Geriatrik Nefroloji

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CHAPTER


DOI :10.26650/B/CH12CH47.2023.014.12   IUP :10.26650/B/CH12CH47.2023.014.12    Full Text (PDF)

Geri̇atri̇k Popülasyonda Glomerülonefri̇tler Ve İmmünosupressi̇f Tedavi̇ Yöneti̇mi̇

Ali Rıza Uçar, Savaş Öztürk

Yaşam beklentisinin artışı ve buna paralel olarak yaşlı nüfusun artmasıyla geriatrik popülasyondaki hastalıklar artık toplumdaki hastalıkların büyük bir kısmını oluşturmaktadır. Yaşla birlikte tGFH düşüşü, başta kardiyovasküler hastalıklar olmak üzere sistemik hastalıkların artışı, medikal ve cerrahi tedavilerin nefrotoksik etkilerinin artışı, ürolojik problemlerin artışı gibi nedenlere bağlı olarak bu popülasyonda böbrek hastalığı insidansı artmıştır1 . Bununla birlikte akut ve kronik glomerüler hastalıklar yaşlılarda mortalite ve hastane yatışının yaygın nedenlerindendir.2 Yaşlılarda gözlenen glomerüler hastalıkların tipleri, genel popülasyondakiler ile sıklıkla benzerdir, fakat klinik seyir, morfolojik bulgular ve tedavi yaklaşımı farklılıklar gösterebilir. Komorbid hastalıklar, kısa yaşam beklentisi, biyopsi komplikasyonları, immunosupressif ilaçların etkileri, yaşlılarda klinik çalışmalar ve kılavuzların yetersizliği nedeniyle tanı ve tedavi aşamasında zorluklarla karşılaşılmaktadır. Bu yüzden yaşlılardaki primer glomerüler hastalıkların genç erişkinlerdeki glomerüler hastalıklarla ayrı bir başlık altında incelenmesi gerekmektedir.3 Geriatrik popülasyondaki hastalarda glomerülonefritin diğer yaş gruplarından farklılıkları Tablo 1’de özetlenmiştir.



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