ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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ındications For Starting Dialysis
Dr. Gülşah ŞAŞAK,a Dr. F. Nurhan ÖZDEMİRa
aNefroloji BD, Başkent Üniversitesi Tıp Fakültesi, ANKARA
It is considered that the use of renal replacement therapy will become widespread with the increase of disease leads to chronic renal failure (eg, diabetes, hypertension). The main goals of these treatments are: to maintain patients free of uremic symptomps, to control volume overload, acid-base and elecrolte disorders, and provide a clearance of uremic toxins enough to allow an adequate dietary protein and caloric intake. The main question is when should be start the treatments of renal replacement. The initiation of dialysis can be decided by volume overload, metabolic acidosis, hyperkalemia, uremic sign and symptoms in acute renal failure but the desicion to initiate dialysis in patients with chronic renal disease is difficult. About this context National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) has provided two clinical guidelines in 1977. The first guideline is based on the level of kidney function and the second is based on nutritional indices. Initiating dialysis has been proposed when malnutriation symptoms appear and/or weekly renal Kt/Vüre falls below 2. But there is no determine that earlier initation of dialysis leads to reduced mortality without overt uremia when weekly renal Kt/V falls below 2. It is demonstrated that mortality and morbidity increase in patients with malnutriation and earlier initiation of dialysis reduces this complications. Therefore, patients with chronic renal disease must be followed up closely to detect the nutritional status deterioration earlier.Keywords: Renal failure, indications of dialysis, nutritional statusTurkiye Klinikleri J Int Med Sci 2006, 2(4):1-5
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