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Periton Diyalizli Hastalarda Acil Servis Başvurusu Nedenlerinin Değerlendirilmesi

Yıl 2022, Cilt 12, Sayı 3, 419 - 423, 30.05.2022
https://doi.org/10.16899/jcm.1050045

Öz

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.

Kaynakça

  • References 1.Ross EA, Mars DR. Peritoneal dialysis, in Tisher CC led): Nephrology led 2). Baltimore, MD, Williams and Wilkins, 1993, pp 243-255
  • 2. Avendano MBI, Solorzano GY, Valenzuela JR, et al. Automated peritoneal dialysis as a lifesaving therapy in an emergency room: Report of four cases. Kidney Int. 2008;73(S108):S173-S6.
  • 3. Labato MA. Peritoneal dialysis in emergency and critical care medicine. Clin Tech Small Anim Pract. 2000;15(3):126-35
  • 4. Wolfson AB. End-stage renal disease: emergencies related to dialysis and transplantation. In: Wolfson AB, Harwood-Nuss A, eds. Renal and urologic emergencies. New York: Churchill Livingstone; 1986:23-50.
  • 5.Sherbotie JR, Polise K, Costarino A, et al. Toxic shock syndrome with Staph. aureus exit-site infection in a patient on peritoneal dialysis. Am J Kid Dis. 1990; 15:80-3.
  • 6. Holley JL, Foulks CJ, Moss AH, et al. Ultrasound as a tool in the diagnosis of exit-site infections in patients undergoing continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 1989;14:211-16.
  • 7.Tzamaloukas AH, Obermiller LE, Gibel LJ et al. Peritonitis associated with intra-abdominal pathology in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 1993; 13: S335-S337.
  • 8. Wellington JL, Rody K. Acute abdominal emergencies in patients on long-term ambulatory peritoneal dialysis. Can J Surg 1993; 36: 522-4
  • 9. Maher JF, Maher AT. Continuous ambulatory peritoneal dialysis. Am Fam Physician. 1989;40:187-92
  • 10. Wina AJ. Brunner FP. Brvnaer H. et al: Cardiovascularrelated ca;ses’of death and the iat: of patients with renovascular disease. Contrib Nephrol 1984;41:306-311
  • 11. Ritz E, Wiecek A, Gnasso A, Augustin J. Is Atherogenesis Accelerated in Uremia Contrib Nephrol 1986;52:1-9
  • 12.Clifford C. Cloonan, Cloyd B. Gatrell, Howard M. Cushner, Emergencies in continuous dialysis patients: Diagnosis and management, The American Journal of Emergency Medicine,Volume 8, Issue 2,1990,Pages 134-148,
  • 13. Morrison G, Michelson EL, Brown S, et al. Mechanism and prevention of cardiac arrhythmias in chronic hemodialysis patients. Kidney Int 1980;17:811-19
  • 14. Wizeman V, Kramer W, Thormann J, et al. Cardiac arrhythmias in patients on maintenance hemodialysis: causes and management. Contrib Nephrol 1986;52:42-53
  • 15. Bailey GL, Hampers CL, Merrill JP. Reversible cardiomyopathy in uremia. Trans Am Sot Artif Intern Organs 1967:13:263- 270
  • 16. lanhez LE, Lowen J, Sabbaga E. Uremic myocardiopathy. Nephron1975;15(1):17-28.
  • 17. Comty CM, Wathen RL, Shapiro FL. Uremic pericarditis. Cardiovasc Clin, 1976;7:219-235
  • 18. Marini PV, Hull AR. Uremic pericarditis: A review of fncidence and management. Kidney Int 1975;7:163-166
  • 19. Mitchell AG: Pericarditis during chronic haemodialysis therapy. Postgrad Med J 1974;50:741-745
  • 20. Comty CM, and Shapiro FL. Cardiac complications, In Drukker W, et al (eds): Replacement of Renal Function by Dialysis (ed 2). Boston, MA, Martinus Nijhoff, 1986, p 605
  • 21. Vas SI, Low DE, Oreopoulos DG. Peritonitis In Drukker W. et al (eds): Reolacement of Renal Function bv Dialvsis led 2). Boston,‘MA,‘Marbnus Nijhoff, 1981, p 344
  • 22. Goldblum SE, Reed WP. Host defenses and immunologic alterations associated with chronic hemodialysis. Ann Intern Med 1980;93:597-613
  • 23. Steiner RW, Halasz NA. Abdominal catastrophes and other unusual events in continuous ambulatory peritoneal dialysis patients. Am J Kidney Dis. 1990;15:1-7.
  • 24.Nomoto Y, Suga T, Nakajima K, et al. Acute hydrothorax in CAPD-a collaborative study of 161 centers. Am J Nephrol. 1989;9:363-7.

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

Yıl 2022, Cilt 12, Sayı 3, 419 - 423, 30.05.2022
https://doi.org/10.16899/jcm.1050045

Öz

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.

Kaynakça

  • References 1.Ross EA, Mars DR. Peritoneal dialysis, in Tisher CC led): Nephrology led 2). Baltimore, MD, Williams and Wilkins, 1993, pp 243-255
  • 2. Avendano MBI, Solorzano GY, Valenzuela JR, et al. Automated peritoneal dialysis as a lifesaving therapy in an emergency room: Report of four cases. Kidney Int. 2008;73(S108):S173-S6.
  • 3. Labato MA. Peritoneal dialysis in emergency and critical care medicine. Clin Tech Small Anim Pract. 2000;15(3):126-35
  • 4. Wolfson AB. End-stage renal disease: emergencies related to dialysis and transplantation. In: Wolfson AB, Harwood-Nuss A, eds. Renal and urologic emergencies. New York: Churchill Livingstone; 1986:23-50.
  • 5.Sherbotie JR, Polise K, Costarino A, et al. Toxic shock syndrome with Staph. aureus exit-site infection in a patient on peritoneal dialysis. Am J Kid Dis. 1990; 15:80-3.
  • 6. Holley JL, Foulks CJ, Moss AH, et al. Ultrasound as a tool in the diagnosis of exit-site infections in patients undergoing continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 1989;14:211-16.
  • 7.Tzamaloukas AH, Obermiller LE, Gibel LJ et al. Peritonitis associated with intra-abdominal pathology in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 1993; 13: S335-S337.
  • 8. Wellington JL, Rody K. Acute abdominal emergencies in patients on long-term ambulatory peritoneal dialysis. Can J Surg 1993; 36: 522-4
  • 9. Maher JF, Maher AT. Continuous ambulatory peritoneal dialysis. Am Fam Physician. 1989;40:187-92
  • 10. Wina AJ. Brunner FP. Brvnaer H. et al: Cardiovascularrelated ca;ses’of death and the iat: of patients with renovascular disease. Contrib Nephrol 1984;41:306-311
  • 11. Ritz E, Wiecek A, Gnasso A, Augustin J. Is Atherogenesis Accelerated in Uremia Contrib Nephrol 1986;52:1-9
  • 12.Clifford C. Cloonan, Cloyd B. Gatrell, Howard M. Cushner, Emergencies in continuous dialysis patients: Diagnosis and management, The American Journal of Emergency Medicine,Volume 8, Issue 2,1990,Pages 134-148,
  • 13. Morrison G, Michelson EL, Brown S, et al. Mechanism and prevention of cardiac arrhythmias in chronic hemodialysis patients. Kidney Int 1980;17:811-19
  • 14. Wizeman V, Kramer W, Thormann J, et al. Cardiac arrhythmias in patients on maintenance hemodialysis: causes and management. Contrib Nephrol 1986;52:42-53
  • 15. Bailey GL, Hampers CL, Merrill JP. Reversible cardiomyopathy in uremia. Trans Am Sot Artif Intern Organs 1967:13:263- 270
  • 16. lanhez LE, Lowen J, Sabbaga E. Uremic myocardiopathy. Nephron1975;15(1):17-28.
  • 17. Comty CM, Wathen RL, Shapiro FL. Uremic pericarditis. Cardiovasc Clin, 1976;7:219-235
  • 18. Marini PV, Hull AR. Uremic pericarditis: A review of fncidence and management. Kidney Int 1975;7:163-166
  • 19. Mitchell AG: Pericarditis during chronic haemodialysis therapy. Postgrad Med J 1974;50:741-745
  • 20. Comty CM, and Shapiro FL. Cardiac complications, In Drukker W, et al (eds): Replacement of Renal Function by Dialysis (ed 2). Boston, MA, Martinus Nijhoff, 1986, p 605
  • 21. Vas SI, Low DE, Oreopoulos DG. Peritonitis In Drukker W. et al (eds): Reolacement of Renal Function bv Dialvsis led 2). Boston,‘MA,‘Marbnus Nijhoff, 1981, p 344
  • 22. Goldblum SE, Reed WP. Host defenses and immunologic alterations associated with chronic hemodialysis. Ann Intern Med 1980;93:597-613
  • 23. Steiner RW, Halasz NA. Abdominal catastrophes and other unusual events in continuous ambulatory peritoneal dialysis patients. Am J Kidney Dis. 1990;15:1-7.
  • 24.Nomoto Y, Suga T, Nakajima K, et al. Acute hydrothorax in CAPD-a collaborative study of 161 centers. Am J Nephrol. 1989;9:363-7.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Sümeyra KOYUNCU Bu kişi benim (Sorumlu Yazar)
ERCİYES ÜNİVERSİTESİ
0000-0002-1159-5818
Türkiye


Cihan UYSAL
ERCIYES UNIVERSITY
0000-0002-6214-0354
Türkiye


Ali GÜNDOĞDU
ERCİYES ÜNİVERSİTESİ
0000-0002-6968-0337
Türkiye


İsmail KOÇYİĞİT
ERCIYES UNIVERSITY
0000-0002-6654-4727
Türkiye


Murat SİPAHİOĞLU
ERCIYES UNIVERSITY
0000-0003-3293-2104
Türkiye


Oktay OYMAK
ERCIYES UNIVERSITY
0000-0003-3256-1745
Türkiye


Bülent TOKGÖZ
ERCIYES UNIVERSITY
0000-0003-0880-3396
Türkiye

Yayımlanma Tarihi 30 Mayıs 2022
Kabul Tarihi 7 Ocak 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 3

Kaynak Göster

AMA Koyuncu S. , Uysal C. , Gündoğdu A. , Koçyiğit İ. , Sipahioğlu M. , Oymak O. , Tokgöz B. Evaluation of the Reasons for Emergency Department Application in Patients with Peritoneal Dialysis. J Contemp Med. 2022; 12(3): 419-423.