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KRONİK HEMODİYALİZ HASTALARINDA KALICI DAMAR YOLU TİPLERİNE GÖRE DİYALİZ YETERLİLİĞİ VE RESİRKÜLASYON ORANLARI

HEMODIALYSIS ADEQUACY AND RECIRCULATION RATIO ACCORDING THE PERMANENT VASCULAR ACCESS TYPE IN PATIENTS WITH CHRONIC HEMODIALYSIS

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Abstract (2. Language): 
Background: Dialysis adequacy is an important parameter with regards to morbidity and mortality in chronic hemodialysis patients. Besides many other factors affecting this parameter, the effect of different permanent vascular access types (PVA), essential for the hemodialysis treatment, on this parameter should be further investigated. As PVA 's, native arteriovenous fistulas (NAVF), graft (polytetrafluoroethylene) arteriovenous fistulas (GA VF) and permanent hemodialysis catheters (PHC) are used. One of the factors during the performing a PVA is to find an answer to whether or not the type of PVA has an effect on Kt/V ratio and recirculation (R%). Our purpose was to find whether there was any difference depending on the type of PVA in terms ofKt/V and R%. Method: Sixty-one patients who have been on hemodialysis with the same vascular access for the past 6 months were grouped according to their types of PVA. Of them, 37 were NAVF, 12 were GAVFand the remaining 12 were with PHC and they all received bicarbonate dialysis with low-flux dialysers 4 hours 3 times a week. Mean average Kt/V and R% ratios for six months were calculated. Kruskal-Wallis H test was used for statistically analysis. Results: Mean average of Kt/V'for six months was found as 1.29 +0.28 in 37 patients with NAVF, as 1.31 ±0.27 in 12 patients with GAVF and as 1.34 ±0.22 in 12patients with PHC. R% was found 9.1 ±4.6% in NAVF, 8.1 ±4.1 % in GA VF and 6 ± 3.1 % in PHC. There was no significant difference among the three groups in terms of Kt/V and R% (p=0.68,p=0.3). Discussion: Dialysis adequacy and R% were found similar in three types of PVA. The type of PVA was not observed as an important factor in means of R% and dialysis adequacy. When creating a PVA, other characteristics of the patient and the cost of the procedure should be taken into consideration.
Abstract (Original Language): 
Amaç: Kronik hemodiyaliz hastalarında diyaliz yeterliliği morbidite ve mortalite açısından önemli bir parametredir. Bu parametre üzerine etkili bir çok faktörün yanısıra hemodiyaliz işlemi için gerekli olan kalıcı damar yolu (KDY) tiplerinin etkilerinin bulunup bulunmadığı araştırılması gereken bir konudur. KDY olarak, nativ arteriovenöz fistüller (NA VF), Greft (politetrafluoraetilen) arteriovenöz fistüller (GAVF) ve kalıcı hemodiyaliz kateterleri (KHK) kullanılmaktadır. KDY oluşturulurken dikkat edilmesi gereken konulardan birisi de KDY tipinin diyaliz yeterliliğine olan etkisi olabilir mi sorusuna cevap aramak için Kt/Vve resirkülasyon (R) açısından KDYtipleri arasında fark olup olmadığını araştırmayı amaçladık. Yöntem: Son 6 aydır aynı damar yolu ile hemodiyalize giren 61 hasta KDYtiplerinegöregruplandırıldı. Hastalardan 37 si NAVF, 12'si GAVF ve 12Si KHK ile haftada 3 kez 4'er saat, bikarbonattı hemodiyalize giriyordu. Altı aylık KT/V ortalamaları ve R oranları hesaplandı. Gruplar arasında farklılık olup olmadığı araştırıldı. İstatistiksel yorumda Kruskal-Wallis H testi kullanıldı. Bulgular: NAVF'lü 37 hastanın son 6 aylık KT/V ortalamaları 1.29±0.28, GAVF'li 12 hastanın 1.31±0.27, KHK'li 12 hastanın 1.34±0.22 olarak bulundu. R oranları NAVF'de % 9.1 ±4.6, GAVF'de % 8.1 ±4.1 ve KHK'de % 6.6±3.1 bulundu. Her üç grup arasında da KT/V ve R oranları açısından farklılık yoktu (p=0.68, p=0.3). Tartışma: Diyaliz yeterliliği ve R oranları üç tip KDY'nda benzer bulunmuştur. KDY tipi R ve diyaliz yeterliliği için belirleyici faktör olarak izlenmemektedir. KDY oluşturulurken hastanın diğer özellikleri ve maliyet göz önüne alınmalıdır.
FULL TEXT (PDF): 
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