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Nuevos consensos y lineamientos del Gobierno para el tratamiento de HPN, MAT y enfermedad renal crónica en Colombia: avances clave para el sector salud
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En el reciente evento Avances y Decisiones en Hemoglobinuria Paroxística Nocturna, Microangiopatías Trombóticas y Enfermedad Renal Crónica: Nuevos Consensos Colombianos y Lineamientos de Gobierno, se presentaron las últimas actualizaciones clínicas, consensos diagnósticos y de tratamiento, así como las políticas públicas para fortalecer el abordaje integral de estas patologías en Colombia.
Este encuentro, de gran relevancia para el sector salud colombiano, permitió analizar los desafíos y avances en la atención de pacientes con enfermedades hematológicas y renales complejas, promoviendo la adopción de prácticas basadas en evidencia científica y alineadas con las prioridades del sistema sanitario nacional.
Consenso hemoglobinuria paroxística nocturna (HPN)
El Dr. Jheremy Reyes inició el evento con una detallada presentación sobre el Consenso Hemoglobinuria Paroxística Nocturna (HPN), resaltando aspectos epidemiológicos y clínicos clave. En Colombia, se estima que hay un subregistro importante, pero reportes recientes indican la presencia de casos diagnosticados que requieren atención especializada. La HPN es una enfermedad rara caracterizada por hemólisis intravascular, trombosis y complicaciones hematológicas severas.
El Dr. Reyes explicó los criterios diagnósticos actuales, basados en la detección de la ausencia o reducción de los anclajes GPI en células hematopoyéticas, usando citometría de flujo como estándar de oro. También enfatizó la importancia de un diagnóstico temprano para evitar complicaciones graves como trombosis venosa, que es la principal causa de mortalidad en estos pacientes.
Se discutieron las opciones terapéuticas disponibles y en desarrollo en Colombia, haciendo énfasis en la necesidad de fortalecer el acceso a terapias innovadoras y la implementación de protocolos nacionales que permitan un seguimiento integral de los pacientes.
Consenso internacional de diagnóstico y manejo de microangiopatías trombóticas primarias (MAT)
El Dr. Camilo Montero, experto nacional en hematología, presentó el consenso internacional actualizado sobre diagnóstico y manejo de Microangiopatías Trombóticas Primarias (MAT). Se trata de un grupo heterogéneo de enfermedades caracterizadas por microangiopatía hemolítica, trombocitopenia y daño orgánico.
Durante su exposición, el Dr. Montero destacó la importancia de diferenciar MAT primaria de secundaria, enfatizando que la adecuada caracterización permite definir el tratamiento más apropiado y mejorar el pronóstico. En Colombia, la incidencia es baja pero significativa para la práctica clínica, y existe la necesidad de fortalecer la vigilancia epidemiológica.
Se enfatizó el papel del diagnóstico rápido mediante pruebas específicas, y la implementación de terapias dirigidas basadas en la fisiopatología de cada subtipo, lo cual debe acompañarse de una atención multidisciplinaria que incluya hematólogos, nefrólogos y otros especialistas.
Lineamientos para la implementación de acciones para la prevención y control de enfermedades cardiovasculares, metabólicas y enfermedad renal crónica (ERC)
El Dr. José Javier Arango abordó las estrategias y lineamientos para la prevención y control de enfermedades cardiovasculares, metabólicas y la enfermedad renal crónica en Colombia, patologías de alta carga epidemiológica y mortalidad.
Explicó que las enfermedades renales crónicas afectan a un porcentaje significativo de la población adulta, con factores de riesgo predominantes como hipertensión arterial (HTA) y diabetes mellitus (DM). Señaló que la prevención secundaria y la detección temprana son fundamentales para disminuir la progresión a etapas avanzadas de ERC.
El Dr. Arango presentó lineamientos que promueven la educación al paciente, el control estricto de HTA y DM, y la integración de programas comunitarios para seguimiento y adherencia terapéutica. Asimismo, destacó la necesidad de políticas públicas que garanticen el acceso a servicios especializados y medicamentos esenciales.
Actualización del consenso basado en evidencia sobre hipertensión arterial (HTA), diabetes mellitus (DM) y enfermedad renal crónica (ERC)
El Dr. Carlos Hernán Mejía cerró el ciclo de conferencias con una actualización basada en la evidencia sobre HTA, DM y ERC, enfatizando los avances en terapias y recomendaciones internacionales que impactan directamente en la práctica clínica en Colombia.
Presentó datos recientes que muestran que el control adecuado de HTA y DM puede reducir hasta en un 30% la progresión a ERC avanzada y disminuir eventos cardiovasculares asociados. Explicó las nuevas guías internacionales que recomiendan terapias personalizadas, incluyendo el uso de inhibidores SGLT2 y bloqueadores del receptor de mineralocorticoides en pacientes seleccionados, aportando beneficios renales y cardiovasculares.
El Dr. Mejía destacó que la implementación de estos lineamientos en el contexto colombiano requiere una alineación entre el sistema de salud, los profesionales y los pacientes, para lograr resultados efectivos a nivel poblacional.
Avanzando hacia un abordaje integral en Colombia
Este evento evidenció la necesidad urgente de fortalecer la coordinación entre especialistas, instituciones y entidades de salud para mejorar el diagnóstico, tratamiento y seguimiento de pacientes con enfermedades hematológicas y renales complejas. Los consensos presentados reflejan un esfuerzo conjunto para adaptar el conocimiento científico internacional a la realidad colombiana, garantizando el acceso a terapias innovadoras y el desarrollo de políticas públicas eficaces.
La integración de estos lineamientos permitirá optimizar la atención, reducir complicaciones y mejorar la calidad de vida de miles de pacientes, alineándose con los objetivos del sistema de salud nacional en materia de equidad, eficiencia y sostenibilidad.
Así mismo, se realizaron dos espacios de discusión en la mañana con los conferencistas Dr. Jheremy Reyes y Dr. Camilo Montero, quienes profundizaron en sus respectivas áreas de especialización. En estos espacios, se abordaron temas claves sobre los consensos diagnósticos y las opciones terapéuticas para las enfermedades tratadas en el evento, lo que permitió un enriquecedor intercambio de ideas y experiencias prácticas.
Al final de la jornada, se llevó a cabo una sesión de preguntas y conversación entre el Dr. Carlos Mejía y el Dr. José Javier Arango. Durante esta sesión, se discutieron las implicaciones de los lineamientos propuestos y se aclararon dudas sobre la implementación de las políticas en el contexto colombiano. También se resaltaron algunos desafíos clave, como la necesidad de mejorar la detección temprana y el acceso a tratamientos innovadores, a pesar de las barreras económicas y logísticas.
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