COVID-19 Durumuna Göre Hemodiyaliz Erişim Sorunu Riskinin Değerlendirilmesi

Abstract

Amaç: COVID-19 nedeniyle yoğun bakıma kabul edilen hastalarda %30'a varan oranda trombotik komplikasyonlar bildirilmiştir. Bununla birlikte, COVID-19'lu kişilerde hemodiyaliz erişim sorununa ilişkin veriler sınırlıdır. Bu çalışma, özellikle COVID-19 durumu açısından hemodiyaliz erişim sorunu sıklığını ve belirleyicilerini araştırmayı amaçlamıştır. Araçlar ve yöntem: Bu çok merkezli kesitsel çalışma, kalıcı hemodiyalize giren kişiler arasında yürütüldü. Hastalar erişim sorunu olan ve olmayanlar olarak iki gruba ayrıldı. Çalışmanın birincil sonuç ölçütleri, iki grup arasındaki hasta özellikleri, laboratuvar ölçümleri ve COVID-19 pozitifliğindeki farklılıklardı. İkincil sonuç ölçüsü, hemodiyaliz erişim başarısızlığı ile bağımsız olarak ilişkili faktörlerin tanımlanması olarak tanımlandı. Bulgular: 26 (%12.2) hastada hemodiyaliz erişim sorunu oluştu. Tip 2 diyabet (%76.9'a [n=20] karşı %50 [n=93], p=0.018), diyaliz sırasında hipotansiyon (%88.5'e [n=23] karşı %58.1 [n=108], p=0.006) ve COVID-19 pozitifliği (%73.1’e [n=19] karşı %15,1 [n=28], p<0.001) erişim sorunu olan hastalarda anlamlı olarak daha sıktı. Çok değişkenli lojistik regresyon, bu faktörlerin üçünün de bağımsız olarak daha yüksek hemodiyaliz erişimi başarısızlığı olasılığı ile ilişkili olduğunu gösterdi. Sonuç: Hemodiyaliz erişim sorunu, COVID-19'lu kişilerde COVID-19 olmayanlara göre daha sık görülmektedir.

Keywords

• diyaliz
• tıkanma
• böbrek
• koronavirüs

Assessing Hemodialysis Access Failure Risk in Subjects Based on COVID-19 Status

Abstract

Purpose: Thrombotic complications have been reported in up to 30% of patients admitted to the intensive care unit for COVID-19. However, data on hemodialysis access failure in patients with COVID-19 are limited. This study aimed to investigate the frequency of hemodialysis access failure and its determinants, especially with respect to COVID-19 status. Materials and Methods: This multi-center cross-sectional study was conducted among subjects undergoing permanent hemodialysis. Patients were divided into two groups, those with and without access failure. The primary outcome measures of the study were differences in patient characteristics, laboratory measurements and COVID-19 positivity between the two groups. The secondary outcome measure was defined as the identification of factors independently associated with hemodialysis access failure. Results: Hemodialysis access failure occurred in 26 (12.2%) patients. Type 2 diabetes (76.9% [n=20] vs. 50% [n=93], p=0.018), hypotension during dialysis (88.5 [n=23] vs. 58.1% [n=108], p=0.006) and COVID-19 positivity (73.1% [n=19] vs. 15.1% [n=28], p<0.001) were significantly more frequent among patients with access failure. Multivariable logistic regression showed that all three factors were independently associated with a higher likelihood of hemodialysis access failure. Conclusion: Hemodialysis access failure is encountered more frequently in patients with COVID-19 compared to those without COVID-19.

Keywords

• Coronavirus
• dialysis
• occlusion
• kidney

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