Peri̇ton Di̇yali̇z Sıvıları (Peritoneal Dialysis Solutions)

Yıl 2014, Cilt: 45 Sayı: 2, 84 - 93, 11.07.2014

Ebru Yılmaz Nida Dinçel İpek Kaplan Bulut Sevgi Mir

Öz

Periton diyalizi (PD) son dönem böbrek hastaları için önemli bir renal replasman tedavi yöntemidir. Hastalar evde uygulanan PD tedavisine kolayca uyum sağlarlar. Geleneksel standart periton diyaliz solüsyonları osmotic ajan olarak glukoz kullanırlar. Glukoz içeren diyaliz sıvıları yüksek konsantrasyonda glukoz içerirler. Laktat ve glukoz yıkım ürünlerinin oluşmasına neden olurlar. Yüksek osmolalite ve düşük pH’a sahiptirler. Tüm bu sayılan özellikler peritona zarar verir (fibrosis, neoanjiogenez).

Yeni PD solüsyonları alternatif tampon sistemleri ve ozmotik ajan kullanırlar (ikodekstrin ve aminoasitler). Yüksek pH’ya sahip olup daha az glukoz yıkım ürünlerinin oluşumuna neden olurlar. Yeni PD solüsyonlarının kullanımı ile daha iyi metabolic kontrol ve vücut kompozisyonu sağlanabilir. Yeni solüsyonların kullanımı daha az fibrozise yol açar ve antiinflamatuvar özelliklerinden dolayı da periton zarı viabilitesini arttırırlar. Ama hasta sağ kalımını artırdıklarına dair kanıt yoktur. Bu derlemenin ile PD için kullanılan farklı tipte periton diyaliz sıvılarının tanımlaması ve gözden geçirilmesi amaçlanmıştır.

Anahtar kelimeler: Kronik böbrek yetmezliği, periton diyalizi,

Abstract

Peritoneal dialysis (PD) is an important kidney replacement therapy for end stage renal disease (ESRD) patients. Patients easily adapt at home based treatment of PD. Standard traditional solutions uses glucose as an osmotic agent.  Glucose based dialysis solutions contains high concentrations of glucose. They cause production of glucose degradation products and lactate. They have high osmolality, and low pH.  All these features damage to the peritoneum by fibrosis and neoangiogenesis.

Newer PD solutions were produced with alternative buffers and osmotic agents (icodextrin or amino acids). They have a higher pH and causes production of fewer glucose degradation products.  With the usage of newer PD solutions we can achieve better metabolic controls of patients and body compositions. Peritoneal membrane viability increases by their less fibrotic and less inflammatory features of new solutions. But their effect on patient survival is not clearly identified yet. The aim of this review is to describe and to overview the different types of peritoneal dialysis solutions used during PD.

Key words: Chronic renal failure, peritoneal dialysis, peritoneal dialysis solution

Anahtar Kelimeler

kronik böbrek yetmezliği, periton diyalizi, periton diyaliz solüsyonu

Kaynakça

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