Evaluation of Urgent Hemodialysis in Maintenance Hemodialysis Patients: A 2-Year Retrospective Single Center Study

Rutin Hemodiyalize Giren Hastaların Acil Hemodiyaliz İhtiyacının Değerlendirilmesi: 2 Yıllık Retrospektif Tek Merkez Çalışması

Harun AKAR, Mehmet TANRISEV, Semih GÜLLE, Mustafa Arif DEMİR, Mustafa YILDIRIM, Burak KARAKAŞ

Abstract

Receiving urgent hemodialysis (HD) in end-stage renal disease (ESRD) patients significantly increases morbidity and mortality. We aimed to explore the factors involved in the development of urgent hemodialysis in patients on maintenance HD and to compare clinical differences between patients with arteriovenous fistula (AVF) and permanent tunelled catheter. MATERIAL and METhODS: We retrospectively studied 242 ESRD patients over 18 years old who required urgent hemodialysis after presentation to the emergency department between November 2013 and November 2015. We excluded referrals from another hospital, drug overdose or toxic substance intake and patients in the intensive care unit.RESULTS: We analyzed retrospective data obtained from 242 patients. Participants' mean age was 61.4 years; 120 (49.6%) were female and 122 (50,4%) were male; 45.5% had diabetes and 65% had hypertension. The mean duration of renal replacement therapy was 37.6 months. Of these, 55% underwent HD through an autologous AVF and 45% had a permanent tunelled catheter. Emergency service complaints were shortness of breath (38.2%), nausea and vomiting (20.2%), cerebrovascular event (7%), catheter-related problems (6,2%), and others. Immediate HD indications of the patients according to the order of frequency were hypervolemia (33.9%), hyperkalemia (24%), metabolic acidosis (21.9%), and uremic symptoms (20.2%). Permanent tunnelled catheter use was found to increase with age (p

Özet

Son dönem böbrek yetmezliği (SDBY) tanısı ile izlenen olguların acil hemodiyalize (HD) alınması morbidite ve mortaliteyi ciddi oranda artırmaktadır. Çalışmamızda, rutin HD programında olan hastaların acil HD endikasyonlarını, kalıcı kateter ve arteriyovenöz fistülü (AVF) olan hastaların özelliklerini sorgulamayı amaçladık.GEREÇ ve YÖNTEMLER: Kasım 2013 - Kasım 2015 tarihleri arasında acil servise başvurusunun ardından acil HD'e alınan 18 yaş üstü 242 hastanın verileri, geriye dönük olarak incelenmiştir. Hastaların sosyodemografik özellikleri, komorbid hastalıkları kaydedilmiştir. Dış merkezden HD amacı ile sevk edilen hastalar, fazla ilaç ve toksik madde alımı olan hastalar ve yoğun bakım ünitelerinde HD'e alınan hastalar çalışmaya dahil edilmemiştir