Avtor/Urednik		Globokar, Mateja; Golob-Kosmina, Polona; Furlan, Polona
Naslov		Pregled dejavnosti peritonealne dialize v dializnem centru Novo Mesto
Prevedeni naslov		The peritoneal dialysis treatment in dialysis centre Novo mesto
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 73, št. 12
Leto izdaje		2004
Obseg		str. 899-903
Jezik		slo
Abstrakt		Background. In the article the development, basic principle and technical basis of peritoneal dialysis (PD), as one of the three methods of renal replacement therapy (RRT), are presented. In addition the PD treatment in dialysis centre Novo mesto from 1994 to 2003 is described. Methods. All available hospital records of 40 patients treated with PD over 9 years in dialysis centre were reviewed retrospectively. The authors were interested in age structure of patients, the causes of end-stage renal disease (ESRD), the course of treatment and complications that had arisen with PD. Results. PD was the first treatment option for 35 patients, There were 28.6% older than 55 years and 17.1% older than 65. The leading causes ofESRD are diabetic nephropathy and the group of glomerular diseases (especially IgA nephropathy) - both in 25% of patients, as well as polycystic kidney disease (in 15%). The noninfectious complications andperitonitis are presented. The incidence of the latter is 1 episode/62,69 patient - months. The Gram positive organisms were responsible in 45.5% and Gram-negative organisms in 13.6%. 3 patients had peritonitis caused by multiple microorganisms, with extremely severe course. In 6 patients renal transplantation was performed, 8 patients were transferred to hemodialysis (HD). Among the dead patients, there was a high percentage of patients with diabetes mellitus, the leading cause of death was cardiovascular complications. Conclusions. PD is highly recommended as first option in RRT in younger, compliant patients. Patients with diabetes and older patients with atherosclerosis are problematic, as various complications commonly arise.
Izvleček		Izhodišča. Prispevek na kratko predstavi razvoj, osnovni princip in tehnične osnove peritonealne dialize (PD), ene od treh metod nadomestnega zdravljenja končne ledvične odpovedi (KLO). V nadaljevanju je orisana dejavnost PD v dializnem centru Novo mesto v časovnem obdobju od 19942003. Metode. Avtorji so pregledali vso razpoložljivo dokumentacijo vseh 40 bolnikov ki so se v 9 letih zdravili v dializnem centru s PD. Zanimali so jih starostna struktura bolnikov, vzroki KLO, potek zdravljenja in zapleti, povezani s tem načinom zdravljenja. Rezultati. Med 35 bolniki, pri katerih je bila PD prva metoda nadomestnega zdravljenja, je bilo 28,6% starejših od 55 let, 17,1% pa starejših od 65 let. Med vzroki ledvične odpovedi prevladujeta diabetična nefropatija in skupina glomerulnih bolezni (zlasti IgA glomerulonefritis) - oboje pri 25% bolnikov, dokaj pogosta pa je tudi policistična bolezen ledvic (v 15%). Predstavljeni so neinfektivni zapleti PD in peritonitis. Incidenca zadnjega je bila 1 epizoda na 62, 69 bolnikovega meseca. V45,5% so bili povzročitelji iz skupine po Gramu pozitivnih bakterij v 13,6% pa po gramu negativne bakterije. 3 bolniki so preboleli polimikrobni peritonitis z izjemno hudim potekom. Pri 6 bolnikih je bila transplantirana ledvica mrtvega dajalca, 8 bolnikov je prešlo na hemodializo (HD). Med 13 umrlimi je visok delež bolnikov s sladkorno boleznijo, najpogostejši vzrok so bili srčno-žilni zapleti. Zaključki. PD je zlasti primerna kot prva metoda nadomestnega zdravljenja pri mlajših, dobro sodelujočih bolnikih. Problematični so diabetiki in starejši bolniki z aterosklerozo, pri katerih prihaja do različnih zapletov.
Deskriptorji		KIDNEY FAILURE, CHRONIC PERITONEAL DIALYSIS HEMODIALYSIS UNITS, HOSPITAL