Diyabetik Kronik Böbrek Hastalığında Akut Koroner Sendrom Yönetimi: Hipoglisemiden Miyokard İnfarktüsüne Bir Olgu Sunumu

Abstract

Dünyada yaygın bir metabolik rahatsızlık olan diabetes mellitus gün geçtikçe artış göstermektedir. Diabetes mellitus varlığı böbrek fonksiyonlarının bozulmasında önemli bir etkendir ve kronik böbrek hastalığı olan diyabetli sayısı da gün geçtikçe artmaktadır. Gelişmiş ülkelerin çoğunda, tip 2 diabetes mellitus son dönem böbrek hastalığının önde gelen nedeni olmakla birlikte kardiyovasküler hastalıklara da neden olmaktadır. Kardiyovasküler hastalıklar ve eşlik eden kronik böbrek hastalığı varlığında hastalar daha az girişimsel ve farmakolojik tedavi almaktadır. Ayrıca bu hastalar normal böbrek fonksiyonu olan hastalara göre daha kötü prognoza sahiptir. Bu nedenle ST yükselmesiz miyokard infarktüsü tanısı olan diyabetik kronik böbrek hastalığı olgusu, Marjory Gordon’un Fonksiyonel Sağlık Örüntüleri Hemşirelik Bakım Modeli ile değerlendirilmiştir.

Keywords

• Akut koroner sendrom
• diabetes mellitus
• hemşirelik
• kronik böbrek hastalığı

ACUTE CORONARY SYNDROME MANAGEMENT IN DIABETIC CHRONIC KIDNEY DISEASE: A CASE REPORT FROM HYPOGLYCEMIA TO MYOCARDIAL INFARCTION

Abstract

Diabetes Mellitus, a prevalent metabolic disorder globally, is steadily on the rise. The presence of diabetes mellitus substantially exacerbates the decline in kidney functions, and the incidence of chronic kidney disease among individuals with diabetes is steadily increasing. In the majority of developed nations, type 2 diabetes mellitus is the primary cause of end-stage renal disease, concurrently playing a significant role in the prevalence of cardiovascular diseases. In the presence of cardiovascular diseases with a concurrent chronic kidney disease, patients often undergo less invasive and pharmacological treatments. Moreover, their prognosis tends to be poorer compared to individuals with normal renal function. Consequently, this study examines a case of diabetic chronic kidney disease diagnosed with non-ST elevation myocardial infarction, employing Marjory Gordon's Functional Health Patterns Nursing Care Model for evaluation.

Keywords

• Acute coronary syndrome
• diabetes mellitus
• nursing
• chronic kidney disease

References

1. 1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. https://doi.org/10.1016/j.diabres.2021.109119.
2. 2. World Health Organization. Diabetes [Internet]. 2023 [cited 2023 Dec 08]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes.
3. 3. Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The global epidemiology of diabetes and kidney disease. AKDH. 2018;25(2):121-32 https://doi.org/10.1053/j.ackd.2017.10.011.
4. 4. Güngör Ö, Ulu MS, Arıkan H, Kutlay S, Arıcı M, Altun B, ve ark. Diyabetik Böbrek Hastalarında Hipergliseminin İlaçlarla Yönetimi: Türk Nefroloji Derneği Uzman Görüşü Raporu 2020 [Internet]. 2020 [cited 2023 Dec 08]. Available from: https://nefroloji.org.tr/uploads/pdf/TND_Diyabetik_Bobrek_Hiperglisemi_Yoonetimi_Raporu_2020.pdf.
5. 5. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709–33. https://doi.org/10.1016/S0140-6736(20)30045-3.
6. 6. Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan R. A, Antunes MJ, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes: Developed by the task force on the management of cardiovascular disease in patients with diabetes of the European Society of Cardiology (ESC). European Heart Journal. 2023;44(39): 4043-140. https://doi.org/10.1093/eurheartj/ehad192.
7. 7. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal. 2023;44(38):3720-826. https://doi.org/10.1093/eurheartj/ehad191.
8. 8. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736–88. https://doi.org/10.1016/s0140-6736(18)32203-7.

9. 9. Szummer K, Lundman P, Jacobson SH, Schön S, Lindbäck J, Stenestrand U, et al. Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome: data from the SWEDEHEART register. J Intern Med. 2010;268:40–9. https://doi.org/10.1111/j.1365-2796.2009.02204.x.
10. 10. Huang HD, Alam M, Hamzeh I, Virani S, Deswal A, Aguilar D, et al. Patients with severe chronic kidney disease benefit from early revascularization after acute coronary syndrome. Int J Cardiol. 2013;168:3741–6. https://doi.org/10.1016/ j.ijcard.2013.06.013.
11. 11. Gordon M. Fonksiyonel sağlık örüntüleri ve klinik karar verme. İçinde: Erdemir F, Yılmaz E, editör. Hemşirelik Sınıflama Sistemleri, Klinik Uygulama, Eğitim, Araştırma ve Yönetimde Kullanımı. 1. Baskı. Başkent Üniversitesi Basın Yayın Halkla İlişkiler Bürosu Ankara; 2003;87-93.
12. 12. Suzuki T, Agarwal SK, Deo R, Sotoodehnia N, Grams ME, Selvin E, et al. Kidney function and sudden cardiac death in the community: the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2016;180:46–53. https://doi.org/10.1016/ j.ahj.2016.07.004.
13. 13. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2017;7:1–59. https://doi.org/10.1016/j.kisu.2017.04.001.
14. 14. Fu R, Li S-D, Song C-X, Yang J-A, Xu H-Y, Gao X-J, et al. Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction–an analysis from China Acute Myocardial Infarction (CAMI) registry. J Geriatr Cardiol. 2019;16:395–400. https://doi.org/10.11909/j.issn.1671-5411.2019.05.002.
15. 15. Fanning JP, Nyong J, Scott IA, Aroney CN, Walters DL. Routine invasive strategies versus selective invasive strategies for unstable angina and non-ST elevation myocardial infarction in the stent era. Cochrane Database Syst Rev. 2016;2016:CD004815. https://doi.org/10.1002/14651858.CD004815.pub4.
16. 16. Elgendy IY, Mahmoud AN, Wen X, Bavry AA. Meta-analysis of randomized trials of long-term all-cause mortality in patients with non-ST-elevation acute coronary syndrome managed with routine invasive versus selective invasive strategies. Am J Cardiol. 2017;119:560–4. https://doi.org/10.1016/j.amjcard.2016.11.005.
17. 17. Panchal HB, Zheng S, Devani K, White CJ, Leinaar EF, Mukherjee D, et al. Impact of chronic kidney disease on revascularization and outcomes in patients with ST-elevation myocardial infarction. Am J Cardiol. 2021;150:15–23. https://doi.org/10.1016/j.amjcard.2021.03.057635.
18. 18. Bülbül E, Çelik S. Kontrast madde nefropatisi ve hemşirelik girişimleri. Nefroloji Hemşireliği Dergisi. 2019;14(3):111-9. https://dergipark.org.tr/tr/download/article-file/818878.
19. 19. Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, et al. Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry. JACC: Cardiovascular Interventions. 2014;7(1):1-9. http://dx.doi.org/10.1016/j.jcin.2013.06.016.
20. 20. Bangalore S, Briguori C. Preventive strategies for contrast-induced acute kidney injury: and the winner is…. Circ Cardiovasc Interv. 2017;10:e005262. https://doi.org/10.1161/circinterventions.117.005262.
21. 21. Davenport MS, Perazella MA, Yee J, Dillman JR, Fine D, McDonald RJ, et al. Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2020; 294(3):660–8.https://doi.org/10.1148/radiol.2019192094.
22. 22. Valgimigli M, Bueno H, Byrne RA, Collet J-P, Costa F, Jeppsson A, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39:213–60. https://doi.org/10.1093/eurheartj/ehx419.
23. 23. Jones WS, Mulder H, Wruck LM, Pencina MJ, Kripalani S, Muñoz D, et al. Comparative effectiveness of aspirin dosing in cardiovascular disease. N Engl J Med. 2021;384:1981–90. https://doi.org/10.1056/NEJMoa2102137.
24. 24. Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk. Eur Heart J. 2019;40:2632–53. https://doi.org/10.1093/eurheartj/ehz372.
25. 25. Gimbel M, Qaderdan K, Willemsen L, Hermanides R, Bergmeijer T, de Vrey E, et al. Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): The randomised, open-label, non-inferiority trial. Lancet. 2020;395:1374–81. https://doi.org/10.1016/s0140-6736(20)30325-1.
26. 26. Casado Arroyo R, Polo-Tomas M, Roncalés MP, Scheiman J, Lanas A. Lower GI bleeding is more common than upper among patients on dual antiplatelet therapy: Long-term follow-up of a cohort of patients commonly using PPI co-therapy. Heart. 2012;98:718–23. https://doi.org/10.1136/heartjnl-2012-301632.
27. 27. Ritsinger V, Malmberg K, Mårtensson A, Rydén L, Wedel H, Norhammar A. Intensified insulin-based glycaemic control after myocardial infarction: mortality during 20 year follow-up of the randomised Diabetes Mellitus Insulin Glucose Infusion in Acute Myocardial Infarction (DIGAMI 1) trial. Lancet Diabetes Endocrinol. 2014;2:627–33. https://doi.org/10.1016/s2213-8587(14)70088-9.
28. 28. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227–337. https://doi.org/10.1093/eurheartj/ehab484646.
29. 29. Wolf A, Vella R, Fors A. The impact of person-centred care on patients' care experiences in relation to educational level after acute coronary syndrome: secondary outcome analysis of a randomised controlled trial. Eur J Cardiovasc Nurs. 2019;18:299–308. https://doi.org/10.1177/1474515118821242.
30. 30. Easthall C, Taylor N, Bhattacharya D. Barriers to medication adherence in patients prescribed medicines for the prevention of cardiovascular disease: A conceptual framework. Int J Pharm Pract. 2019;27:223–31. https://doi.org/10.1111/ijpp.12491.