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Srpski arhiv za celokupno lekarstvo
2012, vol. 140, br. 5-6, str. 313-320
jezik rada: srpski
vrsta rada: originalan članak
objavljeno: 22/03/2013
doi: 10.2298/SARH1206313P
Hronična bolest bubrega tokom dvanaestogodišnjeg perioda u ustanovi tercijarnog nivoa zdravstvene zaštite
Univerzitet u Beogradu, Medicinski fakultet, Institut za zdravstvenu zaštitu majke i deteta Republike Srbije 'Dr Vukan Čupić'

e-adresa: liki_74@yahoo.com

Projekat

Projekat Ministarstva nauke Republike Srbije, br. 145046

Sažetak

Uvod. Hronična bolest bubrega (HBB) je značajan uzrok morbiditeta i mortaliteta dece. Cilja rada. Cilj rada bio je da se analiziraju etiologija, stadijumi i udružene komplikacije HBB u vreme postavljanja dijagnoze oboljenja. Metode rada. Analizirani su podaci o 97 dece (56 dečaka) prosečnog uzrasta od 7,8±5,8 godina koja su u periodu 1998-2009. godine prvi put upućena u Institut za zdravstvenu zaštitu majke i deteta Srbije 'Dr Vukan Čupić' u Beogradu zbog HBB stadijuma 2-5. Nakon uzimanja anamneze, svi bolesnici su podvrgnuti kliničkom pregledu, a potom su obavljena laboratorijska, radiološka i ostala ispitivanja u skladu s indikacijama. HBB je klasifikovana prema jačini glomerularne filtracije u četiri stadijuma: 2 - blaga (60-90 ml/min/1,73 m2); 3 - umerena (30-60 ml/min/1,73 m2); 4 - uznapredovala (15-30 ml/min/1,73 m2); i 5 - terminalna (<15 ml/min/1,73 m2). Rezultati. Vodeći uzrok HBB bile su kongenitalne anomalije bubrega i urinarnog trakta (43,3%); slede glomerularne bolesti (17,5%), nasledne bolesti bubrega (16,5%), metaboličke bolesti (7,2%) i ostali uzroci (15,5%). Blaga HBB dijagnostikovana je kod 29,8% bolesnika, umerena kod 28,9%, uznapredovala kod 22,7%, a terminalna HBB kod 18,6% dece. Kod 75% bolesnika sa stadijumima 4 i 5 HBB se ispoljila akutnom insuficijencijom bubrega, dok je kod preostalih 25% HBB (stadijum 1) bila poznata odranije, ali bolesnici nisu redovno kontrolisani. Udružene komplikacije bile su: metabolička acidoza (63%), anemija (60%), hipertenzija (42,3%), nizak rast (25,8%), renalna osteodistrofija (13,4%) i kardiovaskularna oboljenja (7,2%). Zaključak. Kongenitalne anomalije bubrega i urinarnog trakta jesu glavni uzrok HBB u dečjem uzrastu. Kod značajnog procenta dece (41,3%) beleže se uznapredovala i terminalna HBB. Kod većine ispitanika bolest je dijagnostikovana kasno i kod njih su ustanovljene udružene komplikacije.

Ključne reči

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