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1996-2000 YILLARI ARASINDA SAPD TEDAVİSİ UYGULANAN HASTALARIN KLİNİK VE LABORATUAR BULGULARI AÇISINDAN DEĞERLENDİRİLMESİ

THE EVALUATION OF CLINICAL AND LABORATORY FINDINGS OF THE PATIENTS ON CAPD TREATMENT BETWEEN 1996-2000

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Abstract (2. Language): 
In this study 28 patients with end stage renal disease were evaluated in the light of their clinical status, laboratory data and the adequacy and the complications of dialysis who were on continuous ambulatory peritoneal dialysis (CAPD) treatment between September 1996 and October 2000. Thirteenfemale and 15 male patients were followed up 21±12,39 months in avarage and their mean age was 48,96^15,96 years. rHuEpo treatment was required by 18 patients with anemia and the anemia seen in the rest of the patients became normal, without rHuEpo treatment. Blood pressure control of our patients become easy by CAPD, furthermore, the antihypertensive . treatment were discontinued in some patients. Hypoalbuminemia, as a common complication of CAPD treatment, was not developed in our patients. Hyperlipidemia was seen as an important outcome, whereas renal osteodystrophy and neuropathy did not seem to cause any problem during this period. The adequacy parameters of peritoneal dialysis were achieved in our patients. Peritonitis was still the most serious problem, the rate ofperitonitis was 1 / 10,5 patient-months. The most common responsible agent was Staphylococcus aureus (% 19,64). As a result, two patients passed away, one of them had sudden death and the other one had septicemia after peritonitis. Four patients were converted to HD treatment. The encountered problems for each patient were as follows: relapsing peritonitis, tunnel infection with peritonitis, fungal peritonitis and outflow failure. One of our CAPD patients received renal transplantation. The rest of the patients were continued on peritoneal dialysis. Although CAPD treatment has a lot of advantages as a renal replacement therapy inpatients with end stage renal failure, peritonitis still remains as a serious complication in our country.
Abstract (Original Language): 
Bu çalışmada Eylül 1996-Ekim 2000 tarihleri arasında, sürekli ayaktan periton diyalizi (SAPD) tedavisi uygulanan 28 son dönem böbrek hastasının klinik ve laboratuar muayene sonuçları, diyaliz yeterliliği ve karşılaşılan komplikasyonlar incelendi. Olgularımızın 13ü kadın, 15i erkekti. Yaş ortalaması 48,96±l 5,96 yıl olup, ortalama izle m süresi 21 ±12,39 aydır. Hastalarımızın 18 'inde anemi tedavisi için eritropoietin (rHııEpo) kullanmaya gereksinim duyulmuş, geriye kalan 10'unda ise anemi tedavisiz düzelmiştir. Olgularımızda SAPD tedavisi ile kan basıncı kontrolü kolaylaşmış ve bazı hastalarda anti-hipertansif tedavi kesilmiştir. SAPD hastalarında en yaygın komplikasyon olan, hipoalbuminemi bizim olgularımızda gelişmemiştir. Hiperlipidemi olgularımızda bir sorun oluştururken, renal osteodistrofı ve nöropati ciddi bir sorun yaratmamıştır. Hastalarımızda diyaliz yeterliliği açısından hedeflenen değerler sağlanmıştır. Peritonit önemli bir komplikasyon olmaya devam etmiş, peritonit oranı 1 peritonit atağı /10,5 hasta ayı olarak saptanmıştır. En sık rastlanan sorumlu ajan Staphylococcus aureus 'tur (% 19,64). Sonuç o/arak, bir hasta ani ölüm, bir hasla peritonit sonrası gelişen sepsis nedeniyle olmak üzere olgularımızın 2 'si kaybedildi. Bir hasta tekrarlayan peritonit, bir hasta tünel infeksiyonu ve beraberinde peritonit, bir hasta mantar peritoniti, bir hasta kateter dışa akım yetersizliği nedeniyle SAPD tedavisinden hemodiyaliz (HD) tedavisine geçirildiler. Bir hastaya böbrek transplantasyonu yapıldı. Geriye kalan 21 olgu halen izlenmektedir. Son dönem böbrek yetersizlik/i hastalarda renal replasman tedavisi olarak SAPD'nin birçok üstünlükleri olmasına rağmen, ülkemizde peritonit komplikasyonu halen ciddiyetini korumaktadır.
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