Uludağ Üniversitesi'nin Erişkin Periton Diyalizi Deneyimi

Year 2023, Volume: 49 Issue: 3, 319 - 323, 31.12.2023

Esra Nur Bülbül Ayşegül Oruç Mahmut Yavuz

https://doi.org/10.32708/uutfd.1360585

Abstract

Renal replasman tedavisi (RRT), son dönem böbrek yetmezliği olan hastalarda yaygın olarak kullanılmaktadır. Periton diyalizi (PD), bir kateter aracılığıyla glukoz solüsyonunun periton boşluğuna verilerek belirli periyotlar halinde periton boşluğunda bekletilip boşaltılmasıyla uygulanır. Çalışmamızda Uludağ Üniversitesi'nde PD tedavisi uygulanan hastaların tüm klinik ve demografik özelliklerini (etyolojik nedenleri, böbrek nakli veya hemodiyaliz (HD) öyküsü, PD tedavi modaliteleri ve süresi, hepatit serolojisi, kateter enfeksiyonu ve peritonit öyküsü) araştırmayı amaçladık. Çalışmaya 99 erişkin hasta dahil edildi. Hastaların yaş ortalaması 41,77 yıl olup çoğunluğu erkek idi. PD ortalama tedavi süresi 92,12 aydı. Hastaların 35'inin aletli periton diyalizi (APD), 43'ünün sürekli ayaktan periton diyalizi (SAPD), 21'inin ise tedavi süreci boyunca her iki modaliteyi de uyguladıkları saptandı. APD uygulanan hastalarda tedavi süresinin daha uzun ve peritonit sıklığının daha fazla olduğu saptandı. Hastaların %26,3'ünde kronik böbrek hastalığının altta yatan nedeni saptanmazken, %16,2 sıklıkta glomerülonefrit ve bunu %12 sıklıkta hipertansiyon ve ürolojik nedenlerin izlediği gözlendi. Hastaların %65,9'unda gram pozitif bakterilerin neden olduğu peritonit saptandı ve en sık görülen patojen, koagülaz negatif Stafilokoklardı. Sonuç olarak, merkezimizde PD tedavisi halen uygulanmakta olup modalite seçimi ve RRT seçeneklerinin değişimi açısından enfeksiyonlar temel sorunlardan biri olarak görünmektedir.

Keywords

kronik böbrek hastalığı, periton diyalizi, renal replasman tedavisi

Uludağ University's Experience of Peritoneal Dialysis in Adults

Abstract

Renal replacement therapy (RRT) is commonly used in patients with end-stage renal disease. Peritoneal dialysis (PD) is used by administration of glucose solution into the peritoneal cavity through a catheter and keeping it in the peritoneal cavity for certain periods. We aimed to investigate the whole clinical and demographical features (etiological causes, history of kidney transplantation or hemodialysis, PD treatment modalities and duration, hepatitis serology, experience of catheter infection and peritonitis) of the patients under PD treatment at Uludag University. 99 adult patients were included in this study. The average age of the patients was 41.77 years and the majority of patients were male. The average duration of PD treatment was 92.12 months. It was determined that 35 of the patients used automated peritoneal dialysis (APD), 43 of them used continuous ambulatory peritoneal dialysis (CAPD), and 21 of them used both modalities. It was found that the treatment duration was longer and the frequency of peritonitis was higher in patients undergoing APD. There was not any underlying cause of chronic kidney disease in 26.3% of the patients, however glomerulonephritis was observed with a frequency of 16.2% and followed by hypertension and urological causes with a frequency of 12%. Peritonitis with gram-positive bacteria was determined in the 65.9% of patients and the most common pathogen was coagulase-negative Staphylococci. In conclusion, PD treatment is still applied in our center and infections seem to be one of the main problem in terms of modality selection and exchange of RRT options.

Keywords

chronic kidney disease, peritoneal dialysis, renal replacement therapy

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