Ultrafiltration is not superior than diuretics in type 4 cardiorenal sydrome
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Tarih
2014
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Kardiyorenal sendrom (KRS) birbirlerini etkileyen kalp ve böbrek bozukluklukları olarak tanımlanır. Son zamanlarda bu alanda hemodiyaliz tedavisi tercihi artmıştır. Bu çalışmada amaç geleneksel diüretik ve UF tedavilerinin etkilerini karşılaştırmaktır. GEREÇ ve YÖNTEMLER: Çalışmaya Tip 4 KRS tanısı konulan 34 hasta alındı. Hastaların bazal özellikleri kaydedildi. Başlangıçta ve tedavinin sonunda ekokardiyografik değerlendirme yapıldı. BULGULAR: Hastaların yaş ortalaması 67.4 ± 9.3 (51-93) yıl ve takip süresi 15.9 ± 11.5 ay idi. Hastalar diüretik, n = 12 ve UF grubu, n = 22 olarak sınıflandırıldı. Çalışmanın başında mitral kapak A dalgası, kan üre nitrojeni ve kreatinin değerleri UF grubunda yüksek, çalışmanın sonunda UF grubunda kreatinin değerleri diüretik grubuna göre daha yüksek olarak bulundu. Bazal ejeksiyon fraksiyonu (EF) değerleri her iki grupta farklı olmamasına rağmen UF grubunda çalışmanın sonunda bazale göre artış mevcuttu (42.38 ± 12.70 ve% 29 ± 3.67%, p <0.05). Takip sırasında ölüm oranları her iki grupta farklı değildi (diüretik grubu, 6 hastada (% 17.6), UF grubu 1 hasta (% 2.9), (p> 0.05). SONUÇ: Tip 4 Kardiyorenal sendromda, UF tedavisi uygulananlarda mortalite ve hastaneye başvurular azalmasa da EF ile değerlendirilen kardiyak fonksiyonlarda anlamlı olarak düzelme olması ile seçilmiş hastalarda bu tedavi etkili olabilir.
OBJECTIVE: Cardiorenal syndrome (CRS) describes a dysregulation of the heart and kidneys affecting each other. Recently hemodialysis treatments were used more frequently. Aim was to analyze the effects of conventional diuretic and UF treatments. MATERIAL and METHODS: Thirty-four Type 4 CRS diagnosed patients were included. Baseline characteristics were recorded. Echocardiography measured at the admission and at the end of the treatment. RESULTS: the mean age 67.4±9.3 (51-93) years and follow-up period were 15.9±11.5 months. the patients were grouped as diuretic group, n=12 and UF group, n=22. At the beginning mitral valve A wave, blood urea nitrogen and creatinine values were higher in the UF group while creatinine values were higher in the UF group compared to diuretic group at the end of the study. Although basal ejection fraction (EF) values were not different, it was higher in the UF group at the end of the study (42.38±12.70 % and 29±3.67 %, p <0.05). During follow-up mortality rates were not different in both groups (diuretic group, 6 patients (17.6 %), the UF group 1 patient (2.9 %), (p> 0.05). CONCLUSION: in Type 4 CRS, mortality and hospital admissions were not reduced by UF treatment but cardiac function assessed by EF was significantly improved suggesting this therapy to be beneficial in appropriate patients.
OBJECTIVE: Cardiorenal syndrome (CRS) describes a dysregulation of the heart and kidneys affecting each other. Recently hemodialysis treatments were used more frequently. Aim was to analyze the effects of conventional diuretic and UF treatments. MATERIAL and METHODS: Thirty-four Type 4 CRS diagnosed patients were included. Baseline characteristics were recorded. Echocardiography measured at the admission and at the end of the treatment. RESULTS: the mean age 67.4±9.3 (51-93) years and follow-up period were 15.9±11.5 months. the patients were grouped as diuretic group, n=12 and UF group, n=22. At the beginning mitral valve A wave, blood urea nitrogen and creatinine values were higher in the UF group while creatinine values were higher in the UF group compared to diuretic group at the end of the study. Although basal ejection fraction (EF) values were not different, it was higher in the UF group at the end of the study (42.38±12.70 % and 29±3.67 %, p <0.05). During follow-up mortality rates were not different in both groups (diuretic group, 6 patients (17.6 %), the UF group 1 patient (2.9 %), (p> 0.05). CONCLUSION: in Type 4 CRS, mortality and hospital admissions were not reduced by UF treatment but cardiac function assessed by EF was significantly improved suggesting this therapy to be beneficial in appropriate patients.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
1