Hemoliz Nedeni Olarak Diyalizörler

Amaç: Hemoliz, hemodiyalizin nadir görülen bir komplikasyonudur. Kimyasal kirlilik, ısı veya tıkanan hemodiyaliz hatlarına mekanik zarar verilmesi sonucu oluşur. Laktat dehidrogenaz, piruvatı laktata dönüştüren ve serum seviyeleri, doku parçalanması nedeniyle yüksen bir enzimdir. Hemolitik bozukluklar gibi bir dizi klinik hastalık, yüksek serum LDH'si ile ilişkilidir. Hem Rexeed hem de Leoceed diyalizörler AsahiKASEI tarafından üretilen aynı zar yapısına ve geçirgenliğine sahip diyalizörlerdir ancak kan giriş açısı, hazne uzunluğu ve por sayısı farklıdır. Bu çalışmanın amacı, diyalizör tasarımının hemoliz üzerine etkisini incelemektir. Gereç ve Yöntemler: Haftada toplam 12 saat hemodiyaliz tedavisi gören 142 hasta retrospektif olarak değerlendirildi. Ayrı hemodiyaliz seanslarında her iki diyalizör ile hemodiyalize giren bireylerin HD öncesi ve HD sonrası LDH seviyeleri karşılaştırıldı. Bulgular: Çalışmaya hemodiyaliz (HD) tedavisi gören 142 hasta (%63 kadın) dahil edildi. Komorbid durum olarak 28 (%20) hastada diyabet, 45 hastada (%32) hipertansiyon ve 16 hastada (%11) iskemik kalp hastalığı vardı. LDH düzeyi, Leoceed diyalizer grubunda Rexeed diyalizer grubuna göre istatistiksel olarak anlamlı düzeyde yüksekti (49,1±20 U/l vs 229,8±24,45 U/l;p=0,008). Sonuç: Diyalizörün tasarımı, hücre hasarını arttırarak Leoceed diyalizördeki LDH yüksekiğine neden oluyor olabilir. Diyalizör tasarımı konusunda düzeltici çalışmalar yapabilmek için daha geniş hasta serileri kullanılarak diyalizör tasarımının hücre hasarı üzerindeki etkisinin analiz edilmesi faydalı olacaktır.

Anahtar Kelimeler:

Hemodiyaliz, Hemoliz, Diyalizör

Dialyzers as a cause of Hemolysis

Objective: Hemolysis is a rare adverse effect of hemodialysis. ıt is induced by chemical pollution, heat, or mechanical harm to clogged hemodialysis lines. Lactate dehydrogenase transforms pyruvate to lactate in the absence of oxygen to make energy. LDH serum levels are raised due to tissue breakdown. A number of clinical illnesses, such as hemolytic disorders, are associated with high serum LDH. Both the Rexeed and Leoceed dialyzers are made by AsahiKASEI. They had the same membrane architecture and permeability, but blood entry angle, chamber length, and hole count varied. The aim of this study is to examine if dialyzer design affects hemolysis. Materials and Methods: A total of 142 patients who were chronically undergoing hemodialysis therapy at the ……………….for a total of 12 hours per week were included. A retrospective examination of the patients was performed. The pre-HD and post-HD LDH levels of individuals who had undergone hemodialysis with both dialyzers during separate sessions of hemodialysis were compared. Results: A hundred forty two patients (63% female) on hemodialysis (HD) treatment were enrolled in the study. Twenty eight patients (20%) had diabetes, 45 had hypertension (32%) and 16 had ischemic heart disease (11%) as a comorbid condition. When LDH difference is compared between groups Leoceed dialyzer group) had statistically significantly higher LDH difference when compared with Rexeed dialyzer group (49.1±20 U/l vs229.8±24.45 U/l;p=0.008). (Table 2). Conclusion: It is possible that the design of the dialyzer contributes in some way to the cell damage that is caused by the larger serum LDH increase in the Leoceed dialyzer. In order to carry out corrective studies on dialyzer design, it would be helpful to analyze the impact of dialyzer design on cell damage using a larger series of patients.

Keywords:

Hemodialysis, Dialyzer, Hemolysis,

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