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Yoğun Bakım Ünitelerinde Akut Böbrek Yetmezliği

Acute Renal Failure in Intensive Care Patients

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Abstract (Original Language): 
Akut böbrek yetmezliği (ABY), böbreğin atık maddeleri süzmek, idrarı yoğunlaştırmak, elektrolitleri korumak ve sıvı dengesini sağlamak gibi son derece önemli işlevlerini birdenbire kaybetmesi sonucunda ortaya çıkan bir durum olup, yoğun bakım hastalarında sıklıkla rastlanan bir komplikasyondur. Çeşitli çalışmalarda yoğun bakıma alınan hastaların %15-20'sinde ABY geliştiği dikkati çekmiştir (1,2). Bunların çoğunluğu akut tübüler nekrozdur (ATN) (%75.6). ATN'nin de en sık nedeni olarak, sepsis %35.4, diğer medikal nedenler %35.4, nefrotoksik nedenler %31.6 olarak bildirilmiştir (3). ABY yoğun bakıma gerek duyulan durumlar dışında genellikle tamamı ile geri dönebilen iyi klinik gidişli bir tablodur. Son yıllarda yoğun bakım ve yapay böbrek tedavi olanaklarının çok gelişmesine rağmen, yoğun bakım hastalarında diğer organ yetmezlikleri ile bir¬likte görüldüğünde ölüm oranının %50-70'leri bulduğu bildirilmiştir (4). ABY'de kendisini oluşturan ne¬dene ve birlikte bulunan diğer hastalıkların ciddiye¬tine bağlı olarak ölüm riski farklılık gösterir. Örneğin, nefrotoksik ilaçların neden olduğu ABY'de bu oran %30 iken, olay solunum, karaciğer yetmezliği ve di¬ğer organ yetmezlikleri ile birlikte gelişmişse ölüm riski %90'ları bulur.

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Türk Nefroloji Diyaliz ve Transplantasyon Dergisi /Official Journal of the Turkish Society of Nephrology
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