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      Caracterización de adolescentes trasplantados de riñón y en protocolo pretasplante en Cali, Colombia Translated title: Characterization of adolescent kidney transplant recipients and in pre-transplantation protocol in Cali, Colombia

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          Abstract

          RESUMEN Introducción: El paso del adolescente con trasplante renal del servicio de pediatría al de adulto se relaciona con aumento en el rechazo y pérdida del injerto renal. Identificar las características de esta población podría ayudar a la hora de poder implementar un proceso de transición adecuado. Objetivo: Identificar las principales características sociodemográficas de los adolescentes con trasplante renal o en protocolo pre-trasplante renal previo a la implementación del programa de transición (STARx). Material y Método: Estudio cuantitativo, descriptivo de corte transversal. Se incluyeron los pacientes entre 11-19 años del servicio de nefrología pediátrica de la Fundación Valle del Lili, obteniendo 31 participantes con trasplante renal y 4 en protocolo pre-trasplante. Una prueba piloto de la encuesta sociodemográfica se aplicó a otro grupo con salud similar. La encuesta fue diseñada específicamente para este estudio. Tras la obtención del consentimiento informado la encuesta fue ajustada y aplicada a la población objeto del estudio. Resultados: El 54% de los adolescentes eran de sexo masculino, el promedio de edad fue 14,3±2,3 años, 23% afrodescendientes, el 65% provenían del Valle del Cauca y el 35% de otros departamentos del suroccidente colombiano. El 65% pertenecían a un nivel socioeconómico. El 44% cursó primaria, 47% secundaria y 9% cursaba educación superior. La madre fue el cuidador principal en el 85% y el 63% de los cuidadores cursó algún grado de secundaria. La enfermedad renal de base fueron las malformaciones congénitas 57%, y el 89% calificó su estado de salud como bueno. Conclusiones: El conocimiento de las características de esta población resulta de gran utilidad para poder llevar a cabo un proceso de transición al pasar del seguimiento en consulta pediátrica a la de adulto.

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          ABSTRACT Introduction: The transference of the adolescent with a renal transplant from pediatric healthcare to adult healthcare has been related to an increased risk of graft rejection and graft loss. The evidence supports that an adequate transition program reduces the risk of graft rejection and improves clinical outcomes. Objective: Sociodemographic characterization of adolescents with a renal transplant or in pre-transplantation protocol previous to the implementation of a transition program (STARx). Material and Method: Quantitative, descriptive, and cross-sectional study. Patients aged 11 to 19 and registered in the service of pediatric nephrology were enrolled, obtaining 31 participants with a renal transplant and 4 participants in a pre-transplantation protocol. A pilot test of the sociodemographic survey was applied to a different group with a similar health condition. The survey was designed specifically for the study. Then, consent form was acquired and the survey was adjusted and applied to the target population. Results: 54% were male, the average age was 14.3 ±2.3 years, 23% were Afro-descendants, 65% came from the department of Valle del Cauca and 35% from other departments in the southwest of Colombia. The socioeconomic level was low in 65%. Regarding to schooling, 44% attended primary, 47% secondary and 9% attended higher education. The mother was the main caregiver in 85% and 63% of the caregivers attended some grade of secondary education. The underlying kidney disease was congenital anomalies of the kidney and urinary tract (CAKUT) in 57% and 89% rated their health as good. Conclusions: This study generated an appropriation of knowledge and compliance with treatment in adolescents, leading to the second phase of evaluation of the program in an oncoming study.

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          Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA).

          The transfer of young patients from pediatric to adult renal care takes place after a transition process which involves both sides. It is important that it is individualized for each young person, focusing on self-management skills as well as assessing support structures. The consensus statement has been developed by the panel of adult and pediatric nephrologists and endorsed by the councils of both ISN and IPNA. It is hoped that the statement will provide a basis for the development of locally appropriate recommendations for clinical practice.
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            Associations with Wellbeing and Medication Adherence in Young Adults Receiving Kidney Replacement Therapy

            Background and objectives Young adults receiving kidney replacement therapy (KRT) have impaired quality of life and may exhibit low medication adherence. We tested the hypothesis that wellbeing and medication adherence are associated with psychosocial factors. Design, setting, participants, & measurements We conducted a cross-sectional online survey for young adults on KRT. Additional clinical information was obtained from the UK Renal Registry. We compared outcomes by treatment modality using age- and sex-adjusted regression models, having applied survey weights to account for response bias by sex, ethnicity, and socioeconomic status. We used multivariable linear regression to examine psychosocial associations with scores on the Warwick–Edinburgh Mental Wellbeing Scale and the eight-item Morisky Medication Adherence Scale. Results We recruited 976 young adults and 64% responded to the survey; 417 (71%) with transplants and 173 (29%) on dialysis. Wellbeing was positively associated with extraversion, openness, independence, and social support, and negatively associated with neuroticism, negative body image, stigma, psychologic morbidity, and dialysis. Higher medication adherence was associated with living with parents, conscientiousness, physician access satisfaction, patient activation, age, and male sex, and lower adherence was associated with comorbidity, dialysis, education, ethnicity, and psychologic morbidity. Conclusions Wellbeing and medication adherence were both associated with psychologic morbidity in young adults. Dialysis treatment is associated with poorer wellbeing and medication adherence.
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              ESTILOS DE AFRONTAMIENTO Y CALIDAD DE VIDA EN PACIENTES CON INSUFICIENCIA RENAL CRÓNICA (IRC) EN TRATAMIENTO DE HEMODIÁLISIS

              El propósito de este estudio fue observar si los estilos de afrontamiento asumidos por un grupo de 41 pacientes con IRC guardan relación con su calidad de vida. Para ello, se utilizaron los instrumentos SF-36 y CAE. Se observó un deterioro importante en la calidad de vida de estos pacientes; no obstante, su funcionamiento social se encontró preservado. De acuerdo con los resultados, el afrontamiento focalizado en la solución de problemas correlacionó positivamente con salud mental, mientras que la auto-focalización negativa se asoció inversamente con la mayoría de las dimensiones de calidad de vida evaluadas. La evitación y la religiosidad, como estilos de atontamiento, presentaron resultados distintos a los hallados por otros autores. Se discuten las implicaciones de estos hallazgos.
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                Author and article information

                Journal
                enefro
                Enfermería Nefrológica
                Enferm Nefrol
                Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                2254-2884
                2255-3517
                June 2022
                : 25
                : 2
                : 133-139
                Affiliations
                [2] Cali orgnameFundación Valle del Lili orgdiv1Centro de Investigaciones Clínicas Colombia
                [5] Mount Laurel orgnameInternational Pediatric Transplant Association orgdiv1Outreach Program EE.UU.
                [4] Bruselas orgnameInternational Society of Nephrology orgdiv1Sister Renal Center Program Bélgica
                [3] Cali orgnameFundación Valle del Lili orgdiv1Servicio de nefrología pediátrica y trasplantes Colombia
                [6] Cali Valle del Cauca orgnameUniversidad Icesi orgdiv1Facultad de Ciencias de la Salud Colombia
                [1] orgnameUniversidad del Valle Cali orgdiv1Escuela de Enfermería Colombia
                Article
                S2254-28842022000200133 S2254-2884(22)02500200133
                10.37551/52254-28842022014
                63004d25-6498-4397-bf55-9632e853c37d

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 March 2022
                : 14 February 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 7
                Product

                SciELO Spain

                Categories
                Originales

                enfermedad renal crónica,transition,renal transplantation,chronic kidney disease,adolescence,transición,trasplante renal,adolescencia

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