Acil Serviste Hemodiyaliz Endikasyonu Konulan Hastaların Analizi

Abstract

Amaç: Acil hemodiyaliz akut böbrek yetmezliği oluşan hastalarda hayat kurtarıcı bir tedavidir. Çalışmamızda acil serviste ilk kez hemodiyaliz tedavisi gören hastaların demografik ve klinik özellikleri ile beraber mortalitelerini etkileyen faktörlerin incelenmesi amaçlandı. Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmaya hastanemiz acil servisine başvuran ve hemodiyaliz ünitesinde, 1.1.2017 ile 1.1.2018 tarihleri arasında ilk kez hemodiyalize alınan 95 hasta alındı. Hastalar demografik, klinik ve laboratuvar verileri, diyaliz endikasyonları, 30 günlük sağ kalımları, yaşayan hastaların renal durumları, ölen hastaların ölüm sebepleri açısından değerlendirildi. Bulgular: Hastaların %62.1’i erkek, %37.9’u kadın, yaş ortalaması 62.28 yıl saptandı. Hastaların en sık diyalize alınma sebepleri metabolik asidoz ve kreatinin yüksekliği (%75) idi. Hastaların %41.1’ inin 30 gün içerisinde öldüğü görüldü. En sık ölüm sebebinin %64.1 malignite gibi altta yatan hastalıklara bağlı komplikasyonlar olduğu görüldü. Hastaların %7.4 ü tam iyileşme, %28.4 ü diyalize ihtiyaç duymayan kronik böbrek hastalığı, %64.2’si diyaliz hastası olarak taburcu olmuştur. Sonuç: Acil servise başvuran ve akut böbrek hasarı saptanan pek çok hasta anüri, hipervolemi, hiperpotasemi ve üremik bulgular nedeniyle hemodiyalize alınmaktadır. Bu hastaların otuz günlük mortalite oranları yüksektir ve en sık mortalite sebebi malignite gibi altta yatan hastalıklara bağlı komplikasyonlardır.

Keywords

• acil servis
• akut böbrek hasarı,
• diyaliz,

Analysis of Patients Who Underwent Hemodialysis in the Emergency Department

Abstract

Objectives: Hemodialysis is a life-saving treatment in patients with acute kidney injury. We aimed to compare the etiologic, laboratory, and clinical status and mortality rates of patients who underwent hemodialysis for the first time, as well as to determine the factors impacting mortality. Material and Method: 95 patients who apply to the emergency room and underwent hemodialysis for the first time in our hemodialysis unit between 1.1.2017 and 1.1.2018 were enrolled in this retrospective study. The patients were evaluated in terms of demographic, clinical, and laboratory data, dialysis indications, the mortality rate for 30 days, kidney disease status, and causes of death. Results: %62.1 of patients were male and 37.9% were female and the mean age was 62.28 years. Metabolic acidosis and creatinine increase (75%) were the most cause of dialysis. 41.1% of patients died in 30 days. The most common cause of death was complications due to underlining concomitant illnesses like malignancy (64.1%). 7.4% of patients were recovered completely, 28.4% of patients had chronic renal disease without any renal replacement therapy, 64.2% of patients were dialysis patients at the discharge from the hospital. Conclusion: Most of the patients who access the emergency room, because of anuria, hypervolemia, hyperpotasemia, and uremic symptoms, is taken to hemodialysis. These patients have approximately 40% mortality rate in 30 days of survival, and the primary cause of mortality is complications due to underlining concomitant diseases.

Keywords

• acute kidney injury,
• dialysis,
• emergency department,

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