Risco cardiovascular e constructo subjetivo de pacientes renais crônicos em hemodiálise

Abstract

INTRODUCTION: Chronic kidney disease (CKD) is a public health problem whose mortality is up to 20 times greater than that of the general population, with cardiovascular disease being the most common cause of death of the chronic kidney. The probability of possible cardiovascular events may be stratified by the Framingham Score that, based on clinical variables, obtain a percentage of CVD risk in the next 10 years. The CKD imposes on the individual beyond the increased cardiovascular risk, a series of changes in the physical, psychic and social aspects, besides a permanent treatment, it is necessary that the individual cultivate habits and attitudes that promote the conscience for the self-care. The self-care of the individual with chronic diseases can be measured from the PAM 13 construct, which allows the evaluation of the level of activation in self-care by means of self-reported questions. OBJECTIVE: To evaluate cardiovascular risk according to Framingham score, and the level of self-care activation, according to PAM 13 in individuals undergoing hemodialysis treatment. METHODOLOGY: This was a cross-sectional, analytical and exploratory study with a quantitative, correlational and comparative approach, performed with 145 individuals with terminal CKD who underwent hemodialysis in the period of September-December 2018. Sociodemographic and clinical data were collected and the Framingham score and subjective construct PAM 13. RESULTS: The most of the participants were male (52.41%), self-referred non-black (99.12%), living in Uberlândia (84.14%) and living without a partner (53.79%). There was a predominance of monthly gross family income less than 03 minimum wages (72.41%) and low schooling. The main causes of CKD were diabetic nephropathy and hypertensive nephrosclerosis. Regarding stratification of cardiovascular risk, 46.21% of patients had a low (<10%) risk for cardiovascular events in the next 10 years. In the evaluation of the level of activation that was not self-managed by PAM 13, predominated the very low level among patients (43.45%). CONCLUSION: Subjects with CKD on outpatient hemodialysis had a low risk for cardiovascular disease in 10 years according to Framingham score and activation level for low self-care management using the PAM13 construct, therefore, there was no correlation between the instruments used.