You are here

1992-1996 YILLARI ARASINDA CAPD TEDAVİSİ UYGULANAN HASTALARIN KLİNİK VE LABORATUAR BULGULARI AÇISINDAN DEĞERLENDİRİLMESİ

THE EVALUATION OF CLINICAL AND LABORATORY FINDINGS OF THE PATIENTS ON CAPD TREATMENT BETWEEN 1992-1996

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
In this study 30 patients with end stage rena disease were discussed in point of clinical, laboratory outcomes, adequecy and complications who underwent CAPD treatment during the last 4 years. 16 female, 14 male patients were followed up 52.46+23.46 weeks in average and their mean age was 54.16±13.15 years. Their serum BUN, creatini-ne, uric acid, calcium, phosphorus and electrolyte levels were controlled properly. Their clinical outcomes were excellent and most of them returned to their previous life. Uremic symptoms disappeared. The control of hypertension became easy, even some patients stopped using antihypertensive drugs. Anemia were treated with EPO in only 19 patients; the other 11 patients hematological values became normal without using any treatment. Hypoalbuminemia and malnutrition were not a problem during the follow up period. Hyperlipidemia called attention, but renal osteodystrophy and neuropathy did not seem to cause any problem during this period of time. Peritonitis was still the most serious problem we had to deal. We experienced 1.5 peritonitis attacks every year. The most common responsible agent was staphylococcus aureus (16.3%). As a result; 3 of our case was died, 2 of them had cerebrovascular accident, the other one had fungal peritonitis. 3 out of 30 returned to hemodialysis treatment because of fungal peritonitis. 2 received renal transplantation. The rest of them continue to follow up. Even though treatment has a lot of advantages, peritonitis still keeps its place as a serious complication in our country. The education of patients and its family, the relationship and communication between patients, doctors, nurses and other workers seems very important subjects to lower this complication.
Abstract (Original Language): 
Bu çalışmada son 4yıl içinde, kliniğimize başvuran ve CAPD (Ayaktan Devamlı Periton Diyalizi) endikasyonu konulan 30 son dönem böbrek hastası¬nın klinik ve laboratuar muayene sonuçları, diyaliz yeterliliği, karşılaşılan komplikasyonlar incelendi. Olgularımızın 16'sı kadın,14'Uerkekti. Yaş ortalamaları 54.16±13.15 olup her olgu ortalama 52.46±23.46 hafta izlenmiştir. Olgularımızın BUN, kreatinin, ürik asit, kalsiyum, fosfor ve elektrolit de¬ğerleri son derece iyi kontrol altına alınmıştır. Klinik olarak iyiye giderken günlük yaşamlarını idame edebilir hale gelmişlerdir. Üremik semptomları bü¬yük ölçüde ortadan kalkmıştır. Hipertansiyon kontro¬lü kolay hale gelmiş ve hatta bazı hastalarda tedavi tamamı ile kesilmiştir. Hastalarımızın 19'unda anemi tedavisi için EPO kullanmaya gereksinim duyuldu, geriye kalan 11'inde ise anemi tedavisiz ortadan kalk¬tı. İzlenme süresi içinde hipoalbuminemi ve malnutrisyon gözlenmedi. Olgularımızda hiperlipidemi sorun olurken, osteodistrofi ve nöropati ciddi bir sorun yaratmamıştır. Peritonit önemli bir komplikasyon olmaya devam etmiş; yılda 1,5 kez gibi sıklığını korumuştur. En sık rastlanan sorumlu ajan stafilokokkus aureustur (%16.3). Sonuçta, olgularımızın 3'ü kaybedildi, bunlardan 2'si serebrovasküler atak (SVA) , 1 tanesi mantar peritoniti ile oldu. 3 olgumuz hemodiyaliz tedavisine geri döndü, bunlar mantar peritoniti nedeni ile idi. 2 olgumuza renal transplantasyon yapıldı. Geriye kalan 22 olgu halen izlenmektedir. CAPD tedavisinin bir çok üstünlüklerinin yanı sı¬ra ülkemizde henüz peritonit komplikasyonu ciddiyetini korumaktadır. Bu nedenle hasta ve yakın¬larının eğitimleri, hasta, hekim, hemşire ve diğer ça¬lışanlar arasındaki yakınlık ve iletişimin geliştiril¬mesine önem verilmesi gerektiği kanısındayız.
FULL TEXT (PDF): 

REFERENCES

References: 

1.
Massr
y SG, Glassock RJ. Massry and Glassock's Textbook of Nephrology. 3th edition. 1995.
2. Weiler EW, Saldanha LF, Khalil Manesh F. Relationship of Na-K-ATPase inhibitors to blood-pressure regulation
in CAPD and HD. J Am Soc Nephrol. 1996;7(3):454-63.
3. Canziani ME, Cendoroglo NM, Saragoca MA. Hemodialysis versus continuous ambulatory peritoneal dialysis. Artif Organs. 1995; 19(3): 241-4.
4. Hebert MJ, Falardeau M, Pichette V. Continuous ambulatory peritoneal dialysis for patients with severe left ventricular systolic dysfunction and end-stage renal
disease. Am J Kidney Dis. 1995; 25(5): 761-8.
5. Alpert MA, Huting J, Twardowski ZJ. Continuous ambulatory peritoneal dialysis and the heart. Perit Dial
Int.1995; 15(1): 6-11.
6. McGrath LT, Douglas AF, McClean E. Oxidative stress and erythrocyte membrane fluidity in patients undergoing
regular dialysis. Clin Chim Acta. 1995; 235(2): 179-88.
7. Majdan M, Ksiazek A, Spasiewicz D. Comparison of the ability to control anemia in patients on hemodialysis and peritoneal dialysis considering iron reserves and plasma
erythropoietin. Pol Arch Med Wewn. 1996; 95(4): 307¬12.
8. Raja R, Bloom E, Johnson R. Improved response to erythropoietin in peritoneal dialysis patients as compared to hemodialysis patients: role of iron deficiency. Adv
Perit Dial. 1994; 10: 135-8.
9. Kurz P, Tsobanelis T, Roth P. Differences in calcium kinetic pattern between CAPD and HD patients. Clin
Nephrol. 1995; 44(4): 255-61.
10. Hutchison AJ, Gokal R. Vitamin D therapy in CAPD: what is its role? Adv Perit Dial. 1993; 9: 253-6.
11. Palop L, Vega N, Rodriguez T. Nutritional status of CAPD patients at three years.
Perit Dial Int. 1996; 16 (Suppl. 1): 195-202.
12. Tzamaloukas AH, Murata GH. Adequacy of continuous ambulatory peritoneal dialysis. Int J Artif Organs.1993;
16 (8): 567-72.
13. Arkouche W, Delawari E, My H. Quantification of adequacy of peritoneal dialysis. Perit Dial Int. 1993; 13
(Suppl. 2): 215-8.
14. Spinowitz BS, Gupta BK, Kulogowski J. Dialysis adequacy versus metabolic factors in the clinical assessment of CAPD. Adv Perit Dial. 1993; 9: 295-8.
15. Kumano K, Takagi Y, Yokota S. Urea kinetics and clinical features of long-term continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 1993; 1 (Suppl.
2): 180-2.
16. Jacob V, Marchant PR, Wild G. Nutritional profile of continuous ambulatory peritoneal dialysis patients.
Nephron. 1995; 71(1): 16-22.
17. Aparicio M, Combe C, Larroumet Sornay N. Nutrition and continuous ambulatory dialysis. Nephrologie. 1995;
16(1): 71-6.
18. Wakabayashi Y. Changes in residual dextrose and amount of total protein loss in the effluent during the clinical course of continuous ambulatory peritoneal dialysis-related peritonitis. Nippon Jinzo Gakkai Shi.
1994; 36(10): 1175-83.
19. Shimomura A, Tahara D, Azekura H. Nutritional improvement in elderly CAPD patients with additional
high protein foods. Adv Perit Dial. 1993; 9: 80-6.
20. Horkko S, Huttunen K, Laara E. Effects of three treatment modes on plasma lipids and lipoproteins in
uraemic patients. Ann Med. 1994; 26(4): 271-82.
21. Buggy D, Breathnach A, Keogh B. Lipoprotein(a) and treatment of chronic renal disease. J Intern Med. 1993;
47
234(5): 453-5.
22. Cavagna R, Schiavon R, Tessarin C. Risk factors of ischemic cardiac disease in patients on continuous ambulatory peritoneal dialysis. Perit Dial Int. 1993; 13, Suppl. 2: 402-5.
23. Nissenson AR, Fine RN. Dialysis Therapy. 2nd edition. 1993;
24. Nevalainen PI, Lahtela JT, Mustonen J. Subcutaneous and intraperitoneal insulin therapy in diabetic patients on CAPD. Perit Dial Int. 1996; 16 (Suppl. 1): 288-91.
25. Bistrup C, Siboni AH, Pedersen RS. Peritonitis among patients treated with continuous ambulatory peritoneal dialysis. Ugeskr Laeger. 1995; 10; 157 (28): 4023-6.
26. Hagelskjaer LH, Moller JK. Peritonitis in continuous ambulatory peritoneal dialysis. An evaluation of the empiric initial antibiotic treatment. Ugeskr Laeger. 1996;
29; 158(18): 2532-7.
27. Chan TM, Chan CY, Cheng SW. Treatment of fungal
peritonitis complicating continuous ambulatory peritoneal dialysis with oral fluconazole: a series of 21
patients. Nephrol Dial Transplant. 1994; 9(5): 539-42.
28. Lye WC, Leong SO, van der Straaten JC. A prospective study of peritoneal dialysis-related infections in CAPD patients with diabetes mellitus. Adv Perit Dial. 1993; 9:195-7.
29. Warmington V, Baxter E. A supportive partnership for
CAPD patients. Prof Nurse. 1996; 11(11): 767-8.

Thank you for copying data from http://www.arastirmax.com