Construction and Validation of a Bundle for Screening and Diagnosis of Posttransplant Diabetes Mellitus in Kidney Transplant Recipients

Tamizia Cristino Severo de Souza; Ivelise Regina Canito Brasil; Tainá Veras de Sandes Freitas; Elias Bruno Coelho Gouveia; Francisca Christina Silva Rabelo; Cristina Micheletto Dallago

Autores

Tamizia Cristino Severo de Souza Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brasil. https://orcid.org/0009-0003-7081-9222
Ivelise Regina Canito Brasil Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brasil. https://orcid.org/0000-0002-8440-0911
Tainá Veras de Sandes Freitas Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brasil. https://orcid.org/0000-0002-4435-0614
Elias Bruno Coelho Gouveia Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brasil. https://orcid.org/0000-0003-1884-3674
Francisca Christina Silva Rabelo Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brazil. https://orcid.org/0000-0001-7221-7274
Cristina Micheletto Dallago Universidade Estadual do Ceará – Centro de Ciências da Saúde – Mestrado Profissional em Transplante – Fortaleza (CE) – Brasil. https://orcid.org/0000-0002-7151-9681

Palavras-chave:

Diabetes Mellitus Pós-Transplante, Transplante Renal, Diagnóstico, Protocolos Clínicos, Estudo de Validação

Resumo

Introdução: O diabetes mellitus pós-transplante (DMPT) é uma possível complicação do transplante renal (TR), e sua detecção precoce tem um impacto favorável na sobrevida do paciente e na preservação do enxerto. Apesar de os critérios diagnósticos para DMPT permanecerem os mesmos da população em geral, a acurácia dos testes muda em receptores de TR, e sua detecção é subestimada quando a glicemia de jejum (GJ) é usada isoladamente para triagem. Objetivos: Nosso objetivo foi construir e validar um pacote de cuidados para triagem e diagnóstico de DMPT em receptores de TR. Métodos: As seguintes etapas foram realizadas: a) revisão da literatura; b) elaboração do pacote; e c) validação de conteúdo por juízes especialistas. A revisão integrativa foi considerada um auxílio na construção do pacote. Analisamos as avaliações dos especialistas usando o índice de validade de conteúdo (IVC). O teste binomial foi realizado para avaliar a concordância dos juízes. Resultados: O pacote foi estruturado para fornecer informações sobre: 1) qual(is) teste(s) solicitar; 2) quando solicitá-los para melhor diferenciação entre DMPT e hiperglicemia transitória; e 3) para quem solicitar exames adicionais além da GJ. Todos os itens foram considerados validados, com IVC geral de 0,99. Conclusão: O pacote foi considerado válido para facilitar a tomada de decisão do médico na condução do rastreamento e diagnóstico de DMPT em receptores de transplante renal de forma prática e eficaz. Recomendamos a incorporação dessa ferramenta ao cuidado médico, considerando sua fácil aplicabilidade, baixo custo e potencial para contribuir para o manejo desses pacientes.

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