Diyaliz Dengesizliği Sendromu ve Kanıta Dayalı Tedavi Bakım Uygulamaları
Özet
Diyaliz dengesizliği (disequilibrium) sendromu (DDS) hemodiyaliz tedavisinin yaşamı tehdit edebilen akut komplikasyonudur. Spesifik olmayan belirtiler ve tanının doğrulanmasındaki zorluklar nedeniyle insidansı tam olarak bilinmemektedir. Sendrom, hemodiyaliz tedavisine yeni başlayan hastaları daha sık etkilemektedir. Ters üre etkisi ve intraserebral asidoza bağlı gelişen serebral ödem DDS gelişiminden sorumlu tutulmaktadır. Klinik bulgular serebral ödemin artış derecesine bağlı olarak değişebilir. Şiddetli vakalarda semptomlar koma ve ölüme kadar ilerleyebilir. DDS önleme girişimleri arasında yüksek riskli hastaların saptanması, diyaliz seanslarının düzenli sürdürülmesi, hemodiyaliz uygulama süresinin uzatılması, üre klerensinin sınırlandırılması, diyalizattaki sodyum seviyesinin artırılması ve ozmotik olarak aktif maddelerin uygulanması yer alır.
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