Periton Diyalizli Hastalarda Acil Servis Başvurusu Nedenlerinin Değerlendirilmesi

Abstract

ÖZ Amaç: Periton diyalizi olan hastalarda farklı sistemlere bağlı ciddi akut problemler acil servise başvuru nedeni olabilir. Bu çalışmada bu hastalarda mesai saatleri dışında acil servise başvuru nedenleri ve tedavilerinin değerlendirilmesi amaçlanmıştır. Yöntemler: Bu çalışmaya Üniversitemizde Ocak 2017-Mayıs 2020 tarihleri ​​arasında Acil Servise başvuran takipteki SAPD hastaları dahil edildi. Renal, peritoneal ve haftalık Kt/V, normalize protein katabolik hızı (nPCR), peritoneal UF ve GFR gibi demografik, biyokimyasal ve klinik veriler poliklinik verilerinden kaydedildi. Ayrıca acil servise başvuru ve hastaneye yatış nedenleri değerlendirildi. Bulgular: 2017-2020 yılları arasında 88 kez acil servise başvuran 38 periton diyalizi hastası hastaneye yatırıldı. Çalışmaya mesai saatleri dışında başvuran hastalar dahil edildi. Bu süre içinde SAPD polikliniğimizde yaklaşık 130 hasta düzenli olarak takip edildi. En önemli peritoneal yatış nedenleri çıkış yeri enfeksiyonu ve kateter disfonksiyonu iken, ekstra peritoneal komplikasyonlar çeşitliydi. Hastalar yüksek oranda akut kardiyovasküler olay ve akut karın patolojileri ile Kardiyoloji ve Genel Cerrahi bölümlerine yatırıldı. Sonuç: Bu hastalara acil serviste ilk yaklaşım genellikle konsülte edilen bir nefrolog tarafından yapılsa da etkili ve öncelikli tedavi ancak diyaliz hastalarının özel sorunları hakkında bilgi sahibi bir acil servis doktoru tarafından verilebilir.

Keywords

• periton diyalizi
• acil servis
• hemodiyaliz

Evaluation of the Reasons for Emergency Department Application in Patients with Peritoneal Dialysis

Abstract

ABSTRACT Background: Severe acute problems, which are related to different systems, could be reasons for applying to the emergency department in patients with peritoneal dialysis. In this study, the aim was to evaluate the reasons and treatment of applications to the emergency department in these patients after office hours. Methods: This study included followed up CAPD patients, who applied to the Emergency Department between January 2017 and May 2020 at our University. Demographical, biochemical, and clinical data, such as, renal, peritoneal, and weekly Kt/V, normalized protein catabolic rate (nPCR), peritoneal UF, and GFR were recorded from the outpatient’s department data. In addition, reasons for application to emergency services and hospitalization were evaluated. Results: 38 peritoneal dialysis patients applied 88 times to the emergency department and were hospitalized between 2017 and 2020. Patients, who applied after office hours were included in the study. Around 130 patients were regularly followed-up in our CAPD outpatient clinic during this period. While the most important peritoneal reasons for admission were exit site infection and catheter dysfunction, extra peritoneal complications were various. Patients were hospitalized in the Cardiology and General Surgery departments with a high rate of acute cardiovascular events and acute abdominal pathologies. Conclusion: Although the first approach to these patients in the emergency department is usually performed by a consulted nephrologist, effective and priority treatment could only be given by an emergency doctor, who has knowledge about the special problems of dialysis patients.

Keywords

• peritoneal dialysis
• emergency
• hemodyalisis

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