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Acil Serviste Acil Hemodiyaliz Endikasyonu Konulan Hastaların Retrospektif Analizi

Amaç: Acil hemodiyaliz hayat kurtarıcı bir tedavidir. Literatürde kronik böbrek yetmezliği ya da akut böbrek yetmezliği nedeniyle acil servise başvuran ve sonrasında acil hemodiyaliz ihtiyacı ile hemodiyalize alınan hastalarla ilgili tanımlayıcı çalışma sınırlı sayıdadır. Bu çalışmada Marmara Üniversitesi Tıp Fakültesi Acil Tıp Kliniğine çeşitli şikâyetlerle başvuran ve yapılan tetkikleri neticesinde acil diyaliz endikasyonu konulan hastaların demografik özellikleri, klinik ve laboratuvar bulgularının belirlenmesi amaçlandı. Gereç ve Yöntemler: Bu çalışmaya hastanemiz acil servisine başvuran, acil tıp hekimi değerlendirmesinin ardından konsültasyon sonrası hemodiyalize alınan hastalar dahil edildi. Hastaların demografik, klinik ve laboratuvar verileri, diyaliz endikasyonları ve sonraki süreçleri retrospektif olarak toplandı. Veriler SPSS 22.0 programı ile analiz edildi. Bulgular: Çalışmamıza toplam 380 hasta alınmıştır. Hastaların %56,6’sı erkek olup yaş ortalamaları 63,3±17,3’dir. Hastaların %71,7’sinin bilinen kronik böbrek yetmezliği olup %67’si rutin hemodiyaliz programına girmektedir. En sık başvuru şikayeti nefes darlığıdır. Hastaların %75’i ilk 12 saat içinde hemodiyalize alınmıştır. %54,2 hastaya acil kateter takılması gerekmiştir. Hastaların büyük çoğunluğuna servis ya da yoğun bakım yatışı gerekmiş olup 3 hasta exitus olmuştur. Sonuç: Acil hemodiyalize alınması gereken hastaların çoğunluğuna yatış gerekmekte olup bu hastalar kritik hasta grubunu oluşturmaktadır. Bu hastaların daha iyi tanınması ve acil servis süreci öncesi hastalıklarının kontrol altına alınması için daha geniş tanımlayıcı çalışmalara ihtiyaç vardır.

Retrospective Analysis of Patients with Emergency Hemodialysis Indication in the Emergency Department

Aim: Emergency hemodialysis is a life-saving treatment. There is a limited number of descriptive studies in the literature on patients who applied to the emergency department due to chronic renal failure or acute renal failure and then received hemodialysis with the need for urgent hemodialysis. In this study, it was aimed to determine the demographic characteristics, clinical and laboratory findings of the patients who applied to the Marmara University Faculty of Medicine Emergency Medicine Clinic with various complaints and were given an indication for emergency dialysis as a result of the tests. Material and Methods: Patients who applied to the emergency department of our hospital and received hemodialysis after consultation after emergency medicine physician evaluation were included in this study. Demographic, clinical and laboratory data of the patients, dialysis indications and subsequent processes were collected retrospectively. The data were analyzed with the SPSS 22.0 program. Results: A total of 380 patients were included in our study. 56.6% of the patients were male and their mean age was 63.3±17.3 years. 71.7% of the patients have known chronic renal failure and 67% of them enter the routine hemodialysis program. The most common presenting complaint is shortness of breath. 75% of the patients received hemodialysis within the first 12 hours. An emergency catheterization was required in 54.2% of the patients. Most of the patients required hospitalization in the service or intensive care unit, and 3 patients died. Conclusion: Most of the patients who need emergency hemodialysis require hospitalization and these patients constitute the critical patient group. Larger descriptive studies are needed to better recognize these patients and to control their diseases before the emergency service process.

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