Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
Diyal-TR Kayıt Çalışması: Türkiye'de Kronik Hemodiyaliz Tedavisi Görmekte Olan Hastaların Klinik Özelliklerinin Araştırılması
Diyal-TR Registry: Investigation of Clinical Characteristics of the Patients Under Chronic Hemodialysis Therapy in Turkey
Pınar KIZILIRMAKa, Tevfik ECDERb, Kenan ATEŞc, Mustafa ARICId, Siren SEZERe, Hakan KAPTANOĞULLARIf, Turgay ARINSOYg
aAmgen Türkiye Merkez Ofis, İstanbul, TÜRKİYE
bİstanbul Bilim Üniversitesi Tıp Fakültesi, Nefroloji BD, İstanbul, TÜRKİYE
cAnkara Üniversitesi Tıp Fakültesi, Nefroloji BD, Ankara, TÜRKİYE
dHacettepe Üniversitesi Tıp Fakültesi, Nefroloji BD, Ankara, TÜRKİYE
eAtılım Üniversitesi Tıp Fakültesi, Nefroloji BD, Ankara, TÜRKİYE
fBiruni Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Diyaliz Bölümü, İstanbul, TÜRKİYE
gGazi Üniversitesi Tıp Fakültesi, Nefroloji BD, Ankara, TÜRKİYE
Turkiye Klinikleri J Intern Med. 2020;5(1):1-7
doi: 10.5336/intermed.2019-70393
Article Language: TR
Full Text
ÖZET
 Amaç: Son dönem böbrek hastalığı (SDBH) nedeni ile kronik hemodiyaliz (HD) tedavisi görmekte olan hasta popülasyonu, tüm dünyada olduğu gibi Türkiye'de de artmaktadır. Bu hastalara ait bilgilerin kaydedildiği veri tabanlarında yapılacak analizler, mevcut durum hakkında tespitler yapılmasını ve HD tedavisinde gelişme alanlarının belirlenmesini sağlayarak hastaların tedaviden daha fazla yarar görmelerine katkıda bulunabilir. Bu çalışmada, Türkiye'de kronik HD tedavisi görmekte olan hastaların demografik ve klinik özelliklerinin incelenmesi amaçlandı. Gereç ve Yöntemler: Bu tanımlayıcı çalışma için, Ocak 2017-Şubat 2018 tarihleri arasındaki bir yıllık zaman diliminde Türkiye'nin 7 bölgesindeki 93 merkezde SDBH nedeni ile kronik HD tedavisi görmekte olan hastalar elektronik ortamda kaydedildi. Hastaların bazı demografik özellikleri ile birlikte klinik özellikleri incelendi. Bulgular: Çalışmaya, kronik HD tedavisi görmekte olan 2.461 hasta dâhil edildi. Ortalama yaşı 56,7±14,3 yıl olan çalışma popülasyonunun %65,5'ini erkekler oluşturuyordu. Ortalama SDBH süresi 5,4±6,1 yıl idi. Çalışma popülasyonunun %92,8'i haftada üç kez HD tedavisi alıyordu. Hastaların %74,8'inde eşlik eden en az bir hastalık ve %9,1'inde hastaneye yatış öyküsü saptandı. Bu hastane yatışlarının %21,7'sinde kardiyak etiyoloji mevcuttu. Çalışma popülasyonunun %79,6'sında anemi bulundu. Eritropoez uyarıcı ajan alan hastalar, tüm popülasyonun %57,4'ünü oluşturuyordu. Hastaların %80,0'ında fosfat bağlayıcı ajan kullanımı tespit edildi. Statin kullanan hastaların oranı %8,9 idi. Sonuç: Çok-merkezli bu kayıt çalışması ile Türkiye'de kronik HD tedavisi görmekte olan hastaların klinik özellikleri geniş ölçekte ortaya kondu. Görece genç yaşlarda olan çalışma popülasyonunda azımsanamayacak sıklıkta saptanan komorbidite ve kardiyak hastane yatışı öyküsü, kısa ve uzun dönem izlemlerdeki klinik özellik değişim trendiyle birlikte öngördürücü ve prognostik faktörlerin ortaya çıkarılmasına ışık tutabilir.

Anahtar Kelimeler: Böbrek diyalizi; kronik böbrek yetmezliği; kayıt çalışması; anemi; kardiyovasküler hastalıklar
ABSTRACT
 Objective: The number of patients who received chronic hemodialysis (HD) due to end-stage renal disease (ESRD) has increased both at global and national level. Analyses of disease registries in these patients could contribute to improved therapeutic benefits by addressing potential areas of development in HD therapy after determining current situation. This study aimed to investigate demographic and clinical characteristics of chronic HD patients in Turkey. Material and Methods: This descriptive study enrolled patients who were under chronic HD therapy due to ESRD in 93 centers of seven regions of Turkey between January, 2017 and February, 2018. Some demographic and clinical characteristics of the patients were examined. Results: A total of 2.461 chronic HD patients were included to the study. The mean age of the patients was 56.7±14.3 and men constituted 65.5% of the study population. The mean duration of ESRD was 5.4±6.1 years. Most of the patients (92.8%) were found to receive three sessions of HD per week. Near three-fourths (74.8%) of patients had at least one comorbidity and 9.1% had history of hospitalization, 21.7% of which featured cardiac origin. Anemia was found in 79.6% of the study population. Over half of patients (57.4%) were under erythropoiesis-stimulating agent therapy. Use of phosphate binders were recorded in 80.0% of patients. Statins were found to be used by 8.9% of the study population. Conclusion: This multi-center registry has comprehensively demonstrated clinical characteristics of patients who were under chronic HD therapy in Turkey. Substantial prevalence of comorbidity and cardiac hospitalization in such a comparably younger patient population may shed light on the identification of prognostic and predictive factors, with possible contribution by future trend analysis of other clinical characteristics in short- and long-term follow-up.

Keywords: Renal dialysis; chronic renal failure; registries; anemia; cardiovascular diseases
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