Kako i kada koristimo kontinuiranu zamenu funkcije bubrega za lečenje akutnog oštećenja bubrega u Srbiji

  • Violeta Knežević University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Dejan Ćelić University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Tijana Azaševac University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Sonja Golubović University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Vesna Sladojević University Clinical Center of Vojvodina, Emergency Center, Novi Sad, Serbia
  • Nataša Nestorov University Clinical Center of Vojvodina, Clinic for Anesthesia and Intensive Care, Novi Sad, Serbia
  • Djoko Maksić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
  • Radomir Naumović Zvezdara University Medical Center, Clinical Department of Renal Diseases, Belgrade, Serbia
  • Tatjana Lazarević University Clinical Center of Kragujevac, Department of Nephrology and Dialysis, Kragujevac, Serbia University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
  • Vojislava Nešković Military Medical Academy, Clinic for Anesthesiology and Intensive Therapy, Belgrade, Serbia University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia;
DOI: https://doi.org/10.2298/VSP191231110K
Ključne reči: bubreg, akutna insuficijencija;, nefrolozi;, bubreg, zamena funkcije;, bubreg, zamena funkcije, kontinuirana;, ankete i upitnici.

Sažetak


Uvod/Cilj. Nedostaju jasne smernice u definiciji, dijagnostici i indikacijama za lečenje metodama zamene funkcije bubrega (ZFB). Cilj ove studije bio je da pomogne u kreiranju budućeg kliničkog rada u pogledu poboljšanja ishoda lečenja i smanjenja komplikacija akutnog oštećenja bubrega (AOB) na osnovu aktuelne kliničke prakse. Metode. Sprovedene su anonimne ankete među lekarima različitih specijalnosti. Upitnik je sastavljen u skladu sa


standardnom kliničkom praksom. Rezultati. Istraživanje je sprovedeno kao multicentrična web anketa među nefrolozima (46,8%) i lekarima drugih specijalnosti u Srbiji. Uzorak je činilo 119 učesnika, od kojih su 78,9% korektno popunili anketu i bili uključeni u analizu. Većina učesnika je odgovorila da nefrolog ukazuje na potrebu korišćenja (76,8%) i određuje (74,5%) korišćenje kontinurane ZFB (KZFB). Na osnovu kriterijuma Kidney Disease Improving Global Outcomes (KDIGO) 2 „rani” početak KZFB koristilo je 74,5% ispitanika, a 91,5% među njima „kasno” počinju KZFB kod komplikacija povezanih sa AOB ili slabijeg odgovora na konzervativnu terapiju. U odnosu na kliničko iskustvo ispitanika, 74,5% je smatralo da bi „rani” početak KZFB trebalo da bude unutar 12 h, a 56,4% je odgovorilo da je preko 48 h „kasni” početak. Najčešće je korišćena kontinuirana veno-venska hemodijafiltracija (37,6%). Većina ispitanika (95,7%) je tokom KZFB koristila heparin kao antikoagulans, sa prosečnim trajanjem filtera kraćim od 24 h (71,3%), dok je najzastupljenija doza dijaliznog efluenta bila 25 mL/kg/h (45,2%). Najčešće komplikacije KZFB bile su hipotenzija (55,3%) i infekcije povezane sa prisustvom katetera (29,8%). Zaključak. Većina ispitanika daje prednost „ranom” početku KZFB. Prema dobijenim podacima u dijagnostici i lečenju AOB neophodna je standardizacija strategije.

Biografije autora

Violeta Knežević, University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

nephrologist

Dejan Ćelić, University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

nephrologist

Tijana Azaševac, University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

nephrologist

Sonja Golubović, University Clinical Center of Vojvodina, Clinic for Nephrology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

physician

Vesna Sladojević, University Clinical Center of Vojvodina, Emergency Center, Novi Sad, Serbia

physician

Nataša Nestorov, University Clinical Center of Vojvodina, Clinic for Anesthesia and Intensive Care, Novi Sad, Serbia

anesthesiologist

Djoko Maksić, Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia

nephrologist

Radomir Naumović, Zvezdara University Medical Center, Clinical Department of Renal Diseases, Belgrade, Serbia

nephrologist

Tatjana Lazarević, University Clinical Center of Kragujevac, Department of Nephrology and Dialysis, Kragujevac, Serbia University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

nephrologist

Vojislava Nešković, Military Medical Academy, Clinic for Anesthesiology and Intensive Therapy, Belgrade, Serbia University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia;

anesthesiologist

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Objavljeno
2022/05/20
Broj časopisa
Vol. 79 Br. 4 (2022)
Rubrika
Originalni članak