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HEMODİYALİZDE KAN AKIM HIZINI ARTIRMAK ERİTROPOİETİN GEREKSİNİMİNİ AZALTIYOR MU?

DOES INCREASING BLOOD FLOW IN HEMODIALYSIS LESSEN ERYTHROPOIETIN REQUIREMENT?

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2003

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Inadequate hemodialysis in chronic hemodialysis patients is an independent risk factor that increases mortality and morbidity. One of the factors effecting solute clearance in hemodialysis is blood flow rate. Parameters at initial and 3 month after were compared in 18 chronic hemodialysis patients who were previously treated with low blood flow rate for various reasons and thereafter in whom blood flow rate was increased up to minimum 300 ml/min following removal of the problems related to vascular access and encouragement of the patients and nurses. After 3 months, it is our observation that the less erythropoietin (EPO) is the more hemoglobine. Whereas 10.18±1.02 g/dl of hemoglobin in average was obtained with 6888±3708 U of EPO intake a week in low blood flow rate period , 12.05±0.80 g/dl of hemoglobine was reached after giving 3055±3244 U of EPO as blood flow rate was more than 300 ml/min (p<0.001). With this high blood flow rate, the patients had increased apetite, albumine rised from 3.19±0.29 g/dl to 3.51 ±0.35g/dland Urea Reduction Rate (URR) from 53.39%±7.34 to 64.11%±9.62 (p<0.001). Searching a port entry for a minimum 300 ml/min of blood flow rate leading effective dialysis and thereby patient satisfaction is essential.
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Abstract (Original Language): 
Kronik hemodializ hastalarında yetersiz diyaliz mortalite ve morbiditeyi artıran bağımsız bir risk faktörüdür. Hemodializde solut klirensini etkileyen faktörlerden birisi de kan akım hızıdır (KAH). Çalışmada çeşitli nedenlerle düşük kan akım hızı ile (KAH ortalaması 206 ± 16.4 ml/dk) tedavi gören 18 kronik hemodiyaliz hastasının (11 E, 7 K, ort. Yaş= 55.6 ±8.7 yıl) damar erişim yolu sorunları giderilip, konu ile ilgili hastalar ve diyaliz hemşireleri cesaretlendirildikten sonra, KAH değeri minimum 300 ml/dk'ya yükseltilmiş, üç aylık tedavi sonrasında elde edilen değerler, bazal değerler ile karşılaştınlmıştır. Bu süre sonunda, daha düşük doz eritropoietin (EPO) kullanımı ile daha yüksek hemoglobin düzeylerine ulaşıldığı gözlenmiştir. Düşük KAH periyodunda haftalık ortalama 6888±3708 Ünit EPO kullanımı ile ortalama 10.18±1.02 g/dl hemoglobin düzeylerine ulaşılmışken, 300 ml/dk 'nın üzerindeki kan akım hızlarında 3055±3244 Ünit EPO kullanımıyla 12.05±0.80 g/dl lik hemoglobin düzeyleri elde edilmiştir (p<0.001). Hastaların iştahları artmış serum albumin düzeyleri 3.19±0.29 g/dlden 3.51+0.35 g/ di'ye, Urea Reduction Rate (URR) düzeyleri % 53.39±7.34'den %64.11 ±9.62'ye yükseldiği gözlenmiştir (p<0.001). Hastaların kendilerini daha iyi hissedeceği etkin bir diyaliz tedavisi için minimum 300 ml/dk üzerinde kan akım hızına ulaşabilecek giriş yeri yeterliliğinin aranması önemli bir koşuldur.
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  • 3
148-151
  • Turkish

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