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Vol. 52. Núm. 9.
Páginas 527-532 (Noviembre 2005)
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Vol. 52. Núm. 9.
Páginas 527-532 (Noviembre 2005)
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Incidencia de insuficiencia renal terminal por nefropatía diabética
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E. Esmatjes??
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esmatjes@Clinic.ub.es

Correspondencia: E. Esmatjes. Servei de Endocrinologia. Hospital Clínic. Villarroel, 170. 08036 Barcelona. España.
Servicio de Endocrinología. Unidad de Diabetes. Hospital Clínic i Universitari. IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer). Facultad de Medicina. Universidad de Barcelona. Barcelona. España
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Si analizamos lo sucedido en Europa desde la Declaración de Sant Vincent sobre la base de las cifras del registro de la European Renal Association-European Dialysis and Transplant Association probablemente tengamos que concluir que, en relación con la nefropatía diabética (ND), no se han alcanzado los objetivos postulados. Sin embargo, esta manera de enfocar el problema puede requerir matizaciones. No sabemos exactamente qué quiere decir el aumento registrado de nuevos casos de insuficiencia renal terminal por ND. Por otro lado, es innegable que la calidad asistencial relacionada con el manejo de estos pacientes ha mejorado. Su diagnóstico es más precoz, se han introducido nuevos fármacos para tratar de forma más eficaz la hiperglucemia y la hipertensión y se ha generalizado entre los profesionales que tartan personas con ND la idea de conseguir objetivos terapéuticos reglados y con eficacia probada sobre su evolución. Sin duda, para conocer si estamos avanzando en la prevención y el tratamiento de la ND es fundamental repetir de forma periódica estudios en los que se analicen marcadores de calidad asistencial influenciables por nuestra práctica médica. Probablemente el esfuerzo hecho podría haber sido mayor, y no podemos contentarnos con los resultados alcanzados, pero tampoco podemos caer en el derrotismo de pensar que nada ha cambiado desde la Declaración de Sant Vincent.

If we analyze what has happened in Europe since the Declaration of Sant Vincent, then, based on the numbers in the registry of the European Renal Association-European Dialysis and Transplant Association, we would probably have to conclude that, in relation to diabetic rephropathy (ND), the objectives proposed have not been achieved. However, the way this problem has been focused requires some reflections. We do not know what exactly the increase in new cases of terminal renal insufficiency due to ND means. On the other hand, it cannot be denied that the quality of health care related to the management of these patients has improved. Diagnosis is achieved earlier, new drugs have been introduced for more effective treatment of hyperglycemia and hypertension and the idea of obtaining regulated therapeutic objectives with proven efficacy on evolution has now become generalized among the professionals treating patients with ND. In order to know whether advances in the prevention and treatment of ND have, indeed, been achieved, it is undoubtedly essential to periodically repeat studies which have analyzed markers of healthcare quality which may be influenced by our medical practice. The efforts made could probably have been greater and we should not be satisfied with the reported. results On the other hand, neither can we be pessimistic and think that nothing has changed since the Declaration of Sant Vincent.

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