Lupus eritematoso sistémico y Enfermedad Renal Crónica bajo tratamiento dialítico: Presentación de un caso

Abstract

Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune pathology characterized by the production of autoantibodies that lead to severe organ damage, with lupus nephritis being the main responsible for the progression to terminal Chronic Kidney Disease (CKD). The objective of this study is to analyze the process of comprehensive clinical care and stabilization in a 24-year-old male patient with SLE and stage 5 CKD on triweekly hemodialysis, who was admitted to the emergency department of the Manabita hospital with severe metabolic decompensation. The methodology used corresponds to a descriptive and qualitative clinical case study, structured under the Nursing Care Process (PAE) using the NANDA-I, NOC and NIC taxonomies. The results showed an anuric patient with critical hyperkalemia (potassium 6.5 mEq/L), secondary arterial hypertension, fluid overload (edema ++), fever and an active infectious/inflammatory focus (CRP 87.91 mg/L). The prioritized emergency interventions included the administration of 10% calcium gluconate, nebulizations with salbutamol, antibiotic therapy adjusted to renal function and immediate preparation for rescue hemodialysis. After the execution of the care plan, electrocardiography stabilization, the decrease of serum potassium to safe values (