İlknur Hatice AKBUDAK, Çağla ERDOĞAN, İsmail Hakkı AKBUDAK

Yoğun bakım ünitesinde uygulanan sürekli renal replasman tedavisi sonuçlarının değerlendirilmesi

Amaç: Akut böbrek hasarı teşhisi konan hastaların renal replasman tedavisine (RRT) ihtiyacı vardır. Sürekli RRT'nin daha güvenli olduğuna inanılmaktadır çünkü sıvı ve çözünen uzaklaştırma oranları aralıklı hemodiyalizden daha yavaştır. Birçok merkezde kraniyal basınç artışı, sepsis, yanıklar, kalp ve karaciğer yetmezliği gibi özel durumlarda CRRT tercih edilmektedir. Çalışmamızda yoğun bakım ünitemizde CRRT kullanımının bir yıllık verilerini sunuyoruz.Gereç ve yöntem: Bu çalışmaya Ocak 2019-Haziran 2020 tarihleri arasında üniversitemiz Dahiliye Yoğun Bakım Ünitesi'ne başvuran hastalar dahil edilmiştir. Bu hastalardan 18 yaş üstü ve yatışı sırasında akut böbrek yetmezliği gelişen ve sürekli renal replasman tedavisi çalışmaya dahil edildi.Bulgular: Başvuru anında ortalama SOFA skoru 2.7 idi ve bu ciddi hastalık göstergesiydi. Yoğun bakımda kalış süreleri uzundu ve bu hastaların yaklaşık yüzde 77'si yoğun bakımda öldü. Hastaların komorbid durumları incelendiğinde en sık onkolojik hastalıkların olduğu görüldü. Bunu hipertansiyon, diabetes mellitus ve kalp hastalıkları izledi. ABH tanısı alan hastaların KDIGO puanlarına bakıldığında yüzde 60'ının derece 5 olduğu görüldü. Ortalama 25 saat tedavi uygulanabildi.Sonuç: CRRT'nin endikasyonları, zamanlaması ve faydaları, araştırılması gereken ve henüz çözülmemiş sorulardır. Gelişen teknoloji ile birlikte CRRT, yoğun bakım ünitelerinde en faydalı yardımcımız olacaktır.

Anahtar Kelimeler:

CRRT, akut böbrek hasarı, renal replasman hasarı

Evaluation of continuous renal replacement therapy results applied in the intensive care unit

Purpose: Acute kidney injury diagnosed patients are in need of renal replacement therapy (RRT). Continuous RRT is believed to be safer because the rates of fluid and solute removal are slower than with intermittent hemodialysis. In many centers, CRRT is preferred in special conditions such as increased cranial pressure, sepsis, burns, heart and liver failure. In our study, we present one year data of CRRT usage in our ICU.Materials and methods: This study included the patients who admitted to the Internal Medicine Intensive Care Unit of our university between January 2019 and June 2020. Among these patients, those over 18 years of age and those who had acute renal failure during their hospitalization and received continuous renal replacement therapy were included in the study.Results: Mean SOFA scores at admission were 2.7 which is an indication for severe disease. Lengths of ICU stay were long and approximately 77 percent of these patients died in ICU. When the comorbid conditions of the patients were examined, it was seen that oncological diseases were the most common. It was followed by hypertension, diabetes mellitus and heart diseases. Considering the KDIGO scores of the patients diagnosed with AKI, it was seen that 60 percent of them were grade 5. Treatment could be applied for an average of 25 hours. Conclusion: Indications, timing and benefits of CRRT are the questions that need to be research and yet remained unsolved. With evolving of technology, CRRT will be our most useful helper in ICUs.

Keywords:

CRRT, acute kidney ınjury renal replacement therapy, akut böbrek hasarı, renal replasman hasarı,

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