Abstract

OTERO, Luis Mariano; MUNOZ, Alvaro  and  FIGUEROA, Lunevar. Impact of moderating model of the risk in the chronic renal disease. IPS COMFANDI, Cali, 2006. Colomb. Med. [online]. 2007, vol.38, n.3, pp.274-281. ISSN 1657-9534.

Objective: To assess if a health care model implemented at the basic level of the IPS COMFANDI and based on an early intervention in cardiovascular risk factors and its application to patients with different levels of chronic renal disease, produces significant changes in lab and clinical parameters to be translated into stabilization or regression of the disease. Materials and methods: From the cardiovascular risk program 362 patients were randomly selected with different stages of renal disease, diabetes mellitus (DM), and arterial hypertension, (AHT). Two measurements were made: one before and another after the intervention, with an interval of six months. Wilcoxon hypotheses were tested to compare means of clinical interest and lab variables as well as dynamics of change in the number of patients according to KDOQUI stage, for both periods. Results: A total of 8 factors were evaluated: 4 clinical and 4 lab parameters, as well as patients’ proportion according to nephropathy stage (KADOQUI) found in the two periods. Clinical variables were measured for 24 hours such as systolic, diastolic and mean blood pressure and proteinuria which showed differences before and after the intervention that were statistically significant. BMI (body mass index), glycemia and microalbuminuria did not present statistically significant differences for the two measurements. Conclusion: Implementation of a basic level health care model focused on risk reduction for renal chronic disease, by means of an intensive therapy, has also an affirmative incidence on diseases such as diabetes and hypertension. Results are favorable when measuring key variables in renal chronic disease and suggest a positive impact regarding this important public health problem in Colombia.

Keywords : Primary prevention; Natural history of the disease; Testing hypothesis; Regression; Stabilization; Epidemiological transition.

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