Trakya Üniversitesi Tıp Fakültesi Hastanesi Medikal Onkoloji Kliniğinde mayıs 2015 - mayıs 2017 tarihleri arasında böbrek yetmezliği ile yatan hastaların değerlendirilmesi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kanser ve tedavisinde karşılaşılan sık komplikasyonlardan biri akut böbrek hasarıdır. Böbrek yetmezliği kanser tedavisini güçleştirip hatta imkansız kılmaktadır. Böbrek yetmezliği ile etkili mücade etmenin kanser tedavisinin daha optimal daha uygun şartlarda uygulanmasını sağlamaktadır. Çalışmamızda Mayıs 2015- Mayıs 2017 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Hastanesi Medikal Onkoloji Servisinde ABH tanısı ile yatan 208 erişkin hastanın retrospektif analizi yapıldı. Çalışmamızda 39 (%18,7) vaka ile en sık akciğer kanseri tespit edildi. Tanı öncesinde kanıtlanmış böbrek hastalığı olmayan hastalarda kanser tanısı sonrası kalıcı böbrek hasarı gelişen 14 (%6,7) vaka saptandı. 191 hastanın (%91,8) öldüğü tespit edildi, bu vakaların 117 (%56,3)’sinin böbrek yetmezliği gelişmesini takip eden ilk hastane yatışında öldüğü görüldü. Prerenal akut böbrek hasarı olan hasta grubunda hastane yatış ortanca süresi diğer gruplara göre daha kısa bulunmuş olup aradaki fark istatistiksel olarak anlamlı tespit edildi (p<0,001). Vakalar renal hasarın nedeni açısından irdelendiğinde 118 (%56,7) vaka ile en sık ekstrasellüler dehidratasyon tespit edildi, ekstraselüler dehidratasyonun ardında 54 (%26) vaka ile kemoterapi toksisitesi, 43 (%20,7) vaka ile sepsis, 13 (%6,3) vaka ile hepatorenal sendrom ve nefrotoksik ilaç maruziyeti, 9 (%4,3) vaka ile kontrast madde kullanımının izlediği tespit edildi. Sonuç olarak; akut böbrek hasarı kanser hastalarında sık görülen bir komplikasyon olup, akut böbrek hasarının en sık sebebi olarak prerenal sebepler gözlemlendi. Çalışmamız; böbrek yetmezliği ile etkili mücadele etmeye yardımcı olarak kanser tedavisinin daha optimal şartlarda uygulanmasında destekleyici olacaktır.
Acute kidney injury is one of the frequent complications of cancer and its treatment. Renal failure makes cancer treatment difficult and even impossible. Effective treatment for patients with renal insufficiency enables cancer treatment to be applied more optimally and more favorably. In this study, we retrospectively analyzed 208 adult patients who were hospitalized with the diagnosis of acute kidney injury in Medical Oncology Service, Trakya University Faculty of Medicine Hospital between May 2015 and May 2017. In our study, lung cancer were found to be the most common with 39 (18.7%) cases. 14 (6.7%) cases of chronic kidney injury that developed after cancer diagnosis were detected in patients without proven renal disease prior to diagnosis. 191 (91.8%) patients died and 117 of these cases (56.3%) died in the first hospitalization following development of renal failure. The median duration of hospitalization was found to be shorter in the patient group with prerenal acute kidney injury compared to the other groups and the difference was statistically significant (p <0.001). When the cases were investigated in terms of the cause of renal injury, extracellular dehydration was detected most frequently with 118 (56.7%) cases and followed by 54 (26%) cases with chemotherapy toxicity. In addition, sepsis was the cause of 43 (20.7%) cases, 13 (6.3%) cases were induced by hepatorenal syndrome and exposure to nephrotoxic drugs, and the use of a contrast media was the reason in 9 (4.3%) patients. As a result, acute kidney injury was a common complication in 208 adult cancer patients and the most common cause of acute kidney injury was prerenal causes. Our study will be supportive in the effective application of cancer treatment with more optimal conditions by helping to fight effectively against renal failure.
Acute kidney injury is one of the frequent complications of cancer and its treatment. Renal failure makes cancer treatment difficult and even impossible. Effective treatment for patients with renal insufficiency enables cancer treatment to be applied more optimally and more favorably. In this study, we retrospectively analyzed 208 adult patients who were hospitalized with the diagnosis of acute kidney injury in Medical Oncology Service, Trakya University Faculty of Medicine Hospital between May 2015 and May 2017. In our study, lung cancer were found to be the most common with 39 (18.7%) cases. 14 (6.7%) cases of chronic kidney injury that developed after cancer diagnosis were detected in patients without proven renal disease prior to diagnosis. 191 (91.8%) patients died and 117 of these cases (56.3%) died in the first hospitalization following development of renal failure. The median duration of hospitalization was found to be shorter in the patient group with prerenal acute kidney injury compared to the other groups and the difference was statistically significant (p <0.001). When the cases were investigated in terms of the cause of renal injury, extracellular dehydration was detected most frequently with 118 (56.7%) cases and followed by 54 (26%) cases with chemotherapy toxicity. In addition, sepsis was the cause of 43 (20.7%) cases, 13 (6.3%) cases were induced by hepatorenal syndrome and exposure to nephrotoxic drugs, and the use of a contrast media was the reason in 9 (4.3%) patients. As a result, acute kidney injury was a common complication in 208 adult cancer patients and the most common cause of acute kidney injury was prerenal causes. Our study will be supportive in the effective application of cancer treatment with more optimal conditions by helping to fight effectively against renal failure.
Açıklama
Anahtar Kelimeler
Kanser, Malignite, Akut, Böbrek, Hasar, Yetmezlik, Cancer, Malignancy, Acute, Kidney, Injury, Insufficiency
