Üstün YILMAZ, Ayça İNCİ, Ayşe AKARSU, Ümmühan MADEN

Son Dönem Böbrek Yetmezliği Hastalarında Renal Replasman Tedavi Seçimini Etkileyen Faktörler

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.

Anahtar Kelimeler:

Son dönem böbrek yetmezliği, renal replasman tedavisi, hemodiyaliz, periton diyalizi, renal transplantasyon

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

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.

Keywords:

End stage renal disease, renal replacement therapy, hemodialysis, peritoneal dialysis, renal transplantation,

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