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HEMODİYALİZ YETERLİLİĞİ İLE KOMORBİD FAKTÖRLER ARASINDAKİ İLİŞKİ

THE RELATIONSHIP BETWEEN HEMODIALYSIS ADEQUACY AND CO-MORBID FACTORS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Dialysis adequacy is described as reducing mortality ayid morbidity rates besides improving the uremic symptoms of patients. In this study, it was aimed to assess the relationship between dialysis adequacy determined by urea kinetic model (UKM) and co-morbid factors. Daily Kt/V (Kti/V) value was determined in 52 hemodialysis (HD)patients. A morbidity score (MORS) was created by scoring seventeen clinical, biochemical and radiological parameters as one or zero. Daily Kt/V(Kti/V) of HD patients was found 0.41. The Kti/V value of HD patients was found to be 19.6 % lower than the value proposed by NKF-DOQI. There was a positive correlation between Kti/ V and normalized protein catabolic rate (nPCR) (r=0.814, p<0.01) and a negative correlation between Kti/V and MORS(r=-0.314, p<0.05) while there was no correlation between Kti/V and the other individual parameters of MORS. We concluded that, in assessing the adequacy of dialysis, morbid factors were efficient as well as UKM and it could have been a mistake to use only Kt/V for determining dialysis adequacy.
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Abstract (Original Language): 
Diyaliz yeterliliği, hastanın üremik belirtilerini gidermek yanında, morbidite ve mortalite oranlarının azaltılması olarak tanımlanmaktadır. Bu çalışmada üre kinetik model (ÜKM) ile saptanmış olan diyaliz yeterliliğinin, morbid faktörlerle ilişkisinin araştırılması amaçlanmıştır. Elli iki hemodiyaliz (HD) hastasının günlük eşdeğer Kt/V (Kti/V) değeri tespit edilmiştir. Onyedi adet klinik, biyokimyasal ve radyolojik parametreye 0 ya da 1 puan verilerek bir morbidite skoru (MORS) oluşturulmuştur. Kti/V değeri HD hastaları için 0.41 bulunmuştur. HD hastalarında saptanan Kti/V değerinin NKF-DOQI kriterlerine göre, istenenden % 19.6 daha düşük olduğu saptanmıştır. HD hastalarında Kti/V ile normalleştirilmiş protein katabolizma hızı (NPKH) değerinin kuvvetli korelasyon (r =0.814, p <0.01), MORS'un ters korelasyon gösterdiği (r=-0.314, p <0.05) saptanmış; MORS'u oluşturan parametrelerin herbiri ile Kti /V değeri arasında korelasyon olmadığı belirlenmiştir. Çalışmamızda diyaliz yeterliliğinin belirlenmesinde ÜKM yanında morbid durumların da etkili olduğu, tek başına KtfV ile sonuca ulaşmanın hatalı değerlendirmelere yol açabileceği sonucuna ulaşılmıştır.
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