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Hipoalbüminemi, Kötü Kalsiyum-Fosfor Kontrolü ve Yüksek Geçirgenlikli Periton Karakteri - Periton Diyalizi Hastalarında 10 Yıllık Sağkalımı Belirleyen 3 Önemli Faktör

Hypoalbuminemia, Poor Calcium-Phosphorus Control and High Transporter Peritoneal Characteristics – Three Important 10-Year Survival Predictors for Peritoneal Dialysis Patients

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DOI: 
10.5262/tndt.2014.1001.03
Abstract (2. Language): 
OBJECTIVE: Peritoneal transport characteristic is a potential survival predictor. In this study we evaluated the effect of transport characteristics on 10 year patient survival and compared its’ impact with other possible survival predictors. MATERIAL and METHODS: We included 75 CAPD patients who were followed in our center for at least 10 years after initiation of PD. Based on the standard peritoneal equilibration test, PD patients were divided into two transporter groups: Low / Low average (n:27) and High / High Average (n:48). Clinical and demographic data were collected from patient charts and impact of transporter characteristics and some other well-known survival predictors were studied. RESULTS: 10 year PD survival rates were signifi cantly lower in H/HA group (p:0.001). Atherosclerosis-related mortality rate was signifi cantly higher in H/HA group (45.9% vs. 7.6%, p:0.043). Hypoalbuminemia, increased CaxP, chronic infl ammation, H/HA transport status were independent predictors of PD and patient survival. Further analysis revealed that hypoalbuminemia (p:0.0001) and increased CaxP levels (p:0.0001) were the main predictors. CONCLUSION: This study suggests that peritoneal transport status is an important survival predictor. However keeping the calcium and phosphorus levels in recommended ranges, and improving nutritional status still have more importance for lowering mortality rates of PD patients.
Abstract (Original Language): 
AMAÇ: Periton geçirgenlik özellikleri potansiyel bir sağkalım prediktörüdür. Bu çalışmada geçirgenlik karakteri dahil olmak üzere bazı olası sağkalım prediktörlerinin PD hastalarının 10 yıllık sağkalımı üzerindeki etkileri araştırılmıştır. GEREÇ ve YÖNTEMLER: Çalışmaya PD tedavisinin başından bu yana merkezimizde takip edilmekte olan 75 hasta dahil edilmiştir. Hastalar standart PET testine göre düşük/düşük-orta (n:27) ve yüksek/yüksek-orta (n: 48) geçirgenlikli gruplarına bölünmüştür. Klinik ve demografi k özellikler hasta kayıtlarından toplanarak sağkalım üzerinde etkili olabilecek faktörler analiz edilmiştir. BULGULAR: Yüksek geçirgenlik grubunda 10 yıllık hasta sağkalımı belirgin olarak düşüktür (p:0,001). Bu grupta ateroskleroza bağlı mortalite oranları da belirgin olarak yüksektir (%45,9 ve %7.6, p:0,043). Hipoalbüminemi, artmış CaxP, kronik infl amasyon ve yüksek geçirgenlik bağımsız PD ve hasta sağkalım prediktörü olarak saptanmışlardır. İleri analizdeyse Hipoalbüminemi (p:0,0001) ve artmış CaxP seviyeleri (p:0,0001) ana faktörler olarak görülmektedir. SONUÇ: Bu çalışma periton geçirgenlik karakterinin önemli bir sağkalım prediktörü olduğunu göstermekle beraber beslenme durumunun düzeltilmesi ve kalsiyum-fosfor hedefl erine ulaşılması halen önemini koruyan faktörlerdir.
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