Periton Diyalizine Yeni Başlayan Hastaların Retrospektif Değerlendirmesi

Yıl 2018, Cilt: 13 Sayı: 2, 45 - 54, 20.07.2018

Gülay Bingöl Eylem Topbaş Öznur Görgen Nimet Ferahoğlu Lale Akkaya

Öz

Amaç:

Periton
diyalizine 2016-2017 yılları arasında yeni başlayan hastaların periton
diyalizine ilişkin durumlarının incelenmesidir.

Gereç
ve Yöntemler:

Araştırmanın
evrenini Amasya (n=12) ve Sivas (n=16)’ta yer alan periton diyaliz ünitesindeki
hastalar, örneklemini ise 2016-2017 yılında PD’ye yeni başlayan hastalar (n=17)
oluşturdu.  Veriler Türk Nefroloji,
Diyaliz ve Transplantasyon Derneği Registry raporu rehber alınarak hazırlanan
“PD hasta değerlendirme formu” aracılığıyla retrospektif olarak elde edildi.

Bulgular:

Son iki yılda PD
tedavisine yeni başlayan merkezde 12 hasta, 20 yıldır PD uygulayan üniversitede
ise 5 hastaya PD kateteri takılmıştır. Hastaların %41.1’inin etiyolojisinin
diyabetik nefropati olduğu, %52.9’unun membran tipinin düşük-orta geçirgenlikte
olduğu, %70.5’inin Kt/V üre değerinin 2’nin üstünde olduğu, %76.4’sinin serum
albumin değerinin 3.5-4 aralığında olduğu, %41.1’inin tansiyonun normal
sınırlarda olduğu, %52.9’unun kalsiyum kanal blokeri kullandığı, %70.5’inin Hb
değeri 10.0-11.9gr/dl olduğu saptandı. Hastaların %94.1’inin demir ilacı
kullanmadığı, %52.9’ünün eritropoetin kullandığı, %35.2’si ise halen
kullanmakta idi.  %52.9’ünün serum
fosforunun 4.5-5.49 mg/dl, %41.17’sinin PTH düzeyi 301-600 pg/ml arasında
olduğu, hiçbir hastada kırık gelişmediği saptandı. Hastaların peritonit
geçirmediği ve %47’inin ultrafiltrasyon sorunu yaşadığı,  %11.76’sının mekanik komplikasyon nedeniyle
hemodiyalize transfer olduğu saptandı. 
Hastaların kontrole geldiklerinde sıklıkla yakınmaları iştahsızlık,
bulantı kusma, ödem ve halsizlikdi. Hemşireyi telefonla arama nedenlerinin
sıklıkla drenaja yönelik problemler, oral ilaç kullanımı, PD makinası ve
kateter ile ilgili sorunlardı.

Sonuç:PD
hastalarında hipoalbunimeni, hiperfostatemi, anemi, bulaşıcı hastalık, kırık ve
peritonit gibi ciddi komplikasyonlar gelişmediği saptandı.Bu durum periton
diyaliz tedavisini avantajlı kılmaktadır.

Anahtar Kelimeler

Periton diyalizi, Periyon diyaliz etiyolojisi

Kaynakça

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