Evaluation of Patients with Chronic Renal Failure Admitted to the Emergency Department

Objective: The aim of this study is to retrospectively investigate the files of patients with Chronic renal failure (CRF) who have undergone any dialysis program and have been admitted to the emergency department, drawing attention to the preferred treatments with the most common diagnoses, together with demographic and clinical information. Materials and Method: A total of 683 patients with CRF who were admitted to the emergency department of Meram Medical Faculty, Turkey in the last 5 years were searched and 224 patients, 189 of whom had hemodialysis (HD) and 35 of whom had peritoneal dialysis (PD), were included in the study. The demographic data, complaints and laboratory findings at the time of the admission to the emergency department, diagnoses, treatments and clinical outcomes were analysed. Results: 69 patients had applied to the emergency department more than once. The most common presenting complaint in the HD group was shortness of breath, and for the PD group it was abdominal pain. 14.3% of all patients died at the end of clinical follow-up. The presence of a history of cerebrovascular disease, antibiotic use in the emergency department, and ventilator use were found to be statistically significant in terms of mortality related factors. Conclusion: The complaints pattern of patients on routine dialysis is quite wide1. In some patients, medical treatment in the emergency department consists only of HD treatment. This shows that some of the dialysis patients need additional dialysis.

Keywords:

Emergency department, chronic renal failure,

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(1) Mosenkis A, Kirk D, Berns JS. When chronic kidney disease becomes advanced. Guidelines for care in the emergency department and hospital. Postgrad Med. 2006 Jun-Jul;119(1):83-91, 104.
(2) Grassmann A, Gioberge S, Moeller S, Brown G. End-stage renal disease – Global demographics in 2005 and observed trends. Artif Organ. 2006; 308: 95-7.
(3) Süleymanlar G, Altıparmak MR, Seyahi N, Trabulus S. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon – Registry 2012. Türk Nefroloji Derneği Yayınları, Ankara, 2013.
(4) U. S. Renal Data System, USRDS 2013 Annual Data Report: Atlas of End Stage Renal Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, 2013.
(5) Extracellular fluid volume is associated with incident end-stage kidney disease and mortality in patients with chronic kidney disease Anne- LaureFaucon, MartinFlamant et all Nephro-logy Test Study Group
(6) National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney dise-ase: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 Suppl 1): S1–266
(7) Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351:1296-305
(8) A Brent Alper Jr M, MPH. Associate Professor of Medicine, Section of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine.
(9) Kutner NG, Johansen KL, Kaysen GA, et al. The comprehensive dialysis study (CDS): A USRDS special study. Clin J Am Soc Nephrol. 2009;4:645-50.
(10) Chronic kidney disease in the emergency centre: A prospective observational study African Journal of Emergency Medicine
(11) Sacchetti A, Harris R, Patel K, Attewell R. Emergency department presentation of renal dialysis patients: indications for EMS transport directly to dialysis centers. J Emerg Med. 1991
(12) Loran MJ, McErlean M, Eisele G, Raccio-Robak N, Verdile VP. The emergency department care of hemodialysis patients. Clin Nephrol. 2002
(13) Sacchetti A, McCabe J, Torres M, Harris RL. ED management of acute congestive heart failure in renal dialysis patients. Am J Emerg Med. 1993.
(14) Sacchetti A, Stuccio N, Panebianco P, Torres M. ED hemodialysis for treatment of renal failure emergencies. Am J Emerg Med. 1999.
(15) Heaf JG, Løkkegaard H, Madsen M. Initial survival advantage of peritoneal dialysis relative to haemodialysis. Nephrol Dial Transplant. 2002;17:112-7.
(16) Peritoneal Dialysis in Renal Replacement Therapies Utaş C. Sunum http://www.tsn.org.tr/folders/file/cengiz%20 utas.pdf ,May 2014
(17) Causes of Mortalty in Acute and Chronicc Renal Failure Ferdi Seyyid Taş, Kuddusi Cengiz et all. Fırat Medical Journal 2011