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Son Dönem Böbrek Yetmezliği Hastalarında Renal Replasman Tedavi Seçimini Etkileyen Faktörler

Yıl 2022, Cilt: 44 Sayı: 4, 499 - 507, 19.07.2022
https://doi.org/10.20515/otd.1059206

Öz

Prediyaliz eğitim programı uyguladığımız son dönem böbrek yetmezliği tanısı ile takip edilen hastaların verileri incelenerek renal replasman tedavisi seçimini etkileyen faktörlerin araştırılması amaçlanmıştır. Kliniğimizde takip edilen renal replasman tedavisi başlanan hastalar retrospektif olarak değerlendirildi. Renal replasman tedavisi hemodiyaliz, periton diyalizi ve böbrek transplantasyonu olmak üzere üç gruba ayrılarak bu gruplar arasında hastalar klinik ve demografik özelliklerine göre karşılaştırıldı. Hastaların komorbidite düzeyleri 'modifiye charlson komorbidite indeksi' skoru kullanılarak hesaplandı. Çalışmada 330'u (%71,1) hemodiyaliz, 65'i (%14) periton diyalizi ve 69'u (%14,9) böbrek nakli grubunda olmak üzere toplam 464 hasta vardı. Gruplar arasında yaş anlamlı olarak farklıydı (p<0,001). Böbrek nakli yapılan hastaların hemodiyaliz hastalarına göre; üniversite mezunu oranının (p<0,001) ve hiç evlenmemiş (p=0,004) olma oranlarının daha yüksek olduğu bulunmuştur. Renal transplantasyon hastalarında kentsel alanda yaşama oranı (p=0,021) ve çalışan hasta oranı (p=0,031) daha yüksekti. Renal transplantasyon hastalarında böbrek hastalığı etiyolojisinin diyabetik nefropati olma oranı daha düşüktü. Grupların modifiye charlson komorbidite indeksi skorları incelendiğinde en yüksek değerlerin hemodiyaliz grubunda olduğu ve en düşük değerlerin ise transplantasyon grubunda olduğu tespit edilmiştir (p<0.001).Hastarın sosyodemografik özelliklerinin ve komorbid durumlarının renal replasman tedavi modalitesinin seçiminde etkili olduğu görülmüştür. Seçim öncesi verilen eğitimin yanında bu özellikler de dikkate alınarak en uygun tedavi modalitesi seçilmelidir.

Kaynakça

  • Referans1. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 14;379(9811):165-80.
  • Referans 2. Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 395: 709–33.
  • Referans 3. Süleymanlar G, Utaş C, Arinsoy T, et al. A population-based survey of Chronic REnal Disease In Turkey--the CREDIT study. Nephrol Dial Transplant. 2011; 26(6):1862-71.
  • Referans 4. Foley RN, Collins AJ. End-stage renal disease in the United States: an update from the United States Renal Data System. J Am Soc Nephrol. 2007; 18: 2644–2648
  • Referans 5. National Institutes of Health. "National Institute of Diabetes and Digestive and Kidney Diseases. United states renal data system." 2018 USRDS annual data report: Epidemiology of kidney disease in the united states., bethesda, MD (2018).
  • Referans 6. Saran R, Robinson B, Abbott K, et al. United States renal data system. 2016 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2016.
  • Referans 7. Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol. 2012;23:533-544
  • Referans 8. Chaudhary K, Sangha H, Khanna R. Peritoneal dialysis first: rationale. Clin J Am Soc Nephrol. 2011;6:447-456.
  • Referans 9. Fenton SS, Schaubel DE, Desmeules M, et al. Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Dis. 1997;30:334–342.
  • Referans 10. Jaar BG, Coresh J, Plantinga LC. Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease. ACC Curr J Rev. 2005;14:7-7.
  • Referans 11. Dahlerus C, Quinn M, Messersmith E, et al. Patient perspectives on the choice of dialysis modality: results from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. Am J Kidney Dis. 2016; 68(6):901–10.
  • Referans 12. Nissenson AR, Prichard SS, Cheng IK, et al. Non-medical factors that impact on ESRD modality selection. Kidney Int. 1993; 40: S120–S127.
  • Referans 13. Mendelssohn DC, Mullaney SR, Jung B, et al. What do American nephologists think about dialysis modality selection? Am J Kidney Dis. 2001; 37:22–29.
  • Referans 14. Merkus MP, Jager KJ, Dekker FW, et al. Quality of life in patients on chronic dialysis: Self-assessment 3 months after the start of treatment. The Necosad Study Group. Am J Kidney Dis. 1997; 29:584–592.
  • Referans 15. Golper TA, Vonesh EF, Wolfson M, et al. The impact of pre-ESRD education on dialysis modality selection. J Am Soc Nephrol. 2000; 11:231A.
  • Referans 16. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12.
  • Referans 17. Beddhu S, Bruns FJ, Saul M, et al. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. Am J Med. 2000;108(8):609-13.
  • Referans 18. Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–82.
  • Referans 19. Türkiye’de nefroloji, diyaliz ve transplantasyon. Türk Nefroloji Derneği, Registry 2020. Ankara – 2021.
  • Referans 20. Little J, Irwin A, Marshall T, et al. Predicting a patient’s choice of dialysis modality: experience in a United Kingdom renal department. Am J Kidney Dis. 2001; 37: 981–986.
  • Referans 21. Dimitrios C, Khai N, Bassam F, et al. What influences patient choice of treatment modality at the pre dialysis stage? Nephrol Dial Transplant. 2012; 27: 1542–1547.
  • Referans 22. Cohen LM, Ruthazer R, Moss AH, et al. Predicting six-month mortality for patients who are on maintenance hemodialysis. Clin J Am Soc Nephrol. 2010;5:72-9.
  • Referans 23. Brown EA, Johansson L. Dialysis options for end-stage renal disease in older people. Nephron Clin Pract. 2011; 119 (Suppl 1): c10–c13.
  • Referans 24. Franco MR, Fernandes NM. Dialysis in the elderly patient: a challenge of the XXI century—narrative review. J Bras Nefrol. 2013; 35: 132–141.
  • Referans 25. Oliver MJ, Quinn RR. Is the decline of peritoneal dialysis in the elderly a breakdown in the process of care? Perit Dial Int. 2008;28:452-6.
  • Referans 26. Jager KJ, Korevaar JC, Dekker FW, et al. Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) Study Group. The effect of contraindications and patient preference on dialysis modality selection in ESRD patients in The Netherlands. Am J Kidney Dis. 2004;43:891-9.
  • Referans 27. Knoll G, Cockfield S, Blydt-Hansen T, et al. Canadian Society of Transplantation: consensus guidelines on eligibility for kidney transplantation. CMAJ. 2005;173(10):S1-S25.
  • Referans 28. Seyani N, Ateş K, Süleymanlar G. Türkiye’de renal replasman tedavilerinin güncel durumu: Türk Nefroloji Derneği kayıt sistemi 2015 yılı özet raporu. Turk Neph Dial Transpl. 2017;26:154–60.
  • Referans 29. Panagopoulou A, Hardalias A, Berati S, et al. Psychosocial issues and quality of life in patients on renal replacement therapy. Saudi J Kidney Dis Transpl. 2009;20:212-8.
  • Referans 30. Niu SF, Li IC. Quality of life of patients having renal replacement therapy. J Adv Nurs. 2005; 51: 15–21.
  • Referans 31. Sayin A, Mutluay R, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc. 39(10):3047– 3053, 2007.
  • Referans 32. Jha V, Garcia-Garcia G, Iseki K, at al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013 Jul 20;382(9888):260-72.
  • Referans 33.Hart PD, Bakris GL. Hypertensive nephropathy: prevention and treatment recommendations. Expert Opin Pharmacother. 2010 Nov;11(16):2675-86.
  • Referans 34. Alvares J, Cesar CC, Acurcio Fde A, et al. Quality of life of patients in renal replacement therapy in Brazil: comparison of treatment modalities. Qual Life Res. 2012;21(6):983–91.
  • Referans 35. Couchoud C, Moranne O, Frimat L, et al. Associations between comorbidities, treatment choice and outcome in the elderly with end-stage renal disease. Nephrol Dial Transplant. 2007; 3: 27–32.
  • Referans 36. Chen SF, Wang IJ, Lang HC. Risk of major depression in patients with chronic renal failure on different treatment modalities: a matchedcohort and population-based study in Taiwan. Hemodial Int. 2016; 20(1):98–105.

Factors Affecting the Choice of Renal Replacement Therapy in Patients with End Stage Renal Failure

Yıl 2022, Cilt: 44 Sayı: 4, 499 - 507, 19.07.2022
https://doi.org/10.20515/otd.1059206

Öz

It was aimed to investigate the factors affecting the choice of renal replacement therapy by examining the data of patients with end stage renal disease, to whom we applied a predialysis education program. Patients who were started on renal replacement therapy in our clinic were evaluated retrospectively. Renal replacement therapy were divided into three groups as hemodialysis, peritoneal dialysis and renal transplantation and compared according to their clinical and demographic characteristics. The comorbidities of the patients were calculated using the 'modified charlson comorbidity index' score. There were a total of 464 patients in the study, of whom 330 (71.1%) chose hemodialysis, 65 (14%) peritoneal dialysis, and 69 (14.9%) renal transplantation. Age was significantly different between the groups (p<0.001). According to the hemodialysis patients of renal transplantation patients; that the rate of being a university graduate (p<0.001) and never married (p=0.004) is higher. Rate of living in the urban area (p=0.021) and working patients (p=0.031) were higher in renal transplantation patients. The rate of diabetic nephropathy of renal etiology was lower in renal transplantation patients (p=0.014). When the modified charlson comorbidity index scores of the groups were examined, highest values were in the hemodialysis group and the lowest values were in the transplantation group (p<0.001). Patients sociodemographic characteristics and comorbid conditions were effective in the choice of renal replacement therapy modality. In addition to the educating given before the selection, most appropriate treatment modality should be selected by considering these features.

Kaynakça

  • Referans1. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 14;379(9811):165-80.
  • Referans 2. Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 395: 709–33.
  • Referans 3. Süleymanlar G, Utaş C, Arinsoy T, et al. A population-based survey of Chronic REnal Disease In Turkey--the CREDIT study. Nephrol Dial Transplant. 2011; 26(6):1862-71.
  • Referans 4. Foley RN, Collins AJ. End-stage renal disease in the United States: an update from the United States Renal Data System. J Am Soc Nephrol. 2007; 18: 2644–2648
  • Referans 5. National Institutes of Health. "National Institute of Diabetes and Digestive and Kidney Diseases. United states renal data system." 2018 USRDS annual data report: Epidemiology of kidney disease in the united states., bethesda, MD (2018).
  • Referans 6. Saran R, Robinson B, Abbott K, et al. United States renal data system. 2016 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2016.
  • Referans 7. Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol. 2012;23:533-544
  • Referans 8. Chaudhary K, Sangha H, Khanna R. Peritoneal dialysis first: rationale. Clin J Am Soc Nephrol. 2011;6:447-456.
  • Referans 9. Fenton SS, Schaubel DE, Desmeules M, et al. Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Dis. 1997;30:334–342.
  • Referans 10. Jaar BG, Coresh J, Plantinga LC. Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease. ACC Curr J Rev. 2005;14:7-7.
  • Referans 11. Dahlerus C, Quinn M, Messersmith E, et al. Patient perspectives on the choice of dialysis modality: results from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. Am J Kidney Dis. 2016; 68(6):901–10.
  • Referans 12. Nissenson AR, Prichard SS, Cheng IK, et al. Non-medical factors that impact on ESRD modality selection. Kidney Int. 1993; 40: S120–S127.
  • Referans 13. Mendelssohn DC, Mullaney SR, Jung B, et al. What do American nephologists think about dialysis modality selection? Am J Kidney Dis. 2001; 37:22–29.
  • Referans 14. Merkus MP, Jager KJ, Dekker FW, et al. Quality of life in patients on chronic dialysis: Self-assessment 3 months after the start of treatment. The Necosad Study Group. Am J Kidney Dis. 1997; 29:584–592.
  • Referans 15. Golper TA, Vonesh EF, Wolfson M, et al. The impact of pre-ESRD education on dialysis modality selection. J Am Soc Nephrol. 2000; 11:231A.
  • Referans 16. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12.
  • Referans 17. Beddhu S, Bruns FJ, Saul M, et al. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. Am J Med. 2000;108(8):609-13.
  • Referans 18. Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–82.
  • Referans 19. Türkiye’de nefroloji, diyaliz ve transplantasyon. Türk Nefroloji Derneği, Registry 2020. Ankara – 2021.
  • Referans 20. Little J, Irwin A, Marshall T, et al. Predicting a patient’s choice of dialysis modality: experience in a United Kingdom renal department. Am J Kidney Dis. 2001; 37: 981–986.
  • Referans 21. Dimitrios C, Khai N, Bassam F, et al. What influences patient choice of treatment modality at the pre dialysis stage? Nephrol Dial Transplant. 2012; 27: 1542–1547.
  • Referans 22. Cohen LM, Ruthazer R, Moss AH, et al. Predicting six-month mortality for patients who are on maintenance hemodialysis. Clin J Am Soc Nephrol. 2010;5:72-9.
  • Referans 23. Brown EA, Johansson L. Dialysis options for end-stage renal disease in older people. Nephron Clin Pract. 2011; 119 (Suppl 1): c10–c13.
  • Referans 24. Franco MR, Fernandes NM. Dialysis in the elderly patient: a challenge of the XXI century—narrative review. J Bras Nefrol. 2013; 35: 132–141.
  • Referans 25. Oliver MJ, Quinn RR. Is the decline of peritoneal dialysis in the elderly a breakdown in the process of care? Perit Dial Int. 2008;28:452-6.
  • Referans 26. Jager KJ, Korevaar JC, Dekker FW, et al. Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) Study Group. The effect of contraindications and patient preference on dialysis modality selection in ESRD patients in The Netherlands. Am J Kidney Dis. 2004;43:891-9.
  • Referans 27. Knoll G, Cockfield S, Blydt-Hansen T, et al. Canadian Society of Transplantation: consensus guidelines on eligibility for kidney transplantation. CMAJ. 2005;173(10):S1-S25.
  • Referans 28. Seyani N, Ateş K, Süleymanlar G. Türkiye’de renal replasman tedavilerinin güncel durumu: Türk Nefroloji Derneği kayıt sistemi 2015 yılı özet raporu. Turk Neph Dial Transpl. 2017;26:154–60.
  • Referans 29. Panagopoulou A, Hardalias A, Berati S, et al. Psychosocial issues and quality of life in patients on renal replacement therapy. Saudi J Kidney Dis Transpl. 2009;20:212-8.
  • Referans 30. Niu SF, Li IC. Quality of life of patients having renal replacement therapy. J Adv Nurs. 2005; 51: 15–21.
  • Referans 31. Sayin A, Mutluay R, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc. 39(10):3047– 3053, 2007.
  • Referans 32. Jha V, Garcia-Garcia G, Iseki K, at al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013 Jul 20;382(9888):260-72.
  • Referans 33.Hart PD, Bakris GL. Hypertensive nephropathy: prevention and treatment recommendations. Expert Opin Pharmacother. 2010 Nov;11(16):2675-86.
  • Referans 34. Alvares J, Cesar CC, Acurcio Fde A, et al. Quality of life of patients in renal replacement therapy in Brazil: comparison of treatment modalities. Qual Life Res. 2012;21(6):983–91.
  • Referans 35. Couchoud C, Moranne O, Frimat L, et al. Associations between comorbidities, treatment choice and outcome in the elderly with end-stage renal disease. Nephrol Dial Transplant. 2007; 3: 27–32.
  • Referans 36. Chen SF, Wang IJ, Lang HC. Risk of major depression in patients with chronic renal failure on different treatment modalities: a matchedcohort and population-based study in Taiwan. Hemodial Int. 2016; 20(1):98–105.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Üstün Yılmaz 0000-0003-0237-0278

Ayça İnci 0000-0002-7894-8913

Ayşe Akarsu Bu kişi benim 0000-0001-7975-2595

Ümmühan Maden 0000-0002-9195-6918

Yayımlanma Tarihi 19 Temmuz 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 44 Sayı: 4

Kaynak Göster

Vancouver Yılmaz Ü, İnci A, Akarsu A, Maden Ü. Factors Affecting the Choice of Renal Replacement Therapy in Patients with End Stage Renal Failure. Osmangazi Tıp Dergisi. 2022;44(4):499-507.


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