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Medicinski pregled
2014, vol. 67, br. 11-12, str. 385-391
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/MPNS1412385D


Uticaj nedeljnog trajanja hemodijalize na parametre njene adekvatnosti i kardiovaskularni morbiditet
aKBC Zvezdara
bClinical Division of Nephrology and Metabolic Disorders with Dialysis 'Prof Dr Vasilije Jovanović', Clinical Hospital Center 'Zvezdara' + University of Belgrade, Faculty of Medicine

e-adresa: djuricmed@gmail.com

Sažetak

Uvod. Optimalna dužina lečenja hemodijalizom još je neutvrđena, a trenutni režim od 12 sati nedeljno je medicinski prihvatljiv standard. Cilj ove opservacione studije bio je da utvrdi povezanost različite nedeljne dužine lečenja hemodijalizom sa parametrima adekvatnosti hemodijalize i kardiovaskularnim morbiditetom. Materijal i metode. Ovom opservacionom studijom analizirano je 206 bolesnika (128 muškaraca i 78 žena) lečenih duže od 6 meseci koji su bili podeljeni u grupe shodno nedeljnom trajanju dijalize: grupa I (12 h), grupa II (15 h) i grupa III (≥ 17,5 h). Rezultati. Vrednosti indeksa adekvatnosti dijalize nisu se razlikovale između grupa (grupe I, II, III = 1,32 vs 1,51 vs. 1,42 : p > 0,05), ali su bolesnici grupe III imali najbolje korigovanu acidozu (u grupi I, II i III = 22,7; 21,4; 17,6; p < 0,001). U odnosu na standardne dijalize od 12 h, duže nedeljno trajanje dijalize bilo je praćeno značajno višim vrednostima hemoglobina (12,2 vs 11,4 vs 10,5 g/dl), ređom upotrebom agenasa stimulacije eritropoeze (26,9% vs 65% vs 86,3%), manjom nedeljnom dozom agenasa stimulacije eritropoeze (medijana u grupi I, II, III = 2000 vs 5 000 vs 4 000 i.j.), njihovim nižim indeksom rezistencije (4,9 vs 7,8 vs 8,8), značajno višim vrednostima serumskih albumina (42,3 vs 40,7 vs 38,2 g/dl), ukupnog holesterola (5,1 vs 4,7 vs 4,5 mmol/L) i serumskog kalcijuma (2,38 vs 2,42 vs 2,28 mmol/L), ređom upotrebom vezivača fosfata (53,8% vs 85% vs 84,4%) i kalcitriola (19,2% vs 65% vs 50,6%) i nižim vrednostima intaktnog paratiroidnog hormona (336 vs 363 vs 446 pg/ml). Duža dijaliza bila je praćena i nižim skorom kardiovaskularnog morbiditeta (0,52 vs 1,05 vs 1,26). Zaključak. Nedeljna dužina lečenja hemodijalizom preko trenutnog standarda pozitivno korelira sa parametrima adekvatnosti hemodijalize.

Ključne reči

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