{"id":42806,"date":"2018-03-09T09:44:53","date_gmt":"2018-03-09T09:44:53","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/hiponatremia-dilucional-en-pacientes-con-cirrosis-hepatica-y-ascitis\/"},"modified":"2018-03-09T09:44:53","modified_gmt":"2018-03-09T09:44:53","slug":"hiponatremia-dilucional-en-pacientes-con-cirrosis-hepatica-y-ascitis","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/hiponatremia-dilucional-en-pacientes-con-cirrosis-hepatica-y-ascitis\/","title":{"rendered":"Hiponatremia dilucional en pacientes con cirrosis hepatica y ascitis."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Almudena Porcel Mart\u00edn <\/strong><\/h2>\n<p>Objetivos  analizar la preValencia de la hiponatremia dilucional (hd) entre los cirr\u00f3ticos ingresados, los factores relacionados con su desarrollo, las caracter\u00edsticas cl\u00ednicas, las modificaciones entre los sistemas vasoactivos y la evoluci\u00f3n de estos enfermos. Adem\u00e1s, se evalu\u00f3 la reversibilidad de la hd tras la infusi\u00f3n de seroalb\u00famina.  pacientes y m\u00e9todo  entre junio y noviembre de 1997, 155 cirr\u00f3ticos con ascitis infresaron en el servicio de digestivo del h. Puerta del mar. Fueron selecionados aqu\u00e9llos que presentaron de una forma consecutiva hd (natremia &lt;130 meg\/l. tras 5 d\u00edas con dieta hipos\u00f3dica y sin diur\u00e9ticos). Adem\u00e1s fueron seleccionados 16 cirr\u00f3ticos ingresados con ascitis sin hg (grupo control). Se infund\u00f3 alb\u00famina (40 gr\/d\u00edas, durante 5 d\u00edas), adem\u00e1s de restricci\u00f3n h\u00eddrica a 7 pacientes con hd.  resultados  1,- presentaron hd 54 pacientes (preValencia 34,8%)  2,- el grupo con hd present\u00f3 significativamente:  a,- un mayor porcentaje de pacientes con tama\u00f1o hep\u00e1tico reducido y con episodios previos de ascitis.  b,- mayores concentraciones plasm\u00e1ticas de urea, creatinina, renina y aldosterona.  c,- menores diuresis y natriuresis.  3,- 27 pacientes (50%) desarrollaron hd tras un factor precipitante agudo (hd-fp), hemorragia digestiva por hipertensi\u00f3n portal o infecci\u00f3n bacteriana, en ellos la hd se resolvi\u00f3 en el 67%, mientras que no se resolvi\u00f3 en ninguno del grupo con hd sin fp (27 pacientes). Hubo un mayor desarrollo de s\u00edndrome hepatorrenal en ambos grupos con hiponatremia comparados con el grupo control. La mortalidad fue mayor (93%) en aqu\u00e9llos  con hd espont\u00e1nea que en los pacientes con h_d-fp (44%) y los controles (25%), con un tiempo medio hasta la muerte en los primeros de aproximadamente 4 meses.  4,- la infusi\u00f3n de seroalb\u00famina en los 7 cirr\u00f3ticos con hd sin otra descompensaci\u00f3n asociada produjo un aumento signficativo de la natremia, asociado a un descenso en<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Hiponatremia dilucional en pacientes con cirrosis hepatica y ascitis.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Hiponatremia dilucional en pacientes con cirrosis hepatica y ascitis. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Almudena Porcel Mart\u00edn <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 C\u00e1diz<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 22\/03\/1999<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jos\u00e9 Antonio Gir\u00f3n Gonz\u00e1lez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: avelino Senra varela <\/li>\n<li>Manuel Macias rodriguez (vocal)<\/li>\n<li>gonzalo Mi\u00f1o fugarolas (vocal)<\/li>\n<li>Luis Manzano espinosa (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Almudena Porcel Mart\u00edn Objetivos analizar la preValencia de la hiponatremia dilucional (hd) entre los cirr\u00f3ticos ingresados, los [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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