Çağrı DÜZYOL, Ufuk AYDIN, Erkan ŞENGÜL, Orhan FINDIK, Alper GÖRÜR, Cevdet Uğur KOÇOĞULLARI

Geçici hemodiyaliz kateteri yerleştirilen hastalarda derin venöz tromboz için düşük serum albumin düzeyi risk faktörü müdür?

Amaç: Bu çalışmada geçici femoral hemodiyaliz kateteritakılan hastalarda düşük serum albümin düzeyi ile derin venöz trombozu ilişkisi araştırıldı.Çalışma planı: Kasım 2011 - Haziran 2012 tarihleriarasında kliniğimizde geçici femoral hemodiyaliz kateteri yerleştirilen 60 hasta prospektif olarak incelendi.Hastalar serum albümin düzeyi 3 g/dL üzerinde olanlar(grup 1, n=30) ve serum albümin düzeyi 3 g/dL altında olanlar (grup 2, n=30) olmak üzere iki gruba ayrıldı. Hastaların tümüne kalp damar cerrahisi ameliyathane-sinde lokal anestezi altında ve ultrasonografi eşliğindegeçici femoral hemodiyaliz kateter yerleştirilmesi işlemi uygulandı.Bulgular: Kronik böbrek yetmezliği olan bu hastalardan üçü radyoterapi almıştı; 12 hastada diabetes mellitus, 13 hastada morbid obezite, 23 hastada hipertansiyon ve 19 hastada kronik obstrüktif akciğer hastalığı vardı. Grup 1 ve grup 2 hastaların demografik özellikleri benzerdi. Derin venöz tromboz sıklığı grup 1’deüç hasta (%10), grup 2’de 10 hasta (%33) olarak tespitedildi (p= 0.037). Geçici femoral hemodiyaliz kateteri takılan hastalar için düşük serum albümin düzeyi ilederin venöz tromboz gelişme riski arasında istatistikselolarak anlamlı ilişki bulundu. Sonuç: Geçici hemodiyaliz kateteri yerleştirilecek düşük serum albümin düzeyi olan hastalarda profilaktik antikoa-gülasyon düşünülmelidir.

Is low serum albumin level a risk factor for deep venous thrombosis in temporary hemodialysis catheter inserted patients?

Background: This study aims to investigate the correlation between low serum albumin level and deep venous thrombosis in temporary femoral hemodialysis catheter inserted patients. Methods: Between November 2011 and June 2012, 60 patients who received temporary femoral hemodialysis catheter in our clinic were prospectively analyzed. The patients were divided into two groups according to serum albumin level higher than 3 g/dL (group 1, n=30) and serum albumin level lower than 3 g/dL (group 2, n=30) patients. All patients underwent temporary femoral hemodialysis catheter implantation with the guidance of ultrasonography under local anesthesia in the cardiovascular operating room. Results: Of these chronic renal failure patients, three previously received radiation therapy; 12 patients had diabetes mellitus, 13 patients had morbid obesity, 23 patients had hypertension and 19 patients had chronic obstructive pulmonary disease. The demographic characteristics of group 1 and group 2 were similar. The incidence of deep venous trombosis was three patients (10%) in group 1 and 10 patients (33%) in group 2 (p=0.037). There was a statistically significant correlation between low serum albumin level and risk for deep venous thrombosis in temporary femoral hemodialysis catheter inserted patients. Conclusion: Prophylactic anticoagulation should be considered in patients who are scheduled for a temporary femoral hemodialysis catheter with a low serum albumin level.

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