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Böbrek Nakli Sonrası Kronik Diyaliz Hipotansiyonunun İyileşmesi: Olgu Sunumu

Recovery of Chronic Dialysis Hypotension After Kidney Transplantation: A Case Report

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2014
DOI: 
10.5262/tndt.2014.1001.14

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Chronic dialysis hypotension is described as low systolic blood pressure (<100 mmHg) during interdialytic period. The presence of low predialysis systolic blood pressure, typically <110 mmHg, is signifi cantly associated with increased mortality. Kidney transplantation is the preferred model of renal replacement therapy in the treatment of end-stage renal disease (ESRD) as it improves quality of life and survival. In this article, a long-term hemodialysis (HD) patient with chronic hypotension improved after kidney transplantation is presented. A 39-year-old male patient received a deceased donor kidney transplant. The patient was on HD for 23 years. The patient had suffered from chronic persistent hypotension for the last 8 years. Blood pressure was 70/50 mmHg before dialysis and 60/40 mmHg after dialysis. In the post-transplant period, blood pressure was maintained above 110/70 mmHg by intermittent infusion of dopamine. Hypotension was improved after 24 days and dopamine was discontinued. Various etiologies may cause chronic hypotension in patients receiving long-term HD treatment. Kidney transplantation may improve survival and quality of life by correcting hypotension in these patients. Therefore kidney transplantation should not be avoided as renal replacement therapy in ESRD patients with hypotension.
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Abstract (Original Language): 
Kronik diyaliz hipotansiyonu iki diyaliz arasındaki dönemde sistolik kan basıncı düşüklüğü (<100 mmHg) olarak tanımlanmaktadır. Diyaliz öncesi düşük sistolik kan basıncı varlığı (tipik olarak 110 mmHg’nın altı) artmış mortalite ile anlamlı ilişkilidir. Böbrek nakli yaşam kalitesini ve sağ kalımı iyileştirdiği için son dönem böbrek yetmezliği (SDBY) tedavisinde tercih edilen böbrek yerine koyma modelidir. Bu yazıda böbrek nakli sonrası kan basıncının normale geldiği hipotansiyonu olan uzun dönem hemodiyaliz (HD) hastası sunulmuştur. 39 yaşında erkek hastaya kadaverik böbrek nakli yapıldı. Hasta 23 yıldır HD’e girmekte idi. Kronik hipotansiyon 8 senedir devam etmekteydi. Kan basıncı diyaliz öncesi 70/50 mmHg, diyaliz sonrası ise 60/40 mm Hg civarında seyretmekteydi. Böbrek nakli sonrası erken dönemde aralıklı dopamin infüzyonu ile kan basıncının 110/70 mm Hg’nın üstünde olması sağlandı. Hipotansiyon 24 gün sonra düzeldi ve dopamin infüzyonu kesildi. Uzun dönem HD tedavisi alan hastalarda birçok farklı neden kronik hipotansiyona neden olabilir. Bu hastalarda böbrek nakli hipotansiyonu düzelterek hastanın sağkalım ve yaşam kalitesini düzeltebilir. Bu nedenle kronik hipotansiyonu olan SDBY hastalarında böbrek naklinden kaçınılmamalıdır.
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