk of diabetes mellitus type 2 according to the FINDRISK test. Methodology: prospective, observational, descriptive, cross-sectional study. Patients over 18 years of age who came to consult at the United Family Healthcare in the Chaipe neighborhood from September 2022 to February 2023 were included. The FINDRISK test was applied to select those with moderate to very high risk of diabetes mellitus type 2 for the laboratory’s determinations. Results: the sample was made up of 142 patients, with an age range of less than 45 years and a predominance of the female sex. 42.96 % had an increased body mass index and 62.68 % had an abdominal circumference at risk. 52.11 % did not do physical activity and 27.46 % did not consume fruits and vegetables daily. 25.35 % were hypertensive, 11.97 % had high blood glucose at some point and 56.34 % had family members with diabetes mellitus. 4.93 % had blood glucose ≥ 126 mg/dl and 10.56 % had glycosylated hemoglobin (HBA1C) values ≥ 6.5 %. 14.08 % had total cholesterol ≥ 200 mg/dl and 19.72 % had triglycerides ≥ 150 mg/dl. 26.65 % presented 3 or more criteria for metabolic syndrome and a significant relationship was found with the risk of diabetes mellitus. Conclusions: a significant proportion of patients with increased laboratory parameters of glycemia, HBA1C, cholesterol and triglycerides were found.

ABSTRACT Introduction: Diabetes mellitus is a public health issue affecting an increasing number of workers, representing a disease exacerbated by work with a high social, economic, and personal cost. The nature of the work performed, coupled with occupational risks in a hospital setting, significantly contribute to the disease's progression. This study aims to address the impact of this disease on work and the role of Occupational Health in the prevention of exposure to occupational risk factors in the hospital environment, which can contribute to the metabolic imbalance of type I diabetes mellitus. Methodology: The methodology included search in PubMed, Science Direct, and Google Scholar databases, using keywords such as "diabetes mellitus, occupational medicine, risk factors and occupational health”. Filters were applied, considering publications from 2010 to 2024, totaling 463 works. Exclusion criteria focused on non-diabetes-related diseases, exclusive focus on Type II, and non-occupational approaches. Articles on diabetes and occupational health and safety published in Revista Portuguesa de Saúde Ocupacional were also considered, in a total of five studies. Sources also included Direção Geral de Saúde Clinical Guidance, a national epidemiological study, and a technical manual on workplace diabetes, totaling 30 references in the discussion. Results: The authors report two cases of healthcare professionals from a hospital unit, both diagnosed with Type I Diabetes at the age of five. Case 1: A 35-year-old healthcare assistant with a history of depressive syndrome and recent diabetic retinopathy diagnosis. Case 2: A 57-year-old nurse with diabetic retinopathy, nephropathy, neuropathy, undergoing treatment for osteomyelitis of the right big toe, without cardiovascular changes. In both they work or have worked in shifts, including night shifts, engaging in physically demanding tasks. Discussion/Conclusion: Diabetes is a chronic disease requiring continuous medical care and patient education, alongside support in preventing acute complications and reducing the risk of chronic complications. The incidence of new Type I Dm cases is higher between 12-14 years. During the transition to adulthood and entry into the job market, patients face disease stigma, treatment management challenges, and psychosocial workplace-related issues. Implementing preventive measures and monitoring these workers should help reduce work absenteeism, productivity loss, and income loss for the worker.

RESUMO Introdução: A Diabetes mellitus é um problema de Saúde Pública que afeta um número crescente de trabalhadores. Pode ser considerada uma doença agravada pelo trabalho com um elevado custo social, económico e pessoal. O tipo de trabalho realizado e as exposições a riscos laborais em contexto hospitalar, podem contribuir para a sua progressão, segundo alguns autores. Este trabalho pretende abordar o impacto desta patologia no trabalho e o papel da Saúde Ocupacional na evicção da exposição a fatores de risco laborais, em ambiente hospitalar, que contribuem para o descontrolo metabólico da Diabetes Melitus tipo I. Pretende-se identificar as exposições laborais que podem constituir fatores de risco modificáveis, interferem com a aptidão para o trabalho, podem aumentar a frequência de acidentes laborais e acelerar a progressão crónica da doença. Metodologia: Na metodologia de pesquisa e seleção de estudos utilizou as bases de dados PubMed, Science Direct e Google Scholar, com as palavras-chave “diabetes mellitus, occupational medicine, risk factors, occupational health”. Aplicaram-se filtros de revisão e revisão sistemática, considerando publicações de 2010 a 2024, totalizando 463 trabalhos. Critérios de exclusão incidiram em doenças não relacionadas à diabetes, exclusividade na tipo II e abordagens não ocupacionais. Foram ainda considerados os artigos sobre diabetes e saúde e segurança no trabalho publicados na Revista Portuguesa de Saúde Ocupacional, num total de cinco estudos. Incluíram-se a Norma de Orientação Clínica da DGS, um estudo epidemiológico nacional e um caderno técnico sobre diabetes no local de trabalho, totalizando 30 fontes na discussão. Descrição dos casos: Os autores reportam dois casos de profissionais de saúde de uma unidade hospitalar, ambos com diagnóstico de Diabetes tipo I aos cinco anos de idade. Caso 1: Uma auxiliar de ação médica de 35 anos, com antecedentes pessoais de síndrome depressivo e diagnóstico recente de retinopatia diabética. Caso 2: Uma enfermeira de 57 anos com retinopatia e nefropatia diabética, neuropatia, em tratamento para uma osteomielite do 1º dedo do pé direito, sem alterações cardiovasculares. Ambas trabalham ou trabalharam por turnos, com trabalho noturno e com tarefas fisicamente exigentes. Discussão/Conclusão: A diabetes é uma doença crónica que requer cuidados médicos contínuos e educação do doente, juntamente com apoio na prevenção de complicações agudas e redução do risco de complicações crónicas. A incidência de novos casos de Dm tipo I é maior entre os 12-14 anos. Na transição para a idade adulta e entrada no mercado laboral, os doentes podem ser sujeitos ao estigma da doença, ter dificuldade na gestão do tratamento e/ou desafios psicossociais relacionados com o trabalho. A instituição de medidas preventivas e monitorização destes trabalhadores deverá ajudar a reduzir o absentismo laboral, a perda de produtividade e a perda de rendimento para o trabalhador.

Abstract This article reviews the dermatological manifestations that frequently arise in endocrine disorders, encompassing conditions such as diabetes mellitus, acromegaly, polycystic ovary syndrome, hypothyroidism, Addison’s disease, among others. It explores the interactions between the endocrine system and the skin, highlighting how hormonal imbalances can result in a variety of skin symptoms. With a comprehensive approach, it offers important clinical insights for dermatologists and endocrinologists, aiming at a better understanding and an accurate diagnosis of these conditions.

Resumo Este artigo revisa as manifestações dermatológicas que frequentemente surgem em distúrbios endócrinos, abrangendo condições como diabetes mellitus, acromegalia, síndrome dos ovários policísticos, hipotireoidismo, doença de Addison, entre outras. Explora as interações entre o sistema endócrino e a pele, destacando como desequilíbrios hormonais podem resultar em uma variedade de sintomas cutâneos. Com uma abordagem abrangente, oferece insights clínicos importantes para dermatologistas e endocrinologistas, visando uma melhor compreensão e diagnóstico preciso dessas condições.

Abstract The authors performed a review to investigate if there are alterations in the skin microbiome among individuals with diabetes mellitus (DM) and to assess how these alterations may contribute to specific skin conditions and complications associated with this disease. On December 1st, 2023, searches on the PubMed® and ScienceDirect databases were conducted, using the Mesh Terms “skin microbiome” AND “DM”, limiting the results to those published in the last 10 years. The authors identified seven articles, including two reviews and five original research papers. Both type of papers revealed that individuals with DM exhibited significant less diversity in terms of microbial richness, with a notable colonization by Staphylococcus spp. In conclusion, the skin microbiome appears to be impaired in individuals with DM. However, more longitudinal studies are necessary to determine whether this impairment is a consequence of DM and to understand how it may interfere with DM complications.

Resumo Os autores pretendem esclarecer se existem alterações no microbioma cutâneo em pessoas com Diabetes Mellitus (DM), passíveis de predispor a patologia cutânea e complicações desta doença. As bases de dados PubMed® e ScienceDirect foram pesquisadas a 1 de dezembro de 2023, utilizando os Mesh Terms “skin microbiome” AND “diabetes mellitus”, limitando os resultados aos artigos publicados nos últimos 10 anos. Obtiveram-se 7 artigos, incluindo 2 revisões e 5 artigos de investigação original. Ambos os tipos de artigos revelaram que a pele das pessoas com DM apresenta uma diversidade microbiana significativamente menor, com uma forte colonização de Staphylococcus spp. Em conclusão, o microbioma da pele parece estar alterado nos indivíduos com DM Contudo, são necessários mais estudos longitudinais para compreender se esse comprometimento é consequência da DM e como pode interferir nas complicações da doença.

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02–1.04), male sex (OR 2.13; 95% CI 1.49–3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04–2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06–4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00–1.03), ICU admission (OR 1.81; 95% CI 1.04–3.16), and vasopressor support (OR 7.46; 95% CI 3.34–16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84–0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98–0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes. Introduction (AKI COVID19 COVID 19 COVID-1 identification prevention treatment Methods descriptive retrospective crosssectional, crosssectional cross sectional, sectional cross-sectional 31 202 out KDIGOAKI KDIGO guidelines Information records Results 93 4293 42 42.93 6059 60 59 60.59 KDIGO1, KDIGO1 1, KDIGO-1 99 9 9.9 therapy stay (ICU ventilation OR 1.03 103 03 95 1.02–1.04, 102104 1.02–1.04 , 02 04 1.02–1.04) 2.13 213 2 13 1.49–3.04, 149304 1.49–3.04 49 3 1.49–3.04) DM (DM 1.55 155 55 1.04–2.32, 104232 1.04–2.32 32 1.04–2.32) CKD (CKD 2.07 207 07 1.06–4.04, 106404 1.06–4.04 06 4 1.06–4.04) Creactive C reactive CRP (CRP 1.02 102 1.00–1.03, 100103 1.00–1.03 00 1.00–1.03) 1.81 181 81 1.04–3.16, 104316 1.04–3.16 16 1.04–3.16) 7.46 746 7 46 3.34–16.64 3341664 34 64 0.89 089 0 89 0.84–0.94 084094 84 94 oxygeninspired inspired 0.99 099 0.98–0.99 098099 98 Conclusions predictors outcomes COVID1 COVID- 20 429 42.9 605 6 5 60.5 KDIGO- 9. 1.0 10 10210 1.02–1.0 2.1 21 14930 1.49–3.0 1.5 15 10423 1.04–2.3 2.0 10640 1.06–4.0 10010 1.00–1.0 1.8 18 8 10431 1.04–3.1 7.4 74 3.34–16.6 334166 0.8 08 0.84–0.9 08409 0.9 09 0.98–0.9 09809 42. 60. 1. 1021 1.02–1. 2. 1493 1.49–3. 1042 1.04–2. 1064 1.06–4. 1001 1.00–1. 1043 1.04–3. 7. 3.34–16. 33416 0. 0.84–0. 0840 0.98–0. 0980 1.02–1 149 1.49–3 104 1.04–2 106 1.06–4 100 1.00–1 1.04–3 3.34–16 3341 0.84–0 084 0.98–0 098 1.02– 14 1.49– 1.04– 1.06– 1.00– 3.34–1 334 0.84– 0.98– 1.49 1.04 1.06 1.00 3.34– 33 0.84 0.98 1.4 3.34 3.3 3.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02–1,04), sexo masculino (OR 2,13; IC 95% 1,49–3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04–2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06–4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00–1,03), admissão em UTI (OR 1,81; IC 95% 1,04–3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34–16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84–0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98–0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos. Introdução (LRA COVID19 COVID 19 COVID-1 associase associa se identificação oportuno Métodos Realizouse Realizou descritivo retrospectivo º 3 dezembro 2020 Definiuse Definiu KDIGOLRA. KDIGOLRA KDIGO LRA. KDIGO-LRA eletrônicos Resultados 93 4293 42 42,93 6059 60 59 60,59 KDIGO1 1 KDIGO- 99 9 9,9 substitutiva internação UTIs OR 1,03 103 03 95 1,02–1,04, 102104 1,02–1,04 , 02 04 1,02–1,04) 2,13 213 2 13 1,49–3,04, 149304 1,49–3,04 49 1,49–3,04) DM (DM 1,55 155 55 1,04–2,32, 104232 1,04–2,32 32 1,04–2,32) DRC (DRC 2,07 207 07 1,06–4,04, 106404 1,06–4,04 06 4 1,06–4,04) PCR (PCR 1,02 102 1,00–1,03, 100103 1,00–1,03 00 1,00–1,03) 1,81 181 81 1,04–3,16 104316 16 7,46 746 7 46 3,34–16,64 3341664 34 64 0,89 089 0 89 0,84–0,94 084094 84 94 arterialfração arterial fração 0,99 099 0,98–0,99 098099 98 proteção Conclusões Documentouse Documentou COVID19, 19, preditores associouse associou desfechos COVID1 COVID- 202 429 42,9 605 6 5 60,5 9, 1,0 10 10210 1,02–1,0 2,1 21 14930 1,49–3,0 1,5 15 10423 1,04–2,3 2,0 20 10640 1,06–4,0 10010 1,00–1,0 1,8 18 8 1,04–3,1 10431 7,4 74 3,34–16,6 334166 0,8 08 0,84–0,9 08409 0,9 09 0,98–0,9 09809 42, 60, 1, 1021 1,02–1, 2, 1493 1,49–3, 1042 1,04–2, 1064 1,06–4, 1001 1,00–1, 1,04–3, 1043 7, 3,34–16, 33416 0, 0,84–0, 0840 0,98–0, 0980 1,02–1 149 1,49–3 104 1,04–2 106 1,06–4 100 1,00–1 1,04–3 3,34–16 3341 0,84–0 084 0,98–0 098 1,02– 14 1,49– 1,04– 1,06– 1,00– 3,34–1 334 0,84– 0,98– 1,49 1,04 1,06 1,00 3,34– 33 0,84 0,98 1,4 3,34 3,3 3,