KRONİK BÖBREK HASTALIĞI VARLIĞINDA HASTANEDE EDİNİLMİŞ ANEMİ GELİŞİMİNE ETKİ EDEN FAKTÖRLERİN DEĞERLENDİRİLMESİ

Öz

Kronik böbrek hastalığı (KBH) 3 aydan uzun süren, böbrekte işlevsel ya da yapısal bozukluk ve/veya glomerüler filtrasyon hızında azalma olmasıdır. Hastanede edinilmiş anemi (HEA), hastaneye yatış sonrası hastalarda etyolojik bir neden olmaksızın anemi gelişmesidir. İyatrojenik geliştiği düşünülmektedir. Çalışmamızda KBH tanısıyla hasta-neye yatırılan hastalarda HEA prevalansını ve etki eden faktörleri saptamayı amaçladık. Mart- Eylül 2014 arasında, 18 yaş ve üzerine, KBH tanılı, nefroloji servisine yatışı yapılan hastalar çalışmaya alındı. Hipervolemi, kanama, hemoliz, sepsis, hematolojik malignite varlığı, antikoagülan kullanımı olan hastalar, sıvı replasmanı planlanan ve renal replasman tedavisi alan hastalar çalışmaya dahil edilmedi. Hastaneye yatış sonrasında hemoglobin düzeyinde 0,5 g/dl ve üzerinde düşme olması HEA olarak tanımlandı. Çalışmamızda KBH hastalarında HEA sıklığı %70 saptanmıştır. HEA gelişimi, KBH evresi ve hipotiroidi varlığı ile istatiksel anlamlı olarak ilişkili saptanmıştır (KBH p=0.021, hipotiroidi p=0.002). Günlük flebotomi miktarınin (p=0,203) ve hastanede yatış süresinin (p=0,180) HEA gelişimi ile ilişkisi saptanmamıştır. HEA’nın tanınması ve gelişimi açısından risk faktörlerinin saptanarak, önlenmesinin hastaların sağlık durumuna olumlu etki edeceği düşüncesindeyiz.

Anahtar Kelimeler

• Anemi
• Böbrek yetmezliği
• Kronik
• Flebotomi

EVALUATION OF FACTORS AFFECTING THE DEVELOPMENT OF HOSPITAL-ACQUIRED ANEMIA IN CHRONIC KIDNEY DISEASE

Öz

Chronic kidney disease (CKD) is a functional or structural disorder in the kidneys and/or a decrease in the glomerular filtration rate (GFR) lasting longer than 3 months. The development of anemia in patients following hospitalization that has no identifiable etiological reason is known as hospital-acquired anemia (HAA). It is thought to be iatro-genic. In our study, we aimed to determine the prevalence of HAA and the factors affecting its development in CKD patients. Patients aged 18 years and older who were hospitalized for CKD between March and September 2014 were included in the study. Patients with hypervolemia, hemorrhage, hemolysis, sepsis, hematological malignancies, anticoagulant use, or who were planned for fluid replacement or renal replacement therapy were excluded. HAA was defined as a hemoglobin level fall of at least 0.5 g/dl following hospitalization. In our study, the frequency of HAA in CKD patients was found to be 70%. The development of HAA was significantly associated with the CKD stage and the presence of hypothyroidism (CKD p = 0.021, hypothyroidism p = 0.002). Phlebotomy volume per day (p = 0.203) and length of hospital stay (p = 0.180) were not related to HAA development. We believe that identifying HAA risk factors and taking preventative measures will benefit patients' health.

Anahtar Kelimeler

• Anemia
• Renal insufficiency
• Chronic
• Phlebotomy

Kaynakça

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